I know I’m not the OP, but here is what I did.
I treated with 3 pills/day for 4 weeks, then tapered to 2 pills/day for 2 wks, then 1 pill per day for 2 wks. Ultimately though, I went grain free with my OTTBs. That has had the best results.
2 Likes
I did the nexium treatment after seeing this paper. Had a looooong treatment with daily gastrogard, sucralfate, and doxy. Finally got down to Succeed, Equine Elixirs, and Nexium. Ulcers flared and we were colicing again. Went back to daily 1/4 tube Ulcergard (now do 1 hour before breakfast on an empty stomach b/c we flared when it was given with breakfast), still do nexium at night, stopped Equine Elixirs because it’s expensive and wasn’t doing anything, stopped Succeed because of same, switched to U-Gard Prescription strength which is pectin and lecithin and Smartpak GI ultra. He gets 3 nexium whole topped dressed over liquid food. Has been grain free for over a year and going grain free didn’t make a difference. I do feed all hay on the ground now as allegedly that stimulates more chewing and saliva which is supposed to be protective. He gets an alfalfa mix hay, only alfalfa in the trailer. So far we’ve been clear for about 2-3 months with this regimen. But it stinks.
Hi,
We suspect my daughter’s gelding has ulcers. I found this thread and started this protocol last night. I am just wondering how imperative is it that the Nexium be fed on an empty stomach?
We board and the barn owners feed all feed and hay in the morning and hay to everyone in the evening before we get there.
We try for him to have hay all day.
Thank you any input.
Not very! My horses are never without hay, and I still found it effective. 
Awesome, thank you!
One more question! Did everyone give Nexium at the same time everyday? Is that important?
Also what does everyone use to keep ulcers at bay after you are done with the Nexium protocol?
My Vet recommended Purina Outlast.
Thoughts?
Yeah, giving it approximately the same time every day is best. Down to the minute isn’t important, but you wouldn’t want to jump around wildly.
I’ve always like Uckele’s GUT for stomach support if the horse can’t maintain. But addressing whatever stressors are CAUSING the ulcers is the best way to go…you’re just going to be fighting a constant battle if you can’t fix that part!
Okay, my daughter uses him for OHSET, 4H, other gaming playdays. I am sure all of that stresses him. I am unsure what to do??
After reading this thread, im planning on starting my mare on Nexium. She is showing some strong signs of ulcers. She was on day one yesterday. Symptoms were/are: sensitive behind front leg where girth lies, reluctance to go forwards, general crankyness, laying down alot, drinking more than normal, VERY cinchy. Will report back within a few days and let everyone know if I see a difference.
1 Like
So, I have had my daughter’s horse on Nexium for today is day 10 and neither my daughter or I have noticed any change.
Should I keep going? Or start weaning him down? Is 10 days long enough to tell?
We are also waiting on selenium levels to come back from the lab…
Her gelding is super sensitive to touch where the cinch goes as well as his flank area. He is kicking out at the trot and lope.
Thoughts???
We’ve read of cases here on this board that have been scoped and treated with gastrogard that have taken longer than ten days to improve, but did show improvement when treatment continued.
It might be useful to add something for hind gut support, like Equishure or Succeed. PPIs can make hind gut ulcers worse.
Okay, so will Succeed cure hind gut ulcers??
I am most likely going to have him scoped.
The effective dose of omeprazole is much higher and therfore much more costly. 2.28 grams of omeprazole (gastrogard dose) is 114 20 mg capsules.
1 Like
Oh okay! I read that several times in the thread and didn’t make the connection until now.
My chiro/acupuncture provider (who is a vet who used to have a general practice before deciding to focus on the chiro/acupuncture work) told me today that among the very non-scientific survey of her clients who have been trying Nexium that it appears that Nexium is working better than the generic/compounded omeprazole products. So, GG/UG works and Nexium works. And don’t waste your money on compounded omeprazole. She also said that it appears the clients using Nexium are seeing less of the rebound effects. Again, just observations from someone personally interested in this and who always asks about those things and diet and other management questions when taking patient history.
All I could tell her was that when my horse had his neck and SI injections done about a month ago, which included 3 days of Bute, that he didn’t have an ulcer flare like he was prone to in the past, and I used Nexium for the preventative (plus I double up on his Succeed at the same time).
2 Likes
That’s interesting info, @IPEsq!
I do think it matters WHO is compounding. I have a vet who did scoping studies with the Precision Pharmacy product and found it as effective as gastrogard. But there are a whole lot of compounded omeprazole preps out there, and they are not all effectively buffered.
The bit about rebound is thought provoking. I wonder why that is.
Yeah, I don’t have any details as to what compounded products people were using. This vet has been the only one around here closely watching this and apparently having several clients using Nexium (people at my barn kind of raise an eyebrow at me, including the two boarders who have ulcer prone horses who just paid for yet another round of GG (not even saving a few bucks using UG). Considering that one of them does tend to scope before and after, it would have been really interesting for her to try Nexium. Although I don’t blame her because the horse’s behavior when ulcery is pretty rank.
I kind of wonder about the rebound thing myself. Do we know if those same horses would have rebounded badly that particular course? I dunno. The only thing I can think of is that when you are trying to give 1/2 or 1/4 tube of GG, how much actually gets into the horse every day? What stays on the lips and they wipe it off or is in the little bit that gets spit out or whatever. I personally find it much easier to get the tapering right with Nexium, particularly because my horse will eat a few pills out of my hand with some cookies, so I know they aren’t getting dropped on the floor. And you can be more precise with it if you want to really go down gradually.
So for maintenance after nexium for management problems that can’t be addressed, it seems that ritetrac by KER is the best. I am wondering if there is a generic alternative to feeding KER brand? Ritetrac costs more than treating for ulcers! What do other people do? My source of stress for my horse is frequent trailering. Would trailering with an alfalfa hay net be effective?
Posting here as well as the other Nexium thread. 10 yo TB gelding was rescoped today after 33 days of Nexium at 14 capsules per day (0.5 mg/kg) and all visible stomach ulcers were resolved. Unfortunately, horse is still exhibiting some signs of discomfort (sensitive to touch on sides) so we’re going to begin tapering Nexium and start a course of Sucralfate to go after potential hindgut ulcers.
Looking for tips and tricks for feeding this to make it as easy as possible for my barn I board at. I have tried putting the pills in fig-newtons but my horse doesn’t really care for them. I was thinking about putting a drop of peppermint extract on them…maybe that would help? He does like peppermints. He gets his grain in a feed bag so little to no chance of him spitting out and falling on the ground.
