Esomeprazole (Nexium) for equine ulcers

I know lots of people who use it for this exact scenario. They don’t need 24x7 acid buffering, they just need it prior to work

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So the Nexium/Equishure then taper Nexium?

Yep, that’s a good plan!

Wouldn’t surprise me as it’s not that commonly used for dogs and cats (and that’s what most pet compounding is for)

@ratchet it’s long… but a great thread full of great information. Start from the beginning :wink:

Hi guys, two questions and forgive me if I’ve missed it.
I started giving him nexium with some watered down alfalfa pellets for lunch, while he’s eating out of the dish, I scoop up some up with with my hand and the pills to make sure he’s getting it. I’ve been giving him three “just in case” I’ve since switched to the dimples pockets, they’re the german muffins with holes in them. Since they are more “chewy” though, I’m a little worried he might crush them. What do you think? what is your best delivery method?

In other news I started him on Gut -X yesterday, if anyone has any experience with it I’d love to hear , it’s an alternative to Relyne, Alimend etc. Gut X is having a sale that ends today, I’m not sure what their actual regular price is I’m wondering if I should get more the sale price is pretty great relative to other products.

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Does anyone know what is in Gut X? It’s been recommended but I won’t give a supplement if I don’t know what is in it.

From their website?


(Not familiar with this stuff, never used it, just googled quickly.)

Simkie listed the ingredients. The pdf that @ClerkofCourts posted is a study on ingredients in that product. Well, maybe lol

Hyaluronic acid was part of the study, so that’s that.

Beta glucan is the other ingredient. What’s not clear, but is maybe the case, is whether the b-g in the Gut X is the beta-glucan Schizophyllan in the study. I suspect it is.

I am glad this thread got bumped up and I took the time to read through it (yep, the whole thing!) this time around. Giving it a try for my little fire breathing dragon (who used to be a very chill dude).

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@Simkie or anyone who has really been a heavy contributor to this thread (which has been SO informative - I read all 629 comments in a day)…

Apologies in advance if this question was answered, I missed it or didn’t quite grasp the outcome.

  1. If am thinking about giving Nexium at the dosage/timeline discussed here and my horse is on GUT by Ukele, should I stop giving the GUT while I treat with Nexium or can they be given in tandem?

  2. I looked at the ingredients of both GUT and Equishure… they are relatively similar, with Equishure having higher content of each ingredient. You cannot feed both together, right? Thank you!

Nexium and GUT work in different ways. There is really no harm in using both at once, and GUT may be helpful in protecting the hind gut.

Equishure is encapsulated bicarbonate. GUT contains no encapsulated bicarbonate. They are really not similar at all, besides being digestive supplements. Are you sure you were looking at Equishure and not some other supplement? :thinking:

Sure, you could feed both GUT and Equishure. Although I’d caution against throwing the entire kitchen sink at your horse, because that’s expensive and if something works, it’s tough to know WHAT was the magic ingredient that made things better :slight_smile:

If I were to pick, I’d go with Nexium and Equishure, or Nexium and Succeed–nexium for the stomach and then either Equishure or Succeed for the hind gut.


This was super helpful!! You are totally right, I got lost in my sea of browser tabs and was comparing GUT to Excel by DePaolo, which has most of the same ingredients. Thank you for bringing that to my attention!

Bumping my first question.
What do you find is the best delivery method for the nexium without them getting crunched? Even with the dimples if I’m not super cautious the pills will crack as I “close” them so I’m thinking when he chews them it’s probably game over.

I have no problems tossing them into grain.

If you really want to be sure, you can use a balling gun to deposit the capsules at the back of the tongue.

This is what I did. They are so tiny that they eat them right up and treatment worked very well for the 2 I treated.

@Simkie first I want to thank you for posting the original article, I am now treating my guy with a full, 60mg dose of Nexium capsules on top of his grain and have seen improvement in a week! We did not scope him but the vet was convinced he has them as he showed classic signs.

Anyway, I did want to pick your brain on feeding Purina Outlast while treating with Nexium. To me this seems a bit redundant but I will admit I do not fully know how they both work. Backstory on the Outlast, when the vet discussed ulcers with me (was out for a routine chiro appt.) he was on GUT and signs never really stopped, so she recommended Outlast. I did see some minor improvement a couple of days after switching but not enough to warrant avoiding treatment altogether. He will go back on Outlast once the full Nexium course is done (including the 2 week taper period), unless it makes sense to do both Nexium and Outlast in tandem.

Nexium works by breaking the acid pumps in the stomach. Break the production pumps, the pH of the stomach goes up, and ulcers can heal because they’re not constantly being hammered by the acid.

Outlast is a buffer. It reacts with the acid in the stomach, essentially removing those acid molecules. It’s effect is transient, because it only works when it’s actually IN the stomach. Once it’s moved out of the stomach, it can’t affect the acid.

Some acid is needed for digestion to occur. It’s not like you want to make the stomach neutral, ya know? So if you’re raising the pH of the stomach with Nexium, it’s probably not a good idea to also use Outlast. At best, it’s a waste of your dollars. At worst, you may be risking other problems like delayed gastric emptying, because the stomach can’t achieve the pH needed to empty.

Save the Outlast for post treatment management :slight_smile:

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@Simkie Thank you! I did know that Nexium inhibits/breaks the acid pumps. The Outlast was a little less familiar to me but that totally makes sense it would just be a buffer. I definitely do not want to reduce his stomach acid too much as I do know digestion needs a certain amount of acid to occur. I will hold the Outlast until he is done and save the money :slight_smile:

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I’ve been spending the last 28 days thinking about ulcers as my mare has completed her course of Omeprazole. I am relieved that by the end of her treatment her ulcers have largely healed.

In addition to the medication, I’ve started incorporating a flake or two of alfalfa into her hay, am using Nibble Nets so she’s rarely without hay in front of her, and am feeding papaya puree and chia seed. My vet was not as optimistic about using outlast and other supplements with grain as she said the stomach is already buffered at that point. I do know people who feed outlast before trailering or before other events that might stress their horse.

I will probably put my horse on Sucralfate during the spring and fall hunt seasons and feed Nexium day of our hunts, as well as put some alfalfa in the hay bags. After this last month (and our taper) I’m not sure she’ll let me near her with a syringe for quite some time. I wish they had the injectable in stock!