Omeprazole with low-dosage Bute-UPDATE P2 : )

[2DogsFarm]

My Old Guy (27) is getting ouchy RH.
Not every day, but enough so that I've been giving him 1g Bute daily for about a month and that seems to be taking care of it.

Vet agrees with me it may be arthritic changes from the after-effects of the World's Worst Abcess he had in that foot 2 years ago.
He was here yesterday for Fall vaccinations & checkup.
He pronounced both horses in great shape, but suggested starting Omeprazole as a proactive means of avoiding any gastric upset from the Bute.

Does anyone here have an oldster on that combo?
Side effects?
Benefits?

Plus my horse is verrrrrrrrrry picky about changes to his feed.
It took him a couple weeks to decide the vanilla-flavored Bute powder topfed on his grain was NOT poison.

My vet investigated a suspension I could syringe into him and the compounding pharmacy he uses told him they had just discontinued an apple-flavored one. Drat.
He offered to check out another pharmacy, so if anyone knows of one that has this suspension, or is willing to flavor mixtures, please let me know.

TIA

[Addison]

ulcer/gastro gard is a very palatable way of giving omeprazole.

[JB]

You can always just do ranitidine if you can feed that at least twice a day - much cheaper, and often good enough insurance.

[Gry2Yng]

ulcer/gastro gard is a very palatable way of giving omeprazole.

Agreed. My guys don't mind it at all.

Got a sample of U-7 powder, which is a top dress. My moderately picky TB cleans it up in sweet feed.

[TrotTrotPumpkn]

If it were me I would do a quarter tube Ulcergard every other day (or is your horse on bute forever?). Otherwise I'd do the ranitidine 2x a day.

[2DogsFarm]

Thanks all -
I'm thinking he may very well be on the low-dose Bute for the rest of his life.
Vet agreed, and phoned in a script for the powdered Bute good for 1 year of refills.
The bute is very inexpensive - about $20 inc. shipping for about a month's worth.

Since the gastric buffer will most likely be lifelong as well, I'd like to keep cost down.

Gry2Yng: where did you get your sample? Is U-7 Omeprazole?

I'll Google ranitidine also, but unless it is totally flavorless or masked with something sweet, I'm betting he won't eat it top-dressed.
If possible I'd like to avoid having to dose him from a syringe daily.
I feed whole oats with supplements mixed in - so far Biotin crumbles pass muster along with the bute powder, MSM & Red Cell.

[Gry2Yng]

U-7 is not Omneprozole (excuse the spelling). Different shows and tack shops have given me samples over the course of the summer. Just moved to a new barn with my boys so I have been given them some in deference to the stress of adjusting to a new home.

I use Gastroguard in different ways at different times for different circumstances, but have never had any problem with dosing it. Usually they eat right away after getting it, which is not true with bute - at least for mine.

[lesbrill54]

NSAIDs cause ulcers thru a different pathway than that that protected by omeprozole, so if you're not having problems wgastrically i wouldn't waste the money on gastroguard. Also, compounded drugs are a really bad idea- you dont know whats in them at all. Ask your vet if he/she has read any of the AAEP info warning about compounded bute specifically. Remember those poloponies that all died after getting compounded drugs. For horse that wont eat bute, dosing them with dissolved bute with molasses or applesauce(mixed up new every time because sugar can degrade the drugs) works. There is an FDA aprroved bute powder if its too much trouble for you to dissolve the pills.

[2DogsFarm]

For horse that wont eat bute, dosing them with dissolved bute with molasses or applesauce(mixed up new every time because sugar can degrade the drugs) works. There is an FDA aprroved bute powder if its too much trouble for you to dissolve the pills.

lesbrill: are you a DVM? <not trying for snark, I am curious.
My vet's suggestion was to be proactive and treat with Omeprazole before he showed any symptom of gastric upset.
He is a very up-to-date clinician - takes refresher courses annually and treats conservatively.
He has treated this horse for 13 of the 20 years I've owned him.

Allow me to introduce my horse:
All of your "approved" methods have been tried - plus flavored Jello, pureed babyfood (carrot & apple), pancake syrup, hiding powder inside fresh, hollowed-out apples - all failed his Taste Test.

Syringing dissolved tablets mixed w/corn syrup had middling success, but why fight him? I swear he can smell the syringe hidden behind my back as I approach humming Whistle a Happy Tune...

The powdered Bute I am using is compunded by Wickliffe's in KY - thanks to a suggestion from a COTHer.
They will flavor with molasses, vanilla or orange.

Crushing pills is not my problem. Disguising the taste is.
Have you ever tasted Bute?
Not nice : P
As long as he'll eat the flavored powder top-dressed on his grain that's one less battle in keeping him pain-free.

[TrotTrotPumpkn]

What about keeping it simple and giving him some alfalfa before he gets his grain and meds? Increases saliva which protects the stomach (Texas A&M ?? study--try The Horse.com).

My friend's horse was on daily low dose bute forever and never had a problem--maybe you will be so lucky!

I like the look of U-7 by Finish line if you want to do a supplement instead of a "medicine" per se.

Good luck.

[Schiffon]

NSAIDs cause ulcers thru a different pathway than that that protected by omeprozole, so if you're not having problems wgastrically i wouldn't waste the money on gastroguard.

Clinical trials in humans contradict your theory. Proton pump inhibitors like omeprazole are very effective at preventing NSAID-induced ulcers and are very commonly used for this purpose. H-2 blockers, like ranitidine, on the other hand, are ineffective.

[rcloisonne]

Clinical trials in humans contradict your theory. Proton pump inhibitors like omeprazole are very effective at preventing NSAID-induced ulcers and are very commonly used for this purpose. H-2 blockers, like ranitidine, on the other hand, are ineffective.
While the above is true, long term use of bute has been implicated as a significant cause of right dorsal colitis in horses. Typical ulcer meds, including omeprazole, will not prevent that.

If I were the OP, I'd want a more definitive diagnosis of why the the horse's foot is so sore before condeming him to life-long use of a drug with many potential and serious side-effects. A long ago abscess without hard evidence (basically a guess) wouldn't cut it for me. Just throwing bute at the problem is :rolleyes:.

[Gry2Yng]

NSAIDs cause ulcers thru a different pathway than that that protected by omeprozole, so if you're not having problems wgastrically i wouldn't waste the money on gastroguard. Also, compounded drugs are a really bad idea- you dont know whats in them at all. Ask your vet if he/she has read any of the AAEP info warning about compounded bute specifically. Remember those poloponies that all died after getting compounded drugs. For horse that wont eat bute, dosing them with dissolved bute with molasses or applesauce(mixed up new every time because sugar can degrade the drugs) works. There is an FDA aprroved bute powder if its too much trouble for you to dissolve the pills.

For goodness sake, one very public episode does not make compounded drugs bad. Have you stopped flying in airplanes, eating lettuce, tomatoes?

Omeprozole is one drug that has data to back it up.

The horse is 27 years old. I don't blame the OP if she doesn't want to spend money on the diagnostics. She is a top shelf owner for making the horse comfortable as he probably has a variety of ailments causing pain that will be reduced by bute (what is the likelihood that he has arthritis somewhere in his body) and she is willing to spend some cash on the Omep to give him some stomach protection.

[lizajane09]

For goodness sake, one very public episode does not make compounded drugs bad. Have you stopped flying in airplanes, eating lettuce, tomatoes?

Omeprozole is one drug that has data to back it up.


While I'll agree with you on the first part, they've actually done studies comparing compounded omeprazole to Gastrogard and found that the compounded omeprazole is much less effective - Gastrogard contains a component that protects the omeprazole from the digestive enzymes in the stomach, so that it can reach the small intestine, be absorbed by the horse, and do its job. Compounded omeprazole lacks this component, and therefore is mostly destroyed in the stomach. I'm pretty sure the study was done by Dr. Orsini of UPenn, but I'm not 100% sure. There is a lot of data to back up Gastrogard (and Ulcergard), but not so much the compounded omeprazole. Which is a shame, since it's so much less expensive :lol:!

[Gry2Yng]

Also, compounded drugs are a really bad idea- you dont know whats in them at all. Ask your vet if he/she has read any of the AAEP info warning about compounded bute specifically. Remember those poloponies that all died after getting compounded drugs.

See quote above. You don't say "compounded drugs are less effective", you say don't use them because a compounding pharmacy killed the polo ponies. Name brand Omen has studies, that's what I use. I use name brand Adaq and Legend. I don't worry so much about compounded bute that has apple flavor added. I have used it. I prefer paste. I have used compounded chloramphen. In no instance would I worry about the "polo pony" effect. Could happen, but I could also kill my horses with a bottle of Adaq that was improperly prepared.

You are working two trains of thought here.

[lizajane09]

See quote above. You don't say "compounded drugs are less effective", you say don't use them because a compounding pharmacy killed the polo ponies. Name brand Omen has studies, that's what I use. I use name brand Adaq and Legend. I don't worry so much about compounded bute that has apple flavor added. I have used it. I prefer paste. I have used compounded chloramphen. In no instance would I worry about the "polo pony" effect. Could happen, but I could also kill my horses with a bottle of Adaq that was improperly prepared.

You are working two trains of thought here.


Wrong person - I (lizajane09) posted about the fact that compounded omeprazole is less effective; lesbrill posted about the polo ponies. I agreed with you on that part (that one well-publicized, major problem does not mean something is 100% dangerous, otherwise we'd never use any drugs/go anywhere/etc etc).

[Gry2Yng]

Wrong person - I (lizajane09) posted about the fact that compounded omeprazole is less effective; lesbrill posted about the polo ponies. I agreed with you on that part (that one well-publicized, major problem does not mean something is 100% dangerous, otherwise we'd never use any drugs/go anywhere/etc etc).

Wow! So sorry! That would explain the two trains of thought! Two people. Agree 100% compounded Omep does not have the studies to back it up. Same reason I use compounded "adaq" on the young ones without problems. It is cheep, I can double the dose and I am willing to take a chance that it is "helping". The tried and true campaigners get the "real thing". Again, sorry.

[lizajane09]

Again, sorry.

Not a problem :).

I, for one, would like to see more studies like Dr. Orsini's done - comparing the brand name to the alternatives (generics, compounds, etc) so that we know whether they're doing the same job or not.

Sorry OP... I'm starting to wander away from the point of your original post. My intention with mentioning that study, though, was that if you do choose to put your horse on omeprazole, know the facts behind the compounded drug versus the Gastrogard so that you can make the decision that will help your horse the most. I know Gastrogard is PAINFULLY expensive, but even if the compounded omeprazole is less expensive there's no point in giving it if it won't get the job done.

[FatPalomino]

FWIW I used compounded Omperazole- as well as Gastroguard- and both worked great. The compounded stuff was about 1/3 of the price ad flavored well :)

On the other hand, my vet has mentioned using extreme caution with compounding companies.

[tBHj]

Thanks all -
I'm thinking he may very well be on the low-dose Bute for the rest of his life.
Vet agreed, and phoned in a script for the powdered Bute good for 1 year of refills.
The bute is very inexpensive - about $20 inc. shipping for about a month's worth.

Since the gastric buffer will most likely be lifelong as well, I'd like to keep cost down.

Gry2Yng: where did you get your sample? Is U-7 Omeprazole?

I'll Google ranitidine also, but unless it is totally flavorless or masked with something sweet, I'm betting he won't eat it top-dressed.
If possible I'd like to avoid having to dose him from a syringe daily.
I feed whole oats with supplements mixed in - so far Biotin crumbles pass muster along with the bute powder, MSM & Red Cell.

Do you feed pro-biotics?

[2DogsFarm]

The horse is 27 years old. I don't blame the OP if she doesn't want to spend money on the diagnostics. She is a top shelf owner for making the horse comfortable as he probably has a variety of ailments causing pain that will be reduced by bute (what is the likelihood that he has arthritis somewhere in his body) and she is willing to spend some cash on the Omep to give him some stomach protection.

Um..thanks for the left-handed compliment?
Actually aside from this very recent & minor ouchiness this horse is in A-1 shape for his age. Not a sign of arthritic changes aside from the RH.
For a TB he should be in the Guiness Book for this alone.

For the poster who doubted the abcess caused this: this abcess began in heel tissue (bruising there showed on radiograph) then tracked to the toe and he ended up sloughing off his entire sole.
I spent 8 months taking care of this injury & believing it would be the end of his useful life.
Wrong - he came back 100%, good enough to participate in a 3-day intensive dressage clinic this May.

kitsunegari: no probiotics fed & I asked the vet about adding them.
His advice was to go for the gastric buffer instead.
I am still researching which way to go as horse has no signs of any problem after a month on the bute. That's one reason I posted here.

Yikes! I didn't mean to start a Compounding vs No Compunding war

[Addison]

Gastrogard/Ulcergard are not considered buffers. A buffer may be helpful once a problem has started but the omeprazole will help prevent one. I personally would not wait for a problem to begin and it is most likely just a matter of time.

There have been some good suggestions here such as feeding some alfalfa which acts a s a buffer due to its high calcium content. I would not rely on probios to prevent ulcers. They will help the gut in general when accompanied by a low starch diet but they will not work as effectivley as omeprazole.

Keep in mind that NSAIDs decrease the blood supply to the mucous lining of the gut, decreases the production of mucous and increases HCL production. The increase in HCL production is what irritates the gut and may lead to ulcers. Omeprazole will control the acid production and not just treat the symptoms.

Neighlox, Pro CMC, U-Gard and SmartGut are a few examples of actual buffers and are generally considered a short term "treatment" and not a maintenance supplement.

Good luck with your horse.

[Gry2Yng]

Um..thanks for the left-handed compliment?


Sorry, that wasn't my intent. I guess I am just having a tough day communicating - Mercury anyone?. I was only trying to say that you have already had the vet out and been give a course of treatment. I have a 27 year old and an 18 year old. One retired, the other nearing that day. I won't do anything invasive or painful as a diagnostic for either of them. I will spend all the money that makes sense, but I draw the line at laying them down for surgeries (colic surgery excepted) or myelograms, etc. I probably wouldn't MRI the foot of MY 27 year old, I would do a bone scan on the 18 year old, if it came to it. All was trying to say was that your horse has a great quality of life and more diagnostics probably won't make him a happier or healthier pasture puff. Sorry again. Twice on one thread, yikes. Time to shut up.

[lesbrill54]

Well,on compunde drugs-bute specifically- why not check on what AAEP says about their legality . As for the efficacy, the point is that they're untested in any way unless they are made with FDA approved ingredients and most are not. No, I'mnot a vet- my best frien is and has been seriously concerned with this issue for a long time. If the vets will not educate the clients, maybe the clients need to educate the vets.I'll see if i can get her to post and explain better than i'm obviously doing. But why not ask your own vet on the pros{$} and cons of using compounded drugs?

[2DogsFarm]

Sorry, that wasn't my intent. I guess I am just having a tough day communicating - Mercury anyone?. I was only trying to say that you have already had the vet out and been give a course of treatment.

Sorry for taking your comment the wrong way - gee it sure is hard getting content out of a typed comment, isn't it?
So thanks again & this time I mean it!
I've spent 20 years looking after my guy & totally agree with you that there is a line that gets drawn on diagnostic procedures.

Unfortunately the pharmacist I work for is out until Monday so I can't get numbers from him on getting Omeprazole at cost.

Alfalfa, huh?
Would adding cubed alfalfa to his feed work?
I've used that before as an added forage in cold weather.

Addison: thanks for clearing up the buffer/preventative question.
I certainly do NOT want to wait until my Old Guy gets an ulcer, but would much rather start him on something to prevent that happening ASAP.

[Gry2Yng]

Sorry for taking your comment the wrong way - gee it sure is hard getting content out of a typed comment, isn't it?
:lol::lol:

No worries. :) Some days it just depends on the mood we sit down at the computer with. The stress of caring for our "more mature" horses doesn't help. :no: My 27 yo is loaded with melanomas, then have invaded his throat. It is one day at a time with him and every day the joy of life is still in his eyes. He is not in pain and living the vita dolce until then. :D

[Gry2Yng]

Well,on compunde drugs-bute specifically- why not check on what AAEP says about their legality . As for the efficacy, the point is that they're untested in any way unless they are made with FDA approved ingredients and most are not. No, I'mnot a vet- my best frien is and has been seriously concerned with this issue for a long time. If the vets will not educate the clients, maybe the clients need to educate the vets.I'll see if i can get her to post and explain better than i'm obviously doing. But why not ask your own vet on the pros{$} and cons of using compounded drugs?

You are right. I should check it out. Do you have a link?

[2DogsFarm]

Since the pharmacist I work for is off until Monday I called the vet's office & they gave my info to the compounding pharmacy who called me with good news.
They can get me a sample 2wk supply of apple-flavored Omeprazole powder very reasonably priced & shipped to me UPS @ no added cost.

I am hoping to get it before we leave tomorrow, but realistically it probably won't get here until we get back on Monday.

So at a cost of about $2/day I can get my Old Guy the protection he needs.
After 20 years of service it's the least I can do.
I wonder if they can compound something for his crankiness*.....

*not pain-related, he has been crabby - mostly about grooming - since I got him as a 7yo

[2DogsFarm]

:lol::lol:

No worries. :) Some days it just depends on the mood we sit down at the computer with. The stress of caring for our "more mature" horses doesn't help. :no: My 27 yo is loaded with melanomas, then have invaded his throat. It is one day at a time with him and every day the joy of life is still in his eyes. He is not in pain and living the vita dolce until then. :D

Oh no!
So sorry to hear of your oldster's problem.
Hoping for many more years for you both.
The day Vern can no longer enjoy his food - the Major Fun of his day - is the day I'll make "the" decision for him.
He is a horse who never nickered to me the whole 15 years I had him boarded - now he greets me at every mealtime, sometimes with an edge if I'm running late.
They are funny old guys, aren't they?

[Gry2Yng]

Oh no!
So sorry to hear of your oldster's problem.
Hoping for many more years for you both.
The day Vern can no longer enjoy his food - the Major Fun of his day - is the day I'll make "the" decision for him.
He is a horse who never nickered to me the whole 15 years I had him boarded - now he greets me at every mealtime, sometimes with an edge if I'm running late.
They are funny old guys, aren't they?


He gets "soup" twice a day and slurps it up. Grass and hay are still easy enough for him. I think since 2007 winters have been a worry as I don't know if he can keep enough calories without the grass. We shall see. Best of luck to you.