IIRC, the only concern about keeping them on omeprazole long term (besides $$$) is that it can cause a reduction in bone density. So it’s a balancing act.
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Yes, I had one similar. It’s pretty woo woo but we did the blood food allergy/sensitivity test and cut out all the stuff he was sensitive to and just kind of did a bland whole food diet for a couple months then transitioned him back to more normal food and that helped him be able to maintain on ranitidine rather than omeprazole. I know that’s no longer available, but it did help that horse a lot and may be worth adding into your game plan if you are at the point of being willing to try things that don’t have good data.
I tried this on my ulcer prone mini and his ulcers returned while he was on it 
. I had high hopes it would help but it did nothing for him.
And I have one that does better at a large facility. Gets very nervous if in a small “herd”, we had to move her back to a large busy facility after trying her at my friend’s place with only 3 others on the property. Ideally she’d like to see other horses everywhere she looks at all times and is completely relaxed at shows with 500 horses to be her new best friends.
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I have one like this as well. Bought her as a 5 year old off the track, came to me pretty thin and picky about her food. Tried various treatments including partial doses of Gastrogard, Succeed, GUT, Outlast and free choice alfalfa. She was not improving and we were having lots of tension and issues under saddle, so eventually got her scoped and she had extensive grade 1 squamous ulcers. Vet said none were particularly bad but it was the largest spread of ulcers across then entire squamous portion of the stomach that she had ever seen. Did the full Gastrogard treatment for 28 days, and she scoped clear at the end of treatment. Weaned her off and did a follow up scope after 3 weeks and the ulcers were returning.
She got some extensive time off due to colic surgery and then having a foal, and I was able to maintain her off omeprazole with double performance dose of Gut X. However, once I started riding/traveling with her again, the ulcer symptoms returned. Again treated with Gastrogard for 28 days and she improved, but immediately relapsed once I took her off the meds, even with the Gut X.
Currently she is being maintained on 1/4 tube of Ulcergard daily, and I have ordered the Abler pills to try instead, since I can’t afford $300/mo in ulcer treatments for her. Hoping that the Abler does the trick as it is $1.85/day vs $10/day for Ulcergard. I have suspect that she may just genetically be more prone to higher acid levels, like some people just genetically have heartburn/gastric issues. She also cribs, which vets believe causes acid splash when her stomach is empty.
Since he’s already out 24/7 with grass/hay available 24/7, I’d be inclined to think there is pain somewhere you haven’t found yet, or something else internally going on.
I guess if money is no concern, you could do a full body bone scan and an MRI.
The EPM suggestions are a good thought, too, or any other neurological issue.
Otherwise, there are some issues with keeping a horse on Omeprazole long-term, so it’s not really ideal even without finding a cause for the ulcer recurrences. I’d maybe try a slow transition off the Omeprazole after adding a combination of other supplements that people have had success with:
U-guard
G.U.T.
Aloe vera juice
Vitamin E
Calcium, magnesium, phosphorous
Marshmallow root
Tumeric
Pre- and Pro-biotics
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My thoroughbred is very ulcer prone so he gets a regimen of UG/GG and misoprostal any time he might have stress or acts not quite right. The only way I’ve been able to keep him off an everyday dose was using Nutrient Buffer
https://nutrientbuffer.com/ 2-3 times daily and Total Gut Health (Ramard) every night in his mash. When he is on UG he gets that in AM on empty stomach, and the rest of the day goes the same with a very slow weaning off. I know there is research that says the weaning isn’t necessary but my horse didn’t read it…
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I think this was the thread you were thinking of. The details are in post ~15. Although the title says repeat colics she says he also battled ulcers for 3 years before the colics started.
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Yeah that was it! Thanks!
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For mine it was unfortunately deep chronic pain creating reoccurring ulcers. Working with a large equine hospital they said that’s the number one cause they see for chronic ulcers when the environment has been addressed.
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I’ve had success with this product as well.
What’s his diet like?
I’m off and on with my young horse and ulcers. She moved to an indoor for the winter and I did treat her for ulcers (grade 1, a few grade 2, pyloric and squamous) over the winter and things did improve; now she’s back at home and the “original” ulcer symptoms which where sensitivity on the left side, being kicky with her hind legs, and not wanting to go forward are all returning. Despite giving her ulcergard before, during, and after the move. It’s only been a week of being home. I’m worried the omeprozole isn’t addressing the pyloric ulcers. They have 24/7 turnout and pretty much free choice hay.
I have her on Outlast and the SmartPak supplement that my vet recommended. I just ordered Relyne GI last night which I was holding out on because the study is questionable but the new formulation is slightly less expensive.
Honestly, this is a very unpopular opinion, so I don’t share it often, but here goes.
I have a young gelding that I have gone through the ringer with, with ulcers. I tried every imaginable modification I could make to his diet and environment, within my means. No many how many times we would scope and treat, the ulcers or ulcer behavior would inevitably come back. Eventually I just got tired of the ulcer merry-go-round. I put him on a preventative dose of omeprazole and haven’t had a worry since.
There are no long term studies to determine what, if any, effect there is to leave a horse on a preventative dose of omeprazole. I believe I read somewhere there may be some absorption issues if they are left on a treatment dosage long term. My vet has other patients that she has maintained on long term omeprazole, without any negative consequence.
I decided I’d rather have a happy horse today and worry about any consequences down the road, if it comes to that. 
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i’m in the same boat as @floppyammy. i can’t even tell you how many supplements i’ve tried, three different barns with different turnout situations, more work/less work, vetting, saddle, teeth, chiro/acu, ovaries etc. the only thing that has helped was keeping her on the quarter tube daily. i asked my vet the other day about the long term ramifications, and he said well, what’s worse - the possibility that there may be side effects down the road, or living with ulcers. i’m in the “if that’s what it takes to keep her healthy”, that’s what i’m going to do.
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Like the other two posters above me, I have one that is on ulcer meds for the foreseeable future. I’ve done full workups on this horse and no pain (ultrasounds, blocks, xrayed from head to toe). He is anxious and he stresses. I tried the weaning off and had a good scope only to rescope 6 months later and ulcers.
He has hay in his stall at all times, on a ration balancer, easy keeper, out 18 hours on lush grass. Doesn’t matter, he stresses. So after long discussions with my vet, he is just on ulcer meds full time.
He is so sensitive. This horse does basic dressage, maybe hops over a few jumps every week, and hacks. He lives a low stress lifestyle and for his brain and body that’s what is best for him. I think the long term negative effects probably wont outweigh the positive.
As a human, I’ve struggled with ulcers. Finally had my gall bladder removed. I lived on ulcer medicine until that time, for almost eight years. Worth it over living with excessive discomfort and sometimes downright pain.
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I honestly think a lot more horses struggle with this and go under diagnosed, unless they are actively off their feed, losing weight, dull coat, etc.
My gelding’s only symptom is to get very dramatic and reactive to things that wouldn’t normally elicit that response (or any response) from him. My trainer and Assistant trainer both said, oh he’s just being fresh/green/silly. We scoped and his stomach looked like the zombie apocolypse. Grade 4 squamous ulcers everywhere. Even the vet was shocked at just how bad his were, vs. his symptoms.
Like @rcy I have tried everything. Every supplement imaginable, different barns, different turnout situations, 24/7 hay, alfalfa hay, more work/less work, vetting, saddle, teeth, chiro/acu, massage, magnawave. You name it, I tried it.
Literally the only thing I didn’t try (and cannot try) is 24/7 turnout with a herd on a grass field. Because that does not exist where I live. I would either have to sell him or retire him.
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Add me to permanent Nexium crew, as well. I’ve posted pretty extensively about the ulcer struggle with my 8yo internalizer of an OTTB. We’ve done multiple rounds of vetting (including a carte blanche trip to New Bolton), addressed feet, saddle fit, chiro, you name it. We tried 24/7 turnout on good grass, no grain, every available combination of some buddies, no buddies, all the buddies. Some alfalfa? Exclusively alfalfa? GG alone? Miso alone? GG + miso + Sucralfate? More work, less work, no work? Adequan, Bemer, PEMF. I lost count of how many rescopes we did along the way to evaluate progress with any of the above.
We moved barns last winter - probably slightly less turnout than I would prefer but something about the care and management here seems to really suit my guy. From the moment he stepped off the trailer, it’s like he took a breath and realized life was going to be ok here. We did an aggressive round of treatment with the move because we knew that was likely to be a trigger (compounded omeprazole, miso, and Sucralfate for 30 days). Since then he’s been on Nexium.
Count me among the folks still concerned about potential long term consequences. But it’s been a hell of a road, and his whole care team (multiple vets, farrier, saddle fitter, bodyworker) are floored with his improvement physically and behaviorally. He’s put on probably 150lbs in a year, is making leaps and bounds of progress under saddle. We’ve gotten to go to shows and clinics and he’s been every bit the solid citizen I’ve hoped he’d be. Continuous medication is not ideal, but if it gives me by all accounts a happy, health(ier?) horse… I’m sticking with it.
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I completely understand. He is always in good weight, shiny with dapples. Eats well and no reaction for grooming or saddling.
He just becomes reactive under saddle. Back tense (saddle is custom fitted and back has been fully X rayed he gets regular chiro and massage work) and won’t go forward to the point where he will finally lose it and start bucking. With the ulcer meds that is gone.
I thought it was a training issue because he was young, but after a scope and on GG, it started to go away gradually. Off the GG it came back. So, to have a rideable and safe horse, it’s the best way for him.
Im glad I’m not alone. I was fretting for so long and finally I had to just let that go. He is borderline dangerous without the ulcer meds. With them, he is a functioning member of society. My only regret is that we didn’t scope sooner.
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Yes, more or less. If it’s summer and the grass is in and he is on it 24/7 with no or little work then we are fine.
Nexium, Horseguard, sand clear and neighlox always seem to be in rotation.
This sounds exactly like mine.
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