Sucralfate

Sucralfate is an aluminum–sucrose complex used as a local gastrointestinal mucosal protectant. Its principal veterinary applications involve damaged esophageal, gastric or duodenal mucosa. It is often used as adjunctive therapy while the underlying cause and acid exposure are addressed. Its local barrier action is distinct from inhibition of gastric acid secretion.

Group

Gastrointestinal mucosal protectant

Mechanism of Action

In the gastrointestinal environment, sucralfate forms a viscous complex that adheres to exposed proteins at injured mucosa. This barrier reduces contact of damaged tissue with acid, pepsin and bile components. Additional proposed actions include support of local prostaglandin-mediated defenses. The primary clinical effect is protection at the mucosal surface, with little systemic absorption.

Dose Rates

Dogs

Use / stage	Dose	Route	Schedule	Instructions
Mucosal protection	0.5–1 g/animal	PO	Every 8–12 h
Mucosal protection	0.5–1 g/animal	PO	Every 6–12 h
Severe GI bleeding initial mucosal protection — Loading	3–6 g/animal	PO	Once	Then lower maintenance amounts; suspension may be better retained than intact tablets.
Uremia-associated GI mucosal injury	33.3333333333 mg/kg	PO	Every 6 h	1 g per 30 kg.

Cats

Use / stage	Dose	Route	Schedule
Mucosal protection	0.25 g/animal	PO	Every 8–12 h
Mucosal protection	0.25–0.5 g/animal	PO	Every 8–12 h
Mucosal protection	0.25 g/animal	PO	Every 6–8 h

Horses

Use / stage	Dose	Route	Schedule	Instructions
Mucosal protection in foals	1 g/animal	PO	Every 8 h	Foals only.
Stress-ulcer prevention in foals	10–20 mg/kg	PO	Every 6–8 h	Adjunct to acid suppression.
Equine gastric ulcer syndrome adjunct	20–40 mg/kg	PO	Every 8 h
Right dorsal colitis adjunct	22 mg/kg	PO	Every 6–8 h

Ferrets

Use / stage	Dose	Route	Schedule	Instructions
Mucosal protection	75 mg/kg	PO	Every 4–6 h	About 10 minutes before feeding.

Reptiles

Use / stage	Dose	Route	Schedule	Instructions
GI irritation	500–1000 mg/kg	PO	Every 6–8 h	Very broad reptile report; species-specific reassessment required.

Indications

Adjunctive treatment of esophageal mucosal injury or reflux esophagitis in veterinary patients.
Adjunctive protection of selected gastric or duodenal ulcers and erosions.
Adjunctive treatment of selected equine glandular gastric disease.
Empirical adjunctive mucosal support in selected horses with right dorsal colitis, with limited controlled clinical evidence.

Interactions

Aluminum-mediated binding can reduce absorption of fluoroquinolones, tetracyclines, digoxin and theophylline; administer other medicines 30 minutes to 2 hours beforehand.

Adverse effects

Constipation.

Toxicity

Systemic acute toxicity is expected to be low because absorption is limited; manage GI signs and coingestants as appropriate.

Preparations

Preparation	Form	Strength	Route
Sucralfate 1 g tablet	Tablet	1 g / tablet	PO
Sucralfate suspension 200 mg/mL	Oral Liquid	200 mg / mL	PO

Monitoring and Administration

Crush tablets and prepare a suspension because intact tablets may pass without dissolving. A 200 mg/mL water suspension is described as stable for 14 days refrigerated; shake before dosing.

Reported Helicobacter triple therapy uses metronidazole 33 mg/kg daily, amoxicillin 11 mg/kg every 12 hours and either sucralfate 0.25-0.5 g every 8 hours or omeprazole 0.66 mg/kg daily. Route is not explicitly repeated for all components in that report; it is retained as a combined narrative rather than assumed across the entire protocol.