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Managing a horse after omeprazole treatment

A successful course of omeprazole will heal a horse of existing ulcers, and there are a number of ways of managing a horse after omeprazole treatment. The unfortunate reality is that gastric ulcers are often recurring, especially if no changes have been made to remove the root causes of the ulcers. Common causes of ulcers include poor diet, stress, and gastric splashing.  Ulcer prone horses will need an ongoing care plan to stop ulcers recurring in future, including:

  • Feeding an ulcer appropriate diet
  • Ulcer management & exercising your horse
  • Medication for ulcer management maintenance
  • Lifestyle changes

Best Diet to Prevent Recurring Ulcers in Horses

In a recent study conducted by Nanna Luthersson, from the private Danish practice Hestedoktoren, the effect of dietary changes were compared after horses had completed a course of omeprazole.

32 horses were treated with omeprazole and paired with another horse that had a similar severity of ulcer.  One horse from each pair was kept on their original diet, while the other was assigned a low-starch, fibre based diet.

The ulcers in all horses improved significantly with the treatment of omeprazole. However, the horses that had no diet change regressed after treatment. In fact, 6 weeks after the omeprazole treatment their ulcers were not too different to when they had started treatment .

The horses who’s diet was changed to the low starch, fibre based diet significantly improved during omeprazole treatment and after the treatment had stopped. This confirmed that dietary changes help to maintain omeprazole’s beneficial effects.

Ulcer Management and Exercise

Gastric splashing occurs when a horse is exercised on an empty stomach. Intense exercise causes stomach acid to splash onto the unprotected area of the stomach. Gastric splashing causes gastric ulcers in horses – however with a few key changes this can be easily managed. 

To prevent this, simply feed your horse prior to exercise (simple chaff or hay will do – and you can offer it while you’re tacking up). The feed will help absorb the ‘splashes’ and the saliva generated will neutralize the acid.

Maintenance medication for horses susceptible to ulcers

Once the course of omeprazole has been completed (and your horse has been slowly weaned off treatment) it’s important not to willy-nilly medicate with omeprazole – as stop starting the medication can cause an increase in stomach acid. Instead, sucralfate can be used to protect your horse from ulcers in periods of stress or lifestyle changes (emerging spring grass, moving barns etc).

Lifestyle changes to prevent recurrence of gastric ulcers

Stress is a very common cause of gastric ulcers. Horses stress easily and release an ulcer causing cortisol which causes ulcers.

The easiest way to reduce stress for horses is to mimic their natural environment as best you can. This includes:

  • Increasing turnout time as much as possible.
  • Reducing stall or stable time as much as possible.
  • Providing companionship. Horses are herd animals, and  become anxious when isolated (even if they can see other horses around). Horses paddocked together are much happier. 

Long term use of omeprazole and using sucralfate for ongoing prevention of ulcers.

The content of this article should not be considered, or used as a substitute for, veterinary medical advice, diagnosis or treatment.

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