# Sodium Bicarbonate: veterinary dose and monograph

> Sodium Bicarbonate is a veterinary drug. An alkalinising agent (a source of bicarbonate) with several distinct uses: correcting severe METABOLIC ACIDOSIS (when pH is dangerously low despite treating the cause), a rapid temporising treatment for life-threatening HYPERKALAEMIA (it… Indications include severe metabolic acidosis (pH persistently low despite treating the underlying cause); life-threatening hyperkalaemia (temporary intracellular potassium shift); urinary alkalinisation (enhance excretion of acidic toxins/drugs; certain uroliths). This monograph lists 7 reference doses for dogs, cats, cattle, horses and birds, each with route, frequency and source, plus meat and milk withdrawal periods for food animals.

Source: https://vetmasterji.com/drugs/sodium-bicarbonate · Last reviewed: 2026-10-01

## At a glance

- **Drug class:** Veterinary drug
- **Also known as:** NaHCO3, Sodabicarb, Baking soda (oral)
- **Species with doses:** Dogs, Cats, Cattle, Horses and Birds
- **Routes:** IV, PO
- **Last reviewed:** 1 October 2026

## Indications

- Severe metabolic acidosis (pH persistently low despite treating the underlying cause)
- Life-threatening hyperkalaemia (temporary intracellular potassium shift)
- Urinary alkalinisation (enhance excretion of acidic toxins/drugs; certain uroliths)
- Sodium-channel-blocker (TCA / class-I antiarrhythmic / local-anaesthetic) cardiotoxicity — QRS narrowing

## Sodium Bicarbonate dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

### Dogs

*Sodium Bicarbonate doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Severe metabolic acidosis (blood-gas guided) | Deficit (mEq) = 0.3 × kg × base deficit: give ⅓ slowly IV and the rest in fluids over several hours; blind 1–2 mEq/kg slow IV only if gases unavailable | IV | per deficit, recheck gases in 2–4 h | — |
| Life-threatening hyperkalaemia | 1–2 mEq/kg slow IV (2–3 mEq/kg over 30 min if perfusion is poor) | IV | once (with other therapies) | — |
| Urinary alkalinisation (e.g. urate urolithiasis) | 50 mg/kg | PO | q8–12h | — |

- Severe metabolic acidosis (blood-gas guided): Plumb’s p.1063: consider only if pH <7.2 (7.1 in DKA) and the cause is not readily reversible; 0.3 × kg × base deficit (Drobatz) or 0.5 × kg × (desired − measured TCO₂) giving half over 3–4 h (Schaer). Papich 5e: 0.5–1 mEq/kg IV. Avoid rapid boluses (paradoxical CSF acidosis), ensure ventilation, watch potassium. CPR (Papich): 1 mEq/kg then 0.5 mEq/kg every 10 min — Plumb’s notes it is rarely needed unless CPR is prolonged.
- Life-threatening hyperkalaemia: Plumb’s p.1063: 1–2 mEq/kg IV slowly (Macintire); 2–3 mEq/kg over 30 min with poor perfusion or renal failure, not in DKA (Willard). Temporising — combine with calcium gluconate and insulin/dextrose.
- Urinary alkalinisation (e.g. urate urolithiasis): Papich 5e: 50 mg/kg q8–12h PO. Plumb’s p.1063: individualise to urine pH ~7 (avoid >7.5); urate urolithiasis 0.5–1 g per 5 kg PO three times daily (Senior). Oral antacid use (2–5 g) is less effective than acid suppressants.

### Cats

*Sodium Bicarbonate doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Severe metabolic acidosis | Deficit (mEq) = 0.3 × kg × base deficit: give ⅓ slowly IV, the rest in fluids; recheck gases | IV | per deficit | — |

- Severe metabolic acidosis: Plumb’s p.1063 (dogs/cats): consider if pH <7.2 despite treating the cause; blind 1–2 mEq/kg slow IV only if gases unavailable. Papich 5e: 0.5–1 mEq/kg IV; urinary alkalinisation 50 mg/kg PO q8–12h.

### Cattle

*Sodium Bicarbonate doses for cattle*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Metabolic acidosis (calf diarrhoea / ruminal acidosis) | 2–5 mEq/kg IV over 4–8 h; comatose acidotic calves ≈2 L isotonic (156 mEq/L) bicarbonate over 1–2 h | IV | per deficit | — | no slaughter withdrawal |

- Metabolic acidosis (calf diarrhoea / ruminal acidosis): Plumb’s p.1063: ruminants 2–5 mEq/kg IV over 4–8 h (Howard); isotonic bicarbonate = 13 g per L sterile water (Radostits). Papich 5e: 0.5–1 mEq/kg IV slowly; oral 10–12 g adults, 2–5 g calves; no withdrawal needed.

### Horses

*Sodium Bicarbonate doses for horses*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Metabolic acidosis (e.g. colic) | Deficit (mEq) = base deficit × 0.4 × kg; isotonic (150 mEq/L) preferred, or 5% (600 mEq/L) no faster than 1–2 L/h | IV | per deficit | — |

- Metabolic acidosis (e.g. colic): Plumb’s p.1063 (Stover): consider when pH <7.3 and base deficit >10 mEq/L. Papich 5e: 0.5–1 mEq/kg IV slowly; adults 10–12 g PO. Pre-race bicarbonate (“milkshaking”) is prohibited.

### Buffalo

No buffalo-specific doses are on file, so buffalo are dosed as cattle.

*Sodium Bicarbonate doses for buffalo*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Metabolic acidosis (calf diarrhoea / ruminal acidosis) | 2–5 mEq/kg IV over 4–8 h; comatose acidotic calves ≈2 L isotonic (156 mEq/L) bicarbonate over 1–2 h | IV | per deficit | — | no slaughter withdrawal |

- Metabolic acidosis (calf diarrhoea / ruminal acidosis): Plumb’s p.1063: ruminants 2–5 mEq/kg IV over 4–8 h (Howard); isotonic bicarbonate = 13 g per L sterile water (Radostits). Papich 5e: 0.5–1 mEq/kg IV slowly; oral 10–12 g adults, 2–5 g calves; no withdrawal needed.

### Birds

*Sodium Bicarbonate doses for birds*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Metabolic acidosis | 1 mEq/kg IV (then SC) over 15–30 min, to a maximum of 4 mEq/kg | IV | per response | — |

- Metabolic acidosis: Plumb’s p.1063 (Clubb 1986).

## Contraindications

Metabolic or respiratory ALKALOSIS, hypocalcaemia (bicarbonate lowers ionised calcium → tetany), hypokalaemia, and hypernatraemia/fluid overload. Inability to ventilate (bicarbonate generates CO2 — worsens respiratory acidosis if the patient can't blow it off). Mixing with calcium-containing fluids (precipitation) or catecholamines/many drugs in the same line. Known hypersensitivity.

## Species-specific warnings

> **Caution:** Horses: Bicarbonate "milkshaking" to buffer lactate is a PROHIBITED practice in racing — use only for genuine clinical acid-base correction within medication rules.

## Adverse effects

- Metabolic alkalosis, hypernatraemia, fluid overload (over-correction)
- Hypokalaemia and IONISED HYPOCALCAEMIA (tetany)
- Paradoxical CSF/intracellular acidosis and worsened respiratory acidosis (CO2 generation) if ventilation inadequate
- Tissue irritation/necrosis on extravasation (hypertonic)

## Drug interactions

- Calcium-containing fluids (Ringer's/calcium gluconate): PRECIPITATION — never mix in the same line
- Catecholamines/many drugs: inactivated/incompatible in the same line (alkaline)
- Drugs whose excretion depends on urine pH: altered (e.g. reduced salicylate/acidic-drug reabsorption when urine alkalinised)
- Potassium-losing/lowering therapies: additive hypokalaemia

## Pregnancy and lactation

Used when acid-base correction is clinically necessary; standard cautions apply.

## Monitoring

- Blood gases / acid-base status and electrolytes (Na, K, ionised Ca) — dose to these, not by guesswork
- ECG (QRS width) for sodium-channel-blocker toxicity; potassium in hyperkalaemia
- Ventilation/oxygenation (CO2 handling); fluid/volume status
- IV line compatibility (separate from calcium/catecholamines)

## Toxicity and overdose

Over-correction/overdose causes metabolic alkalosis, hypernatraemia, fluid overload, hypokalaemia and ionised hypocalcaemia (tetany), plus paradoxical intracellular/CSF acidosis and worsened respiratory acidosis if the patient cannot ventilate off the generated CO2. Extravasation of hypertonic solution causes tissue necrosis. Blood-gas-guided, cautious dosing is essential.

Management: Stop administration; support ventilation (blow off CO2), correct electrolytes (potassium, ionised calcium for tetany), and manage fluid overload (diuretics if needed). Recheck blood gases/electrolytes and re-titrate. For extravasation, treat as a hypertonic-solution injury.

## Clinical pearls

- A multi-tool: severe metabolic acidosis, emergency hyperkalaemia (shifts K⁺ into cells), urinary alkalinisation, and the antidote for TCA/sodium-channel-blocker cardiotoxicity (narrows a wide QRS)
- Dose to BLOOD GASES (deficit = 0.3 × kg × base deficit), give slowly, and treat the underlying cause — don't just "chase the pH"
- The patient MUST be able to ventilate (bicarbonate makes CO2); watch for hypokalaemia and ionised hypocalcaemia after correction
- NEVER mix with calcium-containing fluids (precipitation) or catecholamines/many drugs in the same line

## Mechanism of action

Provides bicarbonate (HCO3−), the body's main extracellular buffer, which neutralises excess hydrogen ions (raising pH) — the basis of treating metabolic acidosis and alkalinising urine. The rise in pH shifts potassium from extracellular fluid into cells (temporarily lowering serum potassium in hyperkalaemia). For sodium-channel-blocker cardiotoxicity, the combination of raised pH and the increased extracellular SODIUM load relieves the drug's block of cardiac sodium channels, narrowing the QRS and restoring conduction. Buffering generates CO2, which must be exhaled — hence the need for adequate ventilation.

## Formulations and products

- Injection 7.5 % (0.9 mEq/mL) / 8.4 % (1 mEq/mL)
- Oral powder / tablet (urinary alkalinisation, GI)
- Sodium Bicarbonate 7.5 % / 8.4 % — 0.9 / 1 mEq/mL injection, IV injection (human-label)

## Storage

Injection: 15–30 °C, protect from light; do not freeze. Do not mix with calcium-containing solutions or incompatible drugs. Oral powder/tablets: dry, 15–30 °C.

## Before you use this dose

> **Caution:** Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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## Frequently asked questions

### What is the dose of Sodium Bicarbonate for dogs?

Reference doses for Sodium Bicarbonate in dogs: Deficit (mEq) = 0.3 × kg × base deficit: give ⅓ slowly IV and the rest in fluids over several hours; blind 1–2 mEq/kg slow IV only if gases unavailable IV per deficit, recheck gases in 2–4 h (Severe metabolic acidosis (blood-gas guided)); 1–2 mEq/kg slow IV (2–3 mEq/kg over 30 min if perfusion is poor) IV once (with other therapies) (Life-threatening hyperkalaemia); 50 mg/kg PO q8–12h (Urinary alkalinisation (e.g. urate urolithiasis)). Confirm against the label and the patient before use.

### What is the dose of Sodium Bicarbonate for cats?

Reference doses for Sodium Bicarbonate in cats: Deficit (mEq) = 0.3 × kg × base deficit: give ⅓ slowly IV, the rest in fluids; recheck gases IV per deficit (Severe metabolic acidosis). Confirm against the label and the patient before use.

### What is the dose of Sodium Bicarbonate for cattle?

Reference doses for Sodium Bicarbonate in cattle: 2–5 mEq/kg IV over 4–8 h; comatose acidotic calves ≈2 L isotonic (156 mEq/L) bicarbonate over 1–2 h IV per deficit (Metabolic acidosis (calf diarrhoea / ruminal acidosis)). Confirm against the label and the patient before use.

### What is the withdrawal period for Sodium Bicarbonate?

Cattle, IV (Metabolic acidosis (calf diarrhoea / ruminal acidosis)): no slaughter withdrawal. Follow the product label and national regulations where they differ.

### When should Sodium Bicarbonate not be used?

Metabolic or respiratory ALKALOSIS, hypocalcaemia (bicarbonate lowers ionised calcium → tetany), hypokalaemia, and hypernatraemia/fluid overload. Inability to ventilate (bicarbonate generates CO2 — worsens respiratory acidosis if the patient can't blow it off). Mixing with calcium-containing fluids (precipitation) or catecholamines/many drugs in the same line. Known hypersensitivity.

### What are the side effects of Sodium Bicarbonate in animals?

Metabolic alkalosis, hypernatraemia, fluid overload (over-correction); Hypokalaemia and IONISED HYPOCALCAEMIA (tetany); Paradoxical CSF/intracellular acidosis and worsened respiratory acidosis (CO2 generation) if ventilation inadequate; Tissue irritation/necrosis on extravasation (hypertonic).

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.