Kanamycin Sulfate (Kantrim®): Kanamycin is active against Salmonella, Shigella, Alcaligenes faecalis, E. coli, Proteus and Staphylococcus aureus, all species associated with bacterial enteric infections. Most of the dose is not absorbed from the gastrointestinal tract, providing bactericidal action at the site of infection.

Bismuth subcarbonate and activated attapulgite (aluminum magnesium silicate) are antidiarrheals.

INDICATIONS
AMFOROL is indicated for the treatment of bacterial enteritis in dogs (caused by organisms susceptible to kanamycin) and the symptomatic relief of the associated diarrhea.

CONTRAINDICATION
AMFOROL is contraindicated in treatment of Salmonella septicemias.

WARNING
Treatment of Salmonella infections confined to the gastrointestinal tract with kanamycin may result in prolonged shedding of this microorganism. Follow-up cultures after treatment are strongly advised.

PRECAUTIONS
Because of the bactericidal activity of kanamycin, prolonged treatment may permit overgrowth of nonsusceptible organisms (e.g., fungi). If remission of symptoms is not evident after 2 to 3 days treatment, the diagnosis should be re-established. Do not treat for longer than 5 days.

Dogs, especially those weighing less than 5 lbs, when treated with oral kanamycin should be under close clinical observation for potential nephrotoxic and ototoxic side effects, as the recommended dosage may produce systemic levels of this aminoglycoside. Kanamycin should be used cautiously if the dog is also receiving other nephrotoxic or ototoxic drugs.

SIDE EFFECTS
The bismuth subcarbonate in AMFOROL may produce darkening of the tongue and stools which can be confused with melena. Prolonged exposure to orally administered bismuth salts has been associated with encephalopathies in other species. Signs may include lack of energy, muscle twitching, confusion, convulsions and comas.

DOSAGE
Dogs - The following dosage schedule is recommended, based upon a simple estimation of animal size:
Oral Suspension: Five mL (5 mL) per 20 lbs body weight every 8 hours. Maximum dose, 15 mL every 8 hours. For animals under 10 lbs, 2.5 mL every 8 hours.
Oral tablets: One tablet per 20 lbs body weight every 8 hours. Maximum dose, three tablets every 8 hours. For animals under 10 lbs, one-half tablet every 8 hours.
It is recommended that an initial loading dose preceded the above schedule, consisting of twice the amount of a single dose.