Naraquin for CKD Kitties

[lueyfufu]

Anybody have experience using the phosphate binder supplement Naraquin? The vet just prescribed it earlier this week to help bring Gus's phosphate down. There isn't a whole lot of information about it online other than the basic stuff from the company that makes it, so I wonder if it's new-ish.

I noticed it has a really strong smell. (I can't tell if it's a liver smell or a fishy smell.) And I could be mistaken, but I think maybe Gus actually likes it, to the point that he's been going completely bonkers at meal prep time since we started using it. After his hunger strikes earlier this year, it's so good to see him excited about eating!

I just wondered if this is any else's experience, too.

 

[mrsgreenjeens]

I searched this site for any referenced to Naraquin, and also searched my "go to" for anything CKD related (Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat) and couldn't find anything at all. That being said, I looked it up and I'm thinking that fishy smell comes from the fact that one of the ingredients is crushed shells from shellfish, which has been proven to reduce creatinine in people, and is supposedly very safe for cats and dogs (as long as they aren't allergic to shellfish). You probably already know this.

I say if he's excited to eat his food with this in it, be happy . My biggest issue with all my kidney cats was lack of appetite, often even with appetite enhancers.

 

[FeebysOwner]

I searched this site for anyone who might be using this product and found nothing. I also searched drugs.com and found this information (see link at the end of this post) in case it gives you any more information than the manufacturer's web site. Based on that information, it would seem to be a fishy smell that you are noticing. And, as somewhat duplicated above, I also looked on Tanya's website (Tanya's Comprehensive Guide to Feline Chronic Kidney Disease -All About Phosphorus Binders (felinecrf.org)) and it is new enough not to have been included as of yet.

It does contain a calcium-based product, so the biggest issue is to ensure it doesn't overly elevate Gus's calcium level.

You might want to join this site - [email protected] | Home and ask them about this product. If there is anyone who is using it, it would very likely be them.
Naraquin for Animal Use - Drugs.com

 

[katjoeus]

I"m also interested in this product, because I have various cats with elevated PHOS levels, and I've had trouble bringing them down by using the two most common products - Epakitin and Phosbind. This is a combo product that combines three types of phos binders in one. I had a bottle of this that I got at work (I work at a vet hospital and a rep had dropped off a bottle of this a few months ago). I gave that initial bottle of capsules to my older kidney girl, because it's harder to give her supplements regularly - my young guys with the weirdly elevated PHOS levels are easy, they are always around me and they love Churus. So I was going to look into trying this product for the one with the persistentyl high levels if they are still high at the next blood test (I am now giving him both PhosBind and Epakitin throughout the day). Btw, the ground shellfish shells wouldn't give it a fishy smell - that is the same stuff that is in Epakitin, and that doesn't have a fishy smell at all. But I think there might be some fish oil in the Naraquin.

 

[lueyfufu]

It did work to bring down my boy's phosphorus levels after using it for a month.

I'm a little annoyed by the dosing instructions on the bottle, which say to give one capsule per meal. We feed Gus four times per day, so does that mean four capsules per day? That seemed like a lot, so I called the company that makes it and asked. The person I spoke with said they recommended no more than two capsules per day. (Why not put that on the bottle?) So we give him a half capsule per meal.

 

[Furballsmom]

Thanks very much for the update, and the extra information. That's very helpful, and also great to hear it's working!

 

[lueyfufu]

Just another note about Naraquin, for what it's worth.

Kitty's been taking it for about two months now (I think?) and it has definitely helped bring down his phosphorus level. However, the vet noticed at his checkup earlier this week that there's a blackish/greenish film along the gumline of his top back teeth on either side. It was alarming at first, ("What the heck is this cat eating?!") until we realized it was most likely from the Naraquin. I'm guessing it's the iron element of the supplement building up on his teeth and gums, maybe?

Keep that in mind if you're using it. Also, I'd be interested to hear if anyone else's kitty has experienced this after using it for a while!

 

[Furballsmom]

Kitty's been taking it for about two months now (I think?) and it has definitely helped bring down his phosphorus level.

This is fantastic !

 

[the spare human]

Good to hear it was effective at lowering his phosphorus. I'm about to put my lil buddy on this as well. I was interested in this medicine because of the iron III or ferric citrate. Opie has been anemic all his life and I've seen where many medications used to lower phosphorus also interfere with iron absorption/transit. Supposedly this stuff binds phosphorus and works as a supplement for iron. So for him this could be a win win! Thx for sharing your info

 

[mrsgreenjeens]

Good to hear it was effective at lowering his phosphorus. I'm about to put my lil buddy on this as well. I was interested in this medicine because of the iron III or ferric citrate. Opie has been anemic all his life and I've seen where many medications used to lower phosphorus also interfere with iron absorption/transit. Supposedly this stuff binds phosphorus and works as a supplement for iron. So for him this could be a win win! Thx for sharing your info

We'll be very interested in how this works for Opie as, sadly, there are just too many cats with kidney disease, so anything that helps we need to know about.

 

[white shadow]

To update this thread for T the spare human and for future reference.............

"Tanya's Comprehensive Guide..." . (see post #2 above) - now includes coverage of Naraquin: Calcium-Based Binders : Calcium Acetate : Naraquin
.

 

[CCL3]

Does anyone have any more recent experience with their cats using this?

My vet just started my girl on Varenzin for anemia. She (in a 3rd hand/6 degrees of separation kinda way) knows someone involved in the trials and development of Varenzin, and they told her it works better if also given with Naraquin. I assume it's because of the ferric citrate in it.

I've been doing mad research for the last few days (I'm a human medical professional, so it's engrained in me). I like the fact the ferric citrate acts as a phosphorus binder. She is currently getting Phos-Bind, but it isn't keeping her phosphorus levels controlled. I haven't been able to switch her to some other type, because her calcium is high, and they recently found kidney stones on abdominal ultrasound. So I'm very VERY apprehensive about giving her more calcium. Especially if I'm supposed to give a capsule with each meal (she eats 3 x day). I have yet to call the company to see what the dosage recommendation *actually* is (based on a comment in another post). I also haven't gotten to the point where I've done a deep dive on if an extra 120mg daily of calcium is a lot for a cat. It SEEMS like a lot, especially when she's already high.

I have an email out to my vet to discuss my concerns. I'm wondering if it would be better to just try to find something with only ferric acid in it? Months ago when looking for new binder options, I stumbled across one that is available only in Japan and Taiwan (Lenziaren), and has been out for years. I really wish it was available here. It uses Iron III (ferric citrate) to bind. So I guess I was on to something months ago.

Any help or ideas are greatly appreciated! We thank you!

 

[the spare human]

Naraquin so far seems to be working great for Opie. These capsules separate easily and mix in to his food in a powder form. My vet told me just one pill a day ( 150mg and only 40mg calcium Acetate) so I have to break it up across his meals. The hardest part is predicting his hunger levels. Preparing the estimated daily consumption of his Royal pickyness helps with dosages. However with Naraquin and pourous one his phosphorus has halfed and so has his bun significantly.

There for a while it was pretty bad an I thought he was definitely going to leave us. He had completely stopped eating and drinking. He just wanted to hide and sleep. I kept coaxing him tho and doing fluids an decided to start forcing food and meds in him. Went an got some decent size surenges and then drilled them put wider. Since most seem to clog horribly and make violent spurts when passing food.

We also mixed in Healty kindey, "Kidney Restore" to the blended paste. He absolutely hates the tase but I think it helped him get kick started. He is doing so much better now but we are still working on his levels and won't be able to get his next test results back for a bit.

I'm honestly a bit shocked and so was my vet. He's putting on weight and looking like himself again. He is still a bit nubby but seems like he is filling back out.

 

[CCL3]

My vet told me just one pill a day ( 150mg and only 40mg calcium Acetate) so I have to break it up across his meals ...

We also mixed in Healty kindey, "Kidney Restore" to the blended paste. He absolutely hates the tase but I think it helped him get kick started.

That is good to know about the dosing. The Naraquin website/product info says give 1 cap every meal to cats, and 1 cap per 25 lbs per meal for a dog. There HAS to be a lower dosage for a 9 lb cat. Surely a 9 lb cat shouldn't get as much as a 25 lb dog!!

I will look into Kidney Restore. My brain is filled with CKD information, but nothing is immediately retrievable for me regarding that ...

Are you still syringe (assist) feeding Opie, or is he eating freely on his own now?

Has Opie had problems with his calcium levels being high? That's the ONLY reason I'm hesitating on giving Naraquin. Well, that, and I strongly suspect she has a shrimp allergy, so I'm worried about the chitosan, but to a much less degree.

 

[FeebysOwner]

C CCL3 - Perhaps you have already utilized this web site for CKD information, but if not, there is a complete section on phosphorus binders and their pros/cons. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - The Importance of Phosphorus Control (felinecrf.org)

 

[CCL3]

C CCL3

Oh yeah! I'm a member of the forum. The site itself doesn't offer much information. But thank you.

 

[CCL3]

I just realized how that may have come across. The site doesn't offer much about *Naraquin.* It is a wealth of valuable other information, though, and I use it all the time!

 

[FeebysOwner]

I just realized how that may have come across. The site doesn't offer much about *Naraquin.* It is a wealth of valuable other information, though, and I use it all the time!

Understood!! I just thought it might have offered alternatives to Naraquin.

 

[the spare human]

That is good to know about the dosing. The Naraquin website/product info says give 1 cap every meal to cats, and 1 cap per 25 lbs per meal for a dog. There HAS to be a lower dosage for a 9 lb cat. Surely a 9 lb cat shouldn't get as much as a 25 lb dog!!

I will look into Kidney Restore. My brain is filled with CKD information, but nothing is immediately retrievable for me regarding that ...

Are you still syringe (assist) feeding Opie, or is he eating freely on his own now?

Has Opie had problems with his calcium levels being high? That's the ONLY reason I'm hesitating on giving Naraquin. Well, that, and I strongly suspect she has a shrimp allergy, so I'm worried about the chitosan, but to a much less degree.

Nope we are not having to force feed him anymore. That was...ruff but happy it was done. He has been eating and drinking on his own . No he doesn't have any issues with his calcium but he did become pretty anemic durning all this. The vet said the ferric citrate might help with this to a small degree but there's a possibility he will need it treated.

He also developed cyst in his mouth not sure what from but I see it can be a common issue with CKD. I was worried we would be going back to "assisted" feeding. The vet said a steroid should help those but that didn't do alot...I insisted on at least a short acting antibiotic (Dex) an this cleared his mouth up a ton! The vat said he want to give him a longer acting one now to see if it will fully clear up his mouth.

To my understanding the primary goal should be focus on getting the numbers down, especially the phosphorus. Then worry about fixing other issues. I'm not familiar with chitosan allergies so definitely ask your vet about that.

 

[CCL3]

Thanks for your response. I know phosphorus control is important, but her anemia is FAR more important at this stage, and a much more pressing issue. Anemia can kill a cat. We started Varenzin for the anemia, and Naraquin was recommended as something that helps the Varenzin work.

I was hoping to learn how the phosphorus and calcium of the other cats on it reacted when taking it, so I could make an educated decision about risk vs benefit.