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by Casie Bazay

4 Tips for Detecting Gastric Ulcers in Horses

4 Tips for Detecting Gastric Ulcers in Horses

Key Takeaways:

  • Feeding practices and stress are the two main causative factors behind equine gastric ulcers.

  • It’s safe to assume that the majority of equine athletes competing at elite levels are dealing with ulcers.

  • Signs of ulcers may easily be mistaken for a “sour attitude.”

  • The only way to definitively diagnose ulcers is to have your veterinarian perform gastroscopy. 


Stomach ulcers are a common concern among performance horse owners, and not without just cause. 

In fact, it’s been estimated that as much as 90% of race horses, 70% of endurance horses, and 60% of show horses will be affected by equine gastric ulcer syndrome at some point in their life (1). 

WHOA! Those statistics should stop you in your tracks. 

If ulcers are this common, how do you know if your horse is suffering from this often performance-limiting condition? 

Let’s walk through what you need to know to help you tell if your horse has ulcers.

        1. Understand the equine digestive system

Researchers have pinpointed two main factors associated with the formation of gastric ulcers in horses: feeding practices and stress. 

To explain how gastric ulcers form, we must first understand how the horse’s digestive system functions. 

The horse’s stomach continually produces gastric acid, but fiber from high roughage diets, as well as saliva (primarily formed by chewing forage), both act as a buffer against this acid. 

The problem occurs when a horse has nothing to eat (typically due to stall confinement), which causes saliva production to decrease (2). 

In the absence of forage, the sensitive stomach lining has no way to protect itself from its own gastric acid. 

Another thing to keep in mind is that the horse’s stomach is quite small compared with the rest of its digestive system. Food enters and then exits in about a fifteen to thirty minute time span, so it doesn’t take long for the stomach to empty. 

In other words, it is important to understand that the horse’s digestive anatomy somewhat predisposes them to developing equine gastric ulcer syndrome. 

       2. Take note of your horse’s risk factors

Dr. Keith Latson, FullBucket co-founder and equine surgeon, explains that stabled horses that are not given regular turnout and grazing time are especially prone to developing gastric ulcers, but we need to remember that horses who are experiencing any kind of stress are also at risk. 

“You have to consider social stressors. Horses separated from their buddies, horses recovering from surgery or those on lay-up because of musculoskeletal injury are also undergoing immense physiologic and social stress even though they’re not competing in a high stakes race.”  

Grains and high-carbohydrate feeds can also contribute to the formation of gastric ulcers, as they are not a natural part of the horse’s diet, especially in large amounts. While unintentional, humans may be setting their horse up for ulcer development by feeding high amounts of grain and inadequate forage. 

Additionally, intense exercise can lead to ulcers due to the fact that gastric acid production increases during extreme exertion. This acid is then ‘sloshed’ around inside the stomach, coating it and exacerbating the problem. 

Latson’s business partner, FullBucket co-founder and equine internal medicine specialist, Dr. Robert Franklin, has scoped and treated hundreds of performance horses from various disciplines over the years.

“We have detected that most of the horses competing at the elite level are affected with gastric ulcers,” says Franklin. “You can generally predict that if a horse is in upper-level training, there is an 80-90% chance they have ulcers.”  

It should also be noted that non-steroidal anti-inflammatory drugs (NSAIDs) like bute, flunixin meglumine (banamine), or ketoprofen, decrease the production of the stomach’s protective mucus layer, making it more susceptible to ulcers as well. Because of this and additional side effects, these drugs should be given long-term only under the care and direction of an equine veterinarian. 

         3. Be aware of the symptoms of gastric ulcers in horses 

While many horses stoically contend with ulcers and show no symptoms at all, other horses with gastric ulcers display more obvious signs that every horse owner should be aware of. These clinical signs include: 

  • Poor appetite;

  • Dullness;

  • Attitude changes;

  • Decreased performance;

  • Reluctance to train;

  • Poor body condition;

  • Poor hair coat;

  • Weight loss;

  • Excessive time spent lying down;

  • Low-grade colic; and

  • Loose feces.

“The classic sign of horse ulcers is a horse that puts its head into the feed bucket and then backs away, unwilling to finish a meal, especially a grain meal,” says Franklin.  “You may also see more overt clinical signs of colic. Normally the colic is mild--you don't see the rolling and pain--but you see mild chronic colic symptoms.

Signs of ulcers in horses may not be obvious until work, and many times, these signs are mistaken for a “sour attitude”. If your horse’s behavior changes either gradually or suddenly, it’s important to rule out pain or other medical issues before assuming it’s simply an attitude problem.

“Cinchiness whenever you’re saddling the horse should be taken seriously. There’s a pain point at the bottom of the belly and chest that can be aggravated when the girth is tightened and that can be consistent with gastric ulcers,” notes Franklin. 

Franklin also says that poor performance can be a sign of ulcers, saying, “Once we’ve ruled out orthopedic, respiratory, and muscular problems, then we start looking for things like ulcers, that may contribute to less willingness to work because they’re dealing with chronic abdominal pain.”

        4. If suspicious, use diagnostics to confirm the presence of gastric ulcers

Though many different clinical signs may point to gastric ulcers in your horse, the condition can only be diagnosed through a veterinary evaluation involving gastroscopy. Scoping a horse for ulcers involves placing an endoscope into the stomach in order to view its surface. 

The good news is that this procedure is relatively easy to perform, minimally invasive, and allows your veterinarian to evaluate the esophagus, stomach, and part of the small intestine. Due to the high risk of developing gastric ulcers, performance horse owners may want to include gastroscopy as part of their horse’s routine veterinary check-up.

Dr. Franklin explains more about the process of scoping: “We pass a camera into the horse’s stomach and we look at it after the horse has fasted. We can see the number, severity, and exact location of the ulcers in the stomach.” 

In the next segment of this two-part series on gastric ulcers, we’ll discuss treatment options, including drugs and medications, as well as natural remedies. Stay tuned!


Read More:

  1. https://thehorse.com/118592/diagnosing-and-treating-gastric-ulcers-in-horses/

  2. https://thehorse.com/121846/preventing-equine-gastric-ulcers/

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