Stage 2, diabetic, and how higher phosphorus. At what point do you add binders?
Hello All,
My cat Humphrey is 15 and has been treated for diabetes for the past 16 months. In July 2025 we had a blood panel showing that he was headed into stage 2 CKD. I've put him on renal food (he's eating Young Again Mature Zero, and Royal Canin Renal D), and we've been juggling his blood glucose and his CKD.
I'm in Canada btw, some of these values are in canadian units. I'll convert where necessary.
July panel:
ALT 140 IU/L, Creatinine 218 umol/L (2.47 mg/dL American) , SDMA 19 ug/dL.
His November panel showed an improvement due to the food switch, but his blood pressure was elevated so now he's on amlodipine.
November: ALT 91, BUN 18.5mmol/L (51.8 mg/dL American units), Creatinine 149 (1.69 American), SDMA 20, phosphorus 1.2 mmol/L (3.7 in American units).
March:
ALT 53, BUN 14.8 (41.4 American units), Creatinine 154 (1.74 American units), SDMA 20, phosphorus 1.81 (5.6 American units).
Now the vet wants to place him on a phosphorus binder. We've had a difficult time adjusting my cat to his current diet, and to get his poops regular, I empty two capsules of psyllium husk fiber to his wet food, total of 1000 mg per day.
When trying out the Phos-Bind (prescribed half a scoop twice a day), it created a huge constipation backlog in my cat, and multiple days of dosing with Miralax to clear the backup.
Is my cat's phosphorus high enough that I should be pursuing a new balance with miralax, more fiber, etc. etc.?
What have you figured out that helps your kitty?