Treatment Name: Antacids: AlternaGEL etc. (aluminum hydroxide)

Treatment Type: Medications

Rated for: Golden Retriever

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Easy to use
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More useful as a intestinal phosphorus binding agent

Vuk Ignjic DVM



Posted Jan. 21, 2018

Urea which is not being excreted properly in cases of kidney disease is distributed around the body in almost every tissue, it irritates mucous membranes, especially those of gastrointestinal tract, making gastric lining more susceptible to damage by gastric acid. For this reason antacids which just neutralize gastric acid aren't really enough, since they only act when the acid is already secreted and already doing the damage. Proton pump inhibitors (omeprazol, pantoprazol) which reduce the production of gastric acid thus preventing the damage and irritation much better.
You can use this kind of antacid as a first aid, but your dog really needs to be on proton pump inhibitors if it has digestive problems.

Aluminum hydroxide containing products used to be first choice intestinal phosphate binding agents in dogs because they're effective and inexpressive. They are generally well tolerated by dogs, though there have been reported cases of aluminum toxicosis in dogs with advanced CKD treated with high doses. Symptoms of aluminum toxicosis are those of cranial and peripheral neuropathies, mostly ataxia, absence of patelar reflexes, decreased pelvic limb withdrawal and decreased menace response, though more severe symptoms like tetraparesis can also occur. Microcytosis (small RBCs) along with aforementioned symptoms is a good indicator of aluminum toxicosis.

Besides potential toxicosis, which is relatively rare, alumium hydroxide based binders decrease palatability of the food and can cause constipation.

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