Equine gastric ulcer syndrome (EGUS) affects up to 60% of performance horses and 30% of leisure horses, making it one of the most common gastrointestinal conditions veterinarians encounter in equine practice. Horses with ulcers often show subtle signs like poor appetite, weight loss, dull coat, or behavioral changes, but the condition is manageable with proper nutrition and veterinary care. Feeding plays a central role in both treating ulcers and preventing their recurrence, as the right diet can reduce stomach acid, promote healing of the gastric lining, and improve overall digestive health.
This article provides evidence-based guidance on feeding horses with ulcers. However, this content is not a substitute for veterinary diagnosis or treatment. If your horse shows signs of ulcers—including poor appetite, weight loss, resistance to eating, or behavioral changes—consult your equine veterinarian immediately. A veterinarian can confirm EGUS through gastroscopy and recommend a tailored feeding plan alongside appropriate medical therapy.
Understanding Equine Gastric Ulcers and Nutrition
Horses produce stomach acid continuously, even when not eating. Their stomach lining depends on frequent grazing and forage intake to buffer acid and maintain a protective mucus layer. Ulcers develop when acid overwhelms the protective mechanisms, often triggered by stress, intense exercise, long periods without feed, certain medications (like NSAIDs), or high-grain diets. The connection between feeding practices and ulcer severity is direct: improper nutrition accelerates ulcer development and slows healing.
The goal of feeding a horse with ulcers is twofold: reduce acid exposure to the stomach lining and provide nutrients that support tissue repair. This requires changing both what and how you feed your horse.
Core Feeding Principles for Horses With Ulcers
Feed Constantly With Forage
Horses evolved to graze 16-18 hours daily. Forage intake stimulates saliva production, which buffers stomach acid naturally. Horses with ulcers should have access to quality hay or pasture almost continuously. The minimum recommendation is frequent feeding of small portions throughout the day—ideally every 2-4 hours—rather than two or three large meals. If turnout with pasture is not possible, provide a constant supply of hay using a slow-feeder hay net or multiple hay piles. Even overnight, horses should have access to hay.
Quality alfalfa hay is particularly beneficial for ulcer-prone horses because it has higher buffering capacity than grass hay alone. Consider a mix of 50-75% alfalfa hay and 25-50% grass hay to increase buffering while maintaining forage diversity. If your horse cannot tolerate hay (due to respiratory issues, for example), consult your veterinarian about forage alternatives such as low-dust hay cubes or senior feed products formulated to replace forage.
Reduce or Eliminate Grains
Grain and pelleted concentrates are common ulcer triggers. Grains are metabolized rapidly, creating acidic conditions in the stomach and bypassing the buffering benefits of forage. Horses with active ulcers should have grain intake reduced to the absolute minimum required for caloric needs, and ideally eliminated entirely during the acute treatment phase (typically 4-8 weeks). If your horse requires calories beyond what forage provides, focus on high-fat, low-starch alternatives instead of oats, barley, or corn.
If your horse requires some concentrate (for example, a competitive horse in training), limit it to small meals—no more than 2-3 pounds per feeding—and space feedings at least 4 hours apart. Always provide hay before and after concentrate feeding to buffer acid.
Recommended Feed Types for Ulcer-Prone Horses
| Feed Type | Benefits | Considerations |
|---|---|---|
| Alfalfa hay | High calcium and protein; excellent acid buffering; supports healing | May increase caloric intake; not ideal for horses with obesity or metabolic issues without adjustment |
| Grass hay (timothy, orchard, fescue) | Lower calorie; safe long-term forage; low dust varieties available | Lower buffering capacity than alfalfa; may need to increase quantity for adequate intake |
| Omega-3 rich supplements (flaxseed, chia) | Anti-inflammatory; supports mucosal healing; improves coat and hoof quality | Must be stored properly to prevent rancidity; relatively expensive compared to hay |
| High-fat concentrates (rice bran, vegetable oils) | Calorie-dense without starch; less acidogenic; stable energy | Requires careful introduction; can cause loose manure if increased too quickly |
| Beet pulp | Mild, digestible fiber; buffering effects; palatable | Should be soaked; relatively low in key nutrients without supplementation |
Managing Feeding Schedules
The timing and frequency of meals significantly impact ulcer healing. Here is a practical feeding schedule for a horse recovering from ulcers:
- Early morning (6-7 AM): Offer hay and a small concentrate meal (if needed)
- Mid-morning (9-10 AM): Hay only, or grazing if possible
- Midday (12-1 PM): Small concentrate meal and hay
- Afternoon (3-4 PM): Hay only, or turnout with pasture
- Late afternoon (5-6 PM): Hay and small concentrate meal (if needed)
- Evening and overnight: Continuous access to hay
This schedule ensures your horse is never without feed for more than 3-4 hours while the stomach lining heals. As healing progresses (typically after 4-8 weeks of consistent management), you can gradually transition to more normal feeding if the underlying cause of ulcers has been resolved.
Supplements and Additives for Ulcer Support
Certain supplements may support healing when combined with proper feeding and veterinary treatment. Discuss any additions with your veterinarian to ensure they complement prescribed therapies.
- Probiotics and prebiotics: Support healthy gut bacteria and may reduce inflammation. Effectiveness varies; choose products with research backing.
- L-glutamine: An amino acid that supports intestinal lining repair. Limited equine-specific research, but generally considered safe.
- Omega-3 fatty acids: From flaxseed or fish oil; reduce inflammation and support mucosal healing.
- Slippery elm or marshmallow root: Traditional botanicals with demulcent properties that may soothe the stomach lining.
- Vitamin E and selenium: Antioxidants that support immune function; deficiency can worsen inflammation.
Avoid supplements containing high levels of garlic, ginger, or other gastric irritants marketed for digestive support, as these may exacerbate ulcers in some horses.
Weight Management and Calories
Horses with ulcers often lose weight from reduced appetite and dietary restrictions. However, obesity can worsen ulcers by altering gut motility and increasing metabolic stress. The goal is maintaining a healthy body condition score (BCS) of 5-6 on the 1-9 scale while providing enough calories for healing and activity.
Calculate your horse’s daily caloric needs based on weight and activity level (consult your veterinarian or an equine nutritionist for specific recommendations). Provide these calories through forage first, then add high-fat concentrates or supplements like rice bran, stabilized ground flaxseed, or coconut oil if necessary. Many ulcer-prone horses thrive on a diet of 100% forage with minimal or no grain, which may actually support weight maintenance while promoting healing.
Water and Hydration
Adequate water intake is essential for healing and digestive function. Horses should have constant access to fresh, clean water. Dehydration thickens gastric secretions and can impair healing. If your horse is a poor drinker, offer water before hay (grazing horses naturally drink first), provide access to water before and after exercise, and consider adding small amounts of salt to water or feed to encourage drinking during dry months.
Transitioning Back to Normal Feeding
Once your veterinarian confirms ulcer healing (typically after 4-8 weeks of treatment and proper feeding), transition gradually back to your horse’s previous diet if desired. However, if feeding practices contributed to ulcer development, maintaining the improved feeding protocol long-term may prevent recurrence. Many owners find their horses perform better and look healthier on a forage-based diet with minimal grain, even after ulcers heal.
If returning to grain-based feeding, introduce concentrates slowly—increase by no more than 1 pound per day—and continue frequent feeding schedules rather than reverting to two large meals daily.
When to Contact Your Veterinarian Immediately
Contact your equine veterinarian right away if your horse shows any of the following:
- Complete loss of appetite or refusal to eat
- Severe colic signs (rolling, sweating, pawing, distress)
- Blood in feces or dark, tarry manure
- Rapid weight loss despite adequate feeding
- High fever combined with digestive signs
- Behavioral changes suggesting severe pain
These signs may indicate severe or complicated ulceration requiring immediate medical intervention beyond feeding management.
Frequently Asked Questions
Can a horse with ulcers ever return to a normal grain-based diet?
Yes, in many cases, though prevention requires ongoing attention to feeding practices. The key is identifying what caused the ulcers—stress, NSAIDs, exercise, or diet—and addressing those factors. If grain intake was the primary cause, some horses do well returning to modest amounts of grain (2-3 pounds per day) split into multiple small meals. However, many owners choose to maintain a forage-heavy diet long-term since their horses often perform better this way. Discuss your horse’s individual tolerance with your veterinarian.
How long does it take for ulcers to heal with proper feeding?
Most horses show improvement within 4-8 weeks of consistent proper feeding combined with veterinary treatment (typically acid-reducing medications). Complete healing may take 8-12 weeks depending on ulcer severity and whether the underlying cause has been eliminated. Feeding management alone, without veterinary therapy, generally takes much longer—months rather than weeks. Gastroscopy by your veterinarian can confirm healing progress.
Is alfalfa hay safe for all horses with ulcers?
Alfalfa is generally excellent for ulcer-prone horses because of its buffering capacity, but individual horses vary. Horses with certain conditions—such as equine metabolic syndrome or severe obesity—may need alfalfa limited or excluded. A mix of alfalfa and grass hay often provides the benefits of alfalfa without excessive calories. Consult your veterinarian or equine nutritionist about the ideal forage mix for your specific horse.
What if my horse won’t eat enough hay?
This is common during the acute ulcer phase. Offer small, frequent portions of high-quality hay, try different types (timothy, orchard grass, or high-alfalfa mix), and ensure hay is fresh and palatable. Hay cubes or pellets designed as forage replacers can help if long-stem hay is refused. Ensure fresh water and salt are available, as poor appetite can relate to dehydration or electrolyte imbalances. If appetite doesn’t improve within a few days despite these changes, consult your veterinarian—severe anorexia may indicate complications.
Do commercial ulcer supplements really work?
Supplements can support healing when combined with proper feeding and veterinary treatment, but they are not a substitute for either. Quality matters significantly; choose supplements from reputable manufacturers with ingredients supported by equine research. However, the foundation of ulcer management is always feeding (especially forage), medical therapy if needed, and stress reduction. No supplement alone will heal an ulcer if the underlying feeding problem isn’t corrected.
Key Takeaways
- Horses with ulcers require constant access to forage, fed in small frequent portions throughout the day to buffer stomach acid naturally.
- Reduce or eliminate grain and high-starch concentrates; replace with high-fat alternatives and quality hay if additional calories are needed.
- A mix of alfalfa and grass hay provides excellent buffering and healing support for most ulcer-prone horses.
- Maintain a feeding schedule with no more than 3-4 hours between forage meals, including overnight access to hay.
- Ensure fresh water is always available, and provide salt to encourage hydration and support healing.
- Proper feeding management works best alongside veterinary care, including acid-reducing medications if recommended by your veterinarian.
- Healing typically requires 4-8 weeks of consistent management; gradual transition back to previous diets is necessary if returning to grain feeding.
- This article is not a substitute for veterinary diagnosis. Contact your equine veterinarian if your horse shows signs of ulcers or if signs worsen despite feeding changes.
