? My Beloved Saoirse has Gone to The Bridge

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Critter Mom

Critter Mom

Member Since 2014
Hi all,

More detail on this thread:

http://www.felinediabetes.com/FDMB/threads/how-to-handle-diarrhea.164284/#post-1777614

Story so far:

Saoirse had a 3-day bout of diarrhoea after starting a new batch of her regular Sheba food (and civvie's poops on same batch were a bit suspect). I started slippery elm bark (SEB) and fed her from a different batch. Her appetite was not affected in the least during this time (eating heartily). Diarrhoea stopped after batch switch and 2nd dose of SEB. Saoirse had a normal, solid, healthy poop just over 24 hours later. At this stage Saoirse was in really great form, eating well and enjoying her food, happy (purring, affectionate, scent marking with her cheeks). I ran out of Saoirse's 'emergency' stock of food and I had to give her some more of the other batch (could not source a different batch locally). The diarrhoea returned within hours of her eating it. (I've reported this to the manufacturers.) As soon as Saoirse stopped eating this suspect Sheba batch the diarrhoea stopped again so both myself and the vet really think there was something amiss with it.

I tried a different Sheba batch yesterday morning for AMPS meal. She ate this meal but would not eat any more (occasionally she'll turn her nose up at certain batches and she had not been keen on this particular batch before so nothing out of the ordinary at this stage). I have an emergency alternative food (Kattovit Sensitive Chicken) that Saoirse eats occasionally so she had some of that. After eating the 2nd meal of this food she started growling. She was completely inappetent by PMPS yesterday - wouldn't even lick some i/d gravy or SEB syrup from my fingers. I had to skip her insulin dose last night. (PMBG was 8.1.)

Last night Saoirse got famotidine, ondansetron and 1/8 of a 4mg cyproheptadine tablet (and a quite reasonable amount of water via syringe). About 7 hours after eating the Kattovit paté she produced a poop which looked very much like undigested Kattovit but the stool, while very soft, was better formed than what she was producing on the dodgy Sheba (that was gelatinous, tan-coloured and malodorous). Saoirse vomited clear liquid in the small hours (presumably from the acid build-up due to her stomach being empty - that and constipation are the only things that trigger any vomiting in her and it is a very rare occurrence with her, as is diarrhoea for that matter).

This morning Saoirse had severe abdominal pain. She did not eat or drink anything overnight. I got an emergency consult with the vets. Thus far, treatments received are:

10:30 BST: Vet injections - bupe, vitamin b12, Cerenia, Betamox 3-day antibiotic.
15:00 BST: Ondansetron 2mg

Saoirse was still in a lot of pain and not wanting food so called the vets' OOH service.

16:02 - Vet administered Metacam injection to help with acute pain management.

17:21 - Pain response lessened. Saoirse ate a little puréed low carb food / water mix from my finger but started growling after a couple of teaspoonfuls.

PMBG: 8.1 (dose withheld due to inappetence / 7-day average BG at this time 8.7).
AMBG: 11.1 (insulin dose withheld again).
AM blood ketone level: 0.1 mmol/L.

(Alphatrak glucometer / human ketone meter)

Saoirse is to get 0.2ml bupe every 6 hours.

I am in bits over this. Saoirse has been doing so well over the last couple of months - better regulated BG, blood pressure back in the normal range, pigmentation normalising, healthy and steady appetite, overall contented and happy in herself in spite of the diabetes and other issues. In the days after the first bout of diarrhoea resolved she was very well - coat soft and shiny, terrific appetite, purry and affectionate. It is soul-crushing that she's now really unwell. It is agony to know she is hurting. I'm really scared about this flare.

Please pray and send positive thoughts for my girl; she is in great need of them.

Questions to follow in another post very shortly.


Mogs
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Dear Mogs and Saoirse - sending you both the most positive vibes for getting through this ASAP.
Keep us posted. We care.

HUGS

Diana
 
I'm really scared. I know Saoirse's had flares before but the major problem was nausea; it didn't hurt her when she tried to eat (she might experience a little bit of discomfort now and again after a meal but she certainly didn't growl). An hour or so after the Metacam and 2nd dose today of her bupe she seemed a bit better (side not quite as tender). She wanted the food but then she started to growl after only a few teaspoonfuls. That's all she ate between 6pm yesterday and 5:30pm today (just under 24 hours).

STOP PRESS:

I am a firm believer in the power of the prayers and healing thoughts of the wonderful members here and I am beyond grateful for them.

:bighug::bighug::bighug::bighug::bighug::bighug:

Saoirse perked up a little just after the first responses to this thread. (I think the 2nd dose of bupe might be kicking in.) She purred a little (probably from the bupe - they're not stress purrs) and she started moving around a bit - even visited her scratchy pole. (Up to that point she had barely moved most of the day.)

Saoirse is hungry (and I am beyond thankful for that). I've just given her a tsp of the Hill's i/d gravy (HC) and 3 or 4 chunks of the meat. She wanted more. She didn't growl straight away but she did give a bit of a small grunt about 5 minutes after eating.

I would very much welcome any experience and advice from members who have nursed a cat through a painful acute episode of pancreatitis; in particular:

1. How best to manage feeding Saoirse to minimise her discomfort while still getting sufficient calories into her. (I think I am going to have to go with the Hill's i/d pouch food - high carb.) I know I need to feed little and often but any practical pointers would be beyond welcome; I'm desperate not to do anything that might hurt Saoirse if I can possibly avoid it.)

2. How best to manage Lantus dosing around the higher carb food but most likely less than Saoirse would normally eat. about how best to feed while Saoirse is in pain like this. Also I'd very much welcome suggestions on how to manage Saoirse's Lantus dosing. I think I am going to have to go with the Hill's i/d pouch food (high carb).

3. Whether anyone has used SEB and found benefit from it in similar circumstances to what Saoirse is currently experiencing. (Frankly, I'm petrified of giving her anything which might make matters worse.)


Mogs


@tiffmaxee, @Marje and Gracie, @Meya14, @Chris & China - If you're around can you suggest anything to help? If there's anyone else you can think of who might be able to help I'd be grateful if you might tag them to come and look at this thread, please. I feel really out of my depth with this flare. If I can't manage this at home, Saoirse is not a good candidate for hospitalisation.

Supplies:

I have famotidine, cyproheptadine, ondansetron and slippery elm bark. Saoirse is to get 0.2ml bupe every 6 hours. I managed to secure a supply of different batches of her Sheba food today (some are known good batches). I also have Hill's i/d intenstinal support pouches (higher carb). I also have chicken breast which I could cook for her but I'm worried about giving her this (would have been my natural first choice once upon a time) because there was an occasion in the past when switching to chicken made Saoirse vomit.
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{{{Mogs}}} I'm sorry you and sweet Saoirse are going through this. I don't have any experience with pancreatitis, so I can't help with that, but wanted to send prayers, vines, hugs and scritches:bighug::bighug::bighug:
 
My Eve had a terrible bout of pancreatitis about 6 months after her diabetes diagnosis Note: When she was diagnosed with diabetes, she was DKA and in the hospital for 3 days. She went into remission one week after coming home.

When we got the pancreatitis diagnosis, Eve's fPL was 50 (off the charts) so she was hospitalized and received fluids and cerenia injections for 3 days. When she came home I switched from Purina D/M to low carb FF because I wanted to lower her fat intake. Because there was lots of fluid in her abdomen, we put her on Prednisolone, knowing it would end her diabetes remission and it did. But her internist felt it was necessary to address the pancreatitis. The only other med we had to use was Pepcid 1/4 tab twice a day along with the Pred. We had Cerenia but never needed it.

Over time we were able to wean her off of both the Pred and Pepcid and she went back into remission.
 
Critter Mom said:
I'm really scared. I know Saoirse's had flares before but the major problem was nausea; it didn't hurt her when she tried to eat (she might experience a little bit of discomfort now and again after a meal but she certainly didn't growl). An hour or so after the Metacam and 2nd dose today of her bupe she seemed a bit better (side not quite as tender). She wanted the food but then she started to growl after only a few teaspoonfuls. That's all she ate between 6pm yesterday and 5:30pm today (just under 24 hours).

STOP PRESS:

I am a firm believer in the power of the prayers and healing thoughts of the wonderful members here and I am beyond grateful for them.
:bighug::bighug::bighug::bighug::bighug::bighug:

Saoirse perked up a little just after the first responses to this thread. (I think the 2nd dose of bupe might be kicking in.) She purred a little (probably from the bupe - they're not stress purrs) and she started moving around a bit - even visited her scratchy pole. (Up to that point she had barely moved most of the day.)

Saoirse is hungry (and I am beyond thankful for that). I've just given her a tsp of the Hill's i/d gravy (HC) and 3 or 4 chunks of the meat. She wanted more. She didn't growl straight away but she did give a bit of a small grunt about 5 minutes after eating.

I would very much welcome any experience and advice from members who have nursed a cat through a painful acute episode of pancreatitis; in particular:

1. How best to manage feeding Saoirse to minimise her discomfort while still getting sufficient calories into her. (I think I am going to have to go with the Hill's i/d pouch food - high carb.) I know I need to feed little and often but any practical pointers would be beyond welcome; I'm desperate not to do anything that might hurt Saoirse if I can possibly avoid it.)

2. How best to manage Lantus dosing around the higher carb food but most likely less than Saoirse would normally eat. about how best to feed while Saoirse is in pain like this. Also I'd very much welcome suggestions on how to manage Saoirse's Lantus dosing. I think I am going to have to go with the Hill's i/d pouch food (high carb).

3. Whether anyone has used SEB and found benefit from it in similar circumstances to what Saoirse is currently experiencing. (Frankly, I'm petrified of giving her anything which might make matters worse.)


Mogs


@tiffmaxee, @Marje and Gracie, @Meya14, @Chris & China - If you're around can you suggest anything to help? If there's anyone else you can think of who might be able to help I'd be grateful if you might tag them to come and look at this thread, please. I feel really out of my depth with this flare. If I can't manage this at home, Saoirse is not a good candidate for hospitalisation.

Supplies:

I have famotidine, cyproheptadine, ondansetron and slippery elm bark. Saoirse is to get 0.2ml bupe every 6 hours. I managed to secure a supply of different batches of her Sheba food today (some are known good batches). I also have Hill's i/d intenstinal support pouches (higher carb). I also have chicken breast which I could cook for her but I'm worried about giving her this (would have been my natural first choice once upon a time) because there was an occasion in the past when switching to chicken made Saoirse vomit.
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Why do you need to go with the HC food? Sorry but I haven't read all the past posts to know what's going on with the Sheba and if that is why you have to go with HC...that you don't have anything else.

Have you been in touch with the vet? Have you asked about giving subq fluids? If the vet prescribes them or agrees, that little extra support can help.

For now, I'd stick with your regular dosing unless you see numbers shoot way up. In that event, you'll want to slowly increase the dose by 0.25u. If she isn't eating, you still need to be sure you get insulin in her even if it is a reduced dose. Are you able to syringe feed her (I think I remember that you can.

Small meals more often are good. If the vet has approved it, you could give the ondansetron twice a day at the prescribed amount and that will help with nausea. If you can syringe feed enough calories into her, that might be better than using a stimulant since those can come with their own side effects. But that is up to you. I can syringe feed my cats and I do not like the side effects of appy stimulants.

If she's having an acid vomit (foamy or clear), I'd try the SEB syrup and if that doesn't work,then discuss with the vet using the famotidine. When it comes to tummy acid, one thing that really helps is keeping food in the stomach to help absorb the acid.

However, having said all that, I'm a firm believer in having your vet involved. If one of my cats had pancreatitis, I would definitely be consulting my vet.

Sending tons of vines and prayers for your sweet girl.
 
Dear Mogs, I don't have any advice ( I do SO wish I did...) but please know that I am holding you and your darling Saoirse tightly in my heart; and I'm praying to whatever supernatural power that may exist out there that 'all will be well'.
Do please know that you are very much loved on this forum, and that so many people are wishing Saorise well. xxxx
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Hi Marje,

Thank you very much for checking in and I'm grateful for your help and your prayers.

Marje and Gracie said:
I'm a firm believer in having your vet involved.
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Me, too. I took Saoirse to the vets for an emergency consult first thing this morning, Marje, and the vet also called out to the house this afternoon to give Saoirse a Metacam jab. Everything I'm doing is under veterinary supervision and the vet set the dose for pain relief, ondansetron dosage, etc. I'm relieved that Saoirse is expressing interest in food as I, too, would prefer not to deploy an appy stimulant if at all possible. (Vet says it's OK to do so if necessary.)

I'm feeding the i/d because that's the only option I've got (least distress caused to Saoirse thus far - it's bland, lower in fat, and recommended by the vet as the most suitable thing to feed at the moment because of lower fat content than her regular food). I'm on the same page as you viz-a-viz keeping a little something in Saoirse's tummy in order to avoid issues with stomach acid build-up making matters worse. Saoirse lets me assist feed her by licking food off my fingers (she's not a fan of syringes) and she ate a little from my fingers earlier. I'm just so worried about causing her pain while trying to get food into her. All suggestions welcome on this one; it's the trickiest thing I'm dealing with. Could the SEB help with this?

Marje and Gracie said:
Have you asked about giving subq fluids? If the vet prescribes them or agrees, that little extra support can help.
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That's problematic with our vets (explored the possibility of home admin earlier this year and didn't get very far. Might be a possibility to get them to give them at the practice on Monday if necessary.) I have managed to get some water into Saoirse via syringe. If I can get her eating little and often that will help with hydration (she's OK hydration-wise at the moment, thankfully, but I need to keep on top of it).


Mogs
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Marje and Gracie said:
For now, I'd stick with your regular dosing unless you see numbers shoot way up. In that event, you'll want to slowly increase the dose by 0.25u. If she isn't eating, you still need to be sure you get insulin in her even if it is a reduced dose. Are you able to syringe feed her (I think I remember that you can.
Click to expand...

Status Check: (Alphatrak glucometer / human ketone meter)

PMBG: 8.1 (dose withheld due to inappetence / 7-day average BG at this time 8.7). Current dose: Skinny 2.5IU Lantus BID.
AMBG: 11.1 (insulin dose withheld again). AM blood ketone level: 0.1 mmol/L.
AM+8.00: Ate 1-2 tsps LC (Sheba food - caused growling)
AM+10.00: Ate tsp HC (Hill's i/d - grunt a few minutes after eating but appetite better. Overall still in considerable discomfort but better for pain meds.)
AM+11.25: BG 21.3 / Blood Ketones 0.3 - +1.25 after HC food, +35.25 since last insulin dose.

Marje, I know that her BG is sky high after the HC food but while I'm nervous of giving her the full 2.5IU dose because I'm petrified that I might not get much food into her overnight because of the pain issues. I don't want to leave her without any insulin at all (especially feeding the HC); I am very conscious of keeping her well away from DKA problems. I'd be grateful if you might give a few pointers on what reduced dose might be OK. (Saoirse's spreadsheet is up to date. Colour coding is customised but the US numbers are on the first tab in the sheet. Alphatrak meter.)


Mogs
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Thank you everyone replying for your support, your prayers and your healing wishes for my beloved baby girl. And thank you all again for holding her worried and scared mama's hand. I'm so grateful not to be alone with this.

:bighug::bighug::bighug::bighug::bighug::bighug:


Mogs
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Saoirse's having trouble walking - unsteady on her back legs. I think I need to ring the vets.

The bottom is falling out of my world right now ...
 
I'm so scared. I am more worried about her today than I have ever been throughout all of our ups and downs. She's just gone to hide in the litter box.

I think we're in trouble. I am fearing the worst.


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Critter Mom said:
Status Check: (Alphatrak glucometer / human ketone meter)

PMBG: 8.1 (dose withheld due to inappetence / 7-day average BG at this time 8.7). Current dose: Skinny 2.5IU Lantus BID.
AMBG: 11.1 (insulin dose withheld again). AM blood ketone level: 0.1 mmol/L.
AM+8.00: Ate 1-2 tsps LC (Sheba food - caused growling)
AM+10.00: Ate tsp HC (Hill's i/d - grunt a few minutes after eating but appetite better. Overall still in considerable discomfort but better for pain meds.)
AM+11.25: BG 21.3 / Blood Ketones 0.3 - +1.25 after HC food, +35.25 since last insulin dose.

Marje, I know that her BG is sky high after the HC food but while I'm nervous of giving her the full 2.5IU dose because I'm petrified that I might not get much food into her overnight because of the pain issues. I don't want to leave her without any insulin at all (especially feeding the HC); I am very conscious of keeping her well away from DKA problems. I'd be grateful if you might give a few pointers on what reduced dose might be OK. (Saoirse's spreadsheet is up to date. Colour coding is customised but the US numbers are on the first tab in the sheet. Alphatrak meter.)


Mogs
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If it were me, I would not be skipping shots. I know you are aware of the issues with that. Have you ever read this post on bad advice to newbies? I know you aren't a newbie but I think the point is the same. Any amount of insulin is better than none with a really sick cat, in most circumstances. Yes, there might be some circumstances on a case-by-case basis and especially if the cat is running really low, obviously. You might try a half dose and see how that works. If you can keep her in blue with a half dose, that would be good.

SEB won't help with pain if that was the question. Also, she doesn't have to be dehydrated to need fluid support therapy but if your vet won't allow it, so be it.

It's usually an issue with dogs and pancreatitis to need to feed lower fat diets. Not so with cats, in general. Unless you absolutely know that feeding a regular, LC food makes her pancreatitis worse, I wouldn't feed a higher carb prescription diet just because it is low fat. From 2nd chance:

Felines have a unique requirement for a high level of fat in their diet. So the low-fat, moderate protein and high carbohydrate diets suggested for humans and dogs with pancreatitis do not work well in cats. You can find recipes for low fiber, high protein diets here.

For the long term, once she is through a crisis, other things that might help her are B12 injections and digestive (not pancreatic) enzymes.

I just saw your post......yes, if she's having problems walking, you need a vet.

Good luck....prayers and pls keep us posted.
 
Marje and Gracie said:
I just saw your post......yes, if she's having problems walking, you need a vet.
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Any idea why, Marje? Could it be too much bupe? Or possibly something else? I'd be beyond grateful for any ideas you might have from seeing this in other cats. I don't want to just have vet input on this because vets have failed me in the past. (I am preparing myself for the worst here ...)

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:bighug::bighug::bighug::bighug::bighug:
Critter Mom said:
This is agony! She was wonderful two days ago. I don't want to make the wrong decision.
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Speak to the vet - she may need additional support in the way of fluids, I am a believer in 'if there is anything treatable then it's worth a try', I know how difficult it is for you at the moment - got the tee shirt on that one.
 
Critter Mom said:
Any idea why, Marje? Could it be too much bupe? Or possibly something else? I'd be beyond grateful for any ideas you might have from seeing this in other cats. I don't want to just have vet input on this because vets have failed me in the past. (I am preparing myself for the worst here ...)

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Click to expand...
I would wonder the same thing as Elise.....electrolytes maybe? But not being able to see her and with there being so many other things in the equation, I just don't know. I do know it's difficult if you don't trust the vets but at some point in time we have to realize that they are the ones with the training and they do have the tools (e.g. IV fluids) that can help. As her advocate, continue to gather as much info as you can and ask them questions (I know I'm probably preaching to the choir here).

The wobbly legs could be anything from her just being weak to something like a potassium imbalance and we can't tell you which....the vets would have to run labs.

:bighug::bighug::bighug::bighug::bighug::bighug:
 
You could also take her for labs done in house that could be run right away and based upon that decide next steps. I too know how you feel about not wanting to hospitalize her but somehow you need to get information which only a vet can get. :bighug:
 
Thank you all so much for the suggestion about IV fluids.

I've just spoken to the vets and she didn't mention IV fluids at all. Were it not for your recommendations I would not have known to ask about them.

Vet says it might be weakness due to pain and possibly the pain meds making her wobbly. I told her that similar doses of bupe never had that effect on her before (nor did she camp in the litter box). The vet said they can take her in and put her on a drip overnight. She won't have intensive care monitoring. It's not likely she'll eat without coaxing.

Plan is to give insulin, try to get Saoirse to eat a little more and delay the next bupe dose to see if she can walk a little better as it wears off - and then call the vet again to decide about the hospitalisation. Still freaking out over how much insulin to give her so that she'll be safe in the hospital overnight.

tiffmaxee said:
You could also take her for labs done in house that could be run right away and based upon that decide next steps. I too know how you feel about not wanting to hospitalize her but somehow you need to get information which only a vet can get. :bighug:
Click to expand...

Great ideas, Elise, and I would jump at the chance to get urgent tests run but they're not really that advanced at the practice. I don't know how much testing they can do in-house.

Re the hospitalisation, I'd be far happier having Saoirse where she can get more help. The worry that the vets and myself have is that she freaks out when she's hospitalised. The vet did mention IV pain relief earlier but was worried that Saoirse would not be a good candidate for hospitalisation (stress).

I'm shaking like a leaf and I feel sick.


Mogs
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Mogs Many many many prayers sent your way, I am a firm believer in slippery elm bark...it may not be all Saoirse needs but it certainly can't hurt. If you can't get her feeling better at home, then a vet visit with SubQ fluids, pain relievers and anti-nausea may be the way to go.

:bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:

ETA You have seen Saoirse through many tough times in the past. Please just breathe and trust in your knowledge and love
 
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I wouldn't worry about hospital dose right now. Baby steps so you don't feel even more overwhelmed.

But, just a thought in case I don't get back right away and things change....If they won't monitor her, can you go and feed her so you can at least get half a dose in?
 
Marje and Gracie said:
I would wonder the same thing as Elise.....electrolytes maybe? But not being able to see her and with there being so many other things in the equation, I just don't know. I do know it's difficult if you don't trust the vets but at some point in time we have to realize that they are the ones with the training and they do have the tools (e.g. IV fluids) that can help. As her advocate, continue to gather as much info as you can and ask them questions (I know I'm probably preaching to the choir here).

The wobbly legs could be anything from her just being weak to something like a potassium imbalance and we can't tell you which....the vets would have to run labs.

:bighug::bighug::bighug::bighug::bighug::bighug:
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Thank you for this, Marje.

Saoirse came back out of the litter box and her back legs went out from under her. Shortly after she managed to get back to her dinghy bed but I didn't see her so don't know how well/badly she was walking.

I wish there was a more well-equipped and staffed hospital in the town.


Mogs
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Critter Mom said:
Thank you all so much for the suggestion about IV fluids.

I've just spoken to the vets and she didn't mention IV fluids at all. Were it not for your recommendations I would not have known to ask about them.

Vet says it might be weakness due to pain and possibly the pain meds making her wobbly. I told her that similar doses of bupe never had that effect on her before (nor did she camp in the litter box). The vet said they can take her in and put her on a drip overnight. She won't have intensive care monitoring. It's not likely she'll eat without coaxing.

Plan is to give insulin, try to get Saoirse to eat a little more and delay the next bupe dose to see if she can walk a little better as it wears off - and then call the vet again to decide about the hospitalisation. Still freaking out over how much insulin to give her so that she'll be safe in the hospital overnight.



Great ideas, Elise, and I would jump at the chance to get urgent tests run but they're not really that advanced at the practice. I don't know how much testing they can do in-house.

Re the hospitalisation, I'd be far happier having Saoirse where she can get more help. The worry that the vets and myself have is that she freaks out when she's hospitalised. The vet did mention IV pain relief earlier but was worried that Saoirse would not be a good candidate for hospitalisation (stress).

I'm shaking like a leaf and I feel sick.


Mogs
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Click to expand...

Dehydration and electrolyte imbalance are very common with pancreatitis so IV fluids are a pretty standard part of the treatment. If you are worried about her staying overnight, is it possible to take her in for some fluids and bring her home instead of leaving her overnight?
 
Is it possible for them to put an IV feed line in and send you home with the solution?? I have NO idea if this is possible , but if so at least that way she could be home with you overnite and you could monitor her in more peaceful surroundings.
 
Tuxedo Mom said:
Is it possible for them to put an IV feed line in and send you home with the solution?? I have NO idea if this is possible , but if so at least that way she could be home with you overnite and you could monitor her in more peaceful surroundings.
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If they won't let her give subq fluids at home, I'm thinking there is no way they'll send her home with an IV line. It can be too dangerous.

To give IV fluids at home, she would have to be caged and you can get fluid buildup at the insertion site. I wouldn't do IV fluids at home.
 
Spoke too soon; she ate the gravy under her own steam but I had to mash up the meat and gravy and hand feed to get her to eat a bit of meat. Purred while eating, and only a minor grumble just after she had the food. Managed to get 15g into her. She would have eaten more gravy but I want to keep the feeds small so as not to make things worse.

Would gravy be enough to keep her going overnight in terms of emergency nutrition? (if she'll eat anything at the vets?).

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jacereske said:
Dehydration and electrolyte imbalance are very common with pancreatitis so IV fluids are a pretty standard part of the treatment. If you are worried about her staying overnight, is it possible to take her in for some fluids and bring her home instead of leaving her overnight?
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A good idea in principle but there's one major advantage about her being in hospital because they could give her pain meds through the IV as well as the necessary fluids.


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