Dr. Cameron Stoudt, DVM, shares ways to prevent and treat your performance horse’s gastric ulcers.

Many top equine athletes have experienced the pain and disruption of ulcers. But your horse doesn’t have to suffer. Look for the signs and be proactive about treatment, and your horse can find relief while healing from this common but uncomfortable condition. Dr. Cameron Stoudt, DVM, of Equine Sports Medicine and Rehabilitation in Pilot Point, Texas, shares her advice.

Why Do Horses Get Ulcers?

Stoudt says the reasons horses get ulcers, particularly gastric ulcers, is debatable. The stomach is composed of a glandular and non-glandular portion. Ulcers are most commonly found in the non- glandular portion of the stomach, where there is a thin mucosal layer that protects the area.

“Ulcers in the stomach—the non-glandular area—can occur due to repeated contact with highly acidic contents, (gastric acid) disrupting the mucosal lining that then causes erosions or raw, painful areas,” Stoudt said. “Ulcers can also be found in the distal (lower) portion of the esophagus, the proximal (upper) portion of the small intestine that connects to the stomach, and the hind gut (cecum/large colon). Ulcers can be found in any age horse—foals to adults.”

There are several conditions that can cause ulcers, says Stoudt. Stress is a big one. This can be both physical—such as performing and strenuous exercise—or environmental, such as constant stall confinement. Travel for extended periods of time is another factor. Poor diet, incorrect feeding habits or irregular feeding times can contribute to ulcers, as can a high-grain diet. The chronic use of non-steroidal anti-inflammatory drugs can cause ulcers, and they can also develop due to other illnesses.

Dr. Cameron Stoudt, DVM, shares ways to prevent and treat your performance horse’s gastric ulcers.
Constant stall confinement can contribute to ulcers. Photo by Abigail Boatwright


Horses that have ulcers may exhibit one or multiple symptoms, but Stoudt says the signs can be very subtle.

“Some ulcerative horses can be difficult to diagnose but just seem ‘off’ or not performing as they once used to,” Stoudt said.

Some symptoms include poor appetite and weight loss, poor hair coat, an irritable attitude—such as pinning ears and kicking out—possible changes in performance such as refusing the alley, discomfort while saddling or cinching up and abdominal pain.

“Colic symptoms can occur,” Stoudt said. “You might see discomfort while the horse is eating, such as pawing, rolling and not finishing grain or hay.”

Dr. Cameron Stoudt, DVM, shares ways to prevent and treat your performance horse’s gastric ulcers.
Omeprazole is the only medication approved for the prevention and treatment of gastric ulcers, but Stoudt says she’s had good success treating hindgut ulcers with Succeed. Sucralfate (not pictured) is also helpful for coating the stomach and providing relief from the pain of gastric ulcers. Photo by Abigail Boatwright


Stoudt says the best and most definitive way to properly diagnose gastric ulcers is a gastroscope.

“You may also make a presumptive diagnosis without a gastroscope by choosing to just treat for gastric ulcers and assess the reduction of clinical symptoms and signs,” Stoudt said. “Laboratory tests such as a CBC and chemistry panel are not specific for diagnosing ulcers.”


As of right now, Stoudt says omeprazole is the only medication that has been approved by the FDA for both the treatment and prevention of gastric ulcers.

Dr. Cameron Stoudt, DVM, shares ways to prevent and treat your performance horse’s gastric ulcers.
If you’ll be hauling your horse long distances, stress from travel could trigger ulcers, so consider preventative measures before you go. Photo by Abigail Boatwright

“Generally, treatment for a horse that has been confirmed to have gastric ulcers is 30 days, which is generally followed by a secondary gastroscope to assess the success of treatment,” Stoudt said.

Another medication called Sucralfate has also been shown to help coat the gastric ulcers and provide relief from pain associated with ulceration.

“For treatment of hindgut ulcers, I personally like to use Succeed,” Stoud said.

While your horse is undergoing treatment for gastric ulcers, Stout said it’s best to decrease intense exercise.

“They may still train and perform, however, it is best to do this at a decreased amount while undergoing treatment,” Stoudt said.


When aiming to prevent the occurrence of ulcers, Stoudt recommends taking into consideration both environmental and physical changes, including changes in feeding, stalling and exercise.

“Horses are natural grazers—I find horses tend to be less prone to ulcers when they are fed more frequently, have access to pasture and have alfalfa in their diets,” Stoudt said.

Stoudt says feeding alfalfa can reduce the
occurrence of ulcers. Photo by Abigail Boatwright

Evaluate the type of grain you’re feeding your horse, and consider decreasing the amount. This may help decrease the amount of volatile fatty acids that are being produced, says Stoudt.

If your horse has previously had ulcers or is prone to ulcer-like symptoms, Stoudt advises to start ulcer treatment several days prior to going on the road, as well as throughout the duration of the competition. Keep a close eye on your horse’s behavior and watch for early symptoms of ulcers, especially if your horse is in strenuous training or competitive environments.

“Barrel horses are high-level performance horses,” Stoudt said. “At any level, or any arena, horses tend to deal with situations differently. If your horse begins to exhibit any of these clinical signs, please contact your veterinarian.

This article was originally published in the May 2021 issue of Barrel Horse News.


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