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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 in the
treatment of oral, esophageal, gastric, duodenal and colonic ulcers. Usually,
sucralfate is given on an empty stomach.
Sucralfate is used for the treatment of 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.
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 in to 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 in the treatment of gastric ulcers
and ulcers of the right dorsal-colon in adult horses. It is usually used
with 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.
Side effects are rare. Constipation and hypo-phosphatemia
may occur in a small percentage of patients.
• Sucralfate may decrease the rate of gastric emptying
and slow GI transit time.
• 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.
• 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.
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
To help protect veterinary staff and patients from unnecessary exposure to chemotherapy medications and waste, this handling sheet will be included with all chemotherapy prescriptions we dispense.
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.
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