Efficacy of Omeprazole Powder Paste or Enteric‐Coated Formulation in Healing of Gastric Ulcers in Horses

Abstract

BackgroundGastroGard, 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.ObjectivesTo 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.Animals40 horses; 9.5 ± 4.6 years; 491 ± 135 kg.MethodsProspective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5).ResultsCompared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUCGG = 2856 (1405‐4576) ng/mL × h, AUCGZ = 604 (430‐1609) ng/mL × h; P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56–2.81) times higher than for GastroGard.Conclusions and Clinical ImportanceBoth Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.

Effects of feeding different roughage-based diets on gastric mucosa after weaning in warmblood foals

“…Besides optimizing feeding and housing management, the treatment with pharmaceutical drugs such as omeprazole reduces gastric acid production, resulting in gastric pH values above 4 (Birkmann et al 2014). Other drugs like sucralfate improve the prostaglandin E (PGE) synthesis, by stimulating the bicarbonate and mucus secretion and impeding hydrochloric acid release (Bell et al 2007).…”

Effects of different neutraceutic supplements on the gastric mucosa of weanling foals

“…Introduction into new housing and grouping were performed to ensure adequate intake of the respective supplements and to control the amount of any feed refusals. Medical treatments, such as omeprazole, have been shown to reduce the prevalence of gastric mucosal lesions in adult horses as well as in weanlings (Lester et al 2005, Sykes et al 2014, Birkmann et al 2014). In particular, mucosal lesions located in the Pars nonglandularis demonstrated significantly better healing compared to lesions in the Pars glandularis (Dahlkamp et al 2012).…”

“…Several studies have confirmed an improvement of healing gastric ulcers by administering drugs, such as omeprazole (Birkmann et al 2014), cimetidine and ranitidine (Lester et al 2005). In addition to medical treatment, optimizing feeding and housing management is highly recommended.…”

Effects of two intravenous dose levels of omeprazole on the gastric juice pH of healthy horses

“…Large numbers of stabled horses undergo intense work routines, which can predispose to gastrointestinal problems such as gastric ulcers. EGUS is usually associated with changes in attitude, poor appetite, weight loss, decreased physical performance, diarrhea, abdominal discomfort or recurrent colic episodes (Murray et al, 1996;Birkmann et al, 2014), and is a common pathology in horses (Videla and Andrews, 2009). Anti-ulcer treatments generally consist in neutralizing stomach acidity using antacids or to reduce acid secretion with antisecretory drugs, aiming to provide a favorable environment for healing.…”