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Author Topic: Chronic renal failure and phosphorous binders aluminum hydroxide gel powder  (Read 19178 times)
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3catkidneyfailure
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« on: January 05, 2008, 12:01:58 PM »

Is anyone using generic aluminum hydroxide gel powder for treatment of their crf kitties with or without a
vet recommendation? If so, how has your cat's bloodwork in terms of phosphorous level been? Does your cat
object to it being mixed in their food? Thank you for your help.

See this link:
http://members.verizon.net/~vze2r6qt/supplies/binders.htm

Phosphorus binders are a critical treatment for extending a CRF cat's life.  A 2001 study by Peter Markewell (BSc, BVetMed, MRCVS) for the Waltham Centre for Pet Nutrition found that "...using a phosphate- and protein-restricted diet, in combination with oral phosphorus-binding agents in those cats in which control of hyperphosphatemia [high phosphorus] and RHPTH [renal secondary hyperparathyroidism] was not achieved by diet alone, resulted in more than doubling of average survival time from the commencement of treatment." 
Both aluminum and calcium-based binders are available without prescription, but the aluminum based binders are more effective, safer, and often cheaper.
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lesliek
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Trooper,Remy & Fragile


« Reply #1 on: January 05, 2008, 12:11:37 PM »

3cat- I don't have any experience with this,but would be concerned about any aluminum based product. It can cause allergic & neurological problems in humans. I would think the calcium based might be safer.I know someone whose mother died from a severe reation to it. It caused dementia & liver failure.They think it was from generic mylanta tabs.
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Carol
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« Reply #2 on: January 05, 2008, 12:59:15 PM »

I use Epakitin for Smudge--it's a powder I put in her food in the am and pm to reduce phosphorus.  She's been on this as well as Azodyl (supposed to reduce BUN) since March.  Angel Jessica was on it at first but her kidneys were able to recover, unlike Smudge who was much sicker.  It's hard to know if it's helping as I don't know how she would be if I didn't use it!? These two were recommended by my vet as well as the acid reducer (which I use intermittently)



From my label:

Ingredients: Lactose, Calcium carbonate, Chitosan, Hydrolyzed Soy Protein.
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3catkidneyfailure
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« Reply #3 on: January 05, 2008, 01:17:06 PM »

Been using Alternagel and Epakitin. I think Alternagel is aluminum based. Epakitin is calcium
based. Was wondering if anyone has tried dried aluminum hydroxide gel powder and what results they got.
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Carol
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« Reply #4 on: January 05, 2008, 01:24:40 PM »

Sorry 3cat!  Embarrassed
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Mandycat
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« Reply #5 on: January 05, 2008, 01:57:15 PM »

3cat -
     Alternagel IS aluminum hydroxide in suspension.  So, it is the same ingredient as the generic aluminum hydroxide gel powder you mentioned.  However, I would want to talk to a vet about using it because there might be some question of dosage.  Also, you are also using the Epakitin, which is a calcium based binder and in reading the info on that I was surprised to see that it shouldn't be given to cats with elevated calcium levels.  However, the combination of the two meds might actually be needed to achieve whatever your vet is trying to do to control your kitty's phosphorus levels.  I am no expert, but I do know that it can get complicated balancing all the different electrolytes and mineral levels in the presence of a chronic disease, and really needs to be done on a case by case basis.  So, I suggest asking your vet before trying anything new.  He has his reasons for prescribing what medications he has prescribed and in the dosages he feels work best.  Your kitty's blood test results are the best indication of how that is working. 
     Sorry.  I know this is more than the answer you are looking for, but hope it might help anyway.
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Mandy Barberio
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« Reply #6 on: January 05, 2008, 05:37:40 PM »

Has anyone had positive results with Azodyl? My cat Noella has been on it since Aug., and her lab results showed no change. Don't know if it's preventing her from getting worse or not doing anything for her.
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3catkidneyfailure
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« Reply #7 on: January 05, 2008, 08:11:31 PM »

Carol, no need to be sorry. Epakitin is well studied. Alternagel, too, I think. And
we all learn from each other here and comments are welcome.

Have been discussing the possibility of substituting dry aluminum hydroxide gel for both to
avoid calcium intake, which my cats do not need. This has not been as well studied,
but some folks do use it and was just hoping to talk with someone who has, as my
girls are one year into this process and despite best efforts are showing upward
trending phosphorous levels, still in the mid-4 range. That's all. But it would seem
is not a common veterinary recommended substitute. My vet and I agreed it could
be tried for one month and then blood work done to see what difference it makes.
But you hate to experiment. I was just hoping another forum poster had some experience
with it and could comment. But all comments are welcome and appreciated!

Noella's mom, Mandy, I couldn't get the Azodyl down my cats. I'm pretty good with a piller,
but the capsules were too big. How'd you do it?
« Last Edit: January 05, 2008, 08:13:40 PM by 3catkidneyfailure » Logged
petslave
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« Reply #8 on: January 05, 2008, 10:15:13 PM »

3cat - you probably have this info already, but here's a little more about each of the choices here:

http://www.felinecrf.org/treatments.htm#phosphorus_binders

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Mandy Barberio
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« Reply #9 on: January 06, 2008, 08:56:12 AM »

3cat,

It was really difficult to get her to take the Azodyl at first. They are really big, and I had many bitten fingers and we got this pilling device that didn't help. I sort of developed a system where I sit behind her, hold her head back and push the pill in her mouth towards her throat. I keep my finger under her chin so she keeps her head back and she swishes it around her mouth, then just swallows it. In the beginning we might sit there for 20 minutes before she'd swallow it, or she'd try to chew it up and spit it out. She's pretty used to it now. I am not an experienced piller at all, but she did take antibiotics once, and it was not nearly as difficult to get her to take those (prob because they were much smaller). Unfortunately, you're not really supposed to break the Azodyl capsules open or it would be A LOT easier.
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3catkidneyfailure
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« Reply #10 on: January 06, 2008, 10:10:29 AM »

Thanks, petslave, for great link. I'm reading everything I can find.

Noella's mom, Mandy. Thanks for the description. I couldn't do it due to size of capsule for cats. But BUN values
are trending up, too. I think I have more scars on fingers from hand pilling and needle sticks and cat teeth, but
wouldn't mind some more.

And thanks bunches, Mandycat. Wise advice on discussing with vet choices. Right dosages of this gel powder are
both weight-dependent and phosphorous-level dependent, and I'm really bad with math, on top of a lot of other things.

« Last Edit: January 06, 2008, 10:14:55 AM by 3catkidneyfailure » Logged
3catkidneyfailure
Guest
« Reply #11 on: February 19, 2008, 07:24:51 AM »

Got first set of bloodwork test results back on the use of aluminum hydroxide gel powder. This is
based on one month of tests only, but cats' phosphorous levels are the same or .1 lower than the
previous month.
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Orange Fuzzball
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We miss you KD


« Reply #12 on: February 19, 2008, 08:01:30 AM »

Good to hear!  Smiley
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lesliek
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Trooper,Remy & Fragile


« Reply #13 on: February 19, 2008, 10:51:40 AM »

3cat- Thats great ! Seems like it is helping.
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mainecoonpeg
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« Reply #14 on: February 19, 2008, 11:03:47 AM »

Great news 3cat.
Wishing continued success to you and the fur kids   Cheesy
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