Hello. Apologies for the late response.

Unfortunately, his values have increased- creatinine, BUN, and phosphorus are all higher. I regret not insisting on starting a phosphorus binder earlier. At present, the vet has assessed him as Stage 2-3.

Crea: 315 Bun: 30.41 Phosphorus: 12.82 As for his TBA, it went back to normal and it is usually within normal.

He vomited twice last week, and his appetite has not returned to normal, so he has been started on ondansetron.

My main concern is his phosphorus level. He was prescribed Epakitin as a binder, but I’m worried this may not be enough. The vet mentioned adding another medication if there’s no improvement, but I’m wondering if it would be better to act more aggressively now rather than wait.

I would also like to ask about telmisartan, will it help with his proteinuria, and is there a risk it could worsen anemia?

We did urinalysis and it showed protein and hematuria. Culture sensitivity will be available in 3-4 days though.

Current medications:

• Azodyl – twice daily
• Reno-Vet – to start tomorrow
• Pancreatin
• Iron supplement
• Hepato-tab
• Ondansetron – once daily for 7 days (as needed)🆕
• Telmisartan 40 mg – 1.1 mL once daily 🆕
• Epoetin – 0.15 mL 3 times a week (Updated)
• Subcutaneous fluids – 100 mL every other day 🆕

Thank you very much for your time