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Frequently asked questions about equine stomach ulcers.

Find answers to your questions about equine stomach ulcers and the only proven, and FDA-approved, prevention and treatment – ULCERGARD® (omeprazole) and GASTROGARD® (omeprazole).

About equine stomach ulcers

  • Equine stomach ulcers have been found in horses from a wide variety of breeds, disciplines and ages, including:

    • 92-93% of racehorses1,2
    • 63% of non-racing performance horses3
    • 51% of foals4

    Gastroscopy events at veterinary clinics and university campuses in 25 states identified stomach ulcers in a surprising number of horses.1 See results by discipline.

  • Yes. EGUS stands for Equine Gastric Ulcer Syndrome, another name for equine stomach ulcers.

  • There are two main types of stomach ulcers: ulcers in the glandular portion of the stomach and ulcers in the non-glandular or squamous mucosa portion of the stomach. Glandular stomach ulcers are often related to non-steroidal anti-inflammatory (NSAID) use with products such as phenylbutazone (bute) or flunixin meglumine (Banamine). Non-glandular stomach ulcers, often simply referred to as equine stomach ulcers, are the kind most often encountered in performance horses and are linked to stress.2 Equine stomach ulcers are caused when excess acid eats through the protective lining of the upper (non-glandular) portion of the stomach. Once present, these ulcers cause pain and reduce appetite, which can lead to even greater ulceration and damage. Watch how equine stomach ulcers happen.

  • Painful equine stomach ulcers reduce performance and can even lead to death.5 They can occur in as little as 5 days for horses under stressful conditions, but they may go undiagnosed for long periods of time.6

  • Everyday activities that may not seem stressful to you at all can lead to equine stomach ulcers:

    • Competition7
    • Training7
    • Travel7
    • Trailering7
    • Weekend shows or events6
    • Confinement6
    • Limited turnout or grazing8
    • Lay-up due to sickness or injury8
    • Changes in routine8

    One study showed how easy it is for recreational horses to develop stomach ulcers in just 5 days.6

    20 Horses – Free of Gastric Ulcers
    (confirmed by pre-study scoping)
    10 horses stayed at home 10 horses traveled to simulated event
    • Maintained normal feeding schedule
    • Maintained normal exercise routine
    • Trailered for four hours
    • Mild exercise twice daily
    • Fed oats and grass/alfalfa
     
    All horses scoped at the end of the 5-day study

    2 horses with stomach ulcers

    7 horses with stomach ulcers

  • Horses with stomach ulcers often do not exhibit any obvious clinical signs, and horse owners often do not know that their horses are suffering in silence. Only your veterinarian can accurately diagnose equine stomach ulcers – but you can help by looking for changes in your horse and reporting them to your veterinarian. Here are a few things to look for:

    • Changes in eating and drinking behavior9
    • Weight loss9
    • Change in attitude (for the worse)9
    • Recurrent colic9
    • Dull hair coat9
    • Less-than-optimal performance9
    • Foals may also grind their teeth or lay on their backs4

    Your veterinarian will probably use endoscopy, a procedure that lets them look inside your horse’s stomach via a tiny camera attached to a long, thin tube. Your veterinarian will place the endoscope in through your horse’s nostril, then down the esophagus and into the stomach. There, the lining can be examined for the presence of ulcers. If endoscopy is not practical, then a presumptive diagnosis may be made based on clinical signs, history and a physical examination.

    Is your horse at risk?

  • This test has proven unreliable compared to endoscopy for diagnosing stomach ulcers. It is based on the presence of blood, and stomach ulcers don’t often bleed. Also, the test will not detect a Grade 1 ulcer, which is enough to cause clinical signs in horses. The test may be applicable to the detection of issues further along in the digestive tract.

  • Following successful treatment with GASTROGARD, stomach ulcers can and are likely to recur when your horse is exposed to stress.6 It’s important to discuss stress factors that can lead to recurrence with your veterinarian. You can work together to address feeding and lifestyle changes as well as discuss the benefits of a preventive regimen with ULCERGARD during stressful events. You can purchase 112 days of prevention with ULCERGARD for the cost to treat an existing ulcer.*

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Treating equine stomach ulcers with GASTROGARD

  • GASTROGARD acts at the source of acid production. Unlike other products intended to coat the stomach, neutralize acid within the stomach lumen or act at the mucous barrier, GASTROGARD inhibits the proton pump that produces stomach acid. Only GASTROGARD inhibits enough acid to allow stomach ulcers to heal even while a horse remains in training. Watch the video.

  • After a horse has been diagnosed with stomach ulcers by a veterinarian, treatment with GASTROGARD for 28 days is recommended. GASTROGARD is the only product proven to treat existing stomach ulcers and the only one that is also FDA-approved.

  • Yes. There is no need to interrupt training while treating equine stomach ulcers with GASTROGARD.7

  • Following successful treatment with GASTROGARD, stomach ulcers can and are likely to recur – in as little as 5 days when exposed to stress.6 It’s important to discuss stress factors that can lead to recurrence with your veterinarian. You can work together to address feeding and lifestyle changes, as well as discuss the benefits of a preventive regimen with ULCERGARD during stressful events.

  • Since the use of GASTROGARD requires a professional diagnosis, it is only available as a prescription from your veterinarian.

  • Omeprazole on its own is easily oxidized, or inactivated, when it contacts air, rendering it ineffective. When oxidized, it turns purple. Some illegally manufactured products advertise that their paste is purple, possibly to cover up stability issues. Tests have shown some illegally manufactured products to lose as much as 46% of their potency in just 30 days.10 GASTROGARD and ULCERGARD are specially formulated to be stable when used and stored as recommended. Because they are FDA-approved products, they are continually tested to ensure consistent stability. Every tube of GASTROGARD and ULCERGARD is stamped with an expiration date and should be used by that date to guarantee full potency.

  • Merial is a global animal pharmaceutical company with manufacturing facilities around the world to accommodate our global demand. The facility in Brazil specializes in the production of our equine paste products. Even though it is not in the United States, you can be assured that it is registered with the FDA and is subject to their inspection at any time as are all of the products made there.

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Preventing equine stomach ulcers with ULCERGARD

  • Horses’ bodies are designed to graze throughout the day. Consequently, their stomachs secrete acid 24 hours a day, seven days a week. In many situations, like when they have limited turnout, have infrequent intake of roughage, or are just not eating roughage well for some reason, acid can build up and lead to stomach ulcers. The main ingredient in ULCERGARD – omeprazole – suppresses acid production in a horse’s stomach to a level that prevents ulceration. Watch the video.

  • ULCERGARD is the only product proven and FDA-approved to prevent stomach ulcers in healthy horses.7* A single daily dose of ULCERGARD effectively prevents equine stomach ulcers.12 Each syringe of ULCERGARD contains four daily preventive doses for horses weighing between 600 and 1,200 pounds.7*

  • Horses suffering with stomach ulcers may not eat normally or may exhibit a poor attitude, which can lead to sub-optimal training and performance. ULCERGARD works to prevent the development of stomach ulcers, which can prevent the signs associated with this condition.

  • ULCERGARD is recommended to prevent equine stomach ulcers in healthy horses. When a horse shows signs of an existing stomach ulcer, it is recommended that it be seen by a veterinarian who can conduct a thorough examination and make a proper diagnosis. After a horse has been diagnosed, treatment with GASTROGARD for 28 days is recommended. GASTROGARD is the only product proven to treat existing stomach ulcers and the only one that is also FDA-approved. Following treatment, an ongoing preventive regimen using ULCERGARD should be initiated. Learn more about GASTROGARD.

  • ULCERGARD is available through your veterinarian; in fact, it is the No. 1 veterinarian-recommended preventive for equine stomach ulcers.11 And since ULCERGARD is a preventive, no diagnosis or prescription is necessary.12 The suggested retail price of ULCERGARD is $9.75 per daily dose ($39.00 per tube/4 daily preventive doses). You can purchase 112 days of prevention with ULCERGARD for the cost to treat an existing ulcer.* An ounce of prevention really is worth a pound of cure. Check here for rebate and special offers.

  • Omeprazole on its own is easily oxidized, or inactivated, when it contacts air, rendering it ineffective. When oxidized, it turns purple. Some illegally manufactured products advertise that their paste is purple, possibly to cover up stability issues. Tests have shown some illegally manufactured products to lose as much as 46% of their potency in just 30 days.10 GASTROGARD and ULCERGARD are specially formulated to be stable when used and stored as recommended. Because they are FDA-approved products, they are continually tested to ensure consistent stability. Every tube of GASTROGARD and ULCERGARD is stamped with an expiration date and should be used by that date to guarantee full potency.

  • Merial is a global animal pharmaceutical company with manufacturing facilities around the world to accommodate our global demand. The facility in Brazil specializes in the production of our equine paste products. Even though it is not in the United States, you can be assured that it is registered with the FDA and is subject to their inspection at any time as are all of the products made there.

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Do other types of ulcer products work in horses?

  • GASTROGARD and ULCERGARD are the only products that are FDA-approved specifically for the treatment and prevention of equine stomach ulcers. Horse owners should be aware that other drugs and products are not FDA-approved nor have they been proven to treat or prevent ulcers in horses. This includes:

    • Human antacids (Pepto Bismol® and Maalox® and equine versions such as Gastrolox and Neigh-Lox)
    • Compounded formulations of omeprazole, like those made by compounding pharmacies
    • Non-FDA approved versions of omeprazole, like GastroMax3 or Gastroade Xtra.
    • Succeed®
    • Nutraceuticals
    • Histamine Receptor Antagonists or H2 Blockers (Tagamet® and raniditine)

    While a few of these products may have limited anti-ulcergenic benefits, none have shown enough efficacy or consistency to reach the minimum standards required for FDA approval. GASTROGARD is proven to significantly improve stomach ulcers by up to 99 percent in treated horses. Tests with other anti-ulcer “treatments” did not result in lower odds of moderate or severe ulceration than horses receiving no treatment.13,14,15

  • Simply put, it means peace of mind. From start to finish, FDA-approved drugs have been thoroughly tested for both safety and effectiveness:16

    • The safety and efficacy of the product is based on thorough scientific review prior to approval16
    • The product meets quality, purity and potency specifications16
    • Each unit is consistently manufactured under what are called “Good Manufacturing Practices”16
    • The drug is continually monitored by the FDA after it is on the market to ensure product performance, as well as identify any concerns or questions16
    • Even if these drugs are not manufactured in the United States, the facilities where they are made are still subject to FDA approval and inspection17

    NOTE: When approved medications are available, the use of unapproved medications in horses may result in the denial of a claim made to an insurance company.

  • With so many products on the market, it would be nice to know which ones are worth the money and which ones are just humbug.

    • Look for references to their claims – the legal type at the bottom of the ad. If they only reference their own studies, or no studies at all, or if they’ve simply copied and pasted an approved product’s label or study, there are no guarantees that the product works.
    • See if the product (not just the active ingredient) has gone through the rigorous safety and efficacy testing required for FDA approval.
    • You can learn more about evaluating your horse’s drugs here.
    • Only ULCERGARD and GASTROGARD are proven effective – and FDA-approved – to prevent equine stomach ulcers.* There is no approved generic for ULCERGARD or GASTROGARD. So if you have been told an equine product containing omeprazole is a generic, you know that’s false.
    • While some nutritional supplements may support gastric health, make sure they’re from a trusted source and are backed by independent research.

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IMPORTANT SAFETY INFORMATION: ULCERGARD can be used in horses that weigh at least 600 pounds. Safety in pregnant mares has not been determined.
CAUTION: Safety of GASTROGARD in pregnant or lactating mares has not been determined. For prescribing information click here.
*When administered for 8 or 28 days, ULCERGARD is proven to effectively prevent gastric ulcers in horses exposed to stressful conditions.
1 Data on file at Merial.
2 Murray MJ, Schusser GF, Pipers FS, Gross SJ. Factors associated with gastric lesions in thoroughbred racehorses. Equine Vet J . 1996;28:368-374.
3 Mitchell RD. Prevalence of gastric ulcers in hunter/jumper and dressage horses evaluated for poor performance. Association for Equine Sports Medicine. September 2001.
4 Murray MJ. Endoscopic appearance of gastric lesions in foals: 94 cases (1987-1988). J Am Vet Med Assoc . 1989;195(8):1135-1141.
5 Radostits OM, et al. Veterinary Medicine: A textbook of the diseases of cattle, horses, sheep, pigs and goats. Philadelphia: WB Saunders Co.; 2007:237-241.
6 McClure SR, Carithers DS, Gross SJ, Murray MJ. Gastric ulcer development in horses in a simulated show or training environment. J Am Vet Med Assoc. 2005;227(50):775-777.
7 GASTROGARD and ULCERGARD product labels.
8 Murray MJ. Disorders of the stomach. In: Smith BP, ed. Large Animal Internal Medicine. St. Louis; CV Mosby, 1990;710-777.
9 Equine Gastric Ulcer Council. Recommendations for the diagnosis and treatment of Equine Gastric Ulcer Syndrome (EGUS). Equine Vet Educ. 1999;11:262-272.
10 Stanley SD, Knych HK. Comparison of Pharmaceutical Equivalence for Commercially Available Preparations of Omeprazole. AAEP Proceedings. 2011;57:63.
11 Data on file at Merial, Market Directions Study.
12 Freedom of Information Summary for ULCERGARD (NADA 141-227).
13 Murray, MJ. Suppression of gastric acidity in horses. J Am Vet Med Assoc. 1997:211(1):37-40.
14 Nieto, JE, et al. Comparison of omeprazole and cimetidine in healing of gastric ulcers and prevention of recurrence in horses. Equine Vet Educ. 2001;18:260-264.
15 Nieto JE, et al. Comparison of paste and suspension formulations of omeprazole in the healing of gastric ulcers in racehorses in active training. J Am Vet Med Assoc. 2002;8:1-5.
16 Animal Health Institute and American Veterinary Medical Association and American Veterinary Distributors Association. Veterinary Compounding Guidelines. 2005. Available at: http://www.aaep.org/custdocs/drug_compounding_guidelines.pdf . Accessed February 20, 2010.
17 U.S. Department of Health and Human Services. Food and Drug Administration. FDA Basics. How does FDA oversee domestic and foreign drug manufacturing? Available at: http://www.fda.gov/AboutFDA/Transparency/Basics/ucm194989.htm . Accessed February 29, 2012.
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