Rob called from the local vet

Rob, the young vet from the local vet called today.

I still have the appiontment with the special Cat vet this afternoon. He not specialist aside from the fact his clinic only treats cats and no other animals, but he has experience with CRF and renal transplants. Another vet caroline Webb keeps getting recmomended to me, even by people at work. So its great I have three sources of vets.

Summary;
He asked how Milo was. I said good, eating but skinny
He asked how much he weighs, I said I would tell him tomorrow
I said why does the cat lose weight – I can not remember his answer, but I think it is because the kidney can not process nutrients properly
I expressed a high degree of concern over Milo eating but being skinny
He said Thyroid and glucose were good
A growth on the kidney can cause it, but highly unlikely and especially with a 5 year old.
He said to find out a biopsy is needed, very risky
He said urine was negative – no bacteria
Protein in urine was normal – good (I think this means protein is not being wasted)
Electrolytes are good
We need to keep phosphorous levels down
We need to watch calcium and potassium, if they get too low we give supplements
We need to check blood pressure when he goes in each visit

He does not know enough about phosphorous binders: Rob said he would not use them unless the phosphorous levels go up high. This is the same as Matt (the senior vet said last Wednesday)
He said he did research on a lot of vet sites and they advise against them. They say the they are hard pills to swallow and they also cause vomiting and are not pleasant for the cat, besides being unnecessary if phosphorous levels were ok.

I said Ipaktine is not a pill, it’s a powder. I told him about that it also contains an adsorbent called chitosan, which is a polysaccharide similar to cellulose. That when protein is eaten and digested, an amino acid in the food called tryptophan is converted into indoxyl, which in turn is converted by the body into indoxyl sulphate, a type of uraemic toxin. Chitosan is said to bind with the indoxyl, so it cannot be converted to indoxyl sulphate, thus reducing toxin levels, which helps the cat to feel better. Chitosan is also said by the manufacturer to help reduce BUN/urea levels, and indirectly to reduce creatinine levels (I was reading from this blog as I spoke to him)

He did not know all of that and said he would look into it. He mentioned calcitriol as a drug available in the U.S and would see if that could help Milo. I told him Matt said he would do that for me last Wednesday.