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.
1 Like
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.
1 Like
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.
Esomeprazole (Nexium) for equine ulcers - Horse Care - Chronicle Forums (chronofhorse.com)
1 Like
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
1 Like
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.
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
2 Likes
there are also Purina Outlast Horse Treats. our horses Love these things
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.
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”?
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
thx
1 Like
