Omepazole and Esomeprazole, the most commonly used medications for Equine Gastric Ulcer Syndrome (EGUS) are not without their safety concerns.
One welfare issue which may be associated with the use of gastric ulcer medications and which is commonly overlooked is rebound gastric hyperacidity.
Omeprazole and esomeprazole belong to a class of drugs called Proton Pump Inhibitors (PPIs). These drugs work by stopping the production of hydrochloric acid. Hydrochloric acid is a healthy, key component of normal digestive and immune function in our horses.
When we shut down the production of hydrochloric acid through the use of PPIs, we also interfere with our horses’ own negative feedback mechanisms which regulate hydrochloric acid production. When we stop the use of omeprazole or esomeprazole, particularly abruptly, as commonly occurs at the conclusion of a course of ulcer medication, or in racehorses, prior to racing- then rebound gastric hyperacidity may occur. That is, for a period of time, their bodies lose the ability to regulate the amount of hydrochloric acid produced, resulting in a production of excessive amounts.
This in turn, can increase the risk of EGUS and feed into a self-perpetuating cycle: where a horse is put on ulcer medications, and may (or may not) experience some relief in clinical signs, believed to be associated with EGUS, before coming off the medication and reverting to displaying clinical signs and/or developing EGUS
The use of ulcer medications in any instance should be critically evaluated and when prolonged use is felt necessary, the contributing factors to the development of EGUS should be addressed.
EGUS is often considered a ‘man made’ disease in our horses and ponies: that is, it occurs largely due to our feeding, management and medication practices. The good news is that there is much which can be done to help treat and prevent further episodes of EGUS: Through changing what and how we feed our horses; managing our horses in a way that is conducive to good gastrointestinal ‘gut’ health; providing therapeutic support where appropriate; and reviewing medication practices.
Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.
As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.
