I think I have an idea for Ulcers . . .

[CamdenLab]

My understanding is that Gastrogard (GG) and Ulcergard (UG) are omeprazole and buffers to keep the acid in the stomach from eating the omeprazole -- or something of this nature. Which is why a horse shouldn't chew the pills and why giving the pills to them crushed isn't a good idea.

So, couldn't a person put 2.28g of whole generic omeprazole pills with a stomach buffer (Mylanta) into a very large syringe and shoot it down their horse's throat like wormer?

Wouldn't this have the same effect?

Clearly it wouldn't work on a horse who is bad at this type of thing, but a horse who is easy to work with, it should work. Right?

[deltawave]

Merial would very much like you to believe that the answer is an unequivocal NO. :)

I'd very much like to see a head-to-head study of all different types of ulcer medications, but unless industry supports it it's very unlikely to happen, and you can bet Merial has NO interest in even potentially finding out that their special formulation isn't all that special after all. :)

[Gayla]

I think it would work.

[mybeau1999]

You could make millions, or at least save a lot of people a lot of money if you had this researched and proven :]

[War Admiral]

Where does one acquire generic omeprazole?

HRH Avery will gladly volunteer to be a test case. :yes:

[Simkie]

Where does one acquire generic omeprazole?

HRH Avery will gladly volunteer to be a test case. :yes:

You can purchase compounded omeprazole from www.myprecisionpharmacy.com

You can buy people omeprazole from CostCo (but it's expensive.)

You could buy omeprazole from India at www.ponymeds.com

I have the compounded stuff (which did nothing for my horse) and I have been eyeing the tubes of bismuth paste at Mountain Vet. I wonder if mixing the two would work.

[mkevent]

I used to be a pharmaceutical sales rep-not sure if I have the answer. I think bismuth coats the stomach so sometimes other drugs absorbed through the stomach must be timed differently in order to reach optimum levels. Not sure if omeprazole administered concommitently would have proper absorption or not. I know in people, omeprazole should be administered on an empty stomach to reach proper levels. If you want to Google the info, type in the generic names and you get the research articles explaining this.

[deltawave]

Humans and horses are so different that it's hard to extrapolate too much. Humans take it on an empty stomach and the pH is pretty high, because we only secrete acid when there's something in there. Horses secrete acid all the time. This might (MIGHT) be why there are differences, but it might not. More study needed. ;)

[CamdenLab]

Where does one acquire generic omeprazole?

Wal-Mart, Target and CostCo. I did a price comparison. Basically, if you pay between $18 and $20 for a package of generic omeprazole (42 count, 20mg) you're right in there cost-wise. I asked my mother in law who is a nurse if she could get me a big box of generic omeprazole from work and she said that it would cost the same as the stores above through Kaiser.

For my horse, to equal the amount of omeprazole in GastoGard, it's 11 20mg pills. Generic Mylanta is a bit spendy at about $2.50 per bottle which will last 2-3 doses. I think mixing powdered U-Gard with water to make a paste or liquid would be more cost-effective, but I'm going to try it both ways. I know my horse loves the flavor of U-Gard, so this may be best. I may try a soaked alfalfa pellet/U-Gard/aloe juice paste. We'll see . . .

I haven't found an oral syringe with an opening large enough to fit the pills through with exception of a cattle wormer called Safe Guard (and I'm not positive they would fit). I'm not ready to spend $30 on the wormer, toss it down the drain and clean the syringe yet. So, I'm heading to a more rural feed store later today to check out their stock of oral syringes.

This method will cost about $5 per day vs. $30 for Gasto Gard, so I figure it's worth a shot. I'll give it two weeks and if nothing happens, I guess I'll have to bite the bullet.

[Simkie]

For my horse, to equal the amount of omeprazole in GastoGard, it's 11 20mg pills. Generic Mylanta is a bit spendy at about $2.50 per bottle which will last 2-3 doses. I think mixing powdered U-Gard with water to make a paste or liquid would be more cost-effective, but I'm going to try it both ways. I know my horse loves the flavor of U-Gard, so this may be best. I may try a soaked alfalfa pellet/U-Gard/aloe juice paste. We'll see . . .


You're off by a factor of 10.

1000 mg equals one gram, NOT 100.

To get 2.28 grams of omeprazole, you would need 114 20 mg tabs.

There is a conversion calculator built right into google. Perhaps you should make yourself familiar with it ;)

[Auventera Two]

Yes, but how do you know that Mylanta is the type of buffer that gets the drug past the stomach? Mylanta is an acid buffer. But that doesn't mean that you would know how much Mylanta to use to be effective, or if it would even work. The enteric coating added to ompeprazole thoroughly protects the drug from ALL acid until it reaches the small intestine. The coating breaks down easily in a more neutral environment, but does not break down in an acidic environment.

I'd say you're taking a HUGE risk with no science to back it up by trying to mix Mylanta, and Omeprazole.

Mylanta is an acid buffer but it cannot possibly coat the ENTIRE horse's stomach and protect the drug from every little drop of acid it might encounter while in the stomach.

Acid buffers are generally only effective for 1-2 hours. When my horse was scoped, I gave her 1 baby carrot at 7.am. When she was scoped at 10 a.m., that little carrot was STILL in her stomach! So if your acid buffer runs out, and the Omeprazole is still in the stomach, then what?

The vet told me you'd have to administer roughly 120cc of Mylanta per dose to adequately coat the stomach. Don't know how you plan to squirt 2 huge syringes of Mylanta down your horse's throat every day. It's going to be all over you, all over the stall, the horse, the wall. Good luck with that.....

If you were going to use something to try this, I'd at least use a highly concentrated equine acid buffer like Pro-CMC. ;)

[deltawave]

Are you saying Merial's product is "enteric coated"? That is confusing to me--how can a paste be enteric coated? :confused:

[rcloisonne]

Are you saying Merial's product is "enteric coated"? That is confusing to me--how can a paste be enteric coated? :confused:
I think she was referring to Prilosec tablets (which are enteric coated).

[LarkspurCO]

Well I think it's a good idea, 'cause I thought of it first.:lol:

I recently bought U-Gard and Ponymeds.com pills with the intention of mixing the two so the omeprazole would have a better chance of getting through the stomach acids. But the horse refused to eat the feed with the U-Gard in it, so I just crushed the omeprazole pills into her feed. I would have syringed in into her mouth, but she was getting Banamine paste and was a huge pain in the butt for that, and I didn't have the energy to fight her.

I had given her two tubes of GastroGard to start, then continued with the pills for about two weeks, and her ulcer symptoms resolved.

I wonder how hard it would be for a chemist to analyize a tube of GastroGard and estimate the buffering capacity? Wonder if you could then approximate the buffering capacity of GastroGard using another antacid product?

[Simkie]

I wonder how hard it would be for a chemist to analyize a tube of GastroGard and estimate the buffering capacity? Wonder if you could then approximate the buffering capacity of GastroGard using another antacid product?

I think this would probably be illegal and in direct violation of the patent Merial has? Perhaps someone who knows something about patent law could weigh in.

[Auventera Two]

Are you saying Merial's product is "enteric coated"? That is confusing to me--how can a paste be enteric coated? :confused:

YES, Gastrogard is enteric coated. The paste is full of tiny capsules of the medication, Omeprazole. Each tiny capsule is enteric coated. ;) The "paste" itself is only a carrier for the tiny beads, which contain the medication. Much like the time released sudafed, tylenol, claritin, etc. You swallow one big capsule that is full of many tiny beads, and the tiny beads inside are each coated differently so that some dissolve in 1 hour, some in 4 hours, some in 8 hours, and so forth....

This was explained in detail to me by a Merial rep.

I think another thing you guys aren't considering is that enteric coating isn't just an "acid buffer." It's a solid BARRIER like wax or plastic that doesn't break down until it is in the small intestine. So you're talking about buffering the acid, but enteric coatings provide a physical barrier that completely encapsulates the drug while in the stomach. And those are two very different things.

And not to mention the data that shows generic compounded omeprazole to have little to no guarantee that the pills contain as much Omeprazole as the labeling states. (I've linked to external sites, so please do a search on this forum and find those threads)

Yeah, 1200 bucks was a chunk for me to plop down, but I couldn't imagine taking chances on cheap products with little regulation and no guarantee for results. People will plunk down 1200 bucks, or 2400 bucks on a bone scan, chiro and message therapy, special shoeing, etc. without a blink, but they have such a problem paying for Gastrogard.

Seiously, if someone figures out a way to circumvent $30/tube that is safe, reliable, and guaranteed, I'm all over it. But until then I won't take the risk.

[Guilherme]

I think this would probably be illegal and in direct violation of the patent Merial has? Perhaps someone who knows something about patent law could weigh in.

I don't think analysis would be a problem. That's no more than verifying the "label."

Any attempt to alter and then use or sell the product would likely be an infringement.

Our stallion had an ulcer episode last spring. We used the GastroGuard per label directions and had a good result. He is now ulcer free.

"Home remedies" put the person using them in the position of a "veterinary medical researcher." That means they are accepting all the risks that go along with their "experiment." Will it be effective? Will it be safe? These questions are generally answered during professional testing. Will it even be economical? These are ALL important questions. Personally, I'm probably not well qualified to answer them. Even my MD wife would be out of her areas of expertise in this. Being as we are both modestly "risk averse" we don't screw around with nostrums and 'Net recipies for equine (or humine) medications.

G.

[deltawave]

Thanks for the explanation, it does make sense now. But there's no reason why other carriers couldn't be effective. When the stuff comes off patent, the price will drop by 80% or so, which is good news, but unless Merial comes up with a "me too" version that's "new and improved" then studies on the drug will probably come to a grinding halt in horses, which is the down side.

There's also no earthly reason why the stuff couldn't be given IV. And I wonder if it would be effective given rectally or in an orally-absorbed form? Hmmm.

[bugsynskeeter]

There is currently research on the effectiveness of IV omeprazole. Trust me -if there was a IV version of omeprazole, the hospital I work at would be all over it.

The only ulcer medication in approved IV form is Ranitidine, to my knowledge.

[LarkspurCO]

I didn't know the GastroGard had tiny little "pills" -- interesting.

In my opinion, unless the ulcers are life-threatening and/or resistant to a less expensive treatment, I'll always try the less expensive option first. After all, it's well documented that ulcers heal on their own without medical intervention.

[Auventera Two]

There is currently research on the effectiveness of IV omeprazole. Trust me -if there was a IV version of omeprazole, the hospital I work at would be all over it.

The only ulcer medication in approved IV form is Ranitidine, to my knowledge.

:confused: Omeprazole was available intravenously before there was Gastrogard. I don't have time to dig up the articles now, but I found several old articles that people wrote telling their account of their horse being cured of ulcers with IV Omeprazole before the paste was made available.

http://www.thehorse.com/ViewArticle.aspx?ID=11562
http://www.thehorse.com/ViewArticle.aspx?ID=7635

It's not widely used because it is not as practical, or cost effective as oral medication.

[cosmos mom]

Wal-Mart, Target and CostCo. I did a price comparison. Basically, if you pay between $18 and $20 for a package of generic omeprazole (42 count, 20mg) you're right in there cost-wise. I asked my mother in law who is a nurse if she could get me a big box of generic omeprazole from work and she said that it would cost the same as the stores above through Kaiser.

For my horse, to equal the amount of omeprazole in GastoGard, it's 11 20mg pills. Generic Mylanta is a bit spendy at about $2.50 per bottle which will last 2-3 doses. I think mixing powdered U-Gard with water to make a paste or liquid would be more cost-effective, but I'm going to try it both ways. I know my horse loves the flavor of U-Gard, so this may be best. I may try a soaked alfalfa pellet/U-Gard/aloe juice paste. We'll see . . .

I haven't found an oral syringe with an opening large enough to fit the pills through with exception of a cattle wormer called Safe Guard (and I'm not positive they would fit). I'm not ready to spend $30 on the wormer, toss it down the drain and clean the syringe yet. So, I'm heading to a more rural feed store later today to check out their stock of oral syringes.

This method will cost about $5 per day vs. $30 for Gasto Gard, so I figure it's worth a shot. I'll give it two weeks and if nothing happens, I guess I'll have to bite the bullet.
YOu could probably get a red rubber rectal tube at a medical supply company and cut the end off of it- the tubes fit right onto the end of a 60 ml dose syringe- load the pills into the tube and Mylanta into the syringe and push them through to the back of the horses mouth. I've done this for dogs and it works fine.

[rcloisonne]

YOu could probably get a red rubber rectal tube at a medical supply company and cut the end off of it- the tubes fit right onto the end of a 60 ml dose syringe- load the pills into the tube and Mylanta into the syringe and push them through to the back of the horses mouth. I've done this for dogs and it works fine.
You could (if those tablets would fit though the end of a 60ml catheter tipped syringe, which I doubt) BUT did you miss the part where the amount proposed by the OP would be 10 TIMES too weak? 114 Prilosec tabs per day, no matter where they're purchased, would be WAY more expensive to use than a $30 tube of Gastrogard.

:sigh: It never ends...

[cosmos mom]

You could (if those tablets would fit though the end of a 60ml catheter tipped syringe, which I doubt) BUT did you miss the part where the amount proposed by the OP would be 10 TIMES too weak? 114 Prilosec tabs per day, no matter where they're purchased, would be WAY more expensive to use than a $30 tube of Gastrogard.

:sigh: It never ends...


You wouldn't have to get them into the syringe, just the tube. the mylanta would push them out - but I missed the factor of 10 issue, so it's a moot point. I guess microencapsulation formulations are pretty tricky to make, so the drug companies can charge at least what the human formulation would cost. Probably best to just pay for the horse version. Nothing else seems to work. :sigh:

[deltawave]

Why do horses need 100 times the human dose of omeprazole, I wonder?

[Simkie]

Why do horses need 100 times the human dose of omeprazole, I wonder?

It looks like the human dose is about 0.13 mg/lb (dosage is usually 20 mg once per day...so for a 150 lb person, that would be the above.)

Dosage for equine is 1.8 mg/lb. So that's really only about 10 times the human dose per pound.

However, there is a note regarding Pathological Hypersecretory Conditions in people (which, perhaps, could be analogous to equines, since equines secrete acid continuously?) that says dosage for this this condition starts at 60 mg once per day and goes up to 120 mg three times per day, which is actually above the equine dose (per pound.)

Prilosec info (http://www.rxlist.com/prilosec-drug.htm)
Gastrogard info (http://www.drugs.com/vet/gastrogard.html)

[deltawave]

The difference between the horse dose and the human dose is a fifteen-fold difference. (0.13mg/lb and 1.8mg/lb)--that is the part that confuses me. Horses need fifteen times the drug, pound for pound, that humans do? That is very unusual. Maybe it's because of the continuous acid secretion. Very curious.

[cosmos mom]

The difference between the horse dose and the human dose is a fifteen-fold difference. (0.13mg/lb and 1.8mg/lb)--that is the part that confuses me. Horses need fifteen times the drug, pound for pound, that humans do? That is very unusual. Maybe it's because of the continuous acid secretion. Very curious.

That's probably it. Sometimes you can't do allometric scaling based on body weight for the dose calculation because the physiology is different. It's also possible that the microencapsulation paste formulation for horses causes the increase in dose.

[deltawave]

I think it's a vast, big-pharma conspiracy. :winkgrin:

[Simkie]

The difference between the horse dose and the human dose is a fifteen-fold difference. (0.13mg/lb and 1.8mg/lb)--that is the part that confuses me. Horses need fifteen times the drug, pound for pound, that humans do? That is very unusual. Maybe it's because of the continuous acid secretion. Very curious.

Yes, but did you look at the dosing instructions for pathological hypersecretory conditions? Dosage for those is from 0.4 mg/kg to 2.4 mg/lb.

[rcloisonne]

Sometimes you can't do allometric scaling based on body weight for the dose calculation because the physiology is different.
Absolutely. Take firocoxib (Previcox/Equioxx) as another example. The effective dose for a dog is 2.27 mg/lb while for a horse it's much lower, 0.045 mg/lb. That's a huge difference.

[deltawave]

Does Zollinger-Ellison (hypersecretory acid production out of control) exist in horses?

[Eventer55]

Can someone explain to Merial that if they lower the price MORE people will buy it and they will make MORE MONEY. I know if the price was lower, I would buy a ton of it and Merial would not lose any money. . . I'm stingy at 29.99 a tube.


Did they all fail math??? More clients means more money.:eek::eek::eek::eek::eek::eek::eek:
I mean really they would still have the patent and yet make $$$$. I'm so pissed at them that when the patent expires, I hope I never hear of them again.

[cosmos mom]

I guess since they are the only game in town, they don't have to. The price is probably similar to the human medication (x15). :sigh:

[BornToRide]

My understanding is that Gastrogard (GG) and Ulcergard (UG) are omeprazole and buffers to keep the acid in the stomach from eating the omeprazole -- or something of this nature. Which is why a horse shouldn't chew the pills and why giving the pills to them crushed isn't a good idea.

So, couldn't a person put 2.28g of whole generic omeprazole pills with a stomach buffer (Mylanta) into a very large syringe and shoot it down their horse's throat like wormer?

Wouldn't this have the same effect?

Clearly it wouldn't work on a horse who is bad at this type of thing, but a horse who is easy to work with, it should work. Right?
I like your thinking! :yes: Personally I think the Gastroguard manufacturer is bleeding horse owners dry for money. There's no way this stuff needs to be THAT expensive! :no:

[RedMare01]

So just when does their patent expire?

Caitlin

[Simkie]

So just when does their patent expire?

Caitlin

2012

:( :sigh:

[deltawave]

I wonder why the companies that make the "me too" proton-pump inhibitors don't make their own equine version and undercut Merial. Somebody ought to suggest it to them. :D A little competition is good for the cost of drugs. :yes:

[cosmos mom]

Probably because veterinary meds are not moneymakers relatively speaking. Pfizer and Merck both partner in Merial. I'm not sure which companies have proton pump inhipitors, but they likely don't have enough of the veterinary market to bother.

[CamdenLab]

I screwed up my math. Big-time.

I went to three different feed stores looking for oral syringes with wide enough outlets to fit the pills. No luck.

Sooooo . . . we find out today if we get a holiday bonus and if so, I'll use that for Ulcergard. If we do not have a holiday bonus, I'm going to go the ponymeds or compounded route because I won't have the money or the credit to purchase the "real deal."

That's the bad news.

The good news is that over the past several days, it's been pretty dry here and in the high 40s at night and I've just been leaving my horse outside blanketed with a constant pile of hay. He doesn't have any type of shelter in his small field. His behavior has vastly improved. I asked the barn managers if we could switch his field to one with a run-in and have him be an "outdoor horse." There has to be some switcharoo, asking other people to move, etc. so it's not guaranteed, but if it works, I think this is what causes his ulcers to flare-up. Which would make sense considering that in the summer when he is outside 24/7 he is pretty much an angel. Come fall when I stall him at night, he becomes a nightmare. I was thinking it had something to do with the weather or his longer coat.

[hollyhorse2000]

For the most part, horses on 24/7 turnout on good pasture do not get ulcers or horses with ulcers when turned out like this will heal. So yes, they can heal on their own -- if you have that kind of set-up. In the absence of above, the only thing proven to heal ulcers is ulcergard/gastrogard. Anecdotal evidence says various things have worked for different people in different horses at different times, but to get what has proven to work, you have to spring for the UG/GG. There is a small study that says corn oil can be effective. There is also rationale for using alfalfa to affect stomach pH. I can't do 24/7 turnout or use alfalfa, so I'm on the GG/UG route and it's doing the job.

[CamdenLab]

For the most part, horses on 24/7 turnout on good pasture do not get ulcers or horses with ulcers when turned out like this will heal. So yes, they can heal on their own -- if you have that kind of set-up. In the absence of above, the only thing proven to heal ulcers is ulcergard/gastrogard. Anecdotal evidence says various things have worked for different people in different horses at different times, but to get what has proven to work, you have to spring for the UG/GG. There is a small study that says corn oil can be effective. There is also rationale for using alfalfa to affect stomach pH. I can't do 24/7 turnout or use alfalfa, so I'm on the GG/UG route and it's doing the job.

Well, not a lot of grass out there right now. Free-fed hay and it is 60% alfalfa. When stalled he has the same hay, again, free-fed. So, the only difference, really is outside vs. inside.

[Simkie]

Well, not a lot of grass out there right now. Free-fed hay and it is 60% alfalfa. When stalled he has the same hay, again, free-fed. So, the only difference, really is outside vs. inside.

Keeping my horse outside in a run versus in a box stall in the barn makes a HUGE HUGE difference in her. To the point where it is honestly not humane to keep her in the barn. She gets very upset about being in and spends all her time with her head out her feed door, looking down the barn aisle and out the door at the end.

It is a bit of a pain in the ass keeping a clipped horse outside in the winter, but worth it to see her not miserable.

[CamdenLab]

Keeping my horse outside in a run versus in a box stall in the barn makes a HUGE HUGE difference in her. To the point where it is honestly not humane to keep her in the barn. She gets very upset about being in and spends all her time with her head out her feed door, looking down the barn aisle and out the door at the end.

It is a bit of a pain in the ass keeping a clipped horse outside in the winter, but worth it to see her not miserable.

The funny thing about Brig is that he actually likes to be stalled. Well, except he sucks wind as much as possible. He might be bored, but he's never looked miserable or acted like he was being tortured. I always thought he liked being stalled. He loves shavings, I know that! LOL

[BornToRide]

The funny thing about Brig is that he actually likes to be stalled. Well, except he sucks wind as much as possible
I think most really do this to relieve the discomfort from the ulcers

[deltawave]

I have one who'd rather be in a stall 20 hours a day, one who will only go in a stall to eat, and one who's happy either way. They get to choose--the stalls are open to the paddock--and this set of traits has not changed one iota in 2+ years having them here at home.