Facts and myths about probiotics

Azodyl is a food supplement (not a drug!) belonging to probiotic group. It contains three urease positive, probiotic strains of bacteria named Kibow Biotics®* by Kibow Biotech laboratory. Bacteria actively use uremic toxins from the intestines that are present in animals with impaired renal function.

Bacteria are evaluated, selected and cultured in uremic conditions, so they have higher affinity for toxins than standard probiotics. Administration of Azodyl is recommended in chronic kidney disease stages II-IV according to IRIS system.

Ingredients of Kibow Biotics® include Enterococcus thermophilus (KB 19), Lactobacillus acidophilus (KB 27), Bifidobacterium longum (KB 31) and Psyllium prebiotic — summarily 15 billions [109] of colony forming units (CFU) in one capsule.

Directions for use

  • Dogs and cats weighing up to 2.3 kg: 1 Azodyl capsule daily (in the morning)
  • Dogs and cats weighing 2.3–5 kg: 2 Azodyl capsules daily (1 in the morning and 1 in the evening).
  • Dogs and cats weighing over 4.5 kg: Give 3 Azodyl capsules daily (2 in the morning and 1 in the evening).

Azodyl capsules need to be given whole and not opened or crushed. They can be administered on an empty stomach or during the meal. An animal on Azodyl treatment should have access to water at all times.

A lot of owners describe Azodyl as the last hope for their pet. It is unfortunately wrong. It is necessary to remember that Azodyl in only a food supplement, that can support the function of stable patients. For example, it can be helpful in dog or cat having the chronic kidney disease at stage II, III or IV, but not in the acute-on-chronic stage nor in acute kidney injury.

Azodyl is not effective immediately. First, slight decrease of urea concentration is possible to notice after two weeks of treatment, but it is necessary to wait for the full effect even for eight weeks.

There are no contraindications for Azodyl use, unless intolerance after administration (vomiting, diarrhoea) exists. We do not recommend however to start Azodyl treatment during antibiotic therapy, but preferably straight after the end of it. It is not because of Azodyl’s toxicity, but rather the possibility of reduced effectiveness during antimicrobial therapy and high cost of treatment. Although if the animal is on the Azodyl supplementation and there is a necessity of administering antimicrobials, we shouldn’t stop administering Azodyl. If you decide to give Azodyl during antibiotic therapy — Azodyl should be administered minimum 6 hours apart from antibiotics given orally.

From our experience, Azodyl works better for small animals — cats, small to medium breeds of dogs, but has weaker effect on large to giant breeds.

For best effects of treatment, it is recommended to storage Azodyl in a fridge. Clinical research  however showed that bacterial component was stabile for 14 days in 20,4 and +25 Celsius degrees, and it was significantly lower in temperatures such as 37, 45 and 55 degrees.

One of the most frequently asked questions is about Biopron 9 probiotic — could we switch from Azodyl to Biopron 9, and if yes, what’s the dose?

Biopron 9 ingredients are 9 strains of bacteria, from which only two are same as in Azodyl — 900 millions [106] CFU of Lactobacillus acidophilus and 675 millions [106] CFU of Bifidobacterium longum in one capsule. They are also probiotic bacteria, but they are not selected nor cultured in laboratory for uremic toxins metabolisation before putting them into capsule. That is the reason why efficacy on Biopron 9 as a substitute of Azodyl isn’t proved.