Elephant specific information, if available, is in blue.

Chemistry – Docusate is available in sodium, potassium, and calcium salts. They are anionic, surface-active agents and possess wetting and emulsifying properties.

Docusate sodium (also known as dioctyl sodium succinate , DSS , or DOSS ) occurs as a white, wax-like plastic solid with a characteristic odor. One gram is soluble in approxi­mately 70 ml of water and it is freely soluble in alcohol and glycerin. Solutions are clear and have a bitter taste.

Docusate calcium (also known as dioctyl calcium succinate) occurs as a white, amorphous solid with a characteristic odor (octyl alcohol). It is very slightly soluble in water, but freely soluble in alcohol.

Docusate potassium (also known as dioctyl potassium succinate) occurs as a white, amorphous solid with a characteristic odor (octyl alcohol). It is sparingly soluble in water and soluble in alcohol.

Storage/Stability/Compatibility – Capsules of salts of docusate should be stored in tight containers at room temperature. Temperatures above 86°F can soften or melt soft gelatin capsules. Docusate sodium solutions should be stored in tight containers and the syrup should be stored in tight, light-resistant containers.

Pharmacology – Docusate salts reduce surface tension and allow water and fat to penetrate the ingesta and formed feces, thereby softening the stool. Recent in vivo studies have also demonstrated that docusate also increases cAMP concentrations in colonic mucosal cells which may increase both ion secretion and fluid permeability from these cells into the colon lumen.

Uses/Indications – Docusate is used in small animals when feces are hard or dry, or in anorectal conditions when passing firm feces would be painful or detrimental. Docusate is used alone and in combination with mineral oil in treating fecal impactions in horses.

Pharmacokinetics – It is unknown how much docusate is absorbed after oral administration, but it is believed that some is absorbed from the small intestine and is then excreted into the bile.

Contraindications/Precautions – Use with caution in patients with pre-existing fluid or electrolyte abnormalities; monitor.

Adverse Effects/Warnings – At usual doses, clinically significant adverse effects should be very rare. Cramping, diarrhea and intestinal mucosal damage are possible. The liquid preparations may cause throat irritation if administered by mouth.

Overdosage – In horses, single doses of 0.65 – 1 gm/kg have caused dehydration, intestinal mucosal damage, and death. Because of the secretory effects that high dose docusate can produce, hydration and electrolyte status should be monitored and treated if necessary.

Drug Interactions – Theoretically, mineral oil should not be given with docusate (DSS) as enhanced absorption of the mineral oil could occur. However, this interaction does not appear to be of significant clinical concern with large animals. It is less clear whether there is a significant problem in using this combination in small animals and the concurrent use of these agents together in dogs or cats cannot be recommended. If it is deemed necessary to use both docusate and mineral oil in small animals, separate doses by at least two hours.

Doses –

Horses:

a)   10 – 20 mg/kg diluted in 2 L of warm water PO; may repeat in 48 hours. (Clark and Becht 1987)

b)   7.5 – 30 grams (150 – 600 mls of a 5% solution) PO; or 3 – 5 grams (60 – 100 mls of 5% solution) if used with mineral oil. (Sellers and Lowe 1987)

Monitoring Parameters -1 ) Clinical efficacy; hydration and electrolyte status if indicated

Client Information – Unless otherwise directed, give this medication on an empty stomach. Do not give with other laxative agents without the approval of the veterinarian.

Dosage Forms/Preparations/FDA Approval Status/Withholding Times – There are several docusate products marketed for veterinary use; their approval status is unknown. Docusate products are available without prescription (OTC).

Docusate Sodium 100 mg Tablets & Docusate Sodium Capsules  50 mg, 100 mg, 240 mg, 250 mg, 300 mg; Softgel 100 mg

Docusate Sodium Syrup 20 mg/4 ml in 473 ml; 50 mg/15 ml in UD 15 & 30 ml, 60 mg/15 ml in 240 ml, pt and gal.; 150 mg/15 ml in pt and gal.

Docusate Sodium Liquid/Solution 50 mg/ml and 100 mg/ml in 60 ml and gal.; Veterinary products for use in large animals are generally available in gallons in concentrations of either 5% (50 mg/ml) or 10% (100 mg/ml). There are many trade names for docusate sodium, perhaps the best known is Colace®  (Bristol-Meyers Squibb). It is also available generically.

Docusate Calcium 50 mg and 240 mg capsules (human-labeled); There are many trade names for docusate calcium, perhaps the best known is Surfak®  (Hoechst). It is also available generically.

Docusate Potassium Tablets 100 mg & Docusate Potassium Capsules 240 mg; Kasof® (Stuart), Dialose® (Stuart), Generic