An equine rehabilitation charity is calling for owners to be aware of the “growing impact of modern management” on horse wellbeing, after a “weak, unhappy” horse was returned to full health.

Moorcroft, in West Sussex, is highlighting the risks of practices such as intermittent feeding, diets high in grain, minimal turnout and long-term medication, which can increase the chance of gastric ulcers developing.

The charity has been involved in the rehab of an eight-year-old Connemara, who arrived in June with severe ulcers.

“He has since undergone a marked transformation and is now back jumping, moving with a longer and easier stride on the flat, and feeling much more comfortable to ride,” a Moorcroft spokesperson said.

“The charity believes the ulcers and their associated pain and behavioural issues could have been avoided, or at least significantly reduced, with practices and care that work more closely with a horse’s natural digestive and grazing patterns. These can include increased turnout, more opportunities to forage and ensuring horses are fed before they exercise.”

Moorcroft CEO Mary Frances said some horses with ulcers show very few signs.

“But many, like this pony, make it clear they’re unhappy,” she said. “He arrived weak, lame and with a tight, sore back linked to low-grade pain in both hocks and stifles.

“This is an issue easily missed because it affects both sides equally. He was worryingly stiff and inactive for an eight-year-old, more like an older horse.”

Working with the charity’s vet, physiotherapist and specialist team, Moorcroft staff developed a rehab programme that included long-reining, physiotherapy and injecting platelet-rich plasma in to his hocks and stifles to address his minor joint pain.

“Ulcers are driven by stress and persistent pain, which disrupt normal gastric function,” Mary said. “They do not heal until the underlying pain is addressed.

“We’re delighted the pony’s latest test shows he is now ulcer-free; his journey highlights what compassion, dedication, and expertise can achieve. We’re thrilled he can now look forward to a healthier, happier and far more comfortable life. It truly feels like the perfect Christmas gift for the entire team and a wonderful way to end the year!”

Moorcroft is urging owners to help decrease horses’ risk of developing ulcers by prioritising a high-fibre diet and maximising turnout, with companions, to allow them to graze and relax.

“Ensure correct shoeing or trimming by qualified professionals,” the spokesperson added. “It’s crucial the correct angle of pastern to foot is maintained to establish and maintain soundness at all times.

“Keep work sessions short, calm and empathetic, avoiding force or pressure. Ride with empathy and respect. Take feedback from your horse and he or she will thrive.”

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If you’ve got a horse prone to gastric ulcers, choosing the best feed for them is really important as feeding a horse with gastric ulcers in the right way is key for their health and comfort. A horse with diagnosed or suspected gastric ulcers should receive a high-fibre, high-forage diet that contains little or no whole cereal grains.

We’ve rounded up a selection of feeds that have the BETA EGUS approval mark, but have also included a selection of feeds that are low in sugar and starch, and include other ingredients that support the digestive system. These feeds are all deemed suitable for horses prone to gastric ulcers or horses requiring low-starch diets. If your horse doesn’t need additional feed for energy or condition, you may want to consider a supplement for gastric ulcers, which is formulated to help balance the pH, instead.

Best feeds for horses and ponies prone to gastric ulcers

• Balancers
• Fibres
• Mixes, cubes and mashes

Balancers suitable for horses with or prone to ulcers

NB: Cost per day has been calculated using the maintenance measure for a 500kg horse in light work (where there was variation, unless stated) and the RRP. These costs per day are a guide only.

Chopped fibre feeds suitable for horses with or prone to ulcers

This high-calorie, fibre feed is ideal for promoting condition, coat shine and fuelling work. It’s a natural blend of pure alfalfa, which buffers acidity in the digestive tract, and rapeseed oil, which provides a comparable amount of energy to a conditioning mix/cube, with really low levels of starch (2%) and naturally occurring sugar at (4.5%). It is free from straw, molasses and preservatives.

This combination of precision-dried alfalfa and grass has a high oil coating, which promotes coat shine, and a light addition of molasses and spearmint oil to encourage fussy feeders. It helps to increase chew time and support gastric health, while being naturally low in starch (1.5%) and sugar (12%), which is comparable to grass hay.

This low-starch, high-oil fibre feed that is designed to support horses prone to gastric ulcers following veterinary treatment. The short-chopped alfalfa extends eating time and provides a natural buffer to stomach acid, while the high oil content provides energy for condition and performance. It contains a full range of vitamins and minerals, including vitamin E for immune support and muscle health, plus high-quality protein to support muscle development.

This nutritionally-balanced, high fibre feed is made from pure, chopped and pelleted alfalfa. The energy provided is comparable to a medium-energy mix/cube, but with significantly lower levels of starch (2%) and naturally occurring sugar (4.5%). It contains a prebiotic formula, a high-specification of vitamins and minerals, and a blend of herbs to tempt fussy eaters. It is free from molasses, straw and preservatives.

This high-fibre, low-calorie feed is made of a blend of straw, grass, alfalfa pellets and herbs, which increases chew time without adding too many additional calories. It is naturally low in starch (2%) and naturally occurring sugar (6%). It contains prebiotics and calcium for optimal digestive health, and has a light oil coating that provides slow-release energy and promotes coat shine. It is free from molasses, artificial flavours and preservatives.

This soft, conditioning alfalfa blend with oil contains added vitamin E to balance the high oil content.

This all-in-one, fully balanced conditioning fibre feed is suitable for horses who need to build condition at any level of work, but is particularly ideal for poor-doers, those prone to ulcers, horses coming into (or back into) work, and those who need to gain condition while keeping a cool head.

Blends, cubes, mixes and mashes suitable for horses with or prone to ulcers

Ideal for promoting weight gain, maintaining condition and supporting performance in horses requiring a low starch, high specification diet. Ease & Excel is a low-starch feed that includes no micronised cereal flakes, which means the slow-release calories are provided by fibre and oil. It has a full balance of vitamins, minerals and antioxidants, and contains a bespoke blend of antacids, pre- and probiotics.

The blackcurrant-flavoured Re-Leve cubes are a highly versatile, low-starch (9%), low-sugar (4.5%) cube is formulated specifically to help support a healthy digestive tract and maintain normal muscle function. Highly digestible super-fibres and oil are the main energy sources, which is ideal for horses prone to ulcers. The cubes are fully fortified with a full spectrum of vitamins, chelated minerals, and antioxidants, including natural vitamin E, along with a live yeast to support optimum digestive health.

These cubes supply elevated levels of slow-release energy – for condition or performance – from a low-starch (8%), high-fibre (18%) formula. They are ideal for sensitive horses that require a low-starch diet, and are designed to support healthy gastric and digestive environments and muscle function. Ease & Excel is fully balanced with performance levels of vitamins and chelated minerals, plus grapeseed extract, an innovative concentrated source of natural antioxidants to support immunity and recovery. Compared to Baileys No.21, the cubes are slightly lower in oil and calories.

TopSpec UlsaKind cubes are low in starch (7%) and formulated to provide calories for condition while being highly sympathetic to the digestive system. They contain very high levels of β-glucans, which form a gel and coat the stomach lining with a soothing film. This helps to prevent stomach acid splashing the less protected portion of the stomach.

The gel also slows the rate of passage of feed through the stomach and intestines, reducing the time period that the stomach is empty. The absorption of sugar is also slowed and the glycaemic index of the feed is lowered, reducing the effect on blood sugar levels. UlsaKind is designed to be added to feed balancer or supplement and therefore, contain no added vitamins or trace-elements.

This is the lowest starch (12.5%) muesli in Dodson & Horrell’s range. It provides performance level nutrition suitable for those that may be prone to gastric ulceration, as well as prebiotics and probiotics to support a healthy hindgut and nutrient uptake.

This high fibre, non-heating, fully balanced mash is formulated to maintain condition, while helping encourage a calm temperament. It contains highly digestible super-fibres and is fortified with quality protein, vitamins and minerals, and a prebiotic, while also being low in starch (7%) and sugar (4.5%). It soaks into a mash in 10 minutes and is barley-free, with linseed for a shiny coat. It supplies slow-release energy and is suited to horses in up to medium work.

This cereal-free, low-starch (8%), blackcurrant-flavoured mix has been specifically formulated to replace all cereal-based hard feed for working horses that react adversely to high-starch feeds or are prone to ulcers. It provides controlled energy from highly digestible super-fibres and oils.

It fully fortified with vitamins and minerals along with elevated levels of antioxidants, such a vitamin E, to support normal muscle function and recovery. It also contains the recommended level of yeast to support the maintenance of the hindgut and stabilise the stomach pH level.

This herbal mash, which soaks in less than 10 minutes, is formulated to support immune and digestive function. It’s molasses free, low in starch and sugar, and non-heating, which makes it really versatile. It contains prebiotics, probiotics, yeast and psyllium for digestive support, antioxidants and echinacea for immune support, and mint, fennel and cinnamon.

What is the BETA EGUS Approval Mark?

In 2016, the British Equestrian Trade Association launched a new feed approval mark that offers feed companies the opportunity to highlight products suitable for horses and ponies prone to, or at risk from, EGUS. It aims to make it easier for horse owners to identify feeds most suitable for horses prone to ulcers.

There are many legal restrictions around how feed and supplement products can be described in relation to different ailments – in short, they can’t be linked in a way that suggests they are nutritionally beneficial. But the launch of this scheme has allowed feed manufacturers with approved products to highlight feeds (not supplements) best suited for horses and ponies prone to EGUS without breaking the rules and regulations involved in marketing equine feeds.

Companies can submit products for approval, which includes the examination of ingredients, labelling, marketing claims and independent laboratory analysis. They must have, among other things, lower levels of sugar and starch than comparable products on the market. If accepted, the companies pay an annual fee to cover the cost of running the scheme and can display the logo on their packaging and marketing materials.

Products can be developed that are suitable feeds for horses with gastric ulcers, but the manufacturers may choose not to enter the scheme for various reasons.

What to feed a horse with ulcers

In addition to consuming at least 1.5% of their bodyweight a day in forage (hay, haylage or a suitable forage replacer), a feed balancer that provides a concentrated source of vitamins, minerals and quality protein is a valuable addition to the diet. If your horse requires more energy, this is best to be delivered by fats and oils rather than starch and sugars. It’s important to look for high-fibre, low-starch and low-sugar options when selecting feeds for horses with ulcers.

Adding short chopped fibre, ideally containing alfalfa, to every meal is beneficial as the high protein and calcium content in alfalfa is thought to help buffer stomach acid.

It is important that horses chew regularly, which produces saliva that helps to neutralise this acid – without frequent intakes of forage, the acidity increases and the horse is at a greater risk of developing ulcers. This increase in acidity is what gastric supplements aim to buffer. Lengthy periods without access to forage can leave the stomach walls vulnerable to acid attack, so calorie control should not come at the expense of fibre or other essential nutrients.

Which horses are prone to gastric ulcers?

Equine Gastric Ulcer Syndrome isn’t just a problem for performance horses – it can affect any breed or any age – and there are increasing numbers of leisure horses and ponies being identified as, or suspected of, suffering from the condition. This is especially true for horses or ponies whose forage intake is restricted, perhaps due to poor grazing or in efforts to reduce calorie intake.

You might also be interested in:

Balance the stomach pH – a guide to gastric supplements on the market

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Gastric ulcers in horses: the important facts every owner needs to know

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Feeding a horse with gastric ulcers in the right way is key for their health and comfort. Gastric ulcers can affect any horse or pony of any breed or any age because the horse’s stomach constantly secretes acid. Horses need to chew regularly to produce enough salvia to help neutralise this acid – and without frequent intakes of forage, the acidity increases and they are at a greater risk of developing ulcers.

“Approximately 90% of racehorses and up to 60% of competition horses are thought to have gastric ulcers. Although diet is just one risk factor, appropriate nutritional management helps to reduce the risk and severity of gastric ulcers,” says Sarah Nelson, Spillers nutritionist. Recent studies have also shown that 37% of leisure horses are also affected, so this is a problem for all horse owners.

What to feed a horse with gastric ulcers

A horse with gastric ulcers should receive a high-fibre, high-forage diet that contains little or no whole cereal grains. Their total daily forage intake should be a minimum of 1.5% of their bodyweight. On average for a 500kg horse without access to grazing this equates to approximately 9kg of hay (unsoaked weight) or 10-12kg of haylage.

Some feeds suitable for horses with gastric ulcers have the BETA EGUS Approval Mark, so this is a simple way to identify some safe options.

A horse’s diet should contain less than 1g of non-structural carbohydrate (starch and sugars) per kilogram bodyweight per meal and ideally less than 2g of starch per kilogram bodyweight per day. For a 500kg horse this is equivalent to less than 500g of NSC per meal and ideally less than 1kg of NSC per day.

“Starch, such as found in concentrated cereal feeds, is strongly associated with an increased risk of gastric ulcers. Therefore, stick to the high-fibre diet, supplemented to balance the micronutrients. If additional energy is required then this is best fed through a high-oil diet, which is shown to be beneficial for the ulcer-prone — and don’t forget to balance with vitamin E,” says Kate Hore, head nutritionist at NAF.

For those horses and ponies who only eat forage, feeding oil or one of the best feed balancers can be a valuable addition to their diet.

“Balancers provide a concentrated source of vitamins, minerals and quality protein, but due to the low feeding rate, a negligible level of energy, starch and sugar,” says Sarah.

Saliva provides a natural buffer to a horse’s stomach acid and horses only produce saliva when they chew so maximising forage intake is key.

“The sooner we all feed our horses more naturally, the sooner we can make many equine health issues, including ulcers, a thing of the past. That means not only feeding the high forage diet, but also maximising turnout as much as possible, to encourage good gut motility, as the horse’s digestive system evolved to work to its best when grazing and gently moving around,” concludes Kate.

When to feed a horse with gastric ulcers

“Horses are designed to eat little and often and therefore should receive ad lib forage; research has proven that there is a risk factor for the development of ulcers if there is absence of forage in a horse’s diet for over six hours,” explains Katie Williams, technical and product development manager at Dengie.

“While this can be difficult to avoid overnight, try putting multiple haynets around your horse’s stable or if someone goes to the yard later in the evening than you, ask them to give your horse a haynet so the horse has the shortest possible time without forage.”

You can also use small-holed haynets and slow feeders to extend your horse’s eating time, which will help reduce the time he’s without if he tends to finish his ration.

Adding short chopped fibre, ideally containing alfalfa, to every meal can be hugely beneficial as the high protein and calcium content in alfalfa is thought to help buffer stomach acid.

“It is also advisable to feed a handful of chaff or forage or give a horse a haynet 20-25 mins prior to exercising to help line the horse’s stomach and stop the acid from splashing around while the horse moves,” adds Katie.

Feeding to prevent gastric ulcers

As the diet is the main contributing factor to gastric ulcers, feeding your horse as naturally as possible will go along way to helping prevent them.

Different types of forage should form the majority of your horse’s diet to provide enough fibre to buffer the stomach acid. If you need to feed for additional energy or condition, choose concentrates that are high in fibre and low in starch. There are also gastric supplements that are formulated to help balance the stomach’s pH.

If you give your horse a bucket feed with more than just a forage replacer, split these into smaller meals where possible and ensure plenty of forage is fed in between.

Twenty-four hour turnout is ideal, but not possible for many, but keeping your horse turned out for as long as you can will support their digestive health. If your horse is injured or on heavily restricted turnout due to weather, you will also need to consider how best to feed your horse while on box rest.

Providing forage in stressful situations – for example, travelling – will also help buffer any additional acid. Feeding chaff before exercise may also help to trap acid and limit ulceration.

If you’re unsure on how to proceed or are navigating multiple issues, speak to a nutritionist for advice – most feed companies have free helplines.

You might also be interested in:

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Subscribe to Horse & Hound magazine today – and enjoy unlimited website access all year round

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Thousands of doses of omeprazole and sucralfate used to treat equine gastric ulcers and sent from the US to the UK have been seized – as owners are reminded that it is an offence to import such drugs into the country.

In October and November, Veterinary Medicines Directorate officers, working with Border Force, seized “more than 13,000 unauthorised horse medicines sold illegally online”.

“The Government agency received intelligence that these products were being illegally sold and imported via an equine Facebook group and via Abler’s website,” a spokesperson for the VMD said.

The medicines were seized under the Veterinary Medicines Regulations 2013, as amended.

“The VMD would like to remind horse owners and equine vets that it is an offence to advertise unauthorised products online, it is an offence to import unauthorised veterinary medicines into the UK, it is an offence to administer unauthorised medicines to your horse, and this will also invalidate your insurance,” the spokesperson said.

“The ingredients of unauthorised veterinary medicines may be unknown, and could therefore pose a risk to animals. Veterinary medicines should only be sourced from a VMD registered online retailer.”

The VMD had previously published seizure notices, for shipments of omeprazole and sucralfate destined for residential addresses across England, Scotland and Wales.

As an example of the value of the products seized, one shipment of sucralfate and omeprazole would have cost about £400.

H&H has approached Abler for comment.

• To stay up to date with all the breaking news throughout major shows such as London International and more, subscribe to the Horse & Hound website

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• This article has been edited and approved by Karen Coumbe MRCVS, H&H’s veterinary advisor since 1991.

Gastric ulcers in horses (also known as equine gastric ulcer syndrome or EGUS) are a common problem, particular among racehorses and elite competition horses, although horses of all ages and types can have them, particularly if they have limited access to forage. Foals are also susceptible, not least because they have relatively thin gastric mucosa.

There are two different types of gastric ulcers that can be found in the horse’s stomach. Equine squamous gastric ulcers occur when the digestive stomach acids come in to contact with the upper part of the stomach lining, which does not have the same protective layer as the lower part of the stomach. Glandular ulcers affect the bottom two-thirds of the stomach, which is submerged below the acidic gastric juices. The correct names for these two conditions are equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD).

It can be hard to interpret the significance of gastric ulcers in the horse, as some positive cases will have no definitive clinical signs and it is important to review the whole horse’s health picture and not just the ulcers themselves.

Equine gastric ulcers [1,106 words]: Causes | Diagnosis | Treatment | Prevention

Causes of gastric ulcers in horses

In a natural environment the horse will graze for up to 16hr a day, so the acidity is reduced by the forage filling the stomach almost constantly, as well as by bicarbonate in the saliva that is produced as the horse chews.

If stabled horses have access to ad-lib hay, haylage or grass, this natural preventative process continues. But if they are fed high-concentrate diets with only limited access to forage, the acidity in the stomach increases.

Any prolonged period without forage intake, whether due to management practices or illness, leads to increased gastric acidity and a risk of ulcers.

Training which includes fast work, especially on an empty stomach, increases the risk of the acid splashing around, resulting in damage the upper part of the stomach.

Stress can also be a factor.

Research undertaken in the UK¹ on the stomachs of slaughtered horses showed that even feral ponies living on the moors can develop gastric ulcers, although it was unclear whether they were living with them all the time or had developed them during the brief period between round-up and slaughter. The samples were all taken from animals slaughtered in mid-summer, when grazing was at its best and the predicted environmental stress at its lowest.

Diagnosing gastric ulcers in horses

There are no definitive external signs that a horse is suffering from gastric ulcers, but clues suggesting a performance horse may be suffering include:

• decreased performance
• attitude change (reluctance to work/not wanting to be tacked up)
• poor body condition
• reduced appetite
• low-grade colic

Studies show that stride length in racehorses with ulcers decreases significantly. Equally in sports horses, the discomfort associated with stomach ulcers can cause a reluctance to engage abdominal muscles to extend, collect or jump.

To confirm that ulcers are present and what grade they are, a vet will use a 3m long videoendoscope to view the stomach lining of the horses (a gastric endoscopy) while the horse is sedated.

Treatment options

Gastric ulcers have been most commonly treated with an equine-specific form of omeprazole, given at a dose based on bodyweight. Other medications are now being used in some cases, so consult your vet for the most up-to-date advice. How long the horse requires this will depend on how bad the ulcers are and the management of that horse and its diet.

Squamous lesions that are widespread and shallow typically heal faster (within 14-21 days) than more focal, deep lesions, which can take up to a month or even longer.

After this period gastric endoscopy can be repeated to check how the healing is progressing. If all is well treatment can move on to the maintenance stage to avoid the ulcers from reoccurring. If all treatment is stopped at this point there is a high risk that the ulcers may reform (approximately 80% within six weeks).

For maintenance owners can continue using equine-specific omeprazole, but reduce the amount to a quarter dose. This is relatively effective in most cases and also user-friendly as it is a once-a-day treatment.

The alternative is to use an acid-neutralising feed supplement (containing aluminium hydroxide, magnesium hydroxide and calcium carbonate — think “Rennie” for your horse). This approach is less consistent and the supplement must be given three to four times daily, as its effect is short-lived.

There are a variety of other supplements containing different fibrous material or proteins, seaweed, plant or mineral extracts; however, none of them have been proven to be clinically effective in either the treatment or prevention of squamous ulceration.

Treatment for glandular gastric ulcers

A horse that has ulcers in the glandular area of the stomach (EGGD) will require different treatment.

These glandular ulcers will often need additional treatment with the mucosal protectant sucralfate as well as omeprazole. Another option is a coating agent supplement containing pectin and lecithin, given up to twice daily, which is often started at diagnosis and then continued for at least three months.

Also, a specific prostaglandin analogue is being used as an increasingly popular treatment. This has multiple mechanisms of action that may be of benefit, including suppressing acid production and helping healing, which is particularly beneficial for the glandular form of ulceration.

Different treatment options should be discussed with your vet, depending on the precise type of ulceration affecting your horse.

Preventing gastric ulcers in horses

Any horse that has been diagnosed as having gastric ulcers, alongside horses that are high-risk of developing them, need their management reviewed in order to reduce the likelihood of the ulcers taking hold. Knowing how to feed horses with gastric ulcers is really important.

The following steps are recommended²:

• Allow access to high-quality forage, predominantly during the day (7am to 11pm), at a minimum daily rate of 1.5kg/100kg body weight (BWT). This should ideally be given continuously or at no more than 6hr intervals
• Create multiple forage sources in the stable to improve eating consistency and allow foraging activity
• Either hay (dry, soaked or steamed) or haylage can be used as the main forage source — there’s no difference between them in relation to ulceration
• Feed no more than 0.25kg/100kgBWT of straw. This should not be the only forage source
• Provide continuous access to fresh, clean water 24hrs a day
• Split the concentrate ration into three rather than two meals per day
• Opt for grains such as barley and oats instead of sweet feeds
• Add chaff to all meals
• Completely pelleted diets generate more stomach acid than the same diet formulated as a coarse mix
• Buy a suitable high-quality feed, but bear in mind that there is no scientific evidence to support the use of specific “gastric healthy” commercial diets, nor of one manufacturer’s feed being better than another’s
• Add a little corn oil or rapeseed oil (50-100ml per day) to help reduce the amount of stomach acid produced
• Consider using fermented probiotics and the yeast Saccharomyces cervasii, which may increase the digestibility of the horse’s diet, so improving large intestinal function
• Feed chaff before exercise — 2 litres chaff given within 30mins of exercise may trap acid and limit ulceration, and improve gastric blood supply. Use a 2-litre plastic drink bottle with the top cut off as a measure
• Remember turn out at grass is beneficial for the majority of horses.

Research by feed manufacturer Dengie published in October 20183 found while knowledge of EGUS management techniques was good among the owners that took part in its online survey, many were not implementing all the advice. Specifically, while 67% of respondents who believed their horses had EGUS had increased access to hay or fibre, only 55% were feeding chaff before work, while only 38% had cut cereals and starch out of their horse’s diets.

References and further reading

1: A comparison of the prevalence of gastric ulceration in feral and domesticated horses in the UK – October 2015

2: How to keep gastric ulcers at bay: simple 12-step plan – January 2016

3: Owners failing to act to help horses with ulcers – October 2018

You might also be interested in:

20 feeds suitable for horses prone to gastric ulcers

Expert advice for feeding a horse to avoid gastric ulcers

Balance the stomach pH – a guide to gastric supplements on the market

Subscribe to Horse & Hound magazine today – and enjoy unlimited website access all year round

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

New Zealand’s Jesse Campbell got emotional as he explained that his Tokyo Olympic ride Diachello is back on back on top form after fears he “had ruined him”.

Jesse and the 13-year-old Diarado son delivered a stunning dressage test at Pau five-star to score 26.9, and slot into fourth place ahead of today’s (28 October) cross-country. The event is the gelding’s return to the top level.

Jesse has produced Danny since 2018, and the gelding made his five-star debut with Jesse at Kentucky in 2021, where they jumped clear across country to finish 11th. The following year they represented New Zealand at the Tokyo Olympics, where they finished 22nd individually.

But following the Olympics things were not smooth sailing and Jesse noticed a decline in Danny’s performance.

“To be honest I’m quite emotional about him because when we first bought him and we took him to four-star he was so generous, and he was quiet and easy and everything like that,” said Jesse after his Pau test.

“And then we took him to Kentucky and he was okay, it was his first five-star, and then I sort of put the pressure on him to go to the Olympics and he just didn’t feel very good.”

Jesse started veterinary investigations to get to the route of the problem.

“He’s not the type of horse to show your typical ulcers, but we got him scoped because we had exhausted everything else, bone scan, the whole thing,” said Jesse. “And we found he was riddled with ulcers. We sort of went back to basics with him, and I really thought I’d ruined him.”

Jesse said Danny “let him train him back up” and they have since returned to form. The pair shone during their Pau test, with the eye-catching gelding looking relaxed in the arena.

“Every day he feels better. This week he’s been feeling awesome, and I’m really happy,” said Jesse, adding that he was particularly pleased with Danny’s flying changes in the test.

“With his flying changes where I think he probably would have been uncomfortable in the past we had to be quite conservative, but now he’s really throwing them and letting go. It’s just lovely that he’s feeling happy – that’s the main thing,” he said.

Jesse is first out on the Pau cross-country course today with his first ride, Jay Jaffar’s 11-year-old gelding Cooley Lafitte, who is making his five-star debut.

“As pathfinder there’s a lot of responsibility to do a good job so everyone else can see what the track should ride like, so I’m excited about taking on that role with my first horse. He should give me some really good knowledge for how to ride Danny,” said Jesse.

“They are two very different horses; Danny is quite cold but the other guy’s pretty hot like you saw in his dressage. But they’re both really long striding, so these Pierre Michelet’s distances should be not too bad. It’s Cooley Lafitte’s first five-star but he’s a machine across country, and he jumps for fun so we’ll see if that pays off. It should be a good day.”

The Pau five-star cross-country gets under way at 11.30am local time (10.30am British time). Check out the cross-country times.

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Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

A horse’s stomach produces acid continuously, making it very susceptible to developing wounds or sores. The best gastric supplements for horses help to balance the pH (acidity) levels and protect the stomach lining. Excess acidity in the stomach can exhibit as wind-sucking, crib-biting, weaving and lack of appetite or condition, as well as bloating, napping and “grumpy” behaviour. If horses do not have access to natural acid build-up prevention from ad-lib hay, haylage or grass, the acidity will increase and can cause gastric ulcers.

Gastric supplements are usually particularly suitable for horses that are stabled, consuming grain feed, competition horses, horses that are displaying signs of discomfort, loose stools or tucked up tummies. They are often beneficial for racehorses and horses in hard work, as they are usually at highest risk of increased acidity. However, with some management practices, such as restricted turnout, acidity can build up in horses and ponies that you might not expect.

Whereas gut balancers are usually formulated to support and maintain a healthy hindgut by providing pre- and probiotics, gastric supplements target the digestive system earlier on at the stomach. Some supplements, however, contain ingredients that support both areas of the digestive system. In cases where a horse has received treatment for gastric ulcers, it’s common for vets to recommend a gastric supplement to prevent reoccurrence, alongside choosing a feed suitable for horses prone to gastric ulcers.

Gastric supplements for horses: what are your options?

Here is a selection of the best gastric supplements for horses that are currently available, including the manufacturers’ descriptions of their products…

NB: Cost per day has been calculated using the maintenance measure for a 500kg horse in light work (where there was variation) and the RRP of the smallest available tub. Some products require loading doses and some horses will require a higher dose, which will increase the cost per daily measure, while buying a larger tub will likely decrease it – these costs per day are a guide only.

NAF Five Star GastriVet

Form: Pellets

Sizes: 2kg, 4kg

RRP: £57.50 for 2kg

Daily measure: 67g

Cost per day: £1.93

Formulated to target the stomach, soothing and preserving the stomach lining integrity, GastriVet helps to balance the pH levels. It supports the natural anti-inflammatory processes and helps to retain clear areas in the glandular and non-glandular regions of the stomach. GastriVet also supports the hindgut with nutrients to provide and support live cultures.

BETA NOPS compliant.

Horse First Acid Aid

Form: Powder

Sizes: 1.5kg, 5kg

RRP: £42.90 for 1.5kg

Daily measure: 50g

Cost per day: £1.43

Developed to help improve the digestive health of your horse, Acid Aid effectively soothes and coats the stomach, acting as a buffer, helping to neutralise the gastric acid and protecting the delicate lining. It helps maintain healthy acid levels in the stomach, aiding normal acid production so that digestion is not overly disrupted.

Can be fed short or long term. BETA NOPS compliant.

Aviform EGF Equine Gastric Formula

Form: Powder

Sizes: 1kg

RRP: £25.95

Daily measure: 41g

Cost per day: £1.06

Formulated to promote healthy gastric conditions by supporting the control of acid in the stomach. It contains both calcium and magnesium, which are recognised as alkaline providers. Daily use can help to prevent gastric ulcers occurring and protect the stomach from stress-related gastric issues.

BETA NOPS compliant.

Cavalor Gastro Aid

Form: Powder

Sizes: 2l

RRP: £109

Daily measure: 60ml

Cost per day: £3.27

Gastro Aid creates a healthy environment in the stomach by neutralising gastric acid and protecting the stomach wall. Acid makes the stomach susceptible to developing wounds or sores, and the herbs in Gastro Aid help to protect against this by stimulating saliva production and promoting the healing of ulcers. Also available in powder form.

H Bradshaws Coligone

Form: Liquid

Sizes: 500ml, 1l, 5l

RRP: £16.50 for 500ml

Daily measure: 60ml

Cost per day: £1.98

Coligone helps maintain healthy acid levels, and is suitable for use during training, competing, travelling or during times of stress and ill health where there has been a disturbance to the microflora in the digestive tract. It’s particularly ideal for use when gastric acid levels are high and saliva production is low.

Also available as a powder.

NutriScience Gastro Care

Form: Powder

Sizes: 1.8kg, 3kg

RRP: £76 for 1.8kg

Daily measure: 15g

Cost per day: £0.63

This supplement is designed to have an all-round approach to gastrointestinal health. It contains antacids that help mimic the effects of saliva and protect the stomach lining by absorbing and buffering excess acid, while L-Glutamic acid can help to aid the regeneration of the stomach lining.

BETA NOPS compliant.

Equine America Uls Gard Pellets

Form: Pellets

Sizes: 1.5kg, 3kg, 10kg

RRP: £29.99 for 1.5kg

Daily measure: 100g

Cost per day: £2

Uls Gard pellets provide a fibrous alfalfa and soya hull mat in the stomach, and are formulated to help maintain digestive health and comfort. It contains ingredients that help soothe and support the stomach and gut lining, including pectins, lecithin, marshmallow root, glycine and liquorice. It also contains a slow release calcium and magnesium from marine algae, which help to maintain a healthy gut pH, along with live probiotics and prebiotics to support a healthy microbiome.

BETA NOPS compliant.

In the UK? Buy direct at equine-america.co.uk

Equitop Pronutrin

Form: Pellets

Sizes: 3.5kg

RRP: £100

Daily measure: 250g

Cost per day: £7.14

Equitop Pronutrin pellets contains 77% Apolectol, which is a patented combination of fruit and vegetable fibre, glycerol and lecithin. This forms a gel to support the stomach’s natural defences and maintain healthy gastric acidity for optimal gastric health.

Blue Chip Super Concentrated Ulsa-Cool Balancer

Form: Pellets

Sizes: 3kg

RRP: £28.90

Daily measure: 100g

Cost per day: £0.96

Made to assist horses prone to gastric ulcers with the maintenance of acid balance in the gut. The prebiotic MOS, probiotics, beta glucans, marine minerals, nucleotides and anti-oxidants in the balancer restore the natural balance of the gut flora, which helps to maintain continued digestive wellbeing. This nutrient-dense pelleted balancer, is whole grain and molasses fee, and formulated to be fed in small quantities alongside a fibre-based diet.

BETA NOPS compliant.

Protexin Acid Ease

Form: Powder

Sizes: 1.5kg, 3kg

RRP: £57.99

Daily measure: 50g

Cost per day: £1.93

Acid Ease is a concentrated, palatable combination of calcium and magnesium carbonate, fibre, kaolin, amino acids, plus probiotics and prebiotics. It is suitable to calm excess acid in all horses and weaned foals.

BETA NOPS compliant.

Equine Products UK Gastro-Mag

Form: Liquid

Sizes: 1l

RRP: £25.99

Daily measure: 60ml

Cost per day: £1.56

This complimentary feed is designed to be fed to horses suffering from excess acidity in the stomach, which can exhibit as wind sucking, crib biting, weaving and lack of appetite or condition. It helps to maintain normal stomach pH and improves appetite of horses with excess acidity.

In the UK? Buy direct at equineproducts-ukltd.com

Betta Life PharmaTrac Total Digestive Support

Form: Powder

Sizes: 120g, 400g, 1kg, 2kg, 5kg

RRP: £15 for 400g

Daily measure: 10g

Cost per day: £1.25

This supplement targets both the fore and hindgut, supporting the gastric environment and helping to maintain an optimum pH level.

Fine Fettle Happy Tummy Charcoal

Form: Fine granules

Sizes: 500g, 900g, 3.75kg, 7.8kg, 24kg

RRP: £21.50 for 500g

Daily measure: 20g

Cost per day: £0.86

Fed regularly, this charcoal supplement helps maintain good digestive health by supporting a natural pH balance in the gut, which in turn supports the immune system and provides the foundation for good health, good condition and better performance.

Synovium Gastrosafe

Form: Pellets

Sizes: 1.5kg, 4.5kg

RRP: £52 for 1.5kg

Daily measure: 90–150g

Cost per day: £3.20–5.20

Developed to support a normal and healthy stomach environment and aid digestive function, this supplement has been extensively trialled and is suitable for horses with poor appetite, poor condition, poor performance or behavioural changes.

In the UK? View now at ebay.co.uk

KER RiteTrac

Form: Powder

Sizes: 3kg, 6kg

RRP: £143.50 for 3kg

Daily measure: 120g

Cost per day: £5.74

RiteTrac works by targeting both the foregut and the hindgut of the horse. When fed in conjunction with correct management and forage regimes, RiteTrac helps to maintain an optimal gastric environment. It contains KER Equishure, which helps maintain an optimum pH in the horse’s hindgut and ensure normal fermentation patterns. Suitable for horses experiencingloose droppings, weight loss, lack of appetite, abnormal digestive sounds or stereotypical behaviour.

In the US? View now at chewy.com or smartpakequine.com

How to choose the best gastric supplements for horses

Look out for gastric supplements that include the following ingredients…

• calcium, which has recognised alkaline properties
• magnesium, which also has recognised alkaline properties
• probiotics, which are often referred to as “good bacteria”
• prebiotics, which are the “food” for probiotics, helping them to work effectively

Consider the form the supplement takes – gastric supplements can come in liquid, powder and pellet forms. Your horse may have a preference to one over another, which could make all the difference as if he won’t eat it, your horse won’t receive the benefit.

Cost is another consideration – we’ve calculated the daily cost of all the supplements featured in this guide to help you compare them easily. To make it as comparable as possible, we’ve used the smallest tubs available, but you’re better off buying a larger volume of supplement if you can as the daily cost can become significantly lower.

If you compete with your horse then it is important you make sure any supplements you use do not contain any prohibited substances.

You might also like:

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Subscribe to Horse & Hound magazine today – and enjoy unlimited website access all year round

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

Gastric ulcers remain one of the most claimed-for equine conditions, according to equestrian insurance providers.

Data released by SEIB Insurance Brokers showed that for the second year running, digestive disorders, including colic and ulcers, are the number one cause for claims. External trauma was second and degenerative disease third.

An SEIB spokesman said that in 2022, the average cost of a claim related to digestive disorders was £2,459. Ulcers make up the bulk of this group at 59%, and of the ulcer claims 37% cost more than £3,000. External trauma claims, including accidents, kicks, cuts, wounds and fractures, made up 56% of claims made and had an average cost of £1,379. Degenerative disease and development disorder, including skin disease, was the third most common cause for a claim and had an average claim cost of £2,435.

“There are so many wonderful advances in veterinary treatment and technology which help our horses live longer, happier and healthier lives. However, this has resulted in the cost of treatments going up significantly, meaning that having correct and effective insurance for our horses is more important than ever before,” said Nicolina Mackenzie, SEIB marketing manager.

“We never know what is around the corner, but insurance helps ensure the wellbeing of our horses and provides peace of mind to owners.”

Last year, The Insurance Emporium paid out £724 on average for disease claims affecting the legs, including stifles, hocks, and fetlocks – and hindlimb lameness. The other most common conditions for claims were “disease” affecting tendons and ligaments, digestive issues, bone disease, and back, spine and pelvis problems. The average paid claim for ulcers was £949, external accidents £719, and the average teeth and gum paid claim was £713.

The Insurance Emporium CEO Francis Martin told H&H that at a recent equine insurance providers’ forum, it was noted that due to inflation and the cost of living crisis, fees for providing treatment had “significantly increased”.

“This is when horse owners will truly feel the value of insurance as the cost to treat even the least severe of conditions is considerably more than it was only a few years ago,” he said.

“When considering what equine insurance is right for you, you might look at it as if the worst-case scenario were to happen, could you afford to pay for their treatment? If not, ensure your insurance does cover those types of cases.”

You might also be interested in:

Gastric ulcers in horses: the important facts every owner needs to know

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Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

Home-produced coloured pony Catch Me If You Can is set to make his debut at the Royal International Horse Show (RIHS) next month after qualifying for the small traditional/native/cob final.

Lesley Bunker-Nixon’s Catch Me If You Can (Harry) is a seven-year-old traditional who stands at 13hh. He is ridden by Lesley’s friend Helen Butcher and the pair produce him from home.

The gelding was bought in 2019 as a three-year-old. While he had been backed, Lesley and Helen gave him plenty of time to mature and grow on.

“He was very immature and so we left him until the following year, in the hope that we could get him out to some in-hand shows,” says Helen, who works as a delivery driver. “However, Covid hit and put paid to that idea.”

In early 2021, Helen underwent a hip replacement that put her out of action for several months.

“We asked a friend to come and do a bit of work with Harry but it soon became apparent that something wasn’t right with him; he wouldn’t go forward and wasn’t enjoying his job,” Helen continues. “He ended up at the vets for scoping and he was diagnosed with grade four stomach ulcers. He was treated with injections for several months and he was only allowed to do very light work, so competing him under saddle had to take a back seat again.

“In 2022, after a wet winter, Harry was brought back into work, but with his lack of ridden experience he was still only able to do a couple of novice local shows at the end of the season,” Helen adds. “The start of 2023 was also very wet, meaning his ridden work was again very intermittent. We missed all the early shows due to being unable to ride on the wet ground, but finally got out at the end of April to a local show and another show in May.”

Helen and Harry attended one RIHS qualifier this term, held at Rutland County, as she explains: “We went with no expectations as this was only his fifth ever show under-saddle. To our delight he stood second to an experienced pony, which gave us the qualification!

“We muddle along on a shoestring budget with no facilities, no arena, electricity, hacking or even water, which is a mammoth task when bathing and trying to keeping a hairy coloured clean. Harry is shown from the field and we try to make the best of what we’ve got.

“Lesley and I are both in our 60s and we’re still working full-time. We are proud to have achieved our qualification against all odds.”

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Subscribe to Horse & Hound magazine today – and enjoy unlimited website access all year round

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

RESEARCH into salivary indicators has suggested that in the future, scoping may not be necessary to confirm or rule out gastric ulcers.

This is the objective, and not an imminent possibility, but the pilot study, published in Animals, found that certain substances in equine saliva could “potentially be assessed as biomarkers in horses with gastric ulcers”.

Between February 2020 and May 2021, samples were taken from horses diagnosed with ulcers at the Large Animal Teaching Hospital at the University of Copenhagen and the Veterinary Teaching Hospital of the University of Extremadura, Spain. Samples were also taken from horses presented at the hospitals without signs of ulcers, and who had scoped clear.

It was found that the horses with ulcers, or colic, showed changes in certain biomarkers.

“This report has some limitations and, therefore, should be considered as a pilot study,” the study states, adding that “the possible stressful situation of being in a new place could influence our results”. It said the results should be considered preliminary, and further research should look at higher numbers of horses.

“In addition, further studies should be performed to evaluate whether these oxidative status changes in horse saliva and serum are only observed in gastrointestinal diseases or other types of diseases not related to the gastrointestinal tract,” it said.

But the report concluded that the results indicate, for the first time, that there is potential to measure certain analytes, or substances, in equine saliva and could be biomarkers.

“The evaluation of these analytes has advantages associated with the use of saliva, such as easy, non-painful, and non-invasive collection, and the possibility to be obtained in field conditions, with repeated sampling, producing minimum discomfort and anxiety.”

Lead author María Dolores Contreras-Aguilar told H&H the idea was to look for possible biomarkers that could rule out ulcers or show that a horse needed to be scoped.

David Rendle, chair of the British Equine Veterinary Association’s health and medicines committee, told H&H that from a theoretical perspective, it is an interesting study.

“It confirms that saliva sampling in horses can be used to identify the oxidative stress that typically accompanies inflammation,” he said. “However, from a practical perspective it doesn’t change how vets will investigate gastric disease or colic. Oxidative stress can accompany any inflammatory disease and a saliva test is unlikely to be able to differentiate where the inflammation is located. The use of markers of oxidative stress has been investigated in a number of disease states and hasn’t resulted in diagnostic tests that have been useful in the field.

“Identification of the presence of gastric disease or colic is only part of the clinical process; vets also need to assess the precise nature and severity of disease to determine appropriate treatment options. For both gastric disease and colic there are multiple treatment options and a saliva test is not going to be able to provide the level of information that can be gained from gastroscopic examination of a horse’s stomach or a full clinical examination.

“Furthermore, these saliva tests don’t identify the presence of squamous gastric disease which in some populations, including racehorses, is the primary gastric disease of interest.

“Interesting findings but it is hard to see that they will have any practical implications in the short, and probably long, term.”

You might also be interested in:

Expert advice for feeding a horse to avoid gastric ulcers

Joint medication and ulcer signs: top vets’ views on potentially controversial equine health topics

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Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

PUBLIC perception of joint injections and signs of “ulcers” being caused by other pain have been discussed, as potentially controversial equestrian issues.

At the British Equine Veterinary Association 2021 congress (5–7 September), experts gave presentations on a huge range of topics. One, Controversies Among Us, also covered whether there is any evidence to support the use of oral electrolytes before competition.

Joint medication

US vet Scott Hay, who has long experience, mainly with racehorses but also sport horses, said although he believes joint medication is a “valid part of everyday practice”, for which there is “great justification and good reasons”, he has often come across controversies related to its use.

One is that in the US, there are yards that do it more commonly, which could be caused by their trying to enhance performance; another is whether the medication is associated with increased rates of catastrophic injury.

“There are studies, completed and ongoing, that would indicate some of that, and probably our number one fear when treating lameness, particularly with joint injections, is, are we leading this horse to something that will increase its lameness over time, or even a catastrophic injury?” he said. “It’s a fear you live with every day.”

Another issue is whether the injections are overused. Dr Hay said economics often come into play, and getting a horse to its next race, when there may be better treatment options. He also mentioned medication as scheduled maintenance in some yards; research is under way to find out how often this happens.

“Another controversy is public perception,” he said. “We’re more and more under the watchful eye of the public, on what we do and the risk of injury, and certainly joint injections are often not well perceived.” He added that if a horse gives a high-profile positive dope test and has had joint medication, this puts it back in the public eye whether or not it is related.

“Like it or not, we’re allowed to keep having sport with horses because the public accepts it, so we have a responsibility to make sure public perception is going in the right direction,” he said.

Dr Hay added that although joint medication is entirely valid with an appropriate diagnosis, often assumptions are made without one, and “that’s something we always have to think about”.

Gastric ulcers

Ben Sykes, an associate professor in equine medicine at Massey University, New Zealand, covered the evidence that gastric ulcers in horses causes behavioural and performance issues.

He stressed that squamous gastric disease, which affects the top third of the stomach, and glandular gastric disease, which affects the rest, need to be considered as the separate entities they are.

He discussed studies on performance and behaviour in horses with and without both squamous and glandular disease, but he also cited research that found no correlation between owner-reported clinical signs and glandular disease. This leads to thinking that signs seen by owners as related to ulcers may be caused by other pain issues; he mentioned studies by leading vet Sue Dyson on abnormal equine behaviour during tacking up and mounting being related to pain, and Dr Dyson’s investigations into signs of pain in ridden horses.

He concluded that there is evidence squamous disease can affect behaviour, certainly eating behaviour, and performance, and some evidence glandular disease affects performance.

“Do we have evidence that glandular disease affects behaviour? Then we get into different territory,” he said. “I think we need to step back from talking about these horses presenting for evaluation of gastric disease, to recognise they are presenting for pain.

“I’d say 50% of the horses I see that present for gastroscopy have a non-gastric diagnosis, typically orthopaedic pain… we need to realise what we’re seeing is pain expression, not expression of gastric disease.”

Can electrolytes aid performance?

Bettina Dunkel, an associate professor in equine medicine, looked at whether electrolytes benefit horses and enhance performance.

She cited studies, mainly on endurance and event horses. Asking whether dehydration and electrolyte abnormalities affect performance, she found that although pre-exercise electrolytes disperse quickly to where they are useful, and saline solutions at 20°C increase fluid intake, there is no evidence to suggest electrolytes enhance performance.

“Sometimes when we give supplements, I tell owners it might be good for the horse or not, but it’s unlikely to do harm,” she said, adding that one study suggested this may not be true for electrolytes. The research involved giving them to trail-riding horses for six days and of the 12 supplemented horses, five colicked.

“A word of caution that electrolytes aren’t like other supplements; they can actually do harm,” she said.

You might also be interested in:

The pros and cons of routine joint medication in horses *H&H VIP*

Is routine medication of symptomless joints justifiable? Dr Sue Dyson FRCVS outlines the pros and cons

Expert advice for feeding a horse to avoid gastric ulcers

Education will help us hear what our horses are trying to say *H&H Plus*

The Ridden Horse Pain Ethogram: how the phrase ‘that’s the way the horse has always gone’ is being challenged

For years it’s been thought that horses who swish their tail, put their ears back and open their mouth when

Subscribe to Horse & Hound magazine today – and enjoy unlimited website access all year round

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

Welcome to the fifth weekly episode of The Horse & Hound podcast, in which we chat to top dressage rider, trainer and H&H columnist Anna Ross; our news team discuss the key stories of the week including the possible reinstatement of next year’s European showjumping championships; and vet Ricky Farr talks about gastric ulcers and in what circumstances vets can use drugs that are not licensed for equine use

Now live is episode five of The Horse & Hound Podcast, our exciting new audio service available exclusively every Thursday morning for our H&H Plus subscribers.

In an exciting development, we have decided, for a limited time, to make each episode available for all H&H fans to listen to, 24hrs after its early release to our H&H Plus members. This will allow more listeners to make The Horse & Hound Podcast an essential part of their week on Friday morning. We would love to hear your feedback on this week’s episode, so please do send your thoughts to pippa.roome@futurenet.com

Visit Horse & Hound on soundcloud for all our podcasts

In episode five, our dressage editor Polly Bryan chats to British grand prix dressage rider, trainer and H&H columnist Anna Ross about how she got into the sport from a non-horsey background, the best advice she’s learnt along the way, which of her horses she spent more time running after than riding when he was young and the horses she’s excited about right now.

Our podcast host H&H’s magazine editor Pippa Roome chats to our news editor Eleanor Jones and senior news writer Lucy Elder about this week’s top stories including the possible reinstatement of the European showjumping championships and what’s happening in equestrian sport closer to home.

We also hear from equine vet Ricky Farr MRCVS of Farr & Pursey Equine, who this week is talking about the ways to treat different types gastric ulcers in horses and when vets can use treatment options that are not licenced for horses.

We hope you will enjoy it.

H&H Plus podcast: episode five

What did you think of this week’s podcast? Let us know by emailing pippa.roome@futurenet.com

Listen now to other episodes of the H&H podcast…

The Horse & Hound Podcast: episode four – Polly Jackson on Two For Joy | Vet advice: common healthcare mistakes | News round-up

Our news team discuss the week’s top stories, eventer Polly Jackson remembers her small but mighty skewbald partner Two For

The Horse & Hound Podcast: episode three – Natasha Baker | Vet advice: lameness examinations | News round-up

The Horse & Hound Podcast: episode two – H&H’s royal exclusive | Cuddy-winning hobby breeder | Vet advice: worming

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Cribbing horses are more likely to be reacting to stress than to stomach discomfort, a new study has suggested.

Researchers from the Royal Agricultural University (RAU) have found that while crib-biting and gastric ulcers in horses may not be directly linked, stress could be the common denominator.

The study, published in the peer-reviewed Journal of Veterinary Behaviour (March-April 2019), looked for the presence of ulceration, stomach pH, and gastrin — a hormone that stimulates the production of stomach acid.

The team looked at the stomachs of 42 dead horses — half of which were crib-biters — in the two-part experiment.

The RAU team found there was no difference in the concentrations of gastrin producing cells or the acidity in the stomachs between crib biting and non-crib biting horses.

While the sample size and logistics are limitations — as cadavers may not accurately reflect the physiology of the living stomach — the non-invasive approach has shed further light into the conditions.

“These findings suggest that anatomically and physiologically the stomachs from crib-biting and non crib-biting horses, in this study, were not different from each other,” said lead researcher Dr Simon Daniels, of RAU’s school of equine management and science.

“However in both humans and horses gastric ulceration is associated with stress — both environmental stressors and physiological stress, such as from increased free radical production and too few antioxidants.

“Similarly crib-biting behaviour is understood to be a stress coping mechanism for horses. These horses display higher levels of free radicals and reduced antioxidant defences, which is a sign of physiological stress, when compared to non crib-biting horses.”

He added that therefore crib-biting and gastric ulceration may not be directly linked conditions, “but the conditions may be linked together by stress”.

“If this is the case then management of horses that suffer with these conditions — for example by giving nutritional antioxidant support and reducing environmental stress by changing housing or turnout arrangements — may be beneficial in the welfare of this specific group of horses,” said Dr Daniels.

You might also be interested in:

Gastric ulcers: answers to horse owners’ most frequently asked questions

Confusion often surrounds the cause, diagnosis and treatment of gastric ulcers. Richard Hepburn MRCVS draws on the latest veterinary thinking

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Owners failing to act to help horses with ulcers

Although awareness is high, fewer people than expected are using recommended methods of managing the condition

For all the latest news analysis, competition reports, interviews, features and much more, don’t miss Horse & Hound magazine, on sale every Thursday

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Owners of horses with gastric ulcers are not doing enough to manage the condition, a research project has indicated.

Responses to an online questionnaire showed that although there is awareness of the key ways of managing horses with ulcers, some of these methods are not being widely used.

Of the 267 people who took the survey, 61% knew or suspected that their horses were suffering from equine gastric ulcer syndrome (EGUS).

When asked about key prevention methods, 96% were aware of feeding high levels of fibre or forage, 91% knew plenty of turnout is important and 84% knew feeding a double handful of chaff 20 minutes before exercise will help reduce acid splash.

But while 67% of respondents who believed their horses had EGUS had increased access to hay or fibre, only 55% were feeding chaff before work.

It is understood avoiding feeding cereals and starch is beneficial as these generate increased acidity in the stomach, but only 38% said they had cut these out of their horses’ diets.

“While we fully understand that some EGUS management techniques are not within everyone’s power to deliver, feeding before exercise is quite easy to do, and reducing starch is universally recognised as being essential for managing EGUS,” said Katie Williams of feed manufacturer Dengie, which commissioned the research.

“I’d certainly hope to see both of these strategies used more consistently.”

EGUS affects roughly 40% of leisure horses, 60% of competition horses and up to 90% of racehorses.

Dengie said it was “impressive” that 83% of respondents knew different types of ulcers affect the different regions of the stomach; the glandular and squamous areas.

Continues below…

Gastric ulcers: understanding what is fact and what is fiction

An alarmingly high proportion of competition horses are being diagnosed with stress-related gastric ulcers, but what are the facts?

Gastric ulcers in horses: the important facts every owner needs to know

“This is important as we are really only just starting to understand the factors that contribute to the problem and how to manage it,” said a Dengie spokesman.

“Our next steps are to investigate why more horse owners than we anticipated are not implementing all the recommendations for feeding and managing horses with EGUS.”

For all the latest news analysis, competition reports, interviews, features and much more, don’t miss Horse & Hound magazine, on sale every Thursday.

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Spillers' equine nutritionist Clare Barfoot provides one H&H forum user with some helpful advice on how to feed a horse with suspected gastric ulcers

Q: “My dressage horse hasn’t been quite right. He hates having his rugs on, fidgets when I tack him up, is fussy about having his feet picked out with his saddle on, has started moving away when I try to get on and is reluctant to go off my leg as much as he was. All of these signs lead me to think he might have gastric ulcers. If the vet tells me this is the case, what recommendations do you have for feed and supplements? He is in substantial work.”

A: You are right to investigate gastric ulcers especially if these are all new behaviours at least to confirm or eliminate ulcers as a cause. If your vet does confirm a diagnosis firstly he will need to be medically treated to clear up any existing ulcers. However as ulcers can be caused by many factors it is important to address all the potential management factors you can, one of the most important is nutrition and nutritional management.

Continued below…

Related articles:

• H&H forum: find out what H&H readers suggested
• Find out more about gastric ulcers
• How to keep gastric ulcers at bay: simple 12-step plan *H&H VIP*

• Try to follow the tips below to help reduce the risk of the ulcers re-occurring:
• Feed as much fibre/forage as possible at a minimum of 1.5% of bodyweight (dry matter) per day.
• Avoid prolonged periods without forage.
• Avoid straw being the sole or predominant forage source.
• If extra energy is needed look for feeds that have restricted starch and sugar levels and added oil rather than cereals.
• Aim to feed < 1g/kg bodyweight of non-structural carbohydrate (NSC: starch plus water soluble carbohydrate) per meal and preferably Try to spread meals across the day- multiple small meals are better than one or two large ones.
• Add chopped fibre to every meal – especially alfalfa which has been shown to help buffer gastric acid.
• Avoid very stalky sharp chopped fibre which can increase the risk of damage to the stomach wall.
• Provide a small chopped, fibre based meal or access to forage before exercise to reduce gastric acid splashing up onto the sensitive unprotected upper non-glandular part of the stomach.
• Turn out to pasture as much as possible.
• Provide access to water at all times.
• Avoid using electrolyte pastes.
• Provide forage while travelling.

Continued below…

As your horse is working hard he will need additional energy to help maintain his condition. I suggest you try a high fibre, low starch cube such as SPILLERS RESPONSE Slow Release Energy Cubes alongside SPILLERS Alfalfa-Pro Fibre. SPILLERS has introduced Alfalfa-Pro, a high quality conditioning alfalfa blend with oil, supporting horses prone to gastric ulceration. SPILLERS Alfalfa-Pro is one of only five products in the UK to carry the prestigious BETA Equine Gastric Ulceration Syndrome (EGUS) Certification Mark.

For more information on feeding to support weight gain call the SPILLERS Care-Line on 01908 226626.

Stay in touch with all the news in the run-up to and throughout the major shows and events during 2026 and beyond with a Horse & Hound subscription. Subscribe today for all you need to know ahead of these major events, plus online reports on the action as it happens from our expert team of reporters and in-depth analysis in our special commemorative magazines. Have a subscription already? Set up your unlimited website access now

Can equine eyeballs reveal stress levels — and do semi-feral ponies suffer from gastric ulcers? Peter Green MRCVS explains all in his research round-up

The eyes have it

Stress response is a normal, healthy process involved in the switch from “resting and digesting” to “up and ready for action”.

Scientists have demonstrated that in a number of species, including horses, the temperature of the eyeballs correlates with the level of stress the animal is experiencing.

Research has proven that the stress levels of showjumpers can be measured by this method. Without touching the horse or taking any samples, scientists can assess stress by pointing a sensitive thermography camera at the eye. The temperature of the eyeball goes up when a horse is stressed.

Spanish scientists have just published work on dressage horses. They measured eyeball temperatures during dressage competitions in 343 stallions aged between four and six. They then compared these temperatures with the dressage scores and analysed the breeding of each stallion.

The first part of the study was as expected: for individual horses, eyeball temperature went up during the test and came down again afterwards. This confirmed that dressage tests are stressful.

But when they compared achievement with stress levels they found that the stallions who appeared more stressed were the ones more likely to score highly. This seems to show that youngsters with an enhanced stress response make better dressage horses — they are literally more “on their toes” when they need to be.

Finally, the scientists showed that there were strong indications that both eyeball temperature and stress in response to performance were highly heritable. This suggests that young potential dressage horses might be screened for future achievement by measuring the rise in the temperature of their eyeballs when they are in training as juveniles.

New findings on ulcers

Gastric ulcers are a well-recognised problem in domesticated horses. Glandular ulcers affect the bottom part of the stomach submerged below the acid gastric juices, while squamous ulcers occur higher up where acid sloshes up only during exercise and immediately after eating.

Current wisdom is that ulcers are caused by stress, exercise and relatively unnatural intensive feeding for performance.

So we would predict that semi-feral Exmoor and Dartmoor ponies, animals that live a life just about as close to that of a wild horse as possible, would not be bothered by gastric ulcers. After all, they simply eat, breed and mooch about like the wild horse before domestication.

A recent study had surprising results. Scientists carried out postmortem examinations of the stomachs of 60 horses that had been kept in fully domesticated conditions, and 29 feral ponies from the moors. The samples were all taken from animals slaughtered in mid-summer, when grazing was at its best and the predicted environmental stress at its lowest.

When the stomachs were examined, both kinds of ulcer were found in more than 60% of fully domesticated horses — a higher figure than expected. Even more unexpected was the finding that one or other kind of ulcer occurred in more than 20% of the wild ponies.

There are several possible explanations for this. Perhaps ulcers can form really quickly and the moorland ponies developed them between round-up and slaughter. Or maybe they are not living such an idyllic, stress-free, wild lifestyle after all.

It could be that gastric ulcers are a product of domestication, reflecting the fact that moorland ponies are domesticated ponies that have become feral — rather than truly wild equids such as zebras.

Ref: Horse & Hound; 21 January 2016

Richard Hepburn MRCVS outlines how to heal gastric ulcers and prevent their recurrence

Your horse has been diagnosed with gastric ulcers in the squamous tissue lining the top third of his stomach — so where do you go from here? An online search will reveal a bewildering array of advice and so-called remedies, yet treatment and ongoing management is effective and relatively straightforward if broken down into two stages.

Stage one: the most effective way to resolve ulcers is with an equine-specific form of omeprazole, given at a bodyweight-appropriate dose for a period of time sufficient for the severity of his case. Squamous lesions that are widespread and shallow heal faster (within 14-21 days) than more focal, deep lesions, which can take up to 28 days. At the same time, subtle changes should be made to feeding and management to limit gastric acid production and the mobility of acid within the stomach.

Stage two: complete healing occurs in up to 80% of squamous cases. Gastroscopy should ideally be repeated, but if the horse has responded well then this can be skipped and the horse put onto maintenance treatment for two to three months. Simply stopping all treatment at this point is associated with a high ulcer recurrence rate (approximately 80% within six weeks).

For squamous lesions there are two maintenance options: first, continue using equine-specific omeprazole, but reduce to a quarter dose. This is very effective and also user-friendly as it is a once-a-day treatment.

The second option is to use an acid-neutralising feed supplement (containing aluminium hydroxide, magnesium hydroxide and calcium carbonate — think “Rennie” for your horse). This approach is less consistent and the supplement must be given three to four times daily, as its effect is short-lived.

With either option it is vital that protective feeding and management changes are continued.

This two-stage plan has worked in thousands of horses over the past 15 years. There are a variety of other supplements containing different fibres or proteins, seaweed, plant or mineral extracts; however, none of them has been shown to be clinically effective in either the treatment or prevention of squamous ulceration.

Glandular ulcers, affecting the bottom two-thirds of the stomach, will need additional treatment with the mucosal protectant sucralfate.

12-step plan for preventing gastric ulcers in horses

• Allow access to high-quality forage, predominantly during the day (7am to 11pm), at a minimum daily rate of 1.5kg/100kg body weight (BWT). This should ideally be given continuously or at no more than 6hr intervals.
• Create multiple forage sources in the stable to improve eating consistency and allow foraging activity.
• Use hay (dry, soaked or steamed) or haylage as a forage source — there’s no difference between them in relation to ulceration.
• Feed no more than 0.25kg/100kgBWT of straw. This should not be the only forage source.
• Provide continuous access to fresh, clean water 24hrs a day.
• Split the concentrate ration into three rather than two meals per day.
• Opt for grains such as barley and oats instead of sweet feeds.
• Add chaff to all meals.
• Remember that completely pelleted diets generate more stomach acid than the same diet formulated as a coarse mix.
• Buy high-quality feed, but bear in mind that there is no evidence to support the use of specific “gastric healthy” commercial diets, nor of one manufacturer’s feed being better than another’s.
• Add a little corn oil or rapeseed oil (50-100ml per day) to help reduce the amount of stomach acid produced.
• Consider using fermented probiotics and the yeast saccharomyces cervasii, which may increase the digestibility of the horse’s diet, so improving large intestinal function.
• Also, try feeding chaff before exercise — 2 litres chaff given within 30mins of exercise may trap acid and limit ulceration, and improve gastric blood supply. Use a 2-litre plastic drink bottle with the top cut off as a measure.

H&H 24 December 15

Confusion often surrounds the cause, diagnosis and treatment of gastric ulcers. Richard Hepburn MRCVS draws on the latest veterinary thinking to answer horse owners' most frequent questions

What’s the difference between squamous and glandular ulcers?

Squamous gastric ulcers in horses affect the top, white-coloured third of the stomach, and reflect increased acid exposure of the tissue.

These ulcers form quickly and are consistently associated with changes in appetite, slowed eating and poor performance. Inconsistent changes in behaviour and/or attitude can also occur.

Squamous ulcers can occur with daytime forage deprivation, lack of access to water, high-starch diets, pelleted feeds, straw feeding, intense exercise, travel, a change in housing and lack of daily horse-to-horse contact.

Treatment with an equine formulation of the acid suppressant drug omeprazole is consistently very effective, with most lesions healing within 14-28 days.

Glandular ulcers affect the pink, bottom two-thirds of the stomach, in particular the final part.

Ulcers here form slowly and reflect failure of the mucus coat that protects glandular tissue from acid. It is likely that several different causes — physical, toxic, bacterial or physiological — contribute to this failure. The clinical signs are more variable, and may or may not include appetite change and/or weight loss. Some horses may start to resent the girth being tightened, but this is not specific.

Treatment with omeprazole alone is much less effective than in cases of squamous disease (25% healed after 28-35 days). Instead, a combination of omeprazole and the mucosal protectant sucralfate is used, leading to a 68% healing rate.

Q Why do so many more horses now seem to suffer from ulcers?

The prevalence of squamous gastric ulceration in racehorses in full training is unchanged from 30 years ago, at more than 80%. Interestingly though there are some yards where ulcers are much less frequent, most likely due to protective feeding and management strategies. In sport and leisure horses the prevalence is lower, at 17-60%.

The occurrence of glandular ulceration in racehorses and sport and leisure horses is 30-60%.

Any apparent increase is more likely to be due to increased awareness of the condition, and hence increased willingness to have gastroscopy performed. For example, in 2005 I gastroscoped 150 horses — this year I have looked at more than 400.

Q A horse at my yard has hindgut ulcers — is this something different?

There is much debate as to what “hindgut ulcers” actually are. The study originally performed to identify hindgut ulcers used horses from abattoirs without any clinical history, and so the relevance of the lesions detected is unclear.

A hindgut disease we have more understanding of is inflammatory bowel disease (IBD). In this condition large portions of the hindgut become inflamed and thickened, even shedding part of their surface layers. This causes weight loss, intermittent diarrhoea and/or recurrent colic, but rarely affects behaviour or performance.

Diagnosis of IBD is made by a combination of abdominal ultrasound, blood tests to identify low protein levels, absorption studies and intestinal biopsy. Treatment involves three months of the anti-inflammatory corticosteroid prednisolone, and is successful in 70% of cases.

Further study into whether hindgut ulcers are able to cause behavioural change and poor performance is required, as these signs are rarely seen in IBD, which is a more severe hindgut disease.

Q Are any of the new screening methods effective?

Bleeding from gastric ulcers is not a common or consistent finding, so faecal blood/albumin testing is not recommended. The test is also unable to distinguish between squamous and glandular disease, and so targeted treatment is not possible.

A better screening approach is to look for significant clinical signs developing in your horse: appetite change, slowed eating, below-par performance and potentially development of behavioural change or resentment of girthing.

The Succeed test is a combined faecal occult blood and albumin test that detects blood (originating from anywhere within the gastrointestinal tract) and albumin (lost when the large intestine is inflamed).

It is marketed as a screening test for gastric ulcers (described as “foregut” bleeding), yet a recent Australian study of 44 horses with squamous and glandular ulceration showed no association between the test result and gastroscopy findings.

The test is also marketed as identifying infectious, inflammatory, traumatic, neoplastic and parasitic causes of large intestinal protein leakage, broadly classified as hindgut ulcers. False positive results can occur, however, in horses that have recently had endoscopy or dentistry, during ovulation in mares, in horses with exercise-induced lung bleeding, for five days after deworming, 24 hours after a rectal examination and in horses that have eaten hard or rough particles of feed.

Q Could my horse’s recent spookiness be due to ulcers?

In racehorses, squamous ulceration can reduce stride length, limit training progression and reduce the time to fatigue — potentially as a result of low-grade pain affecting abdominal strength and mechanics of breathing. Similarly, treatment studies have shown improved performance measures in racehorses after ulcer resolution.

The evidence for more specific signs such as spooking or refusing, or for behavioural change, is anecdotal. If ulcers in an individual horse are suspected to be causing these then clinical improvement should occur as the ulcers heal, and so a critical appraisal of the value of treatment at repeat gastroscopy is essential.

Q My horse is a healthy-looking good-doer. Could he still have ulcers?

Yes, there is a population of horses that appear normal, but who benefit from diagnosis and treatment of ulceration. At the same time there are horses that have the same ulcers yet show no clinical signs and no benefit from treatment.

Unfortunately it is not possible to distinguish these cases by endoscopy alone, and so a period of test treatment with omeprazole is used to assess their ulcer relevance.

Q Are ulcers more likely in any particular breed?

Thoroughbreds appear to have a breed predisposition to squamous ulcers, whereas warmbloods are more frequently found to have glandular lesions.

Most horses will be average acid secretors — while a few will produce either more or less. It is reasonable to expect high acid secretors to be more likely to have gastric ulcers.

Q My vet has prescribed a form of omeprazole. Is it safe to use?

Gastrogard is the original equine-specific form of omeprazole.

Safety studies performed on Gastrogard (overdose and prolonged duration studies) did not show any evidence of significant side effects. Hundreds of thousands of doses have been given worldwide over the last 20 years, with minimal adverse events reported (far fewer than for common drugs such as bute or antibiotics).

In the UK there are now two generic forms available: UlcerGold and Peptizole. Studies and clinical experience suggest there is little difference between the available formulations in most horses.

Ref: Horse & Hound; 17 December 2015

A definitive diagnosis combined with a properly targeted treatment programme is essential to the successful management of gastric ulcers in horses – equine gastric ulceration syndrome (EGUS). These key steps should aid the chances of a speedy recovery and help prevent the problematic cycle of repeat ulcer formation.

➤ Step 1

Identify the problem. The development of significant clinical signs — appetite change, weight loss, poor performance or adverse reaction to girthing — within the preceding 6-12 weeks suggests the presence of EGUS. Gastroscopy is the definitive diagnostic test. Squamous or glandular lesions of grade two, three and four and above are considered significant.

➤ Step 2

Formulate an appropriate treatment plan. Primary squamous disease is treated with acid suppressants. The most effective is equine-specific omeprazole, with GastroGard being the most studied formulation. Superficial lesions heal very rapidly (within 14 days), whereas focal, deep lesions take a week or two longer.

The omeprazole dose can be halved if the drug is given in the morning on an empty stomach and the horse is fed 30 minutes later. This increases drug absorption by up to 300%.

Primary glandular disease is treated with a combination of omeprazole and the coating agent sucralfate, but lesions take 28 days or more to heal.

For both diseases, subtle management changes are recommended. Provide free access to roughage in the daytime, add corn oil to the diet to reduce acid production, and feed a small chaff meal within 30 minutes of starting exercise to limit splash ulceration.

➤ Step 3

Assess the clinical signs and the endoscopic response, with repeat gastroscopy, after initial treatment. If the lesions have healed but the horse’s signs have not changed, the ulcers were not relevant to the problem. If the lesions and clinical signs have only partially improved, prolonged or modified treatment is needed. If the lesions have healed, move on to preventative treatment.

➤ Step 4

Prevent ulcer recurrence with a combination of long-term management changes and therapy. A quarter-dose of omeprazole given once daily is most consistently effective. An alternative for squamous disease is an antacid supplement of calcium carbonate, magnesium and aluminium hydroxide, given up to four times daily. For glandular disease, another option is a coating agent supplement containing pectin and lecithin, given up to twice daily.

This article was first published in the 25 September 2014 issue of Horse & Hound magazine

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So much for summer, it’s back to the wind and rain again. My week started with a follow-up gastroscope for a really nice Welsh pony mare who had a prolonged episode of colic due to an impaction last month. A combination of the stress of hospitalisation and extended period of feed restriction (while the impaction resolved) resulted in some nasty gastric ulcers and a miserable pony.

Not all ulcers heal at the same rate and, not surprisingly, deeper ulcers take longer. Therefore it’s important to re-scope to know for certain when treatment can be completed. In this case, the mare had shown a great response clinically and was bright and comfortable, but the gastroscopy showed that, although significantly improved, the ulcers have not completely resolved yet. She needs a few more weeks of medication to ensure full healing.

After a trip to Leicestershire to give a talk to other vets about the management and prevention of gastric ulcers in horses, it was off to Chatsworth on Friday for a weekend of eventing. The chilly weather and occasional showers did nothing to dampen everyone’s spirits. After many years working at horse trials, I have learnt to keep my car fully stocked with woolly hats and spare jackets even in the middle of summer.

There is a large team of vets working behind the scenes at most big horse events. As well as the FEI vets, whose main job is to ensure the health and welfare of the horses during the competition, there are vets positioned out on the course and at the finish to provide emergency treatment where required. My role at Chatsworth is to look after the horses once they leave the course, which can range from treating minor nicks to more significant injuries.

My colleague Peter Clegg — an orthopaedic specialist from the University of Liverpool — and I were kept pretty busy on Saturday morning with a flurry of activity, including a horse returning in the horse ambulance with a tendon injury, another arriving with a laceration to the pastern involving a blood vessel and significant bleeding, and, just for a bit of variety, a lurcher with numerous skin wounds requiring stapling. There were also a few horses that were a bit stiff and sore after falls, but nothing too serious. Add to this the passport checks, trot-ups and hold box duties, and the vet team certainly had plenty to do.

Inevitably, I always head home after these events knowing exactly which horses were injured, but having no idea who actually won…

Rachael

Picture from left to right: vets Peter Clegg, Rachael Conwell and Peter Bowling

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Yorkshire-based referal vet Rachael Conwell specialises in equine internal medicine. She will be blogging for Horse & Hound during May to help raise awareness of equine gastric ulcer ‘InnerVision’ month

As an internal medicine specialist, the next few months are particularly exciting for me; a colleague, Richard Hepburn, is carrying out what we believe to be the world’s first large scale equine ulcer study, as part of his PhD study at the University of Liverpool.

Over 200 performance horses registered with British Dressage, British Eventing and the British Show Jumping Association will be gastroscoped during May via 21 veterinary practices across the UK.

The aim is to improve our understanding of the causes and effects of equine gastric ulcers on performance horses, and how to best manage and prevent them. Much of our current understanding of ulcers comes from studying racehorses, which have very different management and training regimes, so this study will provide new and important information. I am contributing by gastroscoping competition horses on yards in the North East, around my usual caseload.

Common presenting signs of ulcers include discomfort on girthing up, reluctance to work, behavioural changes, and sometimes colic. However during May we are also scoping competition horses without obvious clinical signs, to determine the significance of the lesions we see in this population. It should provide some really useful observations and help target more effective treatment and prevention.

As an estimated 60% of performance horses have ulcers to varying degrees, we expect to find ulcers where riders may not have considered them as an issue. Signs can be very vague and attributed to other causes of poor performance such as back pain, behavioural issues or stress.

It’s not just gastric ulcers that fill my case load. Weight loss, respiratory problems, heart issues and poor performance are just some of the range of problems I see each week, especially at this time of year when performance horse training on many yards steps up a notch.

Stay up to date with Rachael’s weekly highlights as she travels throughout the north of England providing specialist support to equine practices in the region.

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Ongoing studies carried out by Merial Health have found that 76% of elite event horses have gastric ulceration, between 98-100% of racehorses in training are effected and 50% of leisure horses also suffer from the problem.

But with this alarmingly high proportion of competition horses being diagnosed with stress-related gastric ulcers, what are the facts and what is just myth?

• If your horse hasn’t had colic it won’t get stomach ulcers

Fiction: Less than 3% of racehorses with ulceration have had colic.

• A sore or cold back could be an indication of gastric ulcers

Fact: Increasingly, gastric ulceration is found in horses that are reported as having back pain. Often, a horse who has a history of pain on girth tightening is found to have gastric ulcers.

• Gastroscopy is a non-invasive procedure

Fact: Scoping for stomach ulcers is not difficult or painful. It takes about 10min and there is very little discomfort for the horse.

• If my horse is turned out regularly it won’t get ulcers

Fiction: A study carried out on racehorses in New Zealand in 2004 showed that those who were trained from pasture still had a high level of ulceration. Also, turning a horse out with gastric ulcers will not cure him. A dramatic change of routine such as this will lead to increased stress.

For the full article on gastric ulcers, see the current issue of Horse & Hound (7 May, ’09)

Today (Friday 1 May) is the start of Gastric Ulcer Awareness Month 2009 (GUAM). To mark the occasion the UK’s first online gastric ulcer risk assessment for horse owners has been launched by Merial Equine Health.

The assessment process is an tickbox questionnaire, aimed at owners, riders or trainers to work out their horse’s risk of ulcers.

According to Merial Equine Health around 90% of racehorses in training have gastric ulcers. And about 60% of performance horses and 40% of leisure horses are also affected.

Dr Emma Batson from Merial Equine Health said: “While humans only secrete acid into the stomach when they eat, horses, who are designed to be constant trickle feeders, release acid into the stomach constantly, regardless of whether or not they are eating.

“With modern stabling and exercise, the vulnerable top part of the horses’ stomach can become exposed to acid why, and ulcers can develop.”

The stomach of a horse suffering from gastric ulcers

Signs of ulcers include poor performance, picky appetite, mild weight loss, starey coat, discomfort on girth tightening, colic and salivation, and teeth grinding in foals.

Results will be returned by email. Horses which are identified as having a medium to high ulcer risk will be referred to their vets by Merial.

Dr Batson added: “Following the first two GUAM initiatives in 2007 and 2008, many more horses have been identified, diagnosed and successfully treated for gastric ulcers.

“Due to the vague nature of the signs, many of these horses were previously suspected of other ailments such as back and teeth problems, general poor performance, or behavioural issues.

“Our goal is to move gastric ulcers further up the diagnostic process, so the condition is an early consideration for all horses presenting with the vague symptoms associated with ulceration.”

For more information or to complete the questionnaire visit: www.gastriculcerrisk.co.uk

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Q: My six-year-old gelding, Kipper, was successfully treated for gastric ulcers earlier this year. Afterwards, I was advised to turn him out for four weeks, which I have done.

He has put on weight and is much more relaxed. I know he needs to be on a high-fibre, low-starch diet now he is back in work and his education is continuing. However, he doesn’t like alfalfa or sugar beet and many feeds don’t state the starch content.

He is a slow, fussy eater, with a small appetite. He also suffers from stress at times, and his red cell blood count is at the low end of normal. He lacks energy and tires easily, so I had a blood test done, but it came back as “unremarkable”. What feed would you suggest to protect him against future ulcers, give him energy and some topline or muscle?

A: “Studies around the world have established that between 85-90% of racehorses and 75-85% of sport horses suffer from gastric ulcers,” explains nutritionist Dr Teresa Hollands of Dodson & Horrell. “They happen when the acidity production exceeds the protective factors. Saliva provides the most buffering within the equine stomach, so any changes to diet that reduces saliva will increase the risk of gastric ulcers.

“Horses are trickle feeders, so their stomachs produce acid all the time: they therefore need to be producing saliva frequently. Horses produce 1ml of saliva per chew. They chew about once every second and take around 4,500 chews to eat a kilo of forage and 1,200 chews to eat a kilo of concentrates.

“This is why it is vital to ensure adequate fibre intake before you consider any bucket feed. Decreased fibre means decreased chews, decreased chews means decreased saliva production, decreased saliva production equals ouch!

“Decreased fibre intake also means that B vitamin synthesis in the hind gut is likely to be compromised. Reduced B vitamins are associated with loss of appetite and irritability. Increasing his fibre will therefore help rectify several of your concerns. It would also be worth giving Kipper a vitamin B supplement until his fibre intake increases.

“From information and photographs you have supplied, Kipper appears to be at an ideal weight and condition — you can feel his ribs but not see them — but you are worried about his lack of topline and muscle.

“These will improve automatically once you are able to put more work into him. In spite of his fussy attitude to food, you obviously have the correct calorie intake, so I would not advise feeding any more calories.

“It should be very achievable to provide a balanced diet for him on 3-4lb of energy food.”

Teresa has conducted a thorough examination of Kipper’s current diet and regime, and sent his owner a detailed report with specific recommendations on his diet.

In general for horses prone to gastric ulcers, she recommends:

• Ad lib fibre; minimum of 2% bodyweight for horses in light work, 1.5% for performance horses
• Fibre does not have to be simply low-calorie roughage. Any fibre source that stimulates chewing and therefore saliva production should be encouraged. High-calorie fibre sources for the performance horse include alfalfa chaff, grass chaff, sugar beet shreds
• Daily turnout on best possible grazing to ensure anti-oxidant intake, including vitamin E and psychological entertainment
• Feeds should be small and fed little and often so saliva production is spaced through the day
• Feeding starch as an energy source for performance horses is fine as long as enough fibre is fed and the starch meal sizes are small
• Minimise stress in the horse’s life
• Ensure the diet is balanced
• Useful supplements might include anti-oxidants, B vitamins, Yea-sacc

Have you ever had a horse who became increasingly fractious throughout the season, struggled to hold condition and never had a shining coat, no matter how much effort you put in? He may well have been affected by the ongoing pain of gastric ulcers.

These ulcers are not thought to be new but advances in diagnosis, through video endoscopes, have highlighted their existence.

It is now commonly accepted that the “at-risk” horses are those in training – the incidence of gastric ulcers in racing is reported at 80-90% and in competition horses at 50%. However, any horse fed limited amounts of forage and a few separate meals per day has the capacity for gastric ulcers, including dieting ponies, show animals or sales preparation youngstock.

Equine gastric ulcer syndrome (EGUS) is probably a man-made syndrome. The root cause is the imbalance between how the horse evolved to eat and how we now feed.

The horse was designed by nature as a trickle feeder and acid is produced continuously in the stomach in the expectation of food. The acid is produced in the lower part of the stomach, which has in-built protection from it – in the upper part of the stomach, where no acid is produced, no such protection exists.

The acid is buffered when a horse eats by the saliva it produces as it chews. Horses are different to us, and salivate only when food is present. A horse chews less on a high compound diet than a high forage diet, so the capacity for mopping up the acid is less on a diet that offers separate meals of hay and hard feed. This sort of regime also means that the acid is needed only at set feeding times.

So in a situation where there is more acid than buffer, it is easy to see why the physical mixing effect caused by any movement will create ulcers in unprotected areas of the stomach.

Stomach settlers

• The “Zantac” of equine ulcers is Gastrogard, the brand name of the drug Omeprazole. This inhibits gastric acid secretion in the stomach and is highly effective but very expensive.
• Short-term relief is offered by unproven products based on traditional antacids such as calcium carbonate (limestone, rather like a Rennie).
• Herbal preparations that support gastric health include marshmallow (mucilaginous), meadowsweet (said to heal lesions and act as an antacid), and slippery elm (an anti-inflammatory herb).
• All of these treat the symptoms rather than the root cause. Any change back towards a more natural diet will reduce incidence.
• Gastric ulcers disappear if an affected horse is rested and turned out to grass. Alternatively, offer forage or short-chopped fibres ad lib — horses produce twice as much saliva when chewing long fibre as they do grains.