Care and Management Concerns for a Horse with Ulcers

HorseCommon care and management practices may be the primary if not the sole influence leading to gastric ulcers in horses. Unlike humans, where bacterial or viral pathogenic influences can create ulcers, there is absolutely no evidence supporting these possibilities as causes of ulcers in horses. Yet 63% of show horses, 59% of foals and more than 90% of racehorses suffer from these stomach lesions. "Gastrointestinal ulcers are a true occupational disorder, it is a condition that is not present in horses that are turned out."1 (T. Byers)

The digestive system of the horse has evolved to meet the needs of a free grazing animal. In line with this evolution, the bottom portion of the horse's stomach continuously secretes hydrochloric acid to assist in the breakdown of forage. For a horse grazing at will this works well but for a horse whose stomach is empty most of the time, this acid sitting on the stomach lining, can be a problem. The typical feeding regimen of grain twice a day with a couple of flakes of hay does not seem to be enough to protect horses’ stomachs from the effects of this acid.

Horses that are stalled consume grain along with their hay. Since they receive most of their energy from the grain, they are less inclined to eat as much hay - the very roughage that is needed for absorption of hydrochloric acid. "Excessive acidity can result in a very short time. ;With a diet that contains high levels of concentrates and low levels of roughage intake, acidity quickly becomes excessive. Those horses that are turned out on pasture full time can be examined with an endoscope and typically have no gastric lesions. These animals have a very high intake of roughage and no ingestion of concentrates."2 (R. Riegel, DVM)

The bottom line is that your horse needs to be free to graze. If you must stall your horse, give them as much turn out time as possible and supply them with free choice hay. Minimize grain intake or offer it in more frequent and smaller amounts. Remember, the roughage in your horse's stomach acts as a safeguard against the excessive acidity that causes ulcers.


Concerns with Foals

Foals seem to be more susceptible to lesions than adult horses due to the extremely thin lining of the gastroduodenal system. They are also more likely to have duodenal ulcers, while adults are more likely to have gastric ulcers. Foals raised in a pasture rarely develop ulcers, but foals confined to a stall or even a small paddock are commonly affected. The stress of confinement and a grain diet seem to be the highest risk factors of ulcers in foals.

There are two other factors though that are important to mention here. M. Murray, DVM and A. Riggs have reported "a history of nonsteroidal anti-inflammatory drug administration is commonly found in foals with gastroduodenal ulcers."3

In addition, the stress of transportation or surgery may increase your foal's vulnerability to ulceration.

Common Signs of Ulcers in the Foal and Adult Horse

The Foal: Diarrhea is the most common sign. The foal may salivate excessively and grind his teeth. There may be a slightly elevated temperature and a decrease in appetite. The foal may also appear to be in pain although it will not look similar to a colic-like pain.

The Adult Horse: Poor performance, poor appetite and pain (sometimes even colic) are the most common signs of ulcers in the adult horse. They may appear tucked-up in the flanks and have a dulled quality to the hair coat. An adult horse with ulcers is going to have abdominal discomfort that will certainly affect their attitude, so look for any signs of uncharacteristic behaviors.

The only empirical test for ulcers in the foal and adult horse is an endoscopic examination performed by a veterinarian.

Remember that excess hydrochloric acid is the most likely irritant if any of the above signs are present. If you see these signs in your horse and suspect stomach lesions stop their grain feeding and let them to pasture and free grazing as a first possible treatment with our Gastric Ulcers Solution to help your horse recover.


  • T Douglas Byers, DVM, of Hagyard-Davidson-McGee Associates, Lexington, KY
  • Ronald J. Riegel, DVM, "Illustrated Atlas of Clinical Anatomy and Common Disorders of the horse."
  • Michael J. Murray, DVM, Diplomate ACVIM, Associate Professor and Adelaide C. Riggs Chair in Equine Medicine at the Marion duPont Scott Equine Center at the Virginia-Maryland Regional College of Veterinary Medicine in Leesburg, VA