Omeprazole / Ulcergard Treatment Schedule for Horses with Ulcers
Equine gastric ulcer syndrome (EGUS) is a common condition in horses that results from an imbalance between the protective and damaging factors in the stomach. It can significantly impact a horse’s performance, behavior, and overall health. Omeprazole, marketed under brand names such as Ulcergard and Gastrogard, is the most effective treatment and preventive measure available for gastric ulcers in horses. Understanding its administration and treatment schedule is vital for optimal outcomes.
The Role of Omeprazole in Treating Equine Ulcers
Omeprazole is a proton pump inhibitor (PPI) that works by reducing stomach acid production. Horses naturally produce gastric acid continuously, which can lead to ulcers if there is insufficient buffering by saliva or feed. Omeprazole suppresses acid production, allowing the stomach lining to heal and reducing the risk of ulcer formation.
Forms of Omeprazole
Gastrogard: FDA-approved for the treatment of active gastric ulcers.
Ulcergard: FDA-approved for the prevention of gastric ulcers, often used during stressful events like transportation or competition.
Both products contain the same active ingredient, omeprazole, but differ in labeled dosing and packaging.
Identifying Gastric Ulcers in Horses
Before starting a treatment regimen, it is essential to identify the signs of gastric ulcers. Symptoms may include:
Poor appetite
Weight loss or failure to maintain weight
Behavioral changes, such as irritability or reluctance to work
Poor coat condition
Mild colic episodes, particularly after meals
Decreased performance
Diagnosis is confirmed through gastroscopy, where a veterinarian examines the horse's stomach lining with an endoscope. This step helps determine the severity of ulcers and guides the treatment plan.
Treatment Schedule Using Gastrogard
Gastrogard is the preferred choice for treating active gastric ulcers because of its FDA-approved therapeutic dose. The treatment schedule is typically as follows:
Loading Dose: Administer 4 mg/kg of body weight once daily for 28 days. This is equivalent to one tube of Gastrogard for a 1,200-pound horse.
Maintenance Dose: After the initial 28 days, reduce the dose to 1 mg/kg once daily for another 14 days. This step helps prevent the recurrence of ulcers while the stomach continues to heal.
During treatment, it is essential to:
Administer the paste on an empty stomach for maximum absorption.
Restrict access to food for about an hour after dosing.
Avoid abrupt cessation of treatment, as this can cause a rebound effect in acid production.
Preventive Use with Ulcergard
Ulcergard is designed for ulcer prevention in horses prone to stress, such as during travel, competition, or changes in diet. It is dosed based on the horse’s weight:
Administer 1 mg/kg of body weight once daily during periods of stress.
A single tube of Ulcergard contains four doses for a 1,200-pound horse.
Prevention should begin 1-2 days before the stressful event and continue for the duration of the event. For prolonged stress periods, daily dosing may be required.
Key Considerations for Omeprazole Use
Duration of Treatment
The healing process varies depending on the severity of ulcers:
Mild ulcers may heal within 14 days.
Moderate to severe ulcers may require the full 28-day treatment course.
Regular gastroscopic evaluations may be needed to monitor progress and confirm healing.
Administration Tips
Use the calibrated syringe to ensure accurate dosing based on weight.
Avoid crushing or mixing the paste with food, as this can reduce its efficacy.
Store the product as directed to maintain potency.
Stress Management
Omeprazole treatment should be part of a comprehensive approach to ulcer management. Minimizing stressors and optimizing feeding practices are crucial for preventing recurrence.
Combining Treatment with Management Practices
While omeprazole is highly effective, incorporating supportive management strategies enhances its success:
Dietary Changes
Provide frequent, small meals to keep the stomach partially full and reduce acid exposure.
Include alfalfa hay, which has a buffering effect on gastric acid.
Limit grains and concentrate feeds, as they increase acid production.
Access to Forage
Ensure the horse has continuous access to forage, ideally grass or high-quality hay.
Water Access
Maintain constant access to clean, fresh water to encourage hydration and digestion.
Stress Reduction
Modify training routines to avoid overexertion.
Ensure adequate turnout and social interaction with other horses.
Reduce transport stress by acclimating the horse to trailers and providing comfort during travel.
Side Effects and Precautions
Omeprazole is generally safe for horses, but there are considerations:
Long-term use may alter the stomach’s natural acid production and impact digestion.
Rarely, horses may experience diarrhea or changes in appetite.
Use caution in foals and pregnant mares; consult with a veterinarian for specific recommendations.
Abruptly stopping omeprazole after prolonged use can result in rebound hyperacidity. Gradual tapering under veterinary supervision is advisable if discontinuing the medication.
Cost of Treatment
The cost of omeprazole treatment can be significant. Gastrogard is more expensive due to its therapeutic dosing, while Ulcergard is cost-effective for prevention. Some horse owners may explore compounded omeprazole products, but these are not FDA-approved, and their efficacy can vary. Always discuss treatment options with a veterinarian to ensure safety and effectiveness.
Monitoring and Follow-Up
After completing the treatment, regular follow-ups are essential to ensure the ulcers have healed and assess the risk of recurrence. Gastroscopy remains the gold standard for evaluating stomach health. Additionally, maintaining a stress-free environment and proper diet significantly reduces the likelihood of ulcer recurrence.
Conclusion
Gastric ulcers are a significant health concern for horses, especially those exposed to stress. Omeprazole, through its branded forms Gastrogard and Ulcergard, provides a reliable solution for treatment and prevention. Adhering to the recommended treatment schedules, combined with proper management practices, can improve a horse’s quality of life and performance. Always consult with a veterinarian for tailored advice, as each horse’s needs may vary.
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