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Questions about insurance and ulcer medication

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  • Questions about insurance and ulcer medication

    I have been wondering about my five year old and that he might have ulcers.

    He took a long trip back east and was pretty rough after he got back.

    He has since not liked moving forward with leg and gets pissy when you put leg on him. He also gets very agitated when in a stall. He has always been lazy, but he is now kicking out at my leg which he never did before.

    So I wanted to get him checked out.

    Here are my questions.

    Does the vet have to scope in order to recommend ulcer meds? Reason I don't want to scope is that my regular vet doesn't have a scope and I would have to take him to a clinic close by that has had a terrible track record with charging way too much for services and not being thorough.

    Can they just look at them and discuss issues and say ok, yes he may have them lets put him on a month of ulcer gard?

    Will the insurance company make me scope in order to pay for the meds?

    I just don't want to scope him and put him through it if I don't have to.

  • #2
    I've known of lots of cases where the meds were covered without a scope. You may want to call the company to ask first, but as far as I know a scoping isn't a requirement for all companies.
    It's not about the color of the ribbon but the quality of the ride. Having said that, I'd like the blue one please!

    Comment


    • #3
      I'm le ulcer queen.

      Insurance should pay for scoping and 28 days of gastrogard if your horse scopes and has ulcers. Our insurance made us scope.

      There are a few less expensive options to try and see if you notice a change. 3000 mg of Ranitidine given every 8 hrs is a great anti-ulcer drug somewhat similar to omeprazole (which is the active ingredient of gastrogard/ulcergard). It works very well and is very inexpensive. I currently use the compounded buffered omeprazole from Precision Pharmacy (buffered is impotant!!!). It is extremely inexpensive compared to GG and it works GREAT on my horse. However, with a powdered buffered omeprazole, I find that you need contain it and supplement it seperately. It is also climate and light sensitive. He has his own little AM supplement omeprazole tubs that are kept in the dark and only "made" 1 week in advance. The big jar stays in the A/C/heated med room.

      There are also some nutritional and lifestyle changes you may want to try to change. Consider switching to a low starch/higher fat feed. Give about 10 tums right before you bridle and give 1/4 scoop alfalfa pellets as well.

      I have had a lot of success with my ulcer prone horse with a small hole hay net. He lives at a big A circuit barn, and now about 5 of our horses have small hole hay nets. I can answer more questions about that or anything if you'd like.

      If you do use GG/UG make sure to taper off. I have done MANY rounds of gastrogard before I changed his feed and going out time and I usually did 28 days 1 tube, 7-14 days 1/2 tube, 7 days 1/4 tube, 7 days every other day 1/4 tube. Taking them off quickly can make ulcers come back.

      Comment


      • #4
        In my experience, insurance would only pay for ulcer meds if you scope. But they will pay for scoping if the vet suggests it. This was with Great American. My vet said she had been able to convince other insurers to pay for meds without scoping but not mine. She doesn't like scoping as she thinks it actually can create ulcers on its own and prefers to evaluate with response to meds. Just repeating what she has told me and not trying to argue scope vs. no scope!

        I did have Great Am pay for ranitidine when it was prescribed for ulcer prevention following surgery on one horse. But that's far cheaper, for one, than UG/GG, and that was so long ago, it is likely the policy changed since then.

        Comment

        • Original Poster

          #5
          What's interesting is there are studies that ranitidine does cure ulcers. Not the same results as ulcer gard, but many did heal.

          Supposedly gastro gard stops acid reduction where, ranitidine slows acid.

          So I think that I may talk to my vet about starting with ranitidine to see if it makes a difference.

          They do make ranitidine in a paste, anyone know where to find it?

          Comment


          • #6
            I had similar symptoms in my gelding. Scoping was 400 bucks, treatment was over 1000. I scoped and found nothing. Might be worth it just to find out for sure
            Charlie Brown (1994 bay TB X gelding)
            White Star (2004 grey TB gelding)

            Mystical Moment, 1977-2010.

            Comment


            • #7
              Feel his back behind where the saddle pad would end, if he is sore likely he has ulcers (vet scored four of eight horses for free, he said ahead of time which had ulcers and which did not...right on with it).

              Young horses often need more clear reaction to aids. But check (stifles) flexions.

              (And scoping is not any more a big deal that tube worming used to be. Make sure the vet SHOWS you either the pix of the ulcers, or lets you look.) If there are ulcers feed little and often (slow hay feeder/etc).
              I.D.E.A. yoda

              Comment

              • Original Poster

                #8
                I will check his back.

                I am really just not wanting to do the scope!

                My friend swears by the ranitidine, but again it doesn't work for every horse.


                Anyone used the Ranitidine paste?

                Comment


                • #9
                  The scope really isn't bad or invasive. It was pretty easy for my guy.

                  I don't know anything about ranitidine other than that my human friend takes it to try and prevent his allergic reactions to mammalian meat. Not helpful at all!
                  Charlie Brown (1994 bay TB X gelding)
                  White Star (2004 grey TB gelding)

                  Mystical Moment, 1977-2010.

                  Comment


                  • #10
                    The scopes ive seen/been a holder for have been pretty non eventful. Most were track horses and we did it either with mild sedation or no sedation at all. What area are you in? Is there only one referral type clinic or is that just the one your personal vet has a relationship with?

                    Comment


                    • #11
                      Where "out west" are you?

                      I'm sure you can get ranitadine paste compounded. At that point, thought, you're likely better off just getting omeprazole paste compounded. My vet here has scoped, confirmed ulcers, treated for 30 days with the compounded omeprazole/ranitadine paste from Precision Pharmacy and scoped again to confirm total healing. Cost for that is about $250 for a month.

                      If you are in Colorado (or the southern part of WY, perhaps) my vet has the equipment to scope. Shoot me a PM if you'd like her contact info.

                      My insurance experience is with Great American and while they were happy to pay for the scope, they would not pay for a course of gastrogard without the scope.

                      Comment


                      • #12
                        Not saying prices, but the compounded buffered omeprazole powder from Precision Pharm is a lot less...but then again my vet didn't add anything to the price.

                        Comment

                        • Original Poster

                          #13
                          I am in AZ. The clinic is walking distance from my house. It's a good clinic, just extremely expensive and I have had a few issues with them.

                          My breeding vet doesn't have a clinic.

                          It seems that if I can feed the ranitidine two or three times daily that it would be ,inch more cost effective for me.

                          I can crush the pills and put them in something, but it's just more time consuming then the already made paste.

                          But if the paste is a lot more then the pills then I will just use those.

                          I just don't want to go to the extreme of scoping and using my insurance if there are other ways to help him.

                          My deductible is 250 and if he doesn't have ulcers when scoped they won't cover the scope!

                          I can get 2 months worth of ranitidine for much less then $250!

                          Comment

                          • Original Poster

                            #14
                            Will the insurance cover the scope if he doesn't have ulcers?

                            Also, are there ways they can find hind gut ulcers?

                            I am torn because I don't want to do the scope but I want to know if my horse has ulcers!

                            I called the vet that would scope and he will be back wednesday to call me back. Maybe he can give me a little more information.

                            Comment


                            • #15
                              My insurance company covered gastro guard treatment without a scope but I called to check first. They went with the vet's diagnosis based on symptoms. We started with a shorter course of 10 days, and when my gelding showed improvement we continued with a full course. I also didn't want to have to ship him to a clinic to scope and it was apparent after a few days of treatment that he was getting better. The only thing I regret about not scoping is not being sure that he's totally healed. It would be nice to scope now to be certain.

                              Comment


                              • #16
                                If you have questions about coverage, you probably should contact your insurer as they all have differences. When the question came up with mine (whether they would cover meds without scoping), I just asked about it and was told their terms. I would find it hard to believe that they would require a scope then not pay for it if it reveals no ulcers...that's like not paying for an x-ray if it doesn't show anything wrong. Sometimes diagnostics are valuable for what they don't find, as well as what they do find. Heck, the insurance would be "happy" about a clean scope as now they don't have to pay for UG/GG!

                                Comment


                                • #17
                                  Originally posted by Samotis View Post
                                  Will the insurance cover the scope if he doesn't have ulcers?
                                  Mine did. Great American. Three or four years ago now.

                                  Easy enough to call your underwriter and ask.

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