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Phosphate Binders
I'm looking more into phosphorus and phosphate binders, which can be a very confusing subject for many owners. There are many different binders available and vets often seem to have their own particular preference. I hope soon to put some information into a more straightforward article, rather than the somewhat complex information available on the Internet. So far, I do know the relationship between calcium and phosphorus is crucial in treating canine CKD and for homemade diets it's useful to maintain a 3:1 ratio of calcium to phosphorus intake. But this gets more complicated when the binder adopted is also calcium-based. It strikes me this is another reason for having regular blood checks undertaken, just to see how things are balancing out.
My question for now ... what phosphate binders have you used and how effective do you think they have been?
Tony
My question for now ... what phosphate binders have you used and how effective do you think they have been?
Tony
Hi Tony,
I get my dog blood and urine tested every 2 months. He's been diagnosed CKD 2 years in Nov. His phosphorus level is 4.1 on his Aug test. 4.1 is right in the middle of the bar graph, 2.5-6.1 being the normal range. I have only used Rugby brand aluminum hydroxide gel, USP, sugar free, which I mix with about a tablespoon of organic applause and salmon oil to get him to lick it from my hand. I also mix in 3 or 4 days worth of his food 1 teaspoon of pulverized eggshell (which I grind up in a coffee grinder that I only use for this purpose. I mention this because I think I read somewhere this has a favorable effect on the phosphorus level. I follow Dr. Pitcairn's homemade Kidey Diet, but do add extra boiled minced organic carrots and green beans, also usually blueberries, asparagus, sometimes a little cabbage--everything organic and cooked. My dog does not throw up and seems to happily eat this home made chow. Of course, there is chicken, or some meat and egg, & other stuff--all per Dr. Pitcairn's KD recipe.
(While phosphorus # is perfect, his crea and bun are elevated for the last 4 months.)
I get my dog blood and urine tested every 2 months. He's been diagnosed CKD 2 years in Nov. His phosphorus level is 4.1 on his Aug test. 4.1 is right in the middle of the bar graph, 2.5-6.1 being the normal range. I have only used Rugby brand aluminum hydroxide gel, USP, sugar free, which I mix with about a tablespoon of organic applause and salmon oil to get him to lick it from my hand. I also mix in 3 or 4 days worth of his food 1 teaspoon of pulverized eggshell (which I grind up in a coffee grinder that I only use for this purpose. I mention this because I think I read somewhere this has a favorable effect on the phosphorus level. I follow Dr. Pitcairn's homemade Kidey Diet, but do add extra boiled minced organic carrots and green beans, also usually blueberries, asparagus, sometimes a little cabbage--everything organic and cooked. My dog does not throw up and seems to happily eat this home made chow. Of course, there is chicken, or some meat and egg, & other stuff--all per Dr. Pitcairn's KD recipe.
(While phosphorus # is perfect, his crea and bun are elevated for the last 4 months.)
Hi Tony,
My vet recommended I give my dog, who was diagnosed with Stage 4 Kidney disease, Mylanta tablets which are an aluminium based phosphate binder.
I was giving her 6 per day , spread out over the day so that she was having 2 each time she consumed a small meal.
I was concerned that the aluminium may place more strain on her already struggling kidneys but the vet said that they should be fine and that the aluminium based phosphate binders were more effective than the calcium based ones in lowering phosphate levels in the dog's system.
As she was already so far advanced, it was hard to tell whether the Mylanta had a beneficial effect or not.
She did not vomit very much at all though, so possibly they did.
She still would only eat very little food though, so obviously she was still feeling nauseous from the levels of toxin build up in her system.
I read that TUMS ( a calcium based phosphate binder) can also be effective to a degree but did not use these as I was already using the aluminium based Mylanta tablets.
Both Mylanta tablets and TUM tablets are inexpensive and can be purchased at supermarkets or off the shelf at Chemists.
Sadly my dog lived for only 6 weeks after being diagnosed so probably at that late stage of Kidney disease it was too late for her .
Christina
My vet recommended I give my dog, who was diagnosed with Stage 4 Kidney disease, Mylanta tablets which are an aluminium based phosphate binder.
I was giving her 6 per day , spread out over the day so that she was having 2 each time she consumed a small meal.
I was concerned that the aluminium may place more strain on her already struggling kidneys but the vet said that they should be fine and that the aluminium based phosphate binders were more effective than the calcium based ones in lowering phosphate levels in the dog's system.
As she was already so far advanced, it was hard to tell whether the Mylanta had a beneficial effect or not.
She did not vomit very much at all though, so possibly they did.
She still would only eat very little food though, so obviously she was still feeling nauseous from the levels of toxin build up in her system.
I read that TUMS ( a calcium based phosphate binder) can also be effective to a degree but did not use these as I was already using the aluminium based Mylanta tablets.
Both Mylanta tablets and TUM tablets are inexpensive and can be purchased at supermarkets or off the shelf at Chemists.
Sadly my dog lived for only 6 weeks after being diagnosed so probably at that late stage of Kidney disease it was too late for her .
Christina
Hi Tony, I believe the basic goal is to try and keep phosphorus blood levels at or below 4.5(Early Stage).......5(Moderate Stage)........6(Late Stage) with CKD. My Vet put 'Steffie' on Epakitin as a binder. As per her blood exams for reference, her phosphorus levels seemed to be kept in check during her 3.5 years with CKD, It was given twice per day via AM and PM meals. During the last three months when she entered last stage, I would mix it with other medications with baby food as a carrier and use a 65ml syringe to give it to her orally since she was getting off and on with eating.
I've mentioned before the importance of having that syringe in house. Another excellent use is to get the probiotics into their gut when they are getting picky with eating. I used Purina 'FortiFlora'. As everyone knows,.....Phosphate Binders, Probiotics, Azodyl, etc, are very expensive and wasting it in food not eaten is not logical.
Thanks,
Earl
I've mentioned before the importance of having that syringe in house. Another excellent use is to get the probiotics into their gut when they are getting picky with eating. I used Purina 'FortiFlora'. As everyone knows,.....Phosphate Binders, Probiotics, Azodyl, etc, are very expensive and wasting it in food not eaten is not logical.
Thanks,
Earl
Hi Tony,
Never used phosphate binders, spoke to vet about them but instead We opted to treat Rocky on a diet of low phosphorus foods. He lasted almost 3 years on it. Apparently some of the phosphate binders with aluminum had toxic effects on pets, so, my vet and I opted to do the holistic whole food regimen along with hills science kidney diet. I did not use prepared foods or fast foods with him, I used brown rice sometimes white and washed it before preparing it and added to his foods. I also made pasta, or bought fresh pasta and added that to his food as he loved pasta and others I knew who had dogs with kidney disease used pasta for their dogs and rice as food stretchers as our dogs were hungry and later as you suggested used chicken broth. I saved my bones and froze them bringing them out later and added to a big soup pot along with saved carrots, sweet potatoes and green beans to make the broth more nutritious. In short I cooked more and used less processed foods for him.
Sharon
Never used phosphate binders, spoke to vet about them but instead We opted to treat Rocky on a diet of low phosphorus foods. He lasted almost 3 years on it. Apparently some of the phosphate binders with aluminum had toxic effects on pets, so, my vet and I opted to do the holistic whole food regimen along with hills science kidney diet. I did not use prepared foods or fast foods with him, I used brown rice sometimes white and washed it before preparing it and added to his foods. I also made pasta, or bought fresh pasta and added that to his food as he loved pasta and others I knew who had dogs with kidney disease used pasta for their dogs and rice as food stretchers as our dogs were hungry and later as you suggested used chicken broth. I saved my bones and froze them bringing them out later and added to a big soup pot along with saved carrots, sweet potatoes and green beans to make the broth more nutritious. In short I cooked more and used less processed foods for him.
Sharon
Hello Tony,
I'm new to the group, just joined today. My 3 year old Shih Tzu Bailey was diagnosed on 8/31/15 with chronic kidney failure. We've been on a roller coaster for the past two months. On the subject of phosphate blockers, our experience has been that when we give Bailey 2 doses of the aluminum hydroxide per day, she seems to do poorly. She seems weak, sick, and loses her appetite (or is at least more finicky about what she will eat). When she is only on 1 dose (0.5 ml/day), she seems much better. Vet doesn't think this is related to the phosphate blocker. But this has happened both times we've increased her dose. I know she needs it (her phosphate is 9.4) but we're convinced it makes her feel worse. Has anyone else experienced this? We can't use a calcium-based blocker because her calcium is elevated as well.
I'm new to the group, just joined today. My 3 year old Shih Tzu Bailey was diagnosed on 8/31/15 with chronic kidney failure. We've been on a roller coaster for the past two months. On the subject of phosphate blockers, our experience has been that when we give Bailey 2 doses of the aluminum hydroxide per day, she seems to do poorly. She seems weak, sick, and loses her appetite (or is at least more finicky about what she will eat). When she is only on 1 dose (0.5 ml/day), she seems much better. Vet doesn't think this is related to the phosphate blocker. But this has happened both times we've increased her dose. I know she needs it (her phosphate is 9.4) but we're convinced it makes her feel worse. Has anyone else experienced this? We can't use a calcium-based blocker because her calcium is elevated as well.
1 Comments
Hi. Okay, a few issues here. Firstly, much depends on what your dog weighs – so that’s the starting point. Weigh your dog and let me have the result. Next, if you know the amount of aluminium hydroxide binder being given per day in milligrams, let me have that detail. If we can figure out what the current dosing regime is, then I can let you know if that’s appropriate. Side effects are not uncommon, but it is also possible this is due to the kidney disease rather than the binder. Is your dog on any anti-nausea and/or anti emetic medication? Also, are you giving the binder with meals? This is extremely important, as the binder needs to “bind” with the food being eaten. And finally, how many meals are you feeding per day? The ideal is to split a normal daily amount into four meals, spread equally throughout the day and early evening. This helps reduce the number of by-products and toxins the kidneys need to deal with or process. Finally, do you know the stage of kidney disease your dog is at? This can be assessed via blood levels (please let me know SDMA, BUN, creatinine and phosphorus) and from urinalysis specific gravity. I have also given below a link to my article designed for newly diagnosed dogs, which you should have a read of asap. Tony
Thank you all for your posts. I am commenting only to push this back up the post list, hoping others will add to it.
Tony
Tony
Demato69, How long have you been giving your dog Rehmannia 8? I just started 2 weeks ago. Do you think it has been useful? If yes, in what way?
Also, how do you get it into your dog? (I pound the tablet into a powder and then mix with1/2 tablespoon of organic applesauce and a tiny bit of salmon oil to get him to lick the whole thing from my hand.) But maybe there is a better or easier way. Also, the label says to give it "between meals," so I worry that this bit of applesauce and salmon oil might be undermining the supplement.
Also, how do you get it into your dog? (I pound the tablet into a powder and then mix with1/2 tablespoon of organic applesauce and a tiny bit of salmon oil to get him to lick the whole thing from my hand.) But maybe there is a better or easier way. Also, the label says to give it "between meals," so I worry that this bit of applesauce and salmon oil might be undermining the supplement.
I am giving my boy Aluminum Hydroxide each time I feed him. On his last blood work his phosphorus was down to 6.0. I need to find something to help raise his red blood cell count. I am giving him Rhemannia, salmon oil, vitamin e, ubiquinol, b complex, enzymes with probiotics, denamarin for his liver enzymes. I am going to start adding Spirulina (Spirugreen) every day along with Canine Renal Support. Also, I feed him Royal Canine, Renal Support E which he hates. Does anyone have any suggestions? Thanks!!!
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