Equine Ulcers: 5 Feeding Practices for Prevention & Treatment

Equine Gastric Ulcer Syndrome (EGUS) is one of the leading health issues in performance horses. “Unnatural” lifestyle conditions such as infrequent turnout, a high concentrate diet, travel, and physical and emotional stress are all thought to increase the prevalence of gastric ulcers in horses. 

Key points

  • Equine ulcers affect your horse’s performance and behavior.
  • A horse’s saliva acts as a buffer against stomach acids, which horses produce constantly.
  • Whenever possible, mimic natural feeding behavior to encourage ongoing saliva production.

Equine ulcers: Bad for horse and owner

Like anything that causes pain to our horses, equine ulcers are a burden for horse owners. Your horse’s physical discomfort translates to poor performance and, possibly, a cascade of other behavioral and physical problems. And then there are the vet bills and treatment costs.

Diagnosing gastric ulcers definitively involves an expensive and invasive scanning of the horse’s stomach through an endoscopy. Many owners forgo that step and treat for equine ulcers proactively. The go-to acid suppressor treatment, omeprazole, isn’t cheap.

Ulcer prevention can go beyond proactive omeprazole treatments, however. And it doesn’t have to be complicated or terribly disruptive to your routine. Imitating a more natural lifestyle through simple feeding strategies could do the trick, according to recommended practices in the veterinary community.

Horse with head out of stall.

Feeding strategies for equine ulcers

Here are five simple and practical tips for feeding hay to prevent and treat ulcers.

1. Feed high-quality forage

In basic terms, gastric ulcers form when stomach acid irritates the lining of the stomach. The food that enters a horse’s stomach will then affect the acid level (pH) of the gastric fluid, ideally neutralizing and absorbing it. 

To achieve a regulated stomach pH, vets recommend high-quality forage, low in straw and rich in legumes. Alfalfa hay is ideal, as it is high in protein and calcium, both of which reduce acidity. 

2. Offer hay generously

Horses are natural grazers. They’ve adapted to consume forage constantly for up to 18 hours a day. One of the biological benefits of continuous grazing is the constant production of saliva, which acts as a buffer against the constantly produced acid of the horse’s stomach. That natural buffering system is key to preventing ulceration.

Experts recommend free choice hay, or about four to six meals a day (this should add up to consumption of about 1-1.5% of their body weight in forage daily).

Horse grazing to prevent equine ulcers.

If it isn’t realistic for you to offer free choice hay, extended grass pasture time, or multiple hay meals throughout the day, then consider mimicking a natural grazing diet by offering hay through a hay net, or any feeding device that slows down consumption and promotes chewing (chewing produces saliva).

Ultimately, the goal should be to make meals frequent, small, and steady — to promote saliva production, which protects the stomach.

3. Feed hay before exercise

Despite misconceptions about fasting before exercise, a horse should preferably not work on an empty stomach. Horses produce gastric acid continuously, whether or not they are eating. A layer of forage can protect the stomach during periods of work.

Concerns about colic from working after eating are unfounded. In fact, a full stomach likely improves a horse’s mood and increases focus. Offer hay as you tack up, or in the stall shortly before riding.

4. Feed hay before grain

High-starch meals can be ulcer-inducing. Having a belly full of hay neutralizes the stomach and protects it from the rich concentrate grain meal to follow.

5. Withhold hay/fast before omeprazole treatment

Recent studies show that a full stomach decreases the effectiveness of omeprazole by blocking adequate absorption. Said another way, fasting can enhance the bioavailability of the medicine. 

Omeprazole is absorbed two to three times better in an empty stomach than in a fed horse. In some cases, you could therefore administer half a dose on a fasted horse for the same efficacy as a whole dose on a full stomach. Note: Half doses are only recommended if the ulcers are in the non-glandular region of the stomach.

To work with the horse’s natural fasting cycle, offer omeprazole early in the morning, about an hour before their first meal. The horse’s stomach should be empty enough after finishing a last meal at 10 pm. 

These feeding strategies can keep your horse feeling great and performing his best. If you do suspect the horse is suffering from equine ulcers, consult your veterinarian.