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Exploring Esomeprazole for Equine Gastric UlcersBy Kentucky Equine Research Staff · February 27, 2017

Gastric ulcers all too frequently cause poor performance and decreased appetite, loss of condition, poor coats, and even colic in horses and foals. FDA-approved omeprazole products, but not their compounded counterparts, are shown to effectively heal ulcers. Esomeprazole, a compound much like omeprazole, may be an effective option.

Both omeprazole and esomeprazole belong to the same class of compounds, called proton pump inhibitors (PPIs). These drugs block the production of gastric acid, effectively decreasing the acidity of the stomach, which allows ulcers to heal. Currently, omeprazole remains the only FDA-approved PPI for horses.

In a preliminary study*, Sykes and colleagues recently reported that esomeprazole could prove to be a viable treatment option when administered orally to horses.

In their study, the researchers administered either 0.5 or 2 mg of esomeprazole/kg body weight/day and subsequently measured the pH of the stomach for 23 hours/day for 5 days. Horses were fed either free-choice hay or a high-grain/low-fiber diet. The percent of time gastric pH was above 4 (less acidic) was significantly greater on day 5 in horses administered either 0.5 or 2 mg/kg esomeprazole and fed a high-grain/low-fiber diet. When horses were fed hay, only the 2 mg/kg dose increased gastric pH above 4 during the study period.

The finding that diet impacts absorption and dosing of PPIs supports previous research.

Alternatives to PPIs for managing gastric ulcers in horses include dietary changes and possibly sucralfate, a medication that coats the sensitive stomach ulcer allowing it time to heal without further exposure to gastric acid.

“Owners and trainers should consider supplementing either affected or at-risk horses with RiteTrac. This product quickly neutralizes excessive gastric acid, protecting the stomach lining and restoring the normal gastric environment,” recommended Kathleen Crandell, Ph.D., a nutritionist for Kentucky Equine Research. In Australia, look for these research-proven products.

*Sykes, B.W. C. Underwood, P.C. Mills. The effects of dose and diet on the pharmacodynamics of esomeprazole in the horse. Equine Veterinary Journal. In press.