Sucralfate for dog stomach ulcers is a medication obtained by prescription that can be purchased at a vet’s office or at a pharmacy. While this medication is designed for humans, veterinarians can prescribe it and dispense it legally as an extra-label drug. While stomach ulcers in humans are quite a common occurrence, in dogs stomach ulcers are less common and are often triggered by underlying medical conditions or the administration of medications which predispose to their formation. Sucralfate for dog stomach ulcers is a medication that can be effective in preventing and treating gastric erosion and ulcers.
Stomach Ulcers in Dogs
The lining of a dog’s stomach is coated with a thick layer of mucus meant to protect itself from the highly acidic digestive juices which populate this organ. The formation of stomach ulcers occurs when there is a break in the lining of the stomach, but why does a break in the lining of the dog’s stomach occur in the first place? It may occur for various reasons.
Also known as gastric ulcers, stomach ulcers tend to form when there is increased acid production or when the protective measures to prevent ulcers from forming in the first place, are, for some reason, not working as they should.
Underlying causes of stomach ulcers in dogs include certain types of cancers (mast cell cancer, gastrinomas), liver or kidney disease and the administration of certain ulcerogenic types of drugs such as aspirin, nonsteroidal anti-inflammatory drugs ( Rimadyl, Metacam, Deramaxx and Previcox) and high-dose steroids (prednisone). Sometimes ulcers are idiopathic, meaning that no exact cause for their formation is ever found.
Ulcers in dogs, on top of developing in the stomach, may also develop in the dog’s esophagus (esophageal ulcer) and duodenum (duodenal ulcers). Ulcers may have a tendency to bleed which may show up as frank blood in the dog’s vomit (fresh, red blood) or as digested blood in the dog’s feces (melena).
Symptoms of ulcers in dogs include vomiting, hematemesis (presence of blood in the vomit), melena (dark, tarry stools due to digested blood), weight loss, reduced appetite and abdominal pain.
Stomach ulcers are mostly diagnosed by endoscopy, where a tube with a camera attached is inserted through the mouth and then reaches down into the stomach. This procedure requires sedation/anesthesia. Sometimes vets may try to tentatively treat stomach ulcers in dogs solely based on the dog’s history and physical signs.
Treatment of stomach ulcers in dogs consist of promoting rapid healing and protecting the area from further damage. This is accomplished through H2-receptor antagonists drugs such as famotidine (Pepcid), cimetidine (Tagamet), ranitidine (Zantac) and cytoprotective binding agents such as sucralfate.
“Carafate is what we call a liquid bandaid. It helps to heal any ulcers in the esophagus or stomach. But! If there are no ulcers, than it does nothing.”~Dr. Andy, veterinarian
Sucralfate for Dog Stomach Ulcers
Sucralfate for dog stomach ulcers, also known as carafate, is a gastric cytoprotectant medication meaning that, the ulcers are treated not by reducing the secretion of gastric acid, but by increasing mucosal protection. This drug is a complex of sulfated sucrose and aluminum hydroxide and works by reacting with gastric acid and binding to tissue proteins at the base of the ulcer.
The effects of sucralfate have often been compared to a powerful “bandaid, ” forming a protective coating over the injured mucosa while neutralizing stomach acid, inactivating pepsin and absorbing bile acids and pancreatic enzymes. Sucralfate also stimulates local prostaglandins meant to protect the gastric mucosa.
Courtesy of all these powerful effects, sucralfate in veterinary medicine is typically prescribed to treat reflux esophagitis, stomach ulcers and irritation, and duodenal ulcers. It is also prescribed for dogs on non-steroidal anti-inflammatory drugs or high-dosage steroids or dogs suffering from kidney failure or undergoing significant stress.
According to Dr. Robert M. Hardy, a board-certified veterinarian specializing in internal medicine, the recommended dosage of sucralfate for dogs is 1 gram every 8 hours for large dogs and 0.5 grams every 8 hours for smaller dogs. Source: Textbook of Veterinary Internal Medicine. This means 1,000 mg three times a day every 8 hours for large dogs and 500 mg three times a day every 8 hours for small dogs.
Sucralfate works best on an empty stomach and therefore it is best given 1 hour prior to meals or two hours following a meal. Sucralfate is administered by making a slurry made of the tablet dissolved with water.
Side Effects of Sucralfate for Dogs
In humans, the side effects of sucralfate are quite rare. When they occur, they consist of constipation, diarrhea, nausea, upset stomach, indigestion, dry mouth, rash, itching, dizziness, sleepiness and back pain. In dogs, such side effects may probably be unlikely to occur.
Because sucralfate for dog stomach ulcers has a tendency to bind with other drugs, it’s important to administer it separately from other drugs, preferably 2 hours prior or two hours later. Drugs that are particularly affected, with a decrease in effectiveness when given along with sucralfate, include phenytoin, tetracycline and fluoroquinolone antibiotics.
Also, considering that sucralfate works better in an acidic environment, it’s suggested to not give the H2-receptor antagonists drugs famotidine (Pepcid) cimetidine (Tagamet) ranitidine (Zantac) at the same time. These drugs are better off given 30 minutes or more after administering the sucralfate.
While sucralfate is overall a pretty safe drug, long-term use in dogs with kidney failure or in dogs who are administered aluminum containing antacids, can turn to be problematic due to aluminum concentration which may lead to weakening of the bones and negative effects on the brain after many months or years of administration.
Sucralfate is probably safe to give in pregnant or nursing dogs considering that very little of this drug enters the bloodstream, point out veterinarians Dr. Kate A.W Roby and Lenny Southam in “The Pill Book Guide to Medication for Your Cat and Dog.” There are no studies on giving this drug to puppies, but its use is probably safe.
Sucralfate is safe to use in older animals and is one of the best ways to prevent and treat ulcers in senior dogs suffering from chronic kidney failure or other diseases known for causing ulcers in dogs of advanced age.