Vets may prescribe sucralfate for dogs with oral, esophageal, stomach, or small intestinal ulcers and other GI maladies. Integrative veterinarian Dr. Julie Buzby shares what dog parents should know about this “GI band-aid” medication. Discover the uses, dosing options, how to give it, side effects, contraindications, and drug interactions.
Have you ever come home to find that your beloved dog has chewed up your favorite pair of shoes, raided the kitchen trash can, or eaten something unidentifiable in the yard? Yep, we’ve all been there. Inevitably, your dog will ingest something that doesn’t agree with his or her tummy.
While there are dogs with what my grandma used to call a “strong constitution”—the ability to eat anything without so much as a tiny burp—other dogs aren’t so lucky. It’s these not-so-lucky dogs that usually end up taking a trip to the vet for vomiting, diarrhea, and/or belly pain.
At the appointment, the vet may prescribe a medication like sucralfate as part of the treatment plan.
What is sucralfate for dogs?
Sucralfate is a prescription medication that can bind to and protect damaged tissue in the upper digestive tract (mouth, esophagus, stomach, and upper part of the small intestines). Often prescribed under the brand name Carafate®, sucralfate is FDA-approved for treating ulcers in humans. Vets also use it for dogs, cats, and many other animal species in an “off-label” or “extra-label” fashion.
Sucralfate works similarly to Pepto-Bismol® and Maalox®, two over-the-counter products commonly used for digestive upset in people. (Remember the old Pepto-Bismol slogan, “Coats, soothes, relieves”?) However, you should NOT give your dog Pepto-Bismol for dogs or Maalox.
Sucralfate is a much better option. It is safe and effective for dogs and many other animal species, has few side effects, and is cost-effective for pet parents.
What does sucralfate do for dogs?
Sucralfate is a gastroprotectant that works by forming a protective barrier over ulcerated or eroded areas in the lining of the GI tract (mucosa). Once ingested, sucralfate, a sucrose aluminum hydroxide compound, reacts with stomach acid to form a sticky paste that adheres to the damaged tissue.
Much like a band-aid, sucralfate shields damaged areas in the gastrointestinal tract from irritating substances like stomach acid, bile, and digestive enzymes. Plus, it may even actively help the ulcerations heal. Sucralfate also stimulates the production of prostaglandins—molecules which help protect the GI tract against cellular damage.
What is sucralfate used for in dogs?
Veterinarians may prescribe sucralfate for conditions such as:
- Ulcers and erosions in the mouth, esophagus, stomach, and duodenum (the uppermost section of the small intestine).
- Inflammation of the esophagus (esophagitis in dogs) due to vomiting, foreign body ingestion, toxins, infections, etc.
- Inflammation of the stomach (gastritis in dogs) from dietary indiscretion (eating something he or she shouldn’t), food allergies, chronic GI disease, etc.
- GERD (gastroesophageal reflux disease), a condition characterized by chronic acid reflux in dogs
- Ingestion of a toxin that is likely to cause ulcerations of the GI tract
- GI damage due to stress—studies are looking at using sucralfate in stress-related mucosal disease in dogs
However, it is important to remember that while sucralfate does a good job of protecting the damaged lining of the GI tract and helping it heal, it doesn’t really address the underlying cause of the irritation or ulcers. Thus, dogs may need additional treatment beyond sucralfate.
What is the sucralfate dose for dogs?
Sucralfate is available in 1 gram tablets and as a 1 gram/10 milliliter liquid suspension. Your veterinarian will be able to determine an appropriate dose based on your dog’s weight. Compounding pharmacies can also create a sucralfate suspension for dogs that need a different dosing strength.
Dogs typically take sucralfate by mouth every 6 to 12 hours. It is important to administer it on an empty stomach, at least two hours apart from other oral medications. Staggering the doses allows the protective barrier to form on the inflamed mucosa and keeps the sucralfate from interfering with the absorption of other medications.
It is important to follow your vet’s instructions and not stop giving the sucralfate early. Depending on the underlying cause of your dog’s digestive upset, your veterinarian may recommend keeping your dog on sucralfate for several weeks to help ensure a complete recovery.
What if I miss a dose of sucralfate?
If your dog misses a sucralfate dose, a double dose isn’t necessary—just continue on with the regular dosing schedule.
How do you give sucralfate for dogs?
Sucralfate is most effective when given as a slurry or liquid because the tablets don’t dissolve well on their own. If your veterinarian prescribes the tablet form, he or she will likely recommend making it into a slurry before giving it to your dog. Your vet may have a different technique, but this is how I instruct my clients to make a sucralfate slurry:
- Crush the tablets using a pestle and mortar if you have one handy. Otherwise, crushing the tablets between two spoons works great, too!
- Pull the stopper from the oral dosing syringe and block the tip with your finger. Add about half the prescribed amount of water, then the sucralfate powder, and then the remainder of the water.
- Replace the stopper, but leave some air in the syringe. With your finger still over the end of the syringe, gently shake the syringe a few times to mix the powder into the water.
- Push the air out of the syringe, then administer the sucralfate slurry to your dog.
How long does it take for sucralfate to start working?
Sucralfate typically takes effect in as little as one to two hours, but it is often hard to see its effects at first. It is relatively short-lived, so by giving your dog sucralfate several times daily, you are providing continuous protection of the inflamed mucosal tissue.
What are the side effects of sucralfate?
Since sucralfate works locally in the GI tract and is not absorbed into the body, the side effects are minimal. Constipation is the most commonly reported side effect of sucralfate in dogs.
While not truly a side effect of sucralfate, the suspension has an unpleasant, chalky taste, which can make it challenging to give it to some dogs. If your dog experiences vomiting or constipation, or refuses to swallow the medication, contact your veterinarian about alternative treatment options.
Can dogs overdose on sucralfate?
Problems from a sucralfate overdose are unlikely because it has a high margin of safety and is not absorbed into the body. However, it is possible that a significant overdose could cause constipation.
Even so, if you are worried your dog may have gotten an overdose of sucralfate, don’t hesitate to contact your vet or an animal poison control center for advice.
Are there dogs who should not take sucralfate?
While veterinarians consider sucralfate a safe medication, certain conditions make it contraindicated for use in dogs.
Not for dogs who are allergic to sucralfate
As with any medication, do not give sucralfate to dogs with a previous history of an allergic reaction to sucralfate.
Use with caution in dogs who have constipation or have ingested a toxin
Vets will prescribe sucralfate cautiously in dogs with a history of constipation or delayed intestinal transit times, as it could worsen these conditions. This can be especially problematic if your dog has swallowed something potentially toxic. Slower transit times will allow the body to absorb more of the toxin before it passes in the feces.
Sucralfate should not be used in dogs with a perforated stomach ulcer
Sucralfate is contraindicated in perforated stomach ulcers in dogs due to the possibility that the medication will leak into the abdomen along with other intestinal contents. If this happens, peritonitis (inflammation and/or infection in the abdominal cavity) can develop, which can be life-threatening.
Potentially problematic for dogs with kidney failure or those who take aluminum-based antacids
In the late stages of kidney failure in dogs, vets will be very cautious when using sucralfate. If your dog takes aluminum-based antacids or phosphate binders like Amphojel®, administration of sucralfate could inadvertently cause elevated serum aluminum levels. While aluminum toxicity is rare in dogs, symptoms include weakness and difficulty walking.
Do not give to dogs with swallowing problems
Dogs with swallowing disorders should not take sucralfate due to the risk of aspiration.
Be careful using sucralfate in pregnant or lactating dogs
Pregnant women have safely taken sucralfate to help treat esophageal reflux, but veterinarians still recommend using it with caution in pregnant and nursing animals.
Which medications may interact with sucralfate?
Sucralfate can delay the absorption of over-the-counter (OTC) and prescription medications, vitamins, and nutritional supplements. Therefore, your veterinarian will likely recommend giving sucralfate on an empty stomach at least two hours apart from other drugs.
Medications that may be particularly impacted when given at the same time as sucralfate include:
- Antibiotics
- Fluoroquinolones (ciprofloxacin, enrofloxacin, marbofloxacin, orbifloxacin)
- Macrolide antibiotics (azithromycin, erythromycin)
- Tetracyclines (doxycycline, minocycline)
- Anticoagulants (warfarin)
- Antiepileptics (phenytoin)
- Antifungals (ketoconazole)
- Cardiac medications (digoxin, furosemide)
- Bronchodilators (theophylline)
- Chelating agents (penicillamine)
- NSAIDs (carprofen for dogs, meloxicam)
- Steroids (prednisone for dogs)
- Thyroid medication (levothyroxine)
- Vitamins (fat-soluble A, D, E, K)
However, in some cases, separating these medications from sucralfate by at least two hours does help avoid issues with reduced absorption.
Can dogs take sucralfate and omeprazole or famotidine?
There is some debate in the veterinary community about whether or not dogs should take both sucralfate and acid-reducing medications like omeprazole for dogs, famotidine, or cimetidine. One of the concerns is that the antacids may make the sucralfate less effective, since sucralfate relies on the acidity of the stomach to form the protective paste.
To reduce that issue, some veterinarians recommend giving the sucralfate 30 minutes before the antacid if prescribing both medications. However, your vet knows your dog’s particular situation, so it is best to follow his or her advice regarding using antacids and sucralfate.
Sucralfate and other GI medications
Since sucralfate helps heal ulcers but doesn’t address the underlying cause, your vet may prescribe additional medications. In that situation, pay close attention to your vet’s instructions regarding separating the dosing of sucralfate from other medications like metronidazole or Cerenia for dogs.
Work with your veterinarian
Sucralfate can be a great option for dogs with ulcers of the mouth, esophagus, stomach, and upper small intestine when used properly. As with any medication, it is important to follow your veterinarian’s directions about how and when to give the sucralfate.
If you have any concerns about your dog or questions about sucralfate, please talk to your veterinarian. Open communication with your vet is important so you can work together to get your dog, and his or her GI tract, back to feeling good again.
