A Comparison of the Efficacy of Two Omeprazole Formulations in the Treatment of Equine Gastric Ulcer Syndrome in Racehorses: A Blinded, Randomized Clinical Trial.
Authors: Busechian Sara, Conti Maria Beatrice, Sgorbini Micaela, Conte Giuseppe, Marchesi Maria Chiara, Pieramati Camillo, Zappulla Francesco, Vitale Valentina, Rueca Fabrizio
Journal: Journal of equine veterinary science
Summary
Equine gastric ulcer syndrome remains highly prevalent in racing populations, yet treatment protocols rely on extended omeprazole therapy without clear guidance on formulation choice. This blinded, randomised trial evaluated whether omeprazole delivery as gastro-enteric resistant granules or powder paste produced differential healing outcomes in 30 racehorses (aged 2–10 years) with naturally occurring gastric ulcers, using gastroscopic assessment at baseline and 28 days. Both formulations significantly improved squamous mucosal lesions (P = 0.002 for granules; P = 0.01 for paste) with comparable efficacy between delivery methods (P = 0.34), whilst placebo groups showed no improvement, confirming omeprazole's active role rather than spontaneous recovery. Notably, glandular gastric disease proved refractory to omeprazole treatment, suggesting clinicians should anticipate poor response in horses with this pathology and consider alternative or adjunctive strategies. For practitioners managing EGUS in racehorses with squamous involvement, formulation selection can be based on horse compliance and owner preference rather than efficacy differences, though the poor glandular response warrants investigation into supplementary therapeutic approaches.
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Practical Takeaways
- •Both granule and paste formulations of omeprazole are similarly effective for treating squamous gastric ulcers in racehorses; choice can be based on administration preference and horse acceptance
- •Standard 28-day omeprazole treatment successfully resolves squamous lesions, but glandular ulcers require alternative or adjunctive treatment strategies
- •Formulation choice (granules vs. paste) does not impact clinical outcomes, so practicality and cost-effectiveness can guide selection
Key Findings
- •Both gastro-enteric resistant granules and powder paste omeprazole formulations showed significant improvement from baseline to 28 days (P = 0.002 and P = 0.01 respectively)
- •No significant difference in efficacy was found between the two omeprazole formulations at day 28 (P = 0.34)
- •Placebo treatments showed no significant improvement in either squamous or glandular lesions over 28 days
- •Omeprazole was effective for squamous gastric disease but showed poor response in glandular mucosa