How Much Does It Cost to Treat Equine Ulcers?

The cost of treating gastric ulcers comes down to three things: diagnosis (scoping), medication (omeprazole), and follow-up (a re-scope to confirm healing). For an average-size horse, a full branded cycle usually lands somewhere around $1,600–$2,400 or more — and the medication is by far the biggest lever. This guide breaks down each piece and shows where the bill can realistically come down. For the full medical picture, see our complete guide to equine gastric ulcers.

Figures are general US ranges and vary with your region, vet, sedation, and your horse’s weight. They are estimates, not a quote.

Gastric ulcers can only be confirmed with gastroscopy — a camera passed into the stomach after an overnight fast. It usually runs about $300–$500, depending on sedation, your region, and whether it’s done at a clinic or on your property. It can feel like a lot for a diagnosis, but it does two things money can’t buy: it confirms ulcers are actually the problem (rather than something else), and it tells squamous disease from glandular disease — which changes how the horse should be treated.

Omeprazole is the proven treatment, and how you buy it drives most of the total:

• Branded GastroGard — the only FDA-approved omeprazole treatment, dosed at roughly one tube per 1,250 lb of body weight per day for about 28 days. For a full-size horse that’s a lot of tubes, which is why a branded course commonly runs north of $1,000. It’s prescription-only.
• UlcerGard — the exact same omeprazole, but dosed for prevention (about a quarter of the treatment dose), so a tube covers four preventive days. At the preventive dose a 28-day stretch is closer to $250–$300; used at the full treatment dose it costs about the same per day as GastroGard.
• Generic & compounded omeprazole — the same active ingredient is available at considerably lower cost, which is where most savings come from. The honest caveat: compounded products are not FDA-approved, and their potency and stability can vary between suppliers — so choose a reputable source and use them under veterinary guidance.

Not sure how much your horse needs? Use the omeprazole dosage estimator in our main guide to see the standard daily amount for your horse’s weight.

It’s tempting to skip the second scope to save money, but a horse can seem better while ulcers are only partly healed — especially glandular ulcers, which are stubborn. A re-scope at the end of the course confirms you’re actually done, so you don’t stop too early and pay again later. Budget another $300–$500.

Gastric support supplements run about $30–$50 a month and can play a supporting role, but they don’t replace treatment for diagnosed ulcers. The cheapest and most effective spending of all is often free: the feeding and management changes — more forage, less grain, a little hay before exercise, more turnout — that keep ulcers from coming back after you’ve paid to heal them.

• Switch the medication, not the care. The active ingredient is identical across products — sourcing omeprazole affordably (rather than the premium brand) is where the biggest savings live, with your vet’s guidance. Compare affordable omeprazole options.
• Get a plan before you spend. A consult helps you avoid paying for the wrong protocol twice — especially for glandular disease, which needs a different approach.
• Don’t skip management. The feeding and turnout changes that prevent recurrence cost little and protect the money you’ve already spent.
• Buy prevention strategically. Use a preventive dose around known stressors (travel, competition) rather than year-round.