Evidence Update: Azodyl for Chronic Kidney Disease in Dogs

One of the products I have kept track of over the years is Azodyl, a probiotic reported to be useful in treating kidney disease in dogs and cats. Though the company has reported positive results in laboratory studies involving rats, cats, and pigs, the independent studies so far reported in dogs and cats have not found any real-world benefits. Apparently last summer another study was presented at the ACVIM Forum, a conference for veterinary internal medicine specialists.

Kanakubo; S. Ross; H. Finke; J. Kirby; S. Nalor; C. Stafford; L.D. Cowgill. Influence of AzodylTM on Urea and Water Metabolism in Uremic Dogs. ACVIM Forum 2013, June 12-15,. Seattle, WA.28970

The study was not a clinical trial but a laboratory study of a small number of dogs (4) undergoing dialysis for treatment of kidney disease. The investigators evaluated the effects of Azodyl, given at two different doses over 1-2 months of time, by comparing various laboratory tests for measuring kidney function and the processing of nitrogen from protein in the diet in the same dogs before and after giving the probiotic. The study was partially funded by the manufacturer of Azodyl.

The investigators concluded that there were no changes in any of the measured values when these dogs were put on Azodyl. However, the dogs did appear to gain weight from fluid, suggesting that perhaps the product influenced water consumption or absorption.

 The results of this short-term study demonstrated:

  • AzodylTM had no significant or beneficial effect on pre-dialysis BUN in dialysis-dependent dogs.
  • AzodylTM had no significant effect on single treatment or weekly time-average urea, TACurea; urea appearance rate, Ga; or the whole-body urea clearance, Curea.
  • AzodylTM administration produced no demonstrable effect on the intestinal clearance of urea, Cint.
  • AzodylTM administration was associated with a positive increase in total body water requiring increased dialytic removal to maintain dry-weight.
  • Despite manufacturer’s suggestion, AzodylTM did not influence short-term azotemia or nitrogen metabolism in this CKD cohort.
  • AzodyTM was associated with a positive fluid balance in these dogs.
  • These results were unable to support the potential for AzodylTM to facilitate ‘Enteral Dialysis’ in dogs with CKD undergoing hemodialysis


This is a pretty small and unusual population of dogs compared to those who will normally be treated with Azodyl in routine clinical practice, so it does not determine whether or not the product is clinically useful in more typical cases. However, it does undermine some of the theoretical rationale for why Azodyl might be useful in chronic kidney disease in dogs.

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14 Responses to Evidence Update: Azodyl for Chronic Kidney Disease in Dogs

  1. Heart Broken says:

    My puppy was diagnostic with kidney disease at 5 months of age. We used Azodyl as directed. It did no good what so ever. It did not slow down the disease nor extend his life nor did it help him deal with the disease. He died at 10 1/2 months of age. While using this product he went from stage 2 to stage 5 in 2 1/2 months, and then well past. We kept him on it well past what was beneficial. He was a great pup, he would have been a great dog.

  2. kathy malloy says:

    Azodyl is super expense and my dog’s levels are not going down after 2 weeks, they were higher! My question is why can’t I give her my probiotics? A lot less expensive….
    Or what do you recommend??

  3. kathy malloy says:

    can you change my name to Wesleygg please??

  4. skeptvet says:

    The issue is that there is ZERO evidence that probiotics are helpful for dogs with renal disease, so whether you give azodyl or give another veterinary product or a human product really isn’t the point. WHile rpobiotics are helpful for some GI issues, there is not yet any reason to think they are worth giving for kidney failure. I would focus on treatments known to be helpful as listed under the IRIS guidelines for CKD treatment or consult your veterinarian about the specific needs or your pet.

    Good luck!

  5. skeptvet says:

    Sorry, I don’t actively manage the accounts of subscribers, so I have no idea how to change your user name.

  6. James says:

    I have a pair of English Bullies…. bro/sis 4-1/2 yrs old. I recently learned my male has smaller than normal kidneys…. this was diag only after the Eye DVM we see notice some abnormal urine reading in a pre-exam test. X-Ray confirmed kidney size. This vet specialist colleague, has recommended AZODYL probiotic, but after researching on my own, not sure this has any real value. Is there any current studies on this or other. Have visited/read CKD on IRIS web site.

    My normal vet, never picked on this condition, now insists I switch to the Science Diet KD food formula since he is a SD dealer. Grateful for any suggestions or other things I should be researching, besides a new Vet.

  7. skeptvet says:

    I’m not aware of any more recent research on probiotics for renal disease. There is, however, strong evidence that renal diets do have benefits, whether K/D or another brand, so I would try to make a transition to one of these if possible.

  8. Mary Rose Sweger says:

    My 11 year old Llhaspoo had blood work done which showed the early start of kidney problems. He eats L/D food and I was wondering what your views would be to switch him to the K/D food? Also how fast can kidney disease progress. thank you for your time.

  9. skeptvet says:

    Of course, decisions about therapy for kidney disease have to be made on an individual basis in consultation with your veterinarian. Kidney diets do have clear benefits when used appropriately, but I can’t give you specific recommendations for you pet. Progression of kidney disease is very unpredictable, so ths is something that has to be monitored in each case.

    Here is some good general information about kidney disease in dogs and cats. I would also make sure to find a vet you have a good, consistent relationship with to discuss your dog’s treatment options.

    Good luck!

  10. Kathy says:

    Used 1 time never again made my dog very tired not excited she was fine before I used it. She has kidney disease high bun was told it would lower bun used it 1x and next day but good at all. I would not recommend it at all.

  11. Jess says:

    My dog has been taking it for 2/years and its dome nothing for her levels. Dr. Harveys Diet and my own supplements of goats milk, and fish stock have helped immensely. Vets are not extensively trained on nutrition. So I would never go with RX food full of byproducts.

  12. skeptvet says:

    Actually, v, especially board-certified veterinary nutritionists. Your concern about the ingredients in these diets is misplaced and, unfortunately, created by unscientific misinformation out there about pet diets. Kidney diets have been shown by very robust evidence to improve quality and length of life in animals with kidney disease, and whether you do a homemade or commercial diet, it is always better to use a diet formulated for this problem.

  13. Fatima says:

    True! Dr. Harvey is really a savior, my dog has been on that and home cook diet and this is going to be his third year since diagnosed. Goat milk, vitamins and fish fatty acids are a must as well. It’s a lot of mindful feeding and work but totally worth it.

  14. Mesha says:

    Dr. Harvey is not a Veterinarian. His company portrays him as one. I don’t understand how it’s even legal.

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