You are doing the right thing by using GastroGard. You have to cure the ulcers (which is what GastroGard does) and not just relieve the symptoms (which is what Ranitadine, Tums, etc. does).
Wrong. Ranitidine DOES cure them, it just may take longer and you have to dose more frequently than Omeprazole. What do you think was used before the wonderful rainbow colored GastroGard was established?
My mare nearly died from ulcers and related problems, and subsequently spent two years on the Abler product, preventive dose.
Here’s what worked for us:
small hole hay nets, 24/7.
Purina Wellsolve LS concentrate
ground flax
probiotics
saffola oil as needed for weight (up to a cup in the winter)
alfalfa hay cubes
Whenever she went on antibiotics for any length of time I increased her omeprazole to full dose.
In-and-out stall. There have been times when stall rest would have been better, but I had to balance that with her need to get outside.
Her manure was more like cow patties and smelled sour, but her weight held up well. But about February of this year she became more reactive, irritable, spooky.
Time to see what’s next. In April I added Standard Process GI Support, which came from my vet. Ground cruciferous vegetables, l-glutamine, etc. Within 3 days or so her manure became more normal: better color, shape and smell. A month later I added LMF Digest 911 as the probiotic.
We gave her two months of this support to rebuild her hind gut, then started weaning off the omeprazole. She’s calm as a rock, holds her weight (actually could become fat if I hadn’t reduced her feed), gorgeous normal poop.
Weaning her off omeprazole is taking a long time: two weeks at half dose, then two weeks at 1/4 dose, then two weeks at 1/8 dose with skipping days. Yes, it’s a long time. But after all we’ve been through, I figure the investment of time and trouble is worth it.
I don’t know if she’ll remain on the GI Support after we’re done, but it’s less expensive than Succeed, so I’m open to it. The change has been remarkable.
YMMV.
[QUOTE=SuckerForHorses;7093192]
Wrong. Ranitidine DOES cure them, it just may take longer and you have to dose more frequently than Omeprazole. What do you think was used before the wonderful rainbow colored GastroGard was established?[/QUOTE]
Ok, granted, Ranitidine can heal ulcers but only under certain circumstances, i.e., it must be dosed (at the proper amount) every 8 hours, round the clock AND the horse must be taken out of work and/or training for the duration of treatment. If not, the Ranititine will at best, only be helpful in eliminating the symptoms of ulcers but they will not be healed and the horse will most likely suffer a recurrance as soon as the dosage is stopped.
The Merck Veterinary Manual states:
“Suppression of gastric acidity and maintenance of a pH between 4 and 5 are the primary treatment objectives. Studies have examined the use of surface coating agents, antacids, with histamine type-2 receptor antagonists (ranitidine and cimetidine), and the proton pump inhibitor omeprazole in a carrier designed to aid passage through the acid stomach into the small intestine for absorption. Of these, omeprazole in the gastric pass-through formulation has been the only medication shown to consistently allow gastric ulcers to heal in horses that continue their normal training…Ranitidine (6.6 mg/kg, PO, tid) has been shown to be effective in healing gastric ulcers when horses were removed from training.”
The Journal of the American Veterinary Medical Association published a study comparing Omeprazole and Ranitidine in ulcer treatment in TB racehorses. The results were best with Omeprazole.
http://avmajournals.avma.org/doi/abs/10.2460/javma.2005.227.1636?journalCode=javma
I guess it is just a case of we need to agree to disagree about the best, most effective treatment of ulcers. I have used Ranitidine. In fact, I noted symptom improvement with it (my horse had two episodes of mild colic - each remedied easily with a shot of Banamine, thank goodness). After I started him on Ranitidine, he had no more colic episodes. My vet was pleased but said that now we needed to go to GastroGard to cure those ulcers. (And no, he didn’t make any money from that treatment - he wrote me a script for the month of GastroGard since I could get it cheaper online).
In any case, my horse has been 100% ever since. His maintenance dose of Neigh Lox, as well as aloe juice, are continuing to keep him in top form so I have no complaints. He’s a happy camper with no belly aches anymore! 
I just ordered some of the blue pop rocks and from what I understand, they have been proven to work as effectively as GG. However, what about Abler’s paste omeprazole? Proven or just the pop rocks?
[QUOTE=spotmenow;7093317]
I just ordered some of the blue pop rocks and from what I understand, they have been proven to work as effectively as GG. However, what about Abler’s paste omeprazole? Proven or just the pop rocks?[/QUOTE]
There have been no head-to-head trials of pop rocks vs. GG that I’m aware of. However, the pop rocks ARE omeprazole, so assuming that they are what they are claimed to be (and I have no personal problems with that–most of the meds I take and use and prescribe are made overseas) they should be equivalent, either in paste, pill, or pellet form.
Just because ranitidine was shown in one study to work best in horses removed from training doesn’t mean it isn’t a fine drug and a very reasonable alternative to omeprazole. 
They never studied whether ranitidine ONLY worked in horses removed from training, and I would guess the information provided involves racehorses, which are kept in very suboptimal conditions. Not applicable to the average sport or pleasure horse.
Omeprazole is stronger, NO question. But it also comes with the “baggage” of potential rebound acid hypersecretion upon discontinuation that H2 blockers do not seem to have. IMO it is a very reasonable alternative.
Another vote for U7 - I have tried many things and its the only one that works. Very easy to use, just add to feed, and easy on the wallet. If you think you need something stronger to start with, there is Gastrix which is prescription strength U7 and will be available through your vet.
Ulcers
You sound like you are doing a lot of things correctly. I would second the sucralfates for hindgut ulcers. After I added the sucralfates to my meds for him during our treatment, he really started to improve. I added Succeed in while we were treating, kind of like a pre/probiotic all in one. My guy works himself up over just about anything and it took a good year and half to get it all under control and to a point that was manageable.
That said, I still keep my guy on a maintenance dose of pop rocks daily. When I trailer, I give omeprazole before the trip, day of trip and after (or I double on the pop rocks) and then back to the regularly scheduled dose.
I would also like suggest maybe a heavy duty magnesium supplement. All that spasming from ulcers makes a body sore. I keep my guy on Magox 56% from Horsetech, but there is also a 60% too. Don’t forget to add a probiotic in the mix to help replace the good bacteria. Succeed is expensive to use long term, but well worth the $$. I have used Assureguard with success as well as Gutwerks from Horsetech.
If it all gets too confusing, money well spent would be to talk to Claire Thunes with Summit Nutrition. She is an equine nutritionist and has helped me out a lot with my guy last year. She could also council you on what to feed/what not to feed as well. You will get great advice from folks on COTH, but it can be overwhelming. Claire can help you narrow down things and she does check in with you to make sure things are progressing.
I know how expensive this can be. Your mare is lucky you found her. Best of luck.
Shawn
Ranitidine cured my horse’s ulcers as confirmed by scoping before and after four weeks of treatment. He was kept in work. He got it three times a day but not at exactly eight-hour intervals–generally about 7 am, 1-2 pm and 9-10 pm. The vet hospital said to give them so he got the whole dose within 25 minutes or less.
I realize this study has a very small N.
I’ve been battling my OTTB’s ulcers for 15 months. I’ve spent almost $10k on GG and vet bills trying to get my boy’s ulcers healed.
The only time he was ulcer free was the first year I owned him when he was on all-night turnout and had a stall with a view. In Aug 2011 he was confined to his stall for a week with a very bad case of SMZ-resistent cellulitis during which time he got bute, and two types of injectible antibiotics. After that we moved barns and it’s been a downhill spiral since then.
He lost a ton of weight the winter of 2011-12 and became listless and dull; April 2012 scoping showed he had grade 3 ulcers; we treated with GG for 28 days but a few ulcers remained so we treated with full dose GG for 2 more weeks. He scoped clean in Aug. 2012 and then we tapered him off the GG with 4 weeks of 1/2 tube, 4 weeks of 1/4 tube. I also put him on Succeed, a pro-biotic and a Tbls of baking soda in his feed.
The ulcers were back by early December (the one big change being that in October he was switched from all night t/o to partial daytime t/o). In January he went on GG for another 6 weeks; he scoped clean in late Feb and we tapered off the GG again and this time put him on Ranitidine during the tapering-off period. By mid-April the ulcers were back and worse than ever.
He was tested for several other GI issues to rule out an underlying problem so my vet is pretty certain the ulcers are not a secondary issue. I grew convinced that even on daily full dose GG he wouldn’t remain ulcer free without at least 12 hours of t/o all year long. So in June I moved him to a new barn where he’s out all night, has a dutch door on his stall so he can see out all day and has a big bright stall with half-walls of open bars so he can sell all the other horses even when he’s in. He has access to good hay all day, gets a dengi snack mid-morning and mid-afternoon and alfalfa cubes for lunch. He perked up and gained weight inside of a couple of weeks, and is a cheerful happy-go-lucky OTTB once again. However, when I had him rescoped early July (after 8 weeks of full dose GG) to double check that his ulcers were healed before beginning the tapering off process, lo and behold his ulcers were only 80% healed. So while the new lifestyle has done good things for his stress levels and he’s happy and bulking up, it hasn’t been enough to heald his ulcers completely.
My vet finally contacted Merial and at the behest (and with the support) of Merial themselves we’re starting a new treatment protocol of a double dose of GG and 2 different types of antibiotics daily for 28 days. In case you’re wondering, I am not affiliated with Merial in any way other than huge sums of money I’ve paid for their product.
Evidently the hypothesis is that while there’s no good research that shows bacteria causes ulcers in horses (as in humans) some horses with deep ulcers develop a secondary infection because of the ulcers.
I’m not suggesting this is the problem with your horse; in fact I’ve never heard of any other horse that didn’t respond to GG except mine. Just thought I’d share my own experience since we’re trying a different more aggressive approach after all else failed. I’ll keep you posted.
My mare was on gg for two years , many times a double dose, which for her 2,000 pounds 2 tubes, so I feel the pain.
She had Delayed gastric emptying…so her stomach was prone to ulcers. She had to have a tube a day to suppress the ulcers.
I think it also depends on the ulcers to determine how long of a treatment protocol…higher grades= longer time to heal.
You’ve got lots of great advice here. Just a few things to add:
Most tummy treatments (ranitidine, omeprazole) block the absorption of doxy. So if your horse is still being treated for Lyme, make sure you stagger the meds by at least 3-4 hours.
Question: When your horse was going well and you were trailering around, etc. - Were you using any preventative treatment? i.e. 1/4 tube Gastroguard? If not, you might not really have a difficult-to-maintain horse, you might just need to do preventive maintenance when adding stress such as travel.
Good luck, please post updates & let us know what ultimately works!
You definitely need to cure the existing ulcers-(Gastroguard, etc in the comments above). Long term, I’d look for a feed plan that keeps your horse eating for as many hours per day as possible. Horses were built to be grazing constantly so a few big meals per day doesn’t fit the way their gut functions.
I switched my mare to a combination of soaked alfalfa cubes and timothy/grass mix. On this program she’s become easier to keep weight on & colic issues resolved. The alfalfa hasn’t made her hotter. She’s actually mellowed on this feed program- probably a combo of feeling better and being busy eating all the time. It’s a bit more expensive than feeding grain but far less expensive than all the vet bills! If your horse can’t consume enough calories this way, you could add wheat germ oil or use an auto feeder to split grain into as many small feedings as possible.
I’m sorry I haven’t read through everything except the OP, but I don’t think it would hurt to add a probiotic to what you are currently doing–certainly would help any possible hindgut issues. I’m a big fan of SmartDigestUltra. Has worked well for my previously ulcer-prone horse (he also eats the Sentinel Performance LS).
Best of luck!
1st,
Scope until you see NO ulcers. Don’t just assume.
I had to do 2 months of full dose Gastrogard and I scoped 3 times.
uuuugh.
Then I used the Abler product that everyone calls “pop rocks”.
I have mine at home so it was easier to take care of him.
but it’s important to feed the omperazole 30 minutes BEFORE feeding.
When I would give pop rocks I would give them with just a hand full of feed. And then make him wait 30 minutes.
And I always give a snack before riding. A bit of grain and he gets alfalfa.
Also I’ve heard many times that beetpulp helps because it slows down the movement through the gut…where as bulk feed just run right on through.
The only grain he will eat is TC Complete. So that’s why I feed that. And beet pulp. Quite a bit of beet pulp.
I did pop rocks in the AM and gave SmartGut at midnight (again, I live at home. He gets fed at midnight…)
He’s not on anything now unless we are going somewhere. Then he gets 3 sachets of pop rocks a day or two before and then 1/2 tube of gastro/ulcergard the day of.
Sounds to me like you never really cleared the ulcer issue up fully.
Here’s my two cents to your pile of change! Your story sounds very familiar to me.
Omeprazole is the best studied prevention/treatment of ulcers. Do the preventive dose when your horse is trailered off the property. IN ADDITION, feeding TUMS prior to a ride or a stressful event buffers excess acid production. No, it doesn’t last a long time, but yes, you can use this to your advantage by feeding prior to a stressful event (shipping, showing, training session, etc.).
Alfalfa hay has a high Mg and Ca content and acts as an excellent stomach buffer. It can be higher in protein but there’s no real evidence to suggest that alfalfa makes a horse “high” or “hot”. Carbs produce that energy, not protein. It’s buffering capacity outweighs the other considerations, in my opinion. You can add lesser quality hay for the “munchability” all day in the stall if you want (horses tend to scarf down alfalfa because it is palatable). Soaked beet pulp pellets (the non-molasses type) can also help boost weight. Lastly, Magnesium supplements such as MagRestore can make a huge difference in the attitude of some horses. I was a huge skeptic until I tried it myself.
My skinny, high-strung, Grade 1 ulcer WB calmed down after Omeprazole (28 days on, 24 days tapering), alfalfa hay daily (yes, alfalfa for the high strung horse), 12 hour turnout in lush pasture, Supplements (electrolyte, Vits/amino acids, MagRestore) daily. The change in his attitude was immense, and only recently has he gained weight.
Again, my two cents on your pile of change. Good luck!!
Longwaitover, Please do update us on your horse’s health. My vet has seen horses that do not respond to Ulcerguard and needed antibiotics to resolve them. I would appreciate knowing how your approach worked for your horse. Thanks!!!
I went around and around with Gastro Gard, Pop rocks, generic omeprazole for 3 years and I always had to go back to square one with my Trakehner/THBD. He’d be fine for a few months then he’d start acting funny and then lazy then his attitude would diminish. I finally put him on ADR Paste and someting called fish oil factor. He wouldn’t really eat the fish oil factor, but the paste is just like Succeed so you just squirt it in every day. If you go to Equivision.com they sell it there. Its a digestive supplement, but (I believe) targeted for hind gut health.
I tried that and Succeed and had better results with the ADR paste. its expensive, but sooo worth it! I thought I was doomed to have my horse on low doses of omeprazole for the rest of his life. It did 21 days on the ADR paste and as much fish oil factor as he would eat and I saw a difference.
On another note, he is still getting some Blue Seal Sentinel LS and he just doesn’t love it. We just tried Poulin Fiber Max 17.5% sugar (my horse also has Cushings) and is on Pergolide. I know a lot of people use the Sentinel, which I love the idea of because its low sugar and high fat, but if you can find something that, for whatever reason, they love to eat then feed them that!
FWIW, it isn’t the Mg and Ca in the alfalfa that helps with stomach acid. They aren’t bases. I thing the lignins in the alfalfa are what does the buffering?
From http://www.equinews.com/article/use-alfalfa-or-lucerne-and-its-effect-gastric-ulcers (lucerne = alfalfa)
“Lucerne provides greater buffering capacity compared to grass forages for several reasons. First, lucerne contains higher levels of protein and calcium, both of which buffer gastric acid. Also, lucerne cell wall contains certain indigestible compounds such as lignin that gives it a greater buffering capacity than grasses.”
I fought ulcers in a yearling WB for almost an entire year, during which we tried several different products, including double doses of GG courtesy of Merial when the standard prescription failed to work. After 8 months, my vet recommended sucralfate as a last resort. It worked like a charm. He finally scoped clean after a month on the product and (knock on wood), hasn’t had any more digestive problems in the 4 years since. As others have said, this product is much cheaper than omeprazole, its one drawback being more frequent dosing. (I did 3x/day). I keep all my horses on grain free diets, with free access to forage (grass and hay) and turn out, 2x/day ration balancer and use high fat supplements for additional calories if needed. As a result of my experience with this yearling, I no longer take it on faith that omeprazole/Gastroguard is the gold standard for ulcer treatment and would never treat for ulcers without scoping.
Just checking in. Half way through the antibiotic/double GG protocol and my horse is not happy. It’s just so much medicine! 2 tubes of GG and two different antibiotics, three times a day. One oral, one rectal. He seems under the weather; dare I say, depressed. I take him for long walks when the weather is nice, brush him a lot, give him carrots to get rid of the horrible taste left by the antibiotics and had the chiro came out last week for an adjustment and some acupuncture which seemed to relax him. But mostly I’m not asking him to do much of anything. He’s lost weight and he seems disinterested in life (except carrots, baths, and being groomed). The vet said “depression” and “lethargy” are not side effectives of antibiotics even in high doses, but my horse seems definitely depressed. But it’s not upsetting his GI (i.e. no diarreha) so unless and until it does I’m going to continue the “chemotheraphy” - if his ulcers remain unhealed after this I don’t know what I’ll do. I’ve tried everything else including everything suggested in this thread. He gets rescoped on the 27th; I’ll keep you posted. I can’t wait for this to be over; I feel like I’m torturing him 
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