For a long time, stomach ulcers in horses were considered an “occupational hazard” for racehorses and show horses. It was believed that early training, the stress of the racetrack, or frequent travel to competitions triggered the development of stomach ulcers. However, we now know that this condition affects horses of all breeds and performance levels. Even a children’s pony that appears to be grazing peacefully in a pasture can suffer from a stomach ulcer. While approximately 90 percent of all racehorses are still affected by stomach ulcers, the proportion of affected leisure horses ranges from 30 to 60 percent, and among sport horses, it reaches up to 65 percent.
While the human body produces stomach acid only when food is ingested, it is produced continuously in a horse’s stomach. After all, in nature, horses are almost constantly eating. The stomach acid produced by the mucosal glands is essential for life, as it aids in the digestion of food and kills bacteria. A protective mucus produced by the stomach and buffering substances from saliva protect the sensitive stomach lining from the acid. If an imbalance occurs in these protective mechanisms, the acid can irritate or even damage the stomach lining. Gastritis (inflammation of the stomach lining) develops, which can lead to painful stomach ulcers.
All acid-related inflammatory changes and irritations in the horse’s esophagus, stomach, and small intestine are collectively referred to as Equine Gastric Ulcer Syndrome (EGUS). A distinction is made between Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD).
The horse’s stomach is divided into a front, glandless portion and a rear, gland-containing portion that produces stomach acid. If the front, glandless portion is exposed to excessive stomach acid for too long, this leads to ESGD. This condition is more common.
EGGD is less common, and its cause remains unclear. In this case, the acid-producing posterior part of the stomach is affected, which is always exposed to stomach acid even in healthy horses.
Unlike in humans, no bacteria have been identified as a cause of stomach ulcers in horses. In horses, many different factors can trigger the development of a stomach ulcer. The major risk factors include improper housing and feeding, inappropriate training, stress, and prolonged medication regimens.
Known stress factors include long transport in a horse trailer, unfamiliar surroundings, competitions, events, changing stables, changes in diet, and insufficient opportunity to move freely. Even seemingly mundane things like a ride without a companion horse or the radio playing constantly in the stable aisle can cause stress for individual horses. Develop a keen eye for your horse and what specifically stresses it. Whether in stall housing or in open or free-range stables, an unfavorable composition of the herd can cause stress for individual horses. This may be because the stall neighbor is disliked or the hierarchy within the herd is unclear. A change in trainer can also be a stress factor.
In terms of feeding, an excessively high starch or grain content, insufficient roughage, poor-quality roughage, overly long feeding breaks, hot, frozen, or coarse feed, inadequate access to water, and increased intake of tannic acid from acorns and beechnuts can all contribute to the development of stomach ulcers.
During training, pressure conditions in the stomach change during the trot and even more so during the gallop. This causes stomach acid to come into contact with the sensitive, glandless stomach lining and can damage it. Training should not take place on an empty stomach, for example, not before the morning feeding or after a prolonged break from eating. However, do not feed concentrated feed two hours before and two hours after training.
Horses whose immune systems are weakened by other illnesses or surgeries are at higher risk of developing a stomach ulcer. Prolonged administration of certain medications can also trigger the development of a stomach ulcer.
The signs of stomach ulcers in horses are very nonspecific, so they are often overlooked for a long time. In some cases, a positive change in the horse is only noticeable after successful treatment. However, there are some signs and behaviors that suggest gastritis or a stomach ulcer. It is important to distinguish the symptoms in adult horses from those in foals, as they can differ significantly.
Adult horses suffering from stomach ulcers often exhibit one or more of the following symptoms:
Approximately 50 percent of all suckling foals suffer from stomach ulcers, which can be life-threatening. They are often caused by the stress of weaning from the dam. The following symptoms may indicate stomach ulcers in a foal:
If you suspect that your horse is suffering from stomach problems, please contact your veterinarian immediately so that they can conduct a prompt examination and initiate any necessary treatment.
Based on the nonspecific symptoms described above, your veterinarian can only make a preliminary diagnosis. To get an accurate picture of your horse’s stomach lining, he or she must perform a gastroscopy. Horses undergoing a gastroscopy must not eat any feed or bedding for 18 to 24 hours prior to the examination. The procedure is performed on the horse while it is standing and under sedation. A long, flexible endoscope is inserted through the nasal passage, advanced to the larynx, swallowed, and carefully guided through the esophagus into the stomach and the upper section of the small intestine. Using a camera and a light source, your veterinarian can examine the inside of the stomach on a screen and save images and videos. This is the only way to accurately determine the extent and location of the disease. If the veterinary practice has the appropriate equipment, the examination can also be performed at the stable.
If a gastroscopy is not possible or desired—because the horse should not be subjected to additional stress—the presence of stomach ulcers can be inferred using diagnostic therapy. If the symptoms disappear with medication, it can be assumed that the condition was a gastric ulcer or gastritis. However, this approach leaves unclear exactly what findings were present in the stomach.
ESGD is treated with medication containing the active ingredient omeprazole. This inhibits stomach acid production. It is administered daily, ideally 30 minutes before the morning feeding, either directly into the mouth or mixed with some food. In some cases, additional medications or dietary supplements are used. A follow-up examination is conducted after 28 days. In addition to the location of the stomach ulcers, their severity also affects the duration of the healing process.
Optimizing housing, feeding, and training conditions is immensely important alongside medication to prevent recurrence. If triggering factors or an underlying condition are known, these must be eliminated or treated as much as possible.
For ESGD, limit training sessions to a maximum of 40 minutes of trotting and cantering. For EGGD, incorporate two to three rest days per week.
It is not advisable to treat your horse with omeprazole or various dietary supplements on a long-term or preventive basis. Stomach acid serves a natural function in the horse’s body and should not be permanently suppressed or artificially buffered. Your veterinarian will create an individualized treatment plan for your horse.
Once diagnosed, gastric ulcers caused by ESGD are easily treated. The prognosis for EGGD is less favorable, as the causes are not yet known. A large proportion of horses with EGGD do not respond to standard gastric ulcer treatment.
Wild horses move for 16 to 18 hours a day, covering 15 to 30 kilometers, mostly at a walk. In contrast, a horse kept in a stall might cover only three kilometers during a 40-minute lunging session, for example. A housing arrangement that allows for plenty of exercise is the best preventive measure to avoid the development of stomach ulcers.
Proper feeding tailored to the individual horse’s needs is the second key component. Roughage plays a major role. Horses chew roughage three times longer than concentrated feed, which means it is better saturated with saliva. Saliva buffers stomach acid. For this reason, roughage should be fed in sufficient quantities and always before the concentrated feed ration.
Reducing stress for the horse isn’t always easy to implement, as not all stress-inducing factors are obvious. Therefore, pay attention to exactly what leads to unusual behavior in your horse. Ask yourself the following questions to ensure that your horse is doing well in its current living conditions:
In general, special attention should be paid to the following points to expose your horse to as little stress as possible:
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