Gastrogard/Ulcergard research

[OceansAway]

Hi everyone,

I was wondering if anybody has insight regarding something a couple vets told me about Gastrogard/Ulcergard. When I was treating my horse maybe 5 or so years ago, I had two different vets tell me that there is research showing that a 1/4 tube daily has been shown to be enough to heal ulcers, and that administering the whole tube is unnecessary. I haven’t heard much about that since, and wanted to know if anybody has heard about this research or if anything ever came of it. I wouldn’t be surprised if this was the case, as there are other medications that have been found to be superfluous in the same manner, over the years. Thanks, all!

[islgrl]

I have read the same thing. I do know that my vet read it, agreed with it, but whenever we have a problem he still says a full tube so??

[horsepoor]

Curious about this as well, as I had a trainer tell me this same thing a few years ago. At the time, I tried to find the research and wasn’t successful.

[fivestrideline]

I can’t find the research either.

I do wonder if it’s actually just confusion - UlcerGard is OTC and labeled for preventative measures at 1/4 tube/dose. GastroGard is prescription and labeled for treatment at 1 tube/dose.

People use the names interchangeably quite often, and UlcerGard is often dosed at GG levels (full tube) in an attempt to treat without a script or paying GG prices. This does create some confusion, though one would hope a vet would have it correct.

I’m happy to change my tune if the research shows 1/4 tube is effective at TREATMENT. Much easier to get that amount in a horse that’s caught on to the game

[Simkie]

This is Ben Sykes’s research.

He used an enterically coated product. He used it on horses fed a low roughage, high grain diet. Yes, he found that it was sufficient to raise the pH of the stomach enough for healing.

But, enterically coated products are more bio available than buffered products.

And horses that are fed a diet high in forage don’t respond this way–they require more medication to bring the pH of the stomach up. (Which is also Ben Sykes’s research.)

Sykes has also shown that horses respond to PPIs in different ways. While one horse might be nice and responsive at a low dose, another horse may not.

So, short answer: no, a quarter tube of gastrogard has never been shown to heal. Especially for horses fed a lot of roughage.

[endlessclimb]

Ok, so perhaps a stupid idea on my part but I’m good for those so here goes…

If you have a horse with ulcers, to have a better chance of healing them you should feed LESS hay, MORE grain, and add pH buffering meds. Once the horse scopes clean, you can switch it back the other way.

Am I dumb, or is that (potentially) correct?

[Simkie]

You’re not dumb, and yes, that’s been shown by Sykes a few times.

Or, you can just fast them a bit to ensure an empty stomach when you dose the med, and feed hay ad lib otherwise.

ETA: with a PPI. Buffering meds are different, I have no idea what research has been done in those. PPIs don’t buffer, they break the proton pump.

[endlessclimb]

Huh. I’ll keep that in the back of my mind for the horses who just can’t seem to heal up even with extended doses of PPIs. Try a feed regimen change and see what that does.

It makes sense - less volume in the stomach, fewer meds needed - but it goes against what everyone does when their horse gets diagnosed with ulcers - up the hay, reduce the concentrates.

[Simkie]

Unfortunately, Sykes also showed that something like 80% of horses discontinuing a PPI redeveloped ulcers in less than 3 days.

For a horse that can’t heal with an extended course of a PPI, I’d recommend scoping and addition or switching entirely to another med class. Short periods of fasting, especially at natural breaks in the day, are good targets for dosing of meds but extended periods without hay tend to be pretty upsetting for them from a mental perspective.

[OceansAway]

It wasn’t a confusion regarding the labeled use of the different products Gastrogard and Ulcergard. We discussed how frequently people are confused by that! These vets were actively involved in clinical trials for ulcer medications. Their whole point was the research was showing that 1/4 tube of either product (since they are the same except for how they are labeled for usage) was being shown to heal ulcers just as effectively as the entire tube. I remember being emailed some research, but I don’t have it anymore. Just curious if anything more definitive ever came of it.

[JB]

The 1/4 tube was an Australian product that isn’t UG or GG. If memory serves, the product is Gastrozol or similar.

I don’t remember the details of the study to know how robust it was, but I suspect it wasn’t a whole of lot of horses, at the very least.

[OceansAway]

I did see the Australian study, but the article that linked me to the study said it was Gastrogard that was used. I’m guessing that must have been a mistake?

[Simkie]

Can you link the article?

When the original study was published, a lot of press was pretty fast and loose with their copy. That doesn’t mean gastrogard was used, just that the editing on the article was bad.

[JB]

What article was that?

[OceansAway]

Use Less Ulcer Medication - David Ramey, DVM

The link to the study is in there somewhere farther down.

[Simkie]

Lol Ramey is such a charlatan.

Here’s another article about the same research. Which actually mentions the empty stomach & difference in prep of the drug.

Study: Low-Dose Omeprazole and Gastric Ulcers

[OceansAway]

Oh , yeah? I haven’t heard of him before actually. That was the first thing that popped up when I did a (very) brief search

[Simkie]

Yeah. While he occasionally has something useful to say (even a blind squirrel can find a nut every now and then), disregarding him completely isn’t a bad way to go.

[OceansAway]

Thanks for that link, because it was much more comprehensive!

[Simkie]

You’re welcome! Yeah, the bloodhorse often does a pretty good job. What it comes down to, really is that yeah, some horses in some situations may do fine with a lower dose. But some won’t. And there’s no way to know which you’ve got without potentially wasting a bunch of meds with that lower dose, or serial scopes.

There’s also more and more research coming out that it may take more than 30 days to fully heal ulcers. Even the original gastrogard research didn’t show “healed” at 30 days, just “healING.”

A tough nut to crack for sure, especially when you throw in the atypical ulcers (which require more/different/longer treatment meds.)