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Esomeprazole (Nexium) for equine ulcers

Does anyone have any thoughts about combining an UG/GG treatment, with the Nexium? Or transitioning from UG to Nexium? These horses are UG-ing me out of my mind!

I must have missed this information. Does anyone have a link to a study or discussion about using the lower dosage? It sure would be nice to be able to effectively use the lower amount.

You wouldnā€™t use both at the same time. They do the same thing, and act in the same way. Nexium (esomeprazole) and GastroGard (omeprazole) are very closely related biochemically and are in the same class. (Read about enantiomers if youā€™re curiousā€¦esomeprazole is just the s-enantiomer of omeprazole, hence the name)

If youā€™re using ulcergard AS ulcergard (1/4 tube/day to prevent ulcers) nexium is probably not the way to go. An analogous dose would be less than a pill.

If youā€™re using ulcergard as gastrogard (1 full tube to treat ulcers) proceed as outlined. You can probably go directly from omeprazole to esomeprazole because they work in the same way. Get through your treatment and taper carefully.

Keep in mind that Nexium carries all the same potential risks as GastroGard re: hind gut issues, potential for various deficiencies when used long term, etc. Just because itā€™s cheaper and easier to give/source doesnā€™t mean itā€™s benign or ā€œonly a supplementā€ (not saying youā€™ve said that, just speaking generally.) It very well may carry MORE risk than omeprazole because itā€™s more effective at stomping on those proton pumps. I dunno, I am not a pharmacist or a researcher. But Iā€™d advise using wisely and tapering carefully when your treatment period is complete.

Yeah, no. This is not applicable to us in the US. And this is why:

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Also, for those curious (I was!) here is what omeprazole and esomeprazole look like.

Omeprazole is both enantiomers. Esomeprazole is just the one on the right hand side. Neat, huh?

http://www.hon.ch/OESO/books/Vol_6_Bā€¦l2_0_img_4.jpg

Also, there is considerable discussion here regarding how well the various PPIs work in people. People arenā€™t horses, yada yada yada, but still quite interesting.

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Iā€™ve had my guy on it for 5 days now I believe. He was not showing full blown ulcer syndromes like he did in the fall - I did it mainly as a precautionary measure as he is now living alone and weā€™re FINALLY starting to have spring weather here and he is a bit sensitive to weather changes.

But I have to say, he seems much calmer than he was last week even with warm weather and wind blowing. He was nibbling on fence a bit and that also seems to have stopped. Like @Simkie I just toss 3 pills in his dry grain and he gobbles them up. He is a bit of a food thrower but he is fed in his pen which still has snow on the ground so he sucks every little morsel of it up so I donā€™t worry about him missing a pill.

Now if the snow would melt a little more so I could get on the trails and get a handle on his insane shedding, we would be in business!

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Yep thatā€™s me! He still has the ulcers around the pyloric spyncter and we manage with a compounded omeprazole (that I donā€™t think you can get in the States??? Made by Summit)

wow youā€™re paying a lot for your compounding omeprazole!!! I pay $140 for the bottle, and on the 10cc per day maintenance I get about 1.5 months out of it!

The stuff I got didnā€™t come in a bottle. It was in individual dosing syringes like GG is.

If youā€™re in Canada Iā€™d be interested to know where you (or vet) gets compounding omeprazole from in that form. I like to keep something on hand if my horse starts to show symptoms.

My vet orders it from Summit veterinary pharmacy:)

http://www.svprx.ca/svprx/index.aspx

Reporting back to say that while I said Iā€™d try this, I never actually didā€¦ until today. The darling hot house flower landed herself on stall rest for an indefinite amount of time thanks to a muscle tear (great timing, horse :rolleyes:).

Iā€™m going to try the esomeprazole while Iā€™m waiting for pop rocks to arriveā€¦

I tried something similar and it was a no go, he ā€˜sortedā€™ it out in his mouth and spit everything (including the treat) out. I kind of joked with my vet saying gee, maybe SAMe could be given as a suppository, I think Iā€™d have better luck that route! :smiley:

Just bumping this up to say, I donā€™t know why or how this is working, but the worldā€™s pickiest horse has been cleaning up her capsules in her feed no problem.

This is a horse who used to eat around the pellets in sweet feed and sort her Ultium so she left behind all the orange pellets. Sheā€™s like rain man when it comes to not eating things she considers offensive in her feed.

Touch wood, the capsules just thrown in her feed have been no problem and they seem to be helping.

So so glad you shared this, Simkie!

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I give my horses Ulcergard when they are on bute (or any meds, really), and when we travel. They get loose manure and you can tell they are generally stressed. UG makes all the difference. Otherwise they donā€™t need it. I usually give one horse a full tube/day and the other horse 1/2 tube/day and taper them down after we get home. Could I use Nexium for this purpose instead? Does it work as quickly and for short term use?

YAY @Texarkana! Awesome to hear your rain man horse is doing well. I have one of those, too. I just accept that sheā€™s smarter than I am :lol:

@Tiffani B I am not a pharmacist, so I donā€™t know the answer to your questions :slight_smile: If youā€™re game for wading through this article the answers might be in there. (Caveat: thatā€™s about people!) GastroGard takes about 3 days to fully come into affect and limit acid production. Based on my limited understanding about the differences between omeprazole and esomeprazole, I believe nexium acts more quickly and more effectively. I may be wrong.

No recommendations from me about using it temporarily or trying to find a dose analogous to a half tube. Guessing you could use it for your full dose horse, as long as you taper carefully. AFAIK, this stuff hasnā€™t been used or studied a whole lot in horses (unfortunately!) so youā€™ll have to read through what is out there and come to your own conclusions. I am treading carefully, and tapering slowly, as what Iā€™ve read makes me quite cautious about rebound acid production.

Nexium is really like ā€œuberā€ omeprazole. By all accounts, this is pretty potent stuff. Just keep that in mind :slight_smile:

Reporting from my own barn: Piggy and Dove have been off for awhile, with no signs that make me concerned about their bellies. It has been a bit tough as they both came down with anaplasmosis about a week apart (sigh, welcome to Connecticut!) Blush has two days left of the full dose and then Iā€™ll start her two week taper. Sheā€™s definitely picked up and Iā€™m happy with what Iā€™ve seen in her :slight_smile:

Iā€™ve had my horse on 3 pills a day for about a week and he is definitely much happier.

Iā€™m going to continue for a month then taper off. I am also giving probiotics to hopefully assist with the hindgut.

Just a note to those interested in picking some up and trying itā€¦ Costco has it on sale right now, Nexium 42 capsules for $18.99 I believe thru the first week of April. I havenā€™t had my OTTB officially diagnosed with ulcers. was very girthy and sensitive when I first brought him home. I have him Kalm N EZ, some beet pulp and K -Finishā€¦ He has always looked great weight wise and super shiny coat, and was never a picky eater. But i figure what the heck why not try having him on OTC ulcer stuffā€¦ So he is on Ulc-R-Aid and G.U.T. i also give him alfalfa pellets before we rideā€¦ the last two rides I gave him 3 nexiums with some alfalfa pellets and I swear he was happier and more relaxed.
With the sale on at Costco I am going to stock up and try doing a daily dose for a few weeks and see if it helps even more.

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I am using it as a preventative on my pony, since he just moved. Started one day prior to shipping and will continue for the 2 weeks and then taper. Heā€™s prone to ulcers and reacts by by extremely loose stool, off his feed, and his brain disappears if he doesnā€™t feel 100%. Heā€™s eating the pills out of my hand with crushed peppermints. Two days in and no loose stool and no appetite loss. Not a complete idiot at the new place.

Iā€™m glad to hear itā€™s working well! Thanks for reporting in! :smiley:

And definitely good to know about the CostCo sale :yes:

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Thanks for the Costco tip. Iā€™ll go buy a few.

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Sigh. Dove has lost her mind, so I think Iā€™ll put her back on the nexium. I donā€™t think this is any failing of the previous treatmentā€¦she was pretty damn sick with anaplasmosis, and ate poorly for the better part of a week. Perhaps the doxy also did a number on her stomach? Oh yeah, look at that. I hope her brain comes back. Piggy doesnā€™t seem to have the same problem, but we got him started on the antibiotics much more quickly, so he was only off his feed for about 48 hours.