Equine Gastric Ulceration Syndrome
Management Options

Following diagnosis either by scoping or suspicion, a variety of treatments is available,
which are dependant on the severity of signs/symptoms.
As an holistic therapist I normally try & avoid pharmaceutical products when ever possible,
however EGUS is a man made/management disease & if your horses symptoms are severe
or you are treating a headshaking horse, then the first priority is to reduce gastric
secretions & start the healing process with the use of the appropriate a
ntacid therapy. This
can be followed by a holistic approach once the horse is healing.
  • Omeprazole – a PPI (protein pump inhibitor) which virtually shuts down over 90% of
    Hydrochloric acid production for up to 27 hours. Whilst this allows the ulcers to heal,
    the risk of rebound is a possibility, so that when the dose is stopped acid production
    may restart at an even higher rate causing further problems. This product also only
    works on the stomach acid production, so that if ulceration is present in the hind gut
    then it is totally ineffective. The suggested dose rate for omeprazole to be effective is
    usually 0.7gm/kg bodyweight which makes it a very expensive product to use when
    supplied by your vet! From my experience I have found that this drug is not effective
    for most headshakers due to its inability to address hind gut issues.
Alternatively, research indicates that H2 antagonists can be effective, such as;
  • Ranitidine. Available over the counter as an indigestion remedy.(Generic Zantac)
    Also available in quantity on the Internet. This has a similar effect to Gastrogard by
    stopping acid production but as a histamine antagonist, it is effective throughout the
    GI tract not just the stomach, so helps with hind gut problems. Its effects are much
    shorter lived (approx. 6-8 hours) so allows the gut to produce some acid to aid correct
    Digestion. Dose rate is dependant on the severity of symptoms. According to
    research the optimum dose rate for ranitidine in horses is 6.6 mg per kg of
    bodyweight every 8 hours. If you are treating a headshaking horse then I have
    found that the closer you can affordably get to this dose the sooner the
    symptoms will resolve.
For extreme cases I combine both products.
  • Raw cabbage juice. Can be added to assist with healing in the stomach only. This
    contains powerful substances including L-glutamine, S-methylmethionine,
    glucosinolates and gefarnate, proven in clinical studies, to protect and help heal the
    mucous membranes lining of the stomach and digestive tract. The resultant healing
    took 7 – 10 days as opposed to conventional treatment with antacid drugs which take
    over 42 days of continuous use. This can be made by adding raw Savoy cabbage to
    1.5 litres of water & blending or simply juicing. The resulting product can be added to
    feed or fermented in an airtight container for 3/5 days then strained off for enhanced
    probiotic benefit before feeding. Raw cabbage is also proven to kill the helicobacter
    pylori bacteria, so often blamed for human ulcers & lately found in equines.

There are many other excellent natural remedies that can be added if required, including:
 Aloe Vera juice
•        Slippery Elm Bark
Both contain Mucopolysaccharides that aid healing of the gastric mucosa.

However to treat persistant hindgut issues these will not be enough. I have found
from personal experience in trials with not only my horses but those of many clients, that
re are a plethora of supplements available over the counter which are variably effective
in the long term. Many contain numerous chemical compounds & additives designed to
promote hindgut health but in fact overload the already compromised digestive system
, so
do your research and choose wisely. I personally use Coligon & ginger powder which is
proven to protect gastric mucosa very effectively.

The only long term resolution
however is through dietry management

Many proprietary feeds such as mixes & cubes contain grains & sugars that fastrack
through the stomach & small intestine causing a drop in Ph levels & inevitable acidosis. To
prevent this either a buffer such as hay should be fed first or a plain fibre such as lucerne
fed instead. The horses stomach should also be continually drip fed with fibre particularly
when kept in a stable. He should NEVER run out of hay.
Always feed just before exercise or travelling. This prevents acid or bile splash back from
the small intestine & inevitable ulceration. When competing feed a double handful of lucerne
pellets just before getting on & in between classes. Your horse will thank you for it & your
results will improve!