1/18 Shadoe amps 328 pmps 344 +10 230

Yesterday’s Condo

First the question: Shadoe had SubQ fluids last nite at 8pm, and we are to give her more once daily. I am fine with that but is this morn too soon after last nite, should I wait till tonite so it's 24hrs later, or should I give them this morning? I ask because Shadoe seems fine and I may go to work later today, so I may not be here to test during the day but will be here in the evening to give the fluids at the time of her PM shot.
So, fluids this morn or tonite?


So far so good. Just the start of another normal day in the life of Shadoe. We were up till about 3am for the last test and she was still loopy and zoomy if I came near her. She sure can move and hide when she wants to!

Thankfully, she has forgiven me, and deemed me wakeup worthy at 630am; the alarm went off at 5am but no way was I getting up to try and find her to get another test. It could wait till amps.

Shadoe was much more calm; it looked like the loopy juice had worn off and she was eager for her test and shot and of course, more food. I am thinking that whatever nausea she had, it's long gone or there is no way she could be inhaling all this food and not vomiting - thoughts on the nausea anyone?

There was plenty of pee in the litter box, not overly lots since I expected to see a bit more with all the fluids and watered food she has been eating. No more stool but I'll watch for something maybe later today.

She was OK for the test and then the shot, but as usual, even with the pill shooter, she tricked me with that 1/4 tab of pepcid and it almost got spit out except that is when I gave her the syringe of the buprenophine sort of under the tongue on the side where she was trying to 'hide' the pepcid piece. After her glack-gag swallow antics, she forgot about the pepcid and that little sucker got swallowed with the syringe contents. :lol:

She ate half the can of food at first visit to the bowl, and has gone back a couple time in the last 30 minutes to have a bit more. That's pretty much how she has been eating: steady nibbles every 15min or so, no gulping at all. She then retreats to one of her rugs to lie loosely on one side, not in a ball. She is looking pretty good.

I think she will be fine today, so I would like to leave another can of food for her, test one more time, then go to work and leave the fluids till tonite as I will be around to watch her after and if I have problems, I am close to the vets.

So fluids now or later?

Re: 1/18 Shadoe amps 328 - SubQ fluids question

Gayle and Shadoe said:

Yesterday’s CondoFirst the question: Shadoe had SubQ fluids last nite at 8pm, and we are to give her more once daily. I am fine with that but is this morn too soon after last nite, should I wait till tonite so it's 24hrs later, or should I give them this morning? I ask because Shadoe seems fine and I may go to work later today, so I may not be here to test during the day but will be here in the evening to give the fluids at the time of her PM shot.
So, fluids this morn or tonite?

Click to expand...

Hi Gayle,
Just so you know where this is coming from...Ive been giving Latte subq's for 3yrs ...daily! (ugh)

Subq's are given to keep a cat hydrated. Sometimes they will be given every 24hrs, sometimes every 12, and sometimes every few days. It all depends on the cat's needs. Remember, subq's can lower BG's. I dont notice a huge drop, if any with Latte because we now give a pretty small amount. I am however cautious is we get into green, just to be safe.

All that being said, if it were me...I would wait until this evening. I would do this for consistency purposes (every 24hrs), and to monitor what kind of drops you get in BG's. HOWEVER, if shadoe is feeling very dehydrated, vomiting last night/today, then you may want to consider giving some. You can always split the amount in half and give it twice/day. How much were you told to give?

One other note....the pouch that you may see after giving subqs...if you still see that, then do not give more! That means Shadoe is still absorbing the last dose.

Re: 1/18 Shadoe amps 328 - SubQ fluids question

Now that I have read the entire post...

Are you giving ondansetron, as well? Between the pepcid and ondansetron (zofran) you will hopefully see a difference with the nausea. Even just the pepcid. So hopefully something is working.

Its good to hear shadoe is feeling better. despite the lack of response, I have been keeping tabs on you two! :mrgreen:

Have a good day at work!

Re: 1/18 Shadoe amps 328 - SubQ fluids question

Thanks for the replies, Carolyn. There is so much to keep learning.

First, the urge to go to work today has worn off; I'll use a vacation day, so I will be here all day.

OK the pouch or lump from last nite's fluids is all gone, so it's absorbed nicely. We started a fresh 1000ml bag at the vets and we gave down to the first line, I would guess it was 100ml as that is the grading on the bag and what I was told to give each day. I have only 10 needles, one for each day, so I think I should stick to once a day or have to get more needles someplace.

What is preferable though? Shadoe was not upset in the least with the larger needle, but I do wonder about frequent needles all in one area, the scruff. Are there times when twice a day is preferred to once a day? What is the advantage of splitting the fluids?
How will I know if fluids are to be continued or not? When is it required to give fluids every day?
I think I'll spend the day reading the info on the Tanya's site; it looks chock full of good stuff.

Right now, Shadoe is nodding off - I don't know if I should nailbite_smile or just :lol: - she is all sprawled out in the shot chair, front paws stretched out in front of her and her eyes keep closing and then her head dips down, slowly, then touches the chair with her chin and she wakes up.
She looks like those people on transit early in the morn who are dozing off haha_smiley or how I felt last nite trying to stay awake to catch a +8 test.

Last, the Zofran was the injection Shadoe got at the vet's and not what I was given for her. I gave her the buprenorphone in the morn with her 1/4 tab of pepcid. I have Cerenia green tabs that I can give 1/4 to 1/2 tab; since Shadoe is not vomiting and she is eating like gangbusters, I gave her the pepcid. I think it was Cassandra who said she Reglan resulted in bad reactions/ probem for some. Reglan is Cerenia, yes?
Should I give Shadoe the Cerenia tonite in place of the pepcid, or does it sound like she is over the nausea, or does she need both?
For the pain, I have one more syringe of buprenorphine for tonite, then I start the codeine transdermal gel tomorrow on the inner ear flap twice daily for 3-5 days.

I tell you, I need a cheat sheet for what is what, for what, and what to expect. :?

I think Shadoe and I are both finally relaxing after this weekend; she really does seem to be feeling much better, so maybe the fluids can wait till tonite. Does that sound like a plan?

Re: 1/18 Shadoe amps 328 - SubQ fluids question

Gayle and Shadoe said:

OK the pouch or lump from last nite's fluids is all gone, so it's absorbed nicely. We started a fresh 1000ml bag at the vets and we gave down to the first line, I would guess it was 100ml as that is the grading on the bag and what I was told to give each day. I have only 10 needles, one for each day, so I think I should stick to once a day or have to get more needles someplace.
Correct - that would be 100ml, maybe a tad less, depending on how much they ran through the line before starting. Are you in the U.S.? I have needles galore over here. So, give me a holler if you feel like you need to stock up a bit.

What is preferable though? Shadoe was not upset in the least with the larger needle, but I do wonder about frequent needles all in one area, the scruff.
Most vets seem to use an 18gauge, which a lot of cats are more bothered by. Most owners will use a 20gauge, sometimes 19. I use a 19g on days when I need it to go a little faster. 20g on others. The larger the gauge, the faster the flow can potentially be. It all becomes preference after experimentation. Does the cat mind bigger needles or smaller? Is the cat bothered by the flow rate? (which can be adjusted)


Are there times when twice a day is preferred to once a day? What is the advantage of splitting the fluids?
Some cats may need extra help with maintaining hydration thru the day, so get it 2x's/day. Other cats may be getting large amounts of fluids, which are not ideal to give all at once. For example, when Latte had the ARF she was getting 200ml/day and only weighed 6lbs (on a good day). we split the dose in two, sometimes three...just too much for her little system to take on in one big gulp.

How will I know if fluids are to be continued or not? When is it required to give fluids every day?
You and your vet will come to that conclusion when the time comes. Remember, fluids are for hydration. When shadoe stops vomiting and seems well hydrated, you may reduce the amount you give, or the frequency until you see things are balanced on their own.

I think I'll spend the day reading the info on the Tanya's site; it looks chock full of good stuff.
GREAT IDEA!!! I will be around most of today, so let me know if you have other questions or something on there is not clear. That has been my "home" for three years. The yahoo group literally saved latte's life!

Last, the Zofran was the injection Shadoe got at the vet's and not what I was given for her. I gave her the buprenorphone in the morn with her 1/4 tab of pepcid. I have Cerenia green tabs that I can give 1/4 to 1/2 tab; since Shadoe is not vomiting and she is eating like gangbusters, I gave her the pepcid. I think it was Cassandra who said she Reglan resulted in bad reactions/ probem for some. Reglan is Cerenia, yes?
Reglan is not Cerenia. Reglan and Zofran are often used on a regular basis for cats with severe nausea, often related to cancer, ibd, pancreatitis, etc. In my experience Zofran has shown better results for MOST cats and in recent months has proven to be safer. Though I still know plenty of owners who use reglan and have no problems and/or find it better for their cat. ECID. I think going with zofran to start is ideal (my own personal opinion).


Should I give Shadoe the Cerenia tonite in place of the pepcid, or does it sound like she is over the nausea, or does she need both?
Cerenia is different than pepcid and really should only be given if there is vomiting. I believe it is 5 days on 5 days off. Might be 3 on/3off...I never remember until I cross that bridge! Cerenia should not replace pepcid. It is in addition to. For example with us the other night...Latte gets pepcid 1x/day, ondansetron (zofran) 2x/day. She has been vomiting more and when she vomited yet again on Friday with no end in sight I gave the cerenia to put a kapoosh to it all.

I tell you, I need a cheat sheet for what is what, for what, and what to expect. :?
LOL! I know the feeling! It will make sense quickly though. I found this stuff much easier to understand and coordinate than the FD to be quite honest. You are a smart cookie, however...and have lots of knowledgable and supportive people surrounding you here to help you make sense of it all.

I think Shadoe and I are both finally relaxing after this weekend; she really does seem to be feeling much better, so maybe the fluids can wait till tonite. Does that sound like a plan?

Click to expand...

Sounds good to me! :mrgreen:

Re: 1/18 Shadoe amps 328 - SubQ fluids question

I'm glad she's feeling better and that you took the day off. Carolyn gave you fantastic information. A small cheat sheet on drugs and their other names:
Zofran=Ondansetron
Reglan= Metoclopramide
Cerenia=Maropitant
Pepcid=Famotidine

Re: 1/18 Shadoe amps 328 - SubQ fluids question

It's good to hear Shadoe is eating and acting more herself -- despite being loopy.

I'm also really glad Carolyn is around to answer your questions.

Re: 1/18 Shadoe amps 328 - SubQ fluids question

carolynandlatte said:

Gayle and Shadoe said:

Should I give Shadoe the Cerenia tonite in place of the pepcid, or does it sound like she is over the nausea, or does she need both?
Cerenia is different than pepcid and really should only be given if there is vomiting. I believe it is 5 days on 5 days off. Might be 3 on/3off...I never remember until I cross that bridge!

Click to expand...

Click to expand...

It's 5 on, but I don't know how many off. Check with Cassandra. But it would be unusual to have to give for all five days, I'd think, unless it's a chemo kitty or a master puker (I'm not naming names :mrgreen

Re: 1/18 Shadoe amps 328 - SubQ fluids question

First off, Shadoe seems way better now.
Recap:
I gave her the 1/4 tab pepcid and the 0.1 syringe full of buprenorphine along with her am shot.
She has not vomited at all since Friday, and is no longer licking her nose all the time, so I take that to mean that she is not nauseous or it's just mild.
Her appetite is functioning well; it was in overdrive yesterday when she ate almost 4 cans of food after returning home from the vets, but today, she is back to normal and has consumed almost 1 can in the last 5hours.
She is urinating nicely now. She is drinking more now (tub faucet as usual) and had a good firm stool yesterday. We are still waiting for today's stool.
She is cleaning herself more now and definitely seems more aware and with it now.
I have seen a bit of the old snarky Shadoe coming back too. Booboo erred by setting a paw on Shadoe's small area rug, while Shadoe was on it! Shadoe reached across the rug, claws out, to the edge, thereby blocking Booboo from going any further on Shadoe's private property.

1. needles - I have 10 of them, 18g x 1" Shadoe did not mind it at all, but it was only her 2nd time. If she will need them for a long time, don't the punctures cause scarring? I am sure that I could take them back and ask for smaller ones; I am in Toronto, Canada.
As for speed of drip, we squeezed the bag pretty good to get the fluids in her quickly. Does it bother more if entering quickly? How long does it usually take to give the 100ml? Should I go slowly?
2. I'd like to stick to once a day in the eves and with these size needles until we see if this bout will not turn into a frequent need. If it becomes a regular part of our routine with Shadoe, I 'll get the smaller ones for sure.
Goodness, a 6lb cat is smaller than what Booboo is right now around 6.4lb, and she seems light as a feather to me.
3. Amount of fluids and continuing them. I will continue with the 100ml once a day for the 10 days, or do you think I should ask the vet before then to know how long to continue. I would guess that 5 days will not be harmful, will it? I mean if she does not have a need for the extra fluids, what problems will it cause?
4. OK Cerenia is anti nausea to be used if bad vomiting, and the pepcid is if looking nauseous, licking nose and not eating much. Since she is no longer vomiting, I will hold the cerenia tabs for later use and will continue with the pepcid for a bit longer.

I told Shadoe she needs to learn to talk, quickly, so I know what she wants. All she did was sit down, bend over, and clean her rear. What's she trying to tell me with that?

Her numbers, the few I got today, are higher than yesterday; I guess due to no fluids given now.
It will be interesting to see how her numbers tonite change after fluids at pm shot time.

So with all this kerfuffle, Shadoe has stayed on the same dose: 5.25u. This morning was cycle 12, so do we continue with this one or move up to a nice easy to measure 5.5u? I ask because even with the fluids and everything else, we are getting only a few blue.

Do we increase or stay put till the pancreatitis issue is sorted out?

I am sure I have forgotten to reply to something; let me know what I have missed.

Re: 1/18 Shadoe amps 328 - SubQ fluids question

WCF and Meowzi said:

It's 5 on, but I don't know how many off. Check with Cassandra.

Click to expand...

It's 5 days on and 1 day off. It is rare to have to give it that often, but I do know my vet has used it that often in cats with pancreatitis that were vomiting severely. I personally have only given it maybe 3-4 days in a row....master puker that she was. ;-)

The more days in a row you do use Cerenia the more likely you will see the side effect of diarrhea from it. I saw it in Sasha at 3 days in a row, and my vet said she often sees it when using for the full 5 days.

There is some newer research out there that shows that Reglan is not quite as effective in cats as previously thought, and it does have the potential CNS effects and cramping that I saw with Sasha and a few others here have seen in their cats too. That's why I've always been partial to Cerenia and Zofran personally, but like Carolyn said, ECID when it comes to antiemetics. I do agree that Cerenia should not be used for just nausea. It is meant for acute vomiting in cats, and I found that while Cerenia does wonders for a vomiting cat, Zofran works much better for plain old nausea.

I am thinking that whatever nausea she had, it's long gone or there is no way she could be inhaling all this food and not vomiting - thoughts on the nausea anyone?

Click to expand...

Gayle, I agree. If she was nauseated, you would know it. Lack of appetite, drooling, gagging when smelling food - that is nausea. She probably doesn't need any Cerenia or anything else at the moment. Good to have around, though.

Re: 1/18 Shadoe amps 328 - fluids & dose questions

Oh my gosh Gayle, you're doing a fantastic job keeping up with all this. I'm completely lost on all the medicine talk, but just want to give up a big ((hug)) for the dedication you're putting in to make Shadoe feel better - and since she still has an attitude, she must be doing pretty good

Good job!

Re: 1/18 Shadoe amps 328 - fluids & dose questions

Holy crow! You have your hands full. It sounds like you are doing a great job, though. And good work Shadoe, for showing that personality. I hope she's all the way back to herself soon.

Re: 1/18 Shadoe amps 328 - SubQ fluids question

Gayle,
Scar tissue can build up if you are injecting the same spot over and over. To put it in perspective, Latte has been getting subq's for 3yrs. She also gets4-5 more injections daily with all other meds, on and off for the last year or two. Do I want to see what she looks like shaved? NOOOOO! But does she tolerate it - yes, does it seem painful - rarely, does it get harder for us to do it/tough skin?- rarely. Just move the needle around to different areas. i always do the opposite side that I did the last insulin shot. And try to swap sides everyday. I think a smaller size needle would help minimize scarring - but thats just my own suspicions. Have no idea if its true or not.

Speed of drip depends on the cat. If I go too fast with latte, she will let me know...and so will shadoe! I dont often do 100mls anymore. Depending on my drip, it can take 2-4 min with 50mls. Sometimes if you dont get the needle in just right (as in big open part of tip facing up) its going to be veeeeeeeeeeery, veeeeeeeeeeeery slow! If that happens you can try to poke again. i would not poke more than twice because the needles get duller with each poke and will begin to hurt a lot! Back to the speed - some cats can tolerate sitting for extended periods of time and would prefer a slower drip. Other cats are difficult to handle, so making the process quicker with a faster drip is the answer. make sense? :roll:

Sure, you could call your vet and ask if you should continue everyday. The main harm in subq fluids is overloading the cat, which can put stress on the heart. 100mls/day , depending on shadoes weight is not too bad for short time. 200ml/day for 3+ months, with Latte, was a concern we had to watch for. Do you know how to test for hydration by pulling up the skin in the back and/or feeling their gums? This will give you a good indication if you need to continue. You may end up backing down to 50ml/day, or 100ml e/o day. Best to talk with your vet about it...then people can throw out feedback from there.

Pepcid is for tummy acid which will make them nauseated. Common symptoms of tummy acid are licking lips, sitting in a meatloaf position, gurgly tummy, howling at water bowl, clear/foamy vomit, not eating, etc.

How you doing getting through Tanya's sight?

You know there is a yahoo pancreatitis group you could join. I will try to get the link for you later. They are wonderful folks over there.

Keep asking questions! And if they get too excessive, we can have pat come visit to give you some answers! :lol: (*see Michelle and Esse's condo)

Im really glad to hear things are going better. Its so scary when they appear so unwell.

Re: 1/18 Shadoe amps 328 - fluids & dose questions

Ronnie & Luna said:

Oh my gosh Gayle, you're doing a fantastic job keeping up with all this. I'm completely lost on all the medicine talk, but just want to give up a big ((hug)) for the dedication you're putting in to make Shadoe feel better - and since she still has an attitude, she must be doing pretty good

Good job!

Click to expand...

I'm with Ronnie on this one Gayle. When are the 2 of us going to med school??
Crazy day for me so could not read all of the medical. My hats off to you and tumbs up for being so awsome for Shadoe.
You truly are an amazing mommy bean!!!!
BTW, did you have Shadoe tested for Acro? The 2 of us are going to get sent to the High Dose Group. Will we be evicted from Lantus Land? (Max should be at 5.5 - tomorrow he will be)

Re: 1/18 Shadoe amps 328 - fluids & dose questions

Randi,
Naw, we won't be evicted; we may be at a higher dose than some but we are certainly below many others. I am sure Shadoe and Max will come around shortly. It's always darkest just before dawn.

The acro test,not done. When we went to the vets on Friday, I asked about IAA and acro testing, but the know-it-all vet said she called and they don't have those tests. if I could find out where they had been done, maybe they could arrange it. This from the vet who claimed a good knowledge of FD.

Now since the tests done did give us something to work on, the pancreatitis, I am good with that until we re-test in a couple weeks. I will be wanting the acro test done. I will arrange to go when the nicer vet is on duty, the one who set me up with all the stuff for Shadoe on Sunday when I steamrolled in there, demanding an explanation for no call back to discuss the bloodwork. Shadoe's file said I was called and I said she had to go for an emergency but would call back to discuss the test results. She also said we would try to change the diet to fix the pancreatitis. I quite loudly said in the main room that anyone who knows anything about FD should know that pancreatitis is not fixed by a diet change. Switch Shadoe to low carb? Excuse me but are you deaf and have you not read Shadoe's file? What do you think I just said? She is already eating low carb!
I was shuffled aside and the nice vet said to bring Shadoe in and we will get her set up properly with pain meds and anti nausea meds and also the fluids.

The squeaky wheel gets the grease.

Is the acro testing referred to as IGF-1? I just want to be well prepared and demand what is correct.

But first things first; work on the pancreatitis and then see where things go.

I still need to know if I am sticking with this 5.25u dose; I think we have tried it for long enough and even with the fluids and everything else, Shadoe is still hugging those pinks, refusing to let them go. The yellows have been a welcome site and the blues too, but she looks to be going whoa where is this going??

Now, I am getting nervous; it's almost the top of the hour and lots to be done. Before it was just a test n shoot thing. Now with the syringe of the buprenorphine and the fluids tossed into the mix, I am stressing too. The sequence of things stresses me.
My decision is to test, shoot, fluids, and then the pain meds in the syringe.
My logic is that the test and shoot are boring old stuff, so we will get those out of the way.
The fluids will need Shadoe to stay still and I don't know if she will sit still after I squirt that pain meds into her mouth. She did not like it much this morn, so the odds are good she won't like it much more tonite!

OK off I go to get ready for the pmps and all the rest.

Re: 1/18 Shadoe amps 328 - fluids & dose questions

Gayle and Shadoe said:

Is the acro testing referred to as IGF-1? I just want to be well prepared and demand what is correct.

Click to expand...

Yes that is the one. If I obtain any info I will pass it along.
One thing at a time. Now that you are dealing with the pancreatitis you might not need to look into IGF-1.
Sorry your routine got extended with all the extras.
My Sasha (GA) had renal failure and I was busy with IV's for a while. She was a good girl and sat for it. I had to give Max a while back and he did not like it.
I'm sending thoughts to Shadoe to behave for mommy.

Re: 1/18 Shadoe amps 328 - fluids & dose questions

it sounds like you already have a good handle on what you are doing for Shadoe, good mom.

Regarding insulin dose, IMO you have room to bump to 5.5 units. Watch her though (as if you wouldn't! LOL). If pain or other effects from the pancreatitis have been contributing to her need for a higher dose, now that she is on meds her insulin needs could drop. You'll catch it, though.

Re: 1/18 Shadoe amps 328 pmps 344

Oh, Gayle, I've been out of it for a few days and now I see you are having some problems with Shadoe! You are handling yours much better than I am handling mine! confused_cat

Did you ever get the pill pockets?....and do they work for you???...Morris found the pill in one so now that ruse is up! cat(2)_steam He suspects everything presented to him.

Here's hoping that Shadoe improves soon...she is such a cutie-pie! cat_pet_icon

Re: 1/18 Shadoe amps 328 pmps 344

Gayle, I just wanted to pop in and say what a great job you are doing with Shadoe..
I am so relieved to see that he is doing much, much better!
Good luck on the dosecrease and his great progress...

" Randi: The 2 of us are going to get sent to the High Dose Group. Will we be evicted from Lantus Land?"
Nope.. they make you stay here.. YOU CAN NEVER LEAVE LL... haha_smiley

Re: 1/18 Shadoe amps 328 pmps 344

Well, that's over with now.

I got everything all ready so I could have no lags in time between anything.
I think I am very lucky though; Shadoe really is well behaved, and she sat nice like a trooper.

She did not like my speeding up the fluids like we did at the vets office, but that's OK. Since we are doing the fluids at nite, we can take our time. After the fluids, I gave her the last syringe of the buprenorphone, and she did not like that too much, but she does not like me putting anything in her mouth.

Do these fluids make kitties hungry? Right after we were done, she jumped down and ran to the food and started gobbling. She did not eat lots, but still, it was her first reaction.

Now, she is all sprawled out on the sofa chair, looking like she is basking in sunshine.
I am relieved we both have survived our first fluids at home. Whew.

I'll get a couple tests in tonite before bed; hopefully +2 and +3 or 4 will be good enough.
I will wait before increasing the dose to see how things change with the fluids and meds.
No point in rushing to possible problems.

Brenda,
My vet gave me a nifty pill shooter. It just like a plastic syringe and has a little rubber end that you put the pill in, then when you plunge it into the mouth, the pill spits into the throat. Ask your vet for one; I got the pill in the throat with the shooter, but I did not to put the shooter too far back so Shadoe did sort of gag it out, but I scooted it back in and she gave up and swallowed. Sometimes, beans DO win :thumbup

Paula,
If you two guys go over to high dose, I'll keep you company.
Is that kinda like Hotel California? ... you can never leave?


Extra pats and scratches to all the big dose kitties; don't you worry, your parties are coming soon enough.

I have no idea what Shadoe's up to now. I have to sleep and got bored getting the same number 358 a couple times so I went to bed.
And woke up to 230? Crap, who knows what happened while we both slept happily.

Just wanted to say how amazing you are! Shadoe and Booboo are so lucky you are there mama bean. I hope Shadoe has a good day!

thanks Amy.

I have to say that Six is pretty lucky too; Six's bean is doing a bang up job at catering to all of Six's whims!

You and Six, have a great day, and Six, let's see some awesome numbers please.
Can't you just smell Luna's booze cakes from there?