02/11/2026
Gastroscopy has undoubtedly played an important role in improving our understanding of equine gastric health. However, there can be a downside. We risk treating the scope image rather than zooming out and looking the whole horse.
It’s not uncommon to hear reports or read posts on horse forums where owners say their horses were previously prescribed 1-3 month courses of omeprazole for suspected gastric ulcers, often without a gastroscopy, or anyone looking into the horse’s diet, management or individual risk factors.
In my clinical experience, many of the pleasure and performance horses I see with squamous gastric ulcers have healed after just 14 days of enteric-coated omeprazole paste. This doesn’t mean every horse will heal in 14 days, or that longer treatment is never appropriate. Treatment duration should be based on the individual horse, their inherent risk factors and response to therapy, rather than automatically prescribing a prolonged course.
What I find on gastroscopy is also only one piece of the puzzle.
I spend a lot of time discussing why the ulcers may have developed in the first place, including diet, forage access, feeding practices, exercise, travel, turnout, management and other risk factors. Just as importantly, I go back to the clinical signs that prompted the owner to investigate gastric disease in the first place. Not every “girthy” horse has gastric ulcers, and not every recent change in behaviour warrants a course of omeprazole. Underlying and undiagnosed musculoskeletal pain is often present in these horses.
Seeing ulcers on a scope doesn’t necessarily mean they explain everything the owner is seeing.
The goal shouldn’t simply be to treat the ulcers for a clear rescope. It should be to understand the horse, address the factors contributing to disease and use medication for as long as it is actually needed.
With the right diagnosis, management changes and veterinary guidance, treatment may be much shorter and much less expensive than owners have been led to expect.
🐴 To learn more about our mobile gastroscopy service:
https://avonridgeequine.com.au/mobile-gastroscopy-service/