Yes, I have definitely experienced this. I have a scope scheduled for this week because my guy has been on this stuff for way too long. Taza- can you by any chance point to the studies that have talked about gastric supplements? I’d like to show my vet.
Me too. The previous owner of the OTTB I just got on Wednesday, suspected he might have ulcers due to behavior issues and weight loss. Horse was under a lot of stress for various reasons but was not scoped to confirm.
After arriving at my farm horse would only eat hay – turned his nose up at feed. At first I thought it was the feed, that he wasn’t used to my mix, so I tried to duplicate what he was getting at the track which was a molasses based sweet feed. He wouldn’t eat that either…
…so I gave him Nexium. Within 24 hours he started eating and has contiuned eat. I am slowly weaning him off the sweet feed, replacing it with my own healthy feed and he will stay on Nexium for two weeks and then I will taper off.
Since I have never had a horse with ulcers, I’m wondering if this horse just got hungry enough to eat – or was it the Nexium? Can Nexium work in 24 hours?
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Here is an article that cites a study done at Louisiana State University. https://equusmagazine.com/management…currence-27179 I can’t find the actual study but the results were presented at several veterinary conferences in the US, UK and Ireland. And here is a study on Alimend http://www.j-evs.com/article/S0737-0…495-6/fulltext I have no doubt that the manufacturers paid for the research but then that’s true of most brand name drug studies.
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Thank you!! I’m pretty good at assimilating data and dropping false highs and lows, but having some starter links helps a lot. The Nexium definitely helped my horse dramatically but he’s been well for a long time now so it’s time to safely get off the medicine. This should help.
I did the full taper protocol and also had horse on Succeed supplement before, during and after the Nexium.
Any thoughts on why she would rebound?
I’m not a vet, I’m just speaking from experience with a lot of OTTBs and other ulcery horses for the past 17 years or so. I probably had plenty of others with ulcers before that, we just didn’t know it. 
So, my best guess is that your taper period wasn’t long enough. Your original post said 4 weeks at three pills, followed by one week at two pills, then down to one pill. I don’t recall seeing follow up studies to the initial 30 days with esomeprazole but since it is in the same family as omeprazole, that’s what many of us have been copying. The GastroGard regimen is 4 weeks at half dose after the initial 4 weeks at full dose. They used to recommend following that with 6 weeks at 1/4 dose but I’m not sure if they still do. I read another study abstract that said Succeed needed 90 days of administration before it equaled omeprazole in efficacy. http://www.j-evs.com/article/S0737-0…091-5/abstract . Interestingly there was another study that found that esomeprazole treatment was initially more effective in horses on a high grain diet than those on a hay based diet and the hay eating horses needed 4 times as much esomeprazole to neutralize stomach acid. Over time, it did balance out, however.
Given that information and assuming your stall rest mare is eating more fiber than carbs, I’d give her several more weeks on the higher doses of Nexium.
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Thanks @Taza, your feedback is really helpful. In your opinion, at the point I am at now, should I repeat 4 weeks of Nexium at 3/day, then follow with 4 weeks 2/day, etc.? Or is that overkill?
@Simkie didn’t one of your horses have symptoms that came back? I thought I read that further upthread. What did you do? Did you re-treat with full dosage/timeline? Or did you do a shorter course?
I did not. I’ve repeated based on risk–a course of antibiotics for anaplasma, or some herd changes that were stressful–but I have not treated a horse, tapered and had symptoms return.
Years and years ago, I did have that happen with Blush, and Gastrogard. I scoped her–clean scope–but she was obviously more comfortable on gastrogard. I don’t know why and eventually I changed her living arrangements pretty significantly when I retired her and got her off the gastrogard. I think now that she had several things going on, and likely had hind gut ulcers in addition to whatever might have been happening in her belly. Hind gut stuff wasn’t really as “known” then as it is now. She might have done just fine on Succeed or Equishure.
If I had a horse now that I couldn’t get off of nexium, I would scope. Other things can happen in the stomach–like bots, or delayed gastric emptying–that need something different than this. I would also consider the hind gut and if that could be playing a role. I suppose, too, it’s worth taking a hard look at how the horse is living and being fed and the environment…perhaps there’s some stressor contributing to ulcer formation.
If I had a horse now that I couldn’t get off of nexium, I would scope. Other things can happen in the stomach–like bots, or delayed gastric emptying–that need something different than this. I would also consider the hind gut and if that could be playing a role. I suppose, too, it’s worth taking a hard look at how the horse is living and being fed and the environment…perhaps there’s some stressor contributing to ulcer formation.
FWIW, comparing how my TB was on UlcerGard vs Nexium, the Nexium appeared to affect hindgut discomfort. He was on UlcerGard for at least 2 months but was still very reactive if you brushed his flank but after 3 days on Nexium you could brush/massage/do whatever to that lower belly area and he didn’t react. YMMV, of course.
Very interested in seeing what our scope brings on Wednesday. I loved the Nexium and would use it again but I’d love to be off it. I don’t like to use any medicine for such a long time.
I wouldn’t say that I can’t get her off Nexium. I did the 4 week treatment at the full dose, which seemed to be effective, but from what @Taza said, I may have inadvertently cut short the amount/time to taper.
The horse is fairly new to me, and is on stall rest for a soft tissue injury, so I am limited in options for living situation/environment changes at the moment.
That’s probably what I would do. One of the studies used a 2g (100 pills) daily dosage so I wouldn’t worry about 3 pills a day for a few more weeks. Someone mentioned hindgut issues but the Succeed should help with that.
I am now starting 2 Nexium/day. To recap, I followed study #2 and dosed at 0.5mg/kg as the full dose and used Nexium a few days when I had gaps in Gastrogard, and I am using Nexium for all of the tapering. Due to symptoms and trying some other treatments, we held at a half dose for quite some time (7 pills). I then did 5 for a week. Then 3 for a week. During this time in tapering down from the last week or so at 7/day, he’s been on Succeed paste, and on the double loading dose most of the time, since one tube has caused some increase in symptoms. He has a few days left of paste then will move to granules. He seems pretty back to normal as far as his stomach goes. So I have started 2 Nexium/day and am not sure if I will quit after a week at that or go down to 1. Will update if his ulcer symptoms return.
My question in bold – especially the 24 hour part – was a real question.
Anyone?
I think I’ve seen response in my horses in that timeframe, yes.
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Great to know! Thanks.
I know I’ve seen response within 2-3 days, but I can’t remember if I have in 24 hours.
I don’t see why there wouldn’t be an effect immediately since it reduces acid in that timeframe. It might not heal ulcers that fast but I can see it improving a horse’s comfort right away. Glad it helped.
After the 24 hours on Nexium (one 3 capsule dose) my new horse’s appetite improved enough that he wanted to eat and did eat, but he left a few handfulls and wasn’t eating with gusto. But now, after being on Nexium for several days, he’s whinnying for his food and gobbles it up. I was able to wean him off the sweet feed quite quickly.
So there is a 24 hour effect – it did something – but it took 3-4 days to see opitmum results.
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I’m a bit confused as to the full treatment dose. Is it 3 pills? An above poster mentioned half dose as 7. That’s quite a range.
Can an anyone clairify?
