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Sucralfate for Veterinary Use
by Barbara Forney, VMD
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Overview
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Therapeutic Class
Local gastro-protectant
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Species
Dogs, cats and horses
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Commonly Prescribed by Vets for:
Ulcers within the gastrointestinal tract.
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FDA Status
No veterinary approved products available.
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Search for Available Dosage Forms
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Basic Information
Sucralfate is a hydroxy aluminum salt of sucrose octasulfate that acts as a local mucosal-adherent. In an acidic environment, sucralfate forms a sticky viscose-gel that adheres to protenacious exudates within an ulcer crater. This Band-Aid® effect lasts about six hours. At a higher pH, sucralfate may remain in suspension, but may improve the gastric environment by adsorbing pepsin, buffering hydrogen ions, stimulating prostaglandin E, increasing bicarbonate secretion, stimulating mucous secretion and binding epidermal growth factor. The absorption of sucralfate is minimal; its actions are local rather than systemic and it does not affect gastric-acid output or enzyme activity. Sucralfate is used to treat oral, esophageal, gastric, duodenal and colonic ulcers. Usually, sucralfate is given on an empty stomach.
Dogs and Cats
Sucralfate is used to treat ulcers and upper GI disorders of dogs and cat. Common causes of GI erosion and ulceration in dogs include drugs (particularly NSAIDs and corticosteroids), toxic-chemical ingestion, liver disease, renal failure, carcinoma, stress (trauma, shock, sepsis and burns), inflammatory bowel disease, mast-cell tumors, hypoadrenocorticism and any condition causing an excessive secretion of gastric acid.
Horses
Sucralfate is used in neonatal medicine as a local mucosal-protectant. The protective role of sucralfate in the sick equine neonate may be related to local protection against ischemia-reperfusion injury. Sucralfate has been shown to be beneficial in lesions of the glandular mucosa and less so for lesions of the squamous-gastric mucosa.
The gastric environment in the normal neonatal foals is acidic, while the gastric environment in the critically ill neonate is more variable. Recent research in the rat and in humans supports the use of sucralfate and calls into question the use of H2-receptor antagonists and proton-pump inhibitors in the neonatal population. H2-receptor antagonists and proton-pump inhibitors are thought to be more appropriate in the older foal.
Sucralfate is used to treat gastric ulcers and ulcers of the right dorsal colon in adult horses. It usually is used with an H2-receptor antagonist or a proton-pump inhibitor such as omeprazole. Sucralfate appears to provide significant pain-relief in horses that show abdominal pain due to ulcers.
Sucralfate Side Effects
Side effects are rare. Constipation and hypo-phosphatemia may occur in a small percentage of patients.
Precautions
Sucralfate may decrease the rate of gastric emptying and slow GI transit time.
Drug Interactions
Sucralfate may affect the absorption of many drugs and, in general, administration should be separated for other oral drugs including: NSAIDs, H2-receptor antagonists, fluoroquinolones, digoxin, ketoconazole, levothyroxine, penicillamine, tetracyclines, fat-soluble vitamins and warfarin.
Overdose
It is unlikely that an overdose of sucralfate will cause clinical problems because it is so poorly absorbed. Very high doses (50X) have been administered to laboratory animals without mortality.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
The information contained on this site is general in nature and is intended for use as an informational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of the products shown, nor is the information intended as medical advice or diagnosis for individual health problems or for making an evaluation as to the risks and benefits of using a particular product. You should consult your doctor about diagnosis and treatment of any health problems. Information and statements have not been evaluated by the Food and Drug Administration ("FDA"), nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood compounded veterinary preparations are not intended for use in food and food-producing animals.