Esomeprazole (Nexium) for equine ulcers

[AcuAnimal]

I wanted to give everyone an update.

I put 2 horses on Nexium. One is my 7yo pony. (Photo in the thread). The other my 23yo TB.

I wasn’t sure my pony had ulcers. I did not see any real changes with him with the Nexium - 3 pills 2x a day. AND he was never off his feed, etc. He was just very spooky. It turns out he has EPM. So he is being treated with that and is much better.

My TB mare had never been treated with anything for ulcers. I’ve had her since she was 4 and she is now 23. She has always been a picky eater and preferred hay to her grain. Often wouldn’t even finish her grain. Well now she is an eating machine! She won’t leave her stall because she hasn’t eaten every last drop of grain. She begs for treats and will eat any kind. (She wouldn’t do either in the past.) She just seems happier overall. I did 4 weeks 2x a day then 2 weeks once a day then took her off. I put her on 3 once a day when she had a bout with laminitis (She has PPID and insulin resistance) and I had her on 2g of bute 2x a day for a while. She never went back to not eating again.

And I just can’t believe the 180 degree turn around in her eating. So that would be a success story.

My pony isn’t but again, I really wasn’t convinced he had ulcers I the first place.

[GoneridingirlK]

Stumbled across this thread while doing a deep dive on treating ulcers… picked up my new guy from the track 9 days ago. Definitely symptomatic for ulcers - so I figured I’d give this a shot.

He gets 60mg (3 capsules) once a day. It’s been a little over a week and I am seeing improvement. He would pin ears/threaten to kick if I touched his hind gut area - that has subsided. He’s a really sweet guy otherwise so I am hoping this gets him sorted out.

He’s on Buckeye EQ8 gut health, purina outlast, alfalfa pellets & gets unlimited grass hay. Considering adding in Purinas MQ - anyone have experience with that?

[sami-joe]

I may have said this elsewhere on this thread, but my TB gelding eats Costco’s omeprazole caplets with his rice bran a few times a year. Dry. Crunch, crunch, crunch. (Way less expensive than Nexium.)

While he has no symptoms, probably because he had a lush horse-being-a-horse life for his first decade, turned out in the high desert with cows and broodmares, I throw a two or three week regimen at him anytime we do anything that could be construed as stressful, travel, change in routine, dramatic weather, etc. So far, so good.

I became a believer while helping a 20-plus year-old Irish draught schoolmaster to gain weight. Same exact symptoms as your mare and the same results. It’s rare enough to see evidence we’re really making positive change for our horses. Fingers crossed you embrace your success. Congrats.

[Simkie]

@sami-joe

my TB gelding eats Costco’s omeprazole caplets with his rice bran a few times a year. Dry. Crunch, crunch, crunch. (Way less expensive than Nexium.)

So, an effective omeprazole dose is significantly higher than the esomeprazole dose discussed here. Generally it’s untenable cost wise to hit that with the people products.

And like esomeprazole, damaging the coating means the drug is degraded in the stomach and not able to be absorbed. If he’s crunching the pills you’re giving him, he’s not getting the drug.

[JB]

@sami-joe

my TB gelding eats Costco’s omeprazole caplets with his rice bran a few times a year. Dry. Crunch, crunch, crunch. (Way less expensive than Nexium.)

to get the same amount of omeprazole from human 20mg pills/caps, as in a tube of GG/UG, you need 114 of them, which puts the cost in the same price range as UG/GG. UG/GG contains 2.28gm of omeprazole (2,280mg), divided by 20mg, gives 114.pills/capsules

Did you mean omeprazole, or did you mean esomeprazole?

[Minxitbabe]

I am still going through this very long detailed thread but wanted to ask if anyone has used the Kirkland Signature Esomeprazole 20 mg for their horses? I know at the start of the thread it was discussed that there wasn’t a generic available but there clearly is now but I wasn’t sure if anyone had any difference in the Nexium vs Kirkland. Have a young horse that has started to be irritated at girthing up. Still totally pleasant under saddle but I would like to be sure to catch this early if it is an ulcer issue. Horse did move barns and is just coming into work again after time off. Will be checking saddle fit as well but only change in behavior seen is at girthing not undersaddle or other handling times. No fussing over grooming sides and belly just leg lifting and swiping when doing up the girth. Slowly doing up the girth at that. At $15 for 42 capsules I don’t think I can go wrong but I am very hesitant to want to mess with the gut biome if there isn’t something going on.

[Simkie]

Yep, I’ve used the generics with the same results as the brand name.

[QM2]

For all who have been treating and have a pretty good handle on this treatment.
What’s the dosage for an average horse with suspected ulcers.
How many 20mg pills?
How many times per day?
For how long?
Taper or no?
I’ll probably also give sucralafate for a time to coat the possible ulcer if that makes a difference in the answers.

Thanks for your informed answers! 🩷

[Simkie]

@QM2

What’s the dosage for an average horse with suspected ulcers.

Depends on your own interpretation of the research, which is linked and discussed at length in this thread. I encourage you to form your own opinion on it.

How many 20mg pills?

I continue to use 60 mg.

How many times per day?

I continue to treat once daily, on as empty a stomach as possible.

For how long?

I treat for four weeks, generally.

Taper or no?

I certainly do.

[QM2]

Thanks for your reply. I have read through a lot but there is A LOT more to read which is why I asked. I appreciate your answers.

[FitzRoy]

I’ve been using Nexium for the past year to treat suspected ulcers with really good success. I recently found a source for 200 capsule bottles (I was getting really tired of the tiny plastic bottles) through a site called Life Sciences Pharmacy, and after 2 weeks of use can confirm that the pills through that site work just as well as brand name Nexium for my gelding. Not sure if I’m allowed to share a link, but I’d be happy to message it to anyone interested. The 200 pill bottles are $20 each, so significant savings over whatever I was buying through Costco/Amazon.

[FitzRoy]

I’ve been using Nexium since noticing major behavior changes in my horse last spring. A year later and I’m 99% sure the stomach issues were caused by spring grass, and so I’m mainly using nexium in spring/summer. I find that any ulcer related behavior changes in my gelding go away in a day or two after starting nexium.

How many 20mg pills?

I start with 6 wrapped up in Fruit by the Foot for a week, and then taper down by 1 a week to 4 for long term use.

How many times per day?

Once per day in PM grain

For how long?

I started in April this year, and will probably use it every day through September/October

Taper or no?

I did a taper of 1 less pill per week last year and it seemed to work well, but not sure if it was necessary or not. Better safe then sorry I figure.

[avjudge]

@FitzRoy

200 capsule bottles (I was getting really tired of the tiny plastic bottles) through a site called Life Sciences Pharmacy

Thanks for posting this!

It’s also very interesting to hear that you have problems that seem to come with spring grass. Toward the end of May my horse stopped eating her meals, though she ate hay/grass as usual. We were just reaching the end of the adjustment to grass and this continued as I turned her out 24/7. I rotated out all her meal ingredients/supplements to see if she’d gone off something, but no. Finally I tried Nexium and 3 days later she was eating. But she’s the next thing to a pasture pet (occasional trail riding, nothing lately as I’m busy doing spring maintenance/fencing/clearing when it’s not raining) and has been here 6 years now with no hint of ulcers so it really makes no sense to me (or my vet).

On the other hand, of the 2 horses I had here in my childhood/young adulthood, and the 2 plus a mule we have now, she’s the one that if it can go wrong, it does, so of course she’s showing mystery symptoms. If generic Nexium keeps it at bay, I’ll go with that.

[skipollo]

I’m not sure if anyone else has posted about this, but I recently discovered that Nexium (and generic versions) are FSA/HSA eligible. I added my HSA card to my Amazon account and it’s really easy to just order and use that card, and it keeps all of the purchases/receipts in one place just in case I need it at tax time.

I might be late to the party on this, but I felt so dumb when I learned it and figured I’d share the info in case it helps anyone else!