Azodyl for Kidney Failure in Dogs–New Study Finds No Benefit

I have recently summarized the limited evidence concerning the use of Azodyl, a popular probiotic product, for treatment of kidney disease in cats, including a recent study presented as an abstract at the American College of Veterinary Internal Medicine Forum. Another study of this product has also been presented at the same conference.

David J. Polzin, DVM, PhD, DACVIM . Probiotic Therapy of Chronic Kidney Disease

This was a considerably more comprehensive research project, though still with some limitations, as is always true. 32 dogs with moderate kidney failure were randomly assigned to treatment with Azodyl or a placebo. They were otherwise treated identically according to a standardized algorithm for managing kidney disease. They were evaluated in terms of comprehensive bloodwork, body condition, and owner perception of quality of life and 7 time points from 1 month to 1 year after the start of the study. No significant difference in any measure was found between the groups at any time point.

The Azodyl was given as an intact capsule in this study, which eliminated the possible concern about the probiotic organisms being destroyed in the stomach that was raised in the cat study, in which the Azodyl capsules were opened and the product sprinkled on the food. The supplement was also given at twice the manufacturer’s recommended dose. Some of the dogs did have episodes of urinary tract infection during the 12 months of the study and did received short courses of antibiotics, which could potentially interfere with probiotic therapy. But this seems insufficient to entirely invalidate the rather startlingly consistent, negative findings of the study. And since infections are a common and unavoidable problem in kidney failure patients, if the therapy is so easily rendered useless, it would not be of much benefit in the even less controlled conditions of standard clinical use.

Of course, almost no single study should be taken as the final word on any therapy. However, negative results are likely to be more reliable than positive results, and the balance of the evidence is so far pretty negative concerning the usefulness of probiotic therapy for kidney failure. There are theoretical and in vitro study results which suggests that the best one could hope to achieve with probiotic therapy in kidney failure patients is a 10-20% decrease in bloodwork markers of renal failure, which might or might not be sufficient to meaningfully affect the clinical symptoms and the course of the disease. Certainly, in the face of being unable to routinely employ dialysis and transplantation, the most effective therapies available for humans with kidney disease, we should employ any treatment that offers a significant benefit, even a small one. But at this point, it doesn’t look like probiotic therapy holds especially great promise for this disease, unlike some of the other possible conditions in which it might be useful.

In any case, there doesn’t seem to be a strong case for suggesting owners spend their money on this product based on the evidence so far available. And the negative findings so far seen in clinical studies of dogs and cats point out the danger of extrapolating from limited studies in other species. The company-sponsored studies in rats and miniature pigs with artificially induced kidney disease have not proven an accurate indicator of the product’s performance in cats and dogs with naturally occurring kidney failure.

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104 Responses to Azodyl for Kidney Failure in Dogs–New Study Finds No Benefit

  1. skeptvet says:

    Or you will be misled by all the varied reports. It is important to distinguish the reliability of different kinds of evidence, and anecdotes are not as reliable as controlle dscientific research.

  2. Paul says:

    Azodyl is great!!!! Also epaketin, arnica montana, home made food low phosphorous, ACVinager, multivitamins, chiropractor for pets, etc . My cat has CRF after 5 years she is still alive thanks to all these products.

  3. Art Malernee Dvm says:

    Paul,
    does your chiropractor use or sell you products for your cat?

  4. v.t. says:

    Gotta love the drive-by posts with absolutely zero substance/evidence to them.

    Paul, just so you know, many CRF cats can live good quality lives with proper veterinary care, without all the woo you claim. Nothing in your cocktail mix (save for low phosphorus diet) is doing much of anything for your cat, and in fact, the Epakitin could be detrimental to some degree – you need to regularly check blood work to even determine if a phosphorus-binder is even necessary. Likewise, there is little evidence that a home-made food can provide the necessary nutrients/vitamin formulation for long-term use, and quite often, is either deficient or excessive in vitamin/mineral composition. If you’re determined to feed a home-made diet to your CRF kitty, please consult a board-certified veterinary nutritionist for proper advice.

  5. Claudia says:

    Has anyone heard about Renavast? I believe this to be a new form of quackery for renal failure for cats. It is being marketed on Facebook, but I recently noticed it being sold on Amazon. Funniest thing, there was a negative remark and the CEO of the company left a comment as if he were a customer with a glowing report of Renavast.

    My friend bought it and was using it without her vet’s approval, when she told her vet, they told her it could be dangerous as the company will not reveal what is in it! They also got in trouble with the FDA and had to take off all their outrageous claims about curing renal failure from their website. Would love to hear skeptvet’s thoughts on it.

  6. skeptvet says:

    No useful info on the web site, but they do offer to provide more info to veterinarians who request it, so I have emailed the company.

  7. mary r says:

    Well, you know what they say. Opinions are like********* – everyone’s got one. Although the give and take of reasoned opinion can be beneficial – the spouting of prejudice and bias cannot. There is a very good reason why homeopathy is not mainstream in the U.S. It is not a money maker. Big Pharma cannot make a whole lot of money concocting proprietary compounds of cheap, commonly available plants and herbs. There is no R & D and who the hell would invest in homeopathy? I go to a mainstream vet who is very open-minded. But my friend goes to a “holistic” vet who uses acupuncture, Chinese herbs etc. Once when I was dog-sitting for her for a few days her dog got sick. I had to take the dog to her vet who prescribed a homeopathic med and did acupuncture. The dog recovered quickly.

    That said. The fees which this holistic vet charges- $500 for a two hour home visit or Rip-Off City. There are two issues. One, can the vet provide benefit and two, are her prices outrageous. Don’t confuse the two.

  8. skeptvet says:

    Well, you know what else they say. Everyone is entitled to their own opinion, but not their own facts. The idea that homeopathy is not more popular because the bad guys in Big Pharma suppress it is an opinion, one with which I disagree. The idea that hoemopathy is mere water with absolutely no benficial effects on health is a fact, demonstrated by over 100 years of scientific research. The fact that your friend’s dog got better is just that, a fact. The idea that it had anything to do with homeopathy and aculuncture is an opinion. Not recognizing the difference leads to confusion and the persistance of pseudoscientific nonsense like homeopathy.

  9. v.t. says:

    The dog got sick with what? It’s easy to say this without expounding on the issue, and thus impossible to determine what therapy was or was not beneficial.

    That said, how long does it take for people to acknowledge that the jury is out on acupuncture and homeopathy?

  10. Sara says:

    My dog has just been diagnosed with early stage kidney disease. My DVM prescribed her azodyl, enalapril and renal lp modified royal canin food. Reading this post and the comments you seem to think these options are not beneficial to my baby. What do you suggest we use instead? She is only 7 years old and has always been in great health until now. I want to keep her alive and healthy as long as I can. Please help!

  11. skeptvet says:

    Renal diets have been clearly shown to be beneficial, so this is definately a useful thing to do. Enalapril may be useful depending on the specific details of your pet’s disease. Azodyl has failed to show any benefits in the few studies done, so while there is still room for further research, at this point it doesn’t appear to be of any benefit. You might want to look at the International Renal Interest Society guidelines for diagnosis and treatment of kidney disease.

    Good luck!

  12. Aly Copeland says:

    My dog is a mix of Australian Shepard and Chow. She is 13 years old. Her creatinine was tested 1.7 on July 1, 2013; 1.6 on January 21, 2014; and 1.1 on February 11, 2014. We started Azodyl treatment on January 24, 2014 and Renal LP Modified. On February 10, 2014 she had her first seizure; February 11 second seizure, March 13, 2014 third seizure and March 21, 2014 was her fourth. Can Azodyl be the cause of her seizures. Please help! Thank you for your consideration.

  13. skeptvet says:

    I have not heard of any reports like this before, and given what is known about probiotics in general, it seems very unlikely the Azodyl was related to the seizures. I would encourage you to have your vet, or if possible a nearby veterinary neurologist, investigate.

    Good luck.

  14. TOS says:

    Thanks for the analysis, skeptvet. Although my dog’s values have improved on her new diet, her vet prescribed azodyl “to help her improve more” so I was searching for information supporting that treatment.

  15. Jadrana Tatic says:

    I live in Belgrade, Serbia. I need AZODYL for my dog but do not know what is the way of buying it and better still of coming into possession of it. They say I personally cannot claim it at the Customs, cannot get it by means of DHL post!!! So, please let me know if you know the way I can buy it and get it as soon as possible since it is very urgent.

    Please reply though this is space for leaving comments. I could not find your mail address to write and you have mine.

  16. skeptvet says:

    I have no connection with the company and, as you will see if you read this article, I don’t recommend Azodyl, so I can’t help you.

  17. Connie says:

    hi, never been on a blog before but it looks like it’s fun. I think azodyl can help in some cases and in others it doesn’t and can possibly have adverse effects in still others. Each animal is unique.as each human is. For example I tolerate and benefit from vitamin d3, whereas one of my friends is very depressed taking it.
    I’d love to be convinced one way or the other that this supplement Azodyl is either helpful or not, but I don’t think one knows for certain. I don’t think it’s been harmful for any of the 3 cats and 1 dog to whom I’ve given it.Everybody had a better quality of life. It was only one of the variables though so as has been discussed here one can’t be certain how each animal may respond. I do see a bit of a closed mind in skepvet, but that’s your right as you started the blog. I just don’t think anyone’s going to come to any conclusion on here it seems like everybody’s going around in circles.in my case, since it’s not harming and most likely helping, I will continue w azodylm And whatever drugs or supplements I find work. All scientific research is limited. I wouldn’t put my faith in any one study. But that’s how I perceive the process of gathering evidence sometimes it can be telling, other times it says nothing.I think we all have to use our best senses of logic as well as intuition. The problem with scientific study as I see it is that it can be unbalanced, weighing more heavily in the area of logic as opposed to the area of intuition. well, I know people will be continuing to go back and forth on this issue as long as their internet works!

  18. Kimberly says:

    I don’t understand your interpretation of Dr. Polzin’s presentation. The only reference I could find indicates that he DOES see the potential merit of Azodyl. (See below). Is there an actual abstract to the study you are referring to, with the 32 dogs, etc.?

    “In a presentation by Dr. David J. Polzin of the University of California-Davis, the use of probiotics specifically in patients with chronic renal disease was discussed.1 Selected species of bacteria have been developed with the intent of using them to attenuate uremia. These include Streptococcus thermophilus, Lactobacillus acidophilus, and Bifidobacterium species.

    Preliminary studies, cited by Dr. Polzin, that evaluated rats and miniature pigs with renal disease have shown that probiotics may attenuate azotemia, and preliminary observational data in dogs and cats with renal disease suggests that these supplements improve quality of life and may reduce blood urea nitrogen and creatinine concentrations. Probiotics likely have a role in the treatment of renal disease, but when and how to use these agents still requires further study. REFERENCE

    1. Polzin DJ. Probiotic therapy of chronic kidney disease. Presented at the Annual Meeting of the American College of Veterinary Internal Medicine; June 2011.
    from http://veterinarymedicine.dvm360.com/presentation-recap-probiotics-and-kidney-disease

    (note–I am posting again because I believe my script blocker didn’t allow it to go through the first time.)

  19. skeptvet says:

    I believe the results were presented as a poster, so they are not included in the proceedings. The study was conducted between 2007 and 2009, and the preliminary report given at the 2011 ACVIM Forum, so I would have hoped to see the paper published by now. However, as I wrote back in August of 2013, “Given the bias against publishing negative results, and the reluctance of journals to publish studies already reported somewhere, I doubt it will ever appear anywhere else.”

    I will try to find any source for the details of the trial that might be publically available.

  20. Pingback: Evidence Update: Azodyl for Chronic Kidney Disease in Dogs | The SkeptVet

  21. skeptvet says:

    I have looked around, but unfortunately the results have not been published since reported at the meeting in 2011, and as I said it seems unlikely that they will be.

  22. Lyle Sinclair says:

    Our 9 yr old Border Collie had acute renal failure, her BUN readings were terrible. Our vet was discouraged, but hydrated her and prescribed Azodyl, Bendzepril and a KD diet (Hills). She is doing very well, seems energetic and comfortable, kidney disease cannot be cured but she is certainly enjoying everyday. I wouldn’t hesitate to recommend the treatment, we were certain we were going to lose her and she seems happy and energetic now – 4 months later.

  23. April D says:

    I have only anecdotal evidence to offer, but my thirteen year old cat, Baby, was diagnosed with early kidney disease, with the usual elevated blood markers, such as bun levels, etc. The vet recommended a special diet, which I tried, but it had limited success. So I researched a raw food diet, found a company that sold organic raw foods with the proper mix of ground bone, heart, liver, and muscle meat, added the GNC Superfood complex for cats, 1/4 tsp slippery elm bark twice a day, 1/8 tsp of calcium carbonate to control acidity, azodyl, Udo’s pet essentials for cats as it has digestive enzymes in it, and sometimes older cats cannot properly digest their food, 1 tablespoon fermented fish, 1 tablespoon aloe vera inner filet preservative free, 1 tablespoon Answers raw goats milk formula, and 1/4 tsp coconut oil. Within six months, my cat had regained her lost weight and muscle, and has had perfectly normal blood tests for the last two tests. So when I adopted two thirteen year old cats whose owner had died and her husband did not want to keep them, and they both had early kidney disease, with the same elevated blood markers as my other cat, with one also having liver issues, I put them on the same diet. When I got them, they were skin and bones, with a great deal of muscle atrophy. Within a few months, they had both put on weight, had shiny, soft coats, and looked, according to my shocked vet, like cats half their ages. Their blood levels have also been steadily improving. They are due for a new set of blood tests soon, and I will report back how they have done. My vet says she doesn’t know what to think, but still insists that you cannot reverse kidney disease. All I know is that my own cat Baby, is healthy, happy, and more active than she has been in years. Her weight is good, her blood tests are wonderful. Since I was desperate and used a shotgun approach, I am not sure if it was a combination of everything, or a few particular things I did that worked, but I am not about to mess with success. All of my animals, 2 dogs, and 4 cats, are now on raw food diets, and they have all benefited. For the younger crew, that I have trained to eat raw bones, I no longer have to clean their teeth. Even the older crew are not developing tarter at anywhere near the same rate (Yes, I know I should brush their teeth, but the older ones vehemently object, and the younger ones don’t seem to need it now that they are eating bones.) The dogs used to sleep after I fed them, but now they go immediately into play mode, as if I loaded them with jet fuel. I don’t give the two younger dogs the same supplements, they just get the GNC superfood for dogs, the same balanced raw food I purchase for the cats, and a tablespoon each of goats milk. Every one of my animal’s coats now are spectacular, soft and shiny, and they are all well muscled. No one who sees my older cats will believe me when I tell them their ages. Again, this is all anecdotal, but I am thankful every day that I did a bit of research and took a different path for my animals. I wish you all the best with your furry babies. Happy New Year.

  24. Gregory says:

    I lost my 8.5 year old shar pei, Rufus, to CRF 2 years ago. I firmly believe i twas due to tainted jerkey treats our friend was giving him during a visit (they were from China & showed up on reports a few months later). Anyway, I spent thousands on SQT’s at my vet at the time. Rufus would get better for a few days then tank. Fed him Hills K/D & some organic mix. Found something called Kidney Relief Gold online & gave it a try. Appetite went from selective to non-existent. His blood numbers (BUN, creatinine, phosphorus, ect) went from bad to worse to how is he still even alive. He battled for 4 months and the nitrogen build up shut his system down. Horrible.

    Shortly thereafter, my 11 year old shar pei, Kaasa, was diagnosed with CRF. Her numbers were not as bad as Rufus’ however they were all 30-40% out of normal. I thought I would lose my mind! So I found a new, phenomenal vet near where I live in FL (Clint Moore Animal Hospital, Dr. Brian Butzer). We adjusted her diet & added Azodyl, Epakitin, RenAvast & Renal K as supplements. All are given daily as directed for her weight. Nearly 1 year later, Kaasa’s numbers are nearly normal. I have no relationship with any manufacturer. I am not paid to write this. I write this because I truly believe my dog would not be here today without these supplements. One time a few months back, her shipment was held up due to weather near the warehouse. It arrived four days after she had finished her meds. Kaasa showed a marked decline in energy level, diet, & elimination of waste. Dr.Butzer says it is the combination of the products. Each attacks the disease from a different angle. (Note, I purchase online so my vet has zero to gain by his recommendation in this case.) I was skeptical, and still am to a degree or I would not have found this blog. The supplements are very expensive & I have considered eliminating one or two. Then I think about Rufus & what I would give to have him back in my life. Hopefully, I will keep shelling out the $500/month for 11 more years!

  25. Pook says:

    Azodyl cannot be “sprinkled on food.” It must reach the intestine before the capsule disperses; once the stomach acid gets to it, it renders it null. So, that is why it did it work. “Duh” to the researchers. Read the fricking instructions.

  26. skeptvet says:

    It’s not quite as simple as you seem to think. A key requirement for a probiotic is that it survive passage through the stomach and be able to colonize the small intestine. A gelcap is going to dissolve in the stomach, so it does not likely protect the probiotic organism or facilitate colonization. It serves primarily to facilitate administering the supplement. Different probiotic products come as capsules, tablets, chewable tablets, powders, and liquids. Heck, yoghurt contains probiotic organisms that can reach the small intestine, and it IS food. So while the manufacturer recommends giving the capsule as is, there is not evidence suggesting the product is effective when administered this way and ineffective if not.

  27. Ann Marie says:

    In July, my 9 year old German Shepherd was diagnosed with chronic renal failure. He was having accidents in the house, urinating in his sleep and had to be taken out every couple of hours. His vet prescribed Azodyl and within a few days all his symptoms disappeared and he started behaving like his younger self. The vet ran follow up tests and his numbers had all improved. I know renal failure is incurable, but I am convinced Azodyl gets credit for making it seem otherwise.

  28. skeptvet says:

    I’m glad your pet is doing well, and I wish medicine were that easy, but that simply isn’t how things work. Every failed therapy ever used, from bloodletting to homeopathy to ritual sacrifice, has been able to collect hundreds or thousands of the same exact kinds of stories: I did X and everything got better so X works. The reason science has doubled our life expectancy, eradicated entire diseases, and accomplished so much more in a couple of centuries than all the trial-and-error of thousands of years is because anecdotes like this just don’t mean what we want them to mean. Here’s some more discussion of this problem for anyone interested:

    Why We’re Often Wrong

    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)

    Medical Miracles: Should We Believe?

    Testimonials Lie

    Alternative medicine and placebo effects in pets

    Medical Practices Once Widely Accepted that Proved Ineffective or Harmful when Studied Scientifically

  29. Jane E. says:

    It’s about science and medicine. I have a 16-17 YO cat in renal failure. Seriously thought we were going to lose him. No appetite, a couple of seizures, horrible blood work. However, that’s the thing, the blood work! Low on potassium and all the other typical findings. He’s now on fluids at home AND when we added a potassium supplement paste and potassium to his fluids, he improved greatly. Use the science! We’re now watching to see if we will need to add a phosphorus binder. That decision will be based on his labs not some website. Talk to your vet and review the labs. Make decisions based on that info. If your vet doesn’t want to work with you that way, find a new vet.

  30. Michael says:

    I have a 13 year old dog with late stage renal disease. He lost weight and went from 22 lbs to 16 lbs. He had high levels of creatine, poor BUN readings, high phosphorus, and slightly elevated potassium. According to our the various vets we went, he was on death’s door. We tried many things, spent thousands of dollars seeing the best specialists and settled on the following protocol and ALL his kidney-related blood metrics are normal and his weight is back to 19 lbs which is a good weight for my dog:

    (1) Subcutaneous 250 ml saline daily (not Ringers solution because is has potassium)
    (2) Aluminum hydroxide liquid three times a day. This binds and lowers phosphates.
    (3) Azodyl (not sure if this is having an effect but it can’t hurt)
    (4) Diet of primarily white rice (not brown rice which is high in phosphorus) sprinkled with ground, boiled turkey or the leanest ground beef. And we add canned green beans that are unsalted for fiber. He loved the food!
    (5) Kept the dog hydrated by having several bowls in the house that are easily accessible and offered the water bowl to him periodically during the day.

    The subcutaneous fluids and hydration is important as it works like dialysis to remove the toxins from his blood. And the aluminum hydroxide has removed the phosphates to normal levels. Not sure about Azodyl but it can’t hurt.

    I hope this helps.

  31. skeptvet says:

    “it can’t hurt.”

    This is an assumption which might or might not be true. It has proven false for many other alternative therapies, including things that seemed obviously benign like basic vitamins, so we always have to remember that a lack of evidence means not only that we can’t be sure it will help, we also can’t be sure it won’t make things worse.

    Here are examples of the dangers that can turn up in things that are claimed to be safe without adequate testing.

    The Harm Alternative Medicines Can Do
    Safety and Efficacy of Vitamin Supplements

  32. Big Ed says:

    Well, all I can say about azodyl is that it works! Our black lab is 9 years old and her kidney level was 50, and when given azodyl for 3 weeks, her number dropped to 43! I took her off the azodyl and started her on a natural herb outta Canada that got rave reviews! To make a long story short, her kidney level jumped back to 53, then 27 days later it has jumped on up to 63! So much for the natural herb remedy crap! Going back to the azodyl today! I left her on the exact same diet while using the natural herb remedy that I was using on the azodyl diet also! If the azodyl works this time, I’m sticking with it cause I can’t find anything else that does!

  33. skeptvet says:

    Unfortunately, BUN fluctuates throughout the day and from day to day based on many factors. The difference between 50 and 43 is entirely meaningless, and it is trends over time, particularly in the more important creatinine, that determine changes in renal function. You should discuss with your vet the way kidney disease is monitored and understand that making changes in management based on small changes in one bloodwork value over such short periods of time is not a reliable way to manage this chronic disease.

  34. Nonya says:

    In addition to skeptvet’s excellent point about normal BUN fluctuations in healthy and CKD animals, another thing to keep in mind that BUN & creatinine are merely simple markers used to *estimate* likely kidney functioning in non-human animals. Neither BUN nor creatinine are thought to be nephrotoxic in the sense that elevations cause kidney damage, and artificially decreasing them whether through diuresis or Azodyl or “enteric dialysis” (if anyone remembers that phrase) or anything else does NOT mean that the kidneys are functioning any better. However, those artificial decreases *may* lull some less educated or more gullible into a false sense of security, something the marketing of Azodyl, Aminavast, and other similar things rely on. I was an early Azodyl user whose pet saw significant decreases in both BUN & creatinine — I knew those decreases were likely meaningless, something that was confirmed by necropsy after death from completely unrelated causes. I really detest supplement manufacturers who rely on the desperation of people to drain wallets on things that have absolutely no proof of being helpful. It’s one thing for purchasers who have their eyes wide open to make a decision to try something unlikely to cause harm, but it’s a completely different thing to *intentionally* profit financially from the desperation of the uninformed/uneducated.

  35. Debra Nascimento says:

    Ok well this is my story: I have a 19 year old small mixed breed who seems to have developed kidney damage and I know that each day he is still with me is a blessing since tomorrow is not guaranteed. He developed a high fever which went to 105 a couple times and was placed on an antibiotic. He had stopped eating. After one day of antibiotic treatment he ate reluctantly on day 2 then stopped again on day 3 and still had a slight fever. His creatine level was found to be at 2.1 The vet suggested Azodyl and he started to eat better, became more alert and stronger. I continued the antibiotic treatment aiming for 4-6 hours after the Azodyl since I felt that he needed to complete the antibiotic treatment. He continues to show improvement at the end of week 1. At the end of week 2 we will assess his situation.

    I am well aware (re: Nonya’s response) that the Azodyl will not make his kidneys get better!!! If the Azodyl helps reduce the level of toxins in his bloodstream and allows him to feel better and have a certain level of comfort in his remaining days then I’m ok with that. I am even more grateful that it allows me to treat him at home. Agreed that it may not work as well for all situations depending on the individual dog or severity of kidney damage but if it helps then I’m grateful. I am not sure how my situation will develop but just wanted to share my experience so far.

  36. CS says:

    When my black lab (100#) was a year old we started her on Azodyl and thyroid meds and her whole personality changed for the better. My vet says never take her off the meds. Our real problem is she smells SO BAD. She smells so bad that it lingers long after she’s left the room. I have tried every know concoction from Listerine to skunk remedy to baking soda. Does anyone else have this problem and is it related to the kidney/thyroid issues. I’m not talking wet dog smell, I’m talking dead body smell. And no, miconazole did not work.

  37. Edith Englund says:

    this can stand as a comparable study to one that has a larger base population other than 32 and having dogs that are in real research areas…then compare that with the study of canines who were observed and with their owners.

  38. Linda Christopherson says:

    Our love for our pets is exploited by these supplement sellers. We should be very skeptical — especially of products with high price tags. I always check skepvet for good scientifically valid advice, and am not afraid to return supplements to my vet after researching. I wish I could find a vet that didn’t recommend pseudoremedies.

  39. Jen Oropeza says:

    We have a 6. lb cat and a 6.5 lb toy fox terrier both with renal disease. She told us she didn’t think either would or could swallow the pills whole and to sprinkle them on their food, so would that be a total waste then? She said 1-2 pills each per day for both of them…it’s not a cheap supplement either. The cat has high phosphorus levels too, but the dog only has high protein level.

  40. Samantha Holler says:

    My cat is almost 20 and was in early stage renal failure 2 years ago. Today she has the values of a perfectly normal cat. I can’t imagine any cat owner not wanting to try this in an older cat with renal issues. Worth every dime.

  41. Jan Thompson says:

    My dog has CKD now due to years on Rimadyl. My former dog also had kidney failure due to Lepto. He stopped eating, had no energy or joy left. As a last resort I took him for acupuncture. Watching his reaction was phenomenal and he went home, ate a full can of food and lived a good life for 2 more years. Please don’t judge practices that have been around for centuries and may work for some but not others.

    I wish I had not gone the big pharmacy path with my current dog-she might still be in good health? I am an RN so not ignorant of the way bodies function.

  42. skeptvet says:

    Sorry, but you cannot reasonably ask others not to judge alternative medicine any more than I would ask you not to think critically about scientific medicine. Despite what you believe, science has improved our lives far more in the last couple of centuries than all the folk medicine based on anecdotes and trial-and-error in all the centuries that preceded it. Acupuncture and TCM never succeeded in doubling our life expectancy, dramatically reducing childhood and maternal mortality, wiping out smallpox, or any of the other great accomplishments of scientific medicine, and your personal story or belief doesn’t change that fact.

  43. Danie Arnt says:

    My 12.5 year old Border Collie was just diagnosed with early stage kidney disease. My vet recommended the k/d and azodyl. Since I know the k/d helped a previous dog and I’ve already plunked down the cash for the azodyl (I got this news less than a week after losing another dog to lymphoma so I wasn’t thinking too clearly), I’m tempted to just try it for a few weeks and then re-check blood work. After that, I’d put her on the k/d for sure. BUN was 75 and creatinine 1.7. I’m guessing this rather extremely expensive probiotic will have no effect, but I won’t be able to show that if she is on the food as well. Would another month on her regular food be too harmful?

  44. skeptvet says:

    There is strong evidence that the kidney diet is beneficial and weak evidence against the azodyl. While kidney disease is usually slowly progressive, with ups and downs in bloo values, and a month delay in starting the diet shouldn’t be a big deal, the experiment still really doesn’t make a lot of sense. Even if the values go down when you’re giving the azodyl, that says nothing about whether it is doing anything or whether it will help your dog be healthier or live longer since the values vary on their own all the time. This natural variation is one of the reasons why such trial-and-error observations don’t actually tell us much. I would recommend sticking with the evidence and beginning the diet. You can add the azodyl if you want, but it is very likely not going to make any difference either way.

  45. Danie Arnt says:

    Thanks for the advice. I had pretty much come to that decision after reading more myself. Started switching her to the k/d yesterday. Oh well, I guess I have a really expensive pro-biotic if one of my dogs gets a g/i issue and needs a little help getting things back on track.
    Thanks!

  46. Sandy says:

    Hi…thanks for being here. It is now August, 2017 and my Greyhound and my cat have been on Azodyl for 5 months. Both have kidney disease and are on no medications, prescription renal diets.

    My cat in particular has really perked up (been on renal diet for a long time, didn’t start the same time as Azodyl). He “talks” more, is more social, just seems to feel better. The Greyhound is more lively too.

    Has Azodyl changed it’s formula since your post in 2011? Could it be benefitting some animals now? Or is your opinion of it still the same. With two pets on it we go through a $75 bottle every 17 days. If it is not beneficial in anyway, that money could be spent on the Cushing’s horse who is needing additional attention.

    Thank you.

  47. skeptvet says:

    The company does not report any change in formula, and there is no new evidence. There is still no reason to think it is helpful, and unfortunately haphazard trial and error isn’t reliable.

  48. Diana Granat says:

    Vet said renal failure in CATS is easier to treat and less lethal than in dogs.

  49. skeptvet says:

    Not necessarily. Kidney disease is far more common in cats, but the prognosis for individual patients of either species can vary quite a bit based on a lot of factors other than species.

  50. Wilma Kincaid says:

    My 16 yr old Yorkie has been diagnosed with early stage kidney failure.Vet has prescribed clavamox 5mg twice daily along with the Azodyl twice daily. Now I am confused.I thought if u are taking antibiotics that there is no use taking a probiotic at same time because the antibiotic will kill the good probiotics. Am I right ?Should I wait till the 2 weeks of Clavamox are all taken first an then give her the Azodyl ? Or continue giving both at same time twice daily ?

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