Changes

==Treatment==

==Treatment==

Despite the wide spread use of antiulcer medications the prevalence of EGUS remains high. This is probably due to the cost of antiulcer agents, which results in shorter than prescribed treatment courses, the administration of sub-therapeutic doses, or substitution of compounded medications or feed supplements that are ineffective (Orsini et al. 2003).(Nadeau 2009)

 

Omeprazole and ranitidine are approved in many countries for treatment and prevention of EGUS (Andrews et al. 1999; Doucet et al. 2003; Lester et al. 2007), but these drugs are often expensive and require at least 28 days of treatment for complete healing. Omeprazole (4 mg/kg bwt, per os, q. 24 h, 28 days) has been shown to be more effective than ranitidine (6.6 mg/kg bwt, per os, q. 8 h, 28 days) in treatment of EGUS in horses..

 

The prevalence of gastric ulcers in horses remains high regardless of the common use of antiulcer treatments. This has been attributed to the expense of recommended products encouraging subtherapeutic and curtailed dosing schedules(Orsini et al 2003 in Nadeau 2009).  Omeprazole and ranitidine must be administered for at least 28 days for adequate ulcer healing.(Nadeau 2009)  

Omeprazole has been shown to be more effective than ranitidine in treatment of EGUS in horses..

Recently, an omeprazole powder (0.5 mg/kg bwt, i.v.) was given to horses daily for 5 days (Andrews et al. 2006). In that study, gastric juice pH significantly increased 1 h after the first injection and remained increased 24 h after the 4th injection and after the 5th daily injection. Due to the variability of gastric juice pH in the horses, the authors recommended the administration of a loading dose of 1 mg/kg bwt, i.v., then a maintenance dose (0.5 mg/kg bwt, i.v.) daily for treatment of gastric ulcers in horses that are not able to be given the oral paste formulation.

Recently, an omeprazole powder (0.5 mg/kg bwt, i.v.) was given to horses daily for 5 days (Andrews et al. 2006). In that study, gastric juice pH significantly increased 1 h after the first injection and remained increased 24 h after the 4th injection and after the 5th daily injection. Due to the variability of gastric juice pH in the horses, the authors recommended the administration of a loading dose of 1 mg/kg bwt, i.v., then a maintenance dose (0.5 mg/kg bwt, i.v.) daily for treatment of gastric ulcers in horses that are not able to be given the oral paste formulation.

In the USA, compounded omeprazole from bulk powders are used as a substitute for the FDA approved formulation. However, these compounds are not regulated and many lack efficacy intreatment of gastric ulcers (Nieto et al. 2002; Merritt et al. 2003; Orsini et al. 2003). These compounds are used because of the expense of approved products.(Nadeau 2009)

In the USA, compounded omeprazole from bulk powders are used as a substitute for the FDA approved formulation. However, these compounds are not regulated and many lack efficacy intreatment of gastric ulcers (Nieto et al. 2002; Merritt et al. 2003; Orsini et al. 2003). These compounds are used because of the expense of approved products.(Nadeau 2009)

Vet Clin North Am Equine Pract. 2009 Aug;25(2):283-301.

Vet Clin North Am Equine Pract. 2009 Aug;25(2):283-301.

New perspectives in equine gastric ulcer syndrome.

New perspectives in equine gastric ulcer syndrome.