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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 28518
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Hi. My cat is currently on felimazole and amlodipine. Can I

Customer Question

Hi. My cat is currently on felimazole and amlodipine. Can I also give her RenAvast with this medication?
Submitted: 2 years ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking with Dr. Michael Salkin
According to the RenAvast website "There are no known drug interactions or concerns about giving RenAvast™ while on other medications". Upon review, there's also next to no clinical studies indicating that this product is of value for a cat such as Poppy. I'm concerned that a patient such as she requires a protein restricted diet and RenAvast is composed of the building blocks of protein - amino acids and peptides.

Please respond with further questions or concerns if you wish. I'm sorry that your question wasn't answered in a timely manner.
Customer: replied 2 years ago.

Thank you for your reply. Poppy has the onset of Kidney disease which is why she is on Renal prescription food and medication for high blood pressure and over active Thyroid, on her recent blood test it showed the medication has helped a lot which is good but I just wondered if there was anything else out there that would help with the function of the kidneys themselves..or would her diet be the best thing? Thank you

Expert:  Dr. Michael Salkin replied 2 years ago.
Yes, rather than the RenAvast, I would supplement her with Epakitin (Vetoquinol) which acts as a phosphorus binder which then can help prevent the onset of renal secondary hyperparathyroidism - a significant risk when renal insufficiency advances in severity. Weakening of the bones and abnormal calcification of soft tissue can result. Epakitin can be purchased from her vet or found online. Please see here: http://www.amazon.co.uk/Epakitin-Dogs-Cats-150-gm/dp/B000COGXAA A potassium supplement as prescribed by her vet or through the use of cardiac salt (potassium chloride which should be available in your local market) should be considered as well even if Poppy's serum potassium level is normal. Supplemental fluid therapy, however, is the hallmark of successful therapy for cats such as she. Her vet can prescribe the fluids and a vet tech can show you how the fluids are administered subcutaneously at home. The need for Epakitin and fluids, however, would be predicated upon the severity of Poppy's renal insufficiency.

Can you upload a copy of her most recent test results to our conversation? I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or by using an external app such as imgur.com or dropbox.com.

Please continue our conversation if you wish.
Customer: replied 2 years ago.

Ok great, i've emailed my practise to ask them to send the results to me. I will send you a link/copy as soon as I receive it, thank you

Expert:  Dr. Michael Salkin replied 2 years ago.
Sounds good. I'll look for your next post. Please stay in this conversation rather than opening up a new question.
Customer: replied 2 years ago.

Hi Test results:

Creatinine (mmol/L) 198

Urea (mmol/L) 18.6

Potassium (meq/L) 3.03

(all other tests were in normal limit)

Thank you

Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you! Remarkably good for an 18 year old. She has approximately 20% of normal functioning kidney tissue remaining. She needs potassium supplementation. Her phosphorus is normal and so a phosphorus binder isn't necessary at this time but the Epakitin might forestall the development of hyperphosphatemia and subsequent renal secondary hyperparathyroidism.

Do you have a urinalysis to refer to? I'd like to know the specific gravity of her urine and whether or not she's losing excessive protein through her kidneys.
Customer: replied 2 years ago.

Hi,

Specific gravity is 1.015
PH 6

Protein +

Glucose Neg

Ketones Neg

Urobilinogen norm

Bilirubin Neg

Blood Neg

UPC 0.33

Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you! 1.015 is quite dilute and almost isosthenuric which defines kidneys unable to either dilute or concentrate the urine. This isn't unexpected at her age. She's not losing excessive amounts of protein through her urine which is a positive prognostic finding.

Do you have additional questions or concerns for me?
Dr. Michael Salkin and other Cat Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for your kind accept. I appreciate it.

You may receive an inappropriate follow-up from the site ostensibly sent from me. It wasn't and I apologize in advance should you receive it.

Please disregard the info request.
Customer: replied 2 years ago.

No problem :) and thank you very much for your help

Expert:  Dr. Michael Salkin replied 2 years ago.
It's my pleasure. My best to Poppy!