Vet Guide to Aluminum Hydroxide in 2025 🐾

Hi, I’m Dr Duncan Houston, BVSc, founder of Ask A Vet. In this comprehensive guide, we’ll dive into aluminum hydroxide: what it is, how vets use it for kidney and stomach health in pets, dosing protocols, side effects, monitoring, and practical administration tips. Let’s go! 🩺

📘 What Is Aluminum Hydroxide?

Aluminum hydroxide is an antacid and phosphate binder usually formulated as a liquid gel, powder, or capsules. Though not FDA-approved for veterinary use, it’s widely prescribed off-label to reduce high blood phosphorus in pets with kidney disease, and also to neutralize stomach acid/GI upset in dogs, cats, small mammals, and even reptiles :contentReference[oaicite:3]{index=3}.

⌛ Why It’s Prescribed in 2025

• Phosphate binding: helps manage hyperphosphatemia in CKD when diet alone isn’t enough :contentReference[oaicite:4]{index=4}
• Antacid effect: provides relief from acid-related GI issues—ulcers, bilious vomiting :contentReference[oaicite:5]{index=5}
• Large animal use: occasionally used in cows/horses for ulcers or heartburn :contentReference[oaicite:6]{index=6}

📐 Dosing & Administration

Exact doses are tailored by your veterinarian based on species, condition, and patient weigh—here are typical uses:

Liquid Gel (e.g. human-grade)

• Usually given just before meals to bind dietary phosphorus :contentReference[oaicite:7]{index=7}
• Typical dose: often starts at ~320 mg per 5 mL, but varies widely by species and lab results

Powder or Capsules

• Mixed with canned/wet food (easier than gel for finicky pets) :contentReference[oaicite:8]{index=8}
• Wide compounding options (50–500 mg/mL) allow customized veterinary dosing :contentReference[oaicite:9]{index=9}

📅 What If You Miss a Dose?

Ask your vet—typically give it with the next meal. If mealtime is near, skip and resume regular dosing—never double up :contentReference[oaicite:10]{index=10}.

⚠️ Side Effects & Risks

• Constipation: most common side effect :contentReference[oaicite:11]{index=11}
• Aluminum toxicity: rare but possible, especially with overdose or CKD—may cause weakness, stumbling :contentReference[oaicite:12]{index=12}
• Hypophosphatemia, calcium imbalance: with excessive or prolonged use :contentReference[oaicite:13]{index=13}
• Decreased appetite in horses: occasional decrease in feed intake :contentReference[oaicite:14]{index=14}

🔬 Monitoring Your Pet

• Serum phosphorus: measured monthly when stabilizing, then every 2–3 months :contentReference[oaicite:15]{index=15}
• Renal panels: track kidney function over time
• CBC and electrolytes: check for imbalances or signs of toxicity
• GI monitoring: ask about appetite, bowel movements, hydration

💊 Overdose Situations & What to Do

Most overdoses cause constipation or mild imbalance. In serious cases—weakness, stumbling—contact your vet or poison helpline (Pet Poison: 855‑764‑7661; ASPCA: 888‑426‑4435) :contentReference[oaicite:16]{index=16}.

🔐 Storage & Handling

• Store at room temperature (59–86 °F), away from extreme heat/cold, moisture, light :contentReference[oaicite:17]{index=17}
• Keep gel tightly sealed; powders/capsules stored sealed and dry :contentReference[oaicite:18]{index=18}
• Handle with care – wash hands after handling, especially for compounding products :contentReference[oaicite:19]{index=19}

🧪 Drug Interactions

Aluminum can affect absorption of many medications. Administer it 1–2 hours before or after other drugs (like tetracyclines, ciprofloxacin, digoxin, corticosteroids) :contentReference[oaicite:20]{index=20}.

🏡 Practical Care Scenarios

🐶 Dog with CKD & High Phosphorus

• Start aluminum hydroxide gel or powder with each meal.
• Monitor serum phosphorus monthly until target reached.
• Adjust dosage to maintain stable phosphorus without constipation.

🐱 Cat with Bilious Vomiting or Gastritis

• Short-term gel form before meals to neutralize stomach acid.
• Monitor appetite and resolution of GI signs.
• Switch to antacid or proton-pump inhibitor if long-term use needed.

🐰 Small Mammal Support

• Use gel or powder per vet recommendation.
• Helpful when diet can’t lower phosphorus sufficiently.

❓ FAQs

Is aluminum hydroxide safe long-term?

Yes, when dosed carefully and monitored. Monthly lab checks help prevent toxicity.

Can I give human Tums instead?

No—never give human combos like Tums or Pepto—their formulation and doses differ and can harm pets :contentReference[oaicite:21]{index=21}.

What does “off-label” mean?

It means human products are used in pets under veterinary guidance—completely legal and common.

Why choose powder over gel?

• Better for pets who dislike mint-flavored gel :contentReference[oaicite:22]{index=22}
• Pill/capsule forms offer accurate dosing and ease of use

📌 Final Takeaways

• Aluminum hydroxide is a valuable tool for managing phosphate and gastric acid in pets.
• Available in multiple forms—gel, powder, capsule—for tailored use.
• Side effects are uncommon—main concern is constipation and rare toxicity.
• Regular lab monitoring and proper drug timing ensure safety.
• Consult your vet to build an integrated plan using diet, binding agents, kidney support products, and antacids.

Need help crafting a phosphate or GI support plan for your pet? Ask A Vet, Woopf, and Purrz offer personalized guidance—download the Ask A Vet app today for live veterinary support anytime. Your pet deserves expert care! 🐾❤️