Chronic Ulcers - Help Needed

[Brtripp]

Hello!

I have a horse with chronic ulcers. We have treated successfully with omeprazole paste from the vet once (full 30 days). We have maintained with generic powder omeprazole from a company the last several months - We keep him on treatment dose until he dies (chronic chronic ulcers).

He is on Previcoxx daily (also until he dies) for pain management.

He WAS doing GREAT! But recently started dropping weight again, leaving grain, and standing inside in his corner. All typical signs of ulcers.

We’ve immediately started treating with omeprazole paste from the vet again — but I’m desperate for other options.

Hind gut? What do we do to address that? does omeprazole address that? Is there anything else I can do to help this guy out?

Medications?
Feed? This is a big one - He needs lots of grain to maintain weight. What is a good feed for ulcer horse that has a weight issue (too thin) and is hard to maintain.

Desperate for help!!!

[beowulf]

omeprazole does not address hind gut. ask your vet about raniditine AND sulcrafates.

additionally, the only thing I have found that helps manage chronic ulcers is an entire lifestyle change to 24/7 T/O with grass available 24/7 or round bale, supplemented with alfalfa. managing ulcers is expensive but if you don’t change the environment (which is usually what causes the ulcers in the first place) you are essentially shoveling against the tide.

additionally horses with chronic ulcers do need a specific feed regime, lower in starch is better - extruded seems best. some do better with no grain and just cubes of some sort, others do better with beep and a little ration balancer, etc.

[Brtripp]

He pretty much has that lifestyle. He has hay 24/7 and grass until dark. He can go in an out of his stall as he pleases - we only lock him in at night due to coyotes. However - he prefers to be in at night anyways. He’s retired - just want to maintain.

[beowulf]

[QUOTE=Brtripp;8272674]
He pretty much has that lifestyle. He has hay 24/7 and grass until dark. He can go in an out of his stall as he pleases - we only lock him in at night due to coyotes. However - he prefers to be in at night anyways. He’s retired - just want to maintain.[/QUOTE]

Not trying to be snippy but there is a BIG difference between being out 24/7 and being stalled at night. Sounds like what he has is not really close to a 24/7 turn out lifestyle at all. Good that he has hay in front of him always, in what form? Round bale? Does he really get 24/7 hay or does he just get hay at intervals in a slow feeder or some other similar method?

Honestly, I see a huge correlation between stalled horses and ulcers… and I don’t see as big a correlation between horses out 24/7 and ulcers. I don’t think Dr. Green cures everything but it is a good step in the right direction. Isolation and confinement are big contributors to the likelihood of developing ulcers.

[IslandDQ]

Yes on the sulcrafates, I had a horse boarded with severe issues that we were really able to stabilize but he did have flare ups and the combination of gastro guard and sulcrafate treatment at once would heal him. He always had to be on 1/4 tube dose per day, had grazing, ate hay out of hay net (a nice low sugar grass alfalfa mix), some high fat, low starch grain with coco-soya as the fat source (not canola which irritates ulcers) and beet pulp. That combination got him turned around and stabilized. This horse also had cushings and EOD (teeth deterioration) to manage.

[beowulf]

[QUOTE=IslandDQ;8272704]
Yes on the sulcrafates, I had a horse boarded with severe issues that we were really able to stabilize but he did have flare ups and the combination of gastro guard and sulcrafate treatment at once would heal him. He always had to be on 1/4 tube dose per day, had grazing, ate hay out of hay net (a nice low sugar grass alfalfa mix), some high fat, low starch grain with coco-soya as the fat source (not canola which irritates ulcers) and beet pulp. That combination got him turned around and stabilized. This horse also had cushings and EOD (teeth deterioration) to manage.[/QUOTE]

Where did you hear canola irritated ulcers? if anything I’ve heard the opposite.

[cayuse]

I have a pony prone to ulcers. She is also on previcox. I administer the previcox with a dose of ranitidine and this does the trick for her. She was on ranitidine three times a day and we were able to reduce it down to once. I give her alfa-lox a couple times a day which helps and free choice hay. Her turnout is for a couple hours a day and that is all she wants. And believe me, she wants what SHE wants! The ranitidine worked better for her than the omeprazole and is cheaper.
She became ulcery right after surgery several years ago. Probably from a combo of the meds she was on at the time and stress.
She is also retired.
Anyway, that is what worked for her.
Oh, and teeth. Having her teeth maintained, even though they are in good shape for an old girl (25) seems to help.

[twelvegates]

EquiShure.

Or RiteTrac if you are worried about gastric and hindgut ulcers.

[Toaster]

Smartgut is the only thing that worked for mine, she has been maintained on Smartgut for 5-6 years, when first put on the supplement she went from being an anxious ball of fire (could not get a lap around the ring with out dramatics) to a pleasant ammy hunter almost overnight. Now that she is retired and pasture boarded I tried to take her off of it - turned into a total nutcase within 3 days. Put her back on the smartgut and back to normal within 24 hours, I don’t know why it works but it does!

[LDavis104]

Couple of thoughts:

1. maybe the omeprazole powder doesn’t work well - not sure where you got it, but not every omeprazole product works - all depends on what they use as their buffering or coating technique
2. see how your horse does on the omeprazole paste - if you see an improvement, there’s your answer about whether this is a gastric ulcer vs hind gut issue
3. if your horse improves from the omeprazole paste which would tell you it’s a gastric ulcer issue, then try ranitidine instead of going back to the omeprazole powder.

I treated with 45 days of ulcer gard, rescoped to confirm healing before tapering off, and after a little while my horse became symptomatic again. Vet suggested ranitidine and my horse has been on 20 of the 150mg tablets twice a day for 3 years. If I try to taper him off, he starts showing his ulcer symptoms again.

[LDavis104]

Also to add - for my hard keeper lots of quality hay is what keeps his weight on. Tough to do in some boarding situations which is one reason I’m moving barns in a few weeks.

[Lutecia]

The problem with omeprazeole is that is only works when administered in certain forms. It has to do with the body being able to absorb it. It works as a paste in a tube that is why it comes that way from the vet.

Yes, you absolutely need to take a full on preventative approach. I had a horse who I treated for ulcer 3 times in about 6 month intervals. It got not only expensive but also tiring for me and my horse. This is what worked for my horse.

Absolutely no grain feed as the grain fermentation may irritate their digestive tract. There is a number of feeds that do not contain any grain. I used Pennfield’s Fibergize as well as Triple Crown Senior and they both worked well for my guy.

He received regular hay when out in a field in addition to grass and alfalfa hay only in his stall. He would even get hay thrown in run-in shed if it was to rain so he could continue eating if he was hiding from the elements. I used a small net for his hay in stall and it kept him busy munching on his hay for hours. (Otherwise he would eat some, pee on the rest and not have anymore hay the rest of the time he was in his stall. The net really kept him interested in his hay). He had free choice hay which means that in fact he was never out of hay.

During his last ulcer treatment I started him on SmartGut Ultra and he stayed on it for years to come. I was psychotic about him staying on this very particular feeding regiment and not missing a dose of supplement. Thankfully it worked for him and it completely transformed him. While I tried to get him as much turnout as possible at home, once I started boarding, he had to stay on the barn’s turnour schedule. He did not relapse.

Good luck with your guy!

[Brtripp]

Any idea of the cost for 30 days of ranitidine? I would rather do that than go back to the powder. I can’t afford more treatment - but want him comfortable. Honestly if we can’t get it under control this will be what ends him - the cost and he’s miserable and dropping weight like crazy. Doing everything I can

[Brtripp]

Any omeprazole suggestions that work tha are safe and not as expensive ?

[LDavis104]

[QUOTE=Brtripp;8276706]
Any idea of the cost for 30 days of ranitidine? I would rather do that than go back to the powder. I can’t afford more treatment - but want him comfortable. Honestly if we can’t get it under control this will be what ends him - the cost and he’s miserable and dropping weight like crazy. Doing everything I can :([/QUOTE]

I don’t know the official ranitidine dosage per weight, but the equate (Walmart) brand of ranitidine tablets comes in a bottle of 220 of the 150 tabs for $9.88, or 0.045 per tablet. I do 20 tabs 2 x a day but you really should do 3 x a day. An estimate of 20 tablets 3 x per day would be about $80 per month. You may need to up the amount though, but I don’t know the recommended dose off the top of my head.

[LDavis104]

If he’s miserable and dropping weight, were these symptoms consistent with what he displayed before? That is concerning.

[Brtripp]

[QUOTE=LDavis104;8276815]
If he’s miserable and dropping weight, were these symptoms consistent with what he displayed before? That is concerning.[/QUOTE]

Yes - he loses weight fast then starts speding more time inside and leaving grain. Did this before - treated for ulcers and was good for months.

[LDavis104]

[QUOTE=Brtripp;8276833]
Yes - he loses weight fast then starts speding more time inside and leaving grain. Did this before - treated for ulcers and was good for months.[/QUOTE]

Ok - was thinking miserable = some serious illness going on. Every horse’s ulcer symptoms are different. Hopefully the ranitidine will help him out. It’s helped mine a lot!

[Brtripp]

[QUOTE=LDavis104;8276960]
Ok - was thinking miserable = some serious illness going on. Every horse’s ulcer symptoms are different. Hopefully the ranitidine will help him out. It’s helped mine a lot![/QUOTE]

He has leg issues - DSLD and bad arthritis - on previcox daily. Mix in ulcers and he’s one unhappy boy! I just want to get him back where he was and maintain. No more relapsing every few months wondering about abprazole pop rocks.

[stryder]

I’m a fan of the abprazole pop rocks. My mare seems to spend the winter on the one-a-day regimen, then we taper in late spring so she’s off over the summer, then there will be an “incident” that will start the abprazole again.

My mare is in better weight this summer than she’s been for years. I attribute this to the hind-gut conditioner she’s been on for about 14 months. LMF Digest 911, about half a dose. Plus GI Support from Standard Process. I think her digestive system is improving bit by bit.

She also gets free choice hay in small-hole hay nets. Alfalfa pellets will help carry oil when she drops weight. Her “grain” is Purina Wellsolve LS and Purina Sr. Active.

Good luck with your boy.

If you get a prescription from your vet for ranitidine and get it filled at Costco, I think it will be less than described above. And while 3x is ideal, 2x does a lot of good.

When she stops eating, for whatever reason, she gets ranitidine 2 times a day plus 3 packets of abprazole. Ranitidine for 3 days, then continue with the blue pop rocks. When she’s eating well again, we reduce the blue pop rocks to one packet and continue until the weather is nice.

I had her on the abprazole for about 18 months the first time. She started looking tucked up, depressed appetite … just plain ulcery. We started ranitidine, and I read here on COTH about hind-gut issues associated with long-term use of omeprazole. We added the hind-gut conditioners and started transitioning her off omeprazole, using ranitidine as needed.

Over the past couple years we’ve fine-tuned her care. There have been a few incidents - a scratched eye, hole in her false nostril, a few big scrapes and bumps - and the barn staff finally understands that while treating those things, someone HAS to pay attention to how much she’s eating. Otherwise, she’ll stop eating and things will go sideways and downhill fast.