Overview of Calcium Carbonate for Canines and Felines

• Calcium carbonate, also known as Tums®, is an oral calcium salt that is used to treat pets with low calcium levels (hypocalcemia), as an antacid and/or as a phosphate binder in dogs and cats.
• Calcium carbonate can also be used as an oral antacid and for conditions such as esophagitis and/or gastroduodenal ulcerations. However, calcium carbonate is uncommonly prescribed as an antacid as there are stronger and more effective antacids.
• Calcium carbonate is used most often for chronic conditions. Injectable calcium gluconate is often used for an acute hypocalcaemic crisis.
• It is recommended that you work with your veterinarian to monitor calcium and phosphorus levels when giving calcium carbonate.
• Calcium Carbonate is available over the counter but should not be administered unless under the supervision and guidance of a veterinarian.

Brand Names and Other Names of Calcium Carbonate

• Human formulations: Various generic preparations
• Veterinary formulations: None

Uses of Calcium Carbonate for Dogs and Cats

• Calcium carbonate can also be used as an oral antacid and for conditions such as esophagitis and/or gastroduodenal ulcerations. However, calcium carbonate is uncommonly prescribed as an antacid as there are stronger and more effective antacids.
• It is commonly used as a calcium supplement in dogs with chronic hypocalcemia and to treat hyperphosphatemia associated with chronic renal (kidney) failure.

Precautions and Side Effects

• While generally safe and effective when prescribed by a veterinarian, calcium Carbonate can cause side effects in some animals.
• Calcium Carbonate should not be used in animals with known hypersensitivity to it nor in pets with high calcium levels.
• Safety in pregnant or lactating dogs and cats has not been studied. However, calcium carbonate is considered safe during lactation by most veterinarians.
• Calcification of the soft tissues is possible side effects associated with long-term dosing.

  Drug Interactions

• Calcium Carbonate may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with Calcium Carbonate. Interactions may include:
• Simultaneous treatment with other calcium products (such as calcium gluconate, Calcitriol) could lead to high calcium levels (hypercalcemia).
• Calcium carbonate be used with caution in pets with cardiac arrhythmias and are on heart medications such as digoxin. Certain antibiotics are not recommended while administering calcium products including tetracycline and doxycycline and fluoroquinolones such as enrofloxacin (Baytril®) or Ciprofloxacin (Cipro®).
• Other drug interactions may include thyroid supplements, stomach medications including misoprostol, famotidine (Pepcid), ranitidine (Zantac) and cimetidine (Tagamet).

How Calcium Carbonate is Supplied

• There are many oral calcium carbonate products available in chewable and regular tablets in common sizes are 500 mg, 750 mg, and 1000mg.
• There is also oral suspensions 1250 mg/5mL.

Dosing Information of Calcium Carbonate for Dogs and Cats

• Medication should never be administered without first consulting your veterinarian.
• Doses of calcium carbonate vary widely depending on the reason for prescribing and response top initial doses.
• The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.
• It is recommended to give calcium carbonate with food
• The dose most commonly used in dogs as an antacid is 0.5 grams and up to 5 grams total dose orally every 4 hours as needed. Small dogs can receive 500 mg, medium sized dogs 750 to 1000 mg and larger dogs 2000 mg.
• As a calcium supplement, common dosage ranges include:
  • Cats: 1250 mg to 2 grams per day
  • Small breed dogs: 1250 mg per day
  • Medium dogs: 2 grams to 4 grams per day
  • Large breed dogs: 4 grams to 6 grams per day
  • Giant breed dogs: 6 to 10 grams orally per day
• For treatment of hyperphosphatemia associated with chronic kidney failure, the dose commonly recommended is 41 to 68 mg/pound/day (90 – 150 mg/kg/day) total dose divided. It is recommended to give with food. The dose is commonly adjusted based on blood levels.

Resources & References:

• ASPCA Pet Poison Hotline
• Current Veterinary Therapy XV, Bonagura and Twedt
• Pet Poison Helpline
• Plumb’s Veterinary Handbook by Donald C. Plumb, 8th Edition
• Polzin, D. J. (2013). Evidence-based step-wise approach to managing chronic kidney disease in dogs and cats. Vet. Emerg. Crit. Care 23(2): 205-15
• Polzin, D.,et al. (2005). Chronic Kidney Disease. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat 6th Ed. S. Ettinger and E. Feldman, Elsevier: 1756-85.
• Textbook of Veterinary Internal Medicine, Ettinger & Felman