Ulcery after every show?

[DiamondJubilee]

Not sure if your horse would eat them, but my “hotter/nervous” boy loved his soaked timothy/alfalfa cubes, and I never noticed an attitude change in feeding them and he’s the type that would let me know!. I would give him a generous scoop soaked about an hour or two before I rode and it worked wonders for him! I did this about 3 x a day when he’s at a show. He loves them and I continue to feed them 1 x a day through the winter and even now when hes on pasture. It kept the weight on him and I always felt better that he had something in his stomach before I showed.

I still feed timothy hay as well and he would pick at that in-between his cube feedings.

[Maude]

Do not give him alfalfa at shows unless his gut is used to it. Switching from a grass hay to a legume can send a horse’s gut into a tizzy as it takes time for the horse to develop the proper gut bacteria to digest it. Better to introduce alfalfa slowly at home over a couple of weeks. Then feed as needed at the show.

[joiedevie99]

Two days isn’t enough. It takes 4 days for Gastrogard to reach its full effectiveness. My first move would be to start two days earlier.

Second, is 1/4 tube enough for the maintenance dose? I believe one syringe contains enough for a 1200 lb. horse. If your horse weighs more than that, 1/4 tube isn’t enough for the maintenance dose, and 1 full tube isn’t enough for the treatment dose.

Third, I’d try the full tube instead of the 1/4. To avoid rebound, for the two days after you return home, I’d only give 1/2.

Fourth, I’d scope the horse to see if there is something there, and he is just masking it better at home? Maybe he needs a full round of treatment.

If all else fails, try experimenting. Some horses do better with sucralfate for stress than ompeprazole. Some people sweat by liquid HA (i.e. ReLyne GI or Gut X).

[JB]

@DarkHorse1

Is there any truth to the rumor that alfalfa makes them hot?

It’s a myth that alfalfa WILL make horses hot. There are simply way, way too many horses getting some, or only, alfalfa, who are mellow, for that to be true.

What IS true is that it CAN make a given horse “hot” if there’s a sensitivity or outright allergy to it. Allergies don’t always manifest as hives or other physical appearance issues. Sometimes it’s their behavior.

Same with soy - 100% fine for the vast majority of horses, but a problem for a small %

[mdp9]

First - get him scoped. Then you can see where and how bad these ulcers are. Gastric ulcers are not one size fits all, and you won’t know what you’re dealing with unless he’s scoped.

The vet will likely prescribe a month or so of gastroguard or sucralfate or another drug I can’t think of right now that’s starts with an M, re scope to make sure they’re gone, and then help you come up with a maintenance plan so they don’t come back.

For the horses in my program, this usually means a full tube before during and after stressful times like showing, alfalfa hay especially before meals, feeding 3 meals rather than 2, and as much turnout as possible.

[DawgLady]

So, I have mixed emotions about scoping. In order to do a proper scope, you’re (probably) trailering the horse to hang out at a clinic, and removing all feed and water for 10 hours. If the horse didn’t have ulcers before, he probably will after that. For me (and my vet agrees) I just assume ulcers and treat with the full 28 day course of Omeprazole for stomach ulcers (plus a weaning-off period). If symptoms persist, I treat for hindgut ulcers with Sucralfate. If all that failed, then I guess scoping would be my next step. But I haven’t had to cross that bridge. Usually the treatment is enough. Feel free to poke holes in my argument, because this is a really important topic and I’m trying to keep an open mind about it because I’m no vet.

[JB]

@DawgLady

Feel free to poke holes in my argument, because this is a really important topic and I’m trying to keep an open mind about it because I’m no vet.

The biggest risk is that it’s the kind of ulcers you really need misoprostol for, not omeprazole (or maybe you need them both). So, while you could affect improvement with omeprazole due to the higher stomach pH, you could easily not affect healing, so you’ve spent $1000 or so for nothing

Does that mean “you must scope or else…”? No But that is one hole in “no need to scope, just treat and see what happens”, to at least take into consideration.

A cheaper way around that hole is to use Nexium (brand name for esomeprazole magnesium) for that treatment period and see how things go. For < $100 you can use the lower dose (3-4 intact capsules once a day) for 30 days and see what you see.

[DawgLady]

Use it alongside the Gastrogard, or…by itself?

[blob99]

@DawgLady

Use it alongside the Gastrogard, or…by itself?

By itself. It’s an alternative to Gastroguard. I’ve used nexium/generic nexium very effectively with my ulcer prone horse. I first used them to treat and now I use that as a preventative when we are going to shows. It’s not only cheaper, it’s also very easy to feed. The pills are tiny and my horse doesn’t even notice them. You can drop into feed or I sometimes just feed it in a handful of food right out of my hand so I can be sure no pills get flung.

[JB]

Yes, instead of UG/GG. Esomeprazole is another PPI, just like it’s weaker omeprazole cousin. The strength of each is why the dosing is VERY different.

[DawgLady]

But only addresses gastric ulcers, yes? Not hindgut? Where does one find out more about calculating dosages? Also, I’m very grateful for this information, so thank you.

[JB]

@DawgLady

But only addresses gastric ulcers, yes? Not hindgut?

correct, esomeprazole and omeprazole only help gastric issues. They may cause or worsen hind gut issues, so it’s now recognized that adding sucralfate to (es)omeprazole is a good idea.

@DawgLady

Where does one find out more about calculating dosages?

Esomeprazole (Nexium) for equine ulcers - Horse Care - Chronicle Forums (chronofhorse.com)

[JB]

The general idea is there are a couple of different studies.

One looked at a 40mg and 80mg dose and found the same effectiveness
One looked at a 2mg/kg dose to compare to the omeprazole 4mg/kg dose
One looked at .5mg/kg dose to compare to 1mg/kg omeprazole, and found the same pH results
And one looked at .5 and 2mg/kg doses of omeprazole to compare the 2

Not all those studies measure pH for the same amount of time. One only measured for 6 hours. One measured to 23 hours. I don’t remember offhand what the others measured to.

All this means is - there’s currently no standardized minimum dose proven to raise pH above 4 for the 24 hours range, like there is omeprezole. 23 hours is pretty darn good though, and the last study shows the best pH numbers with a 2.0mg/kg dose and a high grain low fiber diet (I have NO idea the deals of “high grain” and “low fiber”)

But the first 40/80mg study is where a lot of people start. 40mg for an average horse (ie not 1400lb or more) may give you feedback. Since the granules inside the capsules need to not be crunched, people give another 1-couple capsules 9which are 20mg OTC) as insurance. When I’ve done it, I put them right in the top middle of the feed, as that first hangry mouthful is less likely to be well-chewed, and gives the capsules a fighting chance. Or, you can bolus gun shoot them in, but really, most horses eat them right like that and people get good results.

So that’s where the 3-4 capsules come in. It doesn’t work for all horses. Some people go with the higher dose, which puts most horses in the 12-14 capsule range, which is a bottle (14 caps). Walmart right now has a 3-pack (3 14ct bottles) for <$26, so you get 3 treatments for less than 1 tube of UG/GG if you go with that high dose

[Gardenhorse]

It’s been a while since I’ve looked at those studies - do they say anything about the type of espramazole they used? (I.e., did they also just use Nexium or equivalent or did they have a different formulation?). Unfortunately the low dose (4 capsules) didn’t work for my horse (confirmed with scope she still had active ulcers) and the vet said it was just unclear with Nexium how much of it survives to get where it needs to go. I was wondering if anyone out there is looking at formulations that would be better for horses.

[JB]

Most or all of them say esomeprazole magnesium.

The survival issue is why many will throw in more capsules, especially since it’s so much less $$ than omeprazole.

the first link has a citation below it that says
“In addition, oral administration of esomeprazole (40 mg or 80 mg, orally, every 24 hours) controlled pH levels of gastric secretions in Thoroughbreds. 68 The results obtained corroborated the efficacy of esomeprazole magnesium in the control of gastric pH at both doses tested, with 100% of the mean pH being greater than 5. Moreover, no statistical difference was noted between the 2 doses tested”

So it was given orally, with positive results

The 2nd was “per os s.i.d.” so also orally given

4th also says “per os once daily”

3rd one says “as an oral paste,”, which makes me realize we don’t know the form of the other 3 study drugs

Clearly the studies are showing that enough drug is absorbed to have a significant impact on stomach pH.

Enough horses have had scopes proving these dosings with capsules can work

I would assume you can compound an esomeprazole paste to be whatever dose you want, buffered, just like you can with omeprazole

[clanter]

@lorilu

What about adding Purina Outlast to his meals during and after the show?

there are also Purina Outlast Horse Treats. our horses Love these things

[blob99]

@Gardenhorse

It’s been a while since I’ve looked at those studies - do they say anything about the type of espramazole they used? (I.e., did they also just use Nexium or equivalent or did they have a different formulation?). Unfortunately the low dose (4 capsules) didn’t work for my horse (confirmed with scope she still had active ulcers) and the vet said it was just unclear with Nexium how much of it survives to get where it needs to go. I was wondering if anyone out there is looking at formulations that would be better for horses.

I had to give 4 capsules for my 800lbs pony to heal his ulcers. When i gave him a lower dose that was calculated for his weight, it didn’t quite work. So I would probably throw in 5 or maybe even 6 for a larger horse.

[lorilu]

Is there a methodology/process to use Nexium to see if a horse has ulcers? SOrt of a “test”? Maybe full dose for X days and see if there is a difference?
What about tapering off a short-term “test”?

[JB]

Same as you would UG/GG - do a reasonable “full dose” (whatever that means, see above) for 7-10 days or so, and see if things change. For that duration, you likely don’t need to taper off, but you could

[lorilu]

thx