Equine gastric disease treatment keeps shifting toward targeted care

Treatment of equine gastric disease still starts with diagnosis, then matching therapy to lesion type. In a sponsored March 9 video article, The Horse highlighted comments from equine internal medicine specialist Dr. Ben Sykes, who said treatment plans should combine pharmacologic therapy with management changes, including feeding adjustments, stress reduction, and repeat gastroscopy to confirm healing. The piece reflects a now well-established distinction between equine squamous gastric disease, which generally responds to acid suppression, and equine glandular gastric disease, which is often more refractory and may need combination treatment. (thehorse.com)

Why it matters: For veterinarians, the practical takeaway is that “gastric ulcers” can’t be treated as a single entity. The ECEIM consensus statement recommends oral omeprazole for squamous disease, with repeat gastroscopy before stopping therapy because only about 70% to 80% of lesions heal within 28 days. For glandular disease, the same statement recommends omeprazole plus sucralfate, with reassessment at four weeks and at least eight weeks of combination therapy before escalating further. In the U.S., GastroGard remains the only FDA-approved omeprazole treatment for equine gastric ulcers, while prevention of recurrence is labeled at a lower dose. (edu-veterinar.ro)

What to watch: Expect continued interest in how veterinarians manage refractory glandular disease, recurrence after omeprazole withdrawal, and whether nutraceuticals can play a meaningful adjunctive role beyond management changes. (pmc.ncbi.nlm.nih.gov)