Sucralfate for Dogs, Cats, and Horses

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Sucralfate (brand name: Carafate) is a prescription drug used to treat ulcers and upper GI disorders for veterinary patients including cats, dogs, and other animals. Sucralfate is not FDA approved for animals, so veterinary use is considered “extra-label.”

What is Sucralfate?

Sucralfate for dogs is an anti-ulcer medication given orally (in liquid or tablet form) for problems involving the mouth, stomach, esophagus, and upper small intestine. This compound of sucrose aluminum hydroxide reacts with stomach acid to create a paste-like substance that binds to proteins at the ulcer site. This works as a bandage to protect the ulcer from further irritation so they may heal.

Sucralfate for dogs is also used to treat related conditions such as cancer, megaesophagus, kidney or liver failure, or poison ingestion. This drug is often prescribed when animals are taking aspirin, NSAIDs, or piroxicam because these medications often cause ulcers.

What is Sucralfate Used for In Dogs?

In addition to treating existing ulcers, stomach lining erosion, and preventing new ulcers from forming, sucralfate can be used to treat additional canine conditions. Sucralfate for dogs is effective in preventing stomach inflammation, and the management of acid reflux disease (protection for the esophagus).

Kidney or liver failure, stomach bloating, stomach bloating, toxin ingestion, cancers, megaesophagus, and steroid treatments often have stomach ulcers as a secondary condition. Sucralfate is effective in countering situations where ulcers are likely to develop.

Sucralfate Side Effects in Dogs

Side effects of sucralfate for dogs are uncommon because this medication works locally and is not absorbed into the body.

Common Side Effects

  • Constipation
  • Vomiting (especially for cats)
  • Phosphate depletion

Less Common Side Effects

  • Weakening bones (with long term use)
  • Allergic reactions (breathing problems, hives).
  • Seizures
  • Fainting

If you notice any of these Carafate side effects in dogs, cease administration of the medication, and contact your veterinarian right away. In the event of an allergic reaction, seek immediate medical attention for your animal.

Sucralfate Precautions

Sucralfate for dogs may not be the best treatment for all veterinary patients.

Who Should Not Use Sucralfate 

  • Patients with known hypersensitivity.
  • Patients who have had an allergic reaction to sucralfate
  • Patients with megacolon (enlarged colon due to long-term constipation and feces retention).

Situations That Require Caution When Giving Sucralfate 

  • When the animal is prone to constipation.
  • When the animal is pregnant or nursing.

To ensure that pet’s sucralfate is the right medication for the patient, the veterinarian needs to be made aware of the following:

  • Side effects the animal has experienced in the past (especially antiulcer or antiacid medications).
  • History of digestive upset.
  • History of liver or kidney disease.
  • Any allergies.
  • Any medications or supplements the animal has been taking recently or will be taking in the future.
  • If the animal is pregnant or nursing, or if she is intended to be bred.

Only give prescription sucralfate to the patient it is intended for and used as directed. Contact your veterinarian if your animal’s condition does not improve, worsens, or if there is vomiting or stools with blood.

Are There Any Drug Interactions With Sucralfate?

Other medications may have negative interactions with sucralfate including hindering the effectiveness of such medications. The chelation with aluminum in sucralfate may interfere with absorption.

If medications are incompatible when taken together, dosing for these should be spaced apart (typically by two hours). The veterinarian can consult the pet owner on an appropriate dosing schedule.

Medications with possible interactions to sucralfate for dogs are:

  • Fluoroquinolone antibiotics (such as enrofloxacin, orbifloxacin, marbofloxacin, etc.)
  • Fat-soluble vitamins
  • NSAIDs
  • Antacids
  • Azithromycin
  • Cimetidine 
  • Digoxin
  • Doxycycline 
  • Enrofloxacin
  • Erythromycin
  • Ketoconazole
  • Levothyroxine or thyroxine
  • Marbofloxacin
  • Orbifloxacin
  • Penicillamine
  • Phenytoin 
  • Tetracyclines
  • Theophylline
  • Warfarin

Are There Any Risk Factors Associated With This Medication?

Sucralfate for dogs is not considered to have any major risk factors, but with some conditions, a patient will need to use an alternative medication, or not take the medication at the same dosing time as other medications. (See above section for important information on precautions.)

Storage

Sucralfate tablets are best stored in a cool dry place. Tablets should be in a tightly sealed container and kept away from direct sunlight.

Liquid sucralfate should also be stored at room temperature. Shake well before administering the dosage.

Medications should not be ingested by humans. In homes with children, a childproof container is recommended. If a human accidentally swallows this medication, call your doctor right away.

Instructions

Sucralfate for dogs can be administered by oral suspension (100 mg per mL), or by scored tablets (1,000 mg each). 

It is recommended to crush the tablets for better absorption. For this, you would administer the crushed tablets orally by mixing the powder with lukewarm water, then draw the mixture into a syringe.

The alternative is a compounding preparation or oral suspension liquid. For oral suspension, shake the medication well before the dose is administered.

Timing is a factor when administering this medication. Ideally, it should be taken at the same time every day on an empty stomach as stomach acid is needed to react with the medication. 

Depending on the veterinarian’s treatment plan, sucralfate doses may be given up to four times a day. Several doses provide continuous protection for the ulcers.

Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.

Timeline Tips

  • Follow your veterinarian’s instructions as they may differ from these recommendations. Finish the package and administer all doses. Don’t cease medication because the animal’s condition has improved as this could cause a relapse of the ulcers.
  • Sucralfate should not be taken with another medication. When the animal is on more than one medication, the doses should be staggered so that the sucralfate does not offset the effectiveness of the medication. Give sucralfate 30 minutes before the animal takes an antacid.
  • Sucralfate takes effect in 1-2 hours. For this reason, wait two hours before giving the animal any other medication. It’s ideal to space doses and feedings by one hour before a meal or two hours after a meal.
  • A dose of sucralfate may last 6 hours and the potency wears off at 24 hours.

Sucralfate for Dogs Dosage

These are general guidelines with sucralfate dosage for dogs. Always follow your veterinarian’s directions exactly.

Because of how quickly the medication passes through the system, dogs typically need two or more doses of the drug per day. 

One half to one full tablet (0.5 – 1 gram) is given orally about 3 times per day, about every 8-12 hours. A small dog may get a reduced dose of only a quarter to one half a gram every six to eight hours.

Sucralfate for Cats Dosage

These are general guidelines with sucralfate for cats dosage. Always follow your veterinarian’s directions exactly.

Carafate for cats dosage is usually 1/4 to 1/2 gram orally every 8-12 hours.

Missed Dose

A missed dose means the ulcerative condition goes unprotected for that time. To maintain the effectiveness of the medication, be careful not to miss a dose, and have the refill on the way before you run out.

In the case of a missed dose, keep up the regular schedule whenever possible. Skip the missed dose if it’s almost time for the next dose, then with the regular schedule. Doubling up is not advised. 

Sucralfate Overdose 

When overdoses of sucralfate occurred it was not fatal and most patients did not show any symptoms. In some cases, there were adverse reactions after the overdose. If there is an overdose, contact your veterinary office right away, or alternate emergency contact.

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