Calcitriol

1. Renal secondary hyperparathyroidism affects at least 5 million dogs and cats today in U.S.
   1. Why important? - High PTH is toxic decreasing quality and length of life:
      1. Bone effects - renal osteodystrophy
      2. Central and peripheral nervous system toxicity of excess PTH
      3. Cardiac and skeletal muscular toxicity of excess PTH
      4. Red and white blood cell toxicity of excess PTH

1. Is PTH elevated in chronic renal failure patients toxic?
2. What is the mechanism of PTH toxicity?
3. Do toxic levels of PTH depress uremic patients appetite?
4. Is the PTH-damaged kidney relationship cyclic?
5. Why doesn't cimetidine work to lower PTH?
6. What is Calcitriol?
7. How do PTH and Calcitriol work together normally?
8. How is Calcitriol affected by chronic renal disease?

1. Step 1: Determine that serum creatinine is consistently elevated above 2 mg/dl and USG is compatible with CRF as cause of azotemia. Patients are best treated early in CRF as low calcitriol doses are useful in preventing disease progression.

2. Step 2: Establish a plasma phosphorous concentration at or below 6 mg/dl through use of phosphorus restricted diets, intestinal phosphorous binders (use those containing aluminum rather than calcium), and, if necessary, fluid diuresis.

Calcitriol as the active form of Vitamin D is actually a hormone over 1,000 times as potent as natural or synthetic vitamin D itself. It is normally created in your pet's body after plants and/or animal tissues are eaten. The ingredients to make the calcitriol must first make their way through the liver and then migrate to the kidneys which if healthy do the final step of making the calcitriol. CalcitrioI helps your pet's body absorb calcium and phosphate from food and put it in growing bones, where extra calcium and phosphate is stored.

Chronic renal failure, common in elderly humans is now common - and treatable - in pets.

If you think back a few decades you remember how uncommon it was to hear of dogs older than ten years. Now it is not at all unusual to hear of dogs over 15 years old, and cats over 20 years old! The advances in veterinary medicine and nutrition can take credit for these remarkable advances. What if human medicine discovered comparable longevity secrets? In the space of a generation average life spans would increase by 50%!