DKA Cat - when to feed after anesthesia? giving fluids

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Re: Sick Cat

This isn't really an etube question but a general eating question. Can you change the subject of your condo- go to the first post and click edit. Change it to something like DKA Cat - when to feed after anesthesia. I would feed as soon as its safe to feed.

Go very slow. Make sure the food is warmed up. Be in a closed contained room or space so there isn't an urge to run/bolt. And make sure its a good experience - brush in between each push, talk to her, sing to her etc. This really is a great bonding opportunity also. 1/2cc to 1cc at a time with thirty second breaks in between. Make sure the food is a bit warm - cold food can cause them to vomit. Watch for signs she's going to vomit. Stop feeding and try again in a half hour. Regarding your discharge instructions - don't overdo the post feeding flush. six cc's of water is enough to clear the tube. if you do more, that takes up space that doesn't contain calories.
 
Re: Sick Cat

I called the ER again. These were two internal medicine daytime vets both at the ER with different instructions. They had left for the day but the tech told me to do what the second vet said and wait until morning.

All this is a lot to handle, I thought the regular insulin injections were a lot.

We need to give her the subq fluids with an IV bag and I'm unclear how to read it, I think we accidently gave her double. I'm unsure wether you are supposed to squeeze the bag to get the reading since it is floppy plastic. I asked the vet tech at the ER about the fluids also and she said the ER night doctor said not to worry and just continue with the regular schedule, I'm still worried though.
 
You just got two replies on the FAF board from two of the most knowledgeable members. Both are saying not to wait especially if she's gone without food that long. Hugs. It gets easier.
 
I would call the ER back and ask the night doctor to call me to clarify. The FAF people might be right, and I wouldn't take the chance without pushing the ER to give me a clear answer from a DOCTOR. Either that or the ER needs to call those two doctors who gave such disparate instructions, and ask them to talk to eachother, get their story straight and have someone from the ER call you. You have paid them enough money to get this right! Don't let them punt this, I say. It could mean the difference for your cat and you deserve a clear answer.
 
Elizabeth,

One of the ladies here, Marje, made a great video that shows how to administer sub-q fluids if that is what you are trying to figure out. Here is a link to it.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=75933
I gave sub-q fluids in 100ml doses to Bob many times. I used to make permanent marker marks at every 100ml line so that I could see them easier when the bag was hanging up and I was sitting on the floor with Bob. If the bag is hanging, you shouldn't need to squeeze it to figure out how much to give her. I'm not sure how many ml's you have to give per treatment, but it doesn't have to be exact. A few ml's on either side of the line is okay.

Carl
 
Hi,

I called the ER back about the differing answers again. They said we need to wait until tomorrow to feed and go with that doctor's advice, since she is the specialist. I'm not sure why but I don't want to risk making her worse. She used the litter box and there was a small bit of poo in there so I hope she's getting better.

Elizabeth
 
Elizabeth,
I wish I had the experience to advise you one way or the other. You are the only ones who can see for yourselves how she is doing. My normal advice to people who say that their gut instincts are telling them something is to go with your gut. You have gotten advice from a lot of people who have dealt with this type of situation, and everyone will try to help you out no matter what you decide.
You will be in my thoughts and prayers tonight.

Carl
 
I think she's a little better. We fed her last night and have been feeding her every six hours. I checked her BG and it was 350 last night. I had to work this morning but she's been fed through the tube during the day, 15 ml every six hours. This afternoon she went poo and actually ate a few bites of chicken on her own. However, she is still lying on the couch and not moving a lot. This morning when I went to work she ran to the front door though, so I think that's a good sign. There is one medication for liver which says to feed on an empty stomach but we're not sure if that means right before feeding or in the middle of feedings?
 
Glad to hear she's okay!!!

As far as giving medicine on an empty stomach, it depends on how quickly she is processing her food. I wouldn't want to give it immediately before feeding because it might stay in the stomach and get trapped with the food. Then it would take until the food was digested to get into the system. I think I'd try to give it sometime between 4 hours after she ate and 5 and 1/2 hours, if that's possible. If not, I would wait at least 2 and 1/2 hours after she ate last. Anyone else think these are good ideas?
 
You can feed her every three hours. I think six hours is too long between feedings if you are home. Feed often. You most likely should do more feedings over night the first week to get her out of this crisis stage. Were you given instructions to feed more food each day working up to 40mls? You have to get more food into her but you have to work up to the full amount over three days if she's been off food for a bit to avoid refeeding syndrome.

Are you feeding the maxcal? Are you monitoring for ketones?

You can put some water in the tube after an hour or so after eating to help keep her hydrated.

An empty stomach would be an hour before feeding. Denamarin can make a cat feel a bit nauseated. You still don't have nausea medication. So make sure she keeps the medication and food down.

Can you post the feeding instructions you were given?

Straining the food as I recommended will avoid clogs. They can take hours to clear and cause a lot of emotional distress. Straining food can save much needed time and energy.
 
I just discovered subscribe to thread option! Wish I had known about this before - its really helpful. I get an email when someone posts so I don't have to log in and check as frequently. I love this group. I wish there were more people like you guys in my real world :lol:
 
Right now I have two cans of the l/d food recommended by the vet. The instructions were to feed 15ml each six hours the first day, day 2 30ml, day 3 45ml, day 4 60ml. We picked up a metal strainer for the food like you recommended before we first fed her. Her BG was 140 6 hours after the insulin. She is using the litterbox and fell over a little in it.

We need to get the Maxgold but have a prescription, also taurine the ketostix and lcaurine. Does it matter if these have added inactive ingredients like eggs, starch, etc? I'm going to get all three items tonight and try petsmart to see if they have the food.
 
MaxGold is not the same as MaxCal. I'll have to look this up and see how it compares. For DKA and FHL survival its the calories that count. For highest calories MaxCal is truly a life saver and is very low carb. If you can get MaxCal please do so and do this quickly.

Most cats cannot handle a 60ml feeding and then a 6ml post flush. You may not be able to get up that high. Most cats can do a 40cc feeding with a six ml post flush. don't do preflushes with an etube. Just make sure to flush well after feeding and after adding medication to the tube. Predisolve crushed meds in a syringe of say 3cc's of water, put it in the tube and then a separate syringe of 6cc's of water to push the meds through the tube and into the stomach and to clear out the tube.
 
I keep calling it MaxGold because you said its worth its weight in gold I mean Maxcal :smile:
I didn't get any recommendation to do a preflush but to do an after flush of 10-15ml
 
I'm so glad your cat is doing a little better and you got the etube, and you have Karrie to help you.
I was thinking about you and your cat all day. Hugs to you, for taking such good care of your cat.
 
Elizabeth

You are doing great....sending many more healing vines for Priss. Please let me know if you have any questions about giving subq fluids or the video.
 
I asked about the medication recommended obstatron and the vet gave us cerenia already
 
Here she is now, the couch is her new spot.
 

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Elizabeth, she's beautiful! And after her last couple of days, she looks like she's doing well. :smile:

Carl
 
She's still pretty weak and not moving a ton but I hope that's normal after all she's been through.
 
When Bob came home from his stay at the ER, he was pretty much just a lump, and couldn't even get up on the couch. He spent most of his time for a couple of days hiding in the carrier (which he wouldn't get anywhere close to before that). He perked up a couple of days later after several sub-q fluids treatments though. He didn't look anything close to how good your girl is looking right now. (don't tell him I said that....he's pretty vain :lol: )
 
Her blood glucose is at 150 still, I just checked. The vet said to keep giving her 1 unit twice a day. It was 140 before she ate a few hours ago. Do you think we should give her half a unit? I'm worried because she is eatin 15ml at a time and should go up to 60ml which is normal.
 
Elizabeth,
The most important number you could check would be in the middle of the cycle, about six hours after her shot. It's different for every cat, but that should be when her BG is at "nadir" or its lowest point. It's the lowest point that really determines how well a dose works. The preshot tests are important as well, of course.
The risk with shooting a lower dose is the chance that ketones might resurface. Ketones can be more likely when too little food, too little insulin, and any sort of infection are all happening at the same time.
I am not a lantus user, so I can't advise on a dose adjustment. Please wait till you hear back from someone with lantus experience...
I'll try to locate someone.
Carl
 
Oh, normal BG for a kitty is between 40-120 on a human meter, so her numbers are not bad at all right now.
Carl
 
I called the ER vet and they said to wait and see if her BG rises and that we can give her 1/2 a unit instead.
It was 140 about 4 hours after her shot and 150 9 hours after.
 
Okay, good to know where those numbers are in relation to the shot. How long until the next scheduled shot?
Carl
 
Right now she is getting the food so probably about 40 minutes. I will recheck again then and see where we are, hopefully it went up. I'm scared to do anything like skipping the shots or giving her too much after all this
 
Did the ER vets give you a "don't shoot" number where you should skip the shot?
Carl
 
I called the ER and spoke to the doctor on call and she said still give the full unit since it is slow acting. She said to call back if it went to 130 before the next shot, but she thought it wouldnt since she is in the normal range.
 
Ok, let's see what Priss tells you in about 20 minutes:-)
Carl
 
I couldn't check because we're having a problem here, she has diarrhea and has gone all over the house. I put her in the bathroom but she wanted out and I'm worried it will stress her. Do you have any advise?
 
You can wait a few minutes, let her calm down and try to test her. The diarrhea is probably from the mostly liquid diet. Did they say this might happen?
Carl
 
272 so I gave her the shot. They said the diarrhea could be related to her condition. My boyfriend is freaking out about it but I already bleached the bathtub and rinsed it and I don't want to put her in there.
 
Did you give her the full 1u dose?
I'd probably freak out just a little too if Bob pooped all over the house:-)
On that list of meds, there isn't one for diarrhea, right?
On the FAF site, do you remember seeing anyone mention they'd had this problem?
 
We gave her the whole dose. I think I have to put her in the bathroom after airing it out for a while. Someone else will go pickup the medicine, night vet said it could happen because of her diabetes or liver problem. I don't think I can stay awake much longer so I think the bathroom is the best idea, I feel bad about locking her up after the kennel. It's pretty bad right after I cleaned her up she sat somewhere and there's more
 
I understand, you all have had a rough couple of days.
How long till her next feeding? If possible, try to test her just before that?
Carl
 
WE're supposed to feed her every 6 hours, so 5 am here, I'll test her before I go to sleep. The vet recommended the diarrhea medicine so we're picking that up, I feel bad giving her another medication but she is also pretty dirty. I cleaned her up twice and each time she was more messy. I saw a few comments about diarrhea but nothing specific. I guess it is better than not pooping hopefully
 
My concern with diarrhea is dehydration. The sub-q fluids should help with that.

I posted a message in the Lantus forum for people to come over here to help. Some of them should be waking up soon:-)
Carl
 
Maverick had horrible diarrhea on the zenequin antibiotic. Did they do a culture to see if this would hit the bacteria? You can add a bit of pure pumpkin in with her food. 1/2 of a teaspoon a day to start.

You have to feed more than every six hours. She is coming out of a DKA crisis and FHL takes weeks to recover from. Maverick had a PEG tube so we could tell when his stomach was empty - at the 2.5 hour mark when I checked his stomach was always empty. Every three hours is recommended. Calories are critical for her.
 
Hi, Elizabeth,

I am so sorry you are having such a tough time! Hang in there!

Help. Would you like me to come over to your house and help you? I would do that if you need me to; let you get a nap today. If my cat's BG does not get low in the next 3 hours, I can get my baby set up with her grandmother (who takes every possible opportunity to babysit) I could do that for you. I'll PM my phone number to you. (I won't be able to tell you what to do about any of this without the board, as I don't know enough, of course, but we have the board, thank goodness, and your ER vet should be answering questions continuously.)

Feeding. I would like to vote for following Karrie's advice to feed more often than every 6 hours. I'm sorry your vet is telling you differently and trust me, I know how hard it is to hear one thing from this board and another from the vet. You could ask the vet if it would hurt to feed more often, and he'll probably say no. In that case, I would definitely error on the side of caution and feed more often.

Insulin. I can't tell you anything about dose, but someone else here will help you with it. It is very tricky in this situation. You are absolutely right to be concerned about giving too much, as well as, giving too little considering the ketones. My best recommendation would be to test her often and put your numbers here in a post like this example:

AMPS 245
+3 300
+6 149
+11 190
PMPS 200

Diarrhea. This may be completely unnecesssary, but I would like to caution you about something that must be very tempting: giving her a bath. Please don't. It's okay to clean her up a little with wet paper towels, but a full bath is unfortunately out of the question. I doubt you are even considering it given the feeding tube being there, but just in case. When my cat came home from ICU, he was absolutely filthy, but bathing a cat is so stressful that it can't be done when they are sick. I had to just put up with the issue until he was better. (In fact, the only time I've ever bathed him was when he came in the house smelling like a strange chemical. The vet said to do it, of course.)

Dale
 
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