My cat has high creatinine. Does he need a phosphorus binder?

Hello. Yes, there are studies done to indicate that phosphorous binders added to non-renal diets will be effective. Many cats will not touch the kidney diets, so adding the binders is the next best way to go. Thanks for using Petco Pet Education Center, formerly Petcoach.

There are many options, the one change which is proven to extend life expectancy and quality is to convert to a specialist kidney diet, preferably wet kidney food. These are enriched with antioxidants and b vitamins, contain highly digestible protein to reduce the amount of work the kidneys need to do and are high in antiinflammatory omega fatty acids. A kidney tonic such as pronefra can also help. Regular blood and urine testing to track progress is important as additional measures to treat high phosphorous, urine protein loss and high blood pressure may need to be added over time

More information would be required in order to help assess Max's case such as his signs and symptoms (including any blood in stool), any change in thirst/appetite and body weight as well whether the bloods were taken fasting more than 12 hours or after feeding. Ipakitine is a phosphate binder and is used to protect the kidney from high blood phosphate levels and monitoring of this would be important.

It should not have a significant impact on his blood pressure. Obviously eating the renal diet is best but with kidney disease studies have shown that it is actually the phosphorus restriction that is the most effective. Since he is on a phosphate binder you don't have to worry about that too much. At this stage it is best to just make sure he is eating so give him whatever he will eat. Sounds like you are doing a great job!

Unfortunately kidney values can not be interpreted without a urinalysis and specific gravity. Elevated BUN is not always CKD but this would be more likely in the face of poorly concentrated urine ( pred will also effect this). CKD is staged via what is called IRIS. This takes in to account creatinine, protein in the urine, and blood prressure. SDMA is newer and thought to be an earlier indicator then BUN/creatinine as these as insensitive markers of kidney function. This has now been incorporated in to the new IRIS scheme. What i would recommend for your kitty is a urinalysis and blood pressure to better stage. For early stage CKD kitties a renal diet is recommended. It is also important to treat any high blood preesure or significant protein in the urine as these can worsen kidney function. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Poor OIiva! I would certainly get her started on a phosphate binder like aluminum hydroxide if her phosphorus is high. Their is a liquid form but most cats don't like it. I would try the capsules as your mentioned above or have it compounded into a liquid that has fish or chicken flavor. Your vet should be able to help you with this prescription. I would also talk to your vet about starting her on daily or every other day subcutaneous fluids. If she is a cooperate patient, fluids would help to flush out her system and keep her kidney values and phosphorus down and therefore allowing her to feel better. Finally I would talk to your vet about an appetite stimulant if she isn't wanting to eat. I hope this helps!

I'm sorry that Twitchy's creatinine and BUN levels are slightly elevated. As I'm sure the vet explained to you, these elevations are typically signs of kidney disease, which is very common in old cats. With kidney disease, it's very important the cat has as much fluid intake as possible, so I would be feeding her a wet food instead of a dry food. That will give her additional water that she needs. It's also recommended to feed her a low protein and low phosphorous food, as both should be restricted to support kidney function. I'd recommend feeding her a kidney formulated wet food, such as Royal Canin veterinary diet renal or Hills Science diet k/d. Cats do tend to enjoy wet food, so feeding her this canned food will hopefully appeal to her taste buds, and feeding a kidney diet will be the best to support her kidney function.