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Equine veterinary journal2025; doi: 10.1111/evj.14477

Assessing omeprazole and flunixin meglumine co-administration in treating equine gastric ulcer syndrome in Mongolian horses.

Abstract: Flunixin meglumine (FM) is commonly used in painful conditions in horses; however, it may contribute to equine gastric ulcer syndrome (EGUS). Some veterinarians combine omeprazole (OME) and FM to reduce EGUS risk. However, the efficacy and safety of this combination in Mongolian horses with chronic lameness remain unknown. Objective: To investigate the changes in lameness and EGUS scores in Mongolian horses through the comparison of three treatment strategies: FM, FM + OME and placebo treated control (CON) and to assess the effects of these treatments on gastric fluid pH, serum total protein, albumin and oxidative stress markers (MPO, SOD, CAT). Methods: In vivo experiments. Methods: Eighteen Mongolian horses with initial American Association of Equine Practitioners lameness scores ≥3 of 5 were selected and equally divided into the placebo (CON), FM (1.1 mg/kg IV q. 24 h) and FM + OME (4 mg/kg PO q. 24 h) treatment groups in a randomised block design. During 15 days of treatment, weekly gastroscopy and physiological and biochemical tests were performed. Stomach tissues were harvested from two horses from each group for histopathological examination with haematoxylin and eosin, Masson's trichrome and periodic acid-Schiff (PAS) staining. Results: FM (median 1.0, interquartile range 0.0-1.0; p < 0.001) and FM + OME (1.0, 1.0-1.0; p < 0.001) significantly decreased lameness scores compared with CON (3.0, 3.0-4.0). Compared with CON (EGGD: 0.0, 0.0-1.0, p < 0.001; PG1: mean 231.9 ± standard deviation 25.2 ng/mL, p < 0.001) or FM + OME (EGGD: 0.8, 1.0-1.3, p = 0.003; PG1: 207.08 ± 34.85 ng/mL, p < 0.001), FM significantly increased equine gastric glandular disease (EGGD) grade (3.0, 2.0-3.3) and pepsinogen 1 (PG1) content (372.2 ± 33.2 ng/mL, p < 0.001). Compared with CON (total protein: 70.1 ± 2.9 g/L; albumin: 37.0 ± 3.0 g/L; Gastrin-17: 482.5 ± 48.1 pg/mL), FM significantly reduced total protein (62.8 ± 2.9 g/L, p = 0.003), albumin (31.5 ± 2.3 g/L, p = 0.01) and Gastrin-17 (GT-17) content (284.6 ± 57.2 pg/mL, p < 0.001). Compared with FM (EGGD: 3.0, 2.0-3.3; pH: 2.4 ± 0.3), FM + OME significantly decreased the EGGD grade (0.8, 1.0-1.3; p = 0.003) and significantly increased gastric fluid pH (7.4 ± 0.2; p < 0.001). FM + OME (207.1 ± 34.9 ng/mL) significantly decreased PG1 content compared with FM (372.24 ± 33.25 ng/mL; p < 0.001). Histopathology revealed that 15 days of FM treatment led to gastric lesions in horses, which were mitigated by combining with OME. Conclusions: Individual differences among horses were large, but the sample size was small and sampling was infrequent. Conclusions: Compared with FM alone, use of FM + OME did not impact the reduction in lameness scores with therapy, but reduced the occurrence of EGGD in Mongolian horses. When used to manage chronic lameness, FM + OME might protect against FM-induced EGGD by increasing the gastric pH and decreasing serum PG1 content.
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Publication Date: 2025-02-18 PubMed ID: 39967295DOI: 10.1111/evj.14477Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study investigates the efficacy of co-administering flunixin meglumine (FM) and omeprazole (OME) in treating equine gastric ulcer syndrome (EGUS) and lameness in Mongolian horses. The authors found that the combined use of FM and OME demonstrated protective effects against FM-induced EGUS in these horses, with the additional benefit of reducing lameness, which FM treatment alone also achieved.

Study Design and Methodology

  • The study involved in vivo experiments with eighteen Mongolian horses that presented with signs of lameness. These horses were randomly divided into three groups – placebo (CON), FM alone, and FM combined with OME.
  • Both FM and the FM + OME regimen were administered for a period of 15 days. During this period, weekly gastroscopy and physiological and biochemical analyses were performed to monitor changes brought about by the treatment.
  • Furthermore, stomach tissues were harvested from two horses in each group for histopathological examination using various staining techniques.

Key Results

  • Both FM alone and the FM + OME combination significantly reduced lameness scores compared to the control group.
  • Treatment with FM alone was found to increase gastric glandular disease (EGGD) and pepsinogen 1 (PG1) content, markers of gastric ulcers in horses. However, these were significantly reduced when OME was added to the FM treatment.
  • FM treatment also led to a significant reduction in serum total protein, albumin, and Gastrin-17 content. This phenomenon was not observed in the FM + OME group, which could indicate potential mitigation of FM’s side effects when OME is co-administered.
  • Gastric fluid pH observed to be lower in the FM group increased significantly when OME was added, indicative of a healthier gastric environment.
  • GAstroscopic pathology revealed that gastric lesions induced by FM treatment were mitigated when OME was added, confirming the protective effect of the drug combination.

Conclusions

  • The study concludes that although both FM alone and FM + OME treatment reduced lameness in the horses, the combined therapy was superior in terms of protecting against FM-induced EGGD.
  • This advantage was achieved by increasing the gastric pH and decreasing serum PG1 content, thereby creating a more favourable environment in the horses’ stomach.
  • However, the authors also note that the sample size for this study was small and the horses exhibited significant individual differences, which may affect the generalizability of the findings.

Cite This Article

APA
Guo W, Li Z, Mao W, Liu X, Yang Y, Yu J, Yang H, Gao R. (2025). Assessing omeprazole and flunixin meglumine co-administration in treating equine gastric ulcer syndrome in Mongolian horses. Equine Vet J. https://doi.org/10.1111/evj.14477

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Guo, Wenrui
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Li, Zhengyi
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Mao, Wei
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Liu, Xinyu
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Yang, Ying
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Yu, Jiahui
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.
Yang, Huidi
  • Basic Medical School, Inner Mongolia Medical University, Hohhot, China.
Gao, Ruifeng
  • Animal Embryo and Developmental Engineering Key Laboratory of Higher Education, Institutions of Inner Mongolia Autonomous Region, Hohhot, China.
  • College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, China.

Grant Funding

  • YLXKZX-NND-012 / Research Special Project of First-Class Discipline by the Education Department of Inner Mongolia Autonomous Region
  • 2023MS03035 / Natural Science Foundation of Inner Mongolia Autonomous Region
  • 2023LHMS03015 / Natural Science Foundation of Inner Mongolia Autonomous Region
  • NJYT24056 / Program for Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region
  • 32160247 / National Natural Science Foundation of China
  • YKD2023ZD007 / Key Projects of Inner Mongolia Medical University

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