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Equine Gastric Ulcer Syndrome: Dietary ManagementJanuary 2019

Story by: Dr. Kathleen Crandell

According to the American Association of Equine Practitioners, approximately 93% of racehorses, 60% or more of performance horses, and 25-50% of foals have or have had equine gastric ulcer syndrome.

Laying down horseThe horse’s stomach is divided into two distinct regions. The upper, nonglandular portion is covered with thin epithelial, or squamous, cells. This portion has little protection from stomach acid. The dividing line between the upper and lower regions of the stomach is known as the margo plicatus and is the most common site of nonglandular ulcers. The lower, glandular region is where acid is secreted, and it has a protective coating to prevent damage from acid. While ulcers can occur in the lower portion of the stomach, the cause is usually from long-term use of nonsteroidal anti-inflammatory drugs. These ulcers are less common than those that occur in the upper portion of the stomach.

Risk factors for EGUS include stall confinement, no access to hay or forage for longer than four to six hours, high-grain diets, stress, and exercise. Signs of ulcers may include lack of appetite, colic symptoms, weight loss, poor performance, girthiness, or any general change in attitude or behavior. Some horses show signs while others are more stoic.

While the only FDA-approved medication for the resolution of ulcers is omeprazole, there are ways to help manage the condition through diet. “For starters, make sure your horse does not go without hay or forage for more than a few hours. A ‘slow-feeder’ haynet can be a useful tool to extend the time it takes a horse to consume hay,” explained Kathleen Crandell, Ph.D., a nutritionist with Kentucky Equine Research.

If possible, offer the horse some alfalfa hay or alfalfa-based forage product, as alfalfa typically contains more calcium than grass hays, and calcium serves as a buffer for stomach acid. If the horse consumes a concentrate, look for a product that is low to moderate in starch and sugar, advised Crandell. Feeding starch in excess of 2 grams per kilogram of body weight increases the risk of ulcers, according to some studies. * Most nutritionists consider low to moderate starch and sugar between 12-20%.

When getting ready to exercise a horse, allow him to consume some hay (about a pound) prior to riding. The ingested forage creates a “mat” that sits on top of gastric juices and reduces the natural splashing of acid that occurs with movement and exercise.

Article reprinted with kind permission of Kentucky Equine Research (KER). Visit for the latest in equine nutrition and management, and subscribe to The Weekly Feed to receive these articles directly (

Dr. Kathleen Crandell is an Equine Nutrition Professional with a MS in Equine Nutrition and Exercise Physiology and PhD in Equine Nutrition and Reproduction from Virginia Tech. For the past 15 years she has worked in the field of equine nutrition with an international nutritional research/consulting company and a university. Her special interest is feed formulation and has worked with feed mills around the world in designing quality concentrates for horses. Her passion is evaluating and improving equine diets and she has consulted with some of the top equestrians in providing sound nutritional programs for their horses.

Dr. Crandell also teaches the Advanced Online Equine Nutrition Course at Equine Guelph.