Esomeprazole (Nexium) for equine ulcers

[CELook]

I thought I would share my experience because I legit feel like I just won the lottery.

A little background: Diagnosed my Morgan with gastric ulcers last Fall via Succeed test (sidenote I will not use this again because I had negative results in the past when I am sure he actually did have ulcers). I treated him for about 5 weeks with UG and Succeed to cover my bases. Tapered him off and we were good until about January 2018 when he started acting a little grumpy and we were trailering to a Jumper show anyway in the next week so I treated him for about 10 days with generic Omeprazole purchased at horseprerace.com. We had a great show and I tapered him off successfully.

A few weeks ago we had a Combined Dressage/Show jumping show at my barn. I didn’t even think about giving him Ulcerguard since we weren’t trailering off property. But boom we stepped into the dressage ring and meltdown. I thought it was an isolated incident but rode him the next day and more meltdowns. I started treating him with Nexium as described here at 60mg a day. We are two weeks into treatment and he is definitely feeling better. He has not had any meltdowns and is getting back to his pre-ulcer performance level. I plan on continuing to treat him with the Nexium and will taper him off slowly. I’m just so happy that this is working so well and is so reasonably priced. Thanks to the OP for posting this!

[Zzahar]

First I want to say thank you for starting this thread, it has been so insightful. I had my horse on the treatment of 3 20 mg capsules for 28 days and then tapered to 2 capsules for 1 week and 1 casule for the final week. During the final week I placed him on U-Gard as well. It has been several months since his treatment ended and he is doing great. I have kept him on U-Gard as a safe guard, which has worked well. I’m sending him to the trainer I use for a month and want to put him back on Nexium to prevent any flare up from the stress that I’m sure he will feel. Does anyone have any information about the dose I should use? I was thinking 3 capsules for 2 weeks stepping down to 2 capsules for 2 weeks and tapering to 1 capsule with U-Gard added the week her returns to my barn. Any thoughts are greatly appreciated.

[Bonitacw88]

I am so grateful and hopeful having found this forum. I have a 34 year old Arabian gelding who colicked this past weekend. He did the same last year at this time and after treating the colic a couple of times my vet decided we should just go ahead and treat him for ulcers. We did not have him scoped and just went ahead and treated him. My vet used a compounded Omeprazole/Ranitidine. It was basically a 3 month process with weaning him off very slowly. Now here we are the same time of year and he’s starting again. I don’t want to put him through all of that again as he got so he didn’t want me anywhere near him because he knew I’d be sticking a tube in his mouth. I started tonight on the 3 Nexium capsules. The only problem is he’s not eating very much right now. I was able to put it in his senior feed and he did eat two of the capsules. I was able to give him the third with some treats. I sure hope this helps him and he’ll feel better.

[lorilu]

I put the capsules in my hand with a bit of sweet feed - and horsie gobbles it right down.

[Lusoluv]

Ugh…after reading through all these pages of great information, I realize the 2nd package of 42 tabs Nexium are just that…tablets - not capsules! I started with a small bottle of Nexium caplets just to see if they would help my horse. They did within 2 days. Went to another store to get a larger bottle and didn’t pay attention/realize that tablets might not have the same coating as the caplets I’ve put in my horses pellets. I don’t want to risk feeding the tablets if they’re worthless and have my horse’s tummy get upset all over again. Rats!!

PS: De-worming time is here. Should I wait a few weeks while treating for ulcers? Will Equimax nullify the Nexium and or upset her tummy? Thanks all!

[HiJumpGrrl]

@Lusoluv I think the consensus on this thread is that it doesn’t matter if tabs vs caps.

[IPEsq]

Deworming should be fine. I’ve used tablets with good results.

[CELook]

I just thought I would add some data to this thread. Quick background: Around mid-March my horse displayed some of his signature ulcer behavior so I put him on Nexium capsules 60mg per day. We have had a show about once per month since then so I have just kept him on the Nexium to continue to treat and keep any new ulcers away (so about 60 days now). Definitely have seen improvement on this protocol.

The vet clinic that I use was hosting an ulcer seminar this week and was offering scoping for just $50 so I took my horse to it. The scope revealed 1 super tiny squamous (point of a ball point pen size) and 1 small glandular lesion. The scope also revealed some healed ulcers. Since it was his first scope it is unknown if it was from his recent ulcer episode or from a previous episode last Fall.

Treatment recommendation was 30 days on UG for the squamous lesion and sulcrafate to treat the glandular lesion. I told the vet that I have been treating with Nexium at 60mg per day. He actually felt that I was under-dosing for treatment, he felt that if the horse broke open the capsule, that the granules would not make it though to where it needs to get absorbed. I have increased my dosing to 80mg per day for the next 2 weeks and then will taper down (the higher dosage does make me a little uncomfortable). I do think that my horses ulcers were quite bad in the beginning based off of his behavior, but of course I don’t know for sure since he was not scoped. So I am not surprised that he still has a couple of lesions.

For anyone having trouble tapering their horse off of Nexium, it is possible that you need a longer treatment period, increased dosage or need to add Sulcrafate. But of course scoping is the only way to know for sure.

I have also put my horse on SP SmartDigest Ultra to help with hindgut support since he has been on the Nexium for so long. I will likely switch over to Equisure for hindgut support, I have a sample on the way to make sure my horse will eat it since he is NOT a fan of powders.

[IPEsq]

@CELook I wouldn’t worry about upping to 80mg. At least, don’t be uncomfortable with that amount. As mentioned on here, one study calls for 0.5mg/kg (so, for my horse that would mean approx 280mg, or bottle of 14 pills). Which I did when advised by my vet to do that dose, as a replacement for 1 tube GG. No ill effects from that.

Of course, it would be nice if someone might study something in between or repeat the lower dose study with some additional pH readings to make sure that dose provides 24 hr results. But in any event, do not be uncomfortable with 80mg. Should be fine.

[morgansnmind]

Here’s our story so far. My mare is a 21yr Morgan, not the typical easy keeper and a little under weight, 15hands, living the retired life with her pony turned out 24/7 , stresses easily, has equine asthma but treated with Dex when it’s really bad, given almost free choice Timothy/Orchard, gets 2 1/2 qt Triple Crown senior and a fat supplement along with spirulina and Msm.

Two weeks ago I went outside to check on the horses before I went off to town and I found her in the field badly shaking. Vet was called and she had a heart rate of 74 but no impaction. Vet thought probably a twist so I thought I was going to loose her. I didn’t but she still wasn’t feeling good and would not eat her grain days later. Vet called out again to check her out and we found that her protein levels were up so the recommendation was to start gastroguard. I asked about Nexium because someone bumped up this thread and the vet said she didn’t recommend because it’s not approved.

Ignoring that because of all of your good results I started her on Nexium mini 3 pill 3days ago. This morning she cleaned up the most she’s eaten since her colic at one time 1 1/2 quarts triple crown plus two cups amplify. She now neighs and bangs on the gate for her grain and it only been day 3!

[ake987]

Started my horse on 28 days of 60mg/day today. Very interested to see how this goes for him, and super grateful to have found this thread.

[mydogs]

Question for all:

Has anyone given Nexium short term for before/during/after traveling?

[IPEsq]

@mydogs

Question for all:

Has anyone given Nexium short term for before/during/after traveling?

I just did as preventative for steroid injections and a few days of Bute. Seems to have been successful in avoiding the ulcer flareup that we had the last 2 times (when I didn’t give anything until after the symptoms of flareup presented).

[mydogs]

@IPEsq

I just did as preventative for steroid injections and a few days of Bute. Seems to have been successful in avoiding the ulcer flareup that we had the last 2 times (when I didn’t give anything until after the symptoms of flareup presented).

What dosage did you use and did you taper your horse off of it?

[Simkie]

I just started a “covering my bases” dose after a moderate colic scare yesterday that necessitated a variety of meds and some time off hay. Will probably do 60 mg for 5 ish days, 40 mg for 5, 20 for 5. But I’m very cautious in tapering…could probably make that shorter without issue.

[IPEsq]

@mydogs

What dosage did you use and did you taper your horse off of it?

Based off what CSU told me to do previously, I did 7 pills, starting a few days before his appointment. They view this as equivalent to 1/2 tube GG. Did that for a few days past the last Bute dose. He was doing so well that I then went through a tube of Ulcergard at 1/4 tube/day (had this–usual store ran out of Nexium). Now doing 40mg this week. Keeping it going a bit longer because of our stupid splint fracture for which he got a dose of bute and some stall time.

[stressgirl37]

This is a long and interesting thread, so no, I haven’t read all the posts. I’m curious though. Do many of you treat for ulcers without scoping? If so, is it a the recommendation of your vet, or something you decide on your own?

[lorilu]

I did not scope but if the nexium had not worked I was prepared to scope. Nexium is so inexpensive there was no reason to scope… Happy to say I have seen a big change in both horses after a full 28 day treatment and tapering off over two weeks.

[mvp]

I, too, benefited from this thread.

I am new to ulcer problems/treatment, so take what I say with a grain of salt.

I did not scope because, as I understand it, that doesn’t tell you anything about hind-gut ulcers. And I was willing to use response to treatment as a diagnostic thing as well as a treatment.

That said, I think I need a clue about treating hind gut ulcers, just to be thorough. The vets in my area have, so far, left a great deal to be desired in terms of being really up on sophisticated ulcer treatment.

[IPEsq]

I scoped the first time I did any treatment. We found very mild ulcers (grade 1), but my horse’s behavior was extreme. He responded exceptionally well to Gastrogard. So, based on that, I tend to go on behavior changes now if it makes sense. Because it was difficult to even see any ulcers on the scope, and the fasting is not any fun for anyone.

If he seemed to stop responding to treatment or seemed to develop a flare that got out of control, then I’d probably rescope to see whts going on.