Aluminum Hydroxide & Kidney Failure – Pet Owner Feedback 

Ron Hines DVM PhD

What About Attempting to Lower My Cat or Dog’s Blood Phosphorus Level With an oral Aluminum Hydroxide containing product such as ConSeal-AIH 200 mg chewable tablets?

Aluminum binds to the phosphorus in your pet’s diet preventing its absorption and reducing the elevated serum phosphorous levels commonly seen in chronic kidney disease. 

One veterinarian, when at Ohio Sate Veterinary School, recommended variable dosages based on your cat’s existing phosphorus level and its current blood creatinine level – higher doses for higher creatinine levels beginning at 25 mg/lb/day (55 mg/kg) when your cat’s blood phosphorus level reached 4 mg/dl . Another at the same institution suggested a similar dose but three times a day and beginning when blood creatinine level reached 4.0 mg/dl. ISIS, the American renal interest veterinary group, recommends beginning aluminum hydroxide when blood phosphorus level reaches 4.6 mg/dl. ISFM, the UK renal interest veterinary group, suggests you begin your cat on 50 mg/kg/day when your cat’s blood phosphorus level has reached 1.3 – 1.9 mmol/liter. However, the makers of the 200 mg aluminum hydroxide ConSeal-AIH tablet widely used to control phosphorus in renal failure cats recommend a dose 200-400 mg/10 lbs/day given in divided doses on their website.

A person who has spent considerably more time considering this issue than I have, Tanya’s Comprehensive Guide to Feline Chronic Kidney Disease, suggested not giving more than 50 mg/lb/cat/day of aluminum hydroxide. If that remains her suggestion today I do not know. I have considerably more trust in her than I do in the veterinary school poohbahs until they present some hard data to supports their recommendations. There are suspicions that over consumption of aluminum has negative effects on bone strength and can hasten progression of kidney failure in humans. ( read here& here) Others dispute that. Another common side effect is constipation.

Please Tell Me About Your Experience Giving Phosphate Binders To Your Pet

Email me information about your pet. What is its name? Where do you live? How much does your pet weigh? What was your pet’s blood phosphorus level before you began giving it the binder?  What product(s) do/did you use, how much do you give? How effective has it been in lowering your pet’s blood phosphorus level? How has your pet’s blood creatinine level changed while taking the phosphorus binder? Does your pet accept it without a fuss? What diet is your pet eating? Has constipation been a problem? If so, how have you been handling that? Anything else you would like to add?

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September 21, 2020

Dr. C. formerly, of Ohio State recommends starting at a P level of 4. IRIS recommends 4.6. Gilbert floats between 4.1 and 4.6. If it is 4.6 next time, I will start Phos-Bind. Lanthium Carbonate is 2nd choice. 
Epakitin is calcium based, so that is ruled out.

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