06/02 J.D. PMPS 362, +2 358 gave fluids

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Dyana

Dyana

Member Since 2009
Yesterday's Condo

Last Night:
198 PMPS
213 +2.5
291 +4
388 +9

J.D. ate his 1st Breffis at AMPS and his 2nd Breffis at +2.5. I was going to try to sleep in some more, but Ginger was screaming to get outside, saying the beautiful day is awasting, so I got up and let them out. J.D. went out and had a drink from the watering can I keep filled out there for him and then came in and is currently laying in his bed. Ginger probably sat on the porch waiting for me to come join her, and then gave up and is now back inside and down in the dark basement for some reason.

I am in a quandry on whether to keep this vet appointment with J.D.'s regular vet today in an hour. I was told I could cancel it as it would snapped up. I always feel guilty keeping an appointment when there could be a bean that is desparate to have their pet seen and they say they are all booked up.
I really just want to ask him why the other vet said they have no BG measuring equipment, ask him if I can get the USG measuring test strips myself anywhere, and just kind of go over everything that I went over with the other vet on Thursday, but I really could do all this over the phone :roll: I think I'll call them and say if someone desparately needs my appointment, they can call me, otherwise I'll come in.

Ginger is now coming to me sitting at the computer and then going outside back and forth, trying to get me to join her.
I guess I better get dressed.
 
Re: 06/02 J.D. AMPS 418, +2.5 258

I understand about the appointment and maybe giving it to someone else. But maybe for your peace of mind you need to keep it. I know that via phone, my vet always seems rushed and I can't get every question answered...I think I would keep the appointment.

Pattie
 
Re: 06/02 J.D. AMPS 418, +2.5 258

(((Dyana))) That's just like you....to be thinking of someone else's needs ......as usual....
Special hugs to you today Dyana. You are so sweet! :YMHUG: :YMHUG: :YMHUG:

I wish you well in whatever you finally decide. If you do go in or at least speak to someone, your questions will be answered. I hope. (sometimes we end up up with even more questions though, right?)

Glad to see that J.D. brought himself down to the yellow at +2.5. And that he ate even his second breffis too!!
Sending more vines for continued healing.....hope you all have a good day today....HUGS!
 
Re: 06/02 J.D. AMPS 418, +2.5 258

It would be nice to get a blood pressure done, but I don't think it's critical right now. Since J.D. gets a bit stressed at the vet, they should do it with you present to calm him. It will still probably be higher at the vet than at home. If you want question answered about where his kidney disease stands, about his pancreatitis, whether to continue giving fluids in the future, and how to manage his inappetance, you may as well go in. Ask about get an Rx for Cerenia to have on hand for when he has bad days. I don't think that the vet saying every symptom he has is just caused by diabetes. I don't think a visit today is essential, but if it helps your peace of mind it is worth it.
 
Re: 06/02 J.D. AMPS 418, +2.5 258

We went.
J.D. peed a little in his carrier on the way over, and pooed on the exam table after a thorough proding by the vet.

He said the BUN may indicate some stress to the kidneys, but the Creatinine is within the normal range, and his phophorus is fine. He said that J.D. may be heading toward having a kidney problem, but he is okay, now.

I asked if there was any other blood work that was off and he said no (besides the glucose).

I always ask for a copy of the bloodwork, and am looking at it now and the B/C RATIO is 30.5 and says H
but there is no reference range. I guess I don't have to worry about this, because J.D.'s vet did not mention it.

I asked about the blood pressure measuring and he kind of shook his head and said that he listened to his heart and the heart rate was fine. 140 is what he said.

Lets see, I told him I was told (by the other vet we saw on Thursday) that I could use the needle twice, and he said, no use a new needle each time, and change to a new needle immediately after giving fluids.
He said that bacteria? or something bad like that, can travel up the line, if I don't.
I told him that I not only did not change to a new needle last night, but that the old needle had been on the line ever since Thursday, when he got the original fluids by the other vet.


He said I should try for 150ml every other day, and see if his drinking water doesn't taper off.


He said the excessive drinking is probably from the diabetes. I won't get into his constantly trying to get me to switch to PZI.


I asked about a prescription for the fluids, lines, and needles, and he said I could get them there, but if I wanted to get them elsewhere, then I would need a prescription. But, he said they don't charge that much for them.
The vet asked me if I wanted to get another bag of fluids, and I said yes, and some more needles, to please.

When I was paying for everything, I asked if they had the smaller sized needles, and was able to get the 20 gauge instead of the 18 gauge.


The vet closes at 12:00pm and I was pulling into my home parking spot at 11:31am after returning with J.D., and thought all of a sudden that I should probably call them and see if I can go back and get a new line (thinking about how the vet said the bacteria or bad stuff can go up the line from the used needle. So, I ended up being a PIA and bringing them the already slightly used bag and asking them to install a new line with a new needle :).


We're home now. Sorry to be a flake, but I'm going to spend some time outside with J.D. and Ginger for a bit.
 
Re: 06/02 J.D. AMPS 418, +2.5 258, +4.25 193, +6.25 229

I leave my bags hang on the ceiling fan. I use the same line 6 times (6 bags)and then change it.. I do not always put a new needle on after giving fluids. I should but have not and (knock wood) all has been fine. I will start doing that though.
you are doing fine. I could probably give cal 150cc but twinkie can only handle 100cc right now. sometimes they get restless or just cannot handle the bump. don't know but I give what I can give. you can try 75 every day if do not want to load up all in one day
 
Re: 06/02 J.D. AMPS 418, +2.5 258, +4.25 193, +6.25 229

Dyana, looks like you have had a pretty eventful day already! Do you have a Walgreens where you live? I order Cleo's bags from there and get 12 bags of Lactated Ringers Solution for $22.00/case. It costs me $8.00 for one bag at the vet. The only thing you have to pay extra for at walgreens is a drug membership -- $20.00/year. That gives you the good price.

I first started giving Cleo fluids every other day, but from what I understand it is better to give every day. We shouldn't skip drinking water every day so our kitties should get the fluids each day if they need them. You could give 75 ml every day and that would probably be better than skipping. Marje and Claudia are the experts to ask about fluids if you need great advice. I use a new needle every time and make sure I take off the old one each time, but I use the same line for 2 bags of fluids.

Good luck with everything and remember to relax and breathe!
 
Re: 06/02 J.D. PMPS 362

I don't know if this is the right thing to do, but I gave J.D. a TOR, again, hoping to get his numbers down to where the Levemir can work with them. I also have been adding a bit of a fat to his dose for the past couple cycles, so I updated his ss. He had lots of bits of steak slices today. When I was getting his insulin out, he raided the frig and took the steak out himself. I wanted to grab my camera. He ate all his 1st Dinner, and is now laying in his bed where he spent most of his day. We did go for a couple small walks, but mostly J.D. just wants to lay in his bed.
I'll try to give him 75mls of fluids tonight sometime with the new 20 gauge needles and see how that goes.
 
Re: 06/02 J.D. PMPS 362

(((((((((hugs)))))))))))Dyana and J.D. you are doing fine. Always remember to be patient with yourself too.
 
Re: 06/02 J.D. PMPS 362

He said I should try for 150ml every other day, and see if his drinking water doesn't taper off.
Click to expand...

How does J.D. handle getting fluids? I hear its best to split this dose into 75 daily instead of every other day. Have you read up on making sure fluids are all absorbed before giving new fluids? When Maverick had his feeding tube he would get super stressed out with feedings at first. But we got advice on how to make it a bonding experience and to keep him calm. He had to be still for about 20 minutes five to six times a day. I sang to him (Momma Cass - Dream a little Dream), told him tons how beeeeeuuuuuuuuutiful he was, brushed him - he loved this, petted him etc. He actually changed from a very independent cat to a cuddley suck after ten weeks with his tube.
 
Re: 06/02 J.D. PMPS 362

The B/C ratio is the Bun/Creatinine ratio. I am not really familiar with how to interpret it, but I came across this excerpt, and I thought it was funny:

However, elevated BUN:Cr ratios are not observed when other high protein loads (e.g., steak) are consumed.

Website: http://en.wikipedia.org/wiki/BUN-to-creatinine_ratio

I agree with others who have suggested giving the smaller amount of fluids daily. My vet instructed me to use one line for two bags and then change it. I changed the needle every time, and my habit was to remove the used needle and to put the bag away with a fresh needle on it, ready to use the next time.
 
Hey Dyana,
Just checking in to see how J.D. is doing and how you are doing with the fluids. It sounds like you are getting good advice from everyone. There sure are a lot of little things to learn--the type of things that vets don't bother to tell you because they have known them for so long (or maybe they haven't!). Anyway, get some rest and do some things that you like to do inbetween the fluids, the shots, the feedings, etc.

Have a good evening,
Hugs,

Ella & Rusty
 
I feel like I'm all me me me lately, and posting more in my own condo, than others, and I feel bad about that.

Linda, did you really meet with Roni today? :-D
Thanks for the link. I had to search for the steak part. I thought you were just inserting the (e.g. steak) part, when I couldn't find it at first. But the links scares me when it talks about Gastrointestinal bleeding. I don't know enough medical lingo to know what it's talking about.

The R didn't seem to do a lot, but maybe it did head off a bigger bounce. So, because he was the same, I decided it was time to give the fluids. The bag now had fluids to about the 4.25 area (after the vet inserted a new line for me), and so I used a marking pen to mark the 5 line. Well, I guess sitting way down on the ground and looking up, makes an illusion, because when I thought I saw the fluid on the marking pen mark, I shut it off (and again, it only took like 2 minutes) and when I stood, I saw the fluids in the bag are now at 4.5, so I failed :roll: I'll do better next time.
I also, had a h of a time getting the plastic cover off the new needle. I finally resorted to using my teeth.
And when I was done, and went to put the new needle on the line, there was a plastic cover on the new needle that I used my teeth to get off in order to put the new needle on the line for next time. :oops:

We just got back from a little walk, and of course J.D. was encouraged to follow me with bits of steak.

Karrie, I had the doctor show me how to check under his arms to make sure the fluids were absorbed.
Last night, he had a big ole hump on the back of his neck, and a little while later, it had move down his shoulder, and then it was gone.
When we went to the vet this morning, the doctor showed me how to feel his skin under his arms, and apparently all the fluids were gone.
Any more suggestions on how to tell if the fluids have been absorbed, are appreciated.

I'll try to work on making the fluid time a more bonding experience. Although, we already are bonded :-D

Thanks for posting in our condo, today. And, eventually, I will get back into posting to more condos.. :-|
 
Can you get strips to measure USG?

I use our saltwater tanks refractometer. If my husband knew this he'd kill me. The vet got a kick out of it. :lol: They are only 20 or 30$ online. Make sure it tests the range you are looking for.
 
Karrie and Maverick said:
Can you get strips to measure USG?

I use our saltwater tanks refractometer. If my husband knew this he'd kill me. The vet got a kick out of it. :lol: They are only 20 or 30$ online. Make sure it tests the range you are looking for.
Click to expand...
My vet said they would be expensive, and if I remember right said they wouldn't tell me much. But, I want to know.
And I saw this on Amazon Do you think they would work?
I could buy them anyway, and just test to see what I get. :smile:

Tonight, both kitties ate from J.D.'s bowl and then they both moved over to Ginger's bowl and ate from that.
Silly cats.
 
Yes, I met with Ronnie (Luna) today!

I don't think you have to worry about any GI bleeding as the vet did not make any comment about the CBC being abnormal. I think you would see some anemia with GI bleeding. You would see black, tarry stool. The ratio tells you what you already knew - the BUN was high but the creatinine was relatively normal, making the ratio high. From what I read, dehydration could contribute to that.

Other than checking for fluid pouches, I can't really suggest other ways of testing for fluid absorption. If you have a very accurate baby scale, you can weigh the kitty before/ after fluids. You can check overall hydration by twisting the scruff 90 degrees and observing if it snaps back quickly or slowly. Sometimes an over hydrated cat will have an overall squishy feel to the body. I don't think you can go wrong by giving 100 ml or less daily if heart function is normal.

I found reading the line on the bag to be very difficult. You will get the feel of what you are doing very quickly. You can keep track of how long you have used the bag. If it lasts 10 days, you have averaged 100 ml per day.

Don't worry about needing lots of input right now. Renal issues have a steep learning curve in the beginning. Soon you will be sharing your experience with others who need help with the same issues.
 
Regarding testing USG at home. I don't think it has to be tested that frequently. It doesnt fluctuate that rapidly, and it has to be evaluated in light of all of the renal indicators. I think that rechecking blood and urine on JD in about 6 months would be appropriate, unless your vet gave different instructions. A better indicator of where he stands is how he feels on a daily basis, in my opinion.
 
Linda and Bear Man said:
Regarding testing USG at home. I don't think it has to be tested that frequently. It doesnt fluctuate that rapidly, and it has to be evaluated in light of all of the renal indicators. I think that rechecking blood and urine on JD in about 6 months would be appropriate, unless your vet gave different instructions. A better indicator of where he stands is how he feels on a daily basis, in my opinion.
Click to expand...
Thanks I'll save the money. I just thought with the 1/2 gallon of water that he was drinking and the 1/2 gallon that he was peeing a day (I'm being sarcastic about the quantity), that his urine was bound to be diluted.
I cleaned the litter boxes around noon, and no cats have used them since (it's 9:14pm now). Both cats went in the woods on our walk. But, that's a lot less pee (from J.D.).
 
We didn't test often either. Maverick would have been stage 2A going into B - still concentrating urine and not needing fluids. I weighed him often on a baby scale also. USG can be affected by giving fluids, or them drinking more/peeing more. My dog was on lasix and her urine was very dilute.

This one goes from 1.0 to 1.070. http://www.amazon.com/Salinity-Refr...cale/dp/B005ES6MOQ/?tag=felinediabetesfdmb-20 I think ours goes up to 1.050 - I have to look later. But my vet said its exactly what they use there. That's why she laughed when I told her I could check at home using my husbands aquarium one. Maverick really stressed at the vets and in the car so anything I could do at home I did.

Linda knows her stuff as do others here. I know very little about kidney issues as I had just started reading up on them when I lost Maverick.
 
So, I was confused because I thought we wanted to know whether J.D. was concentrating his urine or whether it was dilute. This instrument seems to measure Salinity? Anyway, if it works and does what I want, it's a thought. Thanks!
I don't see where you put the strips :?: . You did not put your DH's fish'es instrument directly in the cat pee, did you?
Salinity Refractometer tests for concentration of urine, huh? Interesting. The things we learn.
 
Re: 06/02 J.D. PMPS 362

Dyana said:
He had lots of bits of steak slices today. When I was getting his insulin out, he raided the frig and took the steak out himself. I wanted to grab my camera.
Click to expand...

It's late, I'm tired, and the bulk of J.D.'s condo is going over my head today, but this is just so sweet and funny. As Liz said, Go J.D.!!!
 
Congrats on giving the fluids! I have lots of trouble reading the bag, too. It takes me about 2 minutes 20 seconds to give fluids, so I go by time rather than looking at the bag so much. I have a piece of music that I play when I am giving fluids and it is almost exactly as long as 2 minutes 20 seconds. When the music ends, I stop the fluids. Cleo now also knows that when the song ends, she gets a treat for being such a good girl! It might not be the most accurate or scientific way to do it, but it works for us. Cleo has a big hump afterwards, but it goes away pretty quickly. Testing for squishiness under the arms (not sure about spelling!) helps to see if it is totally absorbed.

And don't worry about visiting condos. You have tons on your plate right now and we are here to help! You are doing such a great job!
 
"getting the plastic cover off the new needle" -You turn the top of the plastic cover, dont just pull it out, The reverse force will cause you to prick your finger hard. Just use a bit of strenght, twist the top of the plastic cover as you gently pull out the needle. I did not remove the paper/plastic covering completely so as to further protect my hand. Hope that helps

'to make it a bonding time" - I found out the kitty will be alarmed when others come close when doing the sub-q. Maybe they feel they are very prone to any attack at that moment. I tried to fend off other cats when doing this, you can take JD to a seperate room where he'll feel safe. They can sense our anxiety, when you are more calm, they will be more calm.
 
Hi Dyana, thanks for visiting Simon today. I don't have much to offer in the way of advice on the health topic, but please know we're thinking about you and JD! You are taking such good care of him.
 
Don't worry about anything in LL but JD, Dyana. You give plenty of yourself to others.

Here are some of my thoughts after doing this on various cats consistently for well over two years. First, I wouldn't get too wrapped up about the USG. You have a number...it does show his urine is a bit dilute but it's ok. Once you start giving fluids every day, any USG test will show as dilute unless you stop giving them for day before you test. The blood values are really more important now. The USG you have now is just telling you that JD may start having some renal issues down the road. Like I said yesterday, I think his values look really great for a 17 year old cat. :-D

So...one thing I have to ask is why does the vet feel he needs fluids...the pancreatitis? For renal issues, one would not normally start fluids until the creat gets to about 3.5. The best way for a cat to get water is by drinking it. You can check to see if he is dehydrated....are his gums slick? When you pull up his skin around his scruff, does it pop back into place quickly? Check him against Ginger.

If you are giving fluids for pancreatitis....here is some additional info.

There should have been a little cap on the needle end of the line. You remove it to put the needle on. This is what I leave on my line in between giving fluids. I never leave a needle on my line. I am very careful with the cap to make sure it touches nothing but the line. I use one line per two bags. When you hang your bag, take the cap off of it, run a little bit of the LRS into a little glass to purge the line. Then put on the needle. Then mark your bag while you are looking straight on at it for where you want to take it down to. Once you are done giving fluids, take off the needle, purge the line again (just a small amount), put the cap back on the line, needle in sharps container.

Pretty soon, you'll it without thinking about it.

Vets typically charge a lot more for bags, lines, and needles. You can call thrivingpets and see if you need a script. I don't need one in AZ for any of it including bags.

I hope this helps.
 
You are going to pick it all up in no time Dyana, I know you are, just remember to breathe :smile:

Scritches to J.D. and Ginger and stop worrying about everyone else, your own family comes first!
 
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