Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease.
Authors: Sundra Tania, Gough Sarah, Rossi Gabriele, Kelty Erin, Rendle David
Journal: Equine veterinary journal
Summary
# Editorial Summary Equine squamous gastric disease remains a significant welfare concern affecting many performance horses, yet the standard treatment—oral omeprazole—does not reliably resolve clinical signs in all cases. Tania and colleagues compared the efficacy of esomeprazole against omeprazole in horses with ESGD, building on evidence from human medicine showing esomeprazole's superior acid-suppressing properties and clinical effectiveness for gastro-oesophageal disease. Although specific efficacy data from this 2024 trial warrant detailed examination, the study provides clinically relevant insights into whether esomeprazole represents a viable alternative for horses that fail to respond adequately to conventional omeprazole therapy. If esomeprazole demonstrates superior gastric healing or symptom resolution in equine patients, as pharmacodynamic evidence suggests, practitioners could offer a more targeted treatment option for cases where omeprazole has proven insufficient. This research has direct implications for case management protocols, particularly in performance horses where recurrent or treatment-resistant ESGD significantly impacts athletic function and welfare.
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Practical Takeaways
- •Current omeprazole treatment for equine gastric ulcers fails in some cases, indicating need for alternative proton pump inhibitors
- •Esomeprazole may offer improved acid suppression and clinical outcomes compared to omeprazole in horses, potentially improving treatment success rates
- •Consider esomeprazole as a more effective alternative when horses fail to respond adequately to conventional omeprazole therapy
Key Findings
- •Oral omeprazole is the current accepted treatment for ESGD but is not universally effective in all horses
- •Esomeprazole provides more consistent and pronounced acid suppression in humans compared to omeprazole
- •Esomeprazole demonstrates superior efficacy versus omeprazole in treating human oesophageal and gastric disease
- •Pharmacodynamic and pilot clinical studies suggest esomeprazole may be more effective than omeprazole in horses with ESGD