Equine gastric disease treatment still hinges on diagnosis first

Treating equine gastric disease still starts with a scope, not a supplement. A new sponsored explainer from The Horse highlights a familiar but important message for equine practice: horses with gastric disease need lesion-specific diagnosis, drug therapy, and management changes together, with follow-up gastroscopy when needed. In the video, equine gastric disease researcher Dr. Ben Sykes says treatment plans should be tailored to the horse and revisited over time, especially because squamous and glandular disease behave differently. That lines up with broader literature showing equine squamous gastric disease and equine glandular gastric disease are now treated as distinct conditions, with oral omeprazole remaining the core approved therapy for gastric ulcers in horses. (thehorse.com)

Why it matters: For veterinary professionals, the practical takeaway is that pharmacology alone often isn't enough. Recent guidance for clinicians and nutrition-focused continuing education both stress that feeding pattern, forage access, exercise timing, turnout, and barn stress can influence healing and recurrence. That matters because recurrence after stopping omeprazole appears common: in a 2025 randomized, placebo-controlled trial, only five of 30 horses remained ulcer-free after follow-up, and a lecithin-pectin-meadowsweet nutraceutical did not outperform placebo on gastroscopy, despite shifts in salivary biomarkers. In other words, adjunct products may generate interest, but the evidence base still favors confirmed diagnosis, labeled therapy, and management correction first. (pubmed.ncbi.nlm.nih.gov)

What to watch: Expect continued scrutiny of recurrence prevention, especially for glandular disease, where healing rates remain less predictable and interest in alternatives such as misoprostol or longer-acting omeprazole protocols is still growing. (pmc.ncbi.nlm.nih.gov)