This is an article about Azodyl, Lactulose, and FOS Inulin in (as an adjuvant of) canine renal disease.

Supporting documents are provided:


Azodyl and FOS Inulin can either PROVIDE or GROW beneficial microbes that:

  1. Directly utilize urea nitrogen in the bloodstream and then allow it to be excreted naturally by a hepatobiliary route.
  2. May stabilize the GI tract microbiota which reduces fluid loss through the bowel, mitigates gut inflammation, reduces the production of toxic products by “bad” bacteria which may proliferate in an azotemic (damaged) gut.

Lactulose induces a diarrhea so bad that in the flushing of water out of the bowel – it drags urea nitrogen (and a ton of other stuff) out of the body as well. In a way, I guess you’d get a similar benefit out of enemas. #kiddingnotkidding

Vetoquinolusa has sold some good stuff over the years. This might or might not be one of their “good ones”

Azodyl takes advantage of the FACT that beneficial bacteria can aid in the excretion / digestion / prevention of urea-nitrogen accumulations in the bloodstream, significantly.

But not all renal diseases and conditions are equal!

So it kind of matters what caused the kidney impairment. Most of the studies were done on rats that were “induced” to kidney disease.

But here’s the thing: They started selling Azodyl years ago and it’s still selling. If it was a dismal failure – it would not STILL be selling. Right?

So it is NOT a “one size fits all” kidney remedy and it might not work at all in your dog’s case. But I think it would be worth a try?

I also looked at Lactulose, and then found something on Inulin FOS supplementation which both ALSO worked to reduce urea nitrogen.

Ostensibly it was by normalizing the Gut Bacteria but also perhaps, putting appropriate germs, or germ-food in the gut to stimulate the growth of nitrogen using germs.

Attached are all the articles that helped me think of these things.

  • I think Azodyl is “worth a try”
  • I think Lactulose is not worth the orange diarrhea it causes.
  • I think the FOS Supplementation is a good idea. I’ve taken that DAILY for years for other reasons, it’s cheap and safe.


You can get Azodyl here.


Vol18 Iss2Sugimoto

Lactulose and Renal Failure- Scandinavian Journal of Gastroenterology- Vol 32, No sup222

Evidence Update- Azodyl for Chronic Kidney Disease in Dogs –

Effects of probiotic VSL#3 on glomerular filtration rate in dogs affected by chronic kidney disease- A pilot study – PMC

Effects of prebiotic oligofructose-enriched inulin on gut-derived uremic toxins and disease progression in rats with adenine-induced chronic kidney disease – PubMed

Effects of lactulose on renal function and gut microbiota in adenine-induced chronic kidney disease rats – PubMed

AMAZON~1 reviews of Azodyl in pet canine renal disease – purely anecdotal

Author: Dr. Erik Johnson
Dr. Erik Johnson is the author of several texts on companion animal and fish health. Johnson Veterinary Services has been operating in Marietta, GA since 1996. Dr Johnson graduated from the University of Georgia College of Veterinary Medicine in 1991. Dr Johnson has lived in Marietta Georgia since 1976.