A long term feed supplementation based on phosphate binders in Feline Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is a very common disorder in elderly cats. A proper renal diet represents the most efficient therapeutic intervention to improve survival and life quality in feline patients with 3 and 4 International Renal Interest Society (IRIS) stages. Twenty cats were selected in this study. Ten were administered the dietary supplementation for 360 days and the other ten, whose owners did not give consent for any supplemental therapies apart from the renal diet, were selected from a clinical database and used as control group. The present study is a long term study (360 days) aiming to evaluate the efficacy and palatability of a dietary supplementation containing calcium carbonate, calcium-lactate gluconate, chitosan and sodium bicarbonate in cats diagnosed with 3 and 4 IRIS stages of CKD. The owners were asked to fill in questionnaires to get information on the cat's appetite, the palatability of the given supplement, the presence of vomit and/or diarrhoea, general health and vitality. Hematochemical, biochemical and urinary analyses were performed on day 0, 30, 60, 90, 120, 150,180 and 360. GraphPad Prism® software was used to perform statistical analysis. Our study shows that the given dietary supplement reduced serum phosphorus and increased serum bicarbonate values in cats with CKD. In turn, this supplement could be used as a support therapy in cats with advanced CKD improving their clinical conditions without any adverse reaction. Finally, it is important to underline that all the animals completed the study and the owners reported a good palatability of the feed supplement.

Efficacy of a new dietary supplement in dogs with advanced chronic kidney disease

“…In addition, the values were recorded at 4-8 weeks following the supplement administration (Zatelli et al, 2012). A more recent study, showed that another type of dietary supplement reduced significantly serum phosphorus and increased HCO 3 values in cats with CKD, improving their clinical conditions, without any adverse reaction (Biasibetti et al, 2018). In our study, the dogs treated with dietary supplementation showed a significant reduction in serum phosphorus level and an increase in HCO 3 compared to the control group (Fig.…”

“…1). In literature, hypercalcemia has been reported in animals receiving calcium-based phosphate binders, and it is considered as an adverse event (Biasibetti et al, 2018). The phosphate binders used in our supplement were chitosan, calcium lactate gluconate and calcium carbonate.…”

“…Blood pressure (BP) was taken by an sphygmomanometers (CONTEC), during the examination, measurements were taken five times and the mean value was recorded. Urinalysis procedures were already described in Biasibetti and colleagues (Biasibetti et al, 2018). A complete clinical examination, blood and urinary tests were performed at the beginning of the study (T0), then at day 30 (T30), 60 (T60), 90 (T90), 120 (T120), 150 (T150) and 180 (T180).…”

“…In dogs with CKD, commercial dietary supplements with different compounds such as chitosan calcium carbonate, and potassium citrate show their beneficial effect to control hyperphosphatemia (Zatelli et al, 2012). A recent study on cats testing an oral supplement with calcium carbonate, calcium-lactate gluconate, chitosan and also sodium bicarbonate confirms the reduced serum phosphorus and the increase in serum bicarbonate with improvement of clinical conditions (Biasibetti et al, 2018).…”

“…Renal diets specifically designed for CKD aims to slow down progression of the disease and extend survival, to improve clinical consequences of uremia and minimize electrolyte and acid-base unbalance, and maintain adequate nutritional intake (Biasibetti et al, 2018;Jacob et al, 2002;Polzin, 2013). The formulation of canine renal diets has changed and improved over the years, the administration of this food is considered the first therapeutic approach for improving survival and life quality of canine patients with CKD, using a four-stage scale of disease progression according to the International Renal Interest Society (IRIS) guidelines (IRIS, 2019;Davies, 2016).…”