Equine gastric ulcer syndrome (EGUS) affects either the squamous (upper) region or glandular (lower) region of the stomach. Veterinarians cannot reach a definitive diagnosis based on clinical signs alone. They must use gastroscopy.Common Signs of EGUSPerformance declineUnwillingness to workReluctance to bend/flexBucking, bolting, rearingPoor attitude/aggressionDispleasure with grooming/saddlingMild colic (especially post-grain)Picky eating/inappetenceWeight lossPoor coat conditionTeeth grinding (bruxism)Practitioners describe glandular ulcers by location, severity, and appearance (e.g., erosive, hemorrhagic).Veterinarians tailor treatment based on clinical findings and typically use Gastrogard (omeprazole) but might add sucralfate and/or misoprostol, depending upon the ulcers location and severity.The severity of ulcers doesnt always match clinical signs veterinarians see. Once treatment finishes, ask your veterinarian to rescope your horse to confirm healing. Sometimes treatment might take longer than the initial course.Take-Home MessageTreat EGUS like lameness: Start with a clear diagnosis before pursuing treatment. Use gastroscopy to guide accurate, effective care.