April Knudson, DVM, is an equine specialist with Merial Veterinary Services. She has a special interest in equine gastrointestinal health, infectious disease and lameness. She holds a doctor of veterinary medicine from the University of California-Davis. Below, she answers a question about the use of bismuth subsalicylate (Pepto-Bismol® or a generic equivalent) in horses.
Q. I’ve heard of people giving bismuth subsalicylate, commonly known as the human product Pepto-Bismol®, to their horses to help treat or prevent stomach ulcers. Does it work?
A. Bismuth subsalicylate is used in people to treat diarrhea and gastric distress such as nausea, indigestion and heartburn. It is not labeled for use in any animal! In fact, in the case of horses with ulcers, the use of bismuth is not recommended.
Once in the gastrointestinal tract, bismuth subsalicylate can be converted to sodium subsalicylate, causing gastric irritation. Additionally, salicylates, like aspirin, decrease prostaglandin secretion, which can further damage an already compromised stomach lining. For these reasons, bismuth is contraindicated in horses.
The only products that have been proven to be effective for the prevention and treatment, respectively, of equine stomach ulcers are Ulcergard® (omeprazole) and Gastrogard® (omeprazole). These drugs work by suppressing the amount of acid produced in a horse’s stomach, which increases the pH, and promotes healing of existing ulcers as well as reducing the potential development of new ulcers.
In some alleged “ulcer” products currently being compounded or marketed, bismuth and omeprazole are combined. There is no scientific proof these drugs work together and there’s actually reason to believe the combination of the two doesn’t treat or prevent equine stomach ulcers at all. Omeprazole is highly unstable in any type of acidic environment. Bismuth is acidic, so omeprazole likely degrades rapidly when combined with bismuth.
For the treatment of ulcers, Gastrogard® is the only FDA-approved and proven product to treat and heal equine stomach ulcers. Omeprazole is an inherently unstable drug, and both of these products contain a formulation proven to protect the active ingredient so that it will work to prevent or treat stomach ulcers in horses.
To determine whether a drug has been FDA approved, horse owners should look for the six-digit New Animal Drug Application (NADA) number, or in the case of generics, the Abbreviated New Animal Drug Application (ANADA) number on the label.
Or, look up the drug in the searchable database at AnimalDrugs@FDA http://www.accessdata.fda.gov/scripts/animaldrugsatfda/
When looking for ulcer prevention or treatment, horse owners should be sure they’re getting what they pay for and insist on using a product that’s been proven to work – in horses.
For more information about equine drugs, go to www.equinedrugfacts.com.
For more information about Merial's equine ulcer products, go to www.ulcergard.com
@FranJurga writes: This information is provided by Merial, which makes the approved products mentioned. This information has been edited and is shared for educational purposes by The Jurga Report.
Vintage Pepto-Bismal bottle by Roadside Pictures.