Horse Stomach Ulcer Treatment

Prevention of Horse Ulcers

Several steps help prevent horse ulcers:

• Using UlcerGard
• Taking Sucralfate (Rx)
• Avoiding high carbohydrate diets
• Avoiding NSAIDs

UlcerGard to prevent horse ulcers

Maintaining a nonstressful environment helps prevent ulcers, but for active horses, UlcerGard is the only proven preventative. UlcerGard is omeprazole, which is given at a concentration of 0.45 mg/lb of body weight (1 mg per kg). This usually equals about a quarter of a tube a day. Omeprazole at higher doses will treat ulcers. For example, ulcers are treated with omeprazole at 4 mg/kg, which is the concentration of GastroGard (Rx). Thus, ulcer treatment is the same as ulcer prevention, but at 4 times the dose.

Sucralfate (Rx) to prevent horse ulcers

Sucralfate (Rx) is used for preventing ulcers in foals at the dose of 5-10 mg/lb (10-20 mg/kg) 3-4 times a day.

Avoid high carbohydrate diets to prevent horse ulcers

High carbohydrate diets can contribute to ulcers, so for some ulcer-prone horses it’s best to provide calories from oils rather than from carbohydrates.

Avoid NSAIDs, such as Bute and Banamine for horse ulcers

Bute [Phenylbutazone (Rx)] and Banamine [Flunixin meglumine (Rx)] are the most commonly used nonsteroidal anti-inflammatory drugs (NSAID). While most horses can tolerate these drugs at normally prescribed doses, some horses develop ulcers when using these drugs at even half the normal dose. If your horse has problems with ulcers, work with your veterinarian to set up a program to avoid NSAIDs, especially bute. If it’s necessary to use an NSAID, ketoprofen (Rx) is less ulcerogenic than Banamine or bute. If continuing with Banamine or bute, consider using a lower dose.

Never use more than one NSAID at a time. For example, don’t use dexamethasone with bute. If possible, rather than using an NSAID, use other techniques to control pain. For example, work with your farrier to correct foot and heel pain. Consider acupuncture, chiropractic, and massage treatments to reduce muscle and bone pain.

Treatment of Horse Ulcers

UlcerGard, an over-the-counter medication, is for horse ulcer prevention: GastroGard, a prescription medication, is for gastric ulcer treatment in horses.

The only stomach ulcer treatment that is effective and approved to prevent stomach ulcers is UlcerGard, which is omeprazole given at a dose of 1 mg/kg. The only effective and approved treatment for ulcers already present is GastroGard, which is omeprazole given at a dose of 4 mg/kg. UlcerGard and GastroGard are exactly the same medication but at different doses. UlcerGard and GastroGard are in a cinnamon paste. They are given once a day and lower stomach acids for a full 24 hours.

When treating horse ulcers, GastroGard (Rx) is given once a day for 28 days. It’s possible to use UlcerGard to treat ulcers by increasing the dose, that is by giving an entire tube rather than ¼ tube per day. This brings the dose to 4 mg/kg and is effective therapy for existing ulcers. Work with your veterinarian if your horse needs ulcer treatment.

GastroGard (Rx) is the only FDA-approved ulcer treatment. There are many less expensive ulcer treatments, but they have not been shown to work. Some holistic veterinarians, including Dr. Madalyn Ward, find that Succeed and products made with algae, such as CT Essentials, help horses with, or prone to, ulcers. Dr. Ward has noted clinical improvement with these products, but published research is not available.

If the horse ulcers are chronic and have eroded deeply into the muscular layer, it may be necessary to treat with GastroGard (Rx) (or 4 times the regular dose of UlcerGard) for longer than one month. Your veterinarian can pass an endoscope into your horse’s stomach and show you on a video what the lining of the stomach looks like. You can discuss how long ulcers of that severity take to heal.

Horse u lcer symptoms should ease within a few days for horses on GastroGard (Rx), but it takes about a month for ulcers to fully heal. Withdrawing omeprazole before healing occurs caused the reappearance of ulcers in over 90% of horses. Once horses are treated and ulcer free, they can go onto preventative doses of UlcerGard during times of stress. For example, horses being shipped to shows can start UlcerGard the day they are shipped and continue it until they are back home eating normally.

Sucralfate (Rx) to prevent horse ulcers

In addition to using GastroGard (Rx) or UlcerGard to block hydrochloric acid production, it is helpful to coat the stomach with sucralfate. Sucralfate tablets, sold as Carafate (Rx) can be crushed and mixed in syrup so the horse receives 1 g/100 lb body weight 2-3 times a day. Sucralfate (Rx) is also available as a liquid.

Sucralfate coats the stomach most efficiently when it is given 1 hour before feeding or 2 hours after feeding, and again at bedtime. Because sucralfate only coats the stomach when acid is present, it should be given ½ hour before cimetidine or ranitidine, which block acid production. Sucralfate should also be given at least ½ hour before an antacid. Sucralfate can interact with some oral medications: cimetidine, tetracycline, phenytoin, and digoxin.

Ranitidine and Cimetidine to prevent horse ulcers

Horse u lcer medications ranitidine or cimetidine are used to treat and prevent ulcers, but these medications are less effective than omeprazole and must be given 3-4 times a day because they lower stomach acids for only a few hours. Ranitidine is more effective than cimetidine. UlcerGard is usually more cost effective than cimetidine and ranitidine.

Reducing stress to prevent horse ulcers

Any steps that reduce stress help reduce ulcers. When possible, relax the training schedule, use longer pasture turnouts, and provide pain relief that does not include NSAIDs.

Regular worming to prevent horse ulcers

Parasites cause colic symptoms that mimic symptoms seen with ulcers. Regular worming may not reduce ulcers, but it will help prevent misdiagnosis and it will improve overall equine health. For tips on worming and a comparison of products, visit www.pethealth101.com and check out the section on Horse Wormers and How to Deworm Your Horse.

Horse ulcer treatments that don’t work

Omeprazole is expensive. Because omeprazole is expensive, horse people have tried a number of alternatives, but passing an endoscope and checking the stomach lining of treated horses shows that ulcers remain. Among the unsuccessful ulcer treatments are:

• Corn oil fed for 6 weeks
• Refined rice bran oil for 6 weeks
• Unrefined rice bran oil for 6 weeks
• Human omeprazole (Prilosec)

Veterinarians that pass an endoscope and observe the stomach lining don’t find the above products effective in treating ulcers.

The articles here were answered by a variety of pharmacists and veterinarians   Date Category Topic 06/24/06  Eye Care  PUG 04/20/06  Eye Care  SCRATCHED EYE 03/13/06  Urinary Tract/Kidneys  VOMITING BLOOD 02/26/06  Eye Care  EYE LOOKS SWOLLEN 12/28/05  Urinary Tract/Kidneys  DIARREAH/HORSE 12/27/05  Eye Care  GREEN MUCUS 12/02/05  Other  PARVO? 11/03/05  Skin Care  RABBITS

 

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