Omeprazole is a proton pump inhibitor commonly used in horses to manage gastric acid-related conditions, such as gastric ulcers. It functions by reducing the production of gastric acid in the stomach, thereby aiding in the healing of existing ulcers and prevention of new ulcer formation. Omeprazole is frequently administered to horses that are at risk of developing gastric ulcers due to stress, intensive training, or other physiological factors. The pharmacokinetics, efficacy, and safety of omeprazole in equine patients have been the subject of numerous studies. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacological properties, therapeutic applications, and clinical outcomes associated with omeprazole use in horses.
Neville E, Pigott J.To describe the clinical presentation of a Thoroughbred filly with acute hemoperitoneum from a splenic source immediately after racing. Methods: A 3-year-old Thoroughbred filly used for racing and that had raced shortly before presentation to the hospital. Unassigned: On presentation, the filly was quiet, alert, and responsive with a heart rate of 76 beats/min, pale mucous membranes, and absent borborygmi. All other physical examination parameters were within normal limits. Abdominal ultrasound was performed and revealed echogenic free abdominal fluid and a splenic hematoma. Abdominocentesis y...
Menzies-Gow NJ, Shurlock T.Feedstuffs are often recommended to mitigate potential damage from acid associated with equine squamous gastric disease (ESGD). In acidic conditions, pectin alters its structure to one like mucus and binds the stomach mucosa, whilst alfalfa has a strong intrinsic acid buffering capacity. The study aimed to determine whether feeding a commercial beet pulp/alfalfa/oat fibre mix aids ESGD healing and/or prevention of recurrence. Ten adult horses with naturally occurring ESGD were included. All animals were treated with omeprazole as per the attending veterinarian's recommendation and randomly all...
Williams Louie E, Nieto J, Wensley F, Morgan JM, Finno CJ, Berryhill EH.Omega-3 fatty acid and alpha-tocopherol supplementation reduces gastric ulcer formation in humans and rodents; however, efficacy of prevention in horses is unknown. Equine Omega Complete (EOC) is an oral supplement containing omega-3 fatty acids and alpha-tocopherol. Objective: Determine if EOC supplementation prevents gastric ulcers and increases serum alpha-tocopherol concentrations in healthy horses. Methods: Nine thoroughbred geldings; 5-13 years old. Methods: Prospective randomized block design, repeated in crossover model. Horses were administered EOC, omeprazole, or water PO for 28 ...
Sundra T, Gough S, Rossi G, Kelty E, Rendle D.Oral omeprazole is the accepted treatment for equine squamous gastric disease (ESGD); however, it is not universally effective. Esomeprazole results in more consistent and pronounced acid suppression in men and is more effective than omeprazole in the treatment of oesophageal and gastric disease. Pharmacodynamic and pilot clinical studies have indicated esomeprazole might also be more effective than omeprazole in horses. Objective: To compare the efficacy and safety of oral esomeprazole and omeprazole pastes in the treatment of ESGD and, where present, concurrent equine glandular gastric disea...
Clark B, Steel C, Vokes J, Shan JR, Gedye K, Lovett A, Sykes BW.Rebound gastric hyperacidity (RGH) secondary to hypergastrinemia has been suggested to contribute to the rapid recurrence of equine squamous gastric disease (ESGD) in horses after discontinuation of omeprazole. Objective: To evaluate changes in serum gastrin and chromogranin A (CgA) concentrations in response to medium-term (57-day) omeprazole treatment and after omeprazole discontinuation. Methods: Fourteen mature Thoroughbred racehorses in simulated race training. Methods: Horses received 2.28 g of oral omeprazole PO q24h for 57 days within a 61-day period, excluding a withholding period...
Li Z, Du S, Wang X, Zhang L, Liu X, Fan Q, Yang H, Gao R.Phenylbutazone (PBZ) is the most commonly used drug to treat symptoms of lameness in horses; however, it is associated with adverse effects such as gastric ulcer syndrome (EGUS). Interestingly, many practitioners prescribe omeprazole (OME) concurrently with PBZ to prevent the development of EGUS. However, the efficacy and safety of this practice in Mongolian horses with chronic lameness remain unknown. Objective: To evaluate the clinical effects of a combination of PBZ and OME on chronic lameness in Mongolian horses. Methods: Randomised block experimental design. Methods: Eighteen Mongolian ho...
Ferlini Agne G, Somogyi AA, Sykes B, Knych H, Franklin S.In humans, omeprazole is metabolised by cytochrome P450 (CYP450) CYP2C19 and CYP3A4 with differences in CYP2C19 genotypes leading to variable response to therapy. Despite a wide use of omeprazole in horses with evidence of variable therapeutic efficiency, information regarding enzymatic metabolism is not currently available. This study aims to describe the in vitro kinetics of omeprazole metabolism and determine which enzyme(s) are responsible for omeprazole metabolism in horses. Omeprazole (0-800 uM) was incubated with liver microsomes and a panel of equine recombinant CYP450s (eq-rCYP). Meta...
Shan R, Steel CM, Sykes B.The impact of recommended withholding periods (RWPs) for omeprazole on the recurrence of Equine Gastric Ulcer Syndrome (EGUS) is unknown. The study was designed to compare the effect of two RWPs on EGUS recurrence post-omeprazole treatment and to determine if a nutraceutical supplement would reduce EGUS recurrence when administrated during an RWP. The study was a blinded, randomized clinical trial. Part 1: Horses were allocated to an RWP0 or RWP2 and crossed over after 4-weeks. Horses received oral omeprazole once daily, except during the RWPs at the end of the treatment periods. Part 2: Horse...
Louie EW, Berryhill EH, Nieto J, Wensley F, Knych H, Finno CJ, Morgan JM.Gastric ulceration can be induced by athletic training and is a significant welfare concern. The objective of this study was to evaluate the effect of gastric ulcer induction on heart rate variability (HRV) in the horse. We hypothesized that induction of gastric ulcers would decrease HRV and increase low frequency fluctuations, consistent with increased sympathetic tone. A convenience sample of 8 horses in a larger study were enrolled. Horses were randomly assigned to receive water or 2 mg/kg omeprazole orally once daily for 28 days. Gastric ulcers were induced through intermittent feed withho...
Hwang H, Dong HJ, Han J, Cho S, Kim Y, Lee I.Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training. Objective: This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole. Methods: Forty-nine horses were randomly recruited, and ga...
Bishop RC, Kemper AM, Wilkins PA, McCoy AM.Equine gastric ulcer syndrome (EGUS) is a common and significant cause of morbidity in horses, with a range of clinical signs, including inappetence, colic and poor performance. Hospitalised horses are exposed to factors that may induce EGUS, including fasting and nonsteroidal anti-inflammatory drug (NSAID) administration, and may be at risk for development of squamous (ESGD) and glandular gastric disease (EGGD). Prophylactic anti-ulcer medication is often prescribed for these patients, but drug selection is complicated by different aetiology and response to treatment of ESGD and EGGD. Objecti...
Wise JC, Hughes KJ, Edwards S, Jacobson GA, Narkowicz CK, Raidal SL.Omeprazole preparations vary in bioavailability in horses. Objective: To characterize the pharmacokinetics and pharmacodynamics of an existing enteric-coated oral omeprazole paste (REF) and a novel, in-feed, enteric-coated dry granule preparation (NOV). Methods: Twelve Standardbred/Thoroughbred mares free from clinical disease. Methods: A prospective, blinded randomized interventional study was trial, conducted in 3 parts: (a) bioavailability study, (b) dose titration study, and (c) comparative clinical pharmacodynamic study, each using a blocked crossover design. Results: Consistent with the ...
Cerri S, Taminiau B, de Lusancay AH, Lecoq L, Amory H, Daube G, Cesarini C.Omeprazole administration is associated with changes in gastric and fecal microbiota and increased incidence of Clostridioides difficile enterocolitis in humans and dogs. Objective: Study purpose was to assess the effect of omeprazole on gastric glandular and fecal microbiota in healthy adult horses. Methods: Eight healthy horses stabled on straw and fed 100% haylage. Methods: Prospective controlled study. Transendoscopic gastric glandular biopsies, gastric fluid, and fecal samples were obtained from each horse twice at a 7-day interval before the administration of omeprazole. Samples were tak...
Pagan JD, Petroski-Rose L, Mann A, Hauss A.Proton pump inhibitors such as omeprazole reduce nutrient digestibility in humans. This study determined the effect of omeprazole on the digestibility of diets containing limestone or marine-derived calcium (BMC) and to assess changes in blood parameters associated with gastric acid production and calcium status in horses. Thoroughbreds were used to evaluate the digestibility of diets containing different calcium sources with or without omeprazole over four 21-day periods. Each 21-day period had a 15-day diet adaptation phase followed by a 6-day collection phase, consisting of a 5-day total fe...
Luthersson N, Bolger C, Fores P, Barfoot C, Nelson S, Parkin T, Harris P.Diet is an accepted risk factor for equine squamous gastric disease (ESGD), but there is little published evidence for the benefit of dietary change (DC). This study evaluated the effect of DC with or without initial omeprazole medication. Twelve pairs of exercising horses with ESGD Grade 2/4 (EM) and 17 pairs with ESGD Grade ≥3/4 (ES), were monitored. Paired horses had similar management, feeding times, workloads, and initially feed or forage. One of each pair was randomly assigned, postgastroscopy (Scope1), to a specified restricted starch ration; the other remained on their original diet....
Varley G, Bowen IM, Habershon-Butcher JL, Nicholls V, Hallowell GD.Previous studies have demonstrated a poor response to healing of gastric glandular lesions with oral omeprazole and other medications. Objective: To evaluate the efficacy of two novel treatments (misoprostol [M] and combined omeprazole-sucralfate [OS]) in horses for gastric glandular disease. Methods: Prospective, clinical study. Methods: Sixty-three sports horses with grade >1/4 glandular disease were identified by gastroscopy. Horses received either 5 μg/kg of misoprostol per os BID 1 h prior to feeding or a combination of 4 mg/kg enteric coated omeprazole per os SID and 12 mg/kg sucral...
Tyma JF, Epstein KL, Whitfield-Cargile CM, Cohen ND, Giguère S.OBJECTIVE To determine the effects of oral omeprazole administration on the fecal and gastric microbiota of healthy adult horses. ANIMALS 12 healthy adult research horses. PROCEDURES Horses were randomly assigned to receive omeprazole paste (4 mg/kg, PO, q 24 h) or a sham (control) treatment (tap water [20 mL, PO, q 24 h]) for 28 days. Fecal and gastric fluid samples were collected prior to the first treatment (day 0), and on days 7, 28, 35, and 56. Sample DNA was extracted, and bacterial 16S rRNA gene sequences were amplified and sequenced to characterize α and β diversity and differential ...
Mason LV, Moroney JR, Mason RJ.Guidelines regarding the impact and value of prophylaxis or maintenance therapy in equine gastric ulcer syndrome (EGUS) are not well-established or defined. The merits and the magnitude of effects of prophylaxis for spontaneous or recurrent squamous gastric ulceration in horses in training are uncertain. Objective: To pool data from randomised controlled trials (RCTs) to eliminate reporting bias and evaluate the efficacy of prophylactic omeprazole in the prevention of EGUS in training horses, and secondarily to compare prophylactic dosages of omeprazole. Methods: Meta-analysis. Methods: This m...
Huxford KE, Dart AJ, Perkins NR, Bell R, Jeffcott LB.AIMS To compare the efficacy of an enteric coated esomeprazole paste with an enteric coated omeprazole paste to increase gastric pH after oral administration in horses. METHODS Nine adult Standardbred horses were randomly assigned to three groups, each containing three horses, for a study comprising three phases of 10 days, with an 18-day washout period between each phase. In each phase, three horses received either 0.5 mg/kg esomeprazole, 1 mg/kg omeprazole or a placebo, as an oral paste, once daily for 10 days (Days 0-9). Over the course of study all horses received all three treatments....
Bush J, van den Boom R, Franklin S.Anecdotally, aloe vera is used to treat gastric ulceration, although no studies have yet investigated its efficacy in horses. Objective: To test the hypothesis that aloe vera would be noninferior to omeprazole in the treatment of equine gastric ulcer syndrome. Methods: Randomised, blinded clinical trial. Methods: Forty horses with grade ≥2 lesions of the squamous and/or glandular mucosa were randomly assigned to one of two groups. Horses received either aloe vera inner leaf gel (17.6 mg/kg bwt) b.i.d. or omeprazole (4 mg/kg bwt) s.i.d. for approximately 28 days, after which a repeat gastrosc...
Zavoshti FR, Andrews FM.Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are nece...
Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC.Conflicting data are presented in the current literature regarding the efficacy of omeprazole for suppressing gastric acidity in the horse. Objective: The objective of this study was to investigate the duration of intraday acid suppression achieved with two doses of omeprazole under two different dietary conditions. Methods: A four-way crossover design. Methods: Six adult Thoroughbred horses instrumented with percutaneous gastrotomy tubes were used. Intragastric pH was measured for continuous 23 h periods (08.00-07.00 h) for six consecutive days (Days 0-5). Baseline data was recorded on Day 0 ...
Wilson CS, Brookes VJ, Hughes KJ, Trope GD, Ip H, Gunn AJ.In human subjects, arytenoid chondritis can be caused by chemical trauma of mucosa attributable to gastro-oesophageal reflux. Although a similar process may be involved in the aetiopathogenesis of arytenoid chondritis in horses, the oesophageal lumen pH in this species is poorly understood. Objective: To determine if gastro-oesophageal reflux occurs in horses by characterising oesophageal lumen pH. Methods: Blinded, randomised, placebo-controlled, crossover, experimental study. Methods: Luminal oesophageal pH in six yearling horses was recorded over four 24 h periods using an ambulatory pH rec...
Sykes BW, Underwood C, McGowan CM, Mills PC.This study aimed to investigate the effect of diet and dose on the pharmacokinetics of omeprazole in the horse. Six horses received two doses (1 and 4 mg/kg) of omeprazole orally once daily for 5 days. Each dose was evaluated during feeding either a high-grain/low-fibre (HG/LF) diet or an ad libitum hay (HAY) diet in a four-way crossover design. Plasma samples were collected for pharmacokinetic analysis on days 1 and 5. Plasma omeprazole concentrations were determined by ultra-high pressure liquid chromatography-mass spectrometry. In horses being fed the HG/LF diet, on day 1, the area under...
Knych HK, Stanley SD, Arthur RM, McKemie DS.The use of anti-ulcer medications, such as cimetidine, ranitidine, and omeprazole, is common in performance horses. The use of these drugs is regulated in performance horses, and as such a withdrawal time is necessary prior to competition to avoid a medication violation. To the authors' knowledge, there are no reports in the literature describing repeated oral administrations of these drugs in the horse to determine a regulatory threshold and related withdrawal time recommendations. Therefore, the objective of the current study was to describe the disposition and elimination pharmacokinetics o...
Sykes BW, Sykes KM, Hallowell GD.Interest in Equine Gastric Ulcer Syndrome (EGUS) has recently increased in part due to a growing awareness of the differences between squamous and glandular disease. The pathophysiology and epidemiology of squamous and glandular disease are different and recently it has been shown that the response of glandular gastric ulceration to monotherapy with omeprazole is poor. Given these differences it has been recommended that specific treatment guidelines be formulated for equine glandular disease and that adjunctive therapies be investigated. Along these lines it has been suggested that the additi...
Birkmann K, Junge HK, Maischberger E, Wehrli Eser M, Schwarzwald CC.GastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric-coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse. Objective: To investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers. Methods: 40 horses; 9.5 ± 4.6 years; 491 ± 135 kg. Methods: Prospective, randomized, blinded study. Horses with an ulcer score ≥1 (Equi...
Nieto JE, Snyder JR, Vatistas NJ, Jones JH.To develop a protocol to induce and maintain gastric ulceration in horses and to determine whether gastric ulceration affects physiologic indices of performance during high-speed treadmill exercise. Methods: 20 healthy Thoroughbreds. Methods: Each horse was acclimatized to treadmill exercise during a 2-week period. Subsequently, baseline data were collected (day 0) and each horse began an incrementally increasing exercise training program (days 1 through 56). Beginning on day 14, horses were administered omeprazole (4 mg/kg, PO, q 24 h until day 56) or no drug (10 horses/group) and underwent a...
Tyma JF, Epstein KL, Whitfield-Cargile CM, Cohen ND, Giguère S.OBJECTIVE To determine the effects of oral omeprazole administration on the fecal and gastric microbiota of healthy adult horses. ANIMALS 12 healthy adult research horses. PROCEDURES Horses were randomly assigned to receive omeprazole paste (4 mg/kg, PO, q 24 h) or a sham (control) treatment (tap water [20 mL, PO, q 24 h]) for 28 days. Fecal and gastric fluid samples were collected prior to the first treatment (day 0), and on days 7, 28, 35, and 56. Sample DNA was extracted, and bacterial 16S rRNA gene sequences were amplified and sequenced to characterize α and β diversity and differential ...
Lester GD, Smith RL, Robertson ID.To compare the effects of oral administration of omeprazole and ranitidine on gastric squamous ulceration in Thoroughbreds in race training. Methods: Modified crossover study. Methods: 60 Thoroughbreds in race training with gastric squamous mucosal ulceration. Methods: Horses were randomly allocated into 3 groups. Group 1 received no treatment for 28 days followed by administration of omeprazole (4 mg/kg [1.8 mg/lb], PO, once daily) for 28 days; group 2 received omeprazole (4 mg/kg, PO, once daily) for 28 days followed by no treatment for 28 days; and group 3 received ranitidine (6.6 mg/kg [3....
Andrews FM, Frank N, Sommardahl CS, Buchanan BR, Elliott SB, Allen VA.The study was performed to evaluate the efficacy of omeprazole powder in sterile water, administered intravenously, on gastric juice pH in adult horses with naturally occurring gastric ulcers. Omeprazole (0.5 mg/kg, IV) was administered once daily for 5 days to 6 adult horses with gastric ulcers. Gastric juice was aspirated through the biopsy channel of an endoscope and pH was measured before and 1 hour after administration of omeprazole on day 1, and then before and after administration of omeprazole on day 5. Gastric ulcer scores were recorded on day 1 before administration of omeprazole and...
Daurio CP, Holste JE, Andrews FM, Merritt AM, Blackford JT, Dolz F, Thompson DR.In a multicentre trial, 13 cannulated horses were treated orally once daily with a paste that delivered omeprazole at a dose of 4 and 5 mg/kg bwt in a 2-period crossover design to evaluate steady state gastric acid suppression. In each period, basal (unstimulated) and pentagastrin-stimulated gastric output were evaluated at 5-8 h after 5 doses, at 13-16 h after 10 doses, and at 21-24 h after 15 doses. Baseline data for gastric acid secretion were collected once for each horse in the month prior to initiation of omeprazole treatment. The inhibition of gastric acid secretion relative to baseline...
Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC.Conflicting data are presented in the current literature regarding the efficacy of omeprazole for suppressing gastric acidity in the horse. Objective: The objective of this study was to investigate the duration of intraday acid suppression achieved with two doses of omeprazole under two different dietary conditions. Methods: A four-way crossover design. Methods: Six adult Thoroughbred horses instrumented with percutaneous gastrotomy tubes were used. Intragastric pH was measured for continuous 23 h periods (08.00-07.00 h) for six consecutive days (Days 0-5). Baseline data was recorded on Day 0 ...
Cerri S, Taminiau B, de Lusancay AH, Lecoq L, Amory H, Daube G, Cesarini C.Omeprazole administration is associated with changes in gastric and fecal microbiota and increased incidence of Clostridioides difficile enterocolitis in humans and dogs. Objective: Study purpose was to assess the effect of omeprazole on gastric glandular and fecal microbiota in healthy adult horses. Methods: Eight healthy horses stabled on straw and fed 100% haylage. Methods: Prospective controlled study. Transendoscopic gastric glandular biopsies, gastric fluid, and fecal samples were obtained from each horse twice at a 7-day interval before the administration of omeprazole. Samples were tak...
Varley G, Bowen IM, Habershon-Butcher JL, Nicholls V, Hallowell GD.Previous studies have demonstrated a poor response to healing of gastric glandular lesions with oral omeprazole and other medications. Objective: To evaluate the efficacy of two novel treatments (misoprostol [M] and combined omeprazole-sucralfate [OS]) in horses for gastric glandular disease. Methods: Prospective, clinical study. Methods: Sixty-three sports horses with grade >1/4 glandular disease were identified by gastroscopy. Horses received either 5 μg/kg of misoprostol per os BID 1 h prior to feeding or a combination of 4 mg/kg enteric coated omeprazole per os SID and 12 mg/kg sucral...
Sanchez LC, Murray MJ, Merritt AM.To evaluate the efficacy of omeprazole paste, a commonly used antiulcer drug, on intragastric pH in clinically normal neonatal foals. Methods: 6 clinically normal foals between 5 and 14 days of age. Methods: Intragastric pH was recorded in each foal by use of a disposable antimony pH electrode with internal reference. Values for intragastric pH were recorded every 4 seconds by use of an ambulatory pH monitor. There were two 24-hour recordings of intragastric pH for each foal, with 24 hours between recordings. Foals were not administered any drugs during the first recording. Foals were administ...
Luthersson N, Bolger C, Fores P, Barfoot C, Nelson S, Parkin T, Harris P.Diet is an accepted risk factor for equine squamous gastric disease (ESGD), but there is little published evidence for the benefit of dietary change (DC). This study evaluated the effect of DC with or without initial omeprazole medication. Twelve pairs of exercising horses with ESGD Grade 2/4 (EM) and 17 pairs with ESGD Grade ≥3/4 (ES), were monitored. Paired horses had similar management, feeding times, workloads, and initially feed or forage. One of each pair was randomly assigned, postgastroscopy (Scope1), to a specified restricted starch ration; the other remained on their original diet....
McClure SR, White GW, Sifferman RL, Bernard W, Hughes FE, Holste JE, Fleishman C, Alva R, Cramer LG.To determine whether omeprazole oral paste administered at a dosage of 0.5 or 1 mg/kg (0.23 or 0.45 mg/lb), PO, every 24 hours would effectively prevent the recurrence of gastric ulcers in horses in race training. Methods: Prospective study. Methods: 135 horses. Methods: Horses with gastric ulcers were treated with omeprazole at a dosage of 4 mg/kg (1.8 mg/lb), PO, every 24 hours for 28 days. Horses in the dose selection portion of the study were sham dose treated or received 0.5 or 1 mg of omeprazole/kg, PO, every 24 hours for an additional 28 days. Horses in the dose confirmation portion of ...
Sykes BW, Underwood C, McGowan CM, Mills PC.This study aimed to investigate the effect of diet and dose on the pharmacokinetics of omeprazole in the horse. Six horses received two doses (1 and 4 mg/kg) of omeprazole orally once daily for 5 days. Each dose was evaluated during feeding either a high-grain/low-fibre (HG/LF) diet or an ad libitum hay (HAY) diet in a four-way crossover design. Plasma samples were collected for pharmacokinetic analysis on days 1 and 5. Plasma omeprazole concentrations were determined by ultra-high pressure liquid chromatography-mass spectrometry. In horses being fed the HG/LF diet, on day 1, the area under...
Baker SJ, Gerring EL.We investigated the effects of a range of IV administered doses of omeprazole (0.125 to 2.0 mg/kg of body weight) on gastric pH (monitored by indwelling electrode) and plasma gastrin concentration, compared with those of IV administered ranitidine (1.0 mg/kg) in 4 Welsh mountain-type ponies. Pharmacokinetic variables of IV administered omeprazole also were examined. Episodes of high gastric pH in the basal state obscured the effect of acid suppression on intragastric pH; however, omeprazole induced dose-dependent increase in mean gastric pH (P < 0.01) during the 11 hours after its administr...
Knych HK, Stanley SD, Arthur RM, McKemie DS.The use of anti-ulcer medications, such as cimetidine, ranitidine, and omeprazole, is common in performance horses. The use of these drugs is regulated in performance horses, and as such a withdrawal time is necessary prior to competition to avoid a medication violation. To the authors' knowledge, there are no reports in the literature describing repeated oral administrations of these drugs in the horse to determine a regulatory threshold and related withdrawal time recommendations. Therefore, the objective of the current study was to describe the disposition and elimination pharmacokinetics o...
Murray MJ, Eichorn ES, Holste JE, Cox JL, Stanier WB, Cooper WL, Cooper VA.A paste formulation of the H+,K(+)-ATPase inhibitor omeprazole was evaluated in Thoroughbred foals and yearlings for its safety and acceptability. Twenty foals age 11-16 weeks and 20 yearling horses age 15-17 months were included and gastroscopic examinations performed 1-3 days before and at the end of each trial. Lesions were scored on a scale of 0 to 3 and animals allocated based on endoscopic lesion score and sex, with 4 animals in each of 5 replicates. Dosages of 4 mg omeprazole/kg bwt or sham treatment were administered once daily for 28 days, from a syringe graduated in 50 lb (22.68 kg) ...
Plue RE, Wall HG, Daurio C, Attebery DK, Cox JL, Wallace DH.Omeprazole has been shown to promote healing of spontaneously occurring gastric ulcers in horses when administered for 28 days at a dose of 4 mg/kg bwt/day and to prevent recurrence of ulcers in almost all horses when treatment is continued at a dose of at least 2 mg/kg bwt/day. The purpose of the 3 studies reported here was to 1) evaluate the evolution of potential effects of omeprazole paste (GastroGard), at a dose of 20 mg/kg bwt/day (5x the recommended dose) for 91 days in mature Thoroughbred horses; 2) evaluate the safety in young horses of omeprazole paste when dosed at 4 mg/kg bwt/day (...
Zavoshti FR, Andrews FM.Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe ulcers in the nonglandular squamous and glandular mucosa, terminal esophagus, and proximal duodenum. Gastric ulcers in the squamous and glandular regions occur more often than esophageal or duodenal ulcers and likely have a different pathogenesis. At present, omeprazole is accepted globally as the best pharmacologic therapy for both regions of the stomach; however, the addition of coating agents and synthetic prostaglandins could add to its effectiveness in treatment of EGUS. Dietary and environmental management are nece...
Wise JC, Hughes KJ, Edwards S, Jacobson GA, Narkowicz CK, Raidal SL.Omeprazole preparations vary in bioavailability in horses. Objective: To characterize the pharmacokinetics and pharmacodynamics of an existing enteric-coated oral omeprazole paste (REF) and a novel, in-feed, enteric-coated dry granule preparation (NOV). Methods: Twelve Standardbred/Thoroughbred mares free from clinical disease. Methods: A prospective, blinded randomized interventional study was trial, conducted in 3 parts: (a) bioavailability study, (b) dose titration study, and (c) comparative clinical pharmacodynamic study, each using a blocked crossover design. Results: Consistent with the ...
Sangiah S, MacAllister CC, Amouzadeh HR.The basal gastric pH and free acid contents from five young adult healthy horses were determined at one hour intervals for eight hours. The basal gastric pH and free acid contents varied from 1.63 +/- 0.06 to 1.97 +/- 0.11 and 26.42 +/- 4.14 to 17.92 +/- 5.28 mmol litre-1, respectively. Misoprostol, a methylester analogue of prostaglandin (5 micrograms kg-1, orally) produced a time-dependent increase in the basal gastric pH to above 3.5 (P less than 0.05) at three, four and five hours after administration with a concomitant reduction of 80 to 90 per cent in the basal gastric free acid contents...
Vatistas NJ, Snyder JR, Nieto J, Thompson D, Pollmeier M, Holste J.Gastric ulceration has been found to occur in 80-90% of Thoroughbreds in active race training. Previously, variable success has been reported using mucosal surface protectants and H2 receptor antagonist. Omeprazole, a substituted benzimidazole, has been shown to inhibit gastric acid secretion in both man and animals. Fourteen horses, in active race training and with endoscopic evidence of moderated to severe gastric ulceration were divided into 2 groups: Group 1 (7 horses) were given placebo paste orally once daily for 28 days; Group 2 (7 horses) received 1.54 g active omeprazole in the placeb...
Bush J, van den Boom R, Franklin S.Anecdotally, aloe vera is used to treat gastric ulceration, although no studies have yet investigated its efficacy in horses. Objective: To test the hypothesis that aloe vera would be noninferior to omeprazole in the treatment of equine gastric ulcer syndrome. Methods: Randomised, blinded clinical trial. Methods: Forty horses with grade ≥2 lesions of the squamous and/or glandular mucosa were randomly assigned to one of two groups. Horses received either aloe vera inner leaf gel (17.6 mg/kg bwt) b.i.d. or omeprazole (4 mg/kg bwt) s.i.d. for approximately 28 days, after which a repeat gastrosc...
Hwang H, Dong HJ, Han J, Cho S, Kim Y, Lee I.Gastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training. Objective: This study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole. Methods: Forty-nine horses were randomly recruited, and ga...
Sykes BW, Sykes KM, Hallowell GD.Interest in Equine Gastric Ulcer Syndrome (EGUS) has recently increased in part due to a growing awareness of the differences between squamous and glandular disease. The pathophysiology and epidemiology of squamous and glandular disease are different and recently it has been shown that the response of glandular gastric ulceration to monotherapy with omeprazole is poor. Given these differences it has been recommended that specific treatment guidelines be formulated for equine glandular disease and that adjunctive therapies be investigated. Along these lines it has been suggested that the additi...
Nieto JE, Snyder JR, Vatistas NJ, Jones JH.To develop a protocol to induce and maintain gastric ulceration in horses and to determine whether gastric ulceration affects physiologic indices of performance during high-speed treadmill exercise. Methods: 20 healthy Thoroughbreds. Methods: Each horse was acclimatized to treadmill exercise during a 2-week period. Subsequently, baseline data were collected (day 0) and each horse began an incrementally increasing exercise training program (days 1 through 56). Beginning on day 14, horses were administered omeprazole (4 mg/kg, PO, q 24 h until day 56) or no drug (10 horses/group) and underwent a...
Kollias-Baker C, Cox K, Jones J.Omeprazole is a proton-pump inhibitor recently approved in the United States for the treatment of gastric ulcer disease in horses. A study was designed to determine the effects of omeprazole treatment on the physiological indices of performance of horses during incremental treadmill exercise. In a crossover-design study carried out over 2 weeks, five horses completed standardized incremental exercise tests on a high-speed treadmill either with no treatment or treatment with omeprazole. No statistically significant effects of omeprazole were found on the mean maximum responses for specific oxyg...
Clark B, Steel C, Vokes J, Shan JR, Gedye K, Lovett A, Sykes BW.Rebound gastric hyperacidity (RGH) secondary to hypergastrinemia has been suggested to contribute to the rapid recurrence of equine squamous gastric disease (ESGD) in horses after discontinuation of omeprazole. Objective: To evaluate changes in serum gastrin and chromogranin A (CgA) concentrations in response to medium-term (57-day) omeprazole treatment and after omeprazole discontinuation. Methods: Fourteen mature Thoroughbred racehorses in simulated race training. Methods: Horses received 2.28 g of oral omeprazole PO q24h for 57 days within a 61-day period, excluding a withholding period...
MacAllister CG, Sifferman RL, McClure SR, White GW, Vatistas NJ, Holste JE, Ericcson GF, Cox JL.A multicentre, blinded, randomised complete-block, field trial was conducted with 140 horses and foals age 4 weeks-28 years to determine if omeprazole paste is effective and safe in promoting healing of spontaneous gastric ulcers under a variety of field conditions and in different breeds and ages of horses. Horses in the study had gastric ulceration as determined by gastroscopy and were divided into replicates of 4 or 5 animals. One horse in each replicate was assigned randomly to receive an empty omeprazole syringe (sham-dosed control) and the remaining horses received omeprazole paste once ...
Bell RJ, Mogg TD, Kingston JK.In recent years, gastric ulceration has been recognised as a common, possibly performance-limiting disease of adult horses. Here, we aim to provide the reader with a useful review of recent literature covering all aspects of equine gastric ulcer syndrome (EGUS) in adult horses. The anatomy and physiology of the stomach, with particular reference to secretion of acid and mucosal protective mechanisms, are reviewed, as are the differing theories relating to the aetiopathogenesis of gastric ulceration. We also explore the possible influence of various management factors on development of the dise...
