Equine gastric disease treatment gets more precise

Treating equine gastric disease still starts with a basic but important point: horses with gastric lesions need the right diagnosis before they get the right drug. Recent educational coverage from The Horse emphasizes that pharmacologic therapy should be paired with management changes, not used as a standalone fix. That aligns with the broader literature, which now clearly separates equine squamous gastric disease, or ESGD, from equine glandular gastric disease, or EGGD, because the two conditions differ in pathophysiology, risk factors, and treatment response. Gastroscopy remains the definitive diagnostic tool, and omeprazole remains the mainstay therapy, especially for squamous disease, while recurrence after treatment discontinuation remains a persistent challenge. (thehorse.com)

Why it matters: For veterinary professionals, the practical takeaway is that “gastric ulcers” can’t be managed as a single entity. Reviews and expert guidance continue to show that ESGD generally responds better to acid suppression, while EGGD may be less predictable and may require a broader plan that includes management changes and, in some cases, adjunctive therapy. Newer research also tempers expectations around supplements: in a 2025 randomized, placebo-controlled trial, a lecithin-pectin-meadowsweet nutraceutical did not significantly prevent ulcer recurrence on gastroscopy after omeprazole treatment, even though some salivary biomarkers shifted in a potentially favorable direction. (mdpi-res.com)

What to watch: Expect continued focus on recurrence prevention, better strategies for glandular disease, and whether biomarkers or adjunctive products can eventually help guide post-treatment management. (pubmed.ncbi.nlm.nih.gov)