One last swift kick to this dead horse…

…and then hopefully we’ll move on?

The one article that has gotten the most attention on this website is my critique of Renafood and why it’s (if you’ll pardon mon français) utter horseshit. Renafood supporters will periodically poke in and sing its praises, claiming their cats are doing fantastically after starting Renafood.

I want to make something really clear here: to all those people, I’m really, really happy to hear that your cats are doing well. I’m shaking my pom poms and cheering their fuzzy butts on. May they live long and prosper, and snuzzle you when you need it most, and knock your keys under the couch, and drool on your boobs because they’re so happy, and bring you their little felt octopus for you to throw so they can run after it and then promptly bat it under the oven, and freak out for no discernible reason in the middle of the damn night so you scream a little and then feel embarrassed because dude, it was just your cat being a spaz per usual. Kick that CRF in the ass.

All those heart-warming stories of how Renafood has worked wonders, however, are inevitably accompanied by the story of how the caretakers have improved the diet in some way. Switching from dry to wet is an immense improvement. Switching from those terrible low-protein, completely unpalatable kidney formulas to something the cat will actually enjoy eating is an even bigger improvement. Prolonged fasting will screw a cat with CRF up but good, because it sets up a horrible feedback loop: the cat feels nauseated and ill from CRF, then is given unpalatable low-protein dry food, so he’ll avoid eating it, and then his body starts breaking down his muscle mass to feed the unrelenting protein engine that keeps feline bodies running, and he’ll feel even more ill and eat even less because it’s a really stressful process that releases some truly nasty by-products into the bloodstream that his wrecked kidneys are incapable of dealing with. So on. So forth. Phosphorus restriction and a high-quality wet diet—or more importantly, a high-quality diet that your CRF cat is willing to eat on a consistent basis, period—will manage his condition better than just about anything; if you’re giving him subcutaneous fluids, even better. But first and foremost is to keep the cat eating. A cat who ain’t eating is a dead cat.

What I’m trying to say here is: a massive diet improvement is what’s making your cats’ lives better. And good on you for making that switch. The fact that you’re making the switch concurrent with or in addition to using Renafood speaks volumes. The bloodwork numbers don’t lie, but I think the credit for the improvements lie with a source other than a pill that (and let me be explicit here) can’t actually work the way the manufacturer claims it works because it makes no scientific sense whatsoever.

If somebody has a cat with kidney disease and uses Renafood to treat it but hasn’t made any other modifications to the diet prior to starting Renafood wants to speak up about how using Renafood miraculously improved kitteh’s bloodwork numbers, I’d love to hear it. Until then: I love hearing how your cats are doing well. I’m completely unconvinced that Renafood is doing anything. Instead, I’m applauding your diet management skills and the obvious love you’re showering on your companions.

Renafood Redux, or: The Reply Comment that Ate the Blog

Given the relative obscurity of this cat blog and the fact that I update it once every never, I was really surprised to see a notification pop in my e-mail that somebody had left a comment on my Renafood post. A very long comment. From a vet working for Standard Process, the manufacturer of Renafood. I started replying to the comment, and suddenly realized that I’d written more than 1,300 words of reply. So: time for a new blog post! One about substantive issues, even, instead of pictures of fluffy kittens. I’m going to quote him verbatim in this post, so don’t feel like you need to run over to my Renafood post to read everything he wrote.

Dr. Cameron wrote:

I have been a practicing veterinarian since 1982, and I have used Standard Process supplements in animals (and my own family) for the past 20 years. I am now employed by Standard Process as a technical support veterinarian. I help veterinarians integrate nutrition into their clinical practices. I would like to respond to this post.

The author of the above post expresses skepticism on the value of using herbs, botanicals (plants) and glandular materials to support compromised organs (in this case, his/her cat’s kidneys). He/she lists multiple points of concern.

1. The author does questions the quality control of the ingredients in Renafood (or supplements in general). I would invite him to view a video of how supplements are made at Standard Process on our website ( Standard Process Inc. produces all supplements under the same stringent regulations used in the manufacture of pharmaceuticals. We are inspected by the FDA, USDA and other regulatory organizations multiple times per year. Each supplement we produce is tested by our in-house laboratory up to six times before it is released to the public. Quality control is taken very seriously at Standard Process Inc.

My response:
Thank you for taking the time to respond to my post. Regarding the quality of your supplements: since I’m unable to inspect your factory, and given that you’re an interested party, I’ll take your word that your products do, in fact, contain what they do, unlike the majority of companies (who also make substantially similar claims regarding quality control).

Dr. Cameron wrote:

2. You don’t believe that herbal detoxification is possible. I would be happy to provide you with references of how herbs and foods can affect detoxification mechanisms in the body. After 28 years of practice and years of clinical experience with these products, I can attest to their value. The FDA does not allow supplement companies to make any claims on their products in relation to specific diseases, so will not be doing so. The fact is that most chronic disease have been linked to nutritional deficiencies, so providing quality nutrition to compromised cells can improve their ability to function.

My response:
If you are willing to point me to some peer-reviewed literature regarding a) the biochemistry behind herbal detoxification and b) the actual efficacy of herbal detoxification, I’d love to read it. I’ve tried for years, and the lack of good evidence eventually led me to my skeptical stance today. I would also like to point out that this statement:

The fact is that most chronic disease have been linked to nutritional deficiencies, so providing quality nutrition to compromised cells can improve their ability to function.

Has nothing to do with detoxification; malnutrition is separate and different from detox. Somebody suffering from scurvy needs vitamin C, not an herbal cleanse devoid of vitamin C. Furthermore, while accepting the relatively uncontroversial assertion that some chronic diseases are linked to nutritional deficiencies or other bad dietary practices, it doesn’t necessarily follow that taking commercial vitamin or glandular supplements will cure or correct the conditions. (Diabetes mellitus comes to mind; so do certain types of liver cirrhosis and gout.)

Dr. Cameron wrote:

3. Cell determinants. As I mentioned, we are severely restricted by the FDA as to what we can say about our ingredients, so the information is vague and difficult to get a clear picture.

My response:
I would first like to begin by disagreeing that the FDA restricts what you can say about how your ingredients work. The FDA regulates the health and structure/function claims a supplement company can make about its products, i.e., what the products’ health benefits are. As far as I know, there is no law or regulation that restricts the dissemination of truthful scientific information explaining the biological or chemical pathways in which particular compounds work. Most of the most stringent regulations directly relate to labels in particular; as far as I know, detailed information sheets aren’t “labels”. In fact, please refer to Section 403B of the Federal Food, Drug and Cosmetic Act:

(a) IN GENERAL.—A publication, including an article, a chapter in a book, or an official abstract of a peer-reviewed scientific publication that appears in an article and was prepared by the author or the editors of the publication, which is reprinted in its entirety, shall not be defined as labeling when used in connection with the sale of a dietary supplement to consumers when it—
(1) is not false or misleading;
(2) does not promote a particular manufacturer or brand of a dietary supplement;
(3) is displayed or presented, or is displayed or presented with other such items on the same subject matter, so as to present a balanced view of the available scientific information on a dietary supplement;
(4) if displayed in an establishment, is physically separate from the dietary supplements; and
(5) does not have appended to it any information by sticker or any other method.

(b) APPLICATION.—Subsection (a) shall not apply to or restrict a retailer or wholesaler of dietary supplements in any way whatsoever in the sale of books or other publications as a part of the business of such retailer or wholesaler.

Dr. Cameron wrote:

For more information on how protomorphogens, cell determinants, or glandular tissues can be of therapeutic value, look at the more recent subject of Oral Tolerance Therapy. OTT is touted as a ‘new and promising’ therapy for a number of diseases, using cell extracts from various glands to treat specific glandular diseases. This can help explain how eating some kidney can help a compromised kidney. This is what the catalog is talking about when supplying cell determinants.

My response:
From a quick check, Oral Tolerance Therapy seems to be a therapy related to autoimmune diseases, especially T-cell mediated disorders. To grossly oversimplify: the idea is to feed somebody with an autoimmune disorder (say, irritable bowel disease or rheumatoid arthritis) extracts from the relevant tissues to help reduce the immune system’s hyperresponsiveness and therefore reduce the attendant inflammation. However, even if it were proven to work consistently (and I think the science is still kind of uncertain on that), and assuming for the moment that protomorphogens work in the same way OTT does, most incidences of chronic feline kidney disease, as far as I know, are not due to autoimmune disorders. For example: my cat Eric’s polycystic kidney disease in particular had nothing to do with his immune system and everything to do with the fact that he’d inherited an autosomal dominant gene from one of his parents for PKD. The majority of feline kidney disease is, as far as I know, idiopathic. Additionally, the mechanism by which Oral Tolerance Therapy works also seems completely different from what is suggested in the Standard Process literature about protomorphogens. OTT works by desensitizing the immune system so it doesn’t attack the body’s own tissues. I can’t speak on how protomorphogens work, since the information sheet was confusing and opaque, but the sheet seems to claim that protomorphogens affect cell division directly, and to target specific cells or tissues in specific organs. If I’m wrong about this, I’m certainly open to being shown where and how.

Dr. Cameron wrote:

Your not understanding what cell determinants are does not qualify you to say they do not exist or cannot be of clinical value. But I will agree that the writing could be more precise.

My response:
If I’m wrong about this, then I’d love to be educated on the fact—in fact, I would love to have a primer on just exactly what protomorphogens are and how they work. I’ve sent a copy of the Standard Process fact sheet to biochemist friends of mine, and they’ve come right out and said that the “mineral template” idea is nonsensical and not how cell determinants work; they also pointed out that substances that could have the sort of dramatic effect on cells claimed by Standard Process would be along the lines of hormones, mutagens and teratogens, and almost definitely not qualify as a mere supplement—it would be regulated as a drug by the FDA. It doesn’t help that “protomorphogen” seems to be a trademarked term of art, so searching science journal databases doesn’t turn up anything, and Googling merely turns up information sheets and promotional materials written by Standard Process or by sites selling Standard Process supplements.

Dr. Cameron wrote:

4. Dr. Royal Lee spent his life fighting the FDA, and yes, he was brought up before them several times. He was an outspoken critic of the adulteration of foods that came into common practice starting in the 1920’s (bleaching of flour, high-heat processing of foods, processing of foods to increase shelf life, the addition of sugar to so many foods, etc.) He constantly wrote letters to the FDA and other industry leaders pointing out the negative health effects these foods were having. As a dentist, he saw oral pathology due to nutritional deficiencies. This is how he came to start Standard Process Inc. – using quality food sources to replace the trace nutrients that were being lost in the food supply. The FDA and others took offense at his criticism and did go after him. Some of his claims (back in the 1930’s and 1940’s) were that these processed foods would lead to increased obesity, heart disease, cancer and diabetes. Are we seeing any of these conditions today? Are they increasing in frequency? Do we eat a lot of processed foods? Do our animals? As veterinarians, we are seeing the same increase in the same diseases in our pets as in humans. Be sure you check other sources besides QuackBusters.

My response:
I think it’s misleading to imply that Dr. Lee was prosecuted because he spoke out against processed foods and refined sugars. He made specific health and medical claims about his supplements and the FDA cracked down on him, and their statements about Dr. Lee being the “largest publisher of unreliable and false nutritional information in the world” concern the false medical claims on his products. Whether or not he’d drawn attention by speaking out against refined foods and existing food processing methods is beside the point; he was guilty of medical fraud because of the various claims he made regarding the efficacy of his supplements for treating various acute and chronic diseases and disorders. If you’re looking for a source beyond Quackwatch, perhaps this particular Notice of Judgment from the FDA regarding Dr. Lee’s products will be more satisfactory. (This is merely the first I found of many; if you go to the Notices of Judgment archive and search for “Royal Lee,” many more hits come up.) Here are the diseases that Dr. Lee claimed various supplements cured, which I’ve excerpted from the bottom of page 2 and on through page 3 of the Notice:

(1) pneumonia, tuberculosis, influenza, colds, whooping cough, measles, and mumps

(2) puerperal sepsis, infection of ear, infections of genito-urinary tract, infections of mucous tract, infections of gastro-intestinal tract, infection of respiratory tract, infections of sinuses, focal infections, and infectious diseases

(3) high blood pressure, low blood pressure, overweight, and underweight

(4) arteriosclerosis, high blood pressure, aortic aneurism, aortic insufficiency, valve leakage, coronary occlusion, coronary thrombosis, or dementia

(5) arthritis, hemorrhagic conditions of the urine, albuminuria, heart disorders, menstrual and ovarian disorders, Bright’s disease, leg ulcers, anemia, wasting of muscles, paralysis, muscular weakness, chronic diseases, amenorrhea, colitis, cystitis, children’s diseases, women’s diseases, liver disorders, dysmenorrhea, eczema, gall-bladder disease, gastritis, eye disorders, and cardiovascular disturbances

(6) acne, acute or chronic alcoholism, angina pectoris, Addison’s disease, adrenal hypertrophy, agranulocytosis, apoplectic sequellae, atrophy of glands or muscles, achlorhydric anemias, backward children, burns, cataracts, chlorosis, chorea, diabetes mellitus, epilepsy, toxic goiter, hyperthyroidism, hyperglycemia, hypertension, hypotension, asthma, hay fever, hyperemesis of pregnancy, sexual impotency, insanity due to endocrine failure, menopause disorders, migraine, menstrual dysfunction, paralysis agitans, phlebitis, poliomyelitis, paralytic sequellae, pancreatic dysfunction, pernicious anemia, nephritis, ideopathic [sic] ovarian disorders, prostate enlargement, peptic ulcers, sclerosis, rheumatic fever and varicose veins

(7) atrophy of organs and glands (testes, liver, spleen, thyroid, pituitary and salivary), infections and degenerations of eyes, physical weakness, nervousness, insomnia, gland swelling in general, renal calculi, bronchitis, endocrinopathies of childhood, nervous indigestion, neurasthenia, disorders of pregnancy, sterility, hypogalactia, retarded growth, loss of hair, fatty infiltration and degeneration of the liver, symptoms of nerve degeneration, Paget’s dermatosis, gastro-enteritis, infantile gastro-intestinal disorders, glycosuria, malnutrition, sprue, low resistance, kidney and bladder disorders, renal dysfunction, formation of stones (calculi), excessive growth of lymphoid tissue, lympathic gland enlargement, loss of weight and vigor, low vitality, stunted growth, emaciation, enlargement of liver, kidney and spleen, acidosis, and [prevention of] carcinoma

The substances to which these claims were attached? Various vitamin and mineral supplements (including A, C, B-complexes) that included various plant and animal extracts, and Catalyn (mostly milk sugar and various wheat extracts, with other plant materials and some “glandular extracts”). I think the list speaks for itself. If still not convinced, I’m certainly happy to dig through more old FDA paperwork and show what exactly the FDA’s beefs were with Dr. Lee’s products and the sorts of medical claims he made about his vitamin and food supplements.

Dr. Cameron wrote:

You make many judgements without much background information. This is the negative side of internet freedom, because people reading your biased opinion will take it as fact. This is unfortunate.

I would be happy to discuss this with you if you would like more information.

Tom Cameron, DVM 800-848-5061

My response:
I’m not a biologist nor a chemist, but I’m trained in the scientific method, and I’m a skeptic and a critical thinker. I’m open to being educated regarding protomorphogens; I’ll admit that the paucity of literature on this topic makes it somewhat suspect in my eyes, but again, my research was hampered by the fact that protomorphogen is not a scientific term but a trademarked term of art, and the Standard Process sheet was not at all clear. I am more than happy to receive information regarding protomorphogens and the way Renafood is supposed to work. I would prefer links to publicly-available documents so that any readers can read exactly what I’m reading as well and draw their own conclusions, but if that’s not feasible, then I would appreciate it if you would e-mail me more information at my address (my username is misshepeshu—I’m giving my e-mail address this way to confound spambots).