Equine gastric disease treatment shifts toward lesion-specific care
Treatment approaches for equine gastric disease are getting renewed attention as clinicians and industry educators put more emphasis on distinguishing squamous from glandular disease, confirming cases with gastroscopy, and pairing medication with management changes rather than relying on acid suppression alone. A March 9, 2026, educational article from The Horse, sponsored by Kelato, highlighted that treatment should start with an accurate diagnosis and then combine pharmacologic therapy with feeding, stress-reduction, and husbandry adjustments, with repeat gastroscopy used as needed to confirm healing. That message aligns with recent review literature showing omeprazole remains the mainstay for equine squamous gastric disease, while glandular disease is more difficult to resolve and often requires adjunctive therapy such as sucralfate, or in some cases alternative approaches such as misoprostol. (thehorse.com)
Why it matters: For veterinary professionals, the practical shift is away from treating “equine ulcers” as a single entity. Recent sources emphasize that equine squamous gastric disease and equine glandular gastric disease differ in pathophysiology and response to therapy. UC Davis notes omeprazole is the only FDA-approved treatment and is highly effective for squamous disease, but has a poorer success rate when used alone for glandular disease, where combination treatment and management correction may be needed. A 2025 review of a blinded, randomized, placebo-controlled nutraceutical trial also found that a lecithin-pectin-meadowsweet product did not significantly prevent ulcer recurrence by gastroscopy after omeprazole treatment, despite changes in salivary biomarkers, underscoring the gap between supportive supplements and lesion-level outcomes. (cehhorsereport.vetmed.ucdavis.edu)
What to watch: Expect continued focus on lesion-specific protocols, recurrence prevention, and whether adjuncts such as misoprostol or nutraceuticals can improve outcomes in horses with recurrent or refractory glandular disease. (academic.oup.com)