4/13 Rex AMPS 483, +2.5 467 +6 342

[RichNW & Rex]

Hello LL,

Thanks again for visiting Rex's condo - Carla, Dyana, Wendy, & Marje.

I increase Rex's insulin to start working on hi BG again (I was so worried about dealing with his BG is he was not eating)
Problem solved now that I know how to assist feed if I have to. So we have two battle fronts - BG and Kidney.

Amazing what 1 day of assisted feeding did for Rex. He is looking, responding and acting like his old self.

Happy Sunday
Rich & Rex

Rex's 4/12 Condo

 

[Tricia Cinco(GA) & Harvey]

I like that subject line much better than yesterday's. Poor Rex. If only you could explain to him why it is so important that he eat, and that the fact that you got food into him is what is making him feel better. Where the heck is Dr. Doolittle when we need him?

Sending tons of good appy vines. Have a great day, Rich!

 

[Marje and Gracie]

Fantastic!!!!

Sorry I didn't respond last night about the Normosol but here's why I would give LRS over Normosol:

From Tanya's on subq fluid types:

Human patients with kidney disease are given solutions containing a buffer such as lactate known as Lactated Ringers Solution (LRS), and this is also the most common choice for cats given sub-Qs. The lactate in LRS 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; However, LRS may not be the best choice for cats with cancers such as lymphoma, which can cause lactate to accumulate.

The bold is mine because it's a very, very important point. CKD cats can be prone to metabolic acidosis (which is different than diabetic ketoacidosis). I think using LRS was a contributing factor to why I never had to deal with metabolic acidosis in Gus.

And from Tanya's regarding Normosol:

This is a type of fluid which is sometimes used instead of Lactated Ringers when a cat has high calcium levels, liver problems or lymphoma (a form of cancer). Normosol-R is the most commonly prescribed, but you may also be offered PlasmaLyte A, or occasionally Isolyte-S. They are all basically the same type of fluid, but different manufacturers use different trade names. If you are using Normosol, you need Normosol-R, not Normosol-M: the latter contains dextrose. There are two versions of Normosol-R, one with a pH of 6.6 (similar to LRS, which has a pH of 6.5) and one with a pH of 7.4. PlasmaLyte A aso has a pH of 7.4. For cats with high calcium levels, the more alkaline varieties (pH of 7.4) may be a better choice.

These products contain magnesium, so may not be suitable if your cat has high magnesium levels; they also seem to sting some cats or make them twitch when the fluids are administered (see Symptoms for other possible causes of more frequent twitching), so cats may resist being given this type of fluid. A lot of vets don't seem to be aware of this possibility. There have also been quite a few reports of cats vomiting after being given this type of fluid. All of these products are also more expensive than Lactated Ringers and may be harder to find. I therefore recommend that, if at all possible, you should use lactated ringers instead.

I know Rex's calcium level is good now but CKD cats "can" be prone to increased calcium and you have to watch that closely. Normosol doesn't increase calcium; but IF his Ca levels were to increase due to CKD, it would be another reason to not give Normosol. I don't remember what Rex's Mg was but it didn't jump out at me so I'm assuming it was normal.

The caveat is that LRS has been at a shortage lately. You are also paying a ton of extra money to get subqs from the vet. IMHO, I'd call around to Walgreens, Target, Costco, CVS, and find out who can get LRS and what it costs. Then I'd get a prescription for LRS and switch him over. Before the shortage, I was able to buy a case of 12-1000ml bags of LRS from Walgreens for $22.98. I recently checked and the current price for Hospira LRS was about $40. Still much cheaper than the vet.

 

[RichNW & Rex]

Rex is still doing good - He is now follow us to the couch and very talkative.

I have started reading up on Tanya's site and also found the details on Lactated Ringer Solution.
Marje you are awesome with the research!

Rex's Magnesium was 1.9 - right in the middle of desirable range. Will check on his new blood work on Monday.

And I will definitely get his switched over to Lactated Ringer fluids. Also from another source than the Vet to help safe on cost.

@Tricia - Thanks for stopping by - He is definitely feeling better today.

~R&R