# Ulcergard (omeprazole)



## Witts Mini Horse Ranch (Mar 29, 2010)

I have researched the archives on treating ulcers, and the web. Has anyone ever used Prilosec or another omeprazole medication over the the counter in place of the ulcergard?

Prilosec:Active Ingredients:

(in each tablet): Omeprazole magnesium delayed-release tablet 20. 6 mg (equiv. to 20mg omeprazole - acid reducer).

Inactive Ingredients:

Glyceral Monostearate, Hydroxypropyl Cellulose, Hypromellose, Iron Oxide, Magnesium Stearate, Methacrylic Acid Copolymer, Microcrystalline Cellulose, Paraffin, Polyethylene Glycol 6000, Polysorbate 80, Polyvinylpyrrolidone, Sodium Stearyl Fumarate, Starch, Sucrose, Talc, Titanium Dioxide, Triethyl Citrate.

Directions state not to chew or put in food, also I would have no ideal how to figure the dosage for a mini.

Advice/opinions Please


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## cretahillsgal (Mar 29, 2010)

bumping for Nancy!

I have no idea, but hoping someone else here will know.


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## Mominis (Mar 29, 2010)

I had asked that my new horse get some Omeprazole for his trip home and Doc told me that he would give him the people variety because it is cheaper. I have no idea the dosage that he is giving, but I know that it is done. Hope that helps some. I would imagine that you would put them in an oral syringe and add some warm water and shake them until they become liquid then dose.


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## MountainMeadows (Mar 29, 2010)

There is a very big difference between human products and the equine products - mainly in how it is distributed in the horse's system. The amount of OTC human product that you would need to get even a small amount of help would be far more expensive than using the equine product in the first place - and the equine product will work far better in the long run -- expensive, yes, but worth it. I know that a lot of people use the human products, but I doubt that you are really doing much for the horse in reality, and if your horse REALLY needs ulcer help, you would be doing a lot more damage by not using the correct products to begin with.

Stacy


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## Witts Mini Horse Ranch (Mar 29, 2010)

Mominis said:


> I had asked that my new horse get some Omeprazole for his trip home and Doc told me that he would give him the people variety because it is cheaper. I have no idea the dosage that he is giving, but I know that it is done. Hope that helps some. I would imagine that you would put them in an oral syringe and add some warm water and shake them until they become liquid then dose.



Did he happen to say which brand of people version he was using? I might could figure the dosage comparing it to the ulcergard, I know it states 20mg on the prilosec, my ulcergard is on order so I don't know the dosage as far as mg.

Thank you for replying!


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## miniwhinny (Mar 29, 2010)

Costco sell a generic Omeprazole I think it's a 3 pack...each pack would treat a human adult for 14 days. Not saying it can or can't be used on horses - just saying Costco sell it cheep.


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## Mominis (Mar 29, 2010)

Sorry, he didn't say what brand he was using. He just said that in some things the human products were cheaper than the equine version. Wish I could be of more help.


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## Witts Mini Horse Ranch (Mar 29, 2010)

Thank you Jill, I will check it out.

Stacy- I really am not being cheap..well I guess I am




Mare spent almost 2 weeks with vet due to impaction so I am finacially embarressed, with that said though I will get what she needs no matter what. I will go over any meds with my vet b4 giving them to her, I expect him to be calling today to see how she is doing. Wanted to have all my info together b4 _I talk to him. I do appreciate the advice, and agree that we should be very careful using the peoples version for horses._


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## maggiemae (Mar 29, 2010)

I think it was stated elsewhere on the forum that the human version gets absorbed in the stomach but the equine digestve system actually needs to be absorbed in the intestine. Also, for a 250lb horse you would need 450mg of omeprazole or there are about five doses of the Gastroguard in each tube.


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## maggiemae (Mar 29, 2010)

I also think it was stated on the forum that at the dose of 20mg tablet of omeprazole a 250lb hourse would need 22 tablets. The cost savings doesn't look as good when you calculate 22 tabs per day. - Or does it?


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## MountainMeadows (Mar 29, 2010)

Nancy, I just hate to see people spending money on a product that will have little or no affect on the animal - I know that emotionally you might feel better by giving her the human product, but in the long run I really think that it will cost you more and get you nowhere, except a false sense of security -- I truly know how it feels to me in your situation, I have had a couple of colic surgeries and c-sections - and adding that $70 tube of UlcerGuard on to the already HUGE bill is a hard one to swallow - but . . .

(((( Hugs )))) Hang in there !

Stac


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## R3 (Mar 29, 2010)

The active ingredient is the same, the problem is that it has to safely get past the stomach and be absorbed in the intestines to have the long lasting effects. The drug is easily broken down by stomach acid, so unless it has the correct 'carrying agent', it won't get to the gut. Even in humans, the instructions are not to crush or bite the pill. It has to have its coating intact in order to get through the human stomach into the intestines.

The makers of Ulcerguard/Gastro Gard spent a lot of time researching their carrying agent to ensure the active ingredient gets past the stomach. Generic brands don't have the same agent, and have not been proven to protect the active ingredient. Crushing or liquifying a human pill would have the same problem, the drug would get quickly processed in the stomach, and not make it into the intestines where it could be slowly absorbed.

Here is an excerpt from a webpage I found that has some good info on ulcer treatments. (http://www.equinepi.com/faq/ulcers.html#ulcer2) Ulcer FAQs

Question: What are the common therapies for Ulcers/EGUS?

Answer: Traditionally antacids were used to decrease the discomfort and increase the pH of the stomach contents. The traditional components are usually a combination of magnesium hydroxide and aluminum hydroxide (i.e. Neighlox). The effect of even a large dose (240-360 ml) of these compounds is short lived and would require repeat dosing every 2-6 hours to have any real effect on ulcer healing (Hinchcliff et al, 2004). Additionally these compounds can reduce the absorbability of some other medications given orally. Bismuth compounds, such as Pepto Bismol have not been shown to have any significant effect at all (Picavet, 2002). Various other remedies (i.e. Papaya, Gastrex) have been used as antacid therapy in horses with variable results.

Coating agents such as Sucralfate (dose range from 10-40 mg/kg) also require frequent dosing (every 6-8 hrs) to have an effect. The act by forming a protective gel-like coating over the ulcers themselves, and therefore have no direct healing effect (Robinson, 2003). They are most effective when used in combination with H2 Antagonist drugs (Hinchcliff et al, 2004).

H2 (Histamine receptor) Antagonist drugs act to suppress acid secretion without completely blocking acid production. This class includes drugs such as Cimetidine (15-25 mg/kg), and Ranitidine (6.6 mg/kg) both of which require dosing 4 times per day (every 8 hours) to be effective (Merritt, 2003; Hinchcliff et al, 2004; Robinson, 2003).

Proton Pump inhibitors such as omeprazole paste (Trade Name GastroGard) block the secretion of acid for up to 27 hours at the full dose (Robinson, 2003), therefore making administration of the medication easier to manage. An Australian study found that omeprazole was more effective at healing ulcers than ranitidine with noticeable improvement after 14 days of therapy and lasting benefit greater than 28 days after the therapy (Lester et al, 2005). Recommended dosage of GastroGard is 1 tube per 1000 lb horse per day (4 mg/kg every 24 hours) to promote healing and prevent recurrence of ulcers. A dosage of ½ tube for a 1000 lb horse per day (2 mg/kg every 24 hours) following 28 days of full dose therapy has been shown to prevent recurrence of ulcers (Andrews, 1999). Studies performed in race horses in training, found that a dose of GastroGard paste at ¼ tube per 1000 lb horse per day (1 mg/kg every 24 hours) was effective in both preventing ulcers in horses starting race training (Andrews, 1999; McClure et al, 2005b; White et al, 2003), and in preventing the recurrence of ulcers in horses in race training (McClure et al, 2005c; White et al, 2003).

GastroGard was formulated and manufactured following extensive research to create a unique drug for horses. Although the active ingredient, omeprazole, is used widely in humans, the molecular structure was modified specifically for extended absorption in horses. Therefore, the use of the human formulations of omeprazole may be less effective and require more frequent administration.

Merial, the makers of GastroGard, have now formulated a non-prescription form of the drug omeprazole (1mg/kg dose label) called UlcerGard. Non-prescription medications are not subjected to the same stringent research and quality control procedures as prescription formulations, which is why the non-prescription form can be marketed at a significantly lower cost.

In summary, the recommended dose of GastroGard (the only FDA approved formulation of omeprazole for horses currently) depends on a number of factors such as whether non-healed ulcers are present, whether ulcers were present, but have healed, or whether there are currently no ulcers at all as well as the "stress" the horse in question is being subjected to currently. In general to heal ulcers requires a dose of 1 tube per 1000 lb horse per day (4mg/kg/day) for at least one month. Maintenance or preventative therapy with GastroGard in horses that have ulcers that have healed may only require ¼ to ½ tube per 1000 lb horse per day (1-2 mg/kg/day). Therapeutic dosage is dependent on all of the above factors including the degree of ulceration present, management and the individual horse in question.

In some horse with chronic EGUS which is not responsive to traditional therapy, a bacterial component may be contributing to the syndrome. A combination therapy of 1 tube per 1000 lb horse per day omeprazole paste (4 mg/kg every 24 hrs), metronidazole (15 mg/kg orally every 6-8 hrs) or SMZ's (15-25 mg/kg orally every 12 hrs), and bismuth subsalicylate (3.8 mg/kg every 6 hrs) for a period of 14 days may be effective (Andrews FM,2005).


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## MountainMeadows (Mar 29, 2010)

Thank you R3 - that was an excellent post, and hopefully will be added to the Best Of Miniature horse info -- too many people try to use generic OTC ulcer products on their horses because of cost, and are infact not helping - possibly hurting their animals even tho they feel like they are doing some good.

Stacy


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## REO (Mar 29, 2010)

{{{{{{Nancy}}}}}}





There's some good info here! I agree with Stacy.





Ulcers need to be cured, not just treated, or they'll keep coming back.

Thanks to questions like this (thanks Nancy) and people answering, we all learn so much!

I hope she feels better soon! *HUGS* Love ya!


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## DarkhHorseFarms (Mar 29, 2010)

We rescued a gelding last year who obviously had some sort of ulcer issue problem.

I tend to try the NATURAL route first and have had good success in the past with SLIPPERY ELM BARK.

This horse responded VERY well to a 6 week course of this and is on a small amount for maintenance.

All his "ulcer" like symptoms have resolved.

Please PM me if you would like more information and how much I was recommended to give him.

Lisa


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## Margo_C-T (Mar 29, 2010)

I have so far, at least, had excellent results using ranitidine. Yes, it requires dosing every 8 hours(effectively, this is only three times/day--ie.,6 AM, 2 PM, 10 PM; the next dose would be the following 6 AM, and so on. I have used 4-150 mg("Extra Strength", or what used to be the Rx dosage; OTC originally was only 75 mg/tab, so if using "Original Strength" OTC, you'd need twice as many tabs/dose every 8 hours, for a horse who weighs @ 225 lbs.)It also needs to be given for a MINIMUM of 30 days straight, perhaps longer, in my experience. At my local Sam's, 4 containers w/ 95--150 mg. tabs each of ranitidine(generic for Zantac)are between $9-10; that's enough for over one month of treatment at the above dosage--a LOT less expensive than either Gastroguard or Ulcerguard, even though more labor-intensive for the owner. .

I also have done a series of 'adjustments' to my feeding and other management. The latest and so far, seeming very helpful, is 'slow feeding' of hay. I invested in several slow-feeding hay bags, and at this time, am VERY happy with the results. I will know more when I am able to get a supply of better (shorter stemmed, softer)grass hay; I am limited in the amount of this hay right now, and it is the most suitable for use in these hay bags--so I can't give them ALL of their grass hay yet in the slow-feeding bags, for maximum effectiveness.

I also have previously seen the info R3 posted regarding omeprazole, and the reasons why it may not work to simply try to 'substitute' human formula for the horse-specific formula.

Margo


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## MountainMeadows (Mar 29, 2010)

I think far too often we jump to the conclusion that the horse HAS ulcers, when it really has not been clinically diagnosed as such - the only way to truly diagnose ulcers is to scope the horse and look for lesions.

With that in mind, it is frequently suggested by vets as a precautionary measure to use UlcerGard in stressful situations - in any case, the OTC products are probably just a temporary "help" (and I use that term very lightly) - if your horse TRULY HAS an ulcer, these products won't do much good and misuse of products can easily result in a dead horse -- REAL, DIAGNOSED ulcers are nothing to fool around with, need immediate action and a real equine oriented product to help ease the inflamation, and CURE the ulcer.


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## Charlotte (Mar 29, 2010)

This just came in from TheHorse.Com

The subject was GI problems in foals, but below was the section on ulcers. I highlighted the treatment info.



> Gastric Ulcer
> This is a break in the tissue lining of the stomach, which is uncomfortable and often makes the foal decrease its nursing or feeding, Wilson says. "In chronic cases, the ulcers can lead to stricture of the stomach's outflow, which leads to splashing of stomach acid up into the esophagus; this is very painful," she says. "If the ulcer perforates (fully penetrates the stomach wall), the foal will usually die of peritonitis." Clinical signs can be absent or include discomfort during eating, backing off of feed or nursing, teeth grinding, and colic. "With perforations, the foal is colicky and rapidly progresses into shock. In a few cases of small perforations, the leak may be plugged by omental tissues (abdominal tissue folds), leading to abscesses that lead to fever, intermittent discomfort, and weight loss."
> 
> Cause: Stress, use of non-steroidal anti-inflammatory drugs (NSAIDs).
> ...



It has been my experience that with severe ulcers (in horses older than foals) they have taken as long as 5 days to respond to omeprazole. For this reason I use Ranitidine and Sucralfate along with Gastroguard or Ulcerguard for 3 days on the sucralfate and 5-7 days on the Ranitidine.

Charlotte

p.s. Stacy, you pay $70 for a tube of Ulcerguard? Did I misunderstand? Price here is $35-39 and online ordering runs about the same.


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## whitney (Mar 29, 2010)

R3-----

Where did this reference material come from. That's the same treatment for people with helicobacter pylori. I didn't know they had discovered that in horses too. Very interesting.

In some horse with chronic EGUS which is not responsive to traditional therapy, a bacterial component may be contributing to the syndrome. A combination therapy of 1 tube per 1000 lb horse per day omeprazole paste (4 mg/kg every 24 hrs), metronidazole (15 mg/kg orally every 6-8 hrs) or SMZ's (15-25 mg/kg orally every 12 hrs), and bismuth subsalicylate (3.8 mg/kg every 6 hrs) for a period of 14 days may be effective (Andrews FM,2005).


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## Bess Kelly (Mar 29, 2010)

Fresh grass is one of the better things for a horse with acid stress and/or ulcers. While we cannot have this at all times, it is a good thing for them if available. Not instead of treatment but, in addition. Actually, many reports show that pastured horses generally have less of these gut issues.

So, you may have to take the horse to some grass to encourage eating. Let's face it that's why they want hay, not grain.....but, fresh grass is better almost every time. Good ole mother nature.


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## R3 (Mar 29, 2010)

That was part of the excerpt that I copied and pasted from this web site: Ulcer FAQs (http://www.equinepi.com/faq/ulcers.html#ulcer2)

It is a website that belongs to an Equine Vet Clinic.

I think that he has cited the references for the different treatments.


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## wildoak (Mar 29, 2010)

There have also been studies out lately reporting that alfalfa is helpful in preventing ulcers. They studied stalled and pastured horses, and even the horses on grass did better/had fewer symptoms when given alfalfa.

My vet is charging $46 for Gastroguard now, much higher than I've heard it quoted elsewhere.

Jan


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## MountainMeadows (Mar 30, 2010)

Hi Charolette - yep, Gastroguard (not Ulcerguard - sorry about that) is at least $70 a tube - I really don't even care to look at the price - it makes me cringe!

Stac


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## albahurst (Mar 30, 2010)

wow- I can't believe the prices you guys are paying for Gastro Gard. Gastro Gard (not Ulcer Gard) here is approx $32 tube.


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## Witts Mini Horse Ranch (Mar 30, 2010)

Wow thanks everyone, I didn't know this subject had been posted b4..I missed it on my search..sorry for the repeat.

I agree the human form does state not to chew or add to food, I thought maybe because of the time release. I found Ulcergard on Amazon.com for 32.19, and I think free shipping. I ordered a tube at a much higher price from Valley Vet just because I usually get it the next day. Rita, has not been clinically diagnosed with ulcers. But I am almost sure she does, sure enough to invest the extra $ for the security. I do have her on the Ranitidine, I have a prescription for it. I am an american native (is that politically correct for Choctaw Indian)




so I get it free...which every lil bit helps right now. Also, treat her to some yogurt. My vet did say only good quality grass hay (hard to find this time of year) and grass only for 2 weeks. Rita does have an appetite, and I am not good at tuff love so at meal time she has been getting a small amout of VERY wet beet pulp.

The book " HORSE OWNERS VETERINARY HANDBOOK" states "The ulcer medications used in people are effective in horses. H2 blockers Tagament & Zantac: Carefate (a mucosal coating agent); and antiacids containing aluminum hydroxide, such as Mylanta. These drugs are best taken in combination and given several times a daily. Treatment is continued for at least 3 to 4 weeks. A follow up gastrocopy may be advisable to ensure that healing is complete." Strange it does not mention Omeprazole.

What I always do is listen to everyones advice, but it all together and do what works for that horse and for sure go over it with my vet. I know he thinks ulcergard is an extremly expensive way to treat ulcers..so don't always go with his opinion (shhh he doesn't know)

My friends, and facebook friends know this...I have lost Rita once already. Very long story..to make it short..Rita was in a bad way had not passed the mineral oil, Doc had worked with her for a week told me he was going to give it one more day and if no improvement we needed to put her down. She was too week for major surgery, which convicing my husband to pay for I don't think was going to happen. Rita is a rescue mare from a good person that had come on really hard times. I told my vet in the beginning I had not rescue her just to let her die. I told him if his decision was to put her down then to call my husband, because I could not handle it. Which he did, and they agreed on an autopsy to be performed this was on a Friday. I called a couple of times for the results and he never would call back..I really needed to know if it was something in my pasture, feed, etc. and was getting very upset that he wouldn't return my calls. He called my husband (he gets our cell #'s confused) told him Rita was still alive and of course that is all my husband relayed to me he was OTR. Doc's reason for gong above and beyond was his little grandson, he got him for spring break and he feel in love with the white pony (Rita) wanted to ride her, Doc told him you cannot she is sick, he said Papa make her well. Doc said he listen to her intestine to her where the blockage was and rotated her. I admit I have no ideal what that involves just so very grateful he gave it one more desperate attempt. Doc said it was the power of prayer and his grandson.

So, I feel Rita and I have been given another chance...and the love I have for this mare I cannot put into words. She also has another family I am going to share her with when 100%, a little boy that fell in love with that white pony.

I have been a little concerned with putting her on grass, my pastures are not green yet but my yard has some grass and I let her eat on it for about 30 minutes, one day. Until yesterday, I would see her roll on her back and draw up her legs which is why I feel the need for the ulcer meds with all the pain meds she has had better safe. She did not roll onto her back yesterday so I guess the Ranitidine is helping with the pain some...but I want to cure her. As I told Doc how can someone put a price value/limit on a life (was talking about my husband).

Thank you everyone, I am going back and reading all the input and making notes.

Thank you too Sis (Robin), for being there for me through all this and you are the reason I have already ordered the Ulcergard. Love ya!


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## MountainMeadows (Mar 30, 2010)

Ahhaaa - Nancy your story is just heartbreaking - what a wonderful "mom" you are to little Rita. I am hoping that your course of action will help her thru this difficult time.

Hugs to you and little Rita





Stacy


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## REO (Mar 30, 2010)

Aw Sis!



I KNOW how much you love your babies and I know you want her WELL. Like I said, if anyone can get her better, it's you! Rita has had a hard life and now she is HOME forever!





I love you too!!


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## Witts Mini Horse Ranch (Mar 30, 2010)

I must be tired, you girls made me tear up. Thank you for saying that, but I cannot forget she got this way while on my watch. I have never experience one this bad, always been able to get them back on their feet.

Rita is a lil better every day, and with all the great advice she will turn around. I am on constant watch, to day after a little crazing when I put her back in her paddock she laid down, rolled and I was saying to myself ok..now get up and shake..she did all is well.



I have never seen a colicky horse worry about shaking it off.

Everyone thank you truly


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## qtrrae (Mar 30, 2010)

I have used Prilosec per Vet instructions - I was told to give Sadie 4 Prilosec tablets (every day) for 3 weeks and then to go to 2 tablets (every day) for 3 weeks.

Sadie completely recovered and has not had any issues with ulcers, since.


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## maggiemae (Mar 31, 2010)

How did you get the prilosec tablets in Sadie? I don't think they are supposed to be crushed are they? In my understanding most of the stomach medicines aren't supposed to be crushed and I can't figure out how to get them in my mini without getting bitten.


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## qtrrae (Mar 31, 2010)

That was also my concern - my Vet suggested that I disolve them in water, (I found using a "shot" glass woks perfectly because it is smaller at the bottom) I also added a bit of molasses to improve the taste, Sadie loved them and looked forward to getting her meds - I know they are not supposed to be crushed but this is what my Vet recommended and it worked.


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## maggiemae (Mar 31, 2010)

Thanks.


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