Picture 1. Stomach anatomy
There are many factors reported to contribute to ulcers
– these include “stress” (of which there can be many trig-
gers), travel, intense training / exercise, high levels of
concentrates versus forage, temperament, water intake,
lack of pasture access and even the presence of a radio
24 hours a day!
Diagnoising the patient through endoscopy
The mainstay of gastric ulcer treatment is inhibition of
the gastric acid secretion (Picture 4). Currently
omeprazole is the drug of choice. There are several
different forms of omeprazole with both treatment and
maintenance doses. Sucralfate is a medication that lines
the ulcer to prevent further damage and seems to be
more effective in the glandular ulcers. Occasionally with
very severe persistent ulcers antibiotics may be con-
sidered. Helicobacter has been shown to cause ulcers in
people but not in horses, there may be however, another
infectious component, which has yet to be isolated.
Occasionally with extremely
severe ulcers at the pylorus,
misoprostol may be used.
As well as medications it is also
important to evaluate the nutri-
tion and management to attempt
to minimise factors that maybe
contributing to the development
of ulcers.
Picture 2. Ulcers in the non glandular portion (above the
margo plicatus)
Given the high propensity for the
performance horse to develop
ulcers, if there is a suspicion of
ulcers or if the horse doesn’t
appear to respond to medication,
then gastroscopy is definitely
advised – after all an equine
athlete marches on it’s stomach.
Picture 4. Ulcer medications
Picture 3. Ulcers at the pylorus
November • December • 2018 • The Australian Quarter Horse Magazine • 31