Phosphorus Binders

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Lydia--(Rosie & Basil) GA

Lydia--(Rosie & Basil) GA

Member Since 2009
Rosie is 19 1/2 and has had mild kidney problems for well over a year. Her last test, in November, showed:
  • CR normal (1.34, scale 0.9 - 2.5)
  • BUN elevated (58, scale 16 - 37).
  • Phosphorus normal (4.4, scale 2.9-6.3)
Her labs are in her SS.

She eats mainly FF LC foods. I have tried getting her to accept a couple of million other kinds of LC canned foods but she really will not eat them reliably if at all. I can get her to eat 9Lives Flaked tuna maybe once a week and Super Supper about the same, although lately she is tired of that. She is never tired of FF.

Since I know that the phosphorus in FF is high, I keep thinking I should introduce a binder as I did for my kidney dog. His phosphorus was normal as well and stayed that way.

Does anyone think that the lowest dose of Aluminum hydroxide might be a good idea? Have you done that for a kitty with normal phosphorus? My dog did well for years, but then it's low number statistics. I don't know that he wouldn't have done the same if we did not feed low phosphorus and a binder.

Thanks for your thoughts!

Lydia
 
My vet wanted Saoirse started on phosphorus binders even though her levels are still in the normal range because the only food she can eat is high in phosphorus (she has chronic pancreatitis so food choices are almost non-existent).

Another thing Tanya's Site advises is that you need to look at both phosphorus and calcium levels when considering whether to start using a phosphorus binder. From Tanya's Site:

Even for cats with lower phosphorus levels, if the cat's phosphorus multiplied by total calcium is higher than 70 in US values or 5 in international values, the cat is at risk of tissue calcification (see secondary hyperparathyroidism). In such a case, again I would opt to use an aluminium hydroxide binder in order to get the phosphorus levels under control as quickly as possible.
Click to expand...
[Emphasis mine]

The linked page also discusses aluminium toxicity.


Mogs
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Larry and Kitties said:
This says start binder when phosphorous is above 6
http://www.felinecrf.org/phosphorus_binders.htm
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Thanks. That is why I am asking about the advisability of doing this with a cat with normal phosphorus.

Ken & Tara said:
You're worried because BUN is elevated? Aluminum hydroxide is said to present a danger of aluminum toxicity.

https://en.wikipedia.org/wiki/Phosphate_binder

I'm bouncing this for you, I don't know much about the topic.
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Well, elevated BUN is something that should be figured out, but no, she has also had elevated CR in the past and abnormally dilute urine. When she had these tests, she had been on some lower phos foods for months and her urine dilution as well as her CR improved. Unfortunately, with the diabetes diagnosis, we are back to the lower carb higher phos foods.
 
Critter Mom said:
My vet wanted Saoirse started on phosphorus binders even though her levels are still in the normal range because the only food she can eat is high in phosphorus (she has chronic pancreatitis so food choices are almost non-existent).

Another thing Tanya's Site advises is that you need to look at both phosphorus and calcium levels when considering whether to start using a phosphorus binder. From Tanya's Site:


[Emphasis mine]

The linked page also discusses aluminium toxicity.


Mogs
.
Click to expand...

I missed that about the Calcium times phosphorus. Thanks. Hers 4.4 X 9.6 which is 42. Interesting. I had read the part about toxicity. I am assuming it is less of a risk for her because I would be using the lowest dose and the toxicity data seems to be few cases and very high doses. Still, it is a consideration.
 
Thanks, Jayla!

I've been through this at length with a dog and briefly with a kitty. It is a very confusing condition at times and not easy to scope out. Diabetes certainly limits the ways you can treat it.
 
I was lucky with my dog Emmett. He accepted egg white and pork and lamb and sticky rice and pasta. He was not diabetic. I may be wrong but I think Rosie will reject the egg white. She's always been a very good eater but as she has gotten older she has become very fussy about the consistency of her food. Apparently FF pates represent some kind of pinnacle! I'll try it though. I just wish she would accept more of the 1 foods and not insist in the 2 and above foods.
 
Stumbled upon another snippet about calcium and phosphorus on Tanya's Site today:

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Calcification
As secondary hyperparathyroidism progresses, the cat is at risk of tissue calcification, which means that normally soft tissue in the body goes hard, which is very painful and can adversely affect proper function. If calcification occurs in the kidneys, kidney function is further worsened and a vicious circle results.

As a rough guide, if phosphorus multiplied by total calcium is higher than around 60 in US values or 5 in international values, your cat is at risk of calcification, though it is less likely to be a problem if the product is above this level because of a higher calcium level rather than a higher phosphorus level. Alternatively, you can multiply phosphorus by ionised calcium, and if the level is higher than 8.75 in US values or 35 in international values, there is a risk of calcification.

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Source Page: http://felinecrf.org/diagnosis_calcium_phosphorus_pth.htm


Mogs
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Critter Mom said:
Stumbled upon another snippet about calcium and phosphorus on Tanya's Site today:

----------------------------

Calcification
As secondary hyperparathyroidism progresses, the cat is at risk of tissue calcification, which means that normally soft tissue in the body goes hard, which is very painful and can adversely affect proper function. If calcification occurs in the kidneys, kidney function is further worsened and a vicious circle results.

As a rough guide, if phosphorus multiplied by total calcium is higher than around 60 in US values or 5 in international values, your cat is at risk of calcification, though it is less likely to be a problem if the product is above this level because of a higher calcium level rather than a higher phosphorus level. Alternatively, you can multiply phosphorus by ionised calcium, and if the level is higher than 8.75 in US values or 35 in international values, there is a risk of calcification.

----------------------------

Source Page: http://felinecrf.org/diagnosis_calcium_phosphorus_pth.htm


Mogs
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Click to expand...

Oh, wow. That's interesting. We are due for blood work in a couple of months. I will be interested to see if any of her values have changed. Thanks. That's something to discuss with the vet, too.
 
Critter Mom said:
Stumbled upon another snippet about calcium and phosphorus on Tanya's Site today:

----------------------------

Calcification
As secondary hyperparathyroidism progresses, the cat is at risk of tissue calcification, which means that normally soft tissue in the body goes hard, which is very painful and can adversely affect proper function. If calcification occurs in the kidneys, kidney function is further worsened and a vicious circle results.

As a rough guide, if phosphorus multiplied by total calcium is higher than around 60 in US values or 5 in international values, your cat is at risk of calcification, though it is less likely to be a problem if the product is above this level because of a higher calcium level rather than a higher phosphorus level. Alternatively, you can multiply phosphorus by ionised calcium, and if the level is higher than 8.75 in US values or 35 in international values, there is a risk of calcification.

----------------------------

Source Page: http://felinecrf.org/diagnosis_calcium_phosphorus_pth.htm


Mogs
.
Click to expand...
I've always said one of the primary things which will help QOL and longevity in a CKD cat is keeping the phosphorus level low. Because I've always focused on that, I've never had a cat even get close to 60 when multiplying Ca x P.
 
Thanks to everyone who weighed in! I think for now, I will just stay away from the binders. May try to introduce some egg white if she will tolerate it. I tried explain to her that the lower phase foods were better for her, but she was quite rude about it!
 
My FURbaby Sadi is 15 & her Phos level is 4, I inquired about binders but he said they typically don't give until phos levels are showing elevation.
 
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