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Kanamycin with Bismuth Subcarbonate and Activated Attapulgite for Dogs

By Barbara Forney, VMD

Last reviewed: 7/13/2022

Commonly prescribed for: Bacterial Diarrhea

Species: Dogs

Therapeutic Class: Antibiotic Combination

General Drug Information and Indications

Kanamycin with bismuth subcarbonate and activated attapulgite is an oral combination drug that is used to treat bacterial diarrhea in the dog. Kanamycin is an antibiotic that is effective against many of the bacteria that cause diarrhea. Bismuth subcarbonate and activated attapulgite are nonspecific protectants for the inside lining of the gastro-instestinal (GI) tract. When this drug combination is given orally, it is being used as local treatment inside teh GI tract. Kanamycin kills the inappropriate bacteria that potentially are causing the diarrhea. Bismuth subcarbonate and activated attapulgite soothe and protect the interior lining of the GI tract. None of these three drugs are substantially absorbed into the general circulation. There are many other potential causes of diarrhea in the dog other than bacterial diarrhea. These include viruses, parasites, medication side effects, toxicity and metabolic problems. This drug combination is unlikely to be effective if the underlying problem is not due to a susceptible bacteria.

Like many other drugs in veterinary medicine, this drug is not FDA-approved for use in animals and is not available from a veterinary pharmaceutical manufacturer. Instead, it is compounded by a specialty pharmacy.

How to Give this Medication

Give this medication to your pet exactly as your veterinarian prescribes. If you miss giving your pet a dose of kanamycin with bismuth subcarbonate and activated attapulgite, give the next dose as soon as you remember or, if it close to the next scheduled dose, return to the regular schedule. Do not double dose to catch up.

Wash your hands after giving your pet this medication.

Side Effects

Be sure to discuss any side effects with your veterinarian immediately.

Bismuth subcarbonate may cause darkening of the tongue and stool.


Keep this and all drugs out of reach of children. This drug should only be given to the animal for which it was prescribed. Do not give this medication to a person. Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Kanamycin, bismuth subcarbonate and activated attapulgie are very poorly absorbed across normal GI lining or mucosa. Systemic absorption is possible if the GI mucosa is ulcerated or abnormal. There are possible systemic side effects associated with kanamycin which include toxicity to the kidneys, hearing loss, head tilt, and loss of balance. Very small dogs may need monitoring if GI ulceration is suspected.

Because Kanamycin, bismuth subcarbonate and activated attapulgite are so poorly absorbed, this combination drugs may be be adquate when the dog is systemically ill due to Salmonella infection.

Drug Interactions

Be sure to review with your veterinarian any medications or supplements your pet may be receiving.

No drug interactions were found for bismuth subcarbonate or activated attapulgite.

Drug interactions are unlikely for oral kanamycin (poor absorption). There are a number of drug interactions for systemic or injectabale use of kanamycin. These include diuretics and any other drugs that are toxic to the kidneys.


If you suspect your pet or another animal was accidentally overdosed or has eaten this medication inadvertently, contact your veterinarian or the A.S.P.C.A.'s Animal Poison Control Center at 888.426.4435. Always bring the prescription container with you when you take your pet for treatment.

If you or someone else has accidentally ingested this medication call the National Capital Poison Center at 800.222.1222.


Different strengths or dosage forms of kanamycin with bismuth subcarbonate and activated attapulgite may have different storage requirements. Read the labeling or ask your pharmacist for the storage requirements of the prescription you receive.
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