Gastric Ulcers - a pain in the stomach

I received several requests this week for help with horses suffering from gastric ulcers. Unfortunately, performance horses are especially prone to developing ulcers because of the way they are fed and managed. Even exercise itself can contribute to ulcer formation. We know from previous research that horses maintained on full-time pasture have almost no incidence of gastric ulcers. If a horse has been diagnosed with ulcers, they must be treated with medication such as ranitidine or omeprazole in order to allow the gastric mucosa to heal. There are also several feeding and management practices that can help prevent ulcers from returning or occurring in the first place. Below is an excerpt from an email I sent to a horse owner looking for help with a horse suffering from ulcers.

For a horse with gastric ulcers, one of the best things you can do is to allow constant access to forage. Not only does this keep some quantity of feed in the stomach at all times, but also the act of chewing produces saliva which can buffer the stomach contents. Allowing 24/7 access to pasture is the optimal scenario, but if this is not possible, then the use of hay nets that slow down the rate of intake to more closely mimic natural grazing behavior can help. One such hay net that I like and recommend is the “Nibble Net”. The type of forage is also important, and including alfalfa hay in the ration has been shown to decrease ulcer incidence. Some horses can tolerate 100% alfalfa hay with no problem while others may do better with a 50:50 grass/alfalfa mix. I would recommend slowly replacing some of the timothy hay with alfalfa. Depending on how he tolerates the alfalfa (maintains normal fecal consistency, no undesirable changes in attitude under saddle), you may even replace all of the timothy and consider replacing some of the chopped forage with alfalfa. This would increase the amount of “chew time” he has, as horses usually consume chopped forages fairly quickly. I do not expect him to have trouble with alfalfa hay, as long as it is introduced slowly.

For the concentrate portion of the diet, a high fat/high fiber feed is recommended. We have had very good luck with Purina Ultium in ulcer-prone horses, especially those which are in regular work. Ultium is also very calorie dense and will help with weight gain. The fiber level in Ultium is actually higher than most Senior feeds, and because this horse can also consume some forage, a senior feed is not necessarily required.

I would NOT recommend that this horse receive oral paste electrolyte preparations, as these can exacerbate ulcers.

Minimizing stress in the horse’s environment is also something that should not be overlooked; this may include increasing turnout time, insuring the horse is not isolated from other horses, and/or preventing “overtraining” (strenuous exercise on a regular basis without adequate rest periods).

As far as dietary supplements go, most of them are untested and unproven in the horse to improve gastric ulcers.

Following some of these suggestions can really make a positive difference for those horses that suffer from ulcers.