Hindgut ulcers in horses are a common, painful affliction for horses. They can be hard to diagnose but the right medication can provide fast relief to your horse.

The difference between gastric and hindgut ulcers in horses

Gastric ulcers occur in horses stomach & upper gastrointestinal tract. They are traditionally diagnosed through diagnostic approaches like gastroscopies.

Hindgut ulcers in horses are slightly less common and much harder to diagnose. Hindgut ulcers occur in the area from the small intestine to the anus. Most of these appear in the large colon and small colon.

Causes of hindgut ulcers in horses

There are three main causes of hindgut ulcers in horses. These are:

  • parasites (namely tapeworm),
  • hindgut acidosis and
  • overuse of certain medications.


Tapeworms live in the gastrointestinal tract of horses and other animals. The site where they attach to the intestine can cause ulcers.

Hindgut acidosis

As the name suggests, hindgut acidosis occurs when the horse's hindgut becomes too acidic.

Too much acid happens when undigested simple carbohydrates reach the hindgut. These starchy carbs produce lactic acid which kills 'good' bacteria and damages the mucous lining of the bowel.

Furthermore, this reduces the hindgut’s mucous production which leaves the surface of the hindgut vulnerable to ulceration.

Prolonged medication

Another cause of hindgut ulcers is prolonged exposure to Non-Steroidal Anti Inflammatory Drugs (NSAIDs). The most common is phenylbutazone or 'bute'.

Non-steroidal anti-inflammatories are used to reduce inflammation and pain in horses.  However, they're proven to cause ulcers and kidney damage with long-term use.

Vets recommend a maximum treatment period of 3-7 days.

Prevention of hindgut ulcers in horses

Parasite Prevention

Horses become infected with tapeworm when they eat hay or grass infected with tapeworm larvae. These develop into adult tapeworms inside the horse’s intestines.

It is important to be aware that not all wormers kill tapeworms. These particular parasites can be treated with one of two drugs -  praziquantel and pyrantel.

You can reduce parasite populations on the pasture by regularly removing droppings. In additon resting grazing and rotating sheep and cattle on to horse paddocks.

Preventing hindgut acidosis

  • Grain feeds should be minimised or elimindated.  
  • Grains should be processed, preferably micronized or extruded.
  • Horses should have constant access to forage such as pasture grass or hay. The absolute minimum is 1.5% of the horse’s body weight in forage daily.

Limiting prolonged use of NSAIDs

Horses have an uncanny knack of hurting themselves. Therefore there are bound to be times when they'll need some pain relief.

While it's a good idea to have ready access to bute for emergencies. However it's not a good idea to have horses on bute for an extended period of time.

Treatment for Hindgut Ulcers

Sucralfate is the best treatment for hindgut ulcers.

It works by forming a viscous gel over the ulcer craters. This protects them from further damage, giving the ulcers a chance to heal.

In addition, sucralfate also:

• Inhibits the action of pepsin, the enzyme that breaks down protein.
• Increases the production of prostaglandins, which protect the stomach lining

How to source sucralfate for horses

Affordable AbSucralfate can be purchased from our website without the need for a prescription. To find out more, please visit the AbSucralfate product page