Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses.

Abstract: Ulceration of the squamous gastric mucosa is commonly associated with intensive training programmes in horses, but only one compound ('Gastrogard') has been subjected to controlled scrutiny as to therapeutic efficacy. Objective: To compare the gastric acid inhibitory efficacy of one manufactured ('GastroGard') and 3 generic pharmacy-compounded preparations of the proton pump inhibitor omeprazole (OME) in the mature horse. Objective: All OME preparations tested would induce a clinically acceptable effect. Methods: Six healthy mature gastrically cannulated horses of various breeds, 3 mares and 3 geldings, were used. Each product was administered per os once daily (0730 h) at an equivalent dose of 4 mg OME/kg bwt, in a randomised complete repeated measures design for sequence of individual preparation treatment per horse. There was a minimum of 14 days between treatment regimens. A portable unit that recorded pH continuously was attached to a recording electrode fixed within the gastric lumen via the gastric cannula. Three 24 h recordings were made one day before and during Days 2 and 7 after commencement of a 7 day treatment with each of the 4 individual preparations. The horses were fed as usual throughout the study. Results: Only the GastroGard and one other preparation induced a significant increase over baseline in mean percentage of time that the pH was > 4.0 and mean median intragastric pH, during the first 14 and 12 h post treatment respectively, for both Days 2 and 7 post treatment. Both these products had a vehicle pH > 8.0, in contrast to the 2 less effective products, where the vehicle pH was < 6.0. Conclusions: OME at 4 mg/kg per os s.i.d. can effectively maintain intragastric pH at an accepted anti-ulcerogenic level for at least 12 h post administration in mature horses. In contrast to GastroGard, it should not be expected that all compounded preparations of OME are equally effective in achieving this performance. It appears that vehicle pH might play an important part in determining preparation efficacy. Conclusions: Optimal timing for daily dosing of athletic horses with an effective OME preparation, in order to suppress gastric squamous ulceration, might be 4-8 h prior to a training session.