Horse Ulcer Treatment Options
When treating horse ulcers, GastroGard (Rx) is given once a day for 28 days. It is possible to use UlcerGard to treat ulcers by increasing the dose, which means giving an entire tube rather than one-quarter tube per day. This increases the dose to 4 mg per kg and can be an effective therapy for existing ulcers. Work with your veterinarian if your horse needs ulcer treatment.
GastroGard 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 find that Succeed and products made with algae, such as CT Essentials, help horses with ulcers or horses that are prone to ulcers. You can explore additional digestive support products in the Horse Digestive Health category on 1800PetMeds.
If the ulcers are chronic and have eroded deeply into the muscular layer, it may be necessary to treat with GastroGard or four times the regular dose of UlcerGard for longer than one month. Your veterinarian can pass an endoscope into your horse’s stomach, show you the lining of the stomach on video, and discuss how long ulcers of that severity may take to heal.
Horse ulcer symptoms should ease within a few days for horses on GastroGard, but it usually takes about a month for ulcers to fully heal. Withdrawing omeprazole before healing occurs causes the reappearance of ulcers in more than 90 percent of horses. Once horses are treated and ulcer-free, they can go onto preventative doses of UlcerGard during times of stress. For example, horses that are being shipped to shows can start UlcerGard the day they are shipped and continue it until they are back home eating normally.
Prevention of Horse Ulcers
Several steps help prevent horse ulcers:
- Using UlcerGard
- Giving Sucralfate (Rx)
- Avoiding high-carbohydrate diets
- Avoiding NSAIDs
UlcerGard
Maintaining a non-stressful environment helps prevent ulcers, but for active horses, UlcerGard is the only proven preventative. UlcerGard contains omeprazole, which is given at a concentration of 0.45 mg per lb of body weight or 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 per kg, which is the concentration of GastroGard. Thus. ulcer treatment is the same as ulcer prevention, but at four times the dose.
Sucralfate
Sucralfate is used for preventing ulcers in foals at a dose of 5 to 10 mg per lb or 10 to 20 mg per kg, given three to four times a day.
In addition to using GastroGard or UlcerGard to block hydrochloric acid production, it may help to coat the stomach with Sucralfate. Sucralfate tablets can be crushed and mixed in syrup, so your horse receives 1 g per 100 lb body weight two to three times a day. Sucralfate is also available as a liquid.
Sucralfate coats the stomach most efficiently when it is given one hour before feeding or two hours after feeding, and again at bedtime. Since Sucralfate only coats the stomach when acid is present, it should be given a half hour before Cimetidine or Ranitidine, which block acid production. Sucralfate should also be given at least half an hour before an antacid.
Sucralfate can interact with some oral medications, including Cimetidine, Tetracycline, Phenytoin, and Digoxin.
Avoid High-Carbohydrate Diets
High-carbohydrate diets can contribute to ulcers. For some ulcer-prone horses, it may be best to provide calories from oils rather than from carbohydrates.
Avoid NSAIDs
Phenylbutazone (bute) and Banamine Paste (flunixin meglumine) are commonly used nonsteroidal anti-inflammatory drugs. While most horses tolerate these medications at prescribed doses, some horses develop ulcers even when using smaller amounts.
If your horse has problems with ulcers, work with your veterinarian to develop a plan that limits NSAID use. If it becomes necessary to use an NSAID, Ketoprofen is less likely to cause ulcers than Phenylbutazone or Banamine. Pain management products for horses can also be explored in the Horse Pain Relief category on 1800PetMeds.
Never use more than one NSAID at the same time. For example, do not combine Dexamethasone with bute. If possible, rather than relying only on NSAIDs, consider other methods to control pain. Work with your farrier to address hoof or heel pain and consider therapies such as acupuncture, chiropractic care, or massage.
Difference Between UlcerGard and GastroGard
UlcerGard, an over-the-counter medication, is used for horse ulcer prevention. GastroGard, a prescription medication, is used for treating ulcers.
The only stomach ulcer treatment approved to prevent stomach ulcers is UlcerGard, which is omeprazole given at a dose of 1 mg per kg. The only approved treatment for ulcers that are already present is GastroGard, which is omeprazole given at a dose of 4 mg per kg.
UlcerGard and GastroGard are the same medication, but given at different doses. It is possible to use UlcerGard to treat ulcers by increasing the dose to a full tube per day. This increases the dose to 4 mg per kg and can provide effective treatment. Work with your veterinarian if your horse needs ulcer treatment.
UlcerGard and GastroGard are different from the omeprazole medication used to treat human ulcers, such as Prilosec, because they are not microencapsulated. Human medications are formulated differently because the human stomach and the equine stomach function differently.
Other Prevention Options
Ranitidine and Cimetidine
Ranitidine and Cimetidine may be used to treat or prevent ulcers, but these medications are less effective than omeprazole. They must be given three to four times a day because they lower stomach acid for only a few hours. Ranitidine is generally more effective than Cimetidine.
Although Ranitidine is not FDA-approved for horses, many veterinarians prescribe it for ulcer treatment.
UlcerGard is often more cost-effective than Cimetidine and Ranitidine.
Reduce Stress
Any steps that reduce stress may help reduce ulcers. When possible, adjust your horse training schedule, allow longer pasture turnout, and provide pain relief methods that do not rely on NSAIDs.
Worm Your Horse Regularly
Parasites can cause colic symptoms that mimic ulcer symptoms. Regular deworming may not directly reduce ulcers, but it can prevent misdiagnosis and support overall equine health. You can find equine parasite control products in the Horse Dewormers category on 1800PetMeds.
Horse Ulcer Treatments That Do Not Work
Omeprazole can be expensive. Because of this, horse caretakers have tried a number of alternatives. However, when veterinarians examine treated horses using an endoscope, the stomach lining often shows that ulcers remain.
Unsuccessful ulcer treatments for horses include:
- Corn oil fed for six weeks
- Refined rice bran oil for six weeks
- Unrefined rice bran oil for six weeks
- Human omeprazole, such as Prilosec
Veterinarians who examine the stomach lining with an endoscope generally do not find these approaches effective in treating horse ulcers.
