And thanks to our sponsors: Momento Pro photo books, Created For Life printing and framing, and Epson for its wonderful printers. Finally, thanks to all the entrants.

There were images entered by photographers from all around the globe. Entrants, you can log into your account to see your scores at any time. A number of entrants have asked where their scores fit into the range - so here is a distribution of the scores. As an average, there were no entries scored below 70, but very few above Some entrants might ask why are the scores bunched so closely together, and why no scores below 70 - which is a fair question.

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Our own sincere regret for not expressing gratitude to earlier. You can read a little more about aluminum hydroxide here. K9KidneyDiet has information on dosages of various phosphorus binders in their Files section you must be a member to view them. Epakitin is a new form of phosphorus binder that is becoming more commonly used, though it is questionable how effective it is at binding phosphorus.

See below for more info. A new product for cats, Renalzin , uses lanthanum carbonate. Renalzin was introduced in Germany and the UK in October, , but was discontinued in and never became available in the U. It is available in the US but is extremely expensive.

Renagel sevelamer hydrochloride , which does not contain either calcium or aluminum, is now being used for people. It has not yet been approved for dogs, though some have used it. All phosphate binders need to be given WITH food or immediately after in order to block the excess phosphorus in the food from entering the bloodstream. Give away from other medications by at least 1 hour, if possible since antacids may effect absorption.

Dosage depends on how bad the phosphorus values are. About Phosphorus Binders also has good information on this subject feline oriented. Although I have no idea if it applies to dogs, apparently people become itchy when their phosphorus levels are too high. Return to Top of Page Epakitin and Azodyl Two new "drugs" really supplements have recently been introduced by Vetoquinol: Epakitin , a phosphorus binder, and Azodyl , a probiotic supplement that can help reduce urea nitrogen levels in the blood.

Epakitin also marketed as Ipakitine in Europe is a chitosan-based phosphate binder and uremic reducer. It contains lactose, calcium carbonate the same form of calcium found in ground eggshells , chitosan, and hydrolyzed soy protein. The amount of calcium is pretty small, only 37 mg per gram of powder according to this analysis.

Epakitin is administered at the rate of 1 gram per 5 kg 11 lbs of body weight twice daily. It is the Chitosan that is the primary active ingredient, according to their literature.

Chitosan is derived from shellfish and is the major source of the nutritional supplement glucosamine. PDRHealth says, "In animal models of chronic renal failure, chitosan produced decreases in serum urea nitrogen, serum creatine and serum phosphate. There is apparently 1 gram per scoop, so you will use around 60 grams per 10 lbs of body weight per month. The best prices I saw were at VetDepot and Amazon.

See SupplementWatch for additional information on Chitosan. Chitosan is also marketed as a weight loss product Vitacost , Now Foods , so you might be able to find it cheaper, but I'm not sure what the dosage would be, nor whether it would be as effective.

The owner of ThrivingPets. If Epakitin is prohibitively expensive for your size dog, you could try giving plain chitosan at this dosage instead. I see no harm in using Epakitin, and some people feel it has helped their dogs, but if phosphorus levels are above normal, you should be using calcium or aluminum binders in place of or in addition to Epakitin. Azodyl is a proprietary probiotic product that claims to help break down the by-products of digestion that contribute to uremia elevated creatinine and BUN.

Note that uremia contributes to symptoms of kidney disease, but is not harmful to the kidneys themselves; elevated creatinine and BUN are the result of kidney disease, not the cause.

The bacteria are called "Kibow probiotics," from Kibow Biotech in Pennsylvania, which sells the same product under its own brand name, and says it contains three strands of probiotics: This company apparently patented the term "enteric dialysis" that is used to market Azodyl.

See this Consumer Lab report for other good probiotic brands. Also see PDRHealth for more general info on these and other probiotic strains. This product must be shipped cold, which can add considerably to the shipping cost. Best prices I found were at VetDepot and Amazon.

TIM PARKIN

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Medical Treatment for Dogs with Kidney Disease

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