Stomach ulcers are the primary health epidemic in the equine world. Allianz Insurance and Pet Plan Equine have more than 42 years of experience insuring horses. They have reported that of the "Top Five Most Common Health Problems in Horses," Gastric Ulcers is the No. 1 ranked health problem in insurance dollars paid out.

More than 80-90% of racehorses in training and 52% of horses of all breeds from 1-24 years old had gastric ulcers during gastro-endoscopic studies. Unfortunately, most people do not know for sure whether their horses have gastric ulcers. For example, adult horses with ulcers can exhibit a combination of poor appetite, dullness, attitude changes, decreased performance, poor body and hoof condition, rough hair coat, weight loss, and colic.

Cost of Treating and Diagnosing Ulcers in Horses

The unfortunate reality of horse ulcers is that they are expensive to diagnose and treat. The only way to truly diagnose ulcers is with a video camera (endoscope) in the horse's stomach. A video camera is placed up its nose, swallowed, passed through the esophagus and into the stomach. A scope can cost $250. Two are usually required — one at the beginning and one at the end of a treatment period to see whether it was effective.

When ulcers are diagnosed, the drug Omeprazole is usually prescribed for a month as the treatment. Omeprazole is the only drug approved by the United States Food and Drug Administration for treating horses with ulcers. Trade names for equine Omeprazole are Gastrogard and Ulcergard. It is expensive. A month's treatment for a full-size horse can cost more than $1,000.

Effects of Long-Term Use of Omeprazole

“Omeprazole for short-term usage is usually not problematic as long as care is taken to wean the horse off of it, but usage beyond 4 weeks is not a good idea,” says Juliet Getty, an independent equine nutritionist and author. “The drug eliminates most of the stomach acid, which is necessary for protein digestion. It should not be treated as a nuisance and removed. Without stomach acid, your horse can experience protein deficits, loss of muscle, depressed immune function, poor digestion and hormonal imbalances. The acid is your horse’s first line of defense against damaging microbes from the ground. Omeprazole also inhibits calcium, magnesium absorption, and other minerals that can potentially damage metabolic pathways and bone health.”

The Real Cause of Gastric Ulcers

SBS Equine Researcher, Dr. Richard Shakalis, points out that gastric ulcers are an unintended consequence of the domestication of the horse, which is inherently a grazing animal. Horses have evolved to eat many small meals per day, almost continually. The horse’s stomach represents only 8% of its digestive tract (8 quarts or 2 gallons).

The small volume of the stomach and the rapid passage of food to the small intestine is why horses are designed by nature to eat almost continuously. Gastric pH can drop lower than No. 2 soon after a horse stops consuming food, and the stomach will continue to produce strong acid even if food is not present. 

Most ulcers occur in the fundic portion of the stomach, which has a phospholipid-rich, protective epithelial layer. Disruption of this barrier (mucous, surface-active phospholipids) is initial to destroying the stomach’s surface epithelium. Because most domesticated horses do not regularly feed like nature designed them to, excess acid can ulcerate this protective layer. Unless the mucous lining is strong enough to withstand the powerful acids produced here, ulcers often develop.

Horse Trainers’ Secret for Preventing Ulcers

Ray Tricca, co-founder of SBS Equine, led a team of researchers that conducted more than 20 interviews with many of the top horse trainers in the racing industry. Although most of the trainers shared health information regularly with their competitors at the winter training facilities in Florida, their feeding program for the horses under their control was, in many cases, considered a trade secret. 

After all, it is a competitive industry and feed is what fuels the animal. Most of the trainers surveyed admitted in private to having problems with equine gastric ulcers. Those who said that they had few or no issues did seem to follow a similar feeding pattern. SBS found in their survey that horses fed four or five small meals a day had far fewer problems with gastric ulcers than those who provided their horses two or three meals a day. 

The bottom line is that concentrated feeding can inadvertently contribute to ulcer formation by its influence on increasing serum gastric levels, lowering the horse’s roughage intake and reducing the amount of time spent eating. Imposed feed deprivation, such as in colic management cases, can result in erosion and ulceration of the gastric mucosa.

Veterinarians Find Inexpensive Treatment for Ulcers

“Many veterinarians are finding the use of lecithin, along with apple pectin, to be very intriguing in its apparent health benefits in preventing and treating gastric lesions,”1 Getty says. “And more recently, it has been used for racehorses that typically suffer from ulcers,2 and horses that experience forage restriction.3 And suppose Omeprazole is used initially for existing ulcers, lecithin with apple pectin can be used as a ‘second-tier’ treatment after a short-term course of Omeprazole to heal irritated tissues further.

“Apple pectin, when combined with lecithin, offers a synergistic approach to avoiding ulcers. Pectin is a water-soluble fiber that acts with lecithin to form a hydrophobic barrier on the gastric mucosal membranes, protecting them against the corrosive effect of stomach acid. This combination is perfect for horses that are on any pain medication, and beneficial in preventing the ulcers that can develop from external stressors such as isolation, travel, showing, or the demands of training.”

Another option is ready-made in USA food grade apple pectin/lecithin (mixed phospholipids) supplement called Starting Gate Granules by SBS Equine, also available on Dr. Getty's Free Shipping Store. For more informative articles and information on gastric equine ulcers or hoof care, please visit SBS Equine.


1. Venner M, Lauffs S, Deegen E. 1999. Treatment of gastric lesions in horses with pectin-lecithin complex. Equine Veterinary Journal Supplement, April, 29, 91-96.

2. Sykes BW, Sykes KM, Hallowell GD. 2013. Efficacy of a combination of a unique, pectin-lecithin complex (Apolectol), live yeast, and magnesium hydroxide in the prevention of EGUS and faecal acidosis in Thoroughbred racehorses: A randomized, blinded, placebo controlled clinical trial. Equine Veterinary Journal, 45, 16.

3. Woodward MC, Huff NK, Garza Jr., F, 2014. Effect of pectin, lecithin, and antacid feed supplements (Egusin) on gastric ulcer scores, gastric fluid pH and blood gas values in horses. Eleventh International Equine Colic Research Symposium, Dublin, Ireland, July 2014, 7-10.

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