Azodyl for Kidney Failure in Cats: An Update on the Evidence

In a recent article about pet supplements for the Science-Based Medicine Blog, I reviewed the dietary supplement Azodyl, marketed for kidney failure in dogs and cats. At the time, the evidence I was able to find was extremely limited, poorly controlled, and subject to a high risk of bias due to association of the research with the company marketing the products. My conclusion was that the theory behind the product was weakly plausible and the evidence insufficient to justify a firm conclusion about efficacy.

An abstract is being presented at the upcoming American College of Veterinary Internal Medicine Forum which reports the results of a controlled study on the use of this product in 10 cats with  chronic kidney disease.

M. Rishniw; S. Wynn
Azodyl Fails to Reduce Azotemia in Cats with Chronic Kidney Disease (CKD) When Sprinkled Onto Food 

The study examined whether there was any difference between commonly measured blood markers of kidney disease, blood urea nitrogen (BUN) and creatinine, in cats given Azodyl and cats given a placebo. The Azodyl was sprinkled on the food since this is commonly how the product is used (making cats take capsules is often difficult). The study was randomized, double blinded, and placebo controlled. The criteria for confirming a positive effect were quite generous, however no difference was found between cats given Azodyl and cats given the palcebo.

The authors concluded:

Based on these results, Azodyl, applied by sprinkling onto food fails to reduce [BUN and creatinin] in cats with [chronic kidney disease]. Whether intact capsule administration reduces reduces azotemia in cats with [chronic kidney disease] remains unknown.

Though generally well-designed, this study was small, and of course single studies are almost never sufficient to provide the final word on a particular therapy. The issue of potential bias for or against a hypothesis is always hard to evaluate objectively, but I am unaware of any direct funding or other involvement of the company in this study. I do know that one of the authors, Dr. Susan Wynn, is a prominent researcher and advocate in the area of herbal and some other alternative therapies, so she certainly would not be expected to have a bias against the product. And negative findings in clinical research are inherently more reliable than positive findings because our studies and our psychology are designed to confirm our beliefs rather than refute them. So while the case is by no means closed, the balance of the very limited evidence is currently against any significant clinical value for this product.

This entry was posted in Herbs and Supplements. Bookmark the permalink.

85 Responses to Azodyl for Kidney Failure in Cats: An Update on the Evidence

  1. Lisa Ashby says:

    OKAY I AM A HUGE SKEPTIC….SO WAIT!! I QUESTION THIS “STUDY”! IT IS NOT PLAUSIBLE. WHY WOULD ANYONE “LEGITIMATE” DO A STUDY ON MEDS WORKING IN ANIMALS WHO CANT EVEN GIVE A CAT A PILL?? SPECIFICALLY AZODYL WHICH NEEDS TO STAY REFRIGERATED FOR EFFICACY! THE PRODUCT IS COMPROMISED BY SPRINKLING IT ON THE FOOD THE DOSAGE AND THE STABILITY ARE NOW IN QUESTION!! IT HAS TO STAY AT CERTAIN TEMPERATURES TO BE EFFECTIVE! IT HAS TO BE A WHOLE DOSAGE ONCE OR TWICE DAILY TO BE EFFECTIVE BASED ON THE CATS WEIGHT. AZODYL WORKS!! I HAVE USED IT AND IT HAS SAVED MY 2ND CAT. MY 1ST CAT I WAS TOO SKEPTICAL TO TRY IT. IF YOU HAVE A CAT WITH CRF AND WANT TO SAVE IT .. READ MY NOTES PLEASE….READ A REAL USERS EXPERIENCE WHO “CAN” GIVE PILLS TO CATS:
    I have had 2 cats with CRF. One died and one is still alive. I am one who is extremely skeptical about non prescription medication and also about SOURCES of online studies. I trust myself and my own experiences. I do not trust all vets..there are good and there are bad…. there are researching vets who have open minds and learn form their experiences and listen to their clients…..and there are vets who think they know it all and only go by textbook knowledge never thinking outside the box. Science is not infallible things change discoveries are made. I have been using vets for 35 years for MANY animals and have much more experience than a pet owner who goes to the vet twice a year. I am a dog breeder and have been for 30 years. I am very knowledgeable about many medicines and treatments for many diseases and conditions. I have seen many over the years with the numbers of animals have cared for. I also have had many cats over the years but I am not as familiar with cat issues as I am dogs….so when I had a cat come down with CRF I did not know what to do other than go to the vet and she prescribed IV Fluids and Pepcid and an Appetite Stimulant. My first cat held on for a while and eventually succumbed to the illness. Then another cat came down with it and I started researching. Went back to the vet and she prescribed Rehmannia 8 and Azodyl….The Rehmannia 8 created too much trauma for the cat…so I only used the Azodyl I found small caps for the cats 90 count bottle. The 60 count caps are too big to be easy. My cats life has reversed back to normal. She no longer lays around and sleeps all day..she is once again active and playing and interested in socializing and going outside into my protected garden area. I know my notes can be passed over as not being credible…but if I am going to believe a study..it needs to be a study where the drug is used properly….by a REAL DOCTOR who can administer medicine to animals…and test results accurately NOT some yahoo who uses no common sense….. who doesn’t even make sure the necessary dosage is given and creates instability in the efficacy of the product in other words… ruins it by leaving it sitting out and sprinkling it on food not knowing if the animal is even ingesting the proper amounts…ps the cat could NOT have ingested the proper amount..the whole theory behind medicating cats with CRF is the lack of interest in eating therefore the cat wastes away and the kidneys shut down due to lack of nutrition.

  2. skeptvet says:

    The issue of how the Azodyl was administered was a limitation of this study, though to be clear it was a study of owned cats and owners were administering the medication, not the investigators. However, another study in dogs did administer the product exactly as recommended and found no effect, so there is still significant doubt about efficacy here. No clear mechanism, no evidence to show relevant biological effects, and failure in two clinical trials is a reason for continued skepticism. Having seen a change in a single cat after using the product is not sufficient evidence to declare that the product works, since such medical miracles are unreliable.

    Skepticism means reserving judgment in the absence of evidence and proportioning your confidence in your beliefs to the strength of the evidence available. You do not appear to be a skeptic by this definition despite claiming to be one. And just so you know, the hysteria of screaming in ALL CAPS does not encourage others to read, or take seriously, your comments.

  3. v.t. says:

    Lisa, the study clearly states the purpose was to determine if Azodyl had any effect on reducing renal values when administered by sprinkling on food, as opposed to the manufacturer’s recommendations to give orally by capsule. I gather this was done based on prior owner complaints and the difficulty to administer the capsule to their cats (this is common, cats generally do not tolerate capsules, capsule administration has been known to be problematic in delivery of medication/lodging in the esophagus, and owners frequently cease giving medications due to those difficulties – all of which do not help the cat!)

    You’re suggesting that the trial directors used an inappropriate delivery method of the product. No, they didn’t. They did what they set out to do (or should we say, the clients did what they were told).

    The problem is, in two studies thus far, with both cats and dogs, with two different methods of delivery, it isn’t looking like method of delivery matters at all. What matters is that both studies have shown NO effectiveness of the product in reducing renal values, therefore raising the question of the marketer’s claims (as well as the question of why vets continue to prescribe, promote the product to their clients without any evidence of efficacy).

    Btw, please reconsider those chinese herbal remedies your vet prescribes. There is every potential they could be contaminated, adulterated, contain no substance of what is claimed, or even an excess or addition of other substances – you’ll have no idea either way, because they are not regulated and safety and efficacy doesn’t seem a priority to many manufacturers of herbal products.

  4. MKT says:

    Azodyl does not reduce the kidney indicator values, according to my friend who had a cat with renal failure that the vet determined was beyond hope. But the cat went on to live on it.
    On recommendation from a homeopathic vet, she started giving the cat one azodyl capsule a day along with sub-Q fluids every other day (fairly small volume—100 ml or so).
    That went on for four years, during which the cat lived perfectly normally: eating, playing, looking beautiful. But the kidney values remained in the extremely critical level the whole time. When the cat died at the age 16, it was from a tumor.
    Hard to believe, right? But the proof is in the pudding, you know.
    Numbers are just numbers.
    If the cat can be allowed to live happily—then that is all that matters.

  5. skeptvet says:

    The problem with this story is that it ignores the fact that many, many cats survive comfortably for years with elevated kidney values without Azodyl. There is no reason to believe the Azodyl had anything to do with the outcome.

  6. Linda says:

    I completely agree with Lisa! I adopted two cats who were brothers (womb mates). One of them came down with CRF in August 2008. He was given 6 months to live. He had a BUN of 75 and creatinine of 5.3. Back then, our Vet told us to give him only 2 Azodyl pills a day, 12 hours apart. Barney’s levels went to a BUN of 70 and creatinine of 3.5 in April 2009. By June of 2009, he had a BUN of 52 and Creatinine of 3.0. Unfortunately, in the winter of 2010, Barney died of CRF. He lived 10 months longer than predicted. In the mean time, his brother Fred was born with a heart murmer. The Vet also discovered, after an EKG when he was 4 years old (in the year 2000), that he had only one functioning kidney. The other one was shriveled up. The Vet gave him 6 months to live and put him on a heart medication. Fast forward to July 2011 (yes, Fred is still alive), the Vet tells us that Fred has CRF (BUN 52, creatinine 3). He says to give him 2 Azodyl in the morning and another one at night, with his heart medication. It is now July 2013. Fred is over 17 years old and he’s doing great. His last blood work showed BUN 42, creatinine 2.2. Now, tell me that Azodyl doesn’t work!

  7. Cynthia says:

    Here’s a link to a citation and abstract of the study referred to above by Wynn, et al. “Azodyl, a synbiotic, fails to alter azotemia in cats with chronic kidney disease when sprinkled onto food”
    Journal of Feline Medicine & Surgery, Volume 13, Issue 6, Pages 405-409
    Mark Rishniw, Susan G. Wynn

    I found it by searching on Google Scholar. If you want the text of the article you’ll have to order it from the publisher Science Direct. Instructions are provided at the abstract.

    http://dx.doi.org/10.1016/j.jfms.2010.12.015

  8. Rebecca Johnstone says:

    Azodyl is intended to be adminstered via capsule, not sprinkled on food. I tried Azodyl on a cat with renal failure, and her creatinine did drop significantly (from somewhere in the threes to the twos). Her chronic diarrhea also improved. I would definitely try this product again with another renal failure cat. It is obviously not a cure, but it does help.

  9. skeptvet says:

    Of course, renal disease changes for many reasons, which is why we cannot assume from stories like this that azodyl is responsible. Such reasoning has fooled us many times in the past.

    As for the method of delivery, there is no evidence that it matters, though of course it could. On the other hand, pilling cats is notoriously difficult, so a therapy that can’t be administered to most patients in an effective form isn’t a very useful therapy in any case.

  10. Ron says:

    I agree with skypevet. If a product is this controversial as to how it is administered, it is a product that needs alot of work yet in terms of even being on the market!

  11. Andrea says:

    I haven’t read anywhere yet that it would harm my cat. Even if it is not proofed in studies whether it helps a cat with CRF or not, I will still give it a try, because I’m a person who does a lot of research and always thinks positiv. So yes, I spent a good amount of money on these pills and I’ll to my very best to administer it to my cat along with the sub-q fluids. And I hope and pray, that I will still have a lot of time with my Tiger.

  12. skeptvet says:

    It’s unlikely to do harm so long as it is not substituted for other, more well-supported therapy.

  13. Joyous1 says:

    I have a cat (only 10yrs) DX w CRF in DEC 2013……typical symptoms, anorexia, wt loss, irritable, muscle-wasting, etc.. I am an RN so naturally I had to research anything that was ordered by my Vet. He would not eat the low-protein diet, and besides from what I have researched, they are now saying that low protein is contraindicated in CRF, especially in the senior cat due to the fact that they naturally lose muscle w age…and actually do better w HIGH quality protein! I had to use an appetite stimulant (Remeron..but VERY low dose -only ~ 1/16 of a 15mg tab) to reverse the anorexia, which was effective. I was also told to give Azodyl & Epakitin . I was very skeptical and did not use it at first…..especially after I read the first article here. However, I changed my mind after doing more research and decided to give it a try. I have no idea IF it is working, but I CAN tell you that he is stable. He is back to eating dry and wet food, “talking”, etc…being pretty normal! So it is the SQ fluids every other day, or the supplements?? Here is what I do to “pill” my cats:: I buy the smaller gel caps, take the Azodyl, put it in the smaller gel cap along w a little Epakitin, a tiny piece of Pepcid and a splash of Alum hydrox (Epakitin and alum hyd are phos binders)..I just pack the gel cap with a flattened toothpick to make sure that I get most of the large Azodyl in along w the other stuff. I have not taken him back to the Vet, so I have no idea what his levels are, and honestly, I could care less! They are just numbers..I judge by how he acts and eats and interacts w my younger cat..So I will keep doing this till it becomes ineffective, then go to Plan B! Thanks)

  14. Joyous1 says:

    –I more thing…I have had cats for >40yrs, here is how I learned to PILL a cat…get a pair of tweezers, I use plastic ones that come in a medical disp kit, put cat on floor or on a table, put pill in tweezers, pop open their mouth and toss it down their throat! They do not have a uvula, so it goes now easy…with the gel caps, they have NO way of accidentally tasting the med as it goes down, it will not melt in the mouth. I also immediately give a ‘treat” after the pill.. I found that watered down wet food or tuna (cat tuna) works, and it makes me feel better that the food/water wash down the pill as well. For years I struggled w “pilling”, but this works if your cat will allow it)

  15. skeptvet says:

    I’m glad your cat is doing well, but I will point out that 1) you are doing multiple things, so no way to know if the azodyl itself is doing anything, 2) cats with CKD often are stable for quite long periods of time once therapy is started, so again there is no reason to think the azodyl is responsible. As I said in the article, it seems unlikely to be harmful, but it seems unlikely to be doing anything also.

    Good luck!

  16. v.t. says:

    Please be careful with ANY gelcaps – they are known to lodge in the esophagus, irritate the esophagus, and the medication does not get distributed properly. You should also be taking care to determine which meds need to be given separately, with or without meals, timing between different meds and contraindications, etc.

  17. Sara Lyn says:

    So back in February, one vet I went to said I needed to have my cat’s teeth pulled because they were so severe. I didn’t have the finances to cover the expenses at the time so I had to hold off on the dental work. Later this May/early June, I took my 16 year old cat back in for an evaluation because she was trying to pee everywhere- even on a book of mine, and nothing was coming out except for a few drops of urine and with some blood in it. When she got her lab results back, it was discovered that she has CRF as well as a minor UTI that she was being treated for. The vet was insistent on her getting her teeth pulled and didn’t explain the correlation between dental issues and kidney disease, so I spent extra to go to another vet for a second opinion. The second opinion was that she did need dental work done sooner rather than later to assist in dealing with her CRF. Well, I set up the dental two weeks later with my third vet and the he told me after my cat was already ready to go under surgery, that she might not make it due to her being a high risk patient from her high levels of BUN (39) and CEN (around 2.5). This being my third vet, he told me that I would have to make the decision on having her teeth pulled right now or waiting, where her levels are high for her body type (she weighs around 5 lbs and has always been small). He did recommend me against the pulling until we stabilize her a little better.

    That was two weeks ago and since then, she has been prescribed IV fluids, Royal Canin diet (she eats just the soft) which will help regulate her calcium, phosphorus and sodium levels, and now if I want to purchase it, the Azodyl. They do not carry Azodyl in the vet hospital, so I would have to purchase it online in order to have her take it. Since last week, her levels have come down: BUN- 32 and CEN-2.3. I consider this great progress if it wasn’t for the fact she has lost a pound in body weight and now weighs 4.1 lbs. The vet has okayed me to add her old food back into her diet until she gets used to the Royal Canin hard food so I plan to do that to help her get back to her regular size.

    My concern from these reviews regarding Azodyl and CRF, is whether or not A) the medication helps in the least bit, and B) are there known side effects??

    I have had my cat for 16 years. She is a relatively healthy and happy cat and even the vet and techs said they think she has a few more years in her as long as we are proactive. I just want to make sure I am not missing a step when it comes to getting my cat proper healthcare. If Azodyl has been shown to help at all, I’m willing to try it, but not if there are severe side effects. Can anyone let me know what they find as I continue to research? And if there are any foods/medications that will help her put on weight while not interfering with her health levels?

  18. skeptvet says:

    As you can tell from the article, there isn’t any evidence the product does anything useful. Only one clinical study, and it didn’t work. Unlikely to be any serious risks, but there’s no reason to believe it will help.

    Good luck!

  19. Honeybee says:

    Our cat was diagnosed with CRF last Nov. She was only 4 yrs old, so very young. The vet recommended that she be put down as she was very poorly – sunken eyes, lethargic, no appetite, etc. She has made a terrific recovery and plays/teases our puppy. We do use Azodyl which is injected with a plastic syringe and we’re lucky that she accepts RC renal food. Her age, I imagine, is a key factor in her improvement. Equally, as one post referred to, her mental alertness and chatty disposition means that we’ve stopped doing blood tests and SQs. There’s no need. No we have no idea what the future holds our beloved Siamese cross. But a while ago we were in a similar position when a vet wanted to put down our 3 yr old German Shepherd as she had anal furunculosis. We did used medication and our gentle lady lived until she was almost 13. I don’t believe any vet takes the decision to put down animals lightly. But we all need to be aware of what we don’t understand. In science its easier to disprove than to prove. Our cat is about to fly home 6,500 miles. Our vet doesn’t use Azodyl. I think its because she can’t source it in Glasgow. We hope our cat copes with the journey. We’re optimistic she will. I’ll be sourcing Azodyl from somewhere. Whether its part of the cocktail that keeps our cat akive , I don’t really know. But since there is no guaranteed alternative route for success, we’ll keep things as they are!

  20. Cynthia Yaswinski says:

    My 15 year old cat was diagnosed with renal failure and I was told I would have to give him fluids with a needle and syringe, I think they told me, every other day. The needle was to be placed between his shoulder blades and I was to hold the bag of fluids high so that it would absorb under his skin and there would be a lump of fluids until it absorbed into his system. My daughter tried helping with this and it proved to be an awful experience for my daughter, myself and our beloved cat. I decided this was not going to be an option I was willing to choose. My cat was crying out and uncomfortable. One of my veterinarians suggested Azodyl and it worked WONDERFULLY!! After his blood work results came back they were quite impressed!! I was given the larger capsules to start and accidentally given the smaller capsules on a refill but the smaller ones were much easier to administer and easier for him to swallow. I also would give him a little water with a syringe after each dose. I started with one capsule at night and one in the morning. After two and a half years on this regimen he levels did change slightly so we had to up his dose to two capsules in the morning and one at night. I was also told about the renal diet and how he should have less protein in his diet but after speaking with a gentleman who was knowledgeable on this subject I also realized it was not just the higher protein level in the food but the food with a better source of high protein. The higher end foods are definitely worth the price when it comes to your pets. The Azodyl definitely worked for my buddy!! I do believe all animals are different just like people, it may work for one but may not work for another but you should absolutely try!!

  21. skeptvet says:

    As usual, there are so many factors here that can explain the change in your cat’s condition besides the Azodyl, and it is just arbitrary to decide the change was due to the product. It might have been, but the evidence so far suggests not. I have treated hundreds of cats with renal disease, and their bloodwork and clinical condition changes all the time, sometimes because of our treatments and sometimes despite them. I could tell you doxens of anecdotes like this that give the credit to something other than Azodyl, but the point is ancdotes don’t helps us decide whether or not a product like this works.

    As for diet changes, there is a lot more to it than the protein content or “quality” (which is a pretty vague term and doesn’t mean much other than as marketing). There is strong evidence that diets formulated for treatment of kidney disease in cats make a big difference in how they feel and how long they live, so I would strongly suggest trying to use such a diet.

    Good luck!

  22. Lynette says:

    I personally started using Azodyl after my cat almost died in March 2014, his BUN and CRE levels were literally off the chart. I started him on this and RenAvast along with Rehmannia 8 and was able to take him from a few months to love and beyond stage 4 renal failure back to renal disease with BUN and CRE levels slightly over the high end or normal. Azodyl should not be sprinkled in a cats food, it should be given at least 30 to 60 minutes prior to meals, it needs to stay in the gut as long as possible prior to food. 60 minutes is preferable. The company does not suggest that the capsules be opened. I use this product and order it in multiples so I dont run out my Bailey would be dead without the supplements he takes. I highly recommended that you try these products. No matter where you on the internet you will find people or articles praising a product and then also find pages disputing it. My Bailey is proof this product works and my vet was astonished at his turn around. I recommend this product to many people who have CRF cats and it has also changed their lives.

  23. Joana Ciurash says:

    My cat just started to take Azodyl one week ago, twice a day. She lost one pound in one week, since she started to take this medication but she has a great appetite and she goes outside in the patio twice a day. I open the capuse, from the middle, and put the powder into a very small spoon, then I open my cat’s mouth gently and pour the entire powder in her mouth with no problem, she likes it. The doctor wants to redo her blood in two months, he also increased the IV fluids from once a week to twice a week. We will see…..

  24. Lee Weng Kwong says:

    Hi Everyone

    My friend’s dog has just been diagnosed of CKD. I did some net research and found that UBIQUINOL ( the reduced/better version of coenzyme Q10 ) can reverse ( yes, reverse) CKD in 80 % of patients. This looks very promising indeed for our feline and canine friends. Some pet owners are so pleased and relieved with the effects of ubiquinol.
    Thank you, Skeptvet, for setting up this informative blog.

  25. skeptvet says:

    Do you have any evidence for this extraordinary claim? Because the only evidence I find is lab animal model studies. For example, here’s a lab study in rats who had half of a kidney removed and then got ubiquinol and had some proxy chemicals measured. These sorts of studies have virtually nothing to do with chronic kidney disease in actual patients.

  26. Lee Weng Kwong says:

    Dear SkeptVet

    Thank you for your prompt response. I do not have any solid evidence per se but I have come across a few links that indicate ubiquinol reverses CKD or improves kidney function.
    The most interesting link with reference to purported human patient study which I quoted the 80% is :
    http://www.rejuvenation-science.com/n_coq10-kidney_failure.html

    Although I’m not a scientist , I know that a more proven study would be supported by peer review/s which I have not come across with regard to ubiquinol reversing CKD.

    Once again, thank you.

  27. skeptvet says:

    Again, interesting article. Sounds like an area worth further investigation. Thanks.

  28. Lee Weng Kwong says:

    Yes, in my humble opinion ubiquinol is definitely worth investigating with regard to reversing CKD or at least stopping its deterioration. Who would be a better professional to undertake this investigation but your goodself who is an experienced veterinary doctor with an objective skepticism to sieve out the truth ?

  29. Barbara Brown says:

    Perhaps my method of administration may help. Capsule swiped through COLD BUTTER, may be followed by 1cc of fluid if needed. Have been giving this med with benefit for some time and have never had a problem with this method. The butter makes it slide down easily and tastes good also. Hope this helps all.

  30. Charlene Platts says:

    My cat Mr. Mew has stage 3 kidney failure. I put him on renal care diet with the two prescription name brands suggested by his Vet. Unfortunately he doesn’t like the wet. I found Hi Tor Neo on Amazon and he loves the new food. My vet says the ingredients are ok for him. I give him fluids every other day which has helped. But I have also added Epakitin to his food. His levels have gone down. In reading reviews on Amazon one person said they use the Epakitin and Azodyl and that has helped tremendously. So, that’s why I am reading this site. I am like everyone else, if there is a chance it will help give me more quality time with Mr. Mew, I am all for trying. All the reviews I have read seem to favor this product. My only concern is of course getting good product.

  31. skeptvet says:

    It is understandable that we all want to do everything we can to help our pets when they have a serious condition like chronic kidney disease. Unfortunately, it is easy to find a thousand products that say they can help, but very hard to find one that has any actual evidence showing it really does. Some may even be harmful, so simply trying things based on marketing and testimonials is risky. In the case of Azodyl, there is little reason to think it does any harm, and also little reason to think it does any good. If it doesn’t interfere with appetite (and almost anything you add to a cat’s food can), then it is probably harmless, but again unlikely to have any benefit either.

    Good luck@

  32. William says:

    I too have a cat in Stage 2 renal failure. The vet suggested Azodyl and I was skeptical of a probiotic medley. I can see that their isn’t much clinical evidence to support the claims of lowering BUN and Creatinine. I can not understand clearly the therapeutic mechanism.

    I have, in the past, been a manufacturer of probiotic supplements for humans and I would like to offer some insights from that experience.

    1. Probiotics are very heat sensitive and should be stored below 40 degrees F. or frozen. They lose potency when exposed to the heat of storage or shipping (including shipping to the vet on a UPS truck!). I live in a very hot Arizona.
    2. Probiotics should be taken on an empty stomach, not with food or liquid, which will activate the bacteria prematurely and render it useless. So you need to pill your cat in between meals.
    3. There is always on issue of whether sufficient bacteria survive the acid and bile of the upper intestinal tract even if you are doing everything right.
    4. The price of Azodyl is high. Premium products for humans with 15 billion bacteria retail for about half the price; the ingredients in Azodyl probably cost no more that $5 to procure.
    5. The product, stored correctly, has a shelf life of maybe 6 months from the date of manufacture before most of the bacteria are rendered useless.

    So, while I do pill my cat between meal periods with refrigerated pills from a vet who refrigerates them at her clinic, It is more an act of hope and love than an exercise in effective medicine. But I keep my fingers crossed and await further developments.

  33. Hazel Greenberg says:

    If probiotics must be taken on an empty stomach, then why does my Animal Essentials Enzymes and Probiotics come in powder form? It must be given mixed in food.

    I am trying to decide whether to try azodyl for my 17.5 year old cat with early stage crf. He has no symptoms at all, just the results of his blood test. He also has very mild hypertrophic cardiomyopathy, which makes administering fluids somewhat risky, which is why I am searching for other methods of making sure he stays healthy. Coincidentally, I have been giving him ubiquinol (50 mg/day) for his heart as well as omega-3 fish oil. Good to know it might help his kidneys as well. Has there been any update on azodyl in 2015-16?

  34. skeptvet says:

    Nope, no additional research. Current evidence suggests no harm and no benefit.

  35. Louise Haley says:

    Please let me know if mixing the Azodyl powder with a little water and administering it via a syringe directly into the cats mouth is effective ? My cay Bobbie isn’t easy to pill.
    Thanks – Louise

  36. skeptvet says:

    My interpretation is that the research so far suggests it isn’t effective regardless of how you give it. However, those who still think it works have claimed that the reason it didn’t work in the study done in cats is because it was sprinkled on the food instead of given as packaged, so they would probably tell you that your method isn’t a good idea.

  37. Angela says:

    Recently told to give my 13yr old Himalayin Azodyl twice a day. The Vet said his level was CEN was 3 . The pills for 45 days cost $96. I will have to change his food from digestive care to k/d diet which is also pricey since I have 2 cats. I adore my cats and would do anything to keep them around healthy and happy as long as possible. Problem is I am disabled and on a limited income. Why does this supplement have to cost so much? I found this site as I was searching for more affordable alternatives. I cant seem to find any. I am not sure how long I will be able to afford these pills so I am desperate for any advice anyone has. Thanks

  38. skeptvet says:

    The fact is that there is no reason to think this supplement will help your cat. One of the dangers of this sort of product is that it uses up resources that could be spent on more important things, such as kidney diets, regular monitoring of blood, urine, blood pressure, etc. If adding a supplement makes the rest of your cat’s care harder to afford and the supplement isn’t doing anything anyway, the best alternative is to stop using it.

  39. Angela says:

    When I took him in to the Vet it was because he was acting like he had some pain and was sluggish. Also he is vomiting usually daily. He did not address the vomiting “probably hair balls” is all he would say.

  40. v.t. says:

    Angela, perhaps a new vet is in order? It’s possible your kitty could benefit from sub-q fluid therapy, anti-nausea medication etc – you should also rule out the possibility something else is going on (not saying there is, but it’s a good rule-out in any renal cat) – the daily vomiting is concerning, it should be addressed properly.

  41. marianne says:

    My cat was diagnosed with kidney disease about 4 yrs ago , she was young . I feed her kd dry , she doesnt eat the wet but the wet food i feed her is pate as it holds more moisture , i also give her Azodyl caps 1x a day , whether it helps her i dont know but it wont harm her. I also give her 5 mlgm of pepsid tablet at nite because cats w kidney disease produce more acid and sometimes cause liquid vomit in the morn especially if they are not fed early. the best and most important thing to do is give her iv fluids . My cat gets them 2x a week .it can be an expense so if you can learn to do it yourself , do it. My cats last lab results were the same if not better than the previous , my vet said keep doing what i am doing because it works for her . She also gets an herbal organ supplement , but if nothing else , give her Fluids and access to plenty of water. good luck.

  42. LuTina says:

    After reading great testimonies on Azodyl I decided to start my kitty who is on stage one renal failure. He has been on it now for approximately a little over a year. Two capsules a day. His weight suggests 3 I decided to start out low and work up as needed. Within 2 weeks he perked up, his appetite increased, and he became more active. Even my vets surprised by the changes. After 6 months his blood levels lowered and 12 months they are continuing to lower. Although, not as significant as the first 6 months. I can’t dispute how this study was conducted but what I can say is I have seen my cats blood levels lowered by using this supplement. Nothing else has been added or changed to his regiment other than giving him Azodyl. Not even his diet has changed. Interesting how the body can be affected by something that defies science. In this case I’m so happy it’s for the positive.

  43. skeptvet says:

    Interesting how the body can be affected by something that defies science.

    Actually, what’s interesting is how easily we can ignore all the complexities and uncertainties of life and of our own perceptions and draw firm conclusions despite all the reasons to doubt them.

    As I have pointed out many times, anecdotes like this exist for every therapy ever tried, including things like bloodletting and ritual sacrifice which no one today would recommend. They are inherently misleading, and the unprecedented success of modern science in more than doubling our life expectancy and improving our quality of life tremendously has come about by specifically decreasing our trust in such anecdotes and placing it in controlled research instead. Science works and stories don’t, so the reason to challenge stories like yours is to help people avoid being misled, as we have for thousands of years, by such stories.

    Why We’re Often Wrong
    Testimonials Lie
    The Role of Anecdotes in Science-Based Medicine
    Why We Need Science: “I saw it with my own eyes” Is Not Enough
    Don’t Believe your Eyes (or Your Brain)

  44. Laura says:

    Thank you for being so patient skeptvet. Us vets appreciate your efforts!

  45. skeptvet says:

    Thanks for the support!

  46. Jane says:

    My cat Gemma is 14 years old and a recent vet visit said she is in the beginning stages of chronic kidney failure. I have been doing a lot of research and read that Dr Becker recommends, ‘A diet high in excellent quality protein and lower than normal amounts of sodium and phosphorous is recommended. Controlling phosphorous intake has proven to be very important in controlling the progression of kidney disease.’ I have been feeding them dry kibble by itself or Weruva. I stopped feeding them any fish two years ago because it can lead to hyperthyroidism. I now have eliminated the dry kibble and switched over from the Weruva chicken to the Weruva steak frites with a sprinkling of kibble for roughage. You can also sprinkle a little psyllium fibre which also helps avoid constipation.the steak frites is low in phosphorous, moist and human grade. I chose to avoid the standard vet renal diet because I knew Gem wouldn’t eat it,it’s poor quality and to feed a cat dry kibble alone can exacerbate the kidney issue. I am still doing a lot of research on holistic aids. CoQ10 looks interesting and giving them a little Brewers yeast for the B vitamins has been recommended.

  47. Aaron Cohn MD says:

    I am skeptical about the skepticism. Azodyl is packaged in a stomach acid resistant pill. The instructions state that it is to be given as a whole pill one hour before meals. When a medication is not administered as directed and you get a negative result, it does not cast doubt on drug efficacy, but rather casts doubt on the ability of the researcher to read the label.

  48. skeptvet says:

    So how do you explain the failure of studies in dogs to find any benefit when the product was not opened and sprinkled on the food but given as directed? Certainly, all research has limitations, and no single study is ever definitive. But if we compare the imperfect research showing no benefit to the absence of clinical studies in dogs and cats that do show a benefit, there is still no support for the manufacturer’s claims, which is why the FDA ruled them illegal.

  49. Aaron Cohn MD says:

    So I guess we should take whatever works in a mouse and apply it without question in humans… Great idea. Perhaps we should never use flagyl in a cat with IBD since it’s been associated with neoplasms in dogs. Perhaps we should never use aluminum hydroxide as a phosphate binder in cats because it’s been linked to neurologic damage in humans. Well in my cat I’m using aluminum hydroxide AND flagyl. And until proven otherwise, I’ll use azodyl in my cat.

    The proper interpretation of the study in dogs is applicable to dogs.

  50. Hi Lisa.
    I just almost lost my almost 17 yr old Chloe due to some tainted food we think and now Renal failure.
    She spent 7 days in ICU ..and came home 1 week ago today.
    Our vet whom I totally trust put her on This med and I think ..anndd hope we just turned a corner..
    I am estatic..
    I recieved the meds last night. She was discharged kadt Tuesd. A week ago…
    And we rechecked her Crea..n Bun nmbers as now stable..n in her “new normal”.
    On last Friday. She hasnt came out frim under the covers of my bed unless I pulled her out to feed her. I totally thought it was over. N she is alm 17.
    Just got the meds last night.
    So now she has eaten 3 DOSES IN WET FOOD Since last night..
    N kinda looks like she MAYBE HAS TURNED A CORNER.
    After alm 4k$.. ( which I dont give a hoot abt..) and over 3 weeks of no sleep n eating for me… losingy girl…
    Thinking this med may have just kicked in n maybe will help?
    She FINALLY JUST ATE MORE THAN 2 BITES!! N CAME OUT FROM UNDER THE COVERS FIRST TIME IN 24 HOURS!!
    But still only peed once n no poop in days….
    But she just chowed…
    Is she gonna make it????!!

Leave a Reply

Your email address will not be published. Required fields are marked *

This blog is kept spam free by WP-SpamFree.