My new horse has shown several signs of ulcers (underweight, dull coat, fidgety/anxious, ouchy around girth area, dislikes being brushed) and also got hit with just about everything known to cause ulcers. He is an ottb, in a new home, and is injured so is now on pen rest for an extended period. I feel so bad for him. I’ve been giving him ulcer guard daily for going on 3 weeks and while he has steadily gained weight and eats like a champ he still has the other symptoms. I have him on a grain free low sugar/starch diet (split into 4 feedings) and he gets unlimited grass/alfalfa hay.
I don’t want to keep him on omeprazole any longer than necessary due to the expense and potential side effects. I have heard very good things about Redmond Gold Stress relief but I don’t really know where to start in terms of ulcer supplements and/or other changes I can make to his daily routine to help him. Any advice is appreciated.
Some ulcers take more than 28 days to heal so you might want to consider scoping being gradually reducing the dose of ulcergard. For long term management alfalfa and Purina Outlast was suggested by the internal medicine specialist whom scoped my horse.
Scope him and see if he’s healed. Ulcers in the upper portion of the stomach respond very well to gastroguard (or a full tube of ulcerguard - same thing) in 1-2 months. Ulcers in the bottom portion of the stomach have a lower success rate. They sometimes take longer to heal, or take different medications.
I have a few in the barn that have dealt long term with ulcers. Things we have found to help and even resolve to issues.
Stride Animal Health ADR, GI Calm, and Fish Oil. That has healed ulcers in numerous horses we have in the barn. The tough ones that hasn’t been enough. We feed 1 cup Outlast 4-5 times a day (esp before a workout), Triple Crown Senior (it can be fed on an empty stomach), free choice hay, and Chaffehay with grain/supplements (just a few handfuls does wonders)
I can’t afford to scope him for a while…I’ve only had him 2 months and between his vet and dentist bills, and an emergency truck bill, I’ve spent $6k in that time and I’m tapped out! So for now I need to see what I can accomplish on a very small budget until January.
I keep seeing Purina Outlast mentioned. What is in that that makes it so special? I can’t find ingredients or anything listed for it.
Have you tried Equine Elixir products? I am tempted to try them - they have one for ulcers, all natural and it is very affordable compared to the alternatives. Anyone used these?
You could transition to Nexium (3 capsules a day unless he’s huge, then 4), and stay on that for a total treatment of 2 months, then start weaning off.
Scoping is expensive but it can help – for instance, specific ulcers might have different treatment protocols. Sometimes it’s cheaper in the long run to just haul out the scope - especially if you’re dumping GG/UG/$$ into a horse and not seeing any improvement.
I don’t really have any experience with Purina Outlast.
Here are some (“free” or cheap) management shifts you can do, to help prevent ulcers from getting worse or returning. Ulcers are a management issue – and if a horse has them, and you treat the ulcers and don’t change the management, you are wasting money and they will return:
Eliminate or limit stall time
Increase turnout time - with companion
Introduce free choice hay - I use a roundbale for this, it is really helpful. You mentioned “unlimited hay” but if he is in a stall setting like a normal barn, chances are he really only sees 5-8 flakes of hay a day which is nowhere near unlimited.
Introduce alfalfa pellets to the diet - this has made a tremendous improvement to the horses I have got that came with ulcers
Introduce Nexium. Like JB said, start slow, treat for 2 months, wean off.
Insure he is 100% sound
Insure saddle fits
Honestly… I think ulcers in most cases are a symptom, that something is upsetting the horse. Horses that are NQR that are in work, tend to develop ulcers. Horses stalled and turned out alone tend to develop ulcers. Horses in hard work tend to develop ulcers. In my time as a BM I’ve seen a lot of horses treated a lot of different ways, and I’ve only seen a few horses truly (as in proven with scope) have their ulcers completely resolved. In those cases, the owners usually shifted them over to a 24/7 turnout situation with other horses, fed them PSSM-type diets with very little NSC/starch, and constantly kept hay in front of them 24/7. They also dumped thousands of dollars to treating it - usually a course of GG/UG, raniditine, sulcralfates for a few months, then Nexium and a long term gastric supplement.
I would not waste your money with Redmond or other supplements - I have my doubts they even work – adjust the diet and living situation how you can, and use the rest of your money on medication proven to work (such as Nexium).
Here’s what I did - generic Nexium for 1 month (I got mine at Costco for $12 for three bottles). I gave him 1 bottle per day for two weeks, then tapered him to 7 pills a day for the rest of the month before tapering him to three pills for an additional week. I calculated my pill dosage based on his weight but it was still significantly cheaper than other meds. The three pill suggested regimen in the Nexium thread didn’t work for him - he needs a higher dose.
Then, I started him on Outlast before his taper ended. He’s on Outlast now and the only time I need to give him Nexium is if we go to a show. He also gets a flake of alfalfa hay once a day in addition to free choice grass hay. I normally give him his alfalfa before I ride. He has not had any major issues since I started the Outlast and alfalfa. I also feed him an alfalfa based feed (Pro Elite Senior or Dynasty XT Pro).
I will say that I did have him scoped a few years ago so now I know what to look for symptom wise. It’s interesting that sudden weather changes seem to set him off worse than anything.
Ulcer Eraser is really great, as is a product from THE Equine Edge called Gastro Plus. Those are my two go-tos for ulcer management. In addition to one (or both, depending on the severity of symptoms) of those, I add in a flake of alfalfa a day, make sure the horse has access to as much timothy or orchard grass hay as they want, and then add in an ounce of apple cider vinegar on grain a couple of times a day as well.
I do still use omeprazole (as sparingly as possible) in super stressful situations like shows for one of my horses, but have found my other two ulcery-type horses do great regardless of stress if they’re on Ulcer Eraser and Gastro Plus.
Thanks for the detailed response! This horse has had it rough. He raced for 4-5 years then went to an ottb rescue where I got him at the end of August. He was very underweight, anxious all that. I only had him a couple weeks when he injured his leg. What we thought at first was just a superficial cut turned out to be a severely torn sdft. So as I’m sure you know that takes ~12 months to rehab. So he is stuck in a small pen with a shelter until he is healed. Luckily I too am a BM so I can control how much he gets fed and when. He gets mostly grass hay (sometimes we have alfalfa) plus Renew Gold, alfalfa/Timothy pellets, hemp hulls, and chopped alfalfa split into 4 feedings. Once he is healed up he will be on 24/7 turnout on 30+ acres with a nice herd of other geldings. I can tell he is starting to get a bit stir crazy being stuck in his pen most of the day but I don’t really have a solution to that.
Just a quick FYI - Nexium IS omeprazole. People keep throwing it around like it’s some cheap non-side-effect alternative to GG. But it is effectively the same thing. Certainly the same risk of side effects and not something you should “just throw a horse on,” IMO.
It’s actually esomeprazole. But I agree it’s still a drug. However, if this drug works as well as some of the more expensive drugs, I see no reason not to use it responsibly when you can help a horse and keep your budget under control as well.
Isn’t Nexium esomeprazole? I don’t pretend to be an expert on drugs, but from what I understood of Nexium vs UG/GG, was that Nexium was esomeprazole and UG/GG omeprazole.
Esomeprazole and omeprazole are PPIs, so have similar side effects… but in my personal experience I have seen better outcomes from Nexium than UG/GG.
This is a great treat/pellet ball but because my horse stomps toys to death I have to duct tape the hole closed. It is WAY easier to load and clean compared to the first toy. I think this takes him a couple of hours to empty
[/LIST] The cheapest toy so far is a milkjug with a couple of holes filled with alfalfa pellets strung up a bit higher than wither height in the corner of his stall. He can't press it into the wall, stomp it to death or annoy his neighbors with the rattling. I think it keeps him busy for 30-60 min.
Yes, it’s an isomer of omeprazole, and studies can’t seem to conclusively decide whether they work the same or esomeprazole is slightly more potent and effective. But both are PPIs. After spending $10k on two hospital admissions for a gelding who was on a maintenance dose of omeprazole, the working theory is that changing the production of acid in his stomach allowed more less-digested food into his hindgut which led to hindgut ulcers and RDC. You know what would have been less expensive? Not using a drug to manage his ulcers in the first place…something that I have since found to be relatively easy to do (not talking about exceptional cases here, of which, I know, there are). My point is that shutting down proton pumps is not a “minor” or side-effect-free proposition (despite several very BN vets who initially told me that omeprazole is completely side effect free, which was countered by my vet with the phrase, “even water has side effects…”)
With that being said, I still use both omeprazole and (more often) esomeprazole for short periods of time (e.g. a show). But I’ve found that the two products I mention above do a better job of managing the symptoms of ulcers than omeprazole anyway on a long-term basis.
My point (always) in this conversation is that Gastrogard (and any drug similar, which includes Nexium) is not something to be “just added to the diet to see if it works,” but instead should be considered carefully because some horses are sensitive to it and it can cause major problems. My personal feeling is that I will never add Gastrogard/omeprazole/nexium to a diet without also adding something that helps to protect the hind gut (e.g. Succeed, SmartDigest Ultra, etc.). But I also won’t “just toss in Nexium” like it’s a completely benign substance with no risks. And it really frustrates me to read threads like these where people talk about it like it’s completely benign and risk-free. Yes, it can work. Yes, it can help. But also, yes, it can cause further complications or completely different problems. Go ahead and use it, but at least be aware that it’s not risk free just because you can buy it cheaply and without a prescription.
Those are some great ideas! We have had a ton of rain and snow lately so his pen is too muddy for most toys, but I’m definitely going to give the milk jug a shot and look into the toys that go on the ground once it’s dried up a bit.
It’s not omeprazole. It’s a “cousin”, but a much more effective drug which results in a significantly lower dose to achieve the same results.
People keep throwing it around like it’s some cheap non-side-effect alternative to GG. But it is effectively the same thing. Certainly the same risk of side effects and not something you should “just throw a horse on,” IMO.
I’m not sure anyone has implied there are no side effects Yes, the effect is the same - a proper treatment dose reduces stomach acid for about 24 hours. At least one study has proven that.
The horse is already on ompeprazole. Transitioning to esomprazole isn’t a leap to something untested and unproven and out there and for no good reason.
I don’t think anyone is casually tossing around nexium. People are offering it as an option if a PPI is needed, because it’s available and inexpensive.
Yes, the effect is the same - a proper treatment dose reduces stomach acid for about 24 hours. At least one study has proven that.