Having trouble weaning off the nexium

[Lunabear1988]

I’m having trouble weaning my horse off nexium. When he is on 3 or 2 pills a day, he does great! Eats great, weight is good, coat condition good, happy in work, not touchy in his body. When I try to wean he gets extremely touchy through his body, nippy and spooky. I’m wondering about a more affordable plan to get him through.

My original plan was to scope and then proceed with gastroguard or whatever was needed…

Now with pandemic and thinking I’m going to be out of job soon, the money saved up is probably going to board and mortgage instead stressful times that we didn’t forsee.

I’m going to talk to my vet about a more affordable option but not sure where to go from here. I really don’t feel comfortable dropping money on 30 days of gastroguard and a scope. This really sucks.

I’m thinking of trying to add some succeed or equishure to help. Or assure guard.

I could do sulcrafate or something else if we aren’t too locked down and can continue going to the barn. Unfortunately don’t know if I can trust barn staff to give anything 3 times a day.

I noticed today his hay wasn’t fed in his hay net which isn’t helping. They use it when they feel like it I guess.

I’m just going to do the best I can. He’s eating well besides swishing his tail the whole time. Ugh I just want him to be 100% but this situation is going to be tough.

[Equestrianette]

How long have you kept him on the 3 pills? I think people have done an extended therapy or more pills. He may not be on it long enough for them to fully heal? Have you eliminated contributing factors that make him susceptible to ulcers?

[beowulf]

Is he stalled? How much turnout is he getting? These are two major components to mitigating ulcer risk - if he’s stalled, find him a quiet buddy that he can live with outside. Then address the forage issue – ulcer horses need hay actually in front of them at all times.

[Lunabear1988]

@Equestrianette @beowulf
he was still in training (situation that I bought him from) in November and December. He lived out 24/7 and had hay 24/7. He became insanely girthy and nearly colicky acting. I put him on the nexium in December. Unfortunately the barn staff didn’t give it every towards the end of the month. And I had to move him closer to me.

So he again during the move was acting ulcery. I decided to retreat him in January. I did a really slow wean and now going into March I can’t get him off.

He lives in an outdoor pen and then goes out daily in a pasture with other geldings. Unfortunately 24/7 hay is mostly unheard of in this part of Colorado. I could try to supplement but not sure it’ll be easy right now. I may just need to move him at a later date.

A few things that might be triggering, he did have a lameness issue and was on previcox for 2 weeks. So maybe that’s contributing? Either lameness or previcox?

He’s not girthy acting yet (although I’m not currently riding) but does get protective of his flank/hind end. That’s what’s making think maybe he needs more hindgut support.

He did seem very happy and settled at the barn. It’s only in the last week that he seems unsettled again.

”‹”‹”‹”‹”‹”‹”‹I was I could just scope him but it’s $500/$550 around here and I need to be cautious with what’s going on in the world.
”‹

[Simkie]

Pain can absolutely contribute to ulcers

If ranitidine were easier to source, I’d recommend that as a transition, but…it’s recalled and gone pretty much everywhere.

Very much agree that a scope would be the best next step, but understand that those $$$ may be tough to commit right now.

In your shoes, I’d leave him on the nexium, at a dose that makes him happy, and provide hind gut support. Maybe go another month and try to taper again?

[Lunabear1988]

@Simkie yeah it’s a frustrating and scary time right now, especially when we don’t have any control of this. I’m hopeful that my husband might still get to work through this but hours are being cut and not sure what will happen. Things are changing so rapidly…

I’ll talk to my vet as well but thinking hindgut and nexium might have to do it for now. At least it’s relatively cheap.

There is a vet in another city that sells compounded omeprazole (I think) for a better price. But not sure about the details on that.

[Simkie]

@Lunabear1988

There is a vet in another city that sells compounded omeprazole (I think) for a better price. But not sure about the details on that.

If you’re interested in switching, precision pharmacy sells a omeprazole/ranitidine paste that I’ve had great success with. It’s (IIRC, it’s been quite awhile) about $300 for a month of treatment.

I’ve also used the omeprazole powder that precision sells, and not found it palatable or effective (but know a vet that prescribes it quite often and has good results.)

Good luck, and keep us posted!

[IPEsq]

I had trouble with this once. I did the Succeed challenge but used the double dose a bit longer than directed. It helped. But I did need to keep him on Succeed for quite a long time…if I tried taking him off of it, I’d see some
symptoms returning towards the end of the week. I did eventually stop it except for times of stress or using omeprazole or other drugs. It is not a cheap option. I think the dose you are using for Nexium would be cheaper. FWIW, when I used Nexium for treatment, my vet told me to use a much higher dose. 3 pills was fine for preventative use. Perhaps he is getting some relief but not healing. Hard to speculate without a scope.

[Pezanos]

FWIW, generic esomeprazole is $11/3 bottles on Amazon. I don’t know how much cheaper a treatment you’re going to get. That being said, I had a horse whose ulcers kept coming back the minute we took him off acid reducers. Turned out there was a physical cause for his stomach issues: severe kissing spines. He never, ever gave me a hint his back was bothering him, but his ulcers would never go away.

[Lunabear1988]

@IPEsq I know it’s not totally uncommon but would love to get him off of it at some point! At least the nexium is cheap…

I definitely have thought about that, maybe it’s helping but not totally healing . I’ll talk to my vet about a higher dose. She’s not crazy about nexium though. Did you get a vet’s guidance for dosing?

Thank you

[Lunabear1988]

@Pezanos yeah I’m wondering about that. We are fixing a foot issue so I wonder if that’s in play.
Overall he’s seemed pretty happy.

[stargzng386]

Financially I know it’s a tough spot right now. I was having similar issues I could not wean off the nexium I had him scoped and he still had 5-6 ulcers, nothing actively bleeding or horrible but definitely causing discomfort. I am treating with gastrogard right now. Maybe keep him on the full dose of Nexium until you can do a scope?

[ClassyJumper]

I tried succeed but its really expensive and I didn’t see any results other than some weight gain/shiny coat. I think equisure helps if sugar rich grass is causing hindgut issues… but not for ulcers in general. I saw great results with Redmond’s daily gold… its very inexpensive and definitly worth a try. My mare was super touchy around her flanks and daily gold was the only thing that made that completely go away.

[Equestrianette]

The fact that he was not dosed correctly previously exacerbated the ulcers. And yes the previcox can also exacerbate it. Providing free choice hay is really the best option, stuff hay in nibble nets to make it stretch for longer periods of time. If he is on high starch foods consider eliminating or replacing that as well.

[bathsheba8542]

If it were me, I’d keep him on a full dose of Nexium, or move him to a full dose of Ulcerguard if you can, until you can get a scope done, even if that might be a month or two away. I tried for a year to dose/taper before scoping, and then found ulcers that required both misoprostol and ulcerguard, and it still took 3 months of meds before they were healed. Like with your horse, mine was telling me fairly quickly when I tried to taper that he was uncomfortable.

[Lunabear1988]

@Equestrianette yeah that’s why I decided I would treat him with a full course again and I would be in charge of giving it.

He does have a nibble net but I came early yesterday and saw that the barn isn’t using it all the time. Very frustrating and it’s one that’s easy to use! Just laziness.

When I bought him he was on hay only and still got ulcers! Poor guy. He is on a tiny amount of low NSC feed just up get s digestive supplements in him. And gets soaked alfalfa pellets and beet pulp once a day.

[Lunabear1988]

@bathsheba8542 yeah I think I’ll either have to do full dose nexium or something the compounded omeprazole like @Simkie mentioned. I can’t see myself spending $900 on ulcergard right now, my husband and I don’t know if we will have jobs in the next few weeks. Really scary time right now.
”‹”‹”‹”‹”‹”‹”‹

[beowulf]

You said foot issues - I’m with Simkie that pain can definitely cause or exacerbate the issue.

So frustrating about reading your barn help isn’t doing the bare minimum to make this horse comfortable… Not sure what your situation is but that’s something that would get me angry - and I don’t get angry!! It may be time to involve management, and/or your vet - a written note from a vet for a horse’s feed instructions can do the trick when you have lazy barn staff who think you are just being a PITA boarder…

I agree with others it may be time for the scope - you never know, there may be other issues causing the ulcers as well. I’ve seen delayed gastric emptying certainly contribute, and you mentioned he’s on some fairly stomach-healthy foods… If at all possible I might see if you can get more alfalfa pellets into him (twice a day?) while continuing the full dose of Nexium.

I feel for you and everyone dealing with ulcers in a boarding barn arrangement. It’s so hard, financially and management wise, to get them to go away.

[Lunabear1988]

@beowulf yeah I was pretty livid! Especially since I bought the type of slowfeed system that they recommended, because of its easy use to the barn staff! I know they know that I saw it, they looked sheepish when I walked around the corner. I’m hoping shame will change that but good thinking on the vet note!

I agree that a scope is a good idea. Unfortunately the money I have set aside for that and gastroguard now might need to be board and bill money. Colorado is pretty shut down right now and I’m not sure my husband and I will be working or not. We have a mortgage, a young daughter and elderly dog on top of the horse to worry about. We thankfully have savings (some people don’t) but I can’t be spending hundreds unless it’s an emergency. Maybe if things look better in a month, I can then scope and treat differently. Right now I think I just have to keep him comfortable any way that I can.

”‹”‹”‹

[Lunabear1988]

I’ll see if I can do more alfalfa though. He sure does love it (he’s a food hound!!!)