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Kanamycin: with Bismuth Subcarbonate and Activated Attapulgite for Veterinary Use

by Barbara Forney, VMD

Basic Information

Kanamycin with bismuth subcarbonate and activated attapulgite is a combination antibiotic and anti-diarrheal. This drug combination is used to treat diarrhea of bacterial origin. There is a similar FDA approved product that has these three ingredients with the addition of pectin.

Kanamycin is an aminoglycoside antibiotic. Aminoglycosides are bactericidal and are very poorly absorbed through the GI tract. Oral administration of kanamycin allows for local treatment within the GI tract of susceptible enteric bacteria, including Salmonella, Shigella, Alcaligenes faecalis, E. coli, Proteus, and Staph aureus. When aminoglycoside antibiotics are used to treat a systemic infection, they must be used parenterally.

Bismuth subcarbonate is a traditional mucosal protectant of the GI tract. It is not thought to be absorbed in any significant quantity. Activated attapulgite is a clay mineral that is also not absorbed from the GI tract. Activated attapulgite binds bacteria and bacterial toxins. It also decreases the number of bowel movements, relieves cramping, and improves fecal consistency.


Kanamycin with bismuth subcarbonate and activated attapulgite is an oral drug combination that is used to treat bacterial enteritis in dogs. These drugs are locally effective within the GI tract. Aminoglycoside antibiotics are generally ineffective against anaerobic bacteria, protozoa, and viruses.

Side Effects

  • Bismuth subcarbonate may cause darkening of the tongue and stool.


  • Oral kanamycin sulfate is poorly absorbed through intact GI mucosa. Systemic absorption is possible through ulcerated or denuded mucosa. Systemic aminoglycosides may cause nephrotoxicity, ototoxicity, and vestibular dysfunction. Very small dogs may require extra monitoring due to possible absorption through GI ulcerations.
  • Oral kanamycin with bismuth subcarbonate and activatted attapulgite should not be used in cases of septicemia due to Salmonella.

Drug Interactions

  • No drug interactions were found for bismuth subcarbonate or attapulgite.
  • Drug interactions are unlikely for oral kanamycin because it is so poorly absorbed. Drugs that may interact with systemic aminoglycosides include diuretics, and any other potentially nephrotoxic drugs.


  • Although there is no information regarding overdosage with oral kanamycin/bismuth subcarbonate/activated attapulgite, gut emptying protocols, attention to hydration status, and possibly intravenous or subcutaneous fluids may be useful when an overdose is suspected.
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Therapeutic Class
Aminoglycoside antibiotic and anti-diarrheal combination


May Be Prescribed by Vets for:
Bacterial enteritis

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About the Author

Dr. Barbara Forney

Barbara Forney, VMD

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 in 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.