Use of Abler/generic omeprazole on confirmed ulcers

[SuckerForHorses]

[QUOTE=awaywego;8202475]
In further full disclosure, the reason I am so skeptical of the “my horse acts ulcer-y so I’m treating him” method is because I did the SAME EXACT THING with my other horse about a month ago.

For a number of reasons, I thought all signs pointed to ulcers. I did a week of gastroguard to see if I saw improvement. I thought I did. So I took BOTH horses to be scoped. The one I thought had them does not, the retired one does. WTH.

So I could have easily spent $$$ on a month of treatment for a horse that did not have ulcers whatsoever, as confirmed by gastroscopy, and spent $$ completely needlessly on a set of glorious silver skates.

I’m not knocking anyone who’s done it - because really it’s all in the interest of doing right for your horse, and I think that’s a good thing to be “guilty” of. But it really hit home for me how impractical that “method” can be :)[/QUOTE]

I’m with you. I like to scope and know for sure. If it’s not ulcers, save the $$$$ on GG and pursue other reasons for the horse’s issues.

[awaywego]

Well I don’t really see giving antibiotics as dangerous, no. Horses are given antibiotics for all kinds of things - I don’t see why this would be any different.

I do find that interesting though that it does sound as if someone had treatment success confirmed by scoping with Abgard.

Well I will definitely have mine re-scoped in September, so i will report back on whatever I end up doing, if it works or not. More anecdotal data! :lol:

[Simkie]

[QUOTE=awaywego;8202654]
Well I don’t really see giving antibiotics as dangerous, no. Horses are given antibiotics for all kinds of things - I don’t see why this would be any different.[/QUOTE]

All things have risks. You want to give antibiotics on a lark, with no actual recognized infection?

It seems very incongruous to me that you’re concerned about the microbiome and recognize that it’s important, but you’re game to use antibiotics in such a willy nilly fashion.

A very quick google turns up this interesting article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466501/

[awaywego]

[QUOTE=Simkie;8202663]
All things have risks. You want to give antibiotics on a lark, with no actual recognized infection?

It seems very incongruous to me that you’re concerned about the microbiome and recognize that it’s important, but you’re game to use antibiotics in such a willy nilly fashion.

A very quick google turns up this interesting article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466501/[/QUOTE]

I think we may have to agree to disagree on this one. It’s probably a matter of semantics, but I think I would say I’m more interested than concerned in the role that the microbiome plays with respect to ulcers, the good vs the bad bacteria.

[Winding_Down]

[QUOTE=Simkie;8202567]
We do have a poster here who verified that the enteric Abler coating was effective.

Enteric coatings in general increase bioavailability by ~25%.

The FDA conveniently confirmed for us that the Alber granules contain the labeled amount of omeprazole, and that the paste is super-potent.[/QUOTE]

I do not recall the latter finding at all. Where was this published?

[Simkie]

[QUOTE=Winding Down;8202862]
I do not recall the latter finding at all. Where was this published?[/QUOTE]

In the FDA warning letter sent to Abler.

awaywego, I am really not trying to be argumentative, but am genuinely curious about your reasoning behind using antibiotics to address some sort of imbalance in the microbiome. I think the attention that is being paid to this in medicine is fascinating, but I just haven’t ever seen any discussion about using a broad spectrum antibiotic to wipe out some unknown imbalance, and then correcting it with an probiotic with unknown bacteria with unknown efficacy.

I could, perhaps, see your line of thinking if you ran a culture of whatever you were able to swap off of the ulcers in his stomach, and targeted your antibiotics to that specific bug, but it doesn’t sound like that’s what you’re doing at all. And that is not bringing the microbiome into the conversation at all–just perhaps addressing an overgrowth of something that you think could be a bacterial cause of gastric ulcers in horses.

You seem to be frustrated and angry with people in this thread who treat ulcers with omeprazole without scoping before and after to confirm that they’re treating the right issue, but by tossing antibiotics at the wall to see if anything sticks, you’re really just repeating that same behavior…only with a drug that’s not proven to do anything for the problem.

Again, not trying to be argumentative and this is the sort of cerebral conversation that goes best with a beer and a bowl of chips and salsa on the porch But really, really curious what role you think antibiotics will play in fixing your horse if you think his microbiome is out of whack.

[J-Lu]

[QUOTE=Simkie;8202121]
Oh, please. FDA approved drugs are made in India all the time. And being FDA approved hardly means quality control is 100%. Have you seen the FDA recall list??

http://www.fda.gov/Drugs/DrugSafety/DrugRecalls/default.htm?tracking=BikePGH

Note this at the top:

[B]NOTE: The recalls on the list are generally Class I., which means there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death.

[/B]Only had to go to page two to find the first “sub potency” issue:

http://www.fda.gov/Safety/Recalls/ucm427952.htmCheck out how long that subpotent drug was on the market (over a YEAR) and the warnings regarding it. All scary.
Being made in India does not automatically = poor quality control and being FDA approved does not automatically = safe.

As with everything, it’s balancing risk/reward.

And the reason the Merial product is so ungodly expensive is being they’re trying to recoup their development costs…[/QUOTE]

I’m in the biomedical field. FDA has standards, and if things don’t meet those standards, they get recalled. Right? Your links prove this. You might not care if your veterinary drugs are compounded in a southeast asian company without oversight. But YOU don’t have to. That’s the point of a message board, right? Obviously, Merial is trying to recoup their R&D.

Of course its about balancing risk. All informed people know this and do this.

[J-Lu]

[QUOTE=candico;8202144]
FWIW, all of the vets that I have been around actually prescribe compounded omeprazole, usually Precision Pharmacy, or just tell you to get the human kind from the drug store. They only dispense Gastroguard if insurance is covering the expense or you insist. The general consensus among them is that Merial is GREEDY, not that they are a superbly superior company investing gobs of money into quality and research. They do invest gobs of money to try and brainwash vets that their product is the only one that could possibly survive the equine gut and be effective, but for those vets that have witnessed plenty of horses including their own rid of ulcers on compounded and generic human omeprazole, Merial just looks like crooks. Look at all the advertising dollars they spend!! That is what you are paying for as well…

I also have never had any of them frown upon my using a “product from India” and in fact have asked for more info for their patients that struggle to pay for the compounded versions they have to offer. I am sure it would be different if it were a product that had to have precise amounts or else could be fatal, but I have yet to hear of a fatal dose of omeprazole or anyone complain of side effects from Ablers pop rocks vs the side effects from Gastroguard - namely rebound and exacerbation of hind gut ulcers.

Also have yet to find a vet here that actually takes any stock in the Succeed test. Seems they see it more of a gimmick rather than a legitimate test for ulcers - but at least it is not terribly expensive. They get you when you buy the Succeed ???[/QUOTE]

That’s OK, and thanks for your opinion.

My vet is vehemently opposed to compounding companies and Abler “poprocks”. I know a couple of others that are, too. We seem to work with very different vets. That’s OK.

You obviously don’t like big pharmaceutical companies and that’s OK, too. Sure, they are greedy. They also fund R&D, and that’s everything that works and everything that never gets to market.

[J-Lu]

[QUOTE=awaywego;8202295]
So is it just that those who pay the $$ to scope also cough up the $$ for gastroguard?

For all the people I see on here talking about their ulcer-y horses, it sounds like an overwhelming majority do NOT have their horses scoped because it is just cheaper to do a course of generic omeprazole. So who really knows if 1) the horse actually had ulcers!, or 2) if the omeprazole “cured” the ulcers.[/QUOTE]

FWIW, in my neck of the woods it costs about $250-300 to scope a horse, more or less (yes, less) if you have a truck and trailer and can drive to the clinic. TO GET AN ANSWER and treat your horse correctly, that’s really not that much money. It also gives you a good idea of your horse’s risk of forming ulcers with stressful events.

But that’s me as a horse owner. I like to know what I’m dealing with if I can. I don’t have unlimited funds but $300…you can spend that on even poprocks.

[candico]

Again, there are risks involved with scoping as it is an invasive procedure and if your horse has all the typical ulcer symptoms that only go away with a week’s worth of omeprazole, I just don’t feel the need to take that risk nor put the horse through that particular procedure. And logically, you cannot equate putting $200 to $300 toward a diagnosis as equal to putting that amount toward a cure especially when it is often quite obvious symptom-wise when the horse has ulcers and what seems to work well in making those symptoms go away. Absolutely, if you are constantly struggling with an unwell horse with either non-standard symptoms or does not improve within a reasonable amount of ulcer treatment, then scope!

Yes, we need big pharm to fund R&D, but there are times that certain companies get greedy with particular products. I live nearby a few of these big pharm higher ups and I can see plenty is left over beyond R&D!!

The vets I use treat both internationally competing high dollar horses as well as the backyard pet variety. The one is also one of the “go to’s” for scoping so I would think he would see the results compared to those using Gastroguard vs compounding, but I will be sure to ask him when I run into him.

[Winding_Down]

FWIW, my vets, who are part of a large and well-respected practice that treat many top performance horses in Northern Virginia, are not enamored with the compounded treatments for ulcers. My primary vet has told me that anectdotal data suggests that the compounded drugs can help but do not yield the same results as Merial.

And for those who do not scope: I have had one horse, and know of several others, that clearly present with the symptoms of ulcers but when scoped, present clear. Treating a horse for ulcers that has never been scoped is risky insofar as you could be missing a different problem altogether and the horse will suffer as a result. For example, if a seemingly ulcer-y horse scopes clear, then I would do further diagnostics (blood work would be the next step) to figure out the problem and the indicated treatment.

If I had a horse that presented with right front lameness, I would not go inject the anke without doing further diagnostics. Same with ulcer-y symptoms: I would not treat for ulcers without confirming their presence, not only because that would be $$ down the drain but also because I would not be using the appropriate treatment.

[SuckerForHorses]

And for those who do not scope: I have had one horse, and know of several others, that clearly present with the symptoms of ulcers but when scoped, present clear. Treating a horse for ulcers that has never been scoped is risky insofar as you could be missing a different problem altogether and the horse will suffer as a result. For example, if a seemingly ulcer-y horse scopes clear, then I would do further diagnostics (blood work would be the next step) to figure out the problem and the indicated treatment.

I agree 100%. Ulcer symptoms are very similar to any number of 3,225 ailments a horse can get :lol: Gastric ulcers are easy to rule out with a scope - I’d want to do that before treating something that may not exist, and missing something else entirely - especially something that is important that it be caught in a timely manner to treat. Screw around treating ulcers when it could be something else and you may have a very sick horse on your hands.

[awaywego]

To be clear, I am not mad or judgy or whatever with anyone who chooses not to scope. I was really truly just looking for specific experiences with scoping, using something other than gastro-guard, and then re-scoping to see how it worked.

No judgment if you choose not to scope! Seriously people, do what works for you and your horse

[SonnysMom]

A friend took her horse to New Bolton to be scoped. He had been on the generic omeprazole powder from the vet for a month at that point. He had ulcers, a few were partially healed and some not healed at all.
So 30 days of GG. Rescope showed a lot of improvement but not gone. She was able to become part of a clinical trial through Merial for 30 more days of GG plus an antibiotic. She had very specific times she had to give the meds in relation to when she fed. She rescoped and they were gone.
So apparently they are looking into the effeciacy of adding an antibiotic to the omeprazole treatment.

I personally have used the Abler pop rocks without scoping. While I might be subject to the placebo effect I can say that I had to keep cutting my horses food back and he has become quite the easy keeper.
He went from grain and alfalfa pellets to less and less alfalfa pellets. Once I get to straight alfalfa pellets I added a ration balancer.
I have had the horse at the same barn, with the same turn-out buddies and the same diet for a few years before trying the pop rocks. Therefore his environment did not change just the pop rocks. I had him on the maintenance does for about 4 months.
Now I only use it if I am going to an overnight clinic.

[awaywego]

[QUOTE=SonnysMom;8203521]
A friend took her horse to New Bolton to be scoped. He had been on the generic omeprazole powder from the vet for a month at that point. He had ulcers, a few were partially healed and some not healed at all.
So 30 days of GG. Rescope showed a lot of improvement but not gone. She was able to become part of a clinical trial through Merial for 30 more days of GG plus an antibiotic. She had very specific times she had to give the meds in relation to when she fed. She rescoped and they were gone.
So apparently they are looking into the effeciacy of adding an antibiotic to the omeprazole treatment.

I personally have used the Abler pop rocks without scoping. While I might be subject to the placebo effect I can say that I had to keep cutting my horses food back and he has become quite the easy keeper.
He went from grain and alfalfa pellets to less and less alfalfa pellets. Once I get to straight alfalfa pellets I added a ration balancer.
I have had the horse at the same barn, with the same turn-out buddies and the same diet for a few years before trying the pop rocks. Therefore his environment did not change just the pop rocks. I had him on the maintenance does for about 4 months.
Now I only use it if I am going to an overnight clinic.[/QUOTE]

Ahh, interesting! Was this recently?

The thing about using the pop rocks is that if it makes your horse better in any way, then it worked. That’s all that matters. In the big picture of owning a horse, a $150 treatment for a month is a drop in the bucket to having a happy horse!

[JB]

@SonnysMom;8203521

So apparently they are looking into the effeciacy of adding an antibiotic to the omeprazole treatment.

Since you sometimes need abx for hind gut ulcers/colitis, this makes me wonder if there’s any possible connection between HGUs causing/allowing/exacerbating foregut ulcers?

[RealityCheck]

Out of curiosity, has anyone’s horse been prescribed sucralfate along with the omeprazole for ulcers? In my previous life as a tech at a large equine hospital we did this frequently to treat and prevent ulcers in foals, however I hardly ever hear of this with show or race horses.

[eclipse]

[QUOTE=RealityCheck;8204407]
Out of curiosity, has anyone’s horse been prescribed sucralfate along with the omeprazole for ulcers? In my previous life as a tech at a large equine hospital we did this frequently to treat and prevent ulcers in foals, however I hardly ever hear of this with show or race horses.[/QUOTE]

not Sucralfate but my guy has just been put on 21 days of Misoprostol along with Gastroguard after his 2nd scope shows significant damage/ulcers/squamous cell carcinoma around the phyloric sphincter (we are waiting on test results)!

[awaywego]

[QUOTE=RealityCheck;8204407]
Out of curiosity, has anyone’s horse been prescribed sucralfate along with the omeprazole for ulcers? In my previous life as a tech at a large equine hospital we did this frequently to treat and prevent ulcers in foals, however I hardly ever hear of this with show or race horses.[/QUOTE]

I used sulcalfrate post gastro-guard years ago - can’t remember the exact details - but it was not in conjunction with.

[SonnysMom]

[QUOTE=awaywego;8203549]
Ahh, interesting! Was this recently?

The thing about using the pop rocks is that if it makes your horse better in any way, then it worked. That’s all that matters. In the big picture of owning a horse, a $150 treatment for a month is a drop in the bucket to having a happy horse![/QUOTE]

Yes it was about 15 months ago.