Hi Robyn! I watched your video of Penny (for those with access on Facebook, here is the link:
https://www.facebook.com/robynhw/vi...5828802500630/?type=2&theater¬if_t=mention). She looks good! Bright eyed, etc.
You had asked earlier about the needle gauge when giving subQ fluids. 18g I believe is the standard that a vet's office gives you with a bag of fluids, and it *is* a kitty harpoon. I always used Terumo ultra-thin wall (UTW) 21g needles. I ordered them, along with Lactated Ringers Solution a case at a time from Thriving Pets. Depending on your state, you will likely need a veterinary prescription for the fluids. But just for comparison's sake, My vet was charging me like $28 for a bag of fluids, an IV admin set (the tube that you spike into the fluids and put the needle on the other end), and 10 needles. Ordering them in bulk from Thriving Pets - 12 bags of fluids, 12 IV admin sets, and 100 Terumo UTW 21g needles brought that cost down to about $6.50 for the same stuff. But back to the needles - the higher the gauge, the smaller the hole in the needle, the slower the fluids go. So it's a trade-off. If she'll sit still while getting fluids, you can go with the more slender needle. Another trick we always used was to keep the needles themselves in the freezer, which seemed to lessen the pinch when inserting it. We also warmed our fluids. Because I was afraid to overheat them in the microwave, I would always just use a big spaghetti pot of hot water, and I would put the fluid bag in that pot of hot tap water (with the end where the spike from the tube that goes into the bag UP and not in the water itself) and leave it for about 5-10 minutes so that it was warmed to roomish-temperature. I would then "bleed" the line - let the colder fluids in the line drain out onto my wrist - to ensure the temperature wasn't too hot or too cold. So that's one thing.
Another thing I'm still stuck on with your Penny is how fast her kidney values ascended since totally normal bloodwork in June of 2015. *Chronic* kidney insufficiency generally onsets slowly. Of course, every cat is different - but going from "I'm normal" to "My creatinine is 11" in an 8 month period just seems more of an acute onset logically speaking, especially given her overall body condition and the demeanor you describe prior to the dental/eating crisis. An acute onset can be caused by a lot of things - infection, sudden serious dehydration, ingesting any kind of an NSAID (ibuprofen, naproxyn sodium etc.), and even ingesting lilies, which are also nephro-toxic. Let me ask: was penny at ANY point on Metacam (meloxicam) oral for either her teeth or her arthritis? Metacam is an NSAID - and it has been known to drive cats into acute onset kidney failure with greater frequency than I think most people are aware.
So, I really, really want you to have a conversation with your vet about acute vs. chronic, and even acute episode over milder chronic kidney insufficiency. The treatment routes are essentially the same, but you'll want to be rechecking bloodwork a lot more frequently than you might otherwise (every two weeks initially) and adjust treatments, particularly subQ fluids, if her kidney values come down. Another reply in this thread referenced needing to post ALL of the bloodwork to the CRF group - I concur with that. It's helpful to see Penny's creatinine, phosphorus and BUN, but there are a whole bunch of other values that kidney cat parents want to see to gauge overall condition. Calcium, ALT, ALP, RBG, HCT or PCV, potassium, TP - all of that is informative even if within normal range when taken into the big picture consideration. So, if you've joined the CRF group, get a hard copy of Penny's FULL laborwork results and provide them to the CRF list with normal ranges included for reference (because lab reference ranges can vary). Be sure you post all results, not just those outside of normal range. For as long as you are managing kidney issues, you'll want to do this.
Finally - how much is she eating today compared to "normal"?
