How to Optimize Skin Biopsy Results
1.0 CE Credit Hour / Veterinarians & Veterinary Technicians
Overview:
The central role for total body phosphate retention will be emphasized in the pathophysiology of CKD-MBD (chronic kidney disease -mineral bone disorder). Phosphate retention either directly or indirectly accounts for many of the complications and progression of CKD. The relationship between circulating phosphate, ionized and total calcium, PTH, FGF23, and Klotho will be introduced. The ability to measure the master phosphate in FGF23 has recently become available – this allows detection of total body phosphate retention even when the circulating phosphate is within the reference range. Dietary restriction of phosphate is the first step in reducing phosphate retention. Adding intestinal phosphate binders to the diet is the next step to gain targeted circulating phosphate. Intestinal phosphate binders (salts of aluminum, calcium, lanthanum, iron) will be compared for their efficacy in binding phosphate and their level of safety. Too much phosphorus restriction, especially in early IRIS CKD stages in cats, can create hypercalcemia that is damaging the kidneys.
Learning Objectives:
- Describe to a client why it is important to reduce or prevent phosphorus retention in dogs or cats with CKD.
- Implement a treatment plan using some combination of phosphate restricted diets and intestinal phosphate binders to gain “targeted” control of serum phosphorus during CKD.
- Compare and contrast the advantages and possible adverse effects from the use of the various classes of intestinal phosphate binders (salts of aluminum, calcium, lanthanum, and iron).
Keith E. Linder, DVM, PhD, Diplomate ACVP
Staff Pathologist, Zoetis Reference Laboratories
Dr. Linder has over 20 years of experience in veterinary dermatopathology, diagnostic pathology, research collaboration, and publication. His expertise is in veterinary diagnostic dermatopathology, skin structure and function, and mechanisms of skin diseases. After graduating in 1995 from Michigan State University, College of Veterinary Medicine in the USA, Dr. Linder completed an anatomic pathology residency at the University of Guelph in Ontario, Canada. Concurrent with his residency, he obtained a PhD in experimental pathology, awarded in 2000. In 2001, he became board-certified by the American College of Veterinary Pathology. For over 20 years, Dr. Linder was a faculty member at the North Carolina State University, College of Veterinary Medicine, where he rose to Clinical Professor and focused on dermatopathology. He enjoys hiking, biking, and indoor rock-climbing with his wife Petra and his son Matthew. Dr. Linder is an amateur metalsmith and can be found every Wednesday evening at “shop-night” rebuilding an old machine tool or fabricating something new with his friends.
Moderator: Robert Forbes, DVM
Dr. Forbes is the US Medical Education Lead for Global Diagnostics with Zoetis. He received his DVM degree from the University of Wisconsin in 2006. Following graduation, Dr. Forbes practiced primary care medicine in Wisconsin prior to transitioning to emergency medicine in 2015. He practiced as an emergency veterinarian at Fox Valley Animal Referral Center in Appleton, WI, for 4 years. Dr. Forbes joined Zoetis in 2019 as a Professional Services Veterinarian. His professional interests include clinical pathology and emergency medicine. He is a former Chairperson of the Wisconsin Veterinary Examining Board.
This program is pending approval for 1.0 hour(s) of continuing education credit in jurisdictions that recognize RACE® approval.
This activity is sponsored by Zoetis.
