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long term omeprazole usage = magnesium deficiency?

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  • #21
    Again, I would take that whole article with a huge grain of salt. Magnesium chloride is fine.

    The ariticle is without bibliography, written 10 years ago by a homeopathic vet who appears to no longer practice anything but "holistic" medicine. I would not lean heavily on the information contained in that paper. She claims the small intestine is "short", that acid secretion is dependent on food intake, that blocking acid LOWERS pH, and many other inconsistencies which makes me wonder if she was reading (with poor comprehension) a HUMAN physiology book when she wrote that. Her statement that a pH > 4 causes digestive enzymes to stop functioning in the small intestine is flat out wrong.

    I'll leave it at that. This is a bad paper.
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    • #22
      DW, I can see your point and I had missed where she said the SI is short, it may be small in volume, but it sure is long, a gross mistake.

      She may well have been the wrong reference to bring to this discussion and it sure loses credibility to some of the things she brings up that have imo a reason for concern.
      She's is not the only one however to wonder about the same question, but I do feel like it's something brought up mostly by holistic vets (or nutraceutical co's that have a $ interest, like Succeed)
      Kerry Ridgway f.ex., I'd like to think his anotomy knowledge is a little better, lol.
      Many veterinarians, myself included, feel that long-term Omeprazole therapy may be setting up another problem. If feed (especially grain) passes quickly through the stomach without adequate breakdown from hydrochloric acid, it can create problems when it reaches the hindgut by making the environment there more acidic. As we previously discussed, but important to reiterate, this results in the death of the normal flora (bacteria). This is setting the stage for ulcer development in the large bowel as well as all the problems associated with the release of endotoxins released by the dead bacteria

      From our conversations here in this thread I do like your rephrase of the same question being couldn't an increased SI PH improve digestibility on the contrary and thereby we have less starches proteins travelling to the hindgut, hence mainting a better hindgut PH?
      Would be interesting to know, if I find something addressing this, I will post it in this thread.

      Else I'll rest my case, again it was put forward for consideration -since some owners with horses on lt omeprazole ran into hindgut trouble-, not a given fact.


      • #23
        I absolutely see where you're coming from and thank you for not being offended. I am critiquing the reference, not the bearer nor the thought process! My philosophy on medications in general is to ONLY use them when it's CLEARLY warranted and the benefits outweigh the risks, with frequent re-thinks. Sadly, this means a lot of people (in my case) stay on them because their risks don't go away and the benefits are large. For things like this, though, I absolutely think caution is a good watchword and random treatment is a mistake.

        To answer your question, it would take a very serious reading of a solid textbook on animal physiology. I think the speculations are fine, but the answers are in the books we all used when we were in school. I certainly haven't read them in a long time and freely admit I blew the dust off a couple last night when I was trying to formulate my rebuttals to your paper.

        It seems as if this theory has traction among at least some vets. I always want to know why--are they anti-medication or pro-some sort of other treatment? Because again, a hard-core reading of several digestive physiology chapters, backed up by referring to scientific papers in humans on long-term PPIs (there are just more papers published in human medicine) would probably answer these vets' suspicions adequately.

        And btw, Ridgway's paper is a big improvement.
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        • #24
          Originally posted by Lieslot View Post

          Agreed on the causation effect, but we do not know for sure yet, and some vets seem to be of the opinion there is a likely correlation. I by far don't know either, just wish to reiterate, it may be warranted to at least be aware of it, rather than assume hurray horse is on Omeprazole and all is well now, monitor your horse, discuss with your vet etc if you take the route of longterm omeprazole administration.
          "Monitor your horse" ... what are you suggesting, specifically? Blood panel to check for ???

          My mare has been on the Abler product for well over a year. She does not do well off of it. She has access to hay 24/7, has a paddock attached to her stall so she can come and go as she pleases, is never alone and does not travel. Her grain (about 3 lbs/day) is forage-based and about 11% NSC. Pro-biotics every day. Extra calories come from flax and oil. In short, I don't think there's anything that can be done from a management perspective.

          However, her manure smells ... acidic, for want of a better term.


          • #25
            I absolutely see where you're coming from and thank you for not being offended.
            DW not offended at all and don't feel personally critiqued either
            Questions like these that have not been clearly established as a yay or neigh in the veterinary world, should just have all of us review both sides and decide for ourselves what to do with it.
            I'd like to think one day some university clinic will do some research on this subject and we will be in a better place to form an opinion and the real answer will indeed lay in some very detailed physiology of the intricaties of the GIT.

            Originally posted by stryder
            "Monitor your horse".....what are you suggesting, specifically? Blood panel to check for ???
            Could be a bloodpanel, some in more knowing of such can probably tell us how soon low protein levels show in the blood. I believe it's the albumin they test. I have zero familiarity with bloodwork, so others may have better info on that.
            Outward symptoms of hindgut acidosis and colonic ulcers are often very similar to stomach ulceration. Possible signs could of course be changes in manure consistency, more watery, loser stools, but also behavioral changes.
            If you do a google 'colonic ulcers in horses symptoms' you'll find some good info as well 'hindgut acidosis'

            Your horse's diet sounds pretty low in starch allround, so that will certainly limit or zero out any large amount of starches leaving the SI undigested and from a management perspective you sound to be doing everything as perfect as possible.


            • #26
              By the time protein levels come up "low" on bloodwork you're going to be pretty clear that the horse is profoundly malnourished by observing its skeletal frame. Serum protein levels don't drop until malnutrition is extreme.

              all of us review both sides and decide for ourselves what to do with it.
              Sometimes "both sides" don't deserve equal consideration. Science is not a play-fair democracy. If there are two groups of "facts" saying oposite things, one is right and one is wrong. The challenge is in sifting fact from belief, with evidence always in short supply.
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              • #27
                Thanks, lieslot and Deltawave. This information is helpful. I also found Dr. Ridgeway's article interesting.