Docusate Sodium / Docusate Calcium
**Docusate** (available as sodium or calcium salts) is an emollient laxative and **surfactant stool softener**. * **Primary Use**: Administered to small animals to alleviate constipation, particularly when passing firm feces would be painful or detrimental (e.g., post-operative anorectal surgery, pelvic fractures). * **Equine Use**: Utilized alone or in combination with mineral oil to treat large colon fecal impactions in horses. * **Clinical Pearl**: Docusate does not significantly stimulate GI peristalsis; rather, it facilitates the softening of the fecal mass, making it easier to pass without straining.
Mechanism: Docusate acts primarily as an **anionic surfactant** (detergent). * **Surface Tension Reduction**: It lowers the surface tension of the stool โ allows water and dietary fats to penetrate the ingesta and formed feces โ softens the fecal mass. * **Secretory Effect**: In vivo studies show docusate increases **cAMP** concentrations in colonic mucosal cells โ stimulates **ion secretion** (such as chloride) and increases fluid permeability from these cells into the colon lumen โ further hydrates the stool.
Dosing by species
- Constipation ยท 50 mg ยท PO ยท per day ยท Docusate Sodium
- Constipation ยท 5-10 mL of Colace ยท Enema ยท as needed ยท Docusate Sodium
- Constipation ยท 50 mg ยท PO ยท as needed ยท Docusate Sodium
- Constipation ยท 1-2 pediatric suppositories ยท PR ยท as needed ยท Docusate Sodium
- Constipation ยท 50 mg ยท PO ยท q12-24h ยท Docusate Sodium
- Constipation ยท 50 mg ยท PO ยท once daily ยท Docusate Calcium
- Large colon impaction (to soften) ยท 6-12 g/500 kg diluted in 2-4 liters of water ยท Nasogastric tube ยท q12-24h
- Constipation ยท 50-100 mg (total dose) ยท PO ยท q12-24h ยท Docusate Sodium
- Constipation ยท 25 mg ยท PO ยท once to twice daily ยท Docusate Sodium; Small Dogs
- Constipation ยท 50 mg ยท PO ยท once to twice daily ยท Docusate Sodium; Medium/large Dogs
- Constipation ยท Two to three 50 mg capsules or one 240 mg capsule ยท PO ยท once daily ยท Docusate Calcium
Routes of administration
Contraindications
- Pre-existing fluid or electrolyte abnormalities (use with caution)
Adverse effects
- Cramping
- Diarrhea
- Intestinal mucosal damage (especially at high doses)
- Throat irritation (liquid preparations)
- Bitter taste (can cause hypersalivation/foaming in cats)
Drug interactions
- Mineral Oil ยท Theoretically enhances absorption of mineral oil. Not a significant concern in large animals, but concurrent use in dogs/cats is not recommended. If both are necessary in small animals, separate doses by at least 2 hours. ยท major
Monitoring
- Clinical efficacy (resolution of constipation/impaction)
- Hydration status
- Electrolyte status (if indicated or in high doses)
Overdose
In **horses**, single doses of 0.65-1 g/kg have caused dehydration, intestinal mucosal damage, and death. Maximum therapeutic dosages of up to 0.2 g/kg have been reported. * **Clinical Signs (Horses)**: Begin 1-2 hours after dosing. Initial signs include restlessness and increased intestinal sounds, followed by increased respiratory and cardiac rates. Abdominal pain, watery diarrhea, and dehydration can occur, deteriorating over hours to days to lateral recumbency and death. * **Treatment**: Supportive care. Because of the secretory effects of high doses, hydration and electrolyte status must be monitored and corrected. GI protectants, bicarbonate, corticosteroids, and antiendotoxemic agents (NSAIDs) have been suggested as potentially helpful.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturerโs current label.