Effect of Changing Diet on Gastric Ulceration in Exercising Horses and Ponies After Cessation of Omeprazole Treatment.
Authors: Luthersson Nanna, Bolger Coby, Fores Paloma, Barfoot Clare, Nelson Sarah, Parkin Timothy, Harris Pat
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Diet and Gastric Ulceration in Exercising Horses Equine squamous gastric disease (ESGD) remains a significant welfare concern in working horses, yet evidence supporting dietary intervention remains sparse despite diet being recognised as a key risk factor. Luthersson and colleagues investigated whether modifying diet—specifically reducing starch intake—could improve outcomes in exercising horses with moderate to severe ESGD, with some animals also receiving omeprazole treatment for four weeks. In moderately affected horses (Grade 2/4), dietary change alone produced no additional benefit beyond the natural healing response, but in more severely affected animals (Grade ≥3/4), horses switched to a restricted starch ration maintained their gastroscopic improvements at 10 weeks, whereas those remaining on their original diet deteriorated significantly after omeprazole treatment ceased—returning to baseline ulceration scores by week 10. The findings suggest that whilst proton pump inhibitors provide short-term improvement, appropriate dietary modification offers genuine long-term management value, particularly for horses with more advanced disease, making this evidence valuable for formulating realistic treatment plans with owners and coaches who may otherwise rely solely on pharmaceutical intervention.
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Practical Takeaways
- •For horses with moderate-to-severe gastric ulcers, implementing appropriate dietary changes (restricted starch ration) appears essential for long-term improvement after stopping acid-suppressive medication
- •Omeprazole treatment alone is insufficient for sustained ulcer healing—dietary management must accompany or follow medication for lasting clinical benefit
- •Dietary modification is a practical, cost-effective management strategy that should be considered standard protocol alongside or after pharmaceutical treatment in exercising horses with ESGD
Key Findings
- •In severe ESGD (Grade ≥3/4), dietary change resulted in sustained improvement between weeks 4-10 (no significant worsening, P=0.32), whereas horses remaining on original diet showed significant worsening after omeprazole cessation (P=0.005)
- •For severe ESGD, dietary change produced significant improvement from baseline to week 10 (P=0.003) even after omeprazole discontinuation
- •Omeprazole alone without dietary change provided only temporary benefit in severe ESGD, with ulcer grades returning to baseline by week 10 (P=0.08)
- •Dietary change had no additional benefit in mild ESGD (Grade 2/4) beyond natural improvement