Effects of intravenously administrated omeprazole on gastric juice pH and gastric ulcer scores in adult horses.
Authors: Andrews Frank M, Frank Nicholas, Sommardahl Carla S, Buchanan Benjamin R, Elliott Sarah B, Allen Vern A
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Equine gastric ulcer syndrome remains a significant clinical challenge, particularly in horses unable to tolerate oral medications due to dysphagia, reflux disease, or other feeding restrictions. Andrews and colleagues investigated intravenous omeprazole administration (0.5 mg/kg once daily for 5 days) in six horses with naturally occurring gastric ulcers, measuring gastric juice pH via endoscopic aspiration and quantifying ulcer scores before treatment and at day 5. The intravenous formulation proved remarkably effective at raising intragastric pH: baseline pH of 2.01 increased to 4.35 one hour after the first dose, climbing further to 7.00 by day 5 post-injection. Whilst nonglandular ulcer numbers decreased significantly from 3.2 to 2.0 lesions per horse, ulcer severity scores and glandular lesions showed minimal improvement, suggesting IV omeprazole may be more effective at preventing new ulceration than healing established lesions. For practitioners, this work demonstrates that intravenous omeprazole offers a viable alternative route for horses unable to consume oral formulations and provides a practical rationale for endoscopic pH monitoring to confirm therapeutic targets (pH >4.0) have been achieved during treatment.
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Practical Takeaways
- •IV omeprazole offers a viable alternative for treating gastric ulcers in horses unable to tolerate oral paste formulations due to swallowing difficulties or gastric reflux
- •Gastric juice pH aspiration via endoscope can verify adequate acid suppression (target pH >4.0) during omeprazole treatment
- •While IV omeprazole reduced ulcer numbers, severity improvement may require longer treatment duration or additional therapeutic approaches
Key Findings
- •Intravenous omeprazole (0.5 mg/kg) significantly increased gastric juice pH from 2.01 to 4.35 within 1 hour of initial dose and to 7.00 by day 5
- •Nonglandular ulcer number score decreased significantly from 3.2 to 2.0 over 5 days of IV omeprazole treatment
- •Nonglandular ulcer severity score remained unchanged despite reduction in ulcer numbers
- •IV omeprazole formulation may benefit horses with dysphagia or conditions restricting oral medication intake