Health Care

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How to Feed a Horse with Gastric Ulcers

Diet plays a big part in easing ulcer severity and avoiding recurrence. Read our guide to feeding a horse with gastric ulcers.

Equine gastric ulcers are prevalent in more than 90% of Thoroughbred racehorses1, and over 50% of competition horses studied2,3. With such a high incidence rate, chances are your horse might have gastric ulcers too, or at least be at risk of developing them.

While most horses will need medication from their veterinarian to treat gastric ulcers, diet and nutritional management can be used in conjunction with medical therapy to decrease ulcer severity and recurrence.

The following factors should be taken into consideration when feeding horses to reduce ulcers:

  • Allow continuous grazing
  • Maximise forage intake
  • Minimise grain rations
  • Provide plenty of water

tips to feed horses with ulcers

1. Allow Continuous Grazing

While research has proven that horses kept either on pasture or in stables are susceptible to Equine Gastric Ulcer Syndrome (EGUS), horses grazing pasture are less likely to develop ulcers compared to those housed in stables4. Intermittent feeding, for example only providing feed two to three times per day, has been shown to cause and increase the severity of ulcers in the non-glandular part of the stomach (the most common location for ulcer formation) 4. It is important to note that it is not the stabling of horses that causes gastric ulcers, but rather the management factors associated with stable confinement. This might include feeding only two large meals per day, insufficient water, social isolation from other horses and lack of free exercise.

2. Maximise Forage Intake

Feeding lucerne hay (sometimes called alfalfa hay in other parts of the world) has been reported to have a protective effect on the stomach lining. The high content of calcium, magnesium and protein in the lucerne hay helps to buffer the acid in the stomach5. To help reduce the risk of ulcer formation, you should provide 1 to 1.5kg/100kg body weight long-stem, good quality forage (hay) free choice throughout the day and night.

3. Minimise Grain Rations

In exercising horses, grain intake should be limited to a maximum of 0.5kg per 100kg bodyweight per day. Feeding hay first, then grain, leads to an optimal mixture of gastric content and helps prevent ulceration5. Where possible, don’t feed grain meals less than six hours apart6. Stabled horses are often fed two large meals per day, and these meals are usually high in grain mixes or “sweet feeds”, or grains such as barley and oats, and eaten rapidly. This leads to a decrease in saliva production, which in turn means less alkaline saliva to buffer the stomach acid. The bacteria that live normally in the horse’s stomach ferment the grain into volatile fatty acids, which in an acid environment such as the stomach, can lead to ulceration7. When treating horses with ulcers, it is important to substitute any sweet feeds, barley or oats where possible for lucerne hay or good quality grass. Learn more about feeding your performance horse.

4. Provide Plenty of Water

One study showed that daily hay intake and body weight of horses fell significantly with increased water restriction during a 3 week period, and also the time spent eating decreased as less water was provided8. Decreased eating will lead to decreased saliva production and therefore less alkaline saliva to buffer the stomach acid. This increases the risk and severity of gastric ulcers. For horses in training, take care to avoid repeated oral administration of hypertonic electrolyte replacement pastes or solutions (those containing sodium and glucose for example that are used to draw fluid back into the blood), as this has been shown to increase the number and severity of gastric ulcers9. If electrolytes need to be given after exercise, try to administer with a small meal to help avoid ulceration. Learn more about choosing the right electrolyte for your horse.

feed horse with ulcers


  1. Murray MJ et al. 1996. Factors associated with gastric lesions in thoroughbred racehorses. Equine Vet J 28: 368-374.
  2. McClure SR et al. 2005. Gastric ulceration in horses exposed to training and activities typical for recreational showing. AAEP Proceedings Vol 51.
  3. McClure SR et al. 1999. Prevalence of gastric ulcers in show horses. J Am Vet Med Assoc. 215: 1130-3.
  4. Reese RE and Andrews FM 2009. Nutrition and dietary management of equine gastric ulcer syndrome. Vet Clin Equine 25: 79-92.
  5. Vervuert I 2016. How to feed horses with gastric ulcer syndrome. AAEP Proceedings Vol 62.
  6. Videla R and Andrews FM 2009. New Perspectives in Equine Gastric Ulcer Syndrome. Vet Clin Equine 25: 283-301.
  7. Nadeau JA et al. 2000. Evaluation of diet as a cause of gastric ulcers in horses. Am J Vet Res 61: 784-90.
  8. Houpt KA et al. 2000. Effect of water restriction on equine behavior and physiology. Equine Vet J 32: 341–344.
  9. Holbrook TC et al. 2005. Effect of repeated oral administration of hyertonic electrolyte solution on equine gastric mucosa. Equine Vet J 37: 501-4.

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