Treating and Maintaing Ulcers

I love thoroughbreds, they are smart, athletic, and can excel in just about anything. In my love for thoroughbreds, however, I’ve had some experience with ulcers; and since I’m a biochemistry geek I extensively researched horse digestion and diet. I was determined to do things right by Blade without breaking the bank or depending on pharmaceuticals for extended periods of time. Over the last few months my dedication to the horse’s gastrointestinal tract has probably become (if it wasn’t before) very evident. Last week I covered ulcers in general, the causes in our Monthly Topic: Ulcers. Today we will cover how to manage ulcers and what has worked for me.

Blade, with suspected ulcers

When we first suspected Blade had ulcers my vet gave me two options; scope first or treat blindly. I decided not to scope Blade for a couple of reasons. The procedure requires fasting (which would worsen ulcers), can be stressful, cannot catch hindgut ulcers, and finally, scoping would be an additional cost to an already expensive treatment if he was positive (and we were pretty certain he had ulcers).

The downside to treating Blade blindly was the potential of wasted money. I took that risk since he was displaying classic symptoms. In only a day or two Blade started to feel better. Problem solved….right?

I followed a full 1 month regimen of Gastrogaurd as laid out by my vet (1 full tube for 2 weeks, 1/2 tube for 1 week, 1/4 tube for 1 week). It was expensive, yet effective. Until it ended. After the full month treatment (which included a gradual weaning off dosage) Blade started acting ulcer-y again.

Hindgut ulcers maybe?

From my research omeprazole is great for gastric ulcers but as you know from Monthly Topic: The Digestive¬†System the hindgut is beyond a large stretch in the small intestine. The drugs don’t reach farther back as effectively to the hindgut so symptoms often reoccur if there is trouble at the later end of the GI tract.

I bought Succeed which is said to help support the hindgut health. It was very expensive and for best result it was recommended he stay on the supplement. That extra $100/month for the supplement was not an option I could financially comply with. So I started researching other options.

After hours of research I came up with a regimen that worked for us and I’m happy to share with you today. I’m not a nutritionist and I’m not a vet…but I am a dedicated horse lover who wants to share our success in hopes it helps one of you.

Blade about 3 months later

The regimen enlists several tools that helped as an overall gut healing cocktail. Each element has it’s own purpose and works in a different way to make my horses feel better. In the first part below I outline WHY I chose each element and how it helps specifically. After I go on to explain how I use each element.


ALFALFA: Alfalfa is rich in protein and calcium. Calcium works to buffer stomach acid and reduce it’s effects.

Bright green bales of western alfalfa. About $40 per 100lb bale but I stretch it about 2 weeks. Given 1/2-1 flake/day during hunter pace season or on trailer rides.

ALOE: Aloe contains digestible fiber and soothes irritation and pain.

FLAXSEED: Flaxseed is high in omega fatty acids and works to reduce the inflammation within the gut. It also helps to balance the high levels of calcium in alfalfa.

I don’t care what online keyboard warriors say I have seen little difference in feeding whole seed vs ground…and have found empty casings of the seeds in manure proving they were digested.

OMEPRAZOLE: When ulcers are bad or first detected I start with omeprazole. I’m not an advocate AGAINST pharmaceuticals completely; I believe there is a time and place for medications and to get the healing process started, omeprazole is a great start. Omeprazole works by essentially turning off/down the flow of stomach acid production. Imagine you need to repair a tear on your swimming pool liner. You wouldn’t fill the pool while you’re repairing the tear…you would turn off the hose and wait until your repair is complete to fill the pool back up. Following the same line of thinking it’s easier to repair an ulcer if you slow the flow of acid.

Omeprazole isn’t cheap but it works. You can also find more cost efficient ways to offer the medication. Instead of Gastrogaurd I use the compounded powder which is often flavored. It ends up being much cheaper and it’s versatile. You can top dress onto the feed (which works great for my horses who gobble it up happily) or you can dilute in water and use a syringe.

PAPAYA: Papaya was a fun new discovery. In my research I’ve learned that papaya and its skin contains enzymes that speed up healing. I simply buy fresh papaya at the grocery store and as it turned out Blade lit up when he got it. Papaya was Blade’s most favorite treat and there’s nothing he wouldn’t do for it.

This “fruit cocktail” was a birthday treat for Blade that he shared with two other horses. It contained papaya, apples and bananas.

PROBIOTIC: Ulcers can result from an imbalance in the gastrointestinal system. While microbes are designed to withstand the harsh environment I’m willing to bet the microbiome is disrupted from the imbalance. A system acidic enough to wear holes into the epithelial lining could most certainly kill off some beneficial bugs. I take the opportunity to heal and simultaneously repopulate the system to create an overall healthy atmosphere going forward. I find a potent probiotic that contains BILLIONS of CFUs (colony forming units); some popular brands only have millions. At a nutrition seminar my vet held several years ago I remember the speaker describing the popular brands as “throwing a water bottle into an ocean.” Remember that the horse’s GI tract is home to about a quadrillion microbes. I specifically love Uckele’s Absorball for this since it contains 68 BILLION CFUs of beneficial bugs plus ingredients that help even further.


ALFALFA: Alfalfa is part of my horses’ daily diet. I feed 1-2 pounds per day, or on days where I’m trailering I may even buy a bale and feed a full flake. Before riding I might offer a handful of soaked cubes.

ALOE: You can purchase aloe pretty cheap at your Walmart. A gallon normally costs about $7. Use it to top dress your feed, a healthy splash is all you need (maybe 1/2 cup each meal for those who want to measure). Some people keep their horses on aloe year-round. I normally taper it off after a month or two. If Tiger starts acting ulcer-y I sometimes buy a gallon and top dress to see if it helps him.

FLAXSEED: Flaxseed is high in omega fatty acids and works to reduce the inflammation within the gut. It also helps to balance the high levels of calcium in alfalfa. I feed 4oz (an old applesauce cup) every meal to both of my horses on a regular basis. As mentioned before it helps to balance the calcium in alfalfa. It also supports a healthy coat and overall health. It’s also affordable. I normally buy a 50-pound bag for $40 and it lasts me a couple months with two horses.

Once upon a time I used to buy whole seeds and grind them every morning using an electric coffee grinder. It got old fast.

“They say” ground flax is best but freshly ground flax can spoil very fast and the nutrients degrade. If you have the time, grind daily is the best option. If not, there are other ways that work just fine.

I feed both ground and whole flax. I tend to choose whole in warmer months and in Fall/Winter I lean towards ground. Personal preference, perhaps, but I feel the winter cold helps preserve the ground. The ground that is sold in stores is cold ground (special process) and stabilized so it’s less likely to spoil and degrade.

Truthfully I have not seen a difference in my horses from whole to the pre-ground varieties. They stay healthy and happy and their coats are always shiny.

OMEPRAZOLE: I am not a vet so I am not at liberty to discuss dosage, your vet is the best bet. Ask for the compounded version. I actually keep the largest sized jar at home ($$$) and use it for trailering and events in addition to treatment. I don’t prefer omeprazole to be a long-term use but for healing and stressful events (or if you’re giving NSAIDS) it’s necessary. There’s another brand (that I haven’t yet used) that is said to help better with hindgut ulcers called Abler. The company uses capsulated granules that help deliver the medication farther into the gastrointestinal tract. I have heard great things about it if it’s something you want to try (Link at the end).

PAPAYA: I only use papaya as a “medicine” for a couple weeks. It can get pricy. Blade loved it so I didn’t mind adding it as a treat from time to time either. If finding the fruits in the store is too difficult or expensive don’t worry…they also make papaya enzyme tablets. Blade wouldn’t eat the tablets, unfortunately, but some horses love them. They are a lot more affordable.

PROBIOTIC: I use Uckele Absorball and typically feed at full dosage for a month. Once my supply is starting to diminish (1/4-1/3 container remaining) I taper off the dose to 1/2. Once it’s gone I discontinue use…”when it’s gone it’s gone.” Sometimes I find it’s helpful to add a few weeks of probiotic once or twice a year to give digestion a boost but I don’t typically keep them on it fulltime (unless there’s a specific need to).

Final Words

It’s important to remember that ulcers are common in working horses. You can heal them but if you don’t maintain a lifestyle that’s more friendly for your horse’s digestive system you are certain to have reoccurrences. When you suspect your horse has ulcers and treat them, the next thing you should be doing is trying to fix some of the other aspects wherever possible. Boarding facilities and your schedule may interfere but the more you CAN do (get creative!) the better.

For example, if you feed a lot of concentrates, find a way to feed less. Find a way to feed more often and keep that hay in front of your horse. Hay nets are excellent options (if your horse is unshod) and you can get wall mounted brackets for easy feeding. Offer some alfalfa before your rides. In other words, keep your horse chewing and don’t stress them more than necessary.

I should also note that what has worked well for me might not work well for everyone. My regimen worked well and was designed to address the digestive system at many angles. My horses now enjoy their concentrate-free forage-based diet and only get the alfalfa and flaxseed regularly. For February and March I’ve been finishing up a round of Absorball probiotics for both of my horses (Blade often had flare-ups in February and late summer/August). I keep the omeprazole on hand and use it as needed as with the other ingredients.

I hope this has helped!


  • The Equine Nutrition Nerd: I pulled a lot of my knowledge from The Equine Nutrition Nerd’s website. She has a lot of excellent information of the site and is far more knowledgeable than myself. I highly recommend the website for your equine nutrition questions.
  • Custom Equine Nutrition: Offers a few tips for feeding the ulcer prone horse.
  • Uckele Absorball: This is a pricey but worthwhile potent probiotic. I actually buy the largest bag (20 pounds) and separate it into five 4-pound bags. It ends up being more affordable and I use it for both horses. I don’t use it long term-however. You can split the cost with friends or save a bag for a later use (make sure to seal it bag up tight).
  • Succeed Equine: I have used this with some success but it’s pricey. You can decided for yourself what will work for you. At the very least they also have some decent educational articles.
  • Aloe Juice: This is the aloe juice I referred to. You can often find this floor level near the pharmacy at Walmart. It comes in an unflavored or triple berry flavor. It’s very affordable and I find the horses don’t pay much attention to it (unflavored) since I already wet their meals down.
  • Abler: Abler offers several options for supporting and healing ulcers using their special granule formulation. I also recently learned they offer a probiotic that might help as well. I have not purchased from this company yet but I have heard great things and it’s been on my radar.
  • Papaya Ezymes: Blade loves his fresh papaya. When I tried giving him the chewable tablets he refused. I used this brand which is affordable and comes in larger packages. I thought they tasted pretty good (they are for humans) and other horses liked them but I must have spoiled him too much on the real deal. I ended up giving them to a friend who’s horse needed support and loved the tablets. Tablets are great for boarding situations since keeping fresh papaya from spoiling is difficult.

If you have any more questions please don’t hesitate to reach out and ask!


  1. Glad you found things that work for your horse.

    I always wonder about ground versus whole flaxseed. I’ve been feeding ground but you may have me convinced to give whole a try. It’s hard to get the horses into much volume of a supplement that’s ground.

    Liked by 1 person

  2. Great info from a wonderful bio geek. Just wondering have you ever fed them barley & have you ever fed it too them not soaked. So many people have told me to soak barley but when I soak there is no difference to the seed at all in hot or cold water & I tend to steer clear of crushed or rolled as that can interfere with the nutrient value. Just wondering in your researching what have you found.

    Liked by 1 person

    1. Actually I haven’t fed barley and haven’t read about soaking…I can definitely see whats out there. I have read an article comparing processing and digestibility. In general processed grains are more digestible than the whole form…and ground is significantly higher in digestibility. The starch in barley is only 35% digestible whole, but changes to 44-50% digestible when extruded. That said I don’t prefer to feed any grains but oats are abetter choice than barley if it’s available (better digestibility and nutrient profile). I know that wasn’t your question so I do apologize if I’m overstepping in that sense.

      Liked by 1 person

      1. You are never over stepping. Thankyou so much for your time. I was never completely sure with barley. I will try oats, I know oaten chaff he digests really well as the green hay makes him scour. Porridge with carrots for breakfast it is for our Danny. lol.
        I will go read up on the digestibility link. Have a wonderful week ahead my pony friend.


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