Help please - Newkitty update & ?s about sub-q

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allie and newkitty

allie and newkitty

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Newkitty is fighting a kidney infection & CRF (stage 2), plus she has chronic pancreatitis, diabetes (currently OTJ but rising), and IBD. We found out about the kidney infection last Thursday via bloodwork & urinalysis, which was sent off for culture and all that. We are still waiting to hear about the best antibiotic, but today we heard it is e coli! :(

In the meantime, we've been using Baytril and giving her fluids to flush out the kidneys. Also I gave her some Cerenia yesterday and a Buprenex shot. This seemed to help. She is walking with her back arched and a waddle, probably because her kidneys hurt. :( She is also not grooming after meals like normal. She is eating today, thanks to cyproheptadine. However, she has been vocal and wants company and responds when you talk to her and rubs her face and wallows, you know the kitty drill. I am just really worried. I don't know how long it takes to start feeling better from a kidney infection--she has only had cystitis before. Last week her only symptoms were really PU/PD and not being 100% Newkitty, seeming tired. This week she really is noticeably off. :(

My question, we were supposed to do 200ml Thursday, Friday and Saturday, and last night and Wednesday. Last night when we looked at the bag we realized we had only done 150 ml the last two times. Do you think it is ok for me to give her 50 or 100 ml tonight rather than short-dose her (for lack of a better word)?

And I have a Terumo needle someone sent me back in 2005 during a panc attack. Is it ok to use it? It is still in the plastic bubble thing.
 
In the meantime, we've been using Baytril

Baytril can make some kitties nauseated -- is that the reason for the cerenia or did it start before that w/ the infection?
Bup only yesterday? is she still acting in pain? If so, I would talk to vet about ongoing pain management.
Rule is -- if it's something that would cause a human to hurt, kitties are in pain too. they just hide it better.
(which i'm sure you know from CP management)

Eating is a good sign even though it is cyproheptatdine induced. ;-)
and again, that med is not w/o SE's --

when was the infection dx'd? It can take a couple/ few days for the ABX to kick.
And as mentioned, baytril can also upset the tummy on some kitties.


My question, we were supposed to do 200ml Thursday, Friday and Saturday, and last night and Wednesday. Last night when we looked at the bag we realized we had only done 150 ml the last two times. Do you think it is ok for me to give her 50 or 100 ml tonight rather than short-dose her (for lack of a better word)?


Did all the fluids get absorbed ? does Newkitty have any heart problems? Does Newkitty get very stressed at being poked? If the answers are Yes, NO, No, then I would think it would be ok to give 50 tonight .
What time of day will you give them tomorrow?
What is the plan for long term fluid use for NK's CRF?
Probably waiting to see what the bw is after infection calms down..... my guess.
But me, if no other problems, I would be giving fluids daily while infection going on. ( UNLESS of course there are other mitigating health factors) Something to discuss w/ vet.
and the aforementioned ongoing pain management.

And I have a Terumo needle someone sent me back in 2005 during a panc attack. Is it ok to use it? It is still in the plastic bubble thing.[/quote]

If still sterile it's fine.
 
Allie I was just about to Pm you to ask how you and Newkitty were doing...and then I saw this post.
I know nothing at about this, and I hope I never do....But I just wanted you to know I am thinking about you and sending (((((Hugs))))) and wishing I could just make it all go AWAY!
If there's anything I can possibly do.....I'm here.
Lori
 
Lori, thank you for your kind post, I really appreciate your thoughts and prayers. Thank you!!!

Cheryl, thank you for answering, I really appreciate it. I will answer your questions below:

Let's see, she had a cardiac ultrasound in May 2008 and her heart was fine at that time. Her BP was fine in December and was fine last week. Her heart rate was tested 3 times because it was hard to find on her paw. It ranged from like 145-170 (she said the last equated to "pissed off cat.") We are not sure if all the fluids are absorbed. There is no hump but she is a fluffy girl (I don't mean fur) so I am not sure about the sides. She will not get the 200 ml tomorrow until about 6 pm.

Her bloodwork & urinalysis was done last Thursday, so almost a week. She has been on Baytril before with no nausea but of course that does not mean she is not this time. She was off her food some for about a week prior. Her cypro dose is TINY, like I scrape a knife against the pill like a coke dealer and get a tiny chunklet, twice a day. It is very very effective in her. 1/4 tab makes her way hyper.

Bup only yesterday. She has been lying down all day and sleeping. When she walks her back is slightly humped and she waddles. (She does have luxating patellas but her walk is more unusual this week). When she is sitting up, she shifts slightly at the hips, then again, then again, looks like she is trying to get comfortable. I do have 2 more Bup shots. If that sounds like pain to you.

As for plan, just like you said, her Creat was 1.2 in December and her BUN has ridden around 30-32 for almost 2 years, in either Oct or Dec it got up to 37. Now her BUN is 61 and her CRE is 2.3, so that is double. She wants to see what will happen with these numbers with the infection controlled.

I am really really worried about resistant e coli because her immune system is suppressed due to a high dose of pred that is ongoing for chronic panc (we have tried to withdraw her or decrease her dose numerous times to failure, I know it's bad). I am having some anxiety, you can probably tell, sorry.

Thank you thank you thank you for posting.
 
Heck, Allie, her numbers aren't bad as far as the creat and BUN. My B.K., age unknown but elderly, has hyper-T, is on bp meds and I'm thankful we can keep her creat at 4.1. We got it down to that after 3 days of IV and now 75mls a day of fluids. Heart problem keeps it from being more than 75 mls. Her potassium is off a little and now her phos. is up so she is on Atenolol, Amlodipine, Tapazole, binders, and Tumil K plus fluids. She eats, she sleeps, she walks around and is very vocal mainly because her hearing is mostly gone but overall she is doing fine.

Now........200mls at a time is, IMHO, too much. I would at least split it and give her 100 in the a.m. and 100 in the p.m. I just don't see why she needs that large amount. Also, Hope was dx'd with an e-coli and culture showed sensitivity to Baytril so she was on that for a month. No problems and she cleared up. She is off insulin but on heart meds for Restrictive Cardiomyopathy and her e-coli never seemed to show signs of bothering her. You can actually do harm with giving too much at one time when it comes to fluids. Even when BigGuy(GA) was dealing with bad CRF the Critical Care Vet would not go over 150mls a day.
 
Hope wrote:
Now........200mls at a time is, IMHO, too much. I would at least split it and give her 100 in the a.m. and 100 in the p.m.

I do agree w/ Hope that 200 is a lot to give at one time and the dose should be split.
My bad for missing that in my previous post to you . :oops: I gave Winnie 200ml per day (split dose) w/ her severe CP, along a myriad of other issues . she sucked fluids up like crazy. never had any problems. ECID.
Since you are now on 200 every other day , you might want to try 100/day instead.

Thing is to make sure whatever is given gets absorbed and how fast. You can feel the squishy pouch after you give the fluids. They may drop to leg or belly . Try to keep an eye on it.

Allie wrote:
Bup only yesterday. She has been lying down all day and sleeping. When she walks her back is slightly humped and she waddles. (She does have luxating patellas but her walk is more unusual this week). When she is sitting up, she shifts slightly at the hips, then again, then again, looks like she is trying to get comfortable. I do have 2 more Bup shots. If that sounds like pain to you.


Winnie had hip dysplasia and civie Wolf later in life had arthritis ( ok winnie too ) . that weight shifting when sitting was part of getting the joints comfy for my kitties. Is she jumping as usual ?
When did this start?
It could be that it is unrelated to the infection and that newkitty is getting some arthritis. And since at the vets recently and assume in carrier(?) that moving around can sometimes irritate those issues.
so yes that would be pain. Dasequin or Cosequin would help that for long term. Short term, you would have to make the call on the Bup. I would check w/ your vet -- cause of course I am not one and I am not there to see what Newkitty is doing ;-)

I am really really worried about resistant e coli because her immune system is suppressed due to a high dose of pred that is ongoing for chronic panc (we have tried to withdraw her or decrease her dose numerous times to failure, I know it's bad). I am having some anxiety, you can probably tell, sorry.

Winnie was on long term roids too ( 5 yrs of dex) and got UTIs on a regular basis. But the ABX always worked.
Do to the roid and FD we always treated w/ ABX for 3-4 weeks min. Then did a follow up culture to confirm the infection was gone.
Do you have routine C&S done ? roids can mask infection (no symptoms) and so they can often only be picked up on culture. Of course the earlier treatment the better. Some recommend C & S done for cats on long term roids every 4 mo.

Keep us posted !
And yes, as Hope pointed out. Numbers not that bad . I bet they go down quite a bit when the infection
clears. Winnie's numbers would go up w/ CP flares. Inflammation like company .

ps did you see earlier I left you links and other CRF info on your other thread. saw that one first
 
Allie I have no experience to share but want you to know I'm keeping you and your baby in my prayers. I just love Newkitty's name . Seems like I always have one around here...
jeanne
 
Thank you, Jeanne!!! We originally argued about what to name her and so the vet's office just wrote Newkitty on the chart. It just stuck. Thank you for praying for her.

Hey Cheryl. Thank you so much for taking the time to post on my thread. I did see the links you sent me, thank you. I am bookmarking and reading like crazy. I find I have to read some sites more than once because it is all sinking in slowly and has more relevance as I learn more if that makes sense.


Cheryl, thanks for the info on the fluids. I have not seen the pouch migrate this time (I have seen it before though so I know what it looks like) but I have my eyes out. The fluids are also sodium hydrochloride rather than LRS, which is what I have been given previously. I have looked on Tanya's site and from the description still don't know why I was given that instead of LRS except maybe because her potassium is fine now and maybe the saline is good for flushing infection? But I could not find anything that said it was... I will have to ask her tomorrow why...

She is also not pooping as well as I would like, generally she is at least once a day and she hasn't since Monday.

Newkitty had xrays in December for bowlegged walking because I suspected dysplasia. She did not see evidence of that but did find the trick knees and arthritis there. She prefers kitty stairs--and over the past few weeks all she generally has to do is look at something or cry and I pick her up. She does not like to climb human stairs at all--she can and does sometimes but only when I am not there and not often.

She gets a full capsule of Dasaquin 2x a day.

Thanks for the info about Winnie being a roidy-cat & ABXs still doing well. That is encouraging. I cannot remember the last time they did a culture--I think it was due to cystitis and so that has been about 3 years. I did not realize this, so I will now be catching urine every 3-4 months!!! I wish I had known that in December when we went! (We do full bloodwork every 6 months and sooner if she gets sick in between, like this time).

I hope you are right about the CRF numbers improving. Her liver values have always flared with a CP attack but her kidney values always looked good. BUN has been 30 or above for awhile but her CRE has usually been like 1.2, 1.3. This time most of her liver values looked better than they have in ages (*anti-jinx*) but her AMY was like 1200. It was 900 in June of last year with a stomach virus but I don't recall it being elevated before that.

YES, I saw the other links thanks so much. I have been reading and rereading because some of it is going over my head until I come here and see something else and then it's like a light bulb comes on. So much to learn! I am just grateful there is so much out there. THANK YOU.
 
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