When my pets have chronic kidney disease, I need to use specialized renal supplements as a dietary add-on to help bind phosphates and protect their kidneys from excessive strain. Since I also need to limit their protein intake, these supplements are a crucial part of their treatment.
I've been using Pronefra on my ferrets, although the product was initially developed for cats and dogs. I've had some experience with Pronefra, and I want to share my story with you.
Product Information:
Manufacturer: Virbac
Volume: There are two formats available – 60 and 180 ml
Form: Suspension for oral administration
Price: 4,500-4,800 rubles for the 180 ml bottle
PACKAGING
When I first needed to buy Pronefra, there were significant issues with its availability in Russia. My vet recommended it as the best option, but warned me that if I couldn't find it, I could use Ipatin as a substitute. I didn't take the easy route, so I looked for an online pharmacy in the UK that shipped to Russia. It took a long time, but I eventually found one and ordered Pronefra from there. Later, the supply chain improved, and I was able to buy it directly in Russia. However, the price difference between ordering from the UK and buying in Russia was still attractive, so I continued to order from the UK.
I've written about how to buy this product in the UK in a separate review.
This winter, I discovered that there's now an official website for Pronefra, although they only sell the 180 ml version. Considering the current price increase, the difference between buying in Russia and ordering from the UK was around 400 rubles. I decided that waiting for the shipment wasn't worth it, so I placed an order on the official website. The packaging is identical to what I received from the UK, and the only difference is the presence of a Russian-language sticker on the back of the box. My last purchase cost 4,800 rubles.
Pronefra comes in a small cardboard box:
Veterinary product Virbac Pronefra / Pronefra
There's a brief instruction on dosages and administration methods:
The pack includes:
The medication bottle.
A measuring syringe.
Instructions for use.
A dosing adapter.
Veterinary drug Virbac Pronefra / Pronefra
Something that really stood out to me was the expiration date on the medication bottle:
The insert has a lot of information, including the principle of action and a detailed sequence of application:
It's really important to shake the bottle thoroughly before each use!
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CONSISTENCY AND AROMA
Pronefra is a suspension for oral administration. It's a pretty thick, uneven mass with a nasty brown color and lots of inclusions and lumps:
Despite its unpleasant appearance, it's actually pretty easy to draw into a syringe. The manufacturer claims it has a palatable taste and smell for pets, which is a big deal when it comes to animals with eating disorders like kidney disease.
Veterinary drug Virbac Pronefra / Pronefra
It smells pretty bad, kind of like fish paste, but all of our pets that took the supplement seemed to enjoy it, so the animal really likes it 😊
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DOSE AND ADMINISTRATION
The dosage is indicated on the packaging:
Cat: 1 ml/4 kg body weight twice a day
Dog: 1 ml/5 kg body weight twice a day
The dosage calculation is based on the animal's weight. In our case, the vet recommended using the values for cats and adjusting the dosage proportionally based on the animal's weight. The included measuring syringe has a special scale that shows the animal's weight:
So, you just pull the plunger to the animal's weight value. In our case, the ferrets weighed 1.4 kg and 1 kg, respectively, so the dosage difference was minimal.
The main goal of Pronefra is to bind phosphates and uremic toxins. That's why you need to give the supplement strictly with food.
We feed our ferrets twice a day, and the first meal was on dry food - we just poured the liquid onto their food. When they started eating really poorly, the vet allowed us to give them baby food puree, and we'd pour the medication into that. Now that our ferrets are on a meat-based mash, it's even easier and more convenient to mix the suspension into it.
So, no major issues to report – the key thing to remember is that you need to give the medication with every meal.
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My Experience with the Product
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First EpisodeWe first encountered signs of Hypertrophic Polycystic Nephropathy (HPN) in our dog when he was 6 years old, which is considered a respectable age. The symptoms were classic – our pet's activity levels had decreased, and he was experiencing appetite problems. We visited the vet, expressed our concerns, and were sent for a routine ultrasound and full blood analysis.
The ultrasound revealed polycystic kidneys, and the blood tests confirmed HPN, with creatinine and urea levels already quite high (though the stage wasn't terminal at that point). Creatinine was around 200 – roughly 2.5 times the upper limit of normal. That's when our vet recommended Pronefra as a lifelong medication. Since then, we've been on a never-ending cycle of ultrasounds and blood tests to keep the situation under control.
Another important point to note is that high-protein food poses a significant risk to the kidneys – but our dog is a 100% obligate carnivore, and his diet should consist of meat. We initially transitioned to a renal-friendly diet, then there was a period where the vet advised feeding him anything – just to ensure he was eating and not losing weight. Without protein, he would continue to lose weight. It's a vicious cycle. Products like Pronefra help break this cycle by binding phosphates and reducing the load on the kidneys.
I can say one thing for sure – Pronefra kept our dog's blood indicators at the original levels, and for a while, he even seemed to perk up, became more active, and his appetite was decent. However, things took a turn for the worse when our 60ml bottle ran out, and the shipment from England was delayed. Although I had ordered a new batch with a buffer, I had to switch to IpaKITINE in an emergency, and that's when everything started to fall apart. The difference in our dog's condition was staggering! Unfortunately, by the time the new shipment arrived, our pet was in the terminal stage, and two days later, he slipped into uremic coma and passed away, with his blood test results off the charts (creatinine was over 500).
That's why, when our vet said Pronefra is significantly more effective than IpaKITINE, I wasn't in any doubt – we've experienced it firsthand.
Second EpisodeAfter some time, we adopted another dog from a shelter (named Joe), who had severe health issues. His passport revealed that he was a breeding dog, kept in poor conditions, and had been neutered too early. By the time he was 2 years old, he had a whole range of health problems.
After a year, I switched our dogs to high-protein Holistic dog food Power of Nature. And it was this diet that highlighted potential issues with his kidneys: the biochemistry showed that his kidneys weren't coping, with high creatinine and urea levels. That's when Pronefra re-entered our lives for the second time. Our vet immediately said there was no overt HPN, but this was a warning sign that this diagnosis might arise in the future, so she prescribed the medication as a lifelong solution.
We've been gradually switching our ferrets to a raw diet (and finally, Joe's become more plump, and at least his ribs aren't sticking out). The base of the raw diet is still meat, fish, and about 10% carbs, so the protein load is quite high.
I transfer all the lab results to Google Sheets, so I can see the dynamics at a glance. So, after 1.5 years on this diet, but with ProNephro, his creatinine has never gone above 56, which is within the normal range. Joe's 5 years old, and his list of health issues has grown, but his kidney function and kidney markers thanks to ProNephro are a non-issue. But there's one more thing - the sooner you notice something's off and start protecting your pet's kidneys, the longer their life will be.
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One 180ml bottle lasts on average for about half a year, maybe a bit more. So, the high price seems justified given the usage, although treating a dog or cat with this product would be expensive due to the higher dosages.
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The effectiveness of ProNephro, according to the manufacturer, is a combination of the following components:
The product contains 5 ingredients that help maintain kidney function in cases of CRF:
Calcium carbonate and magnesium carbonate - limit the bioavailability of phosphates;
Chitosan - reduces the levels of uremic toxins and urea in the blood, improves kidney function, and as a result, reduces creatinine levels in the blood serum. Chitosan also reduces cholesterol levels in the blood serum by binding bile acids in the intestines, increases hemoglobin levels;
Astragales polysaccharides - help maintain normal kidney structure, limiting the progression of fibrosis;
Marine oligopeptides - help maintain balanced blood pressure.
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I'll sum it up. ProNephro's effectiveness is beyond a doubt for me. I'd definitely recommend it for a CRF diagnosis and early kidney issues. Compared to analogs, it works more effectively and significantly improves your pet's condition.
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You can find my detailed review of ferrets here, including where to get them and a recommended list.
My review of temporary sterilization with a hormonal implant is also available.