My horse is very high anxiety, nervous, reactive, etc. He chews wood, has had minor colic episodes while eating, and has on/off wet and smelly manure. We suspected ulcers and I had him scoped. The vet found a few very mild grade 1 ulcers, which he thought were so minor that they probably wouldn’t be causing his behavior, but suggested I could try 7 days of gastrogard to rule it out. Within 12 hours of the first dose, my horse was a different animal. He was calm and relaxed, spent his turnout time laying down snoozing in the pasture rather than looking for things to spook at and chewing wood, and stood with one leg cocked while he contentedly and slowly munched on his feed instead of flying around his stall between every bite. I was amazed (and thrilled!) at the transformation. He maintained this behavior for the first and second day on gastrogard, and on the third day some of his old behavior started to creep back. Today was the fifth day of gastrogard and he is almost completely back to his old self with all the negative behavior. The plan was to continue an omeprazole treatment if we had positive results on gastrogard and head in a different direction if we didn’t. Now the results are quite conflicting…Has anyone experienced fluctuating results on gastrogard like this? Any ideas would be appreciated!
I have not had that particular issue, but I tend to give it a good 10-14 days before making a decision. Every time around day 10 or so is when the noticeable change happens IME.
I agree with IPEsq, I usually don’t see clear results until 10-14 days.
I’ve also noticed my horses’ behavior can fluctuate at the beginning of treatment and can even seem worse before they seem better in the first week.
I agree it may be too soon to declare it a success or failure but also possible that the GG caused hindgut ulcers to worsen.
I had a somewhat similar experience with my TB a number of years ago. I didn’t scope him but suspected ulcers based on behavior. I used pop rocks rather than gastrogard and the first day he was on them he was sooo mellow. Day two slightly less so and then he eventually evened out, but he was never again super mellow like day one, but also not anxious/reactive like before. My theory is that the change felt so dramatic to him on day one, but then he got used to it.
From what you’re seeing, it sounds like something is going on for sure, it’s just not clear what. I’d keep up with the omeprazole for 14 days before you make a decision. I would also consider adding in sucralfate during your omeprazole treatment.
I would also to a careful taper even after just 14 days.
A vet once told me that just because your horse’s ulcers are mild, do not discount how they are affecting him. In other words, like people, some have a high tolerance for discomfort, and others do not. She had seen horses with low grade ulcers act completely nutty - as though they had severe ones…and the reverse - horses with very bad ulcers only acting slightly off. My OTTB is a different horse, even with mild ulcers. He gets them every late fall. 
This year, I thought he was doing better and didn’t scope…and early Dec. he colicked mildly. This time, it took a solid 14 days on Gastroguard for his eating to improve. I ended up treating him longer to be safe - about 40 days, tapered him slowly, and still have him on 1/4 tube a day for maintenance. I may keep him on that long term to be safe. So for some horses, even mild ulcers throw them off and they just do not feel well.
I’ll add (might be obvious)… be sure to do the full treatment even if the horse seems like a new horse after 14 days. I had a client start tapering then and was like wait, what? No, that just means it’s working…you should follow the full treatment protocol if you don’t want to have start all over again.
My horse is one that is a rearing lunatic when you can barely, barely see anything on gastroscope. Like there may be a little bit of bile that won’t wash off so well somewhere or something…to make my vet shrug and say he guesses it’s maybe grade 1? But yeah, complete spooky, rearing lunatic.
Agreed. Anywhere from 14 days + to start working. Gastrogard / Omeprazole isn’t a stomach “coat”. It’s action is to stop or limit the stomach from producing excess acid and irritating the stomach lining. There’s actually meds in the GG that activates in the brain to stop the production. The immediate relief may be less irritant, but the ulcers still need time to heal for ultimate relief.
What is the med in GG that activates the brain? I’ve always thought that GG works on the stomach and just contains 37% omeprazole, gastric acid pump inhibitor. GG is brain altering, too? When a horse does a 360 from raging lunitic to kitten, it really does seem like a brain altering experience has taken place. 
Actually, yes, in a sense it DOES come close to “coating” the stomach. Omeprazole (and other PPI’s, proton pump inhibitons) bind with gastric parietal cells (epithelium cells) which are the ones that secrete gastic acid and intrinsic factor (responsible for B12 absorption). They are located in the gastric pits of the stomach lining (lumen). So, all those little omeprazole molecules are lodged into the gastric pits and bound to gastric parietal cells in an inseparable bond.
GG doesn’t take 14 days to start working. It starts working immediately. If you mean visible positive change in behavior, I’ve seen that occur after just a day or few days of treatment. Recommended full treatment for diagnosed ulcers is 28 days.
I’ve used GG on my horses and the human dose on myself …on myself for years. While horses are not people, I suspect they have a similar response.
With that said, I have noticed, that shortly after taking a dose myself, I get an increase in painful acid. Very nasty. This happens, not after the first few doses but after a few days.
Trying to reduce the dose and get off omeprazole was extremely painful for me and took a few years. Having discussed this with healthcare professionals, I have come to learn that I am among many many others who have experienced the horrors of this medication, not to mention the side effects.
Now, you might say that it’s only to be used for a few weeks and then ended. I’ve done that…several times, and the acid backlash was extreme each time. I’m happy to report that I successfully got off this med and have been omeprazole free for a few years. Having experienced this medication, I can say that I would not reach for this stuff for my horses for more than a few days. I have used it on foals…but only for a few days. There are other medications that I would select first for my horses and myself.
So, if your horse may or may not be feeling better, and you are wondering if the GG is working, keep in mind your horse may be experiencing an acid backlash…increase in irritating acid production before it is reduced. The increase in production of acid occurs after the GG is given and then diminishes.
Good luck…and use something else.
No, omeprazole doesn’t work in the brain. It works on the parietal cells in the stomach. It needs to be absorbed into the bloodstream to do so.
This looks to be a good run down on exact method of action, if you’re curious.
Ooops!!! I stand corrected. I thought PPIs told the brain to tell the stomach to stop producing as much acid. https://www.medicinenet.com/proton-pump_inhibitors/article.htm
Thanks!!!
[quote=“horsegurl,post:12,topic:444020”]
Ooops!!! I stand corrected. I thought PPIs told the brain to tell the stomach to stop producing as much acid. https://www.medicinenet.com/proton-p…rs/article.htm
Thanks!!![/QUOTE]
You’re welcome!!
Thanks for all the responses! I have purchased 3 more tubes of ulcergard to extend the omeprazole test to 10 days to see if he picks up again on it. Unfortunately, a full course of gastrogard is not in the budget, so the plan with my vet had been to switch to a generic if we were seeing positive results indicating that the omeprazole is what he needs. Hopefully this will be enough to help make that decision. I’m also starting him on succeed to make sure the hindgut is cared for. If we do not continue with omeprazole after the 10 days, is a tapering protocol necessary at that point? My vet said no, but I’m hearing otherwise quite a bit. Thanks guys!
If you are not giving a full tube, assuming he isn’t a pony, you aren’t doing a test anyway so it’s no wonder your results were inconclusive. 1/4 tube is for prevention.
I have done a full tube per day for 7 days. I just bought three more tubes to make it 10 days at the treatment dose of a full tube per day. I have not been using a 1/4 tube dose at any point.
Check out the Nexium thread in this forum. Search will bring it up. Many of us have had very positive results, and it is super affordable
Thanks Simkie, I did try the nexium before all of this, and had no luck (you were actually the one who suggested I take him to be scoped because the nexium wasn’t working, and I’m glad I did, so thank you!)
You could order Abguard from Abler. https://www.abler.com/horse-ulcers/abgard. You could also continue treatment with esomeprazole (Nexium): https://www.chronofhorse.com/forum/forum/discussion-forums/horse-care/9650940-esomeprazole-nexium-for-equine-ulcers This is my plan after my guy finishes his month long treatement of Abguard. Some are suggesting you can just use the Nexium in leu of Gastroguard which is infinitely cheaper.
Oh! Hi! What’s the timeline on Nexium to scoping to Gastrogard? Did he ever show improvement on Nexium? Was there any indication of pyloric ulcers or delayed emptying of the stomach when you scoped?
The fact he was already on a PPI makes his behavior more interesting. One more piece of the puzzle It could really be worthwhile to perhaps try him on ranitidine + sulcrafate. That will address his stomach AND the hindgut without putting the stress on the hindgut that PPIs can cause. Any chance you can dose him twice a day? (Three would be even better?)
