Pet Kidney Failure: Phosphorus Binders

Ask Dr. Carol, Avoiding Disease, Cats, Dogs, Kidney Disease, Kidneys Add comments

Pet Kidney Disease affects thousands of dogs and cats each year. Because many pet medications offered for dogs and cats suffering with kidney failure can be confusing, and since online information often offers conflicting recommendations, here are some tips to help pet owners address their dog and cat’s kidney health.

One of the problems that is very common in pets with chronic kidney failure other than elevated BUN and Creatinine levels is Phosphorus and Calcium. This discussion will address binders available to reduce or lower elevated blood Phosphorus levels in dogs and cats with kidney disease.

Calcium-based Pet Phosphorus Binders such as Phos-Lo and Tums are readily available and inexpensive.

But they’re not as effective as the pet Aluminum Hydroxide (ALOH) binders, because they require large doses and they are not as safe.  There is also the risk that supplementing Calcium in a dog or cat with Chronic Kidney Failure can lead to serious problems such as excessively elevated blood Calcium levels, called Hypercalcemia.

Hypercalcemia or high calcium in your pets blood, can lead to calcium deposits which are referred to by vets as “soft tissue calcification.” Calcium based stones like the one in the photograph below, can form in various areas of your pets body, including the urinary bladder, kidneys and heart.

Elevated Calcium can also cause pet kidney failure and pet cancer including kidney cancer and lymphoma cancer in dogs and cats.

Epikacin is an example of a calcium based phosphate binder, often prescribed for dogs and cats in kidney failure.

Epikacin/Ipakitine. Ipakitine has been marketed in Europe for some time and its twin product, Epikacin, is now being heavily marketed in the US as a pet “nutritional supplement.” Epikacin active binding ingredients are calcium carbonate and chitosan.

Tests have shown the calcium carbonate binders are inferior to the aluminum-based binders. Several well-known veterinary researchers that study Pet Chronic Kidney Failure in dogs and cats advise that Epikacin should not be used in dogs or cats with high normal or elevated calcium due to the risk of throwing such pets into hypercalcemia by adding calcium carbonate to their daily medications.

World renowned veterinarian, Dr. Larry Nagode, DVM, PhD., of the Ohio State University, College of Veterinary Medicine advises that Epikacin should not be used with cats or dogs that currently receive Calcitriol nor in any cats or dogs that may need to take Calcitriol in the future, again because of the risk of hypercalcemia.

Epikacin is being marketed directly to vets and more as a pet kidney protectorate/preventive than as a treatment for pets in kidney failure with elevated phosphorus.

Some pet owners have reported that Epikacin seemed to have helped their pets’ appetite and energy, however none of these pets had elevated phosphorus.

Epikacin dosage recommendation are based on the pets weight alone at 1 gram/5 kilograms of body weight given by mouth in the morning and the evening mixed with food. Note that the dosage is given without regard to the pet’s actual phosphorus levels.

This further suggests that Epikacin is intended for pets in early stages of kidney failure and/or pets in chronic kidney failure with normal phosphorus levels.  For pets in chronic kidney failure, Epikacin dosage would normally be adjusted based on the blood phosphorus values.

Epikacin is expensive. The two retail sources currently online charge $19.99 for 50 grams and $49.99 for 150 grams.  One correspondent reported purchasing this from her US vet for $100 for 150 grams!

Epikacin is an “Over-the-counter” pet supplement.  The manufacturer, however, is marketed primarily to veterinarians and some vendors may insist on a “veterinary prescription.”

Dr. Carol’s Tip: Epikacin may be worth a try for pets in early stages of kidney failure that do NOT have elevated phosphorus.  Once your pet’s phosphorus levels are elevated to values above 6, aluminum-based phosphorus binders are more effective in bringing phosphorus levels down quickly.

Please be aware that Epikacin is the only pet phosphorus binder currently being marketed directly to United States Veterinarians for resale to their clients. Some clinics may offer Epikacin because they profit from it and/or because it’s the only phosphorus binder of which they are aware.

Furthermore, Epikacin is very costly especially when you consider what it contains. The primary ingredients in Epikacin are all inexpensive. Epikacin contains lactose, calcium carbonate and chitosan, therefore most of the product’s cost is marketing and profit!

Tomorrow we will review more binders available for pets in kidney failure.

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Holistic veterinarian and researcher, Dr. Carol Osborne, DVM is available for pet health care consultations and pet health questions.

Call Dr. Carol’s office toll free at 1-866-372-2765 to make an appointment for your pet.

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