Why equine gastric disease treatment is getting more specific
CURRENT BRIEF VERSION: Treating equine gastric disease starts with getting the diagnosis right, and that’s the core message in a new March 9, 2026, sponsored educational piece from The Horse featuring equine internal medicine specialist Ben Sykes. The article emphasizes that veterinarians shouldn’t treat “equine gastric ulcer syndrome” as a single condition: squamous and glandular disease have different biology, different responses to therapy, and different management needs. Across the literature, gastroscopy remains the diagnostic standard, while treatment typically combines pharmacologic therapy, especially acid suppression with omeprazole, with changes to feeding, turnout, stress, and daily routine. (thehorse.com)
Why it matters: For veterinary professionals, the practical takeaway is that case management is moving farther away from empiric, one-size-fits-all ulcer treatment. The ECEIM consensus statement specifically distinguishes equine squamous gastric disease from equine glandular gastric disease, and review literature notes that treatment tends to be more consistently successful in squamous disease than in glandular disease. Newer retrospective data also suggest the clinical picture can differ by lesion location: physical signs were more often associated with squamous disease, while behavioral or mixed signs were more common in glandular or mixed ulceration, reinforcing that vague signs alone still cannot localize disease without scoping. Evidence also suggests that for some glandular cases, alternatives such as misoprostol may outperform omeprazole-sucralfate combinations, while newer nutraceutical work has not yet shown clear prevention of ulcer recurrence on gastroscopy after omeprazole treatment. That makes repeat scoping, lesion-specific planning, and realistic conversations with pet parents especially important. (edu-veterinar.ro)
What to watch: Expect continued attention on lesion-specific protocols, recurrence prevention after omeprazole, and whether adjunctive nutraceuticals or longer-acting acid-suppression strategies can improve outcomes in harder-to-treat glandular disease. Clinicians will also be watching whether emerging work on sign patterns by ulcer location can help refine which horses should be prioritized for gastroscopy, even if endoscopy remains essential for diagnosis. (equimanagement.com)