Update on Belle - 4 1/2 months post radioactive iodine tx

[Susan and the girls]

Hey everyone,

I took Belle in for a re-check on her kidney values, since we were concerned that some of the levels were creeping up after we got her thyroid under control with the radioative iodine treatment.

I left her for the morning, which turned into "the afternoon" when (as it turns out) her bladder was empty and it took her all day to get a full bladder.

They did a cysto and examined the urine, and repeated the kidney bloodwork, as well as the thyroid levels.

The thyroid is perfect.

The bloodwork showed the the kidney values had not increased... they're still in the "high" range -- but only slightly. They basically looked the same. Good news there.

The urine sample showed a specific gravity of 1020, though. The vet explained that we'd like to see 1030, since cats concentrate their urine very well. Since Belle only has one functioning kidney (which has only been confirmed by x-ray, and I'm not going to have an ultrasound to prove it), we want to be agressive and NOT let her go into chronic renal failure.

The prescription: 100 mL fluids sub-q every other day. I got the first bag yesterday when I picked her up, and haven't done the sub-q yet. I want it to be a quiet time, when the kids aren't rushing around or wanting to watch, so I'll wait til they either take a nap or go to bed tonight.

I'm also switching her to KD, possibly --- or mixing it with her Hill's Mature Adult food. (We compared the protein content of the two, and KD has between 25-29, and Mature Adult has between 25-35. It might not be that helpful to change her to KD. They said KD isn't very palatable, and since all three cats are eating the Mature Adult, I'd have to change them all.... We're going to talk about that on Monday when the vet has a chance to think about it & look up the foods more specifically.)

Anyway, they told me that cats can live long "otherwise" healthy lives getting sub-q fluids like this. Traci? Phobe? Debbie? Anyone want to reassure me that's true???? I want to (obviously) do everything I can to make sure she does live a LONG, healthy life. She has no symptoms (at all!) of kidney issues, and the vet was VERY pleased with her weight post-RI treatment. She has gained a couple of pounds back since losing so much in a VERY short amount of time with the thyroid issue! (She weighs almost 12 pounds now!)

They have a "cuff" thingy at the vet's office that puts pressure on the fluid bag to make it go in more quickly. They said they have a 19 year old cat that gets fluids every other day there. When I asked about how much it would cost for me to bring her in & let them do it each time, it was going to be $26 EACH TIME. I opted to pay $14 for a 1000 mL bag (and a few cents for each needle) and do it myself!! I'm going to check at the medical supply place for the cuff and buy one myself. I just can't afford $26 three times a week for the rest of her life. My husband is still out of work, and I don't even tell him how much the vet bills are. (LOL)

Thanks for any advice/input!!!!

[Traci]

Actually, you really don't want, or need, a cuff for the bag. What this does, essentially, is called bolusing, which means forcing the fluid at a rapid rate. Generally it is best used in emergency situations only (i.e., intravenously more often than most).

For a cat who requires fluids more than once a week, it is simply sufficient to give the fluids normally, as one would any other cat who requires them. Bolusing could stretch the skin slightly and make it more uncomfortable for the cat since they would be getting a large amount of fluids quite rapidly.

If you keep the fluid bag high enough above the cat, so that the line is free and as vertical as possible with no curving or twisting, the fluid will flow at an even rate. Using correct-sized needles also helps fluid flow freely (the smaller the gauge #, the thicker the needle), but be careful, some cats' skin is super tender and sensitive - especially older cats, and a smaller gauge needle could be more painful upon insertion). The drip-set they give you also needs to be a fast drip, not a slow one, so ask them to make sure they are giving you a fast drip set.

My personal preference for most cats is the 18 or 20 gauge needle (1 inch in length), and the 10 drops/ml drip set (the extension set or line set).

When the needle is inserted correctly, and when the bag is as high above the cat as possible, the fluid will flow fairly quick. Keep the bag high and the line draped over a coat hanger only once. 100 ml isn't very much to give, so it should be relatively quick. When the needle is inserted correctly, you can very very gently adjust the needle by pulling it outward at a tiny fraction and watch the drips from the line set flow faster. In other words, you don't have to insert the needle ALL the way into the skin, just enough to get a good hold, then ever so slightly move it outward (but not all the way out!) if the drips are too slow. Be careful with a nervous cat, one twitch from the back muscle can pop the needle out in a flat second! Best to hold the needle at the hub with your fingers very gently each time you're giving fluids to prevent the cat's twitching from popping out the needle.

If you have any further questions or need help with giving fluids, just ask, I'll be happy to help!

If your vet carries it, you could also try the Purina Veterinary NF instead of Hill's Rx KD. Belle might find it tastier. Dry or canned, ask your vet if she might benefit from canned instead of or in addition to, the dry. Ask him if he has samples of the dry food you can try.