Treating ulcers well comes down to five things: confirm what you’re dealing with, use the right drug at the right dose for long enough, support it with management, and confirm it actually healed. Because the treatment-dose medication is prescription-only, this should always be built with your veterinarian. For the bigger picture, see our complete guide to equine gastric ulcers.
Step 1: Confirm with a scope
Before spending on a long course of medication, it’s worth knowing what you’re treating. Gastroscopy confirms ulcers, grades their severity, and — crucially — tells squamous from glandular disease, which are treated differently. (See what scoping and treatment cost.)
Step 2: Omeprazole, the core of treatment
The backbone of treatment is omeprazole at the treatment dose — roughly 4 mg/kg once daily for about 28 days — which suppresses stomach acid so the lining can heal. The FDA-approved treatment product is prescription GastroGard; you can estimate the daily amount for your horse with the dosage estimator. Give it on the schedule your vet sets and don’t skip days.
Step 3: Glandular ulcers often need more
Squamous ulcers usually respond well to omeprazole alone. Glandular disease (EGGD) is more stubborn and frequently needs a longer course or a combination — your vet may add sucralfate (which coats and protects the lining) or other medications, and will pay close attention to stress and management.
Step 4: Re-scope to confirm healing
At the end of the course, a re-scope confirms the ulcers have truly healed rather than just improved. This is the step most often skipped to save money — and the one that most often leads to paying twice when ulcers were only partly healed.
Begin treatment
Start the omeprazole course your vet directs.
Re-scope
Confirm healing rather than assuming it.
Step down & prevent
Maintenance dose plus management changes.
Step 5: Step down and prevent recurrence
Once healed, many horses move to a lower maintenance dose for a while, and — just as importantly — to better daily management. Healing the stomach without changing what caused the ulcers usually just buys time. See our guide to preventing ulcers through feeding and management.
Build the right plan for your horse
VETR is building nationwide telehealth that connects you with licensed veterinarians from home. Join the list and we’ll help you put together a treatment plan that fits your horse and your budget.
Join VETR →Confirm equine telehealth availability and your state’s prescribing rules before launch.
Affordable gastric care from VETR
VETR’s mission is accessible, affordable animal health — including supportive products that round out daily care during and after treatment.
Shop VETR →Supportive supplements are not a treatment for diagnosed ulcers and don’t replace veterinary care.
Frequently asked questions
How long does it take to treat equine ulcers?
A standard omeprazole course runs about 28 days, after which your vet re-scopes to confirm healing. Glandular ulcers often need longer or a combined approach.
Do I really need to re-scope after treatment?
It is strongly recommended. A horse can seem better while ulcers are only partly healed, and stopping early often means paying to treat again later.
What if the ulcers don’t heal?
Non-healing is more common with glandular disease. Your vet may extend the course, add sucralfate or another medication, and look harder at management and stress.
Can I treat ulcers at home without a vet?
You can manage feeding and stress at home, but the treatment-dose medication is prescription and diagnosis needs a scope, so a vet should direct the plan.
Will the ulcers come back?
They can, especially if management doesn’t change. Stepping down to a maintenance dose and improving feeding and turnout is what keeps them from returning.
References & sources
- Sykes BW, et al. ECEIM Consensus Statement: Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med. 2015;29(5):1288–1299.
- Merck Veterinary Manual — Gastric Ulcers in Horses (clinical)
Dosing figures follow FDA-approved label rates for omeprazole; cost ranges are general market estimates. Always confirm diagnosis, dosing, and treatment with your veterinarian.