Many horse owners assume that a horse with ulcers needs a grain-free diet, but the truth is more nuanced. For horses with ulcers, the primary goal is to maintain a near-constant flow of saliva and buffering stomach acid, which means frequent forage access is key.
Our editorial team emphasizes that the foundation of managing equine ulcers is not a special feed but rather a management strategy centered on unlimited or near-unlimited hay or pasture, along with minimizing stress and avoiding long periods without food. Specific dietary adjustments can help, but they are secondary to consistent forage intake.
The Importance of Constant Forage for Horses with Ulcers
Horses naturally produce stomach acid continuously, and without a steady supply of forage, acid can splash onto the upper, unprotected portion of the stomach, causing or worsening ulcers. The single most important dietary change for a horse with ulcers is to provide free-choice grass hay or pasture access 24/7. This encourages constant chewing and saliva production, which buffers stomach acid.
If free-choice hay is not possible, divide the daily hay ration into as many small meals as feasible, ideally at least four to six times per day. Using a slow feeder hay net can help extend the time between refills. Avoid long gaps of more than 4 hours without forage, as this increases ulcer risk.
For horses that cannot eat hay due to dental issues, consider soaked hay cubes or pellets as an alternative, but ensure they are fed in small, frequent meals. The key is to keep the stomach filled with a fibrous material that promotes chewing and saliva flow.
Choosing the Right Hay and Limiting Concentrates
For horses with ulcers, the type of hay matters. Grass hay such as timothy, orchard grass, or brome is generally preferred over legume hays like alfalfa, which is higher in protein and calcium. However, alfalfa can actually be beneficial in some cases due to its high calcium content, which acts as a natural buffer. Many veterinarians recommend including some alfalfa hay in the diet, but it should be introduced gradually and not exceed 30-50% of the total forage to avoid digestive upset.
Concentrates (grains and pelleted feeds) should be minimized or eliminated if possible, as they are low in fiber and can increase acid production. If the horse needs grain for energy or weight maintenance, choose a low-starch, high-fiber feed specifically formulated for gastric health. Avoid feeds high in molasses or starch. Soaking beet pulp (without added molasses) is a good fiber source that can replace grain. Always feed concentrates in small meals and after the horse has eaten hay, never on an empty stomach.
Supplements and Additives: What Works and What Doesn't
While many supplements claim to support gastric health, evidence is mixed. Some commonly used additives include: antacids (like calcium carbonate or magnesium oxide), which may provide temporary relief but do not treat the underlying cause; and ingredients like pectin, lecithin, or slippery elm, which are thought to coat the stomach lining. However, no supplement has been proven to cure ulcers without veterinary treatment. Always consult a veterinarian before adding supplements.
A more reliable approach is to ensure the horse has access to fresh, clean water at all times, as dehydration can exacerbate ulcer formation. Some owners add a small amount of salt to encourage drinking. Additionally, providing a salt or mineral block can help maintain electrolyte balance.
If the horse is on ulcer medication such as omeprazole, do not rely on supplements as a substitute. Medications work by reducing acid production, while diet management supports healing. Work with your vet to create a comprehensive plan.
Managing Stress and Lifestyle for Ulcer Prevention
Diet alone is not enough; managing stress is crucial for horses with ulcers. Common stressors include intense training, trailering, changes in routine, and social isolation. Ensure the horse has turnout time with companions, as herd interaction reduces stress. If turnout is limited, provide a stable with windows to see other horses and use mirrors if needed.
Feeding schedule consistency is vital. Horses thrive on routine, so feed hay and grain at the same times each day. Avoid abrupt changes in diet; any new feed should be introduced over 7-10 days. For performance horses, consider reducing high-intensity work during ulcer treatment and allowing more free movement.
Regular veterinary checkups, including gastroscopy for diagnosis, are essential. Even with optimal diet, some horses may require medication to heal ulcers. Work with your vet to monitor progress and adjust management as needed.