I know there are many threads out there about ulcers etc, but I don’t have the patience to read through all of them at the moment. My trainer & vet say 3 scoops of powdered omeprazole until we can switch to a maintenance dose… So I’m wondering if it would be cheaper and more effective to just use gastrogard
Would you guys do that, or just use gastrogard until the ulcers are gone?
I don’t have the patience to read through all of them at the moment.
I would suggest the “search” function because there are a lot of us who don’t have the patience to repeat what is out on the board many times over. The opinions on powdered omeprazole are many.
maybe i’m just not searching correctly since I’m fairly new at using the forums but cant find really anything on the powdered omeprazole vs gastrogard, which is why my patience has run thin…lol
Short answer: maybe.
Saying “my horse is on omeprazole powder…will it work?” is like saying “my horse is on grain…will he gain weight?”
Multiple companies make omeprazole powder, and there’s a lot of potential for varying levels of quality control in the amount of omeprazole actually in a dose and also for the method of protecting the drug in the stomach.
This should really be a question for your vet. Why don’t you ask him what scoping studies he’s done to show that this preparation is effective in treating ulcers?
I just had a big discussion with several vets, as well as a human physician who has used various products to treat her horse’s gastric ulcers. Basically, Ulcerguard and Gastroguard only help with stomach ulcers. Those products are of no value for a horse with hindgut ulcers, and may actually trigger worse issues in the hindgut, because they act by reducing stomach acidity, which reduces the amount of digestion that begins in the stomach. That allows more food that has not yet begun the digestion process, to pass to the hindgut, which can intensify problems for horses with hindgut ulcers.
Omeprazole powder is often compounded to work in both the stomach and the hindgut, so you are addressing ulcers in both locations. Also, you can’t see hindgut ulcers via scoping, so studies that rely on scoping to determine the effectiveness of gastric ulcer treatments can be somewhat unreliable.
You might want to verify with your vet that the type of omeprazole he has prescribed, does in fact work in the hindgut. If so, I would definitely use the O powder over UG/GG.
[QUOTE=DownYonder;8204180]
Omeprazole powder is often compounded to work in both the stomach and the hindgut, so you are addressing ulcers in both locations. Also, you can’t see hindgut ulcers via scoping, so studies that rely on scoping to determine the effectiveness of gastric ulcer treatments can be somewhat unreliable.[/QUOTE]
But…this makes no sense 
Omeprazole doesn’t act in the hindgut. It’s a proton pump inhibitor, and there are no proton pumps in the hind gut. It’s absorbed in the small intestine, and then acts systemically wherever there are proton pumps, namely the stomach. If there were proton pumps in the hind gut, it WOULD work on them, too, without any fancy compounding required.
Unless you’re talking, perhaps, about the omeprazole/sulcrafate compounded meds out there? The sulcrafate acts in the hind gut. But that’s a whole different kettle of fish, so to speak.
[QUOTE=Simkie;8204244]
But…this makes no sense
Omeprazole doesn’t act in the hindgut. It’s a proton pump inhibitor, and there are no proton pumps in the hind gut. It’s absorbed in the small intestine, and then acts systemically wherever there are proton pumps, namely the stomach. If there were proton pumps in the hind gut, it WOULD work on them, too, without any fancy compounding required.
Unless you’re talking, perhaps, about the omeprazole/sulcrafate compounded meds out there? The sulcrafate acts in the hind gut. But that’s a whole different kettle of fish, so to speak.[/QUOTE]
Thanks for clarifying. That’s why I said “Omeprazole powder is often compounded to work in both the stomach and the hindgut”, but I couldn’t think of the name of the other component (sulcrafate). And that’s why I stated she should verify with her vet.
Everyone is saying you cannot scope for hind gut ulcers, but isn’t the Pyloric Sphyncter part of the hind gut? If so I can guarantee that my horse was successfully scoped for ulcers in this region. It must be empty and they use a longer scope!
so this powdered omeprazole … how can it work without either enteric coating or a carrier agent (the latter being the patented aspect of gastrogard)?
[QUOTE=eclipse;8204287]
Everyone is saying you cannot scope for hind gut ulcers, but isn’t the Pyloric Sphyncter part of the hind gut? If so I can guarantee that my horse was successfully scoped for ulcers in this region. It must be empty and they use a longer scope![/QUOTE]
No. Hind gut = large colon.
[QUOTE=McVillesMom;8204353]
No. Hind gut = large colon.[/QUOTE]
ah… So this now makes sense why they’re treating my guy with both the GG and meds for hind gut!
so this powdered omeprazole … how can it work without either enteric coating or a carrier agent (the latter being the patented aspect of gastrogard)?
Well, since there’s not just one powdered omeprazole out there, there’s no one answer to that question, Winding Down. Multiple compounding pharmacies are making powdered omeprazole for equines.
The good ones are buffering it in a similar manner to the Merial products (which are no longer under patent, btw, although no one has brought a generic to market.) The bad ones probably aren’t doing anything to protect the omeprazole through the stomach.
That’s one of the reasons this conversation is so difficult. “Powdered omeprazole” tells us nothing about the product, really, other than it’s being marketed as omeprazole. Does it contain the labeled amount of drug? Does it contain a buffer to get it through the stomach? Who knows! Some compounding pharmacies are more “proven” in this realm than others. (And yes, please note I have proven in quotes! ;))
This is a study I rely on in dosing with ulcergard. Unless insured, I do not ever give a full tube (I do not rescope with horses that have scoped positive in the past), but typically give a 1/2 tube for 5 days and then down to a 1/4 tube for 3-4 weeks. I then follow up with ranitidine.
http://www.thehorse.com/articles/34581/study-low-dose-omeprazole-and-gastric-ulcers
And at 1/4 tube per day, the cost is basically the same as pop rocks.
My vet agrees that this can be as effective but also has told me that there are horses that need more than that to resolve ulcers; and there have been cases where it takes more than 1 tube per day to resolve. Those are the cases in which they consult with Merial. BTW, Merial has provided free gastrogard for horses that have ulcers that do not resolve within two months. I am not a big fan of pharmaceutical companies, but this is something that I truly doubt Abler would do.
[QUOTE=Winding Down;8204525]
http://www.thehorse.com/articles/34581/study-low-dose-omeprazole-and-gastric-ulcers
.[/QUOTE]
This is the Australian study, with the enterically coated granules in a paste. Interesting, but likely irrelevent to us in the US without further investigation given the potentials for differences in bioavailability between Gastrozol and GastroGard.
If you have scoping studies showing healing using this protocol with GastroGard, I’d love to know. 
At $30/tube for GastroGard, treating with the full dose of pop rocks is still considerably less expensive. If we’re drawing conclusions from the Australian study, pop rocks are a more apt analog for Gastrozol, and the cost to use 1/4 dose of the Abler product is nearly negligible.
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