I have read through some of the older threads on COTH and was hoping for more recent feedback from those that have tried injectable omeprazole for treating/healing squamous ulcers.
For reference, we are treating Grade 3/Grade 4 Squamous ulcers, no glandular or pyloric ulcers present.
What was your experience?
How successful was the treatment?
What side effects (if any) did your horse experience?
no personal experience, but i did ask my vet about it as we’ve been dealing with ulcers for the better part of a year (which i think we now have resolved, knock wood). my vet strongly cautioned against it as horses have had such bad reactions to it; apparently the injectable here is not the same as the one available in europe that they’ve had success with? i also do know one person who tried it on their horse, and the horse had a horrible reaction so they only did it the one time.
No one with any first hand experience to share?
I tried it when Ulcergard did not work on my horse. His ulcer symptoms did go away, but he also had injection site reactions and with it being a weekly shot, it was just not worth it.
I ended up getting omeprazole/misoprostol compounded from Wedgewood and he does best on that.
Thanks for the reply! We are trying the IM Omeprazole Injectable with my horse. The first shot was fine but the 2nd shot had some unfortunate side effects - injection site swelling (still swollen 1 week later) and he had a mild fever for 3 days after the shot. Vet and I are debating on how to move forward. He has two more bi-weekly shots scheduled. I wish I had known that Wedgewood has omeprazole/misoprostol compounded. Maybe they don’t right now (supply chain issues everywhere). We’re doing misoprostol powder 2x per day. I asked my vet if we could do the misoprostol in paste form (as that is how I have administered it in the past), but she said it is out everywhere. We had to order the mistoprostol powder from Rood & Riddle, I believe.
The compounded miso/omeprazole I get is liquid. I give it to him 20 mins before breakfast and it’s honestly worked the best. Might be worth reaching out to Wedgewood about it. I have been getting it sent monthly (they have an auto-ship program) for a couple years now and haven’t had any supply issues.
Sorry you’re going through this! My guy’s ulcers were awful and we tried everything to get rid of them and determine why he has them. We finally just found out he has a torn meniscus and chondromalacia.
Thanks Kati - that is a huge help! I’m having my vet’s office call Wedgewood now. I’m really hesitant to continue with the injectable Omeprazole. My gelding’s reaction to the 2nd shot was pretty strong and he was miserable.
Reactions can worsen with time and with as many reactions horses have to it, I don’t use it.
It’s so disappointing that we don’t have access to the same injectable omeprazole that is in use in Europe and Australia. Those countries seem to be having so much success with it.
My vet and I agreed today to abandon the injectable omeprazole route after the 2nd injection caused a localized swelling that has yet to go down (7 days later) and a 4-5 day low grade fever. I just can’ take the chance that the next shot would produce a worse reaction.
I think that’s a wise decision. It would certainly make life easier to have an injectable form, that’s for sure. Maybe the availability will eventually develop in the US. 
Bumping up an old thread.
Have some of the injection issues been resolved or are they ongoing? It was recommended by my vet to try a weekly injection for short term use while we sot out some management issues.
I was the OP that started the thread. I did try the injectable Omeprazole. The experience was BAD. My gelding tolerated the first shot, but the second caused localized swelling (a large, hard lump which took weeks to go down), a week long fever and lethargy. He was miserable. My vet and I discontinued the injections. I ended up having to move him to a different boarding barn, one which could commit to giving him a full tube of gastroguard first thing in the AM, 30 min before grain, on a (relatively) empty stomach.
I also tried the injectable Omeprazole last summer and decided to discontinue after the 2nd shot. My poor mare also had a bad reaction and seemed very uncomfortable. Another friend I know who tried it on her horse also had bad injection site reactions.
Ugh he’s booked for shot 1 on friday and they are highly recommending it (I am in Canada)
I’ve never tried the injectable as my vet is wary of the side effects. I did just talk to her about the combined Omeprazole/Misoprostol suspension. She said they’ve had great luck with it. My guy has been on Nexium but I’ve been looking into other options since we’ve got a barn switch coming up in a couple weeks and it wouldn’t surprise me in the slightest if that stress sets him off.
For a 30 day supply of the oil suspension (2.2g Omeprazole/1400mcg Misoprostol per 20 mL dose, 600mL bottle), I was quoted $266. That’s significantly less expensive than I had anticipated. We won’t be scoping to know for sure how it works for him, but I’ll report back on how he does otherwise.
Just sharing in case anyone else is down the ulcer rabbit hole and might find this helpful!
We used it for three weeks for a horse with some intractable ulcers and had good luck. No injection site swelling or fever that we found. But it’s possible we just got lucky!
Thank you. Its a super short term application for 3 weeks of limited turn out. I will hope for these results.
My vet was out yesterday (for a non-ulcer-related appointment) and mentioned to me that the injectable compounded omeprazole was available here now. However, he was not impressed with the known injection site problems. He said it was an approximately 30% rate of issues and that he found that unacceptable, and did not recommend it unless there was no other option (ie. if you board and barn staff won’t give oral omeprazole), and even then said he’d rather try another medication first before going the injectable route.
I hope it works for your pony! I was so hopeful it would work for my mare, as she is VERY ulcer prone and was going on stall rest after colic surgery. Unfortunately I think the side effects of the omeprazole injection just made her feel worse rather than better 
I really wish we had more options other than Gastrogard in the US. It’s just so dang expensive and a PITA to give.
I’ve never heard of this before but sounds promising! Would love to hear an update if you end up trying it during your move and if you think it helps!
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