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Equine Glandular Gastric Ulcer Syndrome

(EGGUS) affecting the lower, glandular part

of the stomach (including the pyloric antrum

or ‘exit’ from the stomach)

(figure 3)


ESGUS and EGGUS should be treated as

different problems, even when both are seen

in the same horse, as the risk factors and

treatments are different.

Does my horse need gastroscopy

or could I just give him some


Whilst ‘typical’ symptoms may lead you to

suspect EGUS in your horse, it is important

this is confirmed by gastroscopy

(figure 4)

to establish whether your horse has ESGUS,

EGGUS or both. Also, ‘trial’ treatment

with medication is costly and in some

horses affected by EGGUS symptoms will

not resolve even after a few weeks of

medication. It is also common for a horse

showing symptoms typical of EGUS to have

a different, or additional issue, such as

lameness or back pain.

Gastroscopy is useful to determine and

measure response to treatment and, should

symptoms return in the future, to confirm ulcer

type remains the same.

My horse has EGUS, what should I do?

Medication is usually necessary following

diagnosis and your vet will prescribe drugs

appropriate for your horse. It is important to

follow any directions as to how these should

be administered to ensure they are effective.

For example, you may be asked to give

medication a set time before feeding.

Nutritional and management changes are

important to aid resolution of ulcers and

reduce risk of future recurrence.

Unfortunately ulcers will return quickly if

changes cannot be implemented, resulting

in reliance on expensive medication.

Management changes alone, however, may

not lead to resolution of EGUS.

As a further prevention, your vet may also

recommend a low dose of medication

is given at times of stress, such as


Management for ESGUS

Risk of ESGUS increases with intensity

of exercise, with ulcers often improving

during rest periods. Feeding a small,

roughage-based feed such as alfalfa chaff

approximately thirty minutes prior to exercise

is recommended.

Horses are designed to be trickle feeders,

so free access to roughage, preferably from

multiple different sources, has been shown to

be helpful. Using straw as the only roughage

source should be avoided (except in

donkeys). Alfalfa may have some beneficial


Increased time at pasture should have a

positive impact, though other ‘stressors’ may

affect this and any supplementary feed given

during turnout should also be considered.

Water should be made available at all times.

Reducing concentrate feed, and the

proportion of soluble carbohydrates within

this feed, is beneficial ensuring small, more

frequent meals. Adding roughage, e.g. chaff,

to feeds will help by encouraging chewing,

increasing saliva production which in turn

buffers stomach acid. Adding corn oil to feed

has a beneficial effect on acid production

as well as being a useful source of ‘non-

carbohydrate’ calories. Commercial feeds

are also now available for horses with


Feed supplements containing antacids are

widely available. Their short duration of

action does limit their usefulness but, given

regularly, they may be of benefit to horses in

regular work. These supplements are often

available in combination with mucosal

protectants such as pectin-lecithin complex

and may be useful in preventing ulcers in

some circumstances. Sugar beet is a good

source of pectins and is therefore useful to

add to the diet. Further feed supplements are

becoming available with some early positive

reports, however additional controlled

clinical studies of these products are

required to confirm their efficacy. The use of

concentrated electrolyte pastes or solutions is

not recommended in horses prone to EGUS.

Management for EGGUS

The cause of EGGUS is poorly understood

and further research is required to improve

our knowledge of this condition. In contrast

to ESGUS, exercise does not appear to be

a key factor. Whilst bacteria have been

detected in horses with ESGUS and

EGGUS they are not currently thought to

be a significant cause, though research is


Use of non-steroidal anti-inflammatory drugs,

such as bute, can cause issues at high

doses. However few problems are seen at

commonly used doses, particularly when

used for short periods, and these drugs are

unlikely to be a significant cause of EGGUS.

Diet may have an impact on EGGUS and

feeding recommendations for ESGUS should

also be appropriate for these horses. The use

of feed supplements may also be beneficial

but again further research is required.

Reducing social and behavioural stress is

also likely to be helpful.


Gastroscopy is essential for diagnosis and

monitoring of EGUS

There are 2 different types of EGUS



Treatment and management of these

conditions are different

Both medication and management

changes are necessary to reduce

recurrence of EGUS

Figure 3. Gastroscopy image from horse affected by EGGUS

Figure 4. Gastroscopy being performed at the practice