Omeprazole… Can long term use actually harm your horse?

What do you do if your horse has been diagnosed with stomach ulcers? One of the most common strategies to manage the ‘ulcer prone’ horse, is to use the drug omeprazole – a protein pump inhibitor that suppresses the release of stomach acid.

What is omeprazole?

Omeprazole has been the ‘go to’ treatment for stomach ulcers in the horse industry for nearly 20 years, so what’s the problem? The drug works by suppressing the release of stomach acid. And, If you’ve ever heard the saying ‘no acid, no ulcer’, then it surely makes sense to use this drug? However… nothing is ever THAT simple. Indeed, a recent article by world expert on equine stomach ulcers, Professor Ben Sykes, explores the potential consequences of long term omeprazole use on horses.

From a personal perspective,. the frequent, routine use of omeprazole has never sat well with me. Simply because stomach acid isn’t produced for fun… it has a function. So if the stomach acid is routinely suppressed for extended periods of time, what does that mean for digestion? What does that mean for the gut microbiome (the diversity and population of bugs)? What does it mean for absorption of key nutrients?

What does the research say?

Research in this area is very much in it’s infancy, but Sykes and his team are asking the right questions. How many times have you heard of horses undergoing pharmacological treatment for stomach ulcers, only for them to reoccur? I always thought that this was most likely due to diet, genetics or insufficient preventative management. However, Professor Sykes proposed an alternative mechanism.

Have you ever heard of ‘rebound gastric hyperacidity’? Well, put VERY simply, it means that when treatment with omeprazole is stopped, the stomach becomes more acidic than it was before the treatment began. This area of research is very new in horses, but preliminary data from Sykes’ team showed rapid development of glandular ulcers (yes the nasty ones – check out our blog) within less than 3.5 days of stopping the omeprazole treatment.

What is the take home message?

The main take home message from this article is that we really need to be looking more closely at the long-term use of omeprazole in horses. Other risks associated with long term omeprazole use are issues with calcium absorption, risk of fractures, overall gut health. Furthermore, he highlighted issues when combined with non-steroidal anti-inflammatories, such as bute, and decreased effectiveness when used for extended periods of time.

This article also provides a sage reminder of the importance to be on the front foot with our horse’s digestive health. We make this an easy ask with our comprehensive range of digestive support products and calmers.

If you are unsure which combination of products would be best for your horse, contact us for a totally obligation free chat.

References

Sykes, BW (2021) A free ride: Is long-term omeprazole therapy safe and effective? Equine vet. Educ. (2021) 33 (10) 556-560

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