I read the entire nexium thread and was thinking of trying it. My question is, my horse is currently getting sucralfate 2x per day, in his AM and PM feed.
Due to my boarding situation, there is no way to feed the nexium before the AM feed. Will I be able to add the nexium to the AM feed, along with the sucralfate, or will the sucralfate block absorbtion of the nexium?
Thoughts/suggestions appreciated.
Yes, sucralfate will block the absorption of Nexium. Gotta separate by at least two hours. It’s a pain in the rear
Would it be worth it to feed nexium in the am feed and sucralfate 1x in the pm feed?
I would try to do the Nexium in a “lunch” meal if possible.
Unfortunately, the only options available to me are AM or PM feed.
I did this regimen and I think it was successful.
Have you thought about asking your vet about injectable omeprazole? Then you don’t have to worry about interaction with the sulcrafate at all. Otherwise, do the best you can - feeding them at the same time should be fine, seeing as sulcrafate coats the stomach, and absorption happens in the intestines (right? I’m not an enterologist…). If you’re seeing good results with sulcrafate, I would keep that at twice a day, and add in an extra tab or two of the nexium.
Thanks for the suggestion! I had forgotten about that option. I had discussed that with my vet, but in her experience with the injectable omeprazole, she has had horses come up pretty sore in the neck, so we were trying to brainstorm other options first. I may need to revisit that option if other means of administration are off the table.
Yep! I also would add a sucralfate dose mid day if I could, but that was only random.
I had a horse that had a terrible swollen neck from injectable omeprazole as well, just fyi.
Is there no way you can tweak the feeding process to have the nexium fed even 30 min before evening meals?
The nexium mini-pills are so easily eaten, that what I arranged was that a small labeled tupperware sat outside my horse’s stall. When AM shift person go there the first thing they did was feed the tupperware (it just had the nexium pills and a small handful of grain - he usually just fed it by hand like a treat).
Then he would go do the rest of the horses and dump grain for my girl last. This usually bought us about 30min between feedings. Sometimes he would start doing turn out prep before dumping my girl’s grain.
Same for PM - first fed the tupperware. Then did all the other horses, then went back and gave mine dinner.
It worked effectively for her and was minimally disruptive to our barn staff – but its dependant on what order of operations are at your place whether a modifed process like that could work.
Coming back to update for anyone who might be searching this thread at a later date.
The Nexium AM and Sucralfate PM was a resounding success. My horse is happy, soft and willing. All behaviors resolved 100%. He’s actually going the best that he’s ever been.
In the interest of full transparency, I did add two other things to our routine, in addition to the nexium and sucralfate.
I now always feed alfalfa cubes immediately prior to our ride. He does not get ridden on an empty stomach EVER.
I added gastro elm plus 1x per day. The cost is minimal so I added it on the “can’t hurt, might help” theory.
Hope anyone reading this is having success with their ulcer management!
That’s great to hear!! Can you add how much nexium you gave in the AM and when (e.g., with breakfast versus 30 min before), and same for sucralfate in PM?
So nice to see a success story on here for a change!!
4 Nexium clear mini capsules dropped in the feed in the AM, along with 1 scoop of the GastroElm Plus.
1.5 scoops (per vet) of Sucralfate powder added to the PM feed.
Best of luck to everyone out there also on the ulcer journey~!
My mare has got to have the most sensitive digestive tract on the planet. Ive had her since weanling age and she will be 12 in June. She has allllways had loose poop but not fecal water symdrome. She was scoped and treated with GG and sucralfate. She did well for a while but then went back to being grouchy. Loose poop never resolved. Did the nexium and sucralfate but no real change.
And theeeeeen, after trying everything else on the market I gave Jeremiah’s Ulcer Repulser a try and SHAZAAM!!! After 30 days i noticed great improvement. 6 months later this is still her daily prevention and her poop has never looked better! She is chipper and lovey!! JUR takes care of fore and hindgut and is all natural. I will never be without it!
Ugh. Coming back with a 2nd, not so great update 
. After tapering s.l.o.w.l.y. off the nexium, my gelding’s ulcer symptoms are returning.
All other parts of my program I kept the same. He’s still getting Gastro Elm Plus in the AM and Sucralfate in PM, plus alfalfa cubes before every ride.
I’m super disappointed and frustrated. Guess I didn’t find the magic answer after all. Calling the vet tomorrow.
Time for a scope, as (es)omeprazole isn’t suitable for some ulcers, you may need to use misoprostol, either in addition to, or instead of, the omeprazole family
Scope scheduled for June 10th. The vet recommended that I put him back on the Nexium until he’s scoped.
It’s just so frustrating, because he was doing SO well. I hope we get some answers.
Definitely need to scope. Each horse/case is individual, but in my case, I spent years listening to trainer and vet treating what were clear ulcery symptoms without scoping. We’d throw Nexium at him daily, misoprostol, injectable omeprazole, sucralfate, and supplements. He’d be “better” for a bit only to have symptoms return. Not once did vet recommend scoping and I wasn’t savvy enough at the time to go against vet and trainer and demand anything else.
Moved horse, got new much better vets. After 10K worth of diagnostics and treatment for ulcers, horse has inflammatory bowel disease, causing delayed gastric emptying, causing ulcers. All that nexium, etc not only didn’t treat the issue but caused a dysbiosis in his gut that has taken months to resolve. He ultimately needed steroids and better management with alfalfa hay added.
I cringe now thinking about how poorly treated he had been.
Thanks Skippy. I have been wondering what would cause him to respond so well to the nexium treatment, but to have symptoms return so quickly after we weaned off of it. I’m hoping it’s not as serious as what your guy went through, but it would be nice to have some answers and a solid treatment approach.
The difficulty with administering any ulcer-related meds in this barn is that the barn employee who comes and feeds in the AM absolutely refuses to handle any of the horses. He feeds and mucks, that is it. So using a medicine that requires being administered on an empty stomach before feed for greatest efficacy is a problem. I live 30 min away from the barn, and driving there every morning before work would mean an hour commute round trip. I could certainly do it for a week, but maintaining that schedule for 4 straight weeks would be difficult, if not impossible
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