Friday, June 17, 2022

Treating Ulcers In Horses With Omeprazole

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Minimize The Use Of Nsaids

Diagnosing & treating ulcers with omeprazole for horses

Non-steroidal anti-inflammatory drugs are administered to horses to reduce pain and treat certain conditions.

Phenylbutazone is a common NSAID used for pain management in skeletal muscles. Firocoxib is more commonly used to reduce pain associated with osteoarthritis or bone injuries.

NSAID use may be necessary at times. When advised and monitored by a veterinarian, NSAIDs can benefit your horse.

However, outside of these circumstances, the use of NSAIDs should be limited.

NSAID use has been directly associated with increased ulcers in the digestive tract of horses. These ulcers occur in the squamous and glandular regions of the stomach, as well as the hindgut.

By inhibiting prostaglandin synthesis, NSAIDs reduce mucous production. They may also lower gastric pH levels below the normal pH of 2.

In healthy adult horses, administering phenylbutazone negatively impacted the mucosal barrier of the gastrointestinal tract. This increased ulcers and reduced overall digestive health.

The Following Is The Current Best Advice On Feeding To Prevent Gastric Ulceration:

  • Allow access to high quality forage, predominantly during the day , at a minimum daily rate of 1.5kg/100kg body weight , ideally given continuously or at no more than 6 hour intervals.
  • Multiple forage sources in the stable improve eating consistency and allow foraging activity.
  • There is no difference between hay and haylage as a forage source in relation to ulceration.
  • Straw feeding should not exceed 0.25kg/100kgBWT, and it should not be the only forage source.
  • Free access to fresh water 24 hours a day.
  • Concentrate ration should be split into 3, rather than 2 meals per day
  • Total starch intake should not exceed 2g per kg bodyweight per day
  • Whilst there is no evidence to support the use of specific âgastric healthyâ commercial diets, the use of BETA EGUS approved feeds does ensure that you will not exceed the maximum starch level.
  • Chaff should be added to all meals.
  • Corn oil or rapeseed oil can reduce the amount of stomach acid produced and could increase barrier mucus function in the glandular mucosa
  • Pre-exercise chaff feeding – 2L un-molassed chaff given within 30 mins of exercise may trap acid and limit ulceration, and improve gastric blood supply.

How To Manage Signs Of Ulcers In Horses

Equine gastric ulcers are thought of as a man-made disease. Horses in the wild or living out at pasture rarely suffer from this painful disorder. Therefore, it is vital to make changes to how the horse is cared for in order to alleviate the symptoms of this condition.

The aim of treating horses with EGUS is to look after them in the most natural way possible. Horses evolved to graze continuously for most of the day, so they should be allowed access to hay or grass at all times. High grain diets should be avoided, as these will make your horses stomach ulcers worse.

If your horse is struggling to gain weight, then adding a high-calorie oil such as corn oil to the diet can help. Veterinarians also advise increasing the amount of alfalfa in the diet, too as much as 50%. Giving a small feed of alfalfa 30 minutes before exercise can help to reduce the amount of acid splashing onto the delicate stomach lining.

Stress is a major cause of stomach ulcers in horses. Ways to reduce stress for your horse include making sure he has equine company, giving him time to relax and play in the field each day, and providing toys and treats to reduce boredom.

Certain medications, such as anti-inflammatory painkillers, must be avoided in horses with EGUS. Some feed supplements, especially those designed for horses with stomach ulcers, can help reduce the symptoms of this painful condition.

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Omeprazole And The Hindgut

Some veterinarians have questioned whether omeprazole has contributed to the rise in hindgut ulcers however, there are no published studies on this possible correlation. Omeprazole must survive the stomachs acidic environment to reach the small intestine, where it blocks the signal for acid production. The small intestine is where starches, sugars, proteins, and fats are absorbed.

When horses are fed high-grain meals, some of the starches are not digested in the small intestine and wind up in the hindgut. The hindgut digests fiber, not starches and sugars. This starch overload in the hindgut then leads to imbalances in the microflora, resulting in hindgut acidosis.

A published study on dogs showed that omeprazole leads to quantitative changes in GI microbiota of healthy dogs.

The Importance Of The Horses Hindgut

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Its important to understand what the horses hindgut is and how it functions. The hindgut includes the cecum and colon and is an essential part of the overall digestive system.

Horses are hindgut fermenters which means that the hindgut is necessary to process digestible energy from the food that a horse consumes. When this function is impaired, it can have wide-ranging impacts on the health and well-being of your horse.

When feed moves through the horses digestive system, the stomach and small intestine produce enzymes that start to break down the feed. Simple sugars and amino acids are mostly absorbed in the small intestine.

But fibre makes up a huge portion of the horses diet and it does not get digested in the small intestine. Horses cannot break down fibre without the help of microbes in the hindgut.

Bacteria, yeast and other microorganisms digest fibre through a process known as fibre fermentation. This process provides the horse with energy, volatile fatty acids, vitamins, minerals, and amino acids necessary for good health.

These nutrients are then assimilated through the intestinal wall for utilization in the horses body. A healthy intestinal wall provides a protective barrier that allows nutrients to be absorbed, but doesnt allow toxins and microbes to enter the body.

If this barrier becomes damaged by ulcers or compromised by leaky gut syndrome, harmful substances can cross into the bloodstream, which can lead to infection and disease.

Also Check: How Do You Check For A Stomach Ulcer

Best Ulcer Treatment For Horses

Stomach ulcers are a common problem that many horses and ponies suffer from. If you own or care for an equine animal, it is important that you understand how to recognize and manage this painful condition. But what is the best ulcer treatment for horses?

With the correct care and attention, stomach ulcers in horses can be cured or the symptoms eased. Lets learn all about this health disorder of horses and find out what ulcer treatments are available.

Gastric Ulcers In Horses: Search For Biomarkers Treatments Continues

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Are you considering having your horses stomach scoped again? Is there any other way to verify the presence of gastric ulcers? Right now, there isnt, but researchers are working on noninvasive ways to diagnose and monitor horses with equine gastric ulcer syndrome .

Many performance horses have gastric ulcers, which are defects in the surface of the stomach lining that occur in either the glandular or nonglandular regions. Thought to be due primarily to management factorsstress due to training or competition, social isolation, diets high in concentrates or low in foragesgastric ulcers often cause poor performance, decreased appetite, and weight loss.

After diagnosing and grading ulcers via gastroscopy, veterinarians typically recommend treatments geared to decreasing the acidity of the stomach. Treatment plans for EGUS typically include diet modifications, management changes, and medications such as omeprazole, sucralfate, and ranitidine. Nutritional supplements designed to control the pH within the stomach could also be included.

Because gastroscopies play a key role in ulcer management, repeated procedures are a necessary evil as horses may be resistant to treatment or the ulcers may return rapidly following cessation of pharmaceutical treatments like omeprazole.

While horse owners wait for this research to advance, Whitehouse suggested using diagnostics and treatments, including gastrointestinal buffers, currently recommended by veterinarians.

Read Also: Things To Eat When You Have An Ulcer

Equine Colonic Ulcer Syndrome

Whereas equine gastric ulcers are found in the stomach, colonic ulcers are lesions that occur in the hindgut . A horse is a hindgut fermenter, meaning it ferments forage in its colon to create Volatile Fatty Acids , which produce the majority of a horses energy. Because the hindgut is where most of the horses digestive process takes place, it is vital to overall equine health.

Cheap Way To Treat Ulcers In Horses

Horse ulcer medication (omeprazole) pros and cons

Stomach ulcers are the primary health epidemic in the equine world. Allianz Insurance and Pet Plan Equine have more than 42 years of experience insuring horses. They have reported that of the “Top Five Most Common Health Problems in Horses,” Gastric Ulcers is the No. 1 ranked health problem in insurance dollars paid out.

More than 80-90% of racehorses in training and 52% of horses of all breeds from 1-24 years old had gastric ulcers during gastro-endoscopic studies. Unfortunately, most people do not know for sure whether their horses have gastric ulcers. For example, adult horses with ulcers can exhibit a combination of poor appetite, dullness, attitude changes, decreased performance, poor body and hoof condition, rough hair coat, weight loss, and colic.

Cost of Treating and Diagnosing Ulcers in Horses

The unfortunate reality of horse ulcers is that they are expensive to diagnose and treat. The only way to truly diagnose ulcers is with a video camera in the horse’s stomach. A video camera is placed up its nose, swallowed, passed through the esophagus and into the stomach. A scope can cost $250. Two are usually required one at the beginning and one at the end of a treatment period to see whether it was effective.

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Short Term Use Of Omeprazole

Remember that short term use of omeprazole is less likely to be problematic than long term use. Even with short term omeprazole administration, ample amounts of calcium and magnesium must be supplied by either legume hay, alfalfa pellets/cubes, or a bioavailable mineral supplement. Ideally, an omeprazole dose should be given between feedings in order to maximize calcium and magnesium digestibility.

Gastric Ulcers And Stress In Horses

    Reports have shown that equine gastric ulcer syndrome develops in 63-93% of horses in active training.

    Arnd Bronkhorst Photography

    It is common practice to use an oral omeprazole product in equine athletes to try to stave off development of gastric ulcers that could be related to stress conditions. Those conditions could include training, competition or transport as well as changes in routine, herd dynamics, stabling and feeding. Reports have shown that equine gastric ulcer syndrome develops in 63-93% of horses in active training.

    This article is brought to you by Boehringer Ingelheim.

    One study examined prophylactic use of oral omeprazole at varying doses and its effect on prevention of EGUS and severity of ulcers . This open access article can be found here.

    Omeprazole doses used ranged from 0.5 to 4 mg/kg. It was noted that there was no difference in risk ratio for ulcer prevention between 1 and 2 mg/kg dosages.

    Based on the study findings, it is thought that omeprazole prophylaxis could result in 556 per 1,000 fewer athletic horses developing squamous gastric ulceration.

    There have been no studies on the use of prophylactic administration for longer than 28 days.

    The meta-analysis report stated It appears from the high prevalence, high efficacy and low incidence of any adverse event associated with the medication that prophylaxis should be continued for as long as a horse is in an ulcerogenic training environment.

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    Pharmacology And Mechanism Of Action

    Omeprazole is the most widely used proton pump inhibitor in animals. Omeprazole inhibits gastric acid secretion by inhibiting the K+/H+ pump . Omeprazole is more potent and longer acting than the histamine H2 antagonists and is associated with better efficacy. There are other PPIs, including pantoprazole , lansoprazole , and rabeprazole . They all act via similar mechanism and are equally effective. PPIs also have some effect for inhibiting Helicobacter organisms in the stomach when administered with antibiotics. Omeprazole is decomposed in the acid environment of the stomach. Oral absorption is decreased if administered with food. Formulations are designed to protect from degradation by stomach acid, such as by adding a buffering agent or enteric coating, to improve oral absorption. Some human formulations also contain bicarbonate.

    An equivalent drug is esomeprazole , which is the S-isomer of omeprazole . It is expected to have equal efficacy at equivalent dosages, but there is some evidence of better efficacy with esomeprazole compared to omeprazole.

    Pharmacokinetics: When administered orally to horses, maximum serum concentration occurs at 4560 minutes with effective acid suppression within 12 hours. Half-life from oral administration to horses varies from 70 to 100 minutes, depending on the formulation. Pharmacokinetics and acid suppression have also been studied in dogs and cats, with effective acid suppression at the dosages provided in the dosing section.

    Signs Of Stomach Ulcers

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    Signs of ulcers in adult horses can be vague and may include:

    • Acute or recurrent colic, particularly after eating.
    • Loss of body condition.
    • Changes in attitude.
    • Frequent lying down.

    Horses with gastric ulcers may be reluctant to eat grain or may take more time than usual to eat the grain. Gastric ulcers also occur along with many other conditions. Horses are often placed on preventative or treatment doses during hospitalization.

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    How To Treat The 4 Types Of Horse Ulcers

    Once you’ve ascertained whether your horse suffers from gastric or hindgut ulcers – you’ll be able to devise a treatment plan.

    Omeprazole is a proton pump inhibitor and it’s most common medication for stomach or gastric ulcers.

    Omeprazole blocks the acid secretion from the stomach, reducing the amount of acid and returning the stomach’s pH balance to horse standard. This decrease in stomach acid stops the formation of ulcers.

    Two More Natural Diets That Help To Heal Ulcers:

    DIET 1:Free choice grass hay 24/7Medication: 1/4, 1/2, or full dose of generic Ranitidine or OmeprazoleAdditional natural stomach healing foods, fed twice a day:Pumpkin Seeds: 1/4 cup which are excellent for healing the stomachDried Cabbage: 1/4 cup of dried cabbage contains L-Glutamine which also heals the stomachOat Flour: 1/2 cup for 30 days and then 1/4 cup thereafter, which is great to heal the hind gutProbiotics ProBios or Fast Track: 1 oz. which aids digestionGround Flax seeds: 1/2 cupI mix the above products with:4 cups of Standlee beet pulp pellets8 cups of Alfalfa cubesI soak the Beet Pulp pellets and Alfalfa Cubes together in water for 1 hour before mixing in the other ingredients and feeding. Follow manufactures instructions.

    DIET 2:We began using the following combination of Aloe Vera and Slippery Elm approximately 2 to 3 weeks before the U-Gard ran out. We wanted to slowly wean him off the U-Gard and get him on something totally natural.

    Slippery Elm helps to regulate bacteria in the intestine, and when combined with Aloe Juice it is also excellent for digestion in horses as well. These natural products can be used on most horses long-term with no negative effects. Both products are very inexpensive in comparison to other horse ulcer products.

    FROM MOUNTAIN ROSE HERBS, Slippery Elm: You can purchase Organic Slippery Elm Bark Powder is sold in bulk at Mountain Rose Herbs Mountain Rose Herbs:

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    The Effects Of Omeprazole In The Body

    Omeprazole is capable of reducing hydrochloric acid in the stomach by up to 99%. While this action is beneficial for healing ulcers in the squamous portion, there are ramifications.

    • Stomach acid is needed by horses to digest proteins.
    • Stomach acid helps create a hostile environment so certain pathogenic bacteria cannot flourish.
    • Stomach acid activates pepsin, an enzyme that breaks protein into amino acids.
    • The suppression of digestive acids by omeprazole affects key mineral absorption of calcium and magnesium.
    • A small digestibility trial by Kentucky Equine Research showed that two weeks of omeprazole administration decreased calcium digestibility by 20% for calcium carbonate, and 15% for marine-derived calcium.
    • Blocking stomach acid for a period of time can cause the body to increase production of stomach acid after omeprazole treatment. This can lead to heartburn and dyspepsia which help to form new ulcers.
    • A study on omeprazole published in the Journal of Equine Veterinary Science concluded: Oral administration of omeprazole in healthy equines interfered with the metabolism of digestive biomarkers of lipid, mineral and protein metabolism, although the animals were treated for a maximum of 11 days. Horses treated with a proton-pump inhibitor need to be evaluated regularly to avoid significant modification in their metabolic parameters.

    What Are The Costs For Treating A Horse With Gastric Ulcers

    AbPrazole (Omeprazole)

    3min. readWritten by Tanja Dietz

    “My horse has changed recently, with bad habits and behaviours that Ive never seen him display before…” Do these symptoms indicate a gastric ulcer?

    When a horse suffers from the pain caused by the gastric ulcer, a certain amount of time often passes until its noticed. Symptoms such as biting, flehmen response, unwillingness and cold back are often not recognized as symptoms of a gastric ulcer and dismissed as bad habits. Many horse owners also report that their veterinarians did not take symptoms seriously. With gastric ulcers in particular, rapid treatment and early diagnosis are key to preventing further damage to the stomach lining.

    If the horse displays various symptoms that indicate a gastric ulcer, a gastroscopy should be performed immediately to exclude other diseases, such as intestinal emptying disorders. This should be followed by a targeted treatment of gastric ulcers.

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    Adjust Your Horses Eating & Exercise Schedule

    Another important step is to adjust the time between meals. This aspect of treatment can pose a real challenge for a lot of equine enthusiasts. Many horse lovers work away from their horses, which makes feeding more frequently than twice a day difficult. Fortunately, today, there are a few feed accessories on the market that make it easier to provide frequent feedings to your horse. This is done by dramatically slowing down how quickly they can consume their feed.

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