Anyone used Nexium AND scoped their horse?

[twostinkydogs]

Bumping this thread back up hoping for some advice. My primary question is whether it is OK to give esomeprazole with grain? The vet told the barn owner it was fine, but I haven’t been able to reach him to confirm and I can’t find any specific instructions about esomeprazole, but lots about how omeprazole must be on an empty stomach. My horse is also getting sucralfate twice/day, but they’ve been putting it in his grain with the esomeprazole and hot water so it may be that neither drug is working very well.

Would it be beneficial to bring him in at lunch (he is out 24/7), fast him for 30 minutes, give the esomeprazole, fast him in for another 30-60 minutes and then turn him back out? I could ask the barn manager to give him the sucralfate about 30 minutes before before breakfast and dinner?

It’s not ideal, but I don’t think I can swing 2 barn trips every day and I think it would be hard for the barn manager to incorporate much more fasting time into their feeding/turnout routine. I would really appreciate any advice, I’ve never dealt with ulcers before.

[Simkie]

Dosing concurrent with sucralfate is not ideal.

Esomeprazole and omeprazole are the same re: dosing guidelines. Half of omeprazole IS esomeprazole. The closer you can get it to an empty belly the better. 30 minutes of fasting, however, is probably not significant.

Giving it with a handful of grain on as empty belly as you can manage is (probably) fine. I personally wouldn’t sweat a 30 minute pre and post fast. Targeting very first thing in the AM when they’re most likely to be empty is probably more useful, or whenever the natural breaks in their consumption are.

[RedHorses]

When I was treating my horse the vet had me do an hour fast, dose Gastroguard, fast for another 30 min, dose misoprostal (sp?), fast another 30 min, dose Sucralfate, fast 30 min, then feed his grain. Sucralfate can block absorption of other drugs and was given last.

My horse did live outside with hay available at all times so we didn’t get the “free” likely to have self fasted before the breakfast grain arrives period that stalled horses have. I must say my BO was fantastic about dealing with the hassle of ulcer meds for the two months of Gastroguard.

We went with this sort of drug spacing because this was a recurrence of ulcers after I’d had a difficult time clearing them the first time.

[twostinkydogs]

I appreciate the responses. I think we worked out something better, but definitely not ideal. He will stay in at night (we are still on day), get his esomeprazole first thing in the AM, wait 30 mins and feed alfalfa/grain/sucralfate and 2 PM and 8PM fast/sucralfate, grain around 6 PM.

He gets Uekele Gut, but the amount in the maintenance dose Smartpak is probably too low for his body weight. Do I need to get something to keep his stomach calm when he tapers off the esomeprazole? I’ve been looking at Succeed, Alimend, Ritetrac. Would any of those help? Or upping the Uekele? I think the ulcers are driven by recent stress/dietary changes from moving to a new barn. I’ve added 3 flakes alfalfa/day and he has 21/7 access to a roundbale. V. little grass