Pumpkin pt3 - archive

Pumpkin and Jack

Pumpkin and Jack

Member
Thread was getting long so starting another.

Pumpkin is starting a medication to support her liver that requires an empty stomach. I neglected to ask how long she needs to be withheld from food or medicine to be considered on an "empty stomach". I'm hoping an hour after meds is sufficient as I just gave her Ondansetron forgetting that Denosyl requires an empty stomach and also needs to be given an hour before a meal. She is walking around the house waiting for me to feed her right now. :S
 
Suzanne & Darcy said:
Good. At least you got something. Same SAMe ingredient but Denamarin has an extra ingredient that is good, but the SAMe is very important.
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I know Denosyl isn't identical to Denamarin but are you familiar with having to give meds on an empty stomach? Hope I didn't just massively screw up here.
 
Pumpkin and Jack said:
I know Denosyl isn't identical to Denamarin but are you familiar with having to give meds on an empty stomach? Hope I didn't just massively screw up here.
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I honestly never gave Denamarin to my cats on an empty stomach. Besides, that’s going to be really difficult to do with a diabetic cat. I always gave it with a small amount of food … even a teaspoon or so. I still had good results with the Denamarin. I NEVER “dry pill” a cat. I’ve seen cats with esophageal damage from being given pills with no food or water. At minimum, water must be syringed in as a chaser.
 
Suzanne & Darcy said:
I honestly never gave Denamarin to my cats on an empty stomach. Besides, that’s going to be really difficult to do with a diabetic cat. I always gave it with a small amount of food … even a teaspoon or so. I still had good results with the Denamarin. I NEVER “dry pill” a cat. I’ve seen cats with esophageal damage from being given pills with no food or water. At minimum, water must be syringed in as a chaser.
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I will definitely be giving water as a chaser at the minimum. I tried making little meatballs like a pill pocket to make pilling slightly more pleasant but I wound up with a dissolved tablet in food she didn't want to swallow so I stopped doing that. I might try to use churu sticks as a reward after for the other pills so she can have something fluid soothe her throat after. I can't imagine it feels good swallowing all these pills.
 
Pumpkin and Jack said:
I will definitely be giving water as a chaser at the minimum. I tried making little meatballs like a pill pocket to make pilling slightly more pleasant but I wound up with a dissolved tablet in food she didn't want to swallow so I stopped doing that. I might try to use churu sticks as a reward after for the other pills so she can have something fluid soothe her throat after. I can't imagine it feels good swallowing all these pills.
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Yes. That’s another reason I use the gelcaps. You can put them into a pill pocket or some other meatball of your own making and if the cat eats around it and spits it out, your meds are still intact and you just stick it into a fresh gelatin capsule and try again.
 
I never use the harpoons (IV needles) they give you at the vet for giving sub-q fluids. They’re generally huge and not that sharp. The largest gauge I will use for fluids is a 19, but generally I use the smaller 20 gauge. I purchase the sharpest needles available, which are Terumo thin walled needles (usually from Thriving Pets). The thin walled needles allow for a fast flow rate with a smaller needle. It’s something to think about if you need to give fluids beyond a week or so. You could also ask them to give you a smaller gauge needle. I find the MonoJect needles to be not sharp at all. I have to use much more force to insert the needle.

Also, hang the bag up as high as you can and still be able to reach Pumpkin. Warm the fluid bag in hot water for a while before giving the fluids. Mix it up a bit by tipping the bag back and forth before hanging the bag. Keep the cord and any connections out of the water. It’s just the bag that can be placed upright in a bowl of hot water to warm it. This can really make the fluid administration more comfortable for your cat as Pumpkin’s body temperature should be around 99-100 or so degrees and that is a lot warmer than room temperature so the fluids feel cold going in. Be sure to run the cold fluids out of the tubing until you feel the warmer fluids flowing out onto your inner wrist or hand.
 
Suzanne & Darcy said:
I never use the harpoons (IV needles) they give you at the vet for giving sub-q fluids. They’re generally huge and not that sharp. The largest gauge I will use for fluids is a 19, but generally I use the smaller 20 gauge. I purchase the sharpest needles available, which are Terumo thin walled needles (usually from Thriving Pets). The thin walled needles allow for a fast flow rate with a smaller needle. It’s something to think about if you need to give fluids beyond a week or so. You could also ask them to give you a smaller gauge needle. I find the MonoJect needles to be not sharp at all. I have to use much more force to insert the needle.

Also, hang the bag up as high as you can and still be able to reach Pumpkin. Warm the fluid bag in hot water for a while before giving the fluids. Mix it up a bit by tipping the bag back and forth before hanging the bag. Keep the cord and any connections out of the water. It’s just the bag that can be placed upright in a bowl of hot water to warm it. This can really make the fluid administration more comfortable for your cat as Pumpkin’s body temperature should be around 99-100 or so degrees and that is a lot warmer than room temperature so the fluids feel cold going in. Be sure to run the cold fluids out of the tubing until you feel the warmer fluids flowing out onto your inner wrist or hand.
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Someone mentioned not to microwave the line and I was so confused why they would say that in the first place but that makes so much sense! Going to go with what I have for now. The medication list is a bit overwhelming as it is. @~@
 
I'm sure if I dug a little more I'd find it somewhere else on the forum but when administering Mirataz how do you manage that and also prick the ear for tests? Do I need to prick on the outside of the ear now and keep the medication on the inner ear...? I don't have any type of wipes / alcohol pads on me but wondering if I should start using those.
 
Mirataz goes on the inner ear. The ear prick is done from the outside of the ear, although I know a few people who do get blood from the inner ear. I never wanted to flip Darcy’s ear back to try to get blood. Also, you can use one ear for the Mirataz and the other for BG tests. Alternate which ear you do for each thing on different days.
 
Go slow with the Mirt. Remember- some cats will become very restless and vocal on it if given the full dose (full 1.5 inch strip). I had one who became very aggressive and started beating up on the other cats in the household. We just needed to back off the dose a bit. Every cat is different with it though, so I always proceed with caution and see how it goes — adjusting the dose as needed.
 
Suzanne & Darcy said:
Go slow with the Mirt. Remember- some cats will become very restless and vocal on it if given the full dose (full 1.5 inch strip). I had one who became very aggressive and started beating up on the other cats in the household. We just needed to back off the dose a bit. Every cat is different with it though, so I always proceed with caution and see how it goes — adjusting the dose as needed.
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Should I start with half a dose then? Unless there's another appy stim that's dermal to the ear I'm certain she's had it before with no issues but I was in a haze back then and it could have been something else. Was same situation but they were leaning towards pancreatitis despite no bloodwork indicating it.
 
I wound up using a third of the dose and it seemed to work! She ate close to 3/4 of a can with some spoon feeding this morning!

Now my next thing to tackle is her constipation. She has been straining in the litterbox producing nothing. Vet didn't want her on miralax but I don't know what I can do to help her since her meds cause constipation and she was already constipated, getting pumpkin and miralax just before this. Any alternative ideas? I know exercise is helpful but she isn't quite back to playing yet. Watched the wand flick back and forth but doesn't quite have the energy yet.
 
Why didn’t the vet want you to use MiraLax. If she gets backed up she will stop eating most likely… and have to go to the vet for an enema. :(
 
You know the drill… fiber like psyllium husk, pumpkin added to food, gerber baby food squash, slippery elm bark, that kind of thing. Personally, I doubt these are going to be enough all on their own — they work better for prevention and maintenance than actually resolving constipation. Ondansetron can be seriously constipating and she’s probably going to need more than fiber, exercise, even bowel massage.
 
Pumpkin and Jack said:
I have contemplated making from scratch and feeding raw so many times before but the odds are against me on it. Local butchers just make fancy brats and human stuff never sell offal or anything I actually need. We have health stores and ethnic stores that carry a lot of the parts recipes call for but it's not always consistent, hard to find, and honestly I'm not convinced it's all that affordable around here. :S
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Any good butcher shop should be able to order anything you request. It may take a few days or more for items to arrive so you have to plan ahead. You could also look into buying meat online from a raw pet food supplier such as Hare-Today.com.

Food Fur Life is one popular pre-mix. Info on the ingredients is here https://www.foodfurlife.com/ezcomplete-fur-cats-premix-information.html#/ TC Feline is another pre-mix and there are others.

You could do a prey model raw diet which is feeding 80% muscle meat, 10% bone, 5% secreting organs, and 5% other organs. That combination results in a complete diet for cats. No additional supplementation is needed.
 
Suzanne & Darcy said:
Why didn’t the vet want you to use MiraLax. If she gets backed up she will stop eating most likely… and have to go to the vet for an enema. :(
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Starting to feel a little bit like gaslighting. Called front desk to leave a note for my vet or one on call and they kept insisting she is straining to urinate, but she has been urinating. I'm not sure how frequently she should be going given she got a large amount of fluids yesterday that vanished immediately but she had gone at least once or twice in large quantities. Trying not to vent my frustrations more than that but I cant believe this. Will maybe ask if I can get on a call with one of the vets instead playing telephone and having someone else interpret the problem for me. Not sure how to get around that as they are the main contact point and filter everything. :(
 
Thankfully my message was relayed correctly and they are getting her on lactulose if I remember correctly. Giving her first at home fluids tonight instead of tomorrow. Have to wait until after work to pick up lactulose but glad I could get through the filter or maybe the vet read through front desk's bologna.
 
Pumpkin has spurts where she seems like she is doing better then I give meds and she seems worse again. Little nervous about how warm she is and how she is trying to find cool surfaces to lay on but she was doing that at the vet and they said nothing about that either. Even though I'm remote I'm a nervous wreck about having to go back in office on Wed. I don't really have anyone that can come over and watch her. :(
 
Pumpkin doesn't have an appetite this second half of the day today and has gone back to being lethargic. Was instructed to give her fluids but wasn't sure on the timing.

With her sitting at 382 I didn't want to wait any longer and gave insulin. I know I should have syringe fed before and checked BG half an hour later but I've been having to do this backwards schedule since she got sick. Guess I'll give some syringe food quick and do fluids shortly after. I have no idea on the timing if this is a bad idea but I don't feel like I should wait any longer with how she is.
 
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Laurie&Petey said:
I don't know the answer to your questions. But assuming you gave fluids, how is Pumpkin doing now?
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Just trying it now as I made myself paranoid after searching other threads and someone said their cat's BG went up when giving it close to insulin. Waited two hours and hoping that's enough buffer for her insulin to absorb since I don't want her climbing higher than 382. Had to run to pick up her lactulose for constipation.
 
Laurie&Petey said:
how is Pumpkin doing now?
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She perked up very quickly to the fluids. I felt so awful because I didn't get it in far enough the first time and panicked pulling it out so I had to poke her again but we made it! She happily ate a few treats but can't get her interested in a real meal still. Unfortunately she associates the high calorie recovery food with syringe feeding so I don't think she will willingly eat it and it seems she maybe associates most flavors with nausea now. Chicken was a given being that's most of Tiki Cat's lineup but now she's not interested in seafood unless it's a Churu stick. Doesn't appear that she's nauseous though. Hoping the lactulose will help because constipation is probably not helping anything.
 
Pumpkin and Jack said:
She perked up very quickly to the fluids. I felt so awful because I didn't get it in far enough the first time and panicked pulling it out so I had to poke her again but we made it! She happily ate a few treats but can't get her interested in a real meal still. Unfortunately she associates the high calorie recovery food with syringe feeding so I don't think she will willingly eat it and it seems she maybe associates most flavors with nausea now. Chicken was a given being that's most of Tiki Cat's lineup but now she's not interested in seafood unless it's a Churu stick. Doesn't appear that she's nauseous though. Hoping the lactulose will help because constipation is probably not helping anything.
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Great news! Awesome job :bighug::bighug:. I hope she continues to feel better. I used to mix the A/D food with some warm water, that helped.
 
Laurie&Petey said:
Great news! Awesome job :bighug::bighug:. I hope she continues to feel better. I used to mix the A/D food with some warm water, that helped.
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Laurie&Petey said:
Great news! Awesome job :bighug::bighug:. I hope she continues to feel better. I used to mix the A/D food with some warm water, that helped.
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So sorry for what you are going thru with the vet, I had the same situation with Corky's vet for 10 years, after diagnosed by the emergency hospital and hospitalized for 8 days, when I took him back to his long time usual vet, not only I was giving the runaround for an appointment, but he indirectly decided not to treat him, not all vets have experience on Feline Diabetes and they shy away from it, and are not regularly schooled, regularly on new developments, so if they do decide to treat Feline diabetes as they do with a do a dog, and problems occur, if you do not feel comfortable with how you are being treated, perhaps it's time to find a new Vet, hope your baby's health gets better, also for constipation you can buy over the counter MIRALAX, PLACE 1/4 TSP TWICE A DAY IN THE FOOD, is odorless and unflavored, in a couple of days you will see results, do know that when you feed wet can food, they usually do not poop daily, but every other day due to the fact that the wet can food contains less waste so mostly is digested, but the MIRALAX, you can switch from the Lactulose to the MiraLAX if you still see constipation, sometimes both my cats become constipated and one decides to work better than the other
 
CORKY said:
So sorry for what you are going thru with the vet, I had the same situation with Corky's vet for 10 years, after diagnosed by the emergency hospital and hospitalized for 8 days, when I took him back to his long time usual vet, not only I was giving the runaround for an appointment, but he indirectly decided not to treat him, not all vets have experience on Feline Diabetes and they shy away from it, and are not regularly schooled, regularly on new developments, so if they do decide to treat Feline diabetes as they do with a do a dog, and problems occur, if you do not feel comfortable with how you are being treated, perhaps it's time to find a new Vet, hope your baby's health gets better, also for constipation you can buy over the counter MIRALAX, PLACE 1/4 TSP TWICE A DAY IN THE FOOD, is odorless and unflavored, in a couple of days you will see results, do know that when you feed wet can food, they usually do not poop daily, but every other day due to the fact that the wet can food contains less waste so mostly is digested, but the MIRALAX, you can switch from the Lactulose to the MiraLAX if you still see constipation, sometimes both my cats become constipated and one decides to work better than the other
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She strained in the litterbox but I found a few rock hard pieces over by where she was resting which I assume came from her and not my tabby so she has gone at least once. I will definitely look back into miralax (she normally gets it when constipated which happens quite often, but vet told me to hold off while medicating, still not sure why). This vet office (or at least her main vet) definitely seems like they know about diabetes well enough, I believe its just a bit of dysfunction from seeing so many different people (rotating vets available each time I visited) and the front desk not always being good at relaying information when I'm not directly in the office with the vet. I really don't want to switch vets though because no other place offers the flexibility these folks offer (being able to go to the vet at 10 pm and not be charged $200 just to be there is kind of critical for me).
 
squeem3 said:
Have you considered a feeding tube? That will assist getting essential nutrients and calories and even medicine into Pumpkin. Here's info: https://catinfo.org/feeding-tubes-for-cats/
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I've considered it but only if she gets worse. She still wants to eat some times so I hate to put her through that when she's bouncing from doing better to not. I think if the vet lets me up her fluids and sorts out the constipation with the lactulose she might be more willing to eat again. Fought a little less when I syringe fed this last time.
 
Thankfully vet upped her fluids to 200 mL daily instead of 100 mL every other day!! Lactulose and fluids are already helping her with the litterbox but she definitely isn't all better yet. Had hoped she would want to eat on her own but she doesn't even want the Churu sticks because of all the forced meds in her face. I really need to get some wipes to clean her up because she is a mess with the syringe feeding but I'm always afraid she'll groom it and mess up her GI further. Using just a wet towel isn't going well though especially now that she has sticky lactulose all over. :S
 
Pumpkin and Jack said:
Thankfully vet upped her fluids to 200 mL daily instead of 100 mL every other day!! Lactulose and fluids are already helping her with the litterbox but she definitely isn't all better yet. Had hoped she would want to eat on her own but she doesn't even want the Churu sticks because of all the forced meds in her face. I really need to get some wipes to clean her up because she is a mess with the syringe feeding but I'm always afraid she'll groom it and mess up her GI further. Using just a wet towel isn't going well though especially now that she has sticky lactulose all over. :S
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You can use a syringe with no needle and extrac 1 ml Of the Lactulose from the bottle place the needle between the back of Jaimes grabbing the scruff between the ears pull back and pushcthe fluid slowly in. It wont make a mess you poor thing,You’re a good mom!!:bighug::bighug::cat::cat:
 
Pumpkin and Jack said:
Thankfully vet upped her fluids to 200 mL daily instead of 100 mL every other day!! Lactulose and fluids are already helping her with the litterbox but she definitely isn't all better yet. Had hoped she would want to eat on her own but she doesn't even want the Churu sticks because of all the forced meds in her face. I really need to get some wipes to clean her up because she is a mess with the syringe feeding but I'm always afraid she'll groom it and mess up her GI further. Using just a wet towel isn't going well though especially now that she has sticky lactulose all over. :S
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That is a lot of fluids for a cat to process. There is a danger of over hydration and causing a pleural effusion. I would not exceed 100 mL per day.
 
Symptoms Associated With Overhydration


Sometimes a CKD cat may develop fluid retention or fluid build-up.This may be a sign of worsening kidney values or of heart problems, but in many cases it is actually a sign of overhydration from either intravenous fluids (IV fluids) or subcutaneous fluids (sub-Qs).



Some vets believe it is impossible to overhydrate a cat through sub-Q fluids but unfortunately this is simply not true. Over the years, I've heard from quite a few people whose cats developed precisely this problem. In Renal Disease(2006) Polzin DJ Delaware Valley Academy of Veterinary Medicine, Dr Polzin states "Chronic subcutaneous fluid therapy can result in fluid overload in some patients, particularly when fluid volumes in excess of those recommended here are used. We have seen several cats given large quantities of fluid (200 to 400 ml/day) present with severe dyspnea due to pleural effusion. This condition can usually be avoided by reducing the volume of fluids administered."



A cat with fluid retention may:


    • exhibit loss of appetite, because the fluid may be pressing on the stomach causing a feeling of fullness.



    • find it uncomfortable to lie down on his or her side, or may sit up and refuse to lie down; this is because it is easier to breathe in this position.



    • appear to be gaining weight rapidly or suddenly (within the space of a few days)



    • be breathing faster (see Diagnosis for normal respiration rates)



    • start coughing



    • purr with a rattly noise



    • develop a nasal discharge



      • have runny eyes



      • have flaring nostrils



      • start breathing from the flanks (as if pushing every breath out)
If your cat feels "squishy" when you stroke him or her, this may indicate fluid retention caused by overhydration from excessive sub-Qs (although sometimes it merely means that air got into the line, in which case you need to work on your sub-Qs technique).



If you see any of these symptoms, you need to see a vet. If you see these symptoms while the vet is closed, it is probably OK to wait a few hours but monitor your cat closely (see Heart Problems for information on monitoring your cat's respiration rate) and of course do not give sub-Qs.


Unfortunately, you may not always see symptoms until the problem is severe. If your cat starts breathing with the mouth open, or has a limp and the limping leg is cold to the touch, this is a medical emergency indicating that your cat might be in congestive heart failure and you need to get to a vet as quickly as possible. In such a situation a chest x-ray is a good idea.



Do not give any sub-Q fluids if you see any of the symptoms above until you have had your cat checked by a vet. You should also never give a cat sub-Qs until the fluids from the previous session have been absorbed.


In many cases, you may find that invasive treatments are not necessary and that simply reducing the amount or frequency of sub-Qs solves the problem; so speak to your vet about this.Subcutaneous Fluids has information on amount and frequency of fluids.



Monitoring your cat's weight with baby scales is a good idea because sudden weight gain may alert you to this problem.


Cats who are on corticosteroids may also develop fluid retention.



Warning signs for congestive heart failureis a helpful site by an individual whose cat, Coco, had both CKD and heart problems, and gives useful information on what to watch for. Coco lived with CHF for quite some time.



Emergency resipratory assessment (2001) Hughes D Presentation to the World Small Animal Veterinary Association World Congress is rather technical but may still be of use.



Managing fluid and electrolyte disorders in renal failure(2008) Langston CL Veterinary Clinics Small Animal Practice 38 pp677-697 explains about the signs of overhydration.



"pouch" of fluid after sub-Qs, which may move down into the front legs; this should gradually disappear as the fluids are absorbed.



Swelling may also be a sign of proteinuria. Alternatively it may be a sign of congestive heart failure.



Occasionally (rarely in cats), such swelling may be a sign ofnephrotic syndrome. Nephrotic syndrome is not a disease in itself, but rather a collection of symptoms that may be seen as a result ofglomerular disease. The primary symptoms of nephrotic syndrome include proteinuria, low albumin levels and high cholesterol levels. You may also see diarrhoea, reduced urine output, anaemia and occasionally saddle thrombus (a blood clot in the leg).



In very rare cases, a cat who develops puffy feet who is limping may have a condition called pillow paw or plasma cell pododermatitis. This is an autoimmune disorder more common in male cats which may need to be treated with steroids. Retrospective study of feline plasma cell pododermatitis based on histopathology submissions to a diagnostic laboratory(2017) Clinical/research abstracts accepted for presentation at ISFM World Feline Congress 2017 p967 mentions that it has been seen in cats with concurrent conditions that include glomerulonephritis. Veterinary Partnerhas some information about this condition.



Pet Place has some information about pleural effusion



Pet MD discusses pulmonary oedema in cats.



Pet Place has some information about ascites.



Pet MDhas information about ascites.



fluid retention, and needs to be investigated urgently, particularly if accompanied by fast heart rate, coughing, loss of appetite, breathing from the flank (as if pushing every breath out), limping, and particularly open-mouth breathing. If you see the last three symptoms, your cat's heart or lungs may be affected and you need to go to the vet immediately. Do not give any sub-Q fluids if you see any of the above symptoms or if your cat has gained a lot of weight suddenly or quickly until you have had your cat checked by a vet.



Sometimes a weight gain may seem small but we have to allow for the relatively small starting weight of a cat. So if, for example, a cat who weighs 8 lbs gains 1lb in a week, that is a weight gain of 12%. The human equivalent would be a 140lb person gaining almost 17 lbs in a week, which is clearly not possible in terms of true weight gain.



I recommend weighing your cat every day and monitoring trends. What is a reasonable weight gain? Be guided by your vet, but if your cat has just eaten or has been given fluids and has not yet urinated, then these will affect weight. 100ml of fluids weighs about 3.5 ounces (100g), for example, so if you weigh your cat immediately after giving fluids you might panic about a non-existent weight gain of 3.5 ounces. If you are trying to get weight onto your cat, an acceptable rate of actual weight gain should be determined by your vet, based on your cat's current weight and goal weight, but roughly speaking an increase of 2-3 ounces (50-75g) a week should be acceptable.



fluid retention.



fluid retention, particularly overhydration with sub-Qs. Other causes of runny eyes include an upper respiratory tract infection or dental problems.


 
Suzanne & Darcy said:
Symptoms Associated With Overhydration



heart problems, but in many cases it is actually a sign of overhydration from either intravenous fluids (IV fluids) or subcutaneous fluids (sub-Qs).



Some vets believe it is impossible to overhydrate a cat through sub-Q fluids but unfortunately this is simply not true. Over the years, I've heard from quite a few people whose cats developed precisely this problem. In Renal Disease(2006) Polzin DJ Delaware Valley Academy of Veterinary Medicine, Dr Polzin states "Chronic subcutaneous fluid therapy can result in fluid overload in some patients, particularly when fluid volumes in excess of those recommended here are used. We have seen several cats given large quantities of fluid (200 to 400 ml/day) present with severe dyspnea due to pleural effusion. This condition can usually be avoided by reducing the volume of fluids administered."



A cat with fluid retention may:


    • exhibit loss of appetite, because the fluid may be pressing on the stomach causing a feeling of fullness.



    • find it uncomfortable to lie down on his or her side, or may sit up and refuse to lie down; this is because it is easier to breathe in this position.



    • appear to be gaining weight rapidly or suddenly (within the space of a few days)



    • be breathing faster (see Diagnosis for normal respiration rates)



    • start coughing



    • purr with a rattly noise



    • develop a nasal discharge



      • have runny eyes



      • have flaring nostrils



      • start breathing from the flanks (as if pushing every breath out)
If your cat feels "squishy" when you stroke him or her, this may indicate fluid retention caused by overhydration from excessive sub-Qs (although sometimes it merely means that air got into the line, in which case you need to work on your sub-Qs technique).



If you see any of these symptoms, you need to see a vet. If you see these symptoms while the vet is closed, it is probably OK to wait a few hours but monitor your cat closely (see Heart Problems for information on monitoring your cat's respiration rate) and of course do not give sub-Qs.


Unfortunately, you may not always see symptoms until the problem is severe. If your cat starts breathing with the mouth open, or has a limp and the limping leg is cold to the touch, this is a medical emergency indicating that your cat might be in congestive heart failure and you need to get to a vet as quickly as possible. In such a situation a chest x-ray is a good idea.



Do not give any sub-Q fluids if you see any of the symptoms above until you have had your cat checked by a vet. You should also never give a cat sub-Qs until the fluids from the previous session have been absorbed.


In many cases, you may find that invasive treatments are not necessary and that simply reducing the amount or frequency of sub-Qs solves the problem; so speak to your vet about this.Subcutaneous Fluids has information on amount and frequency of fluids.



Monitoring your cat's weight with baby scales is a good idea because sudden weight gain may alert you to this problem.


Cats who are on corticosteroids may also develop fluid retention.



Warning signs for congestive heart failureis a helpful site by an individual whose cat, Coco, had both CKD and heart problems, and gives useful information on what to watch for. Coco lived with CHF for quite some time.



Emergency resipratory assessment (2001) Hughes D Presentation to the World Small Animal Veterinary Association World Congress is rather technical but may still be of use.



Managing fluid and electrolyte disorders in renal failure(2008) Langston CL Veterinary Clinics Small Animal Practice 38 pp677-697 explains about the signs of overhydration.



"pouch" of fluid after sub-Qs, which may move down into the front legs; this should gradually disappear as the fluids are absorbed.



Swelling may also be a sign of proteinuria. Alternatively it may be a sign of congestive heart failure.



Occasionally (rarely in cats), such swelling may be a sign ofnephrotic syndrome. Nephrotic syndrome is not a disease in itself, but rather a collection of symptoms that may be seen as a result ofglomerular disease. The primary symptoms of nephrotic syndrome include proteinuria, low albumin levels and high cholesterol levels. You may also see diarrhoea, reduced urine output, anaemia and occasionally saddle thrombus (a blood clot in the leg).



In very rare cases, a cat who develops puffy feet who is limping may have a condition called pillow paw or plasma cell pododermatitis. This is an autoimmune disorder more common in male cats which may need to be treated with steroids. Retrospective study of feline plasma cell pododermatitis based on histopathology submissions to a diagnostic laboratory(2017) Clinical/research abstracts accepted for presentation at ISFM World Feline Congress 2017 p967 mentions that it has been seen in cats with concurrent conditions that include glomerulonephritis. Veterinary Partnerhas some information about this condition.



Pet Place has some information about pleural effusion



Pet MD discusses pulmonary oedema in cats.



Pet Place has some information about ascites.



Pet MDhas information about ascites.



fluid retention, and needs to be investigated urgently, particularly if accompanied by fast heart rate, coughing, loss of appetite, breathing from the flank (as if pushing every breath out), limping, and particularly open-mouth breathing. If you see the last three symptoms, your cat's heart or lungs may be affected and you need to go to the vet immediately. Do not give any sub-Q fluids if you see any of the above symptoms or if your cat has gained a lot of weight suddenly or quickly until you have had your cat checked by a vet.



Sometimes a weight gain may seem small but we have to allow for the relatively small starting weight of a cat. So if, for example, a cat who weighs 8 lbs gains 1lb in a week, that is a weight gain of 12%. The human equivalent would be a 140lb person gaining almost 17 lbs in a week, which is clearly not possible in terms of true weight gain.



I recommend weighing your cat every day and monitoring trends. What is a reasonable weight gain? Be guided by your vet, but if your cat has just eaten or has been given fluids and has not yet urinated, then these will affect weight. 100ml of fluids weighs about 3.5 ounces (100g), for example, so if you weigh your cat immediately after giving fluids you might panic about a non-existent weight gain of 3.5 ounces. If you are trying to get weight onto your cat, an acceptable rate of actual weight gain should be determined by your vet, based on your cat's current weight and goal weight, but roughly speaking an increase of 2-3 ounces (50-75g) a week should be acceptable.



fluid retention.



fluid retention, particularly overhydration with sub-Qs. Other causes of runny eyes include an upper respiratory tract infection or dental problems.
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WOW! All this sounds very serious, hope you follow all this stuff Suzanne has posted for you she is one of the members welll knowledgeable to pay attention to. Hope none of these apply to your Pumpkin :bighug::bighug::cat::cat:
 
That’s a lot to read, but I don’t want you to harm Pumpkin with too many fluids. The cat’s heart has to cope with all that excess fluid and they can be over-hydrated. It happened to my beautiful cat, Tabitha, and I always warn people about it. There is a lot of information on felinecrf.org about how much sub-q fluid is too much, but really 100 mL daily is about all you should give. How much does Pumpkin even weigh at this point.
 
Suzanne & Darcy said:
That’s a lot to read, but I don’t want you to harm Pumpkin with too many fluids. The cat’s heart has to cope with all that excess fluid and they can be over-hydrated. It happened to my beautiful cat, Tabitha, and I always warn people about it. There is a lot of information on felinecrf.org about how much sub-q fluid is too much, but really 100 mL daily is about all you should give. How much does Pumpkin even weigh at this point.
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She used to be around 10-11 pounds but she was 9.7 and now last weighed 9.3 pounds iirc. I will slow down on fluids, I was just very worried about her being dehydrated because her urine is still very pigmented and she won't drink on her own but hovers at the bowl wanting to. She's on cerenia and ondansetron so I'd hope that would help. Yesterday she immediately perked up when we gave fluids (100 mL) but it wore off by this morning but today when I gave it, it was draining at the spot I injected at and she was just as lethargic afterwords.
 
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Worried now that the draining and the lethargy were signs I should have noticed. I called vet and they didn't seem concerned and thought I probably poked all the way through or the hole didn't heal but she was draining for well after an hour despite light pressure held for a minute when we finished. They can't know everything unless they know the right things to ask of course but...

She got fluids 3 hours ago. I had to stop everything because we thought we had a gas leak so I've been all over the place.

I don't want to admit it but she did have a lot of those symptoms. No mouth breathing, limping, and no heaving breaths (breaths seem to be looking more normal currently but she has been snore breathing like when she gets a kitty cold) but she had to be syringe fed today completely (thought it was strange app stim didn't work overnight this time), had goopy eyes, nasal drip (thought she may have aspirated her meds/meals etc but didn't think I could do anything for it), and she was doing this thing she usually does when I overdo her Miralax where she sleeps with her butt sticking up in the air (which I attributed to lactulose doing a number on her).

She's gone back to laying on her side and counted breaths at 28-31 per minute.

Guh I wish I would have known this before!!! I am sort of panicking but I can't exactly afford another emergency bill and don't know what they could even do that I'd be able to afford. I'm losing my mind. Is skipping fluids and never giving more than 100 at once enough or what would they even be able to do? :(
 
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Took off the 911 tag as I doubt anyone will be up. Called around a few ER places to see what they would be able to do given her overhydration and some places didn't have triage on the phone to give me an idea if they could even do anything for her, some places outright denied that overhydration is a thing, and some just told me to hack up the $250 just to be seen and expect a minimum $1.5k bill for the basics. I haven't been able to hospitalize her otherwise I would have done so from the start!! All I can do is pray that she gets through the night and I can squeeze in a vet visit when they open tomorrow.

Edit: read through more of the articles and I believe we will hopefully get through the night and they may not even need to see her tomorrow. Sounds like bed rest and a slap to my wrists might be enough. Wish I would have researched fluids more!!
 
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I didn't give her an appy stim last night due to the stress of the fluids but she was acting hungry and wanting to eat this morning so that's an improvement. Still sitting in different positions to keep comfortable and breaths are still on the high end at 30 per min. Can't say that she does or doesn't have the eyes/nose drip for certain though but I think overall she is at least slowly improving. Does still have that rattly snore breathing (subtle but it's still there)

Only problem is she needs her Ondansetron but I'm afraid of choking now that she's having all these symptoms. It dissolves pretty easily and absorbs quickly in the mouth if I can get her to keep it in her mouth without drooling it out but I also don't want to waste it. Going to have to try to see if I can get it in so she can eat. :(
 
A lot of meds can be compounded into easier to give forms. Wedgewood Pharmacy is one popular place. A local compounding pharmacy is also an option. Compounding takes a few days so not helpful if your cat needs to be on meds right away.

:bighug:
 
Pumpkin and Jack said:
Took off the 911 tag as I doubt anyone will be up. Called around a few ER places to see what they would be able to do given her overhydration and some places didn't have triage on the phone to give me an idea if they could even do anything for her, some places outright denied that overhydration is a thing, and some just told me to hack up the $250 just to be seen and expect a minimum $1.5k bill for the basics. I haven't been able to hospitalize her otherwise I would have done so from the start!! All I can do is pray that she gets through the night and I can squeeze in a vet visit when they open tomorrow.

Edit: read through more of the articles and I believe we will hopefully get through the night and they may not even need to see her tomorrow. Sounds like bed rest and a slap to my wrists might be enough. Wish I would have researched fluids more!!
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You know. We all have trusted our vets at some point and made mistakes because of it. Like I said, my Tabitha had two pleural effusions from being over hydrated. Then I had to take her to the vet to have the fluid drawn off of her. This was quite a few years ago now, but I will never forget.

Just keep an eye on her respiratory rate. Each rise and fall of the chest counts as one breath. Do it while she is sleeping and not purring. Set a timer on your phone for 30 seconds and count then double it. Or if you can’t count that long then do 15 seconds and quadruple the number you counted.
 
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Pumpkin and Jack said:
I didn't give her an appy stim last night due to the stress of the fluids but she was acting hungry and wanting to eat this morning so that's an improvement. Still sitting in different positions to keep comfortable and breaths are still on the high end at 30 per min. Can't say that she does or doesn't have the eyes/nose drip for certain though but I think overall she is at least slowly improving. Does still have that rattly snore breathing (subtle but it's still there)

Only problem is she needs her Ondansetron but I'm afraid of choking now that she's having all these symptoms. It dissolves pretty easily and absorbs quickly in the mouth if I can get her to keep it in her mouth without drooling it out but I also don't want to waste it. Going to have to try to see if I can get it in so she can eat. :(
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Man, I am so upset this happened!
 
Suzanne & Darcy said:
You know. We all have trusted our vets at some point and made mistakes because of it. Like I said, my Tabitha had two pleural effusions from being over hydrated. Then I had to take her to the vet to have the fluid drawn off of her.

Just keep an eye on her respiratory rate. Each rise and fall of the chest counts as one breath. Do it while she is sleeping and not purring. Set a timer on your phone for 30 seconds and count then double it. Or if you can’t count that long then do 15 seconds and quadruple the number you counted.
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When she is actually sleeping her resting rate is lower but I haven't been able to record it yet as she wakes up when I get close. While she is alert and sitting she's at 28-31 breaths. Just looks a bit uncomfortable. I have a vet appt scheduled tonight unless they can get me in sooner to check her over.

She gobbled up some temptations treats after the Ond. finally kicked in. Had to give insulin without food initially though as she wasn't wanting to eat and I'm nervous about syringe feeding.

Don't remember if I made an update on it but she is finally producing (hard) stools after starting lactulose though!!
 
I've been having a really hard time checking her glucose lately though. It's like her blood's viscosity is different or maybe there's a residue from the Mirataz. I prick her ear and instead of a nice little dot forming, it spills out, smears across the skin, then absorbs into the fur on the edge like something is pulling it away. I can't get the reader to suck anything up!! Poor girls ears are so bruised from having to poke her so many times.
 
Pumpkin and Jack said:
I've been having a really hard time checking her glucose lately though. It's like her blood's viscosity is different or maybe there's a residue from the Mirataz. I prick her ear and instead of a nice little dot forming, it spills out, smears across the skin, then absorbs into the fur on the edge like something is pulling it away. I can't get the reader to suck anything up!! Poor girls ears are so bruised from having to poke her so many times.
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I have been poking Corky's top left ear for 3 years every 2 hours, and his ear is not bruised, I cannot poke the right ear because the veins there are microscopic, perhaps you are poking side ways or too hard, a soft poke should do it, even if the blood rolls down you can still pick up a tiny bit to test, it is important to do so, especially how pumpkin is feeling right now. also the Miratz, is just a tip of pin drop in the inner fold of the ear, it should not touch the end of tip of the ear where you test, perhaps you are using too much, Exchanging ears every day; Best to you tonight at the Vets, keep us posted:bighug::bighug::cat::cat:
 
I’m sorry you are having difficulties with the blood. One tip to get it to bead up is to put a little vaseline on the top of the ear before you test — that helps it to bead up. Are you testing from the top (outside) of the ear or the inside of the eat? Are you using a different ear than the Mirataz ear? It’s a good idea to clean the Mirataz off of the ears before applying more Mirataz. The ears can get kind of gooped up.
I am thinking it’s the over hydration problem that is causing this issue, so I hope it resolves on its own. Dehydration can also cause problems, but usually that just makes it difficult to get blood out at all.
 
Suzanne & Darcy said:
I’m sorry you are having difficulties with the blood. One tip to get it to bead up is to put a little vaseline on the top of the ear before you test — that helps it to bead up. Are you testing from the top (outside) of the ear or the inside of the eat? Are you using a different ear than the Mirataz ear? It’s a good idea to clean the Mirataz off of the ears before applying more Mirataz. The ears can get kind of gooped up.
I am thinking it’s the over hydration problem that is causing this issue, so I hope it resolves on its own. Dehydration can also cause problems, but usually that just makes it difficult to get blood out at all.
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I am switching back and forth on the Mirataz ears but cleaning them with warm water and a dry paper towel inbetween as I was told it's not good to use the same ear over and over. I usually prick the inside of the ears as her fur makes it difficult on the outside but tried doing the outside with the same issue of it sucking into the fur or just not drawing anything half the time.

It's very peculiar but I think it is related to the Mirataz residue (or at least hoping it isn't something wonky going on with her blood) and I think she is also still dehydrated to a degree. If I understand correctly, despite getting fluids, it still take a while to work its way through so we just need to wait to administer at appropriate times. I know dehydration first hand though as I passed out while getting a blood draw from dehydration, wasn't fun!
 
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