Gastric Ulcers: Maintaining Horses' Stomach Health

Gastric Ulcers: Maintaining Horses' Stomach Health

Add two to four flakes of alfalfa to your horse's daily hay ration to help combat gastric ulcers.


Gastric ulcers are a big problem in horses. Results from several research studies have revealed that gastric ulcer prevalence in performance horses can be as high as 90%. Many factors have been implicated in gastric ulcer development in horses; however, scientists have not identified a single cause. This is likely because the condition is multifactorial—or, it results from a number of different factors working in concert to create gastric conditions leading to ulceration.

Due to equine gastric ulcers' complex nature, management and prevention recommendations include a wide variety of lifestyle and husbandry modifications. Here are some options horse owners can consider to decrease ulcer risk.

Decrease stress. While this might sound like it should be relatively simple, there are many different stressors in horses’ lives. For those of us who enjoy being active with our horses, eliminating stress would also mean eliminating many of the things we do with them, including strenuous exercise, trailering, showing, and stabling. So what can we do to help offset these stresses?

Increased turnout time and/or pasture access can be a big help. This “time out” allows horses to move freely and interact naturally with one another, alleviating potentially stressful boredom and social isolation.

Consistent daily exercise is also an important stress relief. Physically fit horses can become nervous and irritable if not exercised frequently. Even simple, low-intensity exercise such as longeing or hacking can significantly decrease a horse's stress level.

Finally, research studies have shown that trailering your horse for a few hours can lead to increased cortisol (a hormone associated with stress) concentrations and gastric ulcer incidence. To help minimize this stress, acclimatize your horse to the trailer, haul him with other horses (preferably that get along well), and provide hay for the horse to munch on while moving down the road.

Provide feed for continuous intake. As grazers, horses produce gastric acid constantly, which is meant to be offset by nearly continuous eating and associated saliva production (which contains acid-buffering agents). However, many stalled horses are fed twice-daily grain meals and limited hay. These horses could be at increased risk for gastric ulcer development. Providing continuous access to a forage source (hay or pasture) could help manage a horse with gastric ulcers or prevent ulcers from occurring in the first place.

A note of caution: Be very careful if your horse is overweight or has some other medical condition that requires a restricted diet. In those cases, grazing muzzles or hay nets can provide for slower eating, which will achieve the goal of more consistent intake. And, be sure to check with your veterinarian before making any changes to the diet of horses under medical care.

Include alfalfa hay in the diet. Researchers have shown that horses consuming alfalfa hay have a lower incidence of gastric ulcers than horses consuming only pasture or grass hay. Gastric pH measurements in horses fed alfalfa hay were higher than in horses fed bromegrass hay (a higher pH mean a less acidic environment). Researchers believe alfalfa's high calcium and protein content have a buffering effect in the stomach.

You don't have to limit the forage component of your horse’s diet to alfalfa alone to achieve a buffering effect. Add two to four flakes of alfalfa to your horse's daily hay ration to help combat gastric ulcers.

Avoid non-steroidal anti-inflammatory drugs (NSAIDs), when possible. These drugs—including phenylbutazone (Bute), flunixin meglumine (Banamine), and ketoprofen (Ketofen) —are well-known for their ulcerogenic characteristics in numerous mammalian species, and horses are no exception. NSAIDs suppress a critical component of the stomach lining’s protection, making it more susceptible to acid's deleterious effects.

Use NSAIDs sparingly and only when necessary, and take special care when using these drugs in horses that have ulcers or a history of ulcers. Additionally, use caution when administering NSAIDs in horses under stress and, hence, more susceptible to ulcer development.

Being aware of the risk factors associated with gastric ulcers in horses is an important step in preventing them, and taking steps to alleviate stress and initiate management changes can help decrease the risk of ulcer development. Simple lifestyle and management changes can go a long way toward making your horse happier and healthier, especially when his stomach is concerned.

About the Author

Katherine K. Williamson, DVM

Katherine K. Williamson, DVM, is the manager of veterinary services for Purina Animal Nutrition.

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