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One selection filters the source overview, clinical facts, reports and dose calculator. Literature references are not species-filtered.
Choose one species for its overview and dose calculator, or all species to browse the full evidence.
Source overview
Recorded excerpts for one species. Each dose remains a separate source entry; no regimen is selected.
Choose one species to view its source overview. All-species evidence remains available below.
View full clinical evidence and sources ↓Clinical evidence
Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications4
Hepatic encephalopathy (prevention + treatment — trap ammonia as NH4+ in colon)
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Hepatic encephalopathy (prevention + treatment — trap ammonia as NH4+ in colon) — Extra-label (human drug)
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Hepatic encephalopathy (prevention + treatment — trap ammonia as NH4+ in colon) — Extra-label (human drug)
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Constipation (osmotic laxative; megacolon adjunct)
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Constipation (osmotic laxative; megacolon adjunct) — Extra-label
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Constipation (osmotic laxative; megacolon adjunct) — Extra-label
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens7
This calculator performs arithmetic only on the sourced dosing field shown for each result — it does not verify the field's accuracy, does not select which field to use for a patient, and does not replace a veterinarian's order. Not for clinical use. Confirm every result against the primary source before dispensing.
Choose one species above to view its dose calculator.
Adverse effects203
Flatulence, cramping, gastric distention — Common early, abates with time
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Diarrhea + dehydration — = overdosage — reduce dose
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Altered insulin requirement — Syrup contains free lactose/galactose
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
These are counts of spontaneously reported events, not proven adverse effects, causal relationships, or incidence rates.
Bars compare report counts within each species; they do not show incidence.
More reportsFewer reportsDog
- Lethargy (see also Central nervous system depression in 'Neurological')23 reports
- Other abnormal test result NOS21 reports
- Anorexia18 reports
- Vomiting18 reports
- Seizure NOS14 reports
- Death by euthanasia13 reports
- Elevated alanine aminotransferase (ALT)13 reports
- Diarrhoea12 reports
- Emesis12 reports
- Death11 reports
- Decreased appetite10 reports
- Elevated serum alkaline phosphatase (SAP)10 reports
Cat
- Vomiting33 reports
- Constipation24 reports
- Weight loss24 reports
- Death by euthanasia22 reports
- Lethargy (see also Central nervous system depression in 'Neurological')22 reports
- Ataxia19 reports
- Lack of efficacy - NOS19 reports
- Lethargy (see also Central nervous system depression in Neurological)19 reports
- Decreased appetite18 reports
- Behavioural disorder NOS17 reports
- Anorexia15 reports
- Elevated blood urea nitrogen (BUN)15 reports
Monitoring1
Stool quality (target 2–3 soft stools/day); hydration, electrolytes with prolonged use; neurologic status in HE patients; blood ammonia if available
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
Galactosemia (human)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions5
Preexisting fluid/electrolyte imbalance (diarrhea worsens); diabetes mellitus
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
The dose IS the stool: titrate to 2–3 soft stools per day — this is the exam answer and the practical rule.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Dual mechanism in hepatic encephalopathy: osmotic catharsis + acidifying the colon so NH3 diffuses out of blood and is trapped as NH4+ (ionized, non-absorbable) in feces.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Cats hate the syrup — Kristalose crystals in food or the enema route (HE crisis) solve compliance.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
In feline megacolon: pairs with cisapride (prokinetic) + fiber; lactulose handles the stool texture, cisapride the motility.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions2
Oral antibiotics (neomycin) — May reduce colonic bacteria that ferment lactulose — variable combined use in HE
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Antacids (aluminum) — Reduced cathartic effect possible
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics2
Absorption — <3% absorbed orally (human)
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Action site — Colon — bacterial fermentation to lactic/formic/acetic acids + CO2
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Generally considered safe (human category B historically); no veterinary-specific concerns flagged in sources.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 706–707; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 436 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references18
References are linked to this drug. Species applicability is not recorded here, so the species filter does not narrow this list. Imported dates do not retain their original precision; confirm dates in the original citation.
- Lactulose-Induced Transcriptional Reprogramming and Repression of Persistence-Associated Phenotypes in Non-Typhoidal Salmonella enterica.
Study summary not available in the imported record. Open the original citation to review the study.
- [Prebiotic properties and application of galactooligosaccharides].
Study summary not available in the imported record. Open the original citation to review the study.
- Comparative Genomics and Functional Profiling Reveal Lineage-Specific Metabolic Adaptations in Globally Emerging Fluoroquinolone-Resistant Salmonella Kentucky ST198.
Study summary not available in the imported record. Open the original citation to review the study.
- Effect of oral glutamine supplementation on growth and glutamine and glucose metabolism in suckling piglets.
Study summary not available in the imported record. Open the original citation to review the study.
- Biomarkers of environmental enteric dysfunction and neurodevelopmental outcomes among children in rural Bangladesh and Kenya: a prospective cohort study.
Study summary not available in the imported record. Open the original citation to review the study.
Sources: PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.