08/26 Fistuk, AMPS 358

I would ask them to check the electrolytes in the blood. They are what gets out of balance with DKA. And check for blood ketones
If they do a full blood count that will incorporate it.
And take some higher carb food with you in case you need it as well as the normal low carb.
How does he seem this morning?
Alert? not lethargic?
 
Bron and Sheba (GA) said:
I would ask them to check the electrolytes in the blood. They are what gets out of balance with DKA. And check for blood ketones
If they do a full blood count that will incorporate it.
And take some higher carb food with you in case you need it as well as the normal low carb.
How does he seem this morning?
Alert? not lethargic?
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I just left him. With food for +2 and asked they measure his BG at +2. I’m suppose to come back with other types of food just in case he’s not eating, to being his fav so I’ll grab some high card too

I asked them to take blood test that’s relevant to keton situation including electrolytes so hopefully they’ll know what’s needed.

he was in good energy. Honestly we had such a rough night with me chasing him with the subQ that he wanted to catch up with sleep but he woke up happily for BF and ate some. He protested in the way to the vet so I know he’s got fight in him. He wasn’t lethargic but I could see the change in his back legs and hips that began to feel more heavy and out of strength
 
You did the right thing taking him to the vet to get fluids and blood tests. Ketones can escalate quickly if not treated. Once they get past a certain level, you need to take the cat to the vet for treatments which can't be done at home. It is much better all round to take them sooner rather than later in that situation.
 
Bron and Sheba (GA) said:
You did the right thing taking him to the vet to get fluids and blood tests. Ketones can escalate quickly if not treated. Once they get past a certain level, you need to take the cat to the vet for treatments which can't be done at home. It is much better all round to take them sooner rather than later in that situation.
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Thanks! Yes I agree. I could have probably taken him yesterday. But I agree there’s nothing I can do for him at home and I did injure him with the last IV so I think it’s could they check that for possible infection.
 
shellys said:
Thanks! Yes I agree. I could have probably taken him yesterday. But I agree there’s nothing I can do for him at home and I did injure him with the last IV so I think it’s could they check that for possible infection.
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If you had a more supportive vet at er that you trusted you would have gone sooner.mthey really should have taken him in straight away, I'm glad your regular vet took him in, though saddened that they made you insist. Good Job fighting for him.

When do you expect him back?
 
Gill & George said:
If you had a more supportive vet at er that you trusted you would have gone sooner.mthey really should have taken him in straight away, I'm glad your regular vet took him in, though saddened that they made you insist. Good Job fighting for him.

When do you expect him back?
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If we’re on the subject… you know what’s worse?! All day yesterday’s when I saw traces in the test all I could see was the face of the smug, arrogant, fear monger vet that admired us gloating at me brining Fistuk in again for ketones. What an awful imprint to have from a vet. You’re right. I was just traumatised by being there and I can’t imagine what’s it like for him if that’s the way I feel.

they will squeeze him in between so they’ll give me a call when he’s ready to be picked up.

If somethings going wrong I’m not taking him to the hospital. I found two clinics with English speaking vets. They’re in Zurich city so it’s a long drive but I can bring my body back to that place.

I believe Fistuk has a strong spirit. I don’t have much experience with diabetes or ketones but I sense that once he’s cleared out these ketones, now that his body had the experience of lower number he’ll find his way back there. Just need to kick the K’a out of the way
 
I would ask the vet for some antinausea medications such as cerenia or ondansetron in case you need it once home.
I would also make sure you have supplies of sub Q fluids moving forward and I would ask the vet if he is happy for you to give some each day. I think at the moment he would benefit from daily subQ fluids.
When you get the blood test back I would ask:
If the electrolytes were normal
What the white cell count was
Were there any ketones in the blood.
Ask for a copy of the blood test results.
 
shellys said:
If somethings going wrong I’m not taking him to the hospital. I found two clinics with English speaking vets. They’re in Zurich city so it’s a long drive but I can bring my body back to that place.
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I have to travel an hour to get to a vet I truzt, takes me seriously, works with me and will see them any time of day or night. Nearest vet is 20min.
 
Bron and Sheba (GA) said:
I would ask the vet for some antinausea medications such as cerenia or ondansetron in case you need it once home.
I would also make sure you have supplies of sub Q fluids moving forward and I would ask the vet if he is happy for you to give some each day. I think at the moment he would benefit from daily subQ fluids.
When you get the blood test back I would ask:
If the electrolytes were normal
What the white cell count was
Were there any ketones in the blood.
Ask for a copy of the blood test results.
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I have some supply. And the hospital vet did suggest every day if he can take it or every other day. And the problem is that once I saw he’s getting better I didn’t give him for few days. He screams so much and it hurts me to hurt him. I’ll need the vet to guide me perhaps how to do it better. I’ve watched some YouTube videos for that. All the cats are so relaxed. But he starts growling as soon as he gets what’s coming. M thanks for the guidance on the blood test
 
The vet here said it’s not his case he doesn’t know what to do. He called the hispotal as per usual they didn’t get back to him so I’m just driving there
 
shellys said:
I have some supply. And the hospital vet did suggest every day if he can take it or every other day. And the problem is that once I saw he’s getting better I didn’t give him for few days. He screams so much and it hurts me to hurt him. I’ll need the vet to guide me perhaps how to do it better. I’ve watched some YouTube videos for that. All the cats are so relaxed. But he starts growling as soon as he gets what’s coming. M thanks for the guidance on the blood test
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What is the kind of fluids he is getting? Is it Ringers Lactate or Normal Saline? Normal Saline stings badly.
 
We’re waiting to be seen. He ate some before we left the vet in the village and hade couple of tsp now.
As soon as we got in here he pretended to be a rug :/
 
At
Bandit's Mom said:
Pet meters
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the hospital they do use pet meter. Which is where we’re now.
Just spoke to a vet. She seems much nice and positive than the ones I spoke to so far. She’s gone to consult the internal medicine doc since she already knows a Fistuk. And since he’s stable she’s not entirely sure he needs to stay here. She’ll do a blood test. I asked for white cells count. She asked if I wanted a full check up and I thought it’s a good idea since tThey’re taking blood to rule out anything else

on the whole I think he’s just tired and dying to go back home to his bed. As am I.
 
Bron and Sheba (GA) said:
I’m confused….did you leave the vets and have gone to the hospital now?
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Yes. The vet said he can’t treat Fistuk because “it’s not his case” and he didn’t know what to do. So instead of having Fistuk waiting like a veggie in his box in a room until the hospital calls the vet back I just took him to the hospital. If you wait for a call from them you can wait all day. And if Fistuk does need treatment immediately it’s a waste of precious time
 
Vet (hospital) measure keton w freestyle 6.1 & BG with AT 22.3
She made a point to say the specialist already spoke to me about the meter and bla bla bla. I said I don’t need their advice on dosing just want them to treat him for ketones.
Vet went (again) to consult with the specialist. But they’re likely to keep him here overnight on IV and check electrolytes balance.I asked that they don’t change the dose so he’s not being messed up with dosing. She said ok but also that she can’t make that decision alone. What else can I say
 
I was given two options. Either to keep him here and they’ll put IV and he’ll probably need to stay two days. And that’ll be a 1000!! Or she sends me back home with subQ and wil guide me how to do so. I fear that at home I won’t manage to give it to him. I offered to pay some bc I don’t have all the money and she’s gone to ask her supervisor what to do
If I was confident I could give him subQ I’d go home without a blink. But based on last night’s performance I’m quite hesitant
 
I’m very glad you took him back to the hospital with the blood ketones at 6.1
I think he definitely needs to stay in and get those ketones right back down again.
I hope they do a blood test soon to check the electrolytes..
 
I left our little one at the hospital. I asked that they do a blood test to check electrolytes and if there’s any infection. They’ll do a full blood work. She’ll put him on IV immediately. She’ll keep here just as needed. And I have enormous pain in my chest from stress
 
shellys said:
I left our little one at the hospital. I asked that they do a blood test to check electrolytes and if there’s any infection. They’ll do a full blood work. She’ll put him on IV immediately. She’ll keep here just as needed. And I have enormous pain in my chest from stress
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Oh poor you! it is awful having to leave him there I am sure.:bighug::bighug::bighug:
But he really does need to be there to get the treatment he needs to get those ketones kicked out of the park.
Please keep us updated. Ill be heading to bed before long but will look in first thing tomorrow to see how he is. And Bhooma will be around for several more hours if you need anything.
Try and get some good sleeps if you can while he is in the hospital so you are ready to care for him when he comes back home. We don't want you to get sick.
 
Bron and Sheba (GA) said:
Oh poor you! it is awful having to leave him there I am sure.:bighug::bighug::bighug:
But he really does need to be there to get the treatment he needs to get those ketones kicked out of the park.
Please keep us updated. Ill be heading to bed before long but will look in first thing tomorrow to see how he is. And Bhooma will be around for several more hours if you need anything.
Try and get some good sleeps if you can while he is in the hospital so you are ready to care for him when he comes back home. We don't want you to get sick.
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Thank you :bighug:
The level of care and guidance I’m receiving here is unparalleled really. I would expect to get that sense of responsibility and care from a vet but… dream on!
I’m so grateful to have found you. It meant the world to me to know I’m not alone and that you’re there waiting for an update because you really do care.

I feel good about living him there. I agree that the ketones need to be kicked out. And yes I’m heading to bed! I have a call later with a potential client which is great. We will need the money :woot:
The hospital’s policy is no news is good news so I don’t really expect to hear anything before tomorrow my noon time which about 24hoirs from now

big hug to everyone :kiss::bighug:
 
What a morning Shelly,
Bandit's Mom said:
What is the kind of fluids he is getting? Is it Ringers Lactate or Normal Saline? Normal Saline stings badly.
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Bhooma asked this might be worth doble checking

This I what tanyas ckd site has to say about Saline

Saline Solution (Sodium Chloride or NaCl) 0.9%

Saline solution (sometimes referred to in human medicine as "normal saline") may be suggested by some vets, but it tends not to be the best choice for a CKD cat because:

  • it is usually too acidic

  • it lacks the buffer contained in lactated ringers

  • it does not have added potassium, which many CKD cats need.

  • the higher sodium load is additional work for already damaged kidneys to process

  • it is not usually suitable for cats with hypertension or liver problems.

  • it can sting when injected subcutaneously which may make the cat resist sub-Qs
However, it is sometimes appropriate for:

  • cats with high calcium levels (though Normosol-R may be a better choice); or

  • cats with hyperkalaemia (high levels of potassium), who may initially be placed on intravenous sodium chloride in hospital

On the fkd site, this is what it statement iz more commonly useful, doesn't Sting

Lactated Ringers Solution (LRS)

Human patients with kidney disease are given fluids containing a buffer such as lactate, and this is also the most common choice for CKD cats. The lactate is important for CKD cats because lactate is metabolised by the liver where it is converted to bicarbonate, and this aids in the correction of mild acidosis.


Check the link above there are some other choices as well if there are calcium imbalances
With his strong reaction to the subq I'm j7st wonderingif @Bandit's Mom may have got to the bottom of the problem with fistuk hating the sibq

Hope you get some rest today.
 
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Gill & George said:
Bhooma asked this might be worth doble checking

This I what tanyas ckd site has to say about Saline
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Thanks! I read through the link Bhooma sent during the night when I couldn't sleep. At least I caught up with some important information.

I don't know really I need to ask when I pick him up. I asked to be guided in giving Sub Q so hopefully I'll be able to get answers about the type of liquid. I know that potassium was something he was low on last time he had ketones so I'll be curious to see what's the balance now.

I was thinking it might be a good time to catch up with filling in the lab results tab in the SS from the last time he was hospitalised. i hope I know how to do that, meaning interpreting the lab codes. Lets see how I get along with this. Might help in answering the question of what solution be best for him?
 
shellys said:
I was thinking it might be a good time to catch up with filling in the lab results tab in the SS from the last time he was hospitalised. i hope I know how to do that, meaning interpreting the lab codes. Lets see how I get along with this. Might help in answering the question of what solution be best for him?
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I can help you with this so you can take a break and rest. If you will PM me the labs, I can input them for you.
 
So... I know I should rest.... But.... I searched for videos about giving SubQ to cats who resist. I got to a very interesting resource about a behavioural vet who speaks about a philosophy to giving medication which is more important than any of the details such as needles etc.

I wonder what other ways exist to give Fistuk fluids rather than SubQ with needles. I know now that the way I traumatised him last night, will not happen again. I can't. My heart is simply broken from remembering how I hurt him. after he fell asleep he woke up in a startled panic and I knew it was from a nightmare. I need another way than forcing him and traumatising him. I need him to tell me yes.

I know that giving him fluids with a syringe through the mouth is something he says yes to. But it goes to the digestion so maybe it's not good enough. I don't know.


If anyone knows about other ways to get the fluids he needs into his body I'd appreciate learning.

Thank you!
 
A couple options on the subq fluids. The first is a special harness: https://www.ezivharness.com/ That will help if he gets restless. Second option, I have heard of people giving small amounts of fluids through syringes, but it would take a long time and practice to go slowly. Adding water to the food is also a good idea.

Have you seen this video on giving fluids? How to Give Subcutaneous Fluids (Video) I found it really important to get Neko used to the idea of fluids and have a relaxed place for her. I put a heat reflective pad in front of the hot air vent for her to relax on, and sprinkled freeze dried treats around for her to nibble on. I got her to relax there, and pretend poked at first. It's like BG testing, a comfy place fluids spot and getting them used to it.
 
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