“Considering how prevalent EGGD has become, remarkably few data regarding risk factors and optimal management strategies, including feeding programs, have been designed for horses with this condition,” noted Laura Petroski-Rose, B.V.M.S., a Kentucky Equine Research veterinarian.

Squarmous vs. Glandular: Differences

Unlike squamous ulcers caused by the physical splashing of harsh stomach acids on the “higher” regions of the stomach lining, causes for ulcers in the glandular region remain unclear. One theory is simple failure of normal defense mechanisms, while another includes excess nonsteroidal anti-inflammatory drug administration. Unlike in humans and other mammalian species, Heliocobacter spp. do not appear to play a role in EGGD.

To gain a foothold on this important, performance-limiting welfare and health issue, Benjamin Sykes, an internist and adjunct associate professor at The University of Queensland, together with his colleagues from the United Kingdom and Australia, set to work. The team examined and collected management data (feeding, exercise, overall health.) They compared 109 Thoroughbreds training in eight different facilities in the U.K. and Australia. They found:

• Horses with EGGD vs. ESGD had different management factors and clinical signs of disease, as suspected;
• Exercising >5 times per week was associated with a tenfold increased risk of EGGD;
• Poor performance, or performing below expectation, was associated with an almost fourfold increased risk of EGGD;
• Horses with stereotypies were more likely to have ESGD. However, ironically, horses displaying aggression towards humans were less likely to have ESGD; and
• Individual trainer was also identified as a risk factor for EGGD.

“Indeed, these two conditions appear distinct and must therefore be managed as such. Without clear knowledge of the underlying processes contributing to EGGD development, outlining the best strategies to approach horses with EGGD remains challenging,” summarized Petroski-Rose.

That said, stress does appear to play a role in EGGD. Therefore, further exploration of stress pathways and cortisol are warranted.

Potential Management:

“Without clear insight into the underlying pathways, management of any gastric ulcer relies heavily on forage-based diets including alfalfa hay, using slow-feeders so that the horse can consume forage for most hours throughout the day, and minimizing dietary concentrates,” advised Petroski-Rose.

Contact a Kentucky Equine Research nutrition advisor once your veterinarian has confirmed the presence of gastric ulcers. Be sure to ask about RiteTrac—a supplement designed to quickly neutralize excessive gastric acid, thereby protecting the stomach lining and restoring the normal gastric environment. Horse owners in Australia should look for these research-proven products.

*Sykes, B.W., M. Bowen, J.L. Habershon-Butcher, M. Green, and G.D. Hallowell. 2019. Management factors and clinical implications of glandular and squamous gastric disease in horses. Journal of Veterinary Internal Medicine 33(1)233-240.

“Grazing activity varies over the course of the day, and observational studies on nocturnal grazing are clearly limited,” pointed out Catherine Whitehouse, M.S., a Kentucky Equine Research nutrition advisor.

Understanding Grazing:

Knowing when and how often horses graze will improve understanding of the “biological, environmental, and nutritive factors driving grazing behavior in horses.”^* In addition, the information could also be used to optimize nutrition and decrease management-related conditions such as gastric ulcers.

To facilitate data collection and ultimately improve understanding of grazing and chewing behaviors in horses, a continuous automated monitoring system called EquiWatch System (EWS), was developed. This remote, automated monitoring unit collects data on feeding and grazing behavior for 24 uninterrupted hours through the use of sensors fixed onto the noseband of the halter. To validate the EWS, the unit was used in horses with unrestricted pasture access and horses offered free-choice hay.

Horses with unrestricted pasture access spent more time eating than horses fed hay (14.8 vs 12.0 hr/d), and horses on pasture had a higher chew rate per minute than when fed hay (84 vs 69 chews/min). Data from the EWS and visual observations for grazing time and total bites were compared. They were similar.

Is your horse plagued with gastric ulcers despite a diet rich in good-quality forage? Even horses with full access to pasture can have gastric ulcers. If ulcers are suspected, consider endoscopy. This will reveal definitively if ulcers are present. If so, a veterinarian will usually prescribe a course of omeprazole. Omeprazole will clear the ulcers. Lastly, at the tail end of omeprazole therapy, a digestive supplement designed to keep new ulcers from forming should be started.

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*Weinert, J.R., J. Werner, and C.A. Williams. 2020. Validation and implementation of an automated chew sensor-based remote monitoring device as tool for equine grazing research. Journal of Equine Veterinary Science 88:102971.

• When did the horse start refusing hay?
• Is it a new batch of hay?
• Are other horses eating the same hay?
• Is the horse drinking water?
• Is the horse eating its feed?
• Is the horse exhibiting any other unusual behavior?

Let’s address the first three questions. If hay refusal comes on fairly suddenly, especially if it coincides with a new batch of hay, then it is likely that the hay itself is the issue. Especially if other horses are showing the same behavior.

Horse Sensitivities

Horses may refuse to eat hay that is old, moldy, coarse, stemmy, or full of weeds, so check to make sure that your hay is “clean”—that is, free of mold, dust, weeds, trash, and other impurities. Horses are sensitive to odors and can easily detect off-putting scents that humans cannot and sometimes this is enough to cause refusal. More sensitive horses back off forage intake simply when a change is made to a different type of hay, as some grasses are more palatable than others.

One additional consideration involves access to pasture. Hay intake often corresponds to pasture conditions. For example, some horses may reduce their hay intake when pasture grass is readily available and high quality, but will return to hay when pastures dry out due to drought or season.

If other horses are eating the hay as usual or if no change of hay has been made, the final three questions in the list become more relevant.

The question of water is an important one. Clean, fresh water should always be available. Without sufficient water, a horse will quit eating. Check to make sure your horse’s water source has not been compromised in function or hygiene, such as a broken automatic waterer, a leak in a water tank, or contamination from manure or a decomposing bird or animal.

Health Issues

Once you’ve verified the hygiene of the hay and water source, other causes of hay refusal should be investigated. Common causes of inappetence in horses include dental issues, such as painful chewing due to uneven wear, split or broken teeth, missing teeth, and infection of the teeth, gums, or other oral tissue. Sometimes it could be as simple as the horse eating hay containing foxtail seed heads, which can lodge in the gums and cause pain and infection if not found and removed.

Moreover, dental condition often depends on age, as teeth deteriorate as horses hit their late teens and twenties. When this happens, it can result in a gradual or sudden decline in hay intake. Regular dental care for horses throughout their lives can help address dental issues in a timely manner and ensure that horses are able to comfortably consume hay for as long as possible. When horses reach the point where they no longer can chew hay, there are several alternative forages and fiber sources appropriate to help maintain weight.

Other health issues that can affect a horse’s appetite for hay include colic, ulcers, and choke. In addition, inflammation of the gastrointestinal tract, and generalized infection or disease. In any case, a call to the veterinarian is most likely in order. Determine if there is a significant health condition. As well as the best options to help a horse regain its health and appetite.

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According to Clarissa Brown-Douglas, Ph.D., a nutritionist with Kentucky Equine Research, the first step in creating a high-quality, cost-conscious diet is to clearly define the scenario and the goals. Do you manage a herd of broodmares? Ride competitively; is the horse exercised lightly or intensely? Do you care for a single retired pony?

Diet Evaluation:

Once the feeding goals are clearly understood, a nutritionist should perform a thorough diet evaluation. Carefully collecting information about forages and concentrates, and how much of each is fed to the horse. Moreover, the nutritionist should inventory the supplements that are fed, making note of why each is added to the diet. Other pertinent information may include turnout time, pasture quality, and palatability preferences.

In addition to determining nutritional adequacy of diets, ration evaluations reveal any shortages or overages of specific nutrients. “Eliminating nutritional double-ups is the simplest way to shave off some expense,” said Brown-Douglas.

Optimizing forage intake is another source of potential cost savings. “Pasture can provide a lot of nutrition, sometimes year-round. Maximizing time on pasture is one way to reduce the use of other forages, such as hay or bagged forage products such as cubes, pellets, or chaff, all of which tend to be expensive,” she explained.

Sourcing Hay:

While it may be impractical to eliminate hay from a diet, sourcing local hay often reduces forage costs. Further savings may be achieved if a local grower can be identified and hay can be picked up from the field, as this reduces handling required by the grower. Transportation outlays can add considerably to the cost of hay.

When evaluating feed expenses, the nutritionist will often verify that horses are receiving the most appropriate forage for their age and lifestyle. While premium-quality hay engages the human senses favorably—imagine how beautifully cured alfalfa looks, smells, feels—few horses require it for optimal health. Mid-quality grass hay works well for many horses. For those prone to obesity, even this may be too rich, so owners should be on the lookout for mature hay that is free of dust, mold, and weeds.

“Be conscious of not wasting hay,” Brown-Douglas warned. “Some horses are clever at using hay as bedding, and this isn’t economical. To avoid this, get out the scale, and feed 1.25% to 2% of the horse’s optimal body weight per day in a haynet or feeder.”

Once forage costs have been streamlined, the concentrate portion of the diet can be addressed. Many horses, especially growing horses, performance horses, breeding stallions, and broodmares at certain stages of production, require a concentrated form of calories. This is best accomplished through the provision of a well-formulated, fortified concentrate from a reputable manufacturer. Sometimes a savings can be had by feeding a ration balancer. For example, a feed that rounds out the protein, vitamin, and mineral requirements of a diet, at a lower intake.

Supplement Evaluation:

Finally, careful evaluation of all supplements should be performed. Oversupplying certain nutrients frequently occurs unintentionally when multiple supplements are fed to horses. For some horses that require similar needs, an all-in-one supplement might be appropriate and provide cost savings. These supplements might include high-quality ingredients that address hoof, coat, joint, and antioxidant needs.

To keep feeding costs in perspective, Brown-Douglas encourages horse owners to look at the cost of feeding a horse per day. This opposed to relying on individual product prices. Certainly, she explained, some bagged feeds can be expensive. That price is relative to how long the product will last. “Take a well-formulated ration balancer, for instance. If a 50-lb (23-kg) bag costs $25 and your horse eats 1 lb (0.45 kg) a day, then that single bag will last well over a month.”

Working with a nutritionist has many advantages. Nutritionists are certainly advocates for horses. After all, the goal is to ensure optimal nutrition. However, routine diet evaluations also protect horse owners from needless expense.

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Before exploring dietary options, take inventory of your broodmare. What breed or type is she—a fine-boned Arabian; a rugged, sporty half-Thoroughbred; or a muscly stock-type? Where would she place on the metabolism spectrum: is she an easy keeper, a hard keeper, or average in her conversion of calories to body maintenance and fat stores? What does she weigh when she’s in moderate body condition?

“Horses will generally consume 1.5-3.0% of their body weight in dry matter intake daily, with lactating mares at the upper end of this range,” explained Kathleen Crandell, Ph.D., a nutritionist for Kentucky Equine Research. “Forages would supply at least half of this dry matter but may provide considerably more depending on the mare’s phenotype and metabolism.” Identifying proper forage for broodmares is therefore paramount.

Hay Inventory:

As with all hays intended for horses, broodmares should be offered high-quality hay that is free of any dust, mold, or weeds. The texture of the hay should be soft, and the smell pleasant and appealing. Not only is high-quality hay more palatable, but it can provide significantly more calories than lower quality hay. Toss any hay that is refused or soiled.

The type of hay given—whether it is a grass or legume—depends largely on the mare and availability. Early and mid-bloom alfalfa, for example, provide more energy than many good-quality grass hays, even those harvested in early maturity.

“With this in mind, alfalfa hay or an alfalfa-blend hay may be appropriate for mares that require more energy to maintain body condition during lactation. Think of the hard keepers that put a lot of energy into milk production, like some Thoroughbred mares,” Crandell said. On the contrary, for mares that are known to be easy keepers, alfalfa may provide too many calories. A grass or alfalfa-grass mix might be more appropriate for them.

Depending on the mare’s foaling date, fresh forage might be available to lactating mares. The quality and quantity of pasture may vary from farm to farm. If mares are allowed access to high-quality, properly maintained pasture for much of the day, then this will go far in meeting a mare’s energy requirements but likely will not satisfy them entirely.

Because of their high energy and nutrient needs, mares cannot generally consume sufficient forage to meet their nutritional requirements. Mares in late gestation and lactation are usually provided concentrates to fulfill this caloric shortfall.

The amount of concentrate given will depend on the mare, but the general feeding recommendations supplied by the manufacturer provide a logical starting point. If the mare requires less concentrate than the manufacturer suggests, a ration balancer pellet can offer further nutrition. A ration balancer is a concentrated source of protein, vitamins, and minerals, typically fed in small amounts, such as 1-2 lb (0.45-0.9 kg) per day.

Other considerations when managing lactating mares:

• While mares in late gestation may have a reduced appetite, lactating mares typically have normal, even ravenous, appetites. Because of this, mares should have access to appropriate forage at all times. Tall, large-framed broodmares (1,300 lb or 600 kg) may consume more than 40 lb (18 kg) of hay daily. If high-quality pasture is available as a forage source, hay may not be necessary, but many hours of grazing would be necessary for mares to consume sufficient forage. “Grass contains a great deal of water. Large quantities of pasture are needed to fulfill the forage requirement. Some researchers estimate that four acres of quality pasture is needed for every mare-foal pair,” Crandell said.
• Choose a concentrate formulated expressly to meet the nutritional needs of mares and foals. Use the manufacturer’s recommendations as a launching point, and adjust feed as necessary, staying mindful to keep meals as near to no more than 5 lb (2.3 kg) as possible. Most mares will typically consume 6-12 lb (2.7-5.5 kg) of concentrate per day. Divide into two or three meals. Because energy requirements peak in early lactation, more feed might be necessary then as opposed to mid or late lactation.
• Consider rebreeding efficiency. Keep lactating mares in moderate body condition. Maintaining mares throughout the reproductive cycle at higher body condition scores holds no advantage. In fact, maternal obesity has been linked to systemic inflammation, decreased insulin sensitivity, and an increased incidence of osteochondrosis in foals.^* Further, long-term obesity may predispose mares to endocrine-related disorders, such as insulin dysregulation, and increased risk of dystocia, according to Crandell.
• Mares that are unable to maintain moderate body condition should have their diets evaluated. If high-quality forage is provided in adequate quantities, attention should be turned to the concentrate portion of the diet. A concentrate that features various energy sources should be fed. Different energy sources include starch (as found in cereal grains), fermentable fiber (beet pulp, soy hulls), and fat (vegetable oil, stabilized rice bran). Add more calories to the diet by top-dressing fat. For example, oil or stabilized rice bran, onto concentrate meals. Fat is palatable so long as not too much is given at once. “As a concentrated source of calories, fat can be very helpful for increasing the energy intake without adding bulk to a diet that may already be maxed out in how much the mare can consume,” Crandell explained.

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^*Robles, M., E. Nouveau, C. Gautier, L. Mendoza ,C. Dubois, M. Dahirel, B. Lagofun, M. Aubrière, J. Lejeune, I. Caudron, I. Guenon, C. Viguié, L. Wimel, H. Bouraima-Lelong, D. Serteyn, A. Couturier-Tarrade, and P. Chavatte-Palmer. 2018. Maternal obesity increases insulin resistance, low-grade inflammation and osteochondrosis lesions in foals and yearlings until 18 months of age. PloS One 13(1):

A study at Cornell University was designed to learn a horse’s preference for loose hay or a complete pelleted feed. Horses were put on one of two treatments: free-choice loose hay or free-choice complete pelleted feed. Each horse could get a serving of the alternate product by pressing a plate. First, the horse learned to press the plate once for an alternate serving. The mechanism was then set to give the reward only if the plate was pressed an increased number of times.

Horses with free-choice loose hay did not progress beyond pressing the plate once for a serving of pellets. Meanwhile  horses with free-choice pellets learned to press the plate as many as 13 times for a serving of hay. In addition, horses with free-choice pellets spent 11% of the time nosing through their bedding, a foraging activity. Horses on free-choice hay spent only 1% of their time foraging, possibly indicating their need to chew and swallow fiber had been more completely met.

Owners of stalled horses are advised to provide some hay or turnout/grazing time if possible, and to split the ration of pelleted complete feeds into a number of small meals spaced throughout the day. This strategy may help to combat boredom and reduce the tendency of stalled horses to develop stereotypic behavior such as weaving, cribbing, and kicking.

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