Gastric Ulcers

Equine Gastric Ulcers Syndrome (EGUS):

Gastroscopy - Philip IvensGastric ulcers are common in all types of horses including sports horses and leisure/pleasure horses. Alot of the information available on EGUS has focused on racing thoroughbreds (TBs) however a number of equine internal medicine specialists in the UK and around the world have begun to understand the disease in different horse types. Buckingham Equine Medicine Referrals performs gastroscopy for Buckingham Equine Vets clients and clients from other clinics. Philip's case-load of gastric ulcers consists of diverse horse types and uses including dressage, eventing, show jumping and show ponies/horses. EGUS can be more complicated than in traditional racing TBs therefore accurate diagnosis of the type of ulcers is essential and requires the latest equipment and expertise. 

What are gastric ulcers:

EGUS is a syndrome of a diverse group of diseases that effect the lining of the stomach causing inflammation and leading to erosions of varying depth. Importantly there are two different types of lining of the horses stomach; 1) Squamous (white in pictures) 2) Glandular (pink/red in pictures). What causes ulcers is complicated and probably differs between squamous and glandular ulcers. What are the clinical signs of ulcers (EGUS):
These are non-specific and different for every individual horse. These include:
  • Gastroscopy Philip IvensColic - usually low grade and recurrent
  • Poor appetite and/or weight loss
  • Dull, starry coat.
  • Poor performance
  • Behavioural changes - e.g. discomfort on girthing, resentment to grooming, stretching out to urinate, lying down excessively.


Diagnosis relies on a careful and detailed istory of the horse/pony including diet, exercise and daily routine. The starved (18-24hrs) patient is then gastroscoped with a specially long endoscope by a appropriately qualified person (e.g. specialist in equine internal medicine). The stomach is then inflated/washed to allow detailed examination of all areas of the stomach including the fundus, cardia, margo plicatus, pylorus and duodenum. The ulcers are graded on an international scale for each anatomical position and differentiating squamous and glandular ulcers. The air is then removed by suction pump. Please click here for detailed notes for owners on how to prepare your horse for gastroscopy

Horse ColicEquine Gastroscopy


Treatment relies on detailed anaylsis of the patient's diet, routine and exercise. Proton pump inhibitors such as omeprazole (Gastroguard) are the corner stone for treatment of many patients however other treatments include mucosal protectants such as sucrulfate, pectin/lecithin (eg. Equitop Pronutrin, Gastrocare), anti-microbials and histamine antagonists (e.g. Cimetidine, ranitidine). Dietary manipulation is also key and Philip works with your food manufacturers/nutritionists to get the right balance for your horse. Getting the right and sustainable cure is unique to that patient and can take detailed investigation. Repeat gastroscoping can be very helpful in evaluating treatment and dietary/routine changes as gastric ulcers often do not show clinical signs straight away (ie they are subclinical for a time).

Gastrogard - Horse Gastroscopy Gastrocare - Equine Gastric Ulcers Pronutrin - Equine Colic