The Money Barrel: Trevor Jeffers on Understanding Ulcers in the Performance Horse

Most barrel racers can name omeprazole and sucralfate, but far fewer can say what each one actually does inside the horse, or why giving it on top of a full feed bucket can waste most of the dose.

Trevor Jeffers can. He spent years as a clinical pharmacist in human hospitals, in the ICU and emergency medicine, before founding XactRx, an equine compounding pharmacy, out of one frustration: owners reaching for serious medications without knowing what the drug does, when to use it, or how to give it safely. Kayla Jones brought him on The Money Barrel podcast to work through ulcers in the performance horse, specifically in barrel racing.

• The 411 on Ulcers and Barrel Horses
• The Big, Bad Furosemide: Barrel Racers’ Lasix Questions Answered

The odds are stacked against the horse from the start. Built to graze and trickle stomach acid around the clock, horses were never meant to stand on two grain meals a day and haul down the interstate under lights and fireworks, and the research Jeffers points to suggests the large majority of performance horses have or have had ulcers. The episode gets past the label: how omeprazole, sucralfate, and misoprostol each work on a different part of the problem, why the empty stomach is not a suggestion, and why pulling a horse off an ulcer drug cold can leave it worse than before.

For anyone who has run a tube of ulcer meds because a barn friend swore by it, this one earns the listen. Patreon members get extra minutes with Trevor.

And the standing caveat, which Jeffers makes himself: a podcast is not a replacement for a veterinarian. Everything here is a starting point for that conversation, not a substitute for it.

About the guest

Trevor Jeffers is a clinical pharmacist and the founder of XactRx, an equine compounding pharmacy. He earned his doctorate at the University of Arizona, completed a hospital residency in intensive care and emergency medicine, and spent roughly seven years in human hospitals, learning to read the research and build a drug regimen patient by patient, before turning that training toward horses. His work centers on education: when a medication is worth reaching for, what to ask before giving it, and how to give it so it actually works.

Inside the episode

• Why the modern horse is built for ulcers: a continuous grazer, stalled and grained and hauled “in a little metal building with lights and fireworks”

• Squamous, glandular, hindgut, pylorus: where an ulcer sits, and why the location decides the drug and the timeline

• What each class actually does, from proton pump inhibitors like omeprazole turning the acid down, to H2 blockers, misoprostol, and sucralfate

• The empty-stomach rule, and how a full feed bucket wastes most of an expensive dose

• Why sucralfate “doesn’t play nice with others,” and how it earns its place before a haul or a run

• Why quitting an ulcer drug cold invites rebound ulcers, and what a proper wean-down looks like