Okay, so we’re on the same page then. I thought everything past the foregut (stomach) is considered hindgut. I guess the small intestine is still considered foregut then. Thanks!
So to clarify
80mg for 28 days
60mg for 14 days
40mg for 7 days
20mg 7 days
Look correct?
https://images.app.goo.gl/tKDuHCLWwXShPTGK6
The small intestine is part of the foregut.
80 mg is not the dose I personally prefer to use for an average size horse, and I’ve had plenty of positive experiences with 60 mg through treatment. Keep in mind you’re increasing the risk of side effects with a larger dose.
Would it be fair to assume that bite marks just on the right side indicate right dorsal colon ulcers?
Diagnosing RDC requires an ultrasound of the colon. There’s a good paper out there, let’s see here…
https://www.lsu.edu/vetmed/ehsp/horse_health/lsu_tips/colonic_ulcers.php
I read that one! And a few other things before bothering you nice people with my questions. 
Like this one http://www.ivis.org/proceedings/navc…A/067.pdf?LA=1
I’ve been scouring the internet honestly, trying to educate myself. I cannot find anything about right side bite marks correlating to RDC in literature, but considering the horse I have in mind is fairly fresh off the track and has received plenty of Bute and had a high sugar diet…it kind of makes sense, right? . He was a bad doer at the track and also had chronic diarrhea. He is now on a very low starch, high fat and high fiber diet and has normal looking manure. No NSAIDs since being of track, too. He cleans up great now, but is still opinionated about grooming his belly, touching around his sternum and he is still biting primarily at his right side. He’s been on a supplement called Gastroade but I realize that’s not doing anything to actually treat the ulcers.
To me he is a prime candidate to treat empirically for fore/hindgut ulcers.
Our vet recommends a combination treatment of a PPI and Sucralfate to tackle both the hind and foregut; administered in the proper order/timing of each other of course.
Just a thought…if GG is recommended on a empty stomach, shouldn’t the same logic apply to Nexium given their similarities?
I appreciate being able to bounce these thoughts off of you!
PPI and sucralfate must be given an hour apart to be effective.
Yes, thank you. And PPI given before Sucralfate.
It has been advised to give Gastrogard on a empty stomach, so what I’m wondering is if Nexium should be given the same. If the recommendation here is to drop the capsules in feed then that is not an empty stomach. I realize there has been success in doing it this way, but I wondered if it is ideal to get the Nexium into the horse with an empty stomach?
This nexium protocol is useful for simple, uncomplicated gastric ulcer cases. It is supported by a small amount of literature and the many personal reports of success found in this thread and elsewhere.
While you can certainly choose to use nexium for complex ulcer cases in a new to you horse, I would not recommend that, particularly if hind gut ulcers are suspected. There is no actual research (that I am aware of, if anyone knows of a study, please share!) of how this particular PPI impacts the hind gut. We know that, in general, PPIs can cause harm to the hind gut.
My personal preference would be to scope a horse that is suspected of having both gastric and hind gut ulcers, preferably with an ultrasound of the colon as well. If gastric ulcers aren’t found, that simplifies treatment considerably. Also, true right dorsal colitis isn’t something to mess around with and can be challenging (at best) to treat. I would be very hesitant to put a RDC horse on ANY PPI. There are other options to heal gastric ulcers that aren’t so hard on the hind gut.
This horse does not sound like a good candidate for nexium @Satin Filly. Work with your vet, scope and ultrasound the horse, and question the use of PPIs all together if you do find he’s got any RDC.
Okay so I have horse who I’ve been treating with Nexium for a month. 3 pills a day for mild ulcer symptoms. He was on no grain, only hay 24/7 and lived in a group. Unfortunately I was an hour away (he was in training) and he definitely didn’t get it everyday. He did for the first few weeks but noticed that the bottles were not empty like they should have been. This is incredibly unfortunate but I was far away, not able to come everyday and had to rely on barn staff.
Also unfortunate, is I had to move him to a new barn the week. It was his first time away from his siblings and his first trailer ride alone. Needless to say, he stressed a lot. He’s starting to settle now mentally but he’s showing even more symptoms as far as reactive to certain points in his body.
I have been personally giving him the nexium myself now that he’s moved closer, so I know he’ll get it everyday. Should I just treat at full dose for another 4 weeks? Or switch to omeprazole? Scope? I have a hind gut supplement I want to ad as well.
Poor guy… I’m trying to do my best for him. Moving was hard but we had no choice. And I know him not getting the nexium consistently at the other barn was not good and I’m sure set him back. Previously seemed like it was helping though.
Sorry to hear of the frustrations with your previous barn, Luna 
Scoping is never a bad idea. If that’s an option, more info about the stomach is useful.
My inclination would be to put him back on a full dose until he settles at the new barn, then taper. If you think the hind gut is in play, can you do ranitidine instead?
@Simkie yeah it’s frustrating. Good people, good place but not a good setup for giving meds.
I’m not sure if I really think that hindgut is at play but kind of want a supplement to help keep it from turning into hind gut too. I could do ranitidine but I can’t come multiple times a day to give that, so I would be relying on barn staff again. That always makes me nervous with medication like ulcer medicine where it’s crucial that they get it consistently. And now, even more nervous about that!
I think I’m going to give the nexium at full dose for another 2 weeks then talk more with my vet about scoping/trying something else. Such a bummer as he was seeming much better until they became inconsistent with it/on the cusp of the move.
He’s eating well though, body weight good, poop looks good ECT. Just insanely girthy and touchy again damnit. 😰 One thing that did change is was on alfalfa once a day at old barn. New barn didn’t do alfalfa but I got him some alfalfa pellets, hoping that helps a little.
Just thought I’d update. My horse has been on nexium for 30 days and is acting much more comfortable. No reaction to being curried or touched. No girthy behavior. He had some back soreness and while that could have been from saddle fit, that’s gone too.
Now to taper and hope he can get off if it okay. I’m putting him on a gut supplement and he has a hay net. He also gets a little alfalfa pellets everyday. Here’s hoping 🤞
Please forgive me for not rereading the entire thread to find an answer.
My horse is doing well with no symptoms of ulcers. We are going to a 2 day show this week with a 5 hour trailer ride. Can I give nexium prophylactically? 1 capsule per day?
No, not really. A prophylactic dose would be less than one capsule for a “normal” sized horse.
Well I’m tapering and have been seeing sensitivity on his flank area. Thinking of adding equishure too.
Equestriantte: When my barn pals and I go to shows/clinics/off-farm training, we give our horses 1 Nexium per day starting the morning we leave. Some of us have treated our horses for ulcers in the past, some had their horses go a bit “off” their feed at shows with the added stress and irregular routine. So far, we’ve had good luck with this protocol. Maybe we’ve just been lucky, but it’s given us peace of mind. We also feed Uckele GUT or something similar daily. Hope this helps…
Ok thanks. I’ll give one capsule the night before our travel, the day of the show, and when we come home. 
So if you’re planning on using a PPI for prevention, understand that they do take a couple days to shut down the proton pumps. Starting the day you travel is not particularly effective. Starting 2-3 days before the stressful event is a better idea.
Thanks that’s a good idea!
Update on my test:
I put my anxious and sensitive mare on generic esomeprazole about a year ago. It did not reduce her anxiety and flank sensitivity, but it did increase her overall bloom. I had trouble weaning her off, so it was clearly doing something. I stopped trying to wean her completely off, and just settled on giving 1 or 2 tablets a day.
Long story short, I had to put my horse down, and elected to do a necropsy. No ulcers of any kind were found on physical inspection, and this was a horse that definitely would/should have had them.
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