4/25 Barsa AMPS 21.4 (385)

[Vintry]

Yesterday's: http://www.felinediabetes.com/FDMB/...stion-again-less-is-more.136698/#post-1410904

How many ml of subq fluids were you giving daily? I haven't heard that you can only give it for 4 days straight.

@julie & punkin (ga) The doctor told me that I'll flush out the good stuff too if I overdo it with fluids. Hence 3-4 days in a row, not more. Another reason being that this electrolyte fluids bag is only good for 3-4 days. That is what he told me. I draw liquid straight from bag to syringe (no line).

With your new meter, the nadirs are basically over 300, so you could've increased by 0.5u.

That's exactly what I thought - why have I only increased by 0.25? But I guess I got confused a little bit by that 229 number. Anyways, glad I didn't wait another cycle and upped again.

 

[Marje and Gracie]

Hi Iryna

I've never heard that giving fluids more than 3-4 days in a row could flush out the "good stuff". Although my kitty that got 150 mls of fluids every day for four years had chronic kidney disease, not diabetes or ketones, there was never any mention of flushing out the good stuff. Of course.....perhaps the fluids you are giving aren't the same. Is it lactated ringer's solution?

I used the One Touch Ultra Mini for the first 1.5 years and loved it. I never used control solution on it. But I switched because it took so much blood. We decided we should get a meter that didn't need that much blood so we wouldn't have to poke so hard to get that big drop. If you are going to get an Accu Chek meter, I'd go for the Nano, not the Avviva. I believe the Nanos are more precise than the Avviva's.

I hope Barsa is doing better.....

 

[Meya14]

The vet is probably worried about altering the electrolyte balance (sodium, magnesium, potassium). Too much fluid can overwhelm the body's ability to make up for electrolyte losses. The vet probably doesn't do a lot of outpatient fluids, so is being conservative, especially if it is normal saline without added electrolytes.

 

[Vintry]

The vet is probably worried about altering the electrolyte balance (sodium, magnesium, potassium)

Yes, that is exactly it. I think he said something like that when he heard me say I syringe-feed Barsa a lot of water.

It says on the bag Ringer's Solution for infusion (sodium chloride, potassium chloride, calcium chloride dihydrate).

So you reckon it's safe to give fluids whenever she needs it? Not just 4 days and then a break..?

And is it really true the bag is only good for 3-4 days?

 

[Vintry]

I hope Barsa is doing better.....

Well, BG bounced again after it went to 218 (maybe even lower, but I didn't check). It's very high again but I'm glad that she at least had a short break.

 

[Meya14]

Honestly, with the ketones + fluids + increased insulin, she is at risk for electrolyte imbalance so I'd be asking the vet for every other week labs until I know they are in normal range for a couple weeks or she stabilizes. The diarrhea can be a symptom of electrolyte problems. I think someone mentioned distilled water for supplementing her in another thread, that is a very quick way to upset the electrolytes as well, so it's not recommended that people EVER drink this type of water. Same goes for cats.

If she's not having ketones on a particular day, you really don't need the fluids that day (if she's eating). Since you are doing a good job raising the dose quickly, you should (hopefully) be seeing less and less of them.

My vet said 5 days with the bags. The issue with the bags is that every time you poke the bag you introduce bacteria that can grow within the solution.

 

[Vintry]

All right, thanks for that information! What I do and it works miracles for getting ketones flushed out is this. Subq fluids - 40ml per day when she has high sugar. But when I don't have the bag, then just giving her plenty of water every hour but it's exhausting because I have to get up in the night too. Plus enough food of course. If no ketones then no fluids and I get some me time. So points left to cover are 1) find correct insulin dose that does the job and 2) take care of loose stools. Fortiflora hasn't helped yet. Maybe pumpkin will. If not, then consult with my vet.

Last time you guys gave me so much information about thyroidism tests and short-acting insulin. I printed it all out but the doctor didn't even want to have a look at it. He probably thinks that he knows what he's doing but I'm telling him what to do (which I wasn't!). I was trying hard to avoid making it look like that but it still happened.

 

[Meya14]

Well, there's always differing opinions, and sometimes the vet won't feel comfortable starting a treatment that might have serious consequences if not done properly (like short acting insulin - which is high risk). The vet doesn't know every persons level of knowledge or care they are able to give so I'm sure most vets chose to "play it safe".

It's a relationship that has to develop as you both get to know and trust each other. Sometimes, though, it never happens and you gotta look for a new vet. Some vets level of comfort with diabetes is better than others too. You are on the right track with things though.