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Feeding the Hindgut Ulcer Horse

Tigger Montague

Feeding the Hindgut Ulcer Horse

Hindgut ulcer development and hindgut acidosis have become almost as prevalent as gastric ulcers in horses.

Causes behind colonic ulcers include the use of NSAIDs (particularly Bute and Banamine), acidity of the hindgut being altered (specifically by large quantities of undigested simple carbohydrates such as starches and sugars reaching the hindgut and producing lactic acid which changes the pH to a more acidic environment), stress (mental or physical, which releases corticosteroids that inhibit the specific anti-inflammatory prostaglandins), and long term daily use of omeprazole.


Treatment: Common medications for hindgut ulcers include Sucralfate and Misoprositol. Sucralfate binds to the ulcer bed and forms a kind of bandage over the ulcer. It has also shown that it can stimulate cytoprotective effect on the colon mucosa. Misoprositol, is a synthetic prostaglandin. Prostaglandins are hormone-like substances that act as chemical messengers. Their physiological effects include the regulation of inflammation in the body. Misoprositol protects mucosa by increasing mucus production and thus regulating inflammation.

Feeding the Hindgut Ulcer Horse: It is important during the healing and recovery period that the hindgut is allowed to “rest”. This means reducing hay, which by its nature of lignan fibers is harder to digest, puts more stress on the hind gut.

Substitute soaked hay cubes (timothy/alfalfa) for hay flakes, therefor providing the much needed fiber in an easy-to-digest form. Provide soaked hay cubes every two hours if the horse is stalled, and if needed, a flake of hay can be given at the night check feeding along with another bucket of soaked hay cubes. Allow the horse to hand-graze several times a day if the horse has no access to pasture and grazing. Access to adequate pasture can replace some of the frequent soaked hay cube meals.

On average, a horse will need to be on the soaked cube program for at least 30 days. Once re-ultrasounded or checked, hay can gradually be re-introduced and the soaked cubes reduced.

Consider reducing grain concentrates, and add molasses-free beet pulp (Speedi Beet if you want to avoid GMOs). Add some whole flax seed or stabilized flax for additional Omega 3’s, and some alfalfa pellets or timothy pellets for added easy to digest fiber and protein. For additional fat sources, coconut meal, or rice bran can be added in.

Probiotics: Yeast probiotics are important for fiber digestion and fermentation. However, in a hindgut ulcer horse, there is already inflammation (heat) and yeasts by their nature are “heating” or “warming” elements. I like to recommend starting with cooling probiotics: the Lactobacillus family, abbreviated on labels as “L.” It is also important to include MOS (Mannan Oligosaccharides) which helps to regulate the pH of the hind gut.

Hemp Seed Oil: this oil contains GLA (Gamma Linolenic Acid) which the body can use to regulate the prostaglandins, and decrease inflammation. It is particularly beneficial for horses who begin to transition off of Misoprositol because hemp seed oil continues to support the reduction of inflammation.

Stalled Horse Stress: One of the lesser-discussed issues with horses that are stalled is that they are not in physical contact with other horses. They are confined to a stall, and confined to a turn-out paddock by themselves. We know this is not a normal living situation for a grazing herd animal. Horses who live in groups or get turned out with a buddy, will share neck scratching duties, sometimes graze close together and/or stand side by side for a snooze in the sun. Even with a pristine paddock and beautiful barn/stall set up with super attention paid to every horse, the lack of physical contact with other equines can cause chronic stress. Some horses can adapt to the isolation, and others can’t. Chronic stress leads to hindgut ulcer issues, and many times it is hard to evaluate an individual horse’s stress levels, particularly the stoic ones.

Quantity and Quality: What and how we feed is vitally important: quality of hay, quality of forage, quality of feed and quality of water. As owners and riders we always need to ask ourselves: is this feed, this supplement, this hay going to decrease stress on the GI tract, or increase it?

Feeding grain concentrates three or four times per day is far better for the health and functioning of the GI tract than feeding grain concentrates twice per day. Horses need to eat hay or graze twenty hours per day. Any fasting time lasting longer than four hours is a recipe for increased stress.

Reducing hindgut ulcer recurrence: Yeast probiotics are specific to the digestion of fiber in the hindgut and are important for hindgut fermentation. Only live/viable yeast probiotics (those that are labeled with CFUs) are capable of colonization. Make sure the CFUs are at least 100 billion per serving. BioStar’s Tract Bios is a recommended choice.

BioStar's True Balance EQ for hindgut ulcer horses

BioStar’s True Balance EQ



Adaptogenic herbs are also beneficial to reducing stress. These include Ginseng, ashwaganda, and holy basil, which have shown to reduce cortisol. Ashwaganda is available in BioStar’s Equilibrium, and holy basil is available in BioStar’s True Balance. Ginseng is available in Auburn Lab’s APF Formula. Yeast probiotics are not recommended if a horse has an active hindgut ulcer or acidosis.

Whether you’re dealing with a hindgut ulcer horse or not, keeping human stress in check is also important in reducing stress in horses. Horses can read us like books, and some will start stressing because their owner is stressing, or the groom is stressing, or the trainer is stressing, or the barn manager is stressing. It’s always a good idea to keep the barn a drama-free zone.

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