So sorry for your loss. 
Just my experience- I suspected my horse might have ulcers due to moving and a lameness. He didnāt have any major signs but was just being a little finicky. I put him on Nexium and did notice a positive difference but then a few weeks later his behavior deteriorated. I was never able to wean him off the Nexium and he ended up being unrideable from ulcers confirmed via scope. I wish I had just scoped in the beginning because it might not have gotten as bad. His ulcers werenāt bad on scope either just 4-5 low grade not bleeding ulcers. Nothing in the glandular region. Weāre doing gastrogard for a month then re-scoping.
Did that work for your horse? Iām curious because my gelding is flank sensitive as well (his whole sides and shoulder area are sensitive) and I thought flank sensitivity was more a sign of hind gut ulcers? I would love to be wrong, I just bought nexium (the generic) but I am nervous to try it in case it is actually hind gut ulcers and it makes that worse.
Heās eating fine and has a shiny coat, but is very grumpy and sensitive to brushing/even petting his sides and flank. I did a course of ranitidine for him per my vets instructions, but pretty sure it was too low of a dose and too short. She also didnāt mention anything about weaning him off of it, just said ā10 pills twice a day until the bottles (2) run out.āĀ While he was on it he did seem much less sensitive and grumpy.
Also, before ranitidine he was having very loose stool regularly. I asked the vet about this and she said it was common for horses who eat orchard to have loose stool and it was fine. This seemed odd to me but I didnāt think too much of it. A couple weeks into the ranitidine his poop changed to normal healthy looking poop (no diet change). At first I didnāt connect the two, but then I put it together.
I ran out of the ranitidine about 4-5 days ago and his symptoms are worse than before, I assume it didnāt have enough time to work, and stopping it suddenly made things much worse. Like I said he is still a voracious eater and his coat looks nice, but he does seem to be losing a little weight.
Tldr:
Is flank sensitivity common with gastric ulcers (in addition to girth area/withers) or does it usually point to hind gut ulcers?
Would you just start him on nexium and see how it goes?
side note: I would like to give him something for his hind gut in conjunction with the nexium, as I believe he may have both, but I am not sure. I would just start him on both, but everything is either not shipping right now or way delayed. Also I canāt get ranitidine anymore (banned) anyone know anything similar? My main concern is I want to start him on nexium now so he can hopefully get relief as soon as possible, I just donāt want that to potentially cause issues in the hind gut.
Sorry for the long and not super organized post, any advice would be appreciated!
My mare had flank sensitivity when confirmed with a very mild case of ulcers.
My broodmare stopped eating normally the last month of her pregnancy which isnāt completely unusual due to lack of room in their abdomen. I assumed she would get her usual appetite back after foaling but she didnāt and the weight was falling off her at an alarming rate. I put her on nexium and the very next day it was like there wasnāt enough food on the planet! She is eating a mind boggling amount now and has put some of her weight back on despite lactating. Very thankful we found something cheap that works for her.
@juliab99 Iād personally be kinda hesitant to go the nexium route of the only symptom is flank sensitivity. Itās frustrating that ranitidine is no longer available otc, but your vet can still prescribe, and you can get it from an animal pharmacy like valley vet. Have you touched base with your vet about how your horse did on the short course, and asked to continue it?
If nexium is the only option, Iād really consider adding something for the hind gut along with it. Equishure or Succeed.
@Laurierace thatās awesome your big girl is doing so well, yay!!!
Thatās so awesome that nexium worked for her! Thanks for sharing 
He is sensitive all over his sides, probably more so by his girth area, just also by his flank. I assume he at least has both if anything and not just the hind gut, considering how sensitive he is by his shoulders as well (I wouldnāt think this would be the case if only the hindgutā¦ but maybe?). I was under the impression that on April 1st ranitidine was banned for any use? But I definitely could be wrong.
I read that you can test if your horse has hindgut acidosis by testing the ph of his manure, I ordered some ph strips that said theyād arrive today (donāt know if I believe that), so I guess Iāll try that out. I ordered uckele gut as well because it said itād deliver today, and the next soonest something could come would be equishure on Thursday (which I am thinking Iāll also get, for sure if the ph test is very acidic).
I saw this article and have no idea how accurate it is, at the end I noticed it was written by a vet for Uckele And I was like hmmā¦ if anyoneās interested https://www.google.com/amp/s/horseneā¦ut-ulcers/amp/
Thank you for your response Simkie
Most of the studies I have read use a dose of 0.5 mg/kg. If anyone can link to a study on the lower dose?
Itās in the first post of this thread.
@juliab99 ranitidine has been pulled off the market for people. Itās still available for animal prescriptions. Check out valley vet
I had checked out valley vet and it said ācurrently unavailableāĀ, I thought that may have been because of the recall but I guess itās probably just because of the virus. Iāll keep looking
Ah ha, youāre right! I swear they had it very recently!
Wedgewood might be an option?
Update on my guy whoās been on Nexium for awhile but having trouble getting off of it.
I talked to my vet school although we agree that scoping would be best, with the pandemic thatās not possible right now. So I have added Equishure for g hind gut support. So we will see if that helps and if in can wean him. His symptoms arenāt severe thankfully.
My vet also recommended Assureguard. But the equishure sounded more palatable and my guy is super picky with powders. But if the equishure doesnāt help we will be trying different things.
Fingers crossed Ć°ÅøĀ¤Å¾
I wonder if itās going to be gone everywhere from compounding sources now that all human brands have been recalled. I donāt have a current need for it but would be curious to know if thatās the case.
I have a feeling it is Ć°ÅøĖā
So I gave Levi 3 nexium on Saturday and also started uckele gut. I was under the impression his poop was still normal but right after I gave him the nexium I saw him drop a cow pattyĆ°Åøā¢Ę. Not saying it was caused by the nexium at all (it was literally like 2 minutes after), that was just when I realized heād gone back to the loose poop he had before the ranitidine. I was hoping maybe the GUT would help his hindgut, but so far no improvement in his poop(probably too soon to see results anyways). Having already given him the nexium I didnāt want to just stop it, so I did 2 pills for two days and am going to try to keep him on one for about a week, then hopefully go back to the full dose if his poop goes back to normal.
I ordered equishure and it will be here either tomorrow or Thursday, and I also started him on chia seeds which are supposed to be good for the hind gut as well (I had ordered them before I knew he had ulcers, was originally just using them for the omega 3s and magnesium). So my plan is to start the equishure as soon as it gets here and keep him on 1 pill a day of nexium through this week, and with luck the equishure will improve his poop and Iāll be able to do a full round of nexium. Iām fairly confident he has both foregut and hindgut ulcers, but I donāt want to make the hindgut worse by treating the fore gutā¦ ugh, ulcers suck! Before this he had a very stubborn corneal ulcer. Speaking of, I have to trailer him to an ophthalmologist on Saturday, according to his last owner he trailers great, but this will be the first time trailering him for me and I hope it doesnāt add too much stress for him! Thatās another reason Iām going to keep him on the 1 pill of nexium at least for this week, I at the very least donāt want him getting WORSE.
Sorry for yet another long post, but is there anything else I should be doing? Iāve heard for hind gut issues often people take them off hay completelyā¦ this seems very extreme to me and I will do it if necessary but it just seems kind of like that would add more stress? Even if they were fed 5-6 times a day that still would be a lot less eating time than his free choice hay situation now. Hopefully the equishure comes tomorrow and I see results soonĆ°Åøā¢ĀĆ°ÅøĀĀ¼
random note, I read that you can test for hind gut acidosis by using ph strips to test the manure for acidity. I assumed his would be acidic considering the consistency yet from what I could tell the ph was slightly above neutral? Just thought this was interesting.
@juliab99 After reading several studies and protocols I learned when treating hindgut ulcers you need to minimize the roughage and friction passing through so the lesions can heal. Thats why it can be recommended to remove long stem forage when treating these. On a PPI, the stomach acid does not break down the food nearly as well and then itās up to the hindgut to finish the job. What I did personally was start my horse on chia seeds 1/3 c am & pm, (or psyllium works too, but check on the amount) for its gelatinous effect and also BioVet Equine Generator, which is a very high quality pre & probiotic blend, to help with food digestion/breakdown. While I was not treating my horse for hindgut ulcers, I didnāt want to potentially create them when I used Nexium. I had good results with thisā¦and I still continue to use chia and those probiotics for the health benefits of doing so.
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Quick question: If I am doing a course of Nexium treatment and decide to take my horse for a clinic off property, would it be overkill to dose her with my usual Ulcerguard protocol (1/4 tube for two days prior, day of the event, and then the day after)?
Yeah, donāt double up on a PPI. Youāre already doing a treatment dose, adding a preventive dose isnāt going to make things better
Iām late to the party, there is generic Esomeprazole, and I read nearly this entire thread and it has been a godsend. I canāt afford another round of ulcer treatment and canāt scope post until after COVID crap ends. This post might save my mare from another colic episode
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AND ITS ON SALE! Ć°ÅøĖā
chiming in after reading through this thread. Just started my two on 60mg Nexium earlier this week and will report back.
My mare does not have a history of ulcers (that I know of), but has been girthy for the first time in her life recently. Sheās had 3 days on nexium and today was not girthy at all when tacking up. So, seems to be making a difference on her primary symptom.
My gelding does have a history of ulcers/tummy issue and was treated with omeprazole pop rocks (90 days per vetās recommendation) followed by sucralfate (30 days). He was symptom free for several months and then injured himself and was out for some time. Heās been back in work since the beginning of this year and has recently been exhibiting signs of discomfort during work (lunging or riding)āhead tossing, stopping and backing up, very frequent pooping. Heās also been on the nexium for 3 days now with no difference yet. Though he is small, I am planning to up him to 80mg starting tomorrow. Heās one that I suspect could have a complicated case.
