Carrafate

[albahurst]

I have been trying to find this past info, but to no avail.

For those of you who have used carrafate (sucralfate) for ulcers, how long do you give it, how many times a day did you give it, does it affect ulcers in the stomach or intestines better (I have heard Gastro Gard is better in one area and carrafate is better in the other?), did you take your horse off feed while giving it? anything else you might think important, please add it, too.

Thanks!

 

[stormy]

I have used carafate (Sucralfate) here on several young minis. One was very bad with eosophegeal ulcers that would make it very painful for her to eat anything solid. We used carafate every eight hours, rinitadine as well as plain yogurt and made her pellets into soup for her to eat. For less severe cases hae used carafate twice daily with rinitadine once...can not give them at the same time though as the carafate coats the stomach so they can not absorb other medications. Also the vet recommended using the carafate 1/2 hour before feed time for the best results.

 

[targetsmom]

I used Carafate on Max, alternating each day with Gastorguard, but he died anyway so not sure how much help I will be. I would give the Carafate a half hour before meals as it said - so morning and night - and I would give the Gastroguard mid-day. For meals he was given hay free choice in slow feeders, soaked alfalfa cubes 4 X/day and two of those times there was a small amount of senior feed added. He also got oil and Stomach Soother with the 2 feeding that included grain. I was actually starting to wean him off the Carafate (after 2 bottles of 100 pills each) when Max died. Good luck with yours.

 

[albahurst]

Thank you so much for your replies -

I am also wondering how long of a time period did you continue using it? 4 weeks, 6 weeks ???

 

[drmatthewtaylor]

Gastrogard inhibits acid production while Carafate coats ulcerated tissue. As hind-gut ulcers are not associated with acid production then Gastrogard is not helpful. Carafate can be helpful with both gastric and hind-gut ulcers, but is not nearly as effective for gastric ulcers as Gastrogard is.

It was once thought that Carafate needed an acidic environment to work, that is not believed necessary today. But Carafate is usually given first and at least 30 mins prior to Gastrogard.

Any medicine will take at least 4 weeks to cure an ulcer and most should be continued beyond that.

Pelleted feed and grazing pasture are quite helpful in ulcer treatment.

Dr Taylor

 

[targetsmom]

Thought I would add that Max died in February - and I think if there HAD been grazing instead of record snow depths, he might have survived. He was on grass as long as there was grass and I think it is absolutely the best thing for ulcers. Max was on the GG for months and the carafate for at least 4 weeks, I think more like 6 weeks.

 

[stormy]

Should also mention that clover hay and good quality alfalfa hay have stomach buffering affects as well and can be helpful in the treatment package for ulcers.

 

[Margo_C-T]

targetsmom--what was the dosage you gave, both of Gastroguard and sucralfate?

I have a 33 1/2", 15 YO gelding who I've been fighting ulcer issues with for at least 5 years now. He was also a 'dedicated' cribber. I can get things 'managed', he'll seem fine for awhile, but the symptoms always return. There has seldom been any grass to graze here, and now, with the prolonged drought, there is basically NONE(and even in a better year, there would be nothing to graze during winter... and I do mean, NOTHING.)That said, I have tried to let him graze a bit whenever possible.I have tried about every recommended management/feeding strategy, and most recently, had him looking and feeling quite well on 'Thrive', along w/ generous grass hay, soaked beet pulp, and daily ground flax.

He is a longtime confirmed cribber; about two months back, I finally decided to try putting him back into his Weaver anti-cribbing collar full-time, to prevent it, as he seemed to have become even more 'obcessive' about doing it, and more incessant. He was on a maintenance dose of omeprazole. Lately, he has again begun leaving feed, and infrequently, standing WAY stretched out. Then he abruptly quit eating the 'Thrive', so I've had to put him back onto his previous program, which was about 1/3 or more alfalfa to grass hay, along w/ TC 'Senior' feed, and continuing the soaked beet pulp and ground flax. I also upped the omeprazole to a 'healing' instead of a maintenance dose...and, I removed the anti-cribbing collar.He does not seem uncomfortable, or needing relief from stress(I was amazed to find that so far(it's been about 4-5 days), he has not been cribbing again!)However, he is still leaving a goodly portion of his (grass)hay, and I am starting to see a slight 'drop' in his overall condition again. My vet said a 'full dose' of sucralfate is 4 tabs/twice daily(so 8 per day)--but I'm interested in what your vet might have said as to dosage for a mini.

Margo

 

[targetsmom]

It will be easier for me to just go back through my notes...(when I was also treating several minis for Rhino)

Max was started on Ulcergard (Gastroguard) 10/20 and was also getting Stomach Soother

(He went to Tufts 11/22 - was scoped and they did NOT see bad ulcers or signs of adhesions from his colic surgery in July)

11/30 he was started on Carafate - 2 tablets of 1 gram each, dissolved in water and then added Stomach Soother and dosed him with mixture. TWICE a day before main meals. Note - Max was taped at 36", which is estimated 150 #. Getting 4 notches GG at noon daily.

12/18 - drop Gastroguard to half dose (2 notches for Max), per vet instructions

12/25 start second bottle of Carafate

1/16/2011 Carafate was dropped to 1 tablet twice a day and then 1/20, dropped to 1 tablet once a day. Still on 1/2 dose Gastroguard but alternating every other day

He was briefly taken off meds end of January and then took turn for worse, back on meds and died 2/11. Note that our weather during this time was horrible, with major snow storms once or twice a week with record accumulations.

Hope this helps.

 

[albahurst]

Thank you all so much! This is really helpful information!

 

[Margo_C-T]

Thank you for going back and looking up the information, targetsmom! Now I have to find out the 'size/dosage strength' of the sucralfate tabs I have. They have an "H" and an "S1" on them, are scored for cutting in half, and are fairly large...somewhat comparable to the SMZ 'footballs' I've seen.Does this sound familiar?

You ID'd the omeprazole product as both 'Gastroguard' and 'Ulcerguard'.It is pretty widely known--or thought, at least-- nowadays that they are EXACTLY the same thing,but that the 'Gastroguard' is 'only'? by Rx, and one entire tube is a daily TREATMENT dose for a 'fullsized' horse (not sure of the exact specified weight...perhaps 1000 to 1250 lbs?), while 'Ulcerguard' is available 'OTC', so to speak, and is labeled as a 'maintenance' dosage for a fullsized horse...so I have always presumed it is only @ 1/4 the STRENGTH of the "Gastroguard'. So, which were you using?

Again, thanks for your time and help!

Margo

 

[albahurst]

Thought of another question I would like to ask-

What is a normal BUN count when doing blood tests for bleeding ulcers? Anyone know?

 

[targetsmom]

Replying about the GG vs Ulcerguard dose: I thought the same thing you did Margo, that the STRENGTH of the Ulcerguard was less than the Gastroguard. I bought the Ulcerguard because it was easier to get and then later learned (like the next day) from my vet that the strength is THE SAME, it is just the LABELING that is different. Since I only have Ulcerguard, I can tell you that a full syringe of that has 2.28 g of Omeprazole. Hope that helps.

Just checked the Sucralfate - I seem to have a lot left - and the tabs do have N (that looks like an H unless you look real close)and S1 on them are scored for cutting in half and are about a half inch long. They COULD be a different dose than yours though....

Good luck to those of you dealing with ulcers!

 

[Margo_C-T]

Well, I am thinking that I will try buying one more 100 or so tab bottle of sucralfate; give both together for a sufficient period of time in 'full' dosage, if my vet agrees to this plan. Sounds very much as if what you have and what I have are the same, but when I go in to pick up the new bottle, I'll be sure to ask about the strength.

Even if I use "Ulcergard",then, the cost of use would be about the same. A 'treatment' dose for a mini(approx. 1/4 the weight of an 'average' fullsized horse)would be about 1/4 of a tube of either label. My 33 1/2 ", refined medium-build, ulcer-prone horse tapes at about 225 lbs., which I feel is pretty accurate,and in-line with all the others(from a 30 1/4" mare who tapes at @ 175 lbs. to a 37 1/2", stouter-built gelding who tapes at @ 350 lbs.)

Margo

PS..I will add that I have never had my horse 'scoped'; vet said the symptoms were pretty clear. I also personally believe that my horse has ulcers 'beyond' the stomach, though I have no actual 'proof' beyond my constant observation. I'm sorry you lost your Max; it was clear how deeply you cared for him. My gelding is 15 yrs. old,bred,raised, trained entirely by me, and my favorite of all here to drive...but I accept that some day, if/when all available(to me) avenues of treatment/management may be exhausted, there may be a hard decision to be made.

 

[targetsmom]

That dosing of GG or Ulcerguard sounds about right for your mini and I don't think there is danger in giving a bit more, as I miscalculated badly on the first dose. I was counting the notches, and Max at 150# was getting 4 notches for a full dose and 2 for a maintenance dose. I think 1/4 tube is 6 notches so that would be consistent.

Good luck!