Tapering After Long-Term Omeprazole Treatment?

[Amy3996]

For those of you who have treated for more than 30 days, how long did you taper before stopping completely?

My 6yo OTTB gelding is wrapping up month 4 of aggressive treatment for pyloric ulcers. He had 1 month of just misoprostol in April after being scoped at New Bolton. Recheck scope with our local vet showed little improvement and a gastric fluid PH less than 2. We treated for 30 days (May) with Gastroguard and lower dose of misoprostol, rescoped again. There was massive improvement, from Grade 4 to Grade 1.

We continued with same protocol for June and rescoped to find that while still improved from initial scope, he hadn’t progressed any further. We did a third month of GG (July)and doubled his dose of Misoprostol (back to what New Bolton had prescribed).

After reading some threads here, I put him on Succeed about 3 weeks ago. We did 7 days at 2 tubes/day, and he’s had almost 2 weeks at 1 tube per day. He’s getting rescoped again on Wednesday. I’m planning to talk to my vet about stopping the omeprazole and continuing with misoprostol and Sucralfate. The GG has become cost-prohibitive.

His June scope showed 90% healing of his stomach, with lingering pyloric inflammation. I’m wondering if the consequences of long term omeprazole on the hind gut are hindering healing of the pyloric region?

[DannyBoysMom]

Following.
Wow your poor baby!!
My guy is recovering from salmonellosis that nearly killed him. Now possible abdominal adhesions secondary to the salmonella. And because of bute ans stress - ulcers! He’s now on daily equioxx.
Just finished one month of misoprostol. Have two weeks more of sucralfate. Two weeks full tube, now at two weeks half tube of omeprazole (UG). And just spoke to vet about tapering to quarter tube during last week of sucralfate.
I’ll probably do a quarter tube every other day for a week after.
He’s getting Outlast. SmartPak GI Ultra and Aloe Pellets. And just started GutX Sunday.

[joiedevie99]

For one that was on gastrogard a long time, we tapered over 6 weeks - 2 weeks at 3/4 tube, 2 weeks at 1/2 tube, 2 weeks at 1/4 tube. For a horse that was only on gastrogard for one month, we tapered over 2 weeks.

[J-Lu]

My horse was on Gastroguard for 30 days for very mild stomach ulcers we almost missed (we thought the’d be a huge bloody mess from his behavior). I tapered off over 14 days.

[IPEsq]

I mentioned this somewhere in the Nexium thread but I had success tapering using Nexium because it was easier to be precise and slow with it. Also kept horse on 2 scoops of Succeed (1 scoop 2x a day) for a long time after stoping Nexium (switched from tubes to the granules).

That horse didn’t really respond great to Sucralfate, but it does wonders for current horse, and after last round of GG, vet had me add sucralfate where he’d get sucralfate AM and PM and GG mid day. I also did Succeed. I was able to taper GG in about 10 days, though he’d been on it only 2ish months. Then did Sucralfate 2x a day for I think 6 weeks, then 1x a day for another month. I noticed a big change shortly after adding Sucralfate with this one. So I tend to use it instead of Ulcergard where I’d want short term or trailering/show support.

[eclipse]

I feel your pain, I’ve been battling pyloric and gastric ulcers for over 5 years now! My guy though needs to live on omeprazole so he gets a generic and it seems to of worked. After he gets a full dose of Ulcerguard for horse shows (generally once or twice a year we full dose him on Ulcerguard for 2 weeks) and after the 2 weeks we taper down to the daily maintenance dosage and then switch him back to his 10cc of generic!

Then his pyloric ulcers flared up 4 months ago so now he’s on sucralfate long term and when he coliced again last weekend and we scoped, his pyloric ulcers are actually looking better than even 5 years ago so the sulfracate is really doing it’s job! (This colic isn’t from his ulcers this time he has a polyp….sigh)……My understanding is omeprazole cannot reach the pyloric sphincter so that’s where the sulfracate comes in as it can! Right now he’s on 12 pills 3 times a day and we will go down to twice a day in a few weeks.

Best of luck….pyloric ulcers are a beotch!