Pantoprazole for dogs: Dosage and safety

In this article:

• Uses
• Safety
• Dosage
• Alternatives
• Summary

In this article

• Uses
• Safety
• Dosage
• Alternatives
• Summary

Veterinarians use pantoprazole to treat serious stomach acid-related diseases such as stomach ulcers or erosions (scratches) in the esophagus or stomach wall. Called a gastric acid suppressant, pantoprazole dramatically reduces the stomach’s acid production. For dogs, the reduced stomach acid relieves discomfort and gives damaged tissues time to heal. Side effects are minimal. Though effective and safe in dogs, pantoprazole is not usually a veterinarian’s first choice as a stomach acid suppressant.

RELATED: Save up to 80% on pantoprazole

What is pantoprazole used for in dogs?

Veterinarians use pantoprazole to treat stomach acid diseases. In healthy dogs, gastric acid digests food so the dog can absorb nutrients in the intestines. Stomach acid is very powerful and, in some situations, damages the mucosa (lining) in the stomach or, if the dog has acid reflux, the mucosa in the esophagus. This can cause swelling (gastritis or esophagitis), scratches (erosion), or sores (ulcers). Pantoprazole dramatically reduces acid levels in the stomach, which helps give damaged or ulcerated tissue time to heal. 

Pantoprazole for ulcers

In veterinary medicine, the most common use of pantoprazole in dogs is to treat stomach ulcers. Dogs commonly experience digestive system ulcers for several reasons,

including stress, exercise, drugs (like nonsteroidal anti-inflammatory drugs or NSAIDs), and medical conditions such as kidney disease. 

Dogs can’t tell us when they have stomach ulcers so that owners will notice nonspecific symptoms such as:

• Vomiting
• Appetite loss
• Behaviors indicating abdominal pain
• Weight loss
• Black and tarry stools or blood in the vomit if the ulcer is bleeding significantly

The only way a veterinarian can be sure a dog has an ulcer is to perform an endoscopic examination. The veterinarian will insert a long tube with a camera at one end down the dog’s throat. This will allow the veterinarian to examine the stomach lining closely. 

The preferred treatments for canine ulcers are proton pump inhibitors (PPIs) like pantoprazole. These drugs block the mechanism stomach cells use to pump hydrogen protons into the stomach. The more hydrogen protons in the stomach, the more acidic the stomach contents become. By blocking this process, PPIs dramatically lower the acidity in the stomach environment.

Pantoprazole is not a veterinarian’s first-choice PPI. Most dogs will be started on omeprazole, better known as Prilosec OTC. It lasts longer, and veterinarians have more experience with it. 

Additionally, there are situations when a veterinarian will prescribe omeprazole or pantoprazole to prevent ulcers. These include NSAID or corticosteroid therapy, liver problems, kidney damage, or gastrointestinal disorders. 

Pantoprazole for esophagitis

Veterinarians commonly see esophagitis in dogs, a condition in which the lining of the esophagus is irritated, swollen, or damaged. Like stomach ulcers, it’s not easy to spot from the symptoms. In mild cases, the only symptom might be regurgitation or occasional vomiting. In extreme cases, the dog may be unable to drink or eat. Having a veterinarian perform an endoscopic examination is the only way to know. 

As in humans, the most common cause of canine esophagitis is gastroesophageal reflux, but chemicals or foreign objects can also cause esophagitis. 

The preferred treatment is omeprazole and a drug called cisapride, which speeds up the emptying of the stomach after a meal. Some veterinarians may use pantoprazole, but veterinary medicine does not have specific pantoprazole dosing guidelines for esophagitis.

Is pantoprazole safe for dogs?

Pantoprazole is considered safe for dogs. However, veterinarians typically only use it for a few weeks of treatment. 

Side effects of pantoprazole in dogs

In dogs, pantoprazole side effects are infrequent and usually mild. The most common side effect is diarrhea. Other possible side effects include headache and vomiting.

In humans, pantoprazole can increase liver enzymes in the blood. 

Severe side effects in dogs taking pantoprazole have not been documented. In humans, serious side effects include kidney damage, blood disorders, and severe hypersensitivity reactions. 

Interactions of pantoprazole with other pet meds

Like omeprazole, pantoprazole has some significant drug interactions. For this reason, make sure the veterinarian knows about all the prescription drugs, over-the-counter medications, dietary supplements, and herbal products the dog is taking, particularly:

• Antifungal drugs. Antifungal drugs, such as itraconazole and ketoconazole, won’t be absorbed well unless stomach acid levels are normal, so they’re less effective.
• Ampicillin. Ampicillin is also less effective if a dog is on a PPI.
• The immune-suppressing drug cyclosporine. Cyclosporine is also less effective.
• Iron salt supplements. Iron supplements require normal stomach acid levels to be fully absorbed by the intestines.
• The blood thinner warfarin. Pantoprazole increases the effects of warfarin, increasing the risk of bleeding episodes.
• The stomach protectant sucralfate. Pantoprazole may not be as effective if taken at the same time as sucralfate.

Pantoprazole dosage for dogs

The standard pantoprazole dosage for dogs to treat stomach acid-related diseases is 0.7–1 mg/kg, given as an intravenous or oral dose once daily. Other published recommended dosages include:

• 0.5–1 mg/kg given once daily
• 1 mg/kg given once daily

The use of pantoprazole in dogs is off-label. The FDA has not approved pantoprazole for animals. Veterinarians will use human or compounded formulations of the drug. 

For people, pantoprazole comes as delayed-release tablets, oral suspension, or injections. The tablets come in dosage strengths of 20 mg and 40 mg. Tablets cannot be broken or divided, so it will be difficult to dose the dog accurately. The oral suspension comes in 40 mg packets. Again, it will be difficult to divide the powder into separate doses. Injections are sold in 40 mg vials. 

It’s more likely that the veterinarian will give dog parents a compounded formulation. Compounded forms are custom-made for your pet into capsules, chews, or liquids of specific doses. 

A veterinarian performs injections in a clinical setting.

Can dogs overdose on pantoprazole?

Dogs can overdose on pantoprazole, and the consequences can be serious. There’s at least one documented report of a fatal overdose in a dog. If a dog has ingested too much pantoprazole, call a veterinarian or take the dog to a veterinary hospital. 

If you’re unsure if a dog has been overdosed, an extreme overdose can cause symptoms such as:

• Lethargy
• Loss of coordination
• Shaking or tremor

Can I give my dog pantoprazole every day?

Pantoprazole is a daily treatment for stomach acid problems. Veterinary literature does not specify durations of treatment. However, when dogs take omeprazole for a long time, it can cause significant changes to stomach wall tissues. For this reason, doctors limit omeprazole treatment to four weeks and, if necessary, eight weeks at the most. In humans, pantoprazole is not used for longer than eight weeks.

How to give your dog pantoprazole

The veterinary literature features intravenous injections as typical pantoprazole doses. These can only be administered by a veterinary professional. A veterinarian might send the dog home with oral pantoprazole. Doses must be given faithfully every day for the treatment to be effective. Here are a few tips:

• Follow all the veterinarian’s instructions.
• Give every dose for the prescribed duration, even if the dog seems much better. 
• Pantoprazole doses do not need to be tapered when it’s time to discontinue treatment.
• Pantoprazole works faster if given on an empty stomach. However, doses can be given with or without food without compromising effectiveness. 
• The best time to give a dose is in the morning, about 30 minutes before the dog eats the day’s first meal.
• If the dose causes nausea, vomiting, or appetite loss, give future doses with food.
• If you don’t know how to give a dog a tablet or capsule, ask a veterinary technician to demonstrate the proper technique.
• Pantoprazole tablets should not be crushed, divided, or broken.
• Always measure the dose with an oral syringe if the dog gets an oil suspension. 
• If the oral suspension is in powder form, make sure you understand how to mix it. Human formulations of pantoprazole powder for oral suspension can only be mixed with applesauce or juice, never water.
• If a dose of pantoprazole is missed, give it when remembered. However, if it’s almost time for the next dose, skip the missed dose and give the dog the next dose on the day it’s due. Do not give a double dose to make up for a missed dose. 
• Store pantoprazole at room temperature in a tightly closed container.

Pantoprazole alternatives for dogs

Pantoprazole is not the only treatment for stomach acid diseases. In some cases, less powerful medicines may be more appropriate.

For more severe stomach acid-related diseases like gastric ulcers, proton pump inhibitors are the drug of choice. Veterinarians usually use omeprazole, but others like esomeprazole are also alternatives.

If proton pump inhibitors can’t be used, veterinarians can use another drug that suppresses gastric acid secretion called a histamine 2 receptor antagonist or, more simply, an H2 blocker. These drugs don’t reduce stomach acid as dramatically as PPIs, but they are effective and have minimal side effects. The most commonly used in dogs are famotidine, Pepcid, or Zantac. Other choices include cimetidine and nizatidine, but they’re usually second choices.

Antacids are another safe option, but only for mild conditions like heartburn. Veterinarians do not consider them effective at treating acid reflux or ulcers, and some think they shouldn’t be used on pets. Before giving a dog an antacid, talk to the pet’s veterinarian first.

A veterinarian could also use a type of drug called a stomach protectant. These are drugs that don’t reduce gastric acid but instead protect the stomach wall from acid. There are only two used in dogs: sucralfate and misoprostol. Again, they are not the first choice drugs for treating severe stomach acid problems.

Summary

Pantoprazole safely and effectively treats ulcers and other stomach acid-related diseases in dogs, but it is not the first-choice treatment. Instead, veterinarians usually rely on omeprazole. If pet parents are responsible for dosing the dog, they must give the dog each day’s dose for the full length of treatment. Although pantoprazole can be provided with or without food, giving each day’s dose about 30 minutes before the dog has eaten its first meal is optimal.