Equine Ulcers and Omeprazole
The most commonly embraced western medicine treatment for equine ulcer syndrome is the administration of Omeprazole. This form of treatment can actually be detrimental to the health and wellbeing of a horse long term.
Many horse owners have been taught by veterinarians that they need to treat their horses for 30-60 days with omeprazole followed by a preventative dose daily. This long term use of Omeprazole is often continued for the rest of the horse’s performance career, if not their entire life. Although generic Omeprazole therapy is usually the best option as it costs less than half what the name brands do, any form of this drug can do harm over a long period of time.
The drug Omeprazole works by binding to the H2 receptors in the stomach and preventing them from producing a normal amount of acid. It typically takes five days for the drug to reach its full effect. A normal level of stomach acid is required to digest and absorb a great number of vitamins and minerals and is very important in the breakdown process of protein. One of many common negative side effects of people on long term H2 blocker therapy is a vitamin B12 deficiency. Vitamin B12 is necessary for the prevention of pernicious anemia, it helps to regenerate damaged nerve tissue and it helps with normal liver function, to name just a few of its beneficial effects. The same thing will happen when we treat horses for long periods of time with these drugs.
In a normal horse who is not suffering from ulcers, the digested food coming from the stomach will usually have a neutral pH (no longer be acidic) a short way down the small intestine. This means that, because it is normal for the acid to be gone from the digested food not far from the stomach, that Omeprazole will only treat stomach (gastric) ulcers. This drug is not effective against ulcers of the small intestine, large intestine, cecum or colon.
Many horses are affected by ulcers at more than one site at a time. It is because of this that Dr. DePaolo always recommends a daily digestive conditioning supplement whenever a horse is being treated with Omeprazole.
To be clear, Dr. DePaolo is a proponent of omeprazole therapy in the short run, especially when it is combined with a medicine that will begin treating the ulcers instantaneously with a fast acting acid blocker. These drug combinations can only be attained from compounding pharmacies thus you need a veterinarian’s prescription.
It is imperative the omeprazole be continued only as long as necessary to heal a stomach ulcer and that the horse be fed a natural digestive supplement such as Excel to heal hind gut ulcers and prevent their reoccurrence. If you successfully treat your horse for ulcers but you don’t eliminate the factors that lead to the ulcer formation in the first place they will return in short order. It is essential that you change the diet to include only anti-inflammatory feeds, no sweet feeds and decrease as much stress as possible for your horse.
If you suspect your horse is suffering from ulcers, Dr. DePaolo has an easy YouTube tutorial on ulcer palpation. To learn more about ulcer treatments and proper nutrition, please visit our Health Library on our website.
DEC blog 
Can ulcers heal without medication if the horse is taken out of a stressful environment and fed non ulcer encouraging food? Thanks!
Yes, ulcers can heal themselves if the horse is fed the proper diet and taken out of stressful situations. I encourage you to visit our Health Library on our website and read the articles in our digestive category. (http://hl.depaoloequineconcepts.com/?q=taxonomy/term/3). There are also good digestive supplements on the market, such as our Excel, that can be a great preventative. Thank you for your question!
This article and your others on ulcers as well as your videos are the most helpful source of information I have ever found anywhere. I am in the process now of feeding only alfalfa pellets and possibly Rice Bran pellets. Should I start him off on the same amount of pellets as he was on feed? Will this provide him enough calories? Thankyou.
Hi Lisa,
Thank you for your nice comment! I recommend feeding the same amount of pellets to start. Ideally I would do 2/3 alfalfa pellets and 1/3 rice bran. This can be adjusted depending on appearance, time of year and amount of exercise your horse is getting. If you feel like your horse needs to gain weight, I suggest olive oil. It is also important that your horse is getting a complete vitamin and mineral supplement along with plenty of second or third cutting hay that is almost yellow in appearance because it will not be high in sugar but it will provide enough long stem fiber for your horse to eat throughout the day. This is important when trying to avoid ulcers. If you want to take a look at our website, we have a health library with more extensive articles and an online store with a great daily digestive supplement as well as a host of other products. I hope this helps!
my horse has been on ranitidine for almost 4 wks, His pain from touch on his belly and girth area has gotten worse. I also have a greener stemier looking bernuda hay. decided to use omprazole. My vet says generics may not work as well as gastro or ulcer guard. He is on excel and succed. what do you recommend.
Hi! My horse is an OTTB rescue mare. I’ve been struggling a lot with her weight and have been looking into the possibility of ulcers. I wanted to say THANK YOU for your videos! I now know that her sensitivity could be due to ulcers, and this is a relief! I’ve never had a horse be uncomfortable being groomed before. Her sensitivity has definitely decreased since I’ve had her (probably due to lots of roughage that she wasn’t getting before), but it’s still noticeable. She actually has gotten better with her girthiness, but still doesn’t like her withers or back/flank area to be groomed. She’s also extremely sensitive on her upper hindquarters on either side of her back, above her tail – she tries to duck out of contact there. Could this also be due to ulcers or is that more likely a chiro problem? And what would you recommend as a treatment for her? I want to get a digestive supplement to start. Should I invest in a more aggressive treatment plan as well or would the digestive supplement alone be a good start? Should this help with her weight?
Thank you so much for this information. It is by far the most informative and helpful thing I have seen on ulcers and horse health in general.
Hi Taylor,
I’m sorry it took so long to get back to you. Dr. DePaolo has been traveling to shows to work on horses for the past few weeks. The sensitivity in her upper hindquarters could definitely be high gut ulcers or acidosis. People often mistake it for a chiropractic issue or a bad saddle fit but often times it is just what you suspect…Ulcers! Dr. DePaolo recommends a 10 day paste treatment of an omeprazole product along with a daily digestive supplement. You can read more about digestive issues in our Health Library: http://hl.depaoloequineconcepts.com/?q=taxonomy/term/3 and you can purchase Dr. DePaolo’s supplement Excel on his website: http://www.depaoloequineconcepts.com/collections/digestive-health/products/excel. You can purchase the paste through your veterinarian since it is a prescription product. Good luck and keep us updated on your mare’s progress!
I would like to know what to feed a N/H horse..she has been eating Safe Choice and hay
Please visit the nutrition section on our website (www.depaoloequineconcepts.com) in the Health Library for great recommendations and suggestions from Dr. DePaolo. Thank you.
Hi, please which drug product we can used in Canada who are exactly same effect as Omiprazole TM? What mean TM? I want to treat my horse with 10 days drugs for ulcers but I want to treat is stomach and hind gut at the same time with a product in Canada. Also, I want to order the Excel TM. Thanks for your Help!
TM is just the ‘Trademark’ symbol. You can purchase Omiprazole in Canada through your veterinarian. Please visit our website at http://www.depaoloequineconcepts.com to purchase Excel.