When deciding whether to treat equine ulcers with omeprazole or sucralfate  - it's important to first identify the type of ulcer you're treating. In general terms, omeprazole is effective on gastric ulcers while sucralfate alleviates the pain of both gastric ulcers and hindgut ulcers.

omeprazole or sucralfate
Your horse may need both!

Omeprazole alone wont treat all equine ulcers!

Sucralfate helps horses with ulcers by creating a protective coating on the surface of the ulcer.  It provides pain relief to the horse nearly immediately. However, if you treat a horse with sucralfate alone - you may just be masking the problem.

Gastric Ulcers: Omeprazole works to reduce the production of stomach acid. This will stop the formation of new ulcers, while sucralfate heals existing ulcers.

Hindgut Ulcers: Sucralfate provides a protective coating to the horse's hindgut, allowing existing ulcers to heal. Omeprazole does not treat issues of the hindgut.

However, omeprazole wont stop the formation of new ulcers in the hindgut. This comes down to diet, lifestyle and balancing hindgut bacteria with a probiotic supplement.

Sucralfate is a good preventative treatment for horses in stressful  'ulcer causing' situations. For example stress caused by long distance travel or competition. The protective coating will help prevent ulcers forming in the first place.

When do you need both omeprazole and sucralfate together?

Ulcers located in the pyloric, non glandular region are notoriously slow to heal .

Omeprazole alone will not heal these types of ulcers. Sucralfate inconjunction with omeprazole will be required to heal non-glandular and pyloric ulcers. Bad news is it may take up 8 weeks to completely heal.

Longterm horse ulcer treatment.

Identify and treat the core problem during the healing process.  First and foremost the lifestyle and diet of the horse should be considered to eliminate stressors and acid production. Sucralfate alone is an option for long term prevention of recurring ulcers and stress related ulcers. Read more about different types of equine ulcers.