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Cat Forum / Health and Behavior / September 2006Molly's First Sub Q injection
I just gave Molly 200 cc Ringers Lactate subq--this was my first time and I was quite nervous. She handled it like a trooper--ate treats and sat there very quietly until I was done, licked my fingers a couple of times and then jumped off my lap like nothing had happened. The only glitch was that I backed out the needle once and a little fluid spilled. I hope, hope, hope it continues this easily. She's been dehydrated and lethargic and she probably has some kidney issues. She's 16 plus years and has had some health problems but nothing too terrible. I know with crf that will change but for right now I'm happy she seems to tolerate the subq injection. The main problem right now is trying to get her to eat. She got 200 cc fluid at the vet's yesterday and 200cc today--her appetite seems better today but she's been eating only one thing and that's tuna (catfood--not human). Any suggestions on how to expand her repertoire of acceptable food choices? The vet said that right now calories were more important but I would like to get her eating something better for her kidneys. I appreciate hearing other people's experiences with both the fluid administration and the dietary issues. Thank you, Bonnie > I appreciate hearing other people's experiences with both the > fluid administration and the dietary issues. Congrats on the successful injection! I don't have experience to offer with that, but I was giving my cat allergy shot injections, and may start again since I think they at least kept the needed frequency lower. All I can say is try to make it a happy experience. I'm afraid I don't know the reason for your cats need for fluids; kidney disease? If so, treats wouldn't be good like they would with my cats allergy shots. I do know that he responded positively with encouraging words like "good boy" and lots of hugs and pets. Best wishes and good luck to both of you.  SignatureCheryl >> I appreciate hearing other people's experiences with both the >> fluid administration and the dietary issues. [quoted text clipped - 9 lines] > > Best wishes and good luck to both of you. Thanks for your response! We're pretty sure it's kidney disease. Her BUN and Creatinine have been normal but on the high side consistently for several years. My vet is doing blood work--we should know more tomorrow. I hadn't thought about the treats. Rats. She's deaf so verbal praise doesn't do much for her. She does like the petting and stroking but it's always nice to get treats too! Bonnie > Thanks for your response! We're pretty sure it's kidney disease. Her BUN > and Creatinine have been normal but on the high side consistently for > several years. My vet is doing blood work--we should know more tomorrow. CRF doesn't show up in the bloodwork until at least 60-75% of kidney function has been lost. Did your vet get a urine sample before he started your cat on fluids? P. We've recently done sub-cu, that needle is scary! I'm glad your cat (and you) did so well. The only issue we had was after it was over and pulling out the needle. Many times, she would leak back out of the skin. I watched a vet do it and they actually grab the skin in that area and pinch it closed for several minutes (they hold a big fold of skin.) I just used a kleenex and held it tightly against her for a few minutes. As for trying to eat, we've had good luck with a wet food from Pro Plan, it has sardines in it. Our vet emergency hospital clued us in to that -- they use it on their recovering cats because it is so stinky. Have you tried A/D also? It's a soft, prescription food that is packed with nutrients for cats not eating well, and many cats really like it. I don't know about how these are on kidneys, but I would agree with your vet that the first consideration is just getting something into her. Maybe once you find something she is eating with gusto, you can start slowly mixing in a food that is better for her kidneys (we used prescription NF for our renal failure cat.) Good luck, Rhonda > I just gave Molly 200 cc Ringers Lactate subq--this was my first time and I > was quite nervous. She handled it like a trooper--ate treats and sat there [quoted text clipped - 17 lines] > > Thank you, Bonnie > The only issue we had was after it was over and pulling out the needle. > Many times, she would leak back out of the skin. This happened with Molly, also. She's amazingly tolerant of this--I've always called her my bomb-proof cat and she certainly is holding true to form! I've heard that cats don't always tolerate fluid administration. My mother had a cat with CRF that hated the whole thing so much she began to run and hide from my mother. It really can destroy any trust a cat has with a person. > As for trying to eat, we've had good luck with a wet food from Pro Plan, > it has sardines in it. Our vet emergency hospital clued us in to that -- > they use it on their recovering cats because it is so stinky. Have you > tried A/D also? It's a soft, prescription food that is packed with > nutrients for cats not eating well, and many cats really like it. Is A/D a Hills product--do you have to get it through the vets? We tried her on one of the kidney diets two or three years ago and she adamantly refused to eat it--sigh. > I don't know about how these are on kidneys, but I would agree with your > vet that the first consideration is just getting something into her. Maybe [quoted text clipped - 5 lines] > > Rhonda Thanks for your suggestions, Rhonda. She is actually eating fairly well tonight so she must be feeling better. Bonnie Hi Bonnie, A/D is prescription and it is Hills. There is some CRF food information here: http://www.felinecrf.com/managd.htm Good luck with your kitty! Rhonda > Is A/D a Hills product--do you have to get it through the vets? We tried her > on one of the kidney diets two or three years ago and she adamantly refused > to eat it--sigh. > Hi Bonnie, > [quoted text clipped - 4 lines] > > Rhonda Thanks for the link--it's got some great information! Bonnie > The main problem right now is trying to get her to eat. She got 200 cc > fluid at the vet's yesterday and 200cc today That's a lot of fluid to give at once and in one day! How big is your cat? Here's a chart you can use for calculating the volume of fluid to give: http://www.maxshouse.com/Calculation_of_24-Hour_Fluid_Requirement_at_Different_L evels_of_Dehydration.htm Also, your cat should be getting a potassium supplement- especially if she's getting fluid therapy. Fluid therapy promotes rapid urine production which in turn promotes potassium excretion. Potassium depletion can lead to an assortment of problems one of which is death. Potassium supplementation along with omega-3 supplementation can delay or even interrupt the downward spiral of CRF. I think you may want to look for a vet whose a bit more experienced in treating cats with renal disease. Best of luck, Phil >> The main problem right now is trying to get her to eat. She got 200 cc >> fluid at the vet's yesterday and 200cc today [quoted text clipped - 22 lines] > > Phil Phil, Thanks for responding--I always respect your expertise and advice. I'm long time lurker, occasional poster. Molly is small--only about 6 lb 5 oz. I couldn't get an appointment with my regular vet so am seeing one of her partners. The vet didn't mention a percentage of dehydration but Molly's skin was really "tenting". She is getting supplemental potassium--Tumil K 1/8th tsp twice daily. My regular vet put her on that several years ago--her BUN and Creatinine were high side normal but her potassium was low. The potassium has been normal ever since but last year the BUN & Creatinine were slightly higher than normal limits. I don't remember the exact numbers but they weren't very high. From what the vet said, she wanted Molly on 200 ml fluids for 5 days and then once a week, see how she does and maybe back it down further. I will definitely talk to her about the volume--she should be calling with lab results today. The vet did not collect a urine specimen. She does seem to be feeling better--she's purring all the time and is happy to be picked up and petted. Her appetite also is better. She's gotten fluids once before for dehydration but I've never given them at home. I'm interested in the omega-3 supplementation--how much, how often, in what form? Thanks again for your input--it's much appreciated. Bonnie > >> The main problem right now is trying to get her to eat. She got 200 cc > >> fluid at the vet's yesterday and 200cc today [quoted text clipped - 3 lines] > > > > Here's a chart you can use for calculating the volume of fluid to give: http://www.maxshouse.com/Calculation_of_24-Hour_Fluid_Requirement_at_Different_L evels_of_Dehydration.htm > > Also, your cat should be getting a potassium supplement- especially if > > she's [quoted text clipped - 38 lines] > I'm interested in the omega-3 supplementation--how much, how often, in what > form? I use 3V Caps HP liquid. Its made by DVM Phamaceuticals: http://www.dvmpharmaceuticals.com/display.html?c=6&fam=3VCaps%20Liquid%20HP Don't use omega-3's derived from flax seed or from any plant material (eg., Derm Caps)- they contain too omega-6 which are pro-inflammatory. Use only omega-3s derived from menhaden fish oil or salmon. Call Dr. Boos at DVM- she'll work out the dose for your cat. I don't have her number on me- but you can reach her through DVm's contact number on their website. Best of luck, Phil > >> The main problem right now is trying to get her to eat. She got 200 cc > >> fluid at the vet's yesterday and 200cc today [quoted text clipped - 3 lines] > > > > Here's a chart you can use for calculating the volume of fluid to give: http://www.maxshouse.com/Calculation_of_24-Hour_Fluid_Requirement_at_Different_L evels_of_Dehydration.htm > > Also, your cat should be getting a potassium supplement- especially if > > she's [quoted text clipped - 23 lines] > > She is getting supplemental potassium--Tumil K 1/8th tsp twice daily. That's a little low with respect to the amount of fluids she's receiving. 1/8 tsp = about 1 mEq. I think she should be getting at least 2-4 mEq/day. My > regular vet put her on that several years ago--her BUN and Creatinine were > high side normal but her potassium was low. The potassium has been normal [quoted text clipped - 4 lines] > will definitely talk to her about the volume--she should be calling with lab > results today. The vet did not collect a urine specimen. OK- that sounds better. Fluids therapy to promote diuresis should only be used on a short term basis to lower uremic toxin levels in the blood- Long term or continued large volume fluids promotes glomerular hyperfiltration, which promotes progression. Best of luck, Phil > She does seem to be feeling better--she's purring all the time and is happy > to be picked up and petted. Her appetite also is better. She's gotten [quoted text clipped - 6 lines] > > Bonnie >> >> The main problem right now is trying to get her to eat. She got 200 >> >> cc [quoted text clipped - 41 lines] > That's a little low with respect to the amount of fluids she's receiving. > 1/8 tsp = about 1 mEq. I think she should be getting at least 2-4 mEq/day. I meant to ask my vet about that--the 1/8th tsp was her dose prior to getting fluid replacement. I'm taking her back in a couple of weeks for repeat bloodwork and I'll ask her about it then. From what the vet said, she wanted Molly on 200 ml fluids for 5 > days >> and then once a week, see how she does and maybe back it down further. I [quoted text clipped - 11 lines] > > Phil I'm giving her 100ml for the next couple of days and then 100 ml every two or three days. She's very good about sitting quietly throughout the administration of the fluids--she doesn't seem to feel it at all and I'm using 18 gauge needles. It's truly amazing how much better she feels with the fluids. She's eating better, purring more and just basically is more like her sweet self. Now the next thing is to find a food that friendly to her kidneys and that is palatable. Thanks much for your input! Bonnie > That's a lot of fluid to give at once and in one day! How big is your > cat? [quoted text clipped - 19 lines] > > Phil Phil, I just got a call from my vet regarding lab results; it is her kidneys. Her BUN is 78, Creatinine 3.7 and Phosphorus is 8.1. My vet wants me to give her one more dose of 200 ml and then cut back to 100ml daily until Monday and then go to every 2 or 3 days (100ml each time) as needed. I asked her about the Omega-3 and she wants her to have that as well--Wellactin (sp?). She is not anemic (yet). She doesn't feel that Molly needs a phosphorus binder yet. She wants to repeat blood work in a couple of weeks. Thanks again, Bonnie I've been having trouble getting Kira to eat. She lost 2 months in a couple months and is currently anemic. The vet gave me an appetite stimulant, but she had a bad reaction to it. Her appetite did pick up again after being put on prednisolone (for the anemia prblem), but it also helped that I found a food that she prefered. Friskies Liver and Chicken dinner. It is the stinkiest nastiest stuff, but it seems really attractive to her. I tried to go back to her previous favorite food once her appetite picked up, but she just took a couple licks and glared at me. Back to the stinky stuff. She is eating much better, but not gaining yet. Her bloodwork is improving, but her weight has stalled. At least it didn;t go down any more. Hopefully, it will start picking up. Anyway, I recommend trying the stinkiest stuff you can find and offer it frequently. > I've been having trouble getting Kira to eat. She lost 2 months in a > couple months and is currently anemic. The vet gave me an appetite [quoted text clipped - 12 lines] > Anyway, I recommend trying the stinkiest stuff you can find and offer > it frequently. Thanks for the suggestion--I'll try that! She is eating better now that she's more hydrated but at some point I want to get her on something a bit more kidney friendly! Molly's not anemic yet. Good luck with Kira--it's so frustrating when they don't eat. Bonnie >I just gave Molly 200 cc Ringers Lactate subq--this was my first time and I was >quite nervous. She handled it like a trooper--ate treats and sat there very quietly [quoted text clipped - 17 lines] > > Thank you, Bonnie I did subQ fluid injections to a hyperthyroid cat I rescued, for a week. I hung the LR bag on a hook on a door, tented a lump of tissue behind the neck and allowed 150 cc to flow to a 3.5 lb cat. She did well but I did not like doing it. I used a new needle each time but the same bag and tubing. Adam
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