Omeprazole equine
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Omeprazole Use in Equine Gastric Ulcer Syndrome (EGUS)
Introduction to Equine Gastric Ulcer Syndrome (EGUS)
Equine Gastric Ulcer Syndrome (EGUS) is a prevalent condition in horses, particularly those in active training or under stress. It affects both the squamous and glandular regions of the stomach, with varying prevalence rates. Omeprazole, a proton pump inhibitor, is widely used to treat and prevent this condition.
Omeprazole and Phenylbutazone-Induced Gastric Ulcers
Concurrent administration of omeprazole with phenylbutazone, a non-steroidal anti-inflammatory drug (NSAID), has been studied to mitigate the gastrointestinal side effects of phenylbutazone. Research indicates that while omeprazole can reduce phenylbutazone-induced equine glandular gastric disease (EGGD), it may also increase the risk of intestinal complications. This suggests that while omeprazole is effective in protecting the stomach lining, caution is needed due to potential adverse effects on the intestines.
Extended-Release Injectable Omeprazole (ERIO)
Extended-release injectable omeprazole (ERIO) has been evaluated for its efficacy in treating equine squamous gastric disease (ESGD) and EGGD. Studies show that administering ERIO at five-day intervals is more effective in healing EGGD compared to seven-day intervals, although no significant difference was observed for ESGD healing between the two schedules. This highlights the importance of dosing intervals in the treatment regimen.
Comparison of Oral Esomeprazole and Omeprazole
Oral esomeprazole has been compared to omeprazole for treating ESGD. Findings suggest that esomeprazole is more effective, with a higher proportion of horses showing healing of ESGD and concurrent EGGD lesions compared to those treated with omeprazole. This indicates that esomeprazole might be a superior alternative for certain cases of EGUS.
Withholding Periods and Recurrence of EGUS
The impact of recommended withholding periods (RWPs) for omeprazole on the recurrence of EGUS in Thoroughbred racehorses has been studied. Horses subjected to a two-clear-days RWP showed a higher prevalence of squamous ulceration compared to those with a not-on-race-day RWP. However, the administration of a nutraceutical supplement during the RWP partially mitigated this effect. This suggests that RWPs can influence the recurrence of EGUS and that supplements may help in managing this risk.
Dose-Response Relationship in Omeprazole Treatment
A dose-response clinical trial has shown that lower doses of omeprazole (1.0 and 2.0 mg/kg) are as effective as higher doses (4.0 mg/kg) in treating squamous ulceration, but not glandular ulceration. Healing rates were significantly higher for squamous ulcers compared to glandular ulcers. This indicates that while lower doses may be sufficient for squamous ulcers, glandular ulcers may require more aggressive treatment.
Efficacy of Different Omeprazole Formulations
Comparative studies of different omeprazole formulations, such as GastroGard and Gastrozol, have shown that both are effective in healing gastric ulcers. However, plasma omeprazole concentrations were higher with GastroGard, suggesting better bioavailability. This highlights the importance of formulation in the efficacy of omeprazole treatment.
Prophylactic Use of Omeprazole
Meta-analyses have demonstrated that prophylactic use of omeprazole significantly reduces the occurrence of gastric ulcers in horses in active training compared to no prophylaxis. The severity of ulceration was also lower in horses receiving prophylactic omeprazole. This supports the use of omeprazole as a preventive measure in high-risk horses.
Conclusion
Omeprazole is a cornerstone in the management of EGUS in horses, with various studies supporting its efficacy in both treatment and prevention. However, considerations such as dosing intervals, formulation, and potential side effects are crucial for optimizing outcomes. Further research and careful management are essential to maximize the benefits of omeprazole while minimizing risks.
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