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Grant Miller, DVM Vet Check
by Grant Miller, DVM
Grant Miller is a Veterinary Editor for the Horse Journal and currently practices in Northern California. His areas of interest include acupuncture, chiropractics, performance horse medicine, geriatric horse care, and forensics. He grew up riding in the Pony Club and studied dressage until he attended veterinary school at UC Davis. In 2007 he founded The Sonoma County CHANGE Program to assist his local animal control department with equine humane cases. View more blogs

FDA Issues Warning About Several Gastric Ulcer Products

By Grant Miller, DVM, November 24, 2014


An equine ulcer. Looks painful, doesn't it?

As we've told you in our initial news story and Dr. Deb Eldredge's blog, the FDA has warned several companies with products they claim treat ulcers. The products are:

  • AbGard
  • Abler Omeprazole
  • Abprazole
  • Abprazole Plus
  • Gastro 37 OTC
  • Gastroade Xtra
  • GastroMax 3 (marketed by Horse Gold, Inc. and Horse PreRace)
  • Gastrotec (marketed by Horse Prerace and Tri-Star Equine Marketing, LLC)
  • Lomac Equine
  • Omaktive Oral Paste
  • Omeprazole Oral Paste
  • Omeprazole/Ranitidine Oral Paste
  • Omoguard Paste
  • UlcerCure OTC

 

So, why am I talking about this again? Because I believe equine health is at stake here and many horse owners do not fully understand the point of the warnings. 

 

First, as most of us know, the FDA is responsible for protecting the public health by assuring the safety, efficacy and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. That's an important job.

 

In this particular incident, the FDA revealed that several of these products contained higher or lower levels of omeprazole than stated on their labels, ranging from as little as 36.3% to as much as 135% of the level claimed on the label.”  The statement goes on to say, “FDA has serious concerns about unapproved animal drugs. They may not be properly manufactured or labeled. Horse owners and caretakers are advised to avoid using unapproved animal drug products, including omeprazole products.”

 

We've heard grumblings from consumers believing the FDA just targeted those particular companies for hidden reasons and/or that Merial, the maker of the only FDA-approved equine gastric ulcer medications, was behind the warning. However, these beliefs are misguided.

 

The use of medications that are not FDA-approved is risky. Remember our articles about compounding pharmacies? We believe it's risky and not worth your time or money to use drugs from compounding pharmacies.  And, given that some of these products involved in the FDA warning are inconsistent with their dose strength, their use would subject your horse to a roller coaster of medication doses. Usually, horses given non-FDA approved medications wind up receiving subtherapeutic doses,  which not only equates to dollars being tossed into the manure pile, but also can confuse owners as to what is actually going on with their horse.  

 

Consider this: if your horse shows signs of gastric ulcers, you would expect that giving the horse an omeprazole anti-ulcer medication would cause a resolution of those signs.  But if you use a product that is not true to its label, you may end up mistakenly concluding that the cause of your horse’s problems are not gastric ulcers… when in fact they actually are.  This is probably the biggest factor weighing into why use of non-FDA approved products results in harm to horses. 

 

With the problem of equine ulcers becoming increasingly familiar to horse owners and veterinarians, the use of ulcer medication is likely to become more prevalent.  

 

There are two FDA approved anti-ulcer formulations on the market.  Both manufactured and marketed by Merial, Gastrogard and Ulcergard may be given at varying doses on a daily basis.  They both actually contain the exact same contents: each tube consists of 2.28 grams of omeprazole paste.  The difference is that Gastrogard has been approved by the FDA to be marketed as a prescription product to use for the treatment of diagnosed gastric ulcers.  Ulcergard, on the other hand, has been approved for marketing as an over-the-counter product for use in preventing gastric ulcers.  Other than their labels, there are no differences between the two products.  

 

But what makes these products so special?  What they have that the others lack boils down to a few critical elements:

 

1.   They are FDA approved.  This means that they have been rigorously tested for safety, efficacy and accuracy of label claims.  

 

2.  The chemical make-up of Gastrogard and Ulcergard renders them much more usable by the body.  Most folks assume that because gastric ulcers are occurring in the stomach, that the medications work once they are in the stomach.  This is inaccurate.  The medications must pass through the stomach and into the small intestine where they can then be absorbed into the bloodstream.  Once in the blood, they travel to the stomach from the other side of the wall and act to shut off the hydrogen proton pumps that create stomach acid.  The key to the product success relies partly on the omeprazole being able to pass through the stomach without being denatured by the acid.  To accomplish this, the drug manufacturer enterically coats the medication.  

 

Take home point: The copy-cat medications are not enterically coated in most cases, rendering them susceptible to digestion by stomach acid.  End result: your money being wasted and your horse not getting the treatment he needs.

 

Make life easy on yourself and your horse!  Use FDA-approved medications and work with your veterinarian to determine an appropriate dose.  Beware of compounded drugs!

 

 


John Strassburger The Equine Things That Matter Most
by John Strassburger

John Strassburger, Horse Journal’s Performance Editor, is a graduate A Pony Clubber. He currently competes in eventing at the Intermediate level. As editor of The Chronicle of the Horse for 20 years, he covered six Olympics and thousands of competitions. With his wife, he operates Phoenix Farm (phoenixsporthorses.com), a breeding/training facility in California.

Email John

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Oh The Weather Outside Is Frightful

By John Strassburger, November 19, 2014

November in Northern California--green fields, fog and rain.November in Northern California--green fields, fog and rain.

 

Yes, this is one more blog about the dread of winter and taking care of horses in it. (You can insert the

Game of Thrones

meme about “Winter Is Coming” here.) I can already hear you saying, while you’re dealing with the arctic cold and blizzard conditions gripping much of the country right now, “But you live in California. How can you complain about winter? You don’t even have winter.”

Well, you’re half-right. I’m a New Jersey native, and then I lived for almost 30 years in Pennsylvania and Northern Virginia. So I’m intimately familiar with the joys of trying to ride on frozen ground, chipping the ice out of water buckets, shoveling a path to get to the barn, getting stuck in snow or ice on the way to or from work, being snowed in for days by blizzards, having no electricity because an ice storm has torn down the power lines.

My wife, Heather, is a native Californian, and when we met on the East Coast, I confess I found her extreme reaction to winter a bit out of proportion. And she tells me that I met her after the worst of it was over—she’d already gone through her first winter, where she’d had to learn from scratch how to dress and how to function in a winter wonderland.

She never really adapted to what I thought of as just the way the seasons worked. And when we discussed moving back to her homeland, her hatred of winter weather was a primary reason for wanting to return.

 I was a bit more ambivalent. I mean, seasons are seasons—how do you move through the year without them?

As it turns out, I’ve done just fine without seasons as I knew them. I don’t miss the ice and snow at all, and when I see footage of my old stomping grounds covered in the white stuff, I remember how much I don’t mind not living in fear of frozen pipes, chipping ice out of tanks and waterers, or schlepping hay through deep snow.

But contrary to popular belief, we do have seasons here in Northern California, even if they are very different than what I grew up with. Our winter is usually mid-November to mid-March, and it usually consists of 45-degree temps and rain, interspersed with spikes of 25- or 30-degree nights with 65- or 70-degree days.

(In December and January our pipes can freeze at night, but by 9:00 a.m. the morning sun has almost always melted the ice in them. And in the winter we can see snow on the mountain tops about 25 miles to the east—the best way to experience snow!)

Once it stops raining in March or April, we don’t see the rain again until October or November. Spring strikes with a blast of warmth and green.  Some years it’s a lovely slow climb of progressively warmer days, and some years it goes straight to the 80s, but either way spring is generally short, because pretty much from May to October, we have summer.

Our fall is usually just a short prelude to the rain of winter, and while we don’t have a lot trees that change color, we do live in wine country, so we do get to watch all the grape leaves turn in the wineries across the county.

Horses, being creatures of habit and nature, tend to all behave as though the seasons are occurring, even when they aren’t. So we often have to clip their coats as early as early October, as many of them grow coat for Maine or Wisconsin, and we often experience 80-plus-degree days. The change from seasons can be a bit abrupt also, so we often talk about “colic weather” and “abscess weather,” so we keep a close watch when the temperature and moisture levels start yo-yoing in the spring and fall.

 The final, and biggest difference, is hay season—when I lived in the East, we fed lots of hay in the winter but usually drastically reduced hay feeding in the spring and summer, as thunderstorms made the grass long and lush.

But it’s the opposite in California. As I’m sitting here in Mid-November, and I’ve just seeded my pastures, and I’m watching green grass fight its way to the surface after our first strong rain. If this is a good rain year (which we haven’t had since the winter of 2011-2012) we’ll nearly stop feeding hay in another few weeks, as our grass grows lush though the winter and in to spring. Then, in late April or May, hay consumption will increase again, as the grass dries out and becomes dormant.

While we do avoid the snow of winter, we do spend several months fighting mud—scraping it off the horses, ourselves and everything else. We do get tired of the mud, and it sometimes feels like your horses will never be properly clean again.

But spring will come, and the mud will dry, the horses will get a bath, and we’ll remember why we live here. And even before that, as we scrape the mud from their coats, we’ll think to ourselves, “At least it isn’t snowing.”

 

 

 


Grant Miller, DVM Vet Check
by Grant Miller, DVM
Grant Miller is a Veterinary Editor for the Horse Journal and currently practices in Northern California. His areas of interest include acupuncture, chiropractics, performance horse medicine, geriatric horse care, and forensics. He grew up riding in the Pony Club and studied dressage until he attended veterinary school at UC Davis. In 2007 he founded The Sonoma County CHANGE Program to assist his local animal control department with equine humane cases. View more blogs

Tips to Make Your Horse Drink

By Grant Miller, DVM, November 16, 2014


Automatic waterers can fill slowly or completely freeze in cold weather, thus restricting available water.

This week’s front of bitter cold arctic air sweeping the middle and eastern United States is making many pull the horse blankets out of storage and finally accept that winter is here.  With the change of season comes the resurgence of winter problems.  Pesky ailments like rain rot and thrush are among them, but they pale in comparison to the big guys - like colic- an issue that commonly occurs when temperatures abruptly plummet.  Why? 

Because horses have trouble drinking cold water and often “give up” a few sips in. Consequently, they can gradually become dehydrated to the point where their digesta impacts in the tortuous curvatures of the intestine or colon. Healthy drinking can head colic, as well as several other problems off at the pass.  Thinkstock
Credit: Thinkstock
Winter snow's pretty, but it's not without critical horsekeeping challenges.


Here are some tips to increase your horse’s water intake this winter:

1.   Check water to make sure pipes aren’t frozen/ ice sheet hasn’t formed.

This tip goes without saying- but it is so easy to forget to check your horse’s water source daily (especially when the roaring fire and cup of apple cider await you back in the house!).  Horses can only last for a matter of hours without water before they begin to be dehydrated.  To avoid the vet’s colic tube, check those water sources! Make sure that they have adequate and accessible water, and also routinely test that they are filling in a timely manner if they are automatic. See Solar Tanks.

2.   Heat water with an electric bucket warmer.

There are all sorts of bucket heaters available on the market ranging from handheld submersible warmers to buckets with permanent heating coils built in. In the case of the handhelds, most people just submerse them in the water bucket while they are cleaning the stall each day.  The water doesn’t necessarily get warm, but it is heated enough to bring the temperature into a more tolerable range to encourage drinking. 

The advantage of a hand held warmer is that it works relatively quickly (a 20 gallon bucket can be heated up by 10 degrees in about 15 minutes). The disadvantage is that they are labor intensive. 

Buckets with permanent heaters are great because you just have to plug them in.  But therein lies a weakness since the cord must be kept out of reach of the horse. Additionally, the heating implements are not known for their longevity and so these types of buckets may only last a season or two.

3.   Feed a warm bran mash a couple of times per week.

The high fiber content of bran along with the warm water used to make it into a mash can provide a bit more water content in the diet.  The average bran mash combines between 5 and 8 cups of bran with enough water to make it stick together in clumps when handled.  Be careful about feeding bran too often- it can lead to a calcium/ phosphorous imbalance which could result in serious problems! Truth be told, most horse owners use bran mashes as a vehicle to deliver salt into the horse’s system, but we will get to that in a moment. 

4.   Make sure your horse is current on dental care.

If a horse unevenly wears his teeth, excessive pressure on some of the teeth can result in gingival (gum) recession and subsequent root sensitivity.  We all know what ice cold water feels like when it touches the nerves in our teeth.  Horses feel no different.  They will be deterred from drinking frigid water if they have dental issues.  Because routine dental care enables us to balance the occlusal surfaces in the horse’s mouth, gingival recession is minimized, thus reducing tooth root nerve sensitivity.

5.  Feed salt.

What is the best way to make a horse drink?  Make him thirsty! What is a cheap and easy way to induce thirst? Feed salt! A couple of tablespoons of salt or electrolytes can go a long way when you “lead a horse to water.” Remember- the goal is to make him drink. Be careful though- from time to time horse owners will decide to put electrolytes in the horse’s water. But that is not what electrolytes were designed for - and drinking salt water is not going to result in a favorable outcome! Just feed some salt or electrolytes every day, and it will help with water intake. See Supplementing Salt.

With these tips in practice, you will keep your horse happier at the water trough.  Happy horses make for happy owners so enjoy the fire and the cider, and rest assured that your horse is getting enough to drink.

Deb M. Eldredge, DVM From The Pile And Beyond
by Deb M. Eldredge, DVM
Deb M. Eldredge, DVM is a semi-retired veterinarian and award winning writer. She spent the first 15 years of her life earning money to buy a horse and never looked back. Deb was involved with 4-H and Pony Club, then moved on to polo at Cornell where she earned her DVM degree. She has competed in Western and Hunter/Jumper, low level combined training and competitive trail rides. She currently lives with six equines. Three are senior horses – an Arab, An Appaloosa and a Quarter Horse. The “youngsters” are a mini horse and two donkeys. View more blogs

FDA Warnings On Ulcer Drugs

By Deb M. Eldredge, DVM, November 14, 2014


UlcerGard is available without a prescription. GastrGard requires a prescription. Both are FDA-approved for the treatment of ulcers.

 

As of today, November 12, 2014, the U.S. Food and Drug Administration (FDA) has sent out letters of warning to a number of companies about unapproved drugs that contain omeprazole and are being marketed for horses. Omeprazole is most commonly used in the treatment of and prevention of gastric ulcers in horses. 

These particular versions of the drug have not gone through safety and efficacy testing that the FDA requires. In addition, the FDA’s own testing showed that some versions did not contain the stated amount of omeprazole. Some were under (as little as 36% of the drug present) and some were over (up to 135 % of the drug found). 

The only FDA-approved versions of omeprazole for horses at this time are GastroGard and UlcerGard, both manufactured by Merial.

Products covered in the warning letter include: AbGard, Abler Omeprazole, Abprazole, Abprazole Plus, Gastro 37 OTC, Gastroade Xtra, GastroMax 3, Gastroted, Lomac Equine, Omaktive Oral Paste, Omeprazole Ranitidine Paste, Omoguard Paste, UlcerCure OTC and Omeprazole Oral Paste. We think these products should be voluntarily removed from the market. If we were consumers who purchased these medications, we would consult with the retailer where they were purchased about possible refunds. 

As always, any complaints about animal medications can be made to the FDA by contacting a consumer complaint coordinator or filing a report using the Veterinary Adverse Drug Reaction form.  You do not have to be a veterinarian to do so. 

We all like to complain quite loudly about the FDA – wishing they would approve drugs we want for our horses faster, wishing they would lighten up on requirements for drug approvals, etc. This case demonstrates why our system of drug approval with the FDA works. 

Yes, all the products tested contained a drug that is approved for ulcers – one that we know helps horses with gastric ulcers or a tendency to develop ulcers in certain situations. BUT, the FDA states these companies did not go through the required procedures to market the products as drugs, and the actual amount of medication found in some of these products did not match the label. 

If your horse has liver disease, giving what amounts to an overdose of omeprazole could cause some problems. If your horse is taking omeprazole to help counter side effects of NSAIDs (nonsteroidal anti-inflammatory drugs) and he is not actually getting the full amount prescribed, you could, again, have problems as the lower amount may not be effective. 

The FDA looks at a variety of areas before doing a recall. There may be adulteration problems – something in the medication that does not belong there. This could be a chemical contaminant or a biological one. The formulation may not be correct (and that would include not having the specified amount of medication present in the product). 

Depending on the exact situation, I wouldn't be surprised if an official recall is sent out. However, the most serious recalls are for products that have the potential to cause serious health problems or even death. Less serious are for products that have a low likelihood of causing a health problem or are only going to cause temporary/reversible problems. Least serious are products that aren’t going to cause any adverse health problems but don’t work or are misleading. 

So while we do grump about the FDA at times, we should also thank them for keeping our horses (and our food supply and our own medications) safe.

 

 

 


Cynthia Foley Horses Keep Us Grounded
by Cynthia Foley

Cynthia Foley is the Editor-in-Chief of Horse Journal, which focuses on real-life horse-product field trials with buying advice and recommendations. An experienced horsewoman, writer and editor, she competed successfully in the hunter/jumper divisions for many years and, after completing college, moved to Kentucky where she learned the Thoroughbred racing industry, including several years as assistant manager at a major rehabilitation and training clinic outside of Lexington. When she and her husband moved to Virginia’s Hunt Country, she secured a position at The Chronicle of the Horse, where she worked as assistant editor. She is an avid dressage rider.

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Benefits of Barn Work

By Cynthia Foley, November 12, 2014

Thinkstock
Credit: Thinkstock
Grooming and throwing hay are part of the fun.

A friend told me today that her daughter made her school's volleyball team. She was surprised by the feat because the family wasn't a "sports" family. Oh, they're accomplished, all right. Both parents are successful doctors, and the kids are equally brilliant and have made their mark in things like music and, of course, horses. But the sports team thing was a first.

Still, she said, her daughter is strong and fit. How could she not be with a barn full of horses and other animals to take care of, she said?  When you're a horse kid, you learn early on to carry 50-lb. feed bags and toss hay. You don't consider the physical benefits of all that work. And that got me thinking . . .

As a kid, my dad used to tease me that I was as muscled as I was because all I did was ride (no, I don't look as good as that now). My legs were hard and muscled - not pencil thin elegant like some of my classmates - but I wouldn't have had it any other way. All I wanted to do was horses. Still is. Every spare hour and every spare dime goes to the horses. (Yes, I'll talk more about barn building in upcoming blogs.)

I know I'm fit. I know I could weigh less, especially as I battle middle age, but I have strength and endurance. Have you ever seen a non horse person try to gracefully put a saddle on a horse's back, especially a Western saddle? It's not pretty.

Like you, I'd bet, I've developed other handy skills that many people lack, like knowing how to mend a fence, fix minor plumbing issues and handle other barn emergencies. I'm sure I'm not the only horse person who can hold a bandage against a bleeding horse with one hand while dialing the vet's phone number with the other. And most of us can drive with the best, especially when it comes to backing a trailer into a tight spot. 

We mow, throw hay bales, carry bedding, clean stalls, fill and hang water buckets, drag arenas, move jumps or set up a dressage arena - all part of having a horse and your own barn. Hard work, they call it. A thorough grooming - "spa day" for the horses - will leave you wearing more dirt than the horse and an ear-to-ear grin as you look at your beautiful steed. I guess work doesn't seem like work when you love it so much. 

Riding itself is a fitness builder. I remember Mike Plumb, three-day Olympic champion and renowned trainer, telling readers in the early days of Horse Journal that, if they can't ride several horses a day, try to find a place to swim, as it's the best non-horse sport we can do to increase our physical condition for riding. That's because it also involves the entire body.

My favorite riding instructor, Ellen Stanton, said students were often amazed when they learned how much work riding well really is. And she was right. If you find that long-rein walk break during a training session is just for the horse's sake, you aren't putting enough effort into your riding.

Yes, it's work. And it gets more difficult every year. But we don't care. Life wouldn't be worth living without it.

 

 


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