The most palatable presentation (based on useful consumption) was Pronefra®, which was significantly higher than Azodyl® (p = 0.046), Ipakitine® (p < 0.0001), Renalzin® (p < 0.0001) and Rubenal® (p < 0.0001). The product with the highest rate of prehension was also Pronefra®, which was significantly higher than Azodyl® (p = 0.0019), Ipakitine® (p = 0.0023), Renalzin® (p = 0.0008) and Rubenal® (p < 0.0001). Conclusion Pronefra for Cats and Dogs has been developed to be highly palatable for optimal compliance, allowing a higher consumption rate than other solutions. Plantinga EA, Everts H, Kastelein AMC, Beynen AC: Retrospective study of the survival of cats with acquired chronic renal insufficiency offered different commercial diets. Vet Rec. 2005, 157: 185-187. Plantinga EA, Everts H, Kastelein AMC, Beynen AC. Retrospective study of the survival of cats with acquired chronic renal insufficiency offered different commercial diets. Vet Rec. 2005; 157:185–187. [ PubMed] [ Google Scholar]

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Virbac Pronefra 

Boyd LM, Langston C, Thompson K, Zivin K, Imanishi M: Survival in cats with naturally occurring chronic kidney disease (2000–2002). J Vet Intern Med. 2008, 22: 1111-1117. 10.1111/j.1939-1676.2008.0163.x. Pronefra can be poured over the food of can be given directly into the mouth while using the syringe. A syringe is included. This syringe is based on the body weight of the cat or dog, and allows for easy and correct dosage. Shake well before use.

Barber PJ, Rawlings JM, Markwell PJ, Elliott J. Effect of dietary phosphate restriction on renal secondary hyperparathyroidism in the cat. J Small Anim Pract. 1999; 40:62–70. doi: 10.1111/j.1748-5827.1999.tb03039.x. [ PubMed] [ CrossRef] [ Google Scholar] Is suitable for bigger dogs from 5 kg. Dogs can be given 1 ml per 5 kg of body weight, twice a day. Prehension was defined as the animal voluntarily taking the product in the mouth, whether or not it was then subsequently consumed. Tested products Kalantar-Zadeh K: Patient education for phosphorus management in chronic kidney disease. Patient Prefer Adherence. 2013, 7: 379-390. The best performing product of the four currently on the market was Azodyl®. One key point to note about this study was that the capsules of Azodyl® were opened and the contents applied to the food, while the manufacturer’s recommendation is to administer it as an entire capsule. It is extremely rare for cats to voluntarily consume a capsule without any forced administration. However, although not all owners are able or willing to forcibly administer products to their cats, for those who are experienced, direct administration of a capsule guarantees that the entire dose is received by the animal. It is probable that the technique we used is relatively widespread in the field.Ingestion of ≥50% (total plus good partial consumption) was assumed to represent a useful level of consumption. This was therefore defined as useful consumption. Developed to be highly palatable for optimal compliance, the complementary feed allows a high consumption rate than other solutions, and has a unique 4 in 1 formula that has a combination of 5 ingredients, corresponding to 4 properties. Virbac Pronefra is a tasty oral mixture based on the combined effects of five specific ingredients (calcium carbonate, magnesium carbonate, chitosan and marine oligopeptides). Cortadellas O, del Palacio MJ F, Talavera J, Bayón A. Calcium and phosphorus homeostasis in dogs with spontaneous chronic kidney disease at different stages of severity. J Vet Intern Med. 2010; 24:73–79. doi: 10.1111/j.1939-1676.2009.0415.x. [ PubMed] [ CrossRef] [ Google Scholar]