I’m in week 3 of daily Gastrogard. It’s making a difference in her behavior. Question: do I run full dose to end of Week 4 or do I start to taper off?
I do 4 full weeks, scope the horse to confirm healing, and then taper over two more weeks. In several cases, it’s taken 8 weeks to heal the ulcers, then 2 weeks to taper.
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Well I have 4 weeks, and not sure when I can get horse scoped…
I’ve always been told that a taper is necessary to avoid acid rebound. I’ve also seen that borne out in the horses I’ve treated–stopping cold turkey resulted in returning discomfort/in some cases a recurrence of the ulcers.
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Treat for 4 weeks for sure. After that, it’s debatable whether 4 weeks is long enough to cause a rebound effect - some say it does for their horse, plenty have come off cold turkey.
Earlier this year I did the scope, 28-day treatment, rescope (and one more week to clear up a patch of minor discolouration that was left) and my vet told me to just stop the Gastrogard. I asked about the rebound problem and he said with a shorter length of treatment like this, it’s not necessary - maybe if they’ve been on it for longer term.
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AFAIK Dr Ben Sykes is working on some research to look into the rebound theory. So, the “need” for it isn’t yet proven, only theory.
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You could always do 4 weeks, and then use Nexium to taper off. If rebound isn’t an issue, you haven’t spent a ton, and if it is, Nexium anecdotally seems to work just fine. This is what I’ve done when using Ulcergard for shows.
What’s the advantage of Nexium? It’s a very similar proton pump inhibitor. Is it way cheaper than Gastrogard?
Esomeprazole (Nexium) is a stronger “cousin” to omeprazole, so yes, a PPI. You could do a whole 30 days of the highest studied dose (12-14 capsules/tabs for an average horse) for $500-ish, so yeah, way, way cheaper. And you could potentially treat with a much lower dose than that.
Where do you get it?
I just get the generic from Target. You can also get name brand Nexium from Target or any drugstore/grocery store/Amazon
We dont have Target in Canada 
Whoops forgot you’re in Canada. Amazon may have it, and I can get it from any drugstore or grocery store. “Esomeprazole magnesium” not just plain ‘omeprazole’
So the human box is 14 caps per box. You’d feed one box a day then. So in Canada $15 a day. Yes, cheaper. But I bet getting the pills into the horse is a challenge!
Here’s a post I made on this in the giant Nexium thread:
The highest dose used in the studies I know of was 2mg/kg.
Here’s a copy/paste from another thread the other day. Hopefully the links also copy over:
One looked at a 40mg and 80mg dose and found the same effectiveness
One looked at a 2mg/kg dose to compare to the omeprazole 4mg/kg dose
One looked at .5mg/kg dose to compare to 1mg/kg omeprazole, and found the same pH results
And one looked at .5 and 2mg/kg doses of omeprazole to compare the 2
that’s from this thread
Ulcery after every show? - Horse Care - Chronicle Forums (chronofhorse.com)
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