Hello:
My first post didn't seem to go through so I'm trying again (I reloaded the page, etc., but if it double-posts, forgive me).
My kitty, Casey, was Dx'd CRF a few years ago, but now it's escalated in the last 5 months or so. She has to urinate at least every hour, and we went from weekly Sub-Qs at the vet to doing it at home at least 2-3x/week. We're still not comfortable doing it, so it's stressful for both me and the cat (today will be #4).
How do you know when you need to Sub-Q even more often? How often can they go to the litter box and you still feel there's "quality" of life left (I mean, how can she get in a good snooze?)? She has good days and she has some "complaining" days. I'm still trying to figure out exactly what her complaining means (she's always been a vocal cat, though). She gets constipated often, so I'm now forcing Laxatone on her each day--which she absolutely hates, but it helps. Yesterday I discovered CatSure and she likes it, so it'll be good for more liquids. Unfortunately for her, she still prefers her dry Science Diet that she's eaten all her life. I try canned food each day, but she's usually not receptive.
I just don't know how much longer to go on with this. I feel like crying each time she meows, but I don't know who's in more discomfort--me or her. My husband won't talk about it (Casey is our "only child"). I guess I'm just seeking some advice and ideas/suggestions from those of you who've been through this........
Thank you in advance for your thoughts!
Tracey
20.5 y/o in CRF questions
Re: 20.5 y/o in CRF questions
Isn't your vet answering your questions and advising you through this?
How often is she seen by your vet? That's the only way to know how it's progressing. Bloodwork determines how her kidneys are functioning and how much fluids she needs, as well as checking her blood pressure, ruling out secondary infections or secondary health illness, like hyperthyroidism or diabetes, are these things being checked for on a regular basis?
Also, supplements may be needed to keep her calcium/phospohorus balanced, ask your vet about that promptly.
Has your vet recommended a strict renal diet? There are several prescription diets available for this, both in canned and dry. If she doesn't like one veterinary brand, try another, your vet needs to give you samples so you can determine which one she will prefer. It is ideal to keep her on a veterinary prescribed diet because it is specifically formulated and balanced for renal impairment. (low in fat, low in potassium, salt, phosphorus). Feeding one of the canned prescription diets may help give her added moisture which helps in renal impairment.
The amount of fluids each day/week depends on the cat, dehydration status, renal perfusion and the kidney's functioning level. Again, bloodwork is crucial frequently to determine this.
Some cats have as few as once or twice a week of fluid maintenance, others several times a week. When done properly, it benefits the cat greatly. If you're not comfortable, you may be stressing her or not following through with giving her the required amounts she needs. Talk to your vet and have him show you again and again when necessary, how to give them, how to gently restrain kitty, how to keep her occupied while you're giving fluids etc etc. Also make sure he gives you a line set that provides a fast, rapid flow of fluids for quicker administration, and also the correct size needles that will allow a faster flow of fluids and yet not aggrivate her sensitive skin, these two things are very important!
The constipation needs to be addressed immediately by your vet. The correct diet should help this (preferrably in canned form). He also has mild medications available to prevent or manage frequent constipation problems. IBD should also be ruled out! If you're feeding a proper diet geared for her needs, she shouldn't have constipation issues, and she could also require an extra day or more of fluids per week.
BTW, the CatSure you're feeding would best be replaced with the PetAg Formula V Enteral Care MLP, since it is lower in protein than the CatSure. You do NOT want a high protein product in a renal impaired cat, you want low protein. Also, these liquid diets are supplemental only, designed to be fed in supplemental form to an already established balanced diet. The CatSure, and possibly even the Enteral Care MLP might be the cause of the constipation, so you must ask your vet about that. If you decide to switch to the Enteral Care MLP, make sure your vet evaluates the ingredients and protein levels first, and make sure it isn't going to be a cause for constipation.
With fluids, you can also space them apart to make kitty more comfortable. For example, if your vet says to give her 200 ml fluids one day, give 100 ml fluids in the morning, and the other 100 ml in the evening, this helps them feel better for the majority of the day when they are most active. Likewise, you can split each amount in different locations on the body, for example: If giving the morning 100 ml's of fluids, give 50 ml just over the left shoulder, the other 50 mls over the right shoulder, this helps to prevent the large lump of fluids that occurs when a large amount is given in one area. Please talk to your vet about this, since when you're more comfortable giving them, kitty is more comfortable and is less stressed at the time you have to give fluids.
The frequent urinating could be a sign of a urinary tract infection (or newly forming diabetes), so talk to your vet about that immediately and get those things ruled out. Her urine might be dilute or overly concentrated, so the diet also plays a role in that, just another reason to ensure she is on the most appropriate diet for her needs.
As long as she is seemingly enjoying her days, is able to and enjoys her surrounding and her environment, is eating and drinking normally, continues to bond with you and enjoys even slight activity/play or her favorite things, then don't assume she isn't faring well. When there is constant vomiting (and/or diarrhea), obvious pain, lethargy, withdrawal or disinterest or cognitive signs, then you have to worry and you'd want her examined and bloodwork done to ensure there isn't more you and your vet could do for her. If your vet isn't addressing your concerns, you need to see a vet who will and is committed to providing the best care possible for her. Again, appropriate renal diet, appropriate fluids maintenance, supplements when necessary (as rx'd by your vet only) and with bloodwork and monitoring, all things necessary to manage renal disease. If you're getting frustrated, you might slip into a complacent attitude, and her care will suffer, so talk to your vet (or see a new one), get your concerns met directly and make sure to avail the medications/treatment available to treat symptoms that may occur.
How often is she seen by your vet? That's the only way to know how it's progressing. Bloodwork determines how her kidneys are functioning and how much fluids she needs, as well as checking her blood pressure, ruling out secondary infections or secondary health illness, like hyperthyroidism or diabetes, are these things being checked for on a regular basis?
Also, supplements may be needed to keep her calcium/phospohorus balanced, ask your vet about that promptly.
Has your vet recommended a strict renal diet? There are several prescription diets available for this, both in canned and dry. If she doesn't like one veterinary brand, try another, your vet needs to give you samples so you can determine which one she will prefer. It is ideal to keep her on a veterinary prescribed diet because it is specifically formulated and balanced for renal impairment. (low in fat, low in potassium, salt, phosphorus). Feeding one of the canned prescription diets may help give her added moisture which helps in renal impairment.
The amount of fluids each day/week depends on the cat, dehydration status, renal perfusion and the kidney's functioning level. Again, bloodwork is crucial frequently to determine this.
Some cats have as few as once or twice a week of fluid maintenance, others several times a week. When done properly, it benefits the cat greatly. If you're not comfortable, you may be stressing her or not following through with giving her the required amounts she needs. Talk to your vet and have him show you again and again when necessary, how to give them, how to gently restrain kitty, how to keep her occupied while you're giving fluids etc etc. Also make sure he gives you a line set that provides a fast, rapid flow of fluids for quicker administration, and also the correct size needles that will allow a faster flow of fluids and yet not aggrivate her sensitive skin, these two things are very important!
The constipation needs to be addressed immediately by your vet. The correct diet should help this (preferrably in canned form). He also has mild medications available to prevent or manage frequent constipation problems. IBD should also be ruled out! If you're feeding a proper diet geared for her needs, she shouldn't have constipation issues, and she could also require an extra day or more of fluids per week.
BTW, the CatSure you're feeding would best be replaced with the PetAg Formula V Enteral Care MLP, since it is lower in protein than the CatSure. You do NOT want a high protein product in a renal impaired cat, you want low protein. Also, these liquid diets are supplemental only, designed to be fed in supplemental form to an already established balanced diet. The CatSure, and possibly even the Enteral Care MLP might be the cause of the constipation, so you must ask your vet about that. If you decide to switch to the Enteral Care MLP, make sure your vet evaluates the ingredients and protein levels first, and make sure it isn't going to be a cause for constipation.
With fluids, you can also space them apart to make kitty more comfortable. For example, if your vet says to give her 200 ml fluids one day, give 100 ml fluids in the morning, and the other 100 ml in the evening, this helps them feel better for the majority of the day when they are most active. Likewise, you can split each amount in different locations on the body, for example: If giving the morning 100 ml's of fluids, give 50 ml just over the left shoulder, the other 50 mls over the right shoulder, this helps to prevent the large lump of fluids that occurs when a large amount is given in one area. Please talk to your vet about this, since when you're more comfortable giving them, kitty is more comfortable and is less stressed at the time you have to give fluids.
The frequent urinating could be a sign of a urinary tract infection (or newly forming diabetes), so talk to your vet about that immediately and get those things ruled out. Her urine might be dilute or overly concentrated, so the diet also plays a role in that, just another reason to ensure she is on the most appropriate diet for her needs.
As long as she is seemingly enjoying her days, is able to and enjoys her surrounding and her environment, is eating and drinking normally, continues to bond with you and enjoys even slight activity/play or her favorite things, then don't assume she isn't faring well. When there is constant vomiting (and/or diarrhea), obvious pain, lethargy, withdrawal or disinterest or cognitive signs, then you have to worry and you'd want her examined and bloodwork done to ensure there isn't more you and your vet could do for her. If your vet isn't addressing your concerns, you need to see a vet who will and is committed to providing the best care possible for her. Again, appropriate renal diet, appropriate fluids maintenance, supplements when necessary (as rx'd by your vet only) and with bloodwork and monitoring, all things necessary to manage renal disease. If you're getting frustrated, you might slip into a complacent attitude, and her care will suffer, so talk to your vet (or see a new one), get your concerns met directly and make sure to avail the medications/treatment available to treat symptoms that may occur.
..........Traci
-
TabBaldwin
- Posts: 12
- Joined: Sat Jul 22, 2006 9:26 pm
Re: 20.5 y/o in CRF questions
Thank you for the lengthy reply, Traci. I appreciate your time.
Yes, the kitty has had regular blood work--last was about a couple of months ago; we'll be doing it again soon. The only elevations were BUN and Creatinine; Albumin was approaching the high end of normal. No diabetes, no thyroid problems. I can't lay my hands on the most recent results, or I'd tell you what they were.
Ideally, I know she should be on a renal diet, but we tried that 5 years ago when her enzymes started to elevate; she refused and lost a lot of weight and muscle mass. She's SO finicky there is no getting her to eat what she doesn't want to eat. She's stubborn enough she'll starve herself. I throw away several cans a day of different flavors of can food to try and get her to eat--it's getting expensive! I've stayed to the premium brands so far, but we've run out of that "new flavor excitement"--no new ones to try. She also only likes seafood flavor. She considers can food "treats" and her regular dry as her food--hard to change an old cat's habits, even if it's in her best interest.
She's always been a light drinker and always tended towards constipation. She first got the Cat Sure last night after I discovered it at Petsmart when buying more Laxatone.
I think she's having a bad day because she had a BM problem last night which led her to throw up (they go hand-in-hand with her, not quite 1x per week--the straining problem/vomiting, not the BMs). She has had one UTI--2 months ago. I have Clavamox on standby, just in case. The increased frequency of urination started back about July-August, and our vet said it's probably the kidneys needing to dump the urine more often due to toxins.
I guess I was just hoping that others who've been through this might offer a little insight, but I guess every case is different. This is my first time to deal with an aged or chronically ill pet, and I don't think I'm handling it very well. I think I'm in more distress than she is, and I know that my stress then impacts her. I just don't want to put her through unnecessary treatment at her expense. It's not like there's a cure at the end of all this.
Thank you again.
Tracey
Yes, the kitty has had regular blood work--last was about a couple of months ago; we'll be doing it again soon. The only elevations were BUN and Creatinine; Albumin was approaching the high end of normal. No diabetes, no thyroid problems. I can't lay my hands on the most recent results, or I'd tell you what they were.
Ideally, I know she should be on a renal diet, but we tried that 5 years ago when her enzymes started to elevate; she refused and lost a lot of weight and muscle mass. She's SO finicky there is no getting her to eat what she doesn't want to eat. She's stubborn enough she'll starve herself. I throw away several cans a day of different flavors of can food to try and get her to eat--it's getting expensive! I've stayed to the premium brands so far, but we've run out of that "new flavor excitement"--no new ones to try. She also only likes seafood flavor. She considers can food "treats" and her regular dry as her food--hard to change an old cat's habits, even if it's in her best interest.
She's always been a light drinker and always tended towards constipation. She first got the Cat Sure last night after I discovered it at Petsmart when buying more Laxatone.
I think she's having a bad day because she had a BM problem last night which led her to throw up (they go hand-in-hand with her, not quite 1x per week--the straining problem/vomiting, not the BMs). She has had one UTI--2 months ago. I have Clavamox on standby, just in case. The increased frequency of urination started back about July-August, and our vet said it's probably the kidneys needing to dump the urine more often due to toxins.
I guess I was just hoping that others who've been through this might offer a little insight, but I guess every case is different. This is my first time to deal with an aged or chronically ill pet, and I don't think I'm handling it very well. I think I'm in more distress than she is, and I know that my stress then impacts her. I just don't want to put her through unnecessary treatment at her expense. It's not like there's a cure at the end of all this.
Thank you again.
Tracey
Re: 20.5 y/o in CRF questions
While renal disease is not cured, the progression can be slowed, but as stated above, all those things need to be taken into account. Medications for this aren't invasive, they are mild and treat symptoms, alleviate them to allow the cat to feel and be more comfortable.
Although I never ever recommend it, ask your vet about Fancy Feast canned cat food, many renal cats seem to like it. Again, ask vet first.
It's not really productive to have to keep giving her laxatone, it's not intended for long term use.
Ask the vet about Fancy Feast, possibly more sub-q fluids. Ask him to rule out dehydration, acid in the stomach, mineral imbalance, etc. (things like an acidic stomach isn't obvious to owners, but simple meds like pepcid, on the direction of your vet only, can work wonders).
If you're talking about clavamox in the powder form, that is, it has NOT been mixed with water yet, do not use it without asking your vet first and make sure it isn't expired. If it's clavamox that's already been mixed, you can't use it, once reconstituted, it is only good for 7-14 days then must be discarded. Again, don't use it without first discussing it with your vet, because sometimes, antibiotics make them feel even worse. It should only be used in the event there's a known infection.
Your vet might consider lactulose or something similar to help with regulating her stools, but ideally, the diet should be appropriate, and in canned form as much as possible, providing the protein content is low.
Although I never ever recommend it, ask your vet about Fancy Feast canned cat food, many renal cats seem to like it. Again, ask vet first.
It's not really productive to have to keep giving her laxatone, it's not intended for long term use.
Ask the vet about Fancy Feast, possibly more sub-q fluids. Ask him to rule out dehydration, acid in the stomach, mineral imbalance, etc. (things like an acidic stomach isn't obvious to owners, but simple meds like pepcid, on the direction of your vet only, can work wonders).
If you're talking about clavamox in the powder form, that is, it has NOT been mixed with water yet, do not use it without asking your vet first and make sure it isn't expired. If it's clavamox that's already been mixed, you can't use it, once reconstituted, it is only good for 7-14 days then must be discarded. Again, don't use it without first discussing it with your vet, because sometimes, antibiotics make them feel even worse. It should only be used in the event there's a known infection.
Your vet might consider lactulose or something similar to help with regulating her stools, but ideally, the diet should be appropriate, and in canned form as much as possible, providing the protein content is low.
..........Traci
-
TabBaldwin
- Posts: 12
- Joined: Sat Jul 22, 2006 9:26 pm
Re: 20.5 y/o in CRF questions
Thank you for the info about Fancy Feast....but Casey might prove you wrong on that--she proved our vet wrong when she said chicken baby food would get her to eating (when she had a bout with pancreatitis 2 years ago), and that didnt' work--now if they made baby seafood, she might eat it 
Our vet did say, when I asked her about it, that she'd rather have Casey eat her Sci. Diet Senior kibble as opposed to the "lesser" grades of canned food, but I'll ask her about Fancy Feast.
This cat can tell if Metamucil or Pepcid is mixed with food and will ignore it! It's also VERY hard to try and pill her. I barely got the Clavamox down her, but I did seem to have better luck with the liquid and dropper (ABX) than pills. She's never been "manhandled" and I've let her be the boss all these years, unfortunately.
I don't like giving her Laxatone any better than she likes getting it--via oral syringe--but it's better than the alternative (crying from constipation). I did ask for an Rx for Lactulose and have it on stand-by for real emergencies. I haven't used it yet.
She IS dehydrated--probably has been somewhat all her life. She is better when freshly hydrated--that's why I was glad to be doing it at home, but I guess I celebrated that too soon. I have ordered some Terumo needles (supposedly sharper than Monoject) to try--a smaller size that has ultra thin walls so you aren't trading off too much in the flow rate.
Thank you again for your helpful replies!
Tracey
Our vet did say, when I asked her about it, that she'd rather have Casey eat her Sci. Diet Senior kibble as opposed to the "lesser" grades of canned food, but I'll ask her about Fancy Feast.This cat can tell if Metamucil or Pepcid is mixed with food and will ignore it! It's also VERY hard to try and pill her. I barely got the Clavamox down her, but I did seem to have better luck with the liquid and dropper (ABX) than pills. She's never been "manhandled" and I've let her be the boss all these years, unfortunately.
I don't like giving her Laxatone any better than she likes getting it--via oral syringe--but it's better than the alternative (crying from constipation). I did ask for an Rx for Lactulose and have it on stand-by for real emergencies. I haven't used it yet.
She IS dehydrated--probably has been somewhat all her life. She is better when freshly hydrated--that's why I was glad to be doing it at home, but I guess I celebrated that too soon. I have ordered some Terumo needles (supposedly sharper than Monoject) to try--a smaller size that has ultra thin walls so you aren't trading off too much in the flow rate.
Thank you again for your helpful replies!
Tracey
Re: 20.5 y/o in CRF questions
Many of the Fancy Feast flavors are fish varieties, they're relatively inexpensive so it might not hurt to pick up a few cans. I normally don't recommend this for any cat, but it's not the absolute worst out there and alot of cats like it. Do you have the Science Diet senior in canned form? Have you tried it? Have you tried Iams canned, or even Friskies?
You can dissolve a pepcid tab in a syringe with about a 1/4 or 1/2 ml of water in a syringe or eyedropper. You can also use tuna water or gravy from canned food to draw up in the syringe with it to sort of mask the taste. Be sure the tabs are scored and dosed correctly first (scoring them into quarters also helps them dissolve faster). Again, make sure the amount you have on hand is not expired, because it can and does and when exposed to air and light or unused for periods of time, it loses it's effectiveness.
You can also ask your vet about sucralfate (carafate), it works as a buffer in the stomach. (it is NOT like pepto or any bismuth types, these are hazardous to cats since they contain salicylates)
If she's nauseous, which is common in renal disease, your vet can prescribe a temporary dose of reglan, it's worth talking to him about.
I think if you can get her to eat more canned food, and give more fluids during the week (your vet will advise you on amounts and how many times a week, based on her dehydration and weight), she might feel alittle better and might have more normal stools.
BTW, when giving fluids, also make sure the fluid bag is raised well above kitty when you're administering them. It flows faster, but again, you want a line set that allows more drips per second. Try putting the bag on a big plastic clothes hanger, and hang the hanger's hook on an open top cupboard door, and administer fluids for kitty on the countertop. Distract her with soothing voice or maybe her favorite toy (for comfort) in front of her, or let her eat a small amount of food when you're doing it. Place a soft blanket under her in case the fluids are cold and she feels cold. Most of the time, it's just better not to do anything but give the fluids and keep her calm and get it done quickly. Don't move the needle around, just insert it at a slight angle and don't insert it very far, it's not necessary to insert it too far. Warming the fluids bag prior also helps, just lay it in a sink with warm water for a few moments before administering. (do NOT let it get hot). You don't have to refrigerate fluids, keep them on a hanger in your closet or somewhere at normal house temps, and drape, do not coil, the line over the hanger once.
I know how hard it is for you, I've been there. But, once you get the hang of giving fluids, you will then be more confident and won't be worrying so much. They really do help perk them up, and they rehydrate well and give them an overall better feeling. When she feels better, you feel better.
She has amazed you with 20+ years of life, it sounds like she has alot of will left in her, so if you get concerned about something, just call your vet, if he's busy, leave a message with the staff that you wish your call to be returned promptly so you can get your concerns met. Do not feel like you're badgering him, that's what he's there for. Hang in there and don't get discouraged!
You can dissolve a pepcid tab in a syringe with about a 1/4 or 1/2 ml of water in a syringe or eyedropper. You can also use tuna water or gravy from canned food to draw up in the syringe with it to sort of mask the taste. Be sure the tabs are scored and dosed correctly first (scoring them into quarters also helps them dissolve faster). Again, make sure the amount you have on hand is not expired, because it can and does and when exposed to air and light or unused for periods of time, it loses it's effectiveness.
You can also ask your vet about sucralfate (carafate), it works as a buffer in the stomach. (it is NOT like pepto or any bismuth types, these are hazardous to cats since they contain salicylates)
If she's nauseous, which is common in renal disease, your vet can prescribe a temporary dose of reglan, it's worth talking to him about.
I think if you can get her to eat more canned food, and give more fluids during the week (your vet will advise you on amounts and how many times a week, based on her dehydration and weight), she might feel alittle better and might have more normal stools.
BTW, when giving fluids, also make sure the fluid bag is raised well above kitty when you're administering them. It flows faster, but again, you want a line set that allows more drips per second. Try putting the bag on a big plastic clothes hanger, and hang the hanger's hook on an open top cupboard door, and administer fluids for kitty on the countertop. Distract her with soothing voice or maybe her favorite toy (for comfort) in front of her, or let her eat a small amount of food when you're doing it. Place a soft blanket under her in case the fluids are cold and she feels cold. Most of the time, it's just better not to do anything but give the fluids and keep her calm and get it done quickly. Don't move the needle around, just insert it at a slight angle and don't insert it very far, it's not necessary to insert it too far. Warming the fluids bag prior also helps, just lay it in a sink with warm water for a few moments before administering. (do NOT let it get hot). You don't have to refrigerate fluids, keep them on a hanger in your closet or somewhere at normal house temps, and drape, do not coil, the line over the hanger once.
I know how hard it is for you, I've been there. But, once you get the hang of giving fluids, you will then be more confident and won't be worrying so much. They really do help perk them up, and they rehydrate well and give them an overall better feeling. When she feels better, you feel better.
She has amazed you with 20+ years of life, it sounds like she has alot of will left in her, so if you get concerned about something, just call your vet, if he's busy, leave a message with the staff that you wish your call to be returned promptly so you can get your concerns met. Do not feel like you're badgering him, that's what he's there for. Hang in there and don't get discouraged!
..........Traci
-
TabBaldwin
- Posts: 12
- Joined: Sat Jul 22, 2006 9:26 pm
Re: 20.5 y/o in CRF questions
Hi:
Yes, I've tried all the flavors of Sci Diet and Iams. Some of the seafood flavors she ate a few times then turned up her nose at them.
I just picked up some fresh Pepcid AC tabs to have on hand. If I need to use it, I'll dissolve in water and give to her via a syringe--thanks for the idea.
Regarding fluids--we had a really good set-up going, just not the cooperative patient! The bag is high above her head, and she's restrained in her nice leather carrier that has a zip-top opening. I have rolled up towels placed all around her so she can't move much. I also warmed the fluid bag in a bowl of rather warm water, and I drain the line of the colder water before sticking her with it. I'm waiting on the Terumo needles to try. I won't give up, but we may do it 2x/week at the vet for awhile before I try it again (unless bad winter weather forces me to do it). Afterwards, she has her heated pet bed to go to. Oh, thanks for telling me I don't have to insert the needle the whole way. I guess just a tiny bit more past that initial breakthrough should do it?
Oh, I just started trying Miralax (1/8th to 1/4th tsp mixed in tuna juice) on Casey. We had a small BM today that didn't seem to cause too much straining. I found that mentioned on another forum(s) about constipated cats.
I think I'm also going to have my vet do another urine culture for infections. I can't find anyone else who's cared for a CRF pet that had them urinating 1-2x an hour! Other literature suggested that a 2-week dose of ABX isn't enough to kill off the infection (we did ABX 2 months ago). I know a lot of that frequency is her trying to pass stool and at those times she passes tiny amounts of urine, so I can't be for sure exactly which trip to the box is for what. Poor kitty.
Oh, regarding urine samples. Is it horribly bad or unsafe for the vet to use a needle to get urine directly from the bladder for the most accurate test? That was done once a long time ago, but Casey was much younger and not sick at the time, so I didn't think much about it. Now, I worry.....
Thanks so much.
Tracey
Yes, I've tried all the flavors of Sci Diet and Iams. Some of the seafood flavors she ate a few times then turned up her nose at them.
I just picked up some fresh Pepcid AC tabs to have on hand. If I need to use it, I'll dissolve in water and give to her via a syringe--thanks for the idea.
Regarding fluids--we had a really good set-up going, just not the cooperative patient! The bag is high above her head, and she's restrained in her nice leather carrier that has a zip-top opening. I have rolled up towels placed all around her so she can't move much. I also warmed the fluid bag in a bowl of rather warm water, and I drain the line of the colder water before sticking her with it. I'm waiting on the Terumo needles to try. I won't give up, but we may do it 2x/week at the vet for awhile before I try it again (unless bad winter weather forces me to do it). Afterwards, she has her heated pet bed to go to. Oh, thanks for telling me I don't have to insert the needle the whole way. I guess just a tiny bit more past that initial breakthrough should do it?
Oh, I just started trying Miralax (1/8th to 1/4th tsp mixed in tuna juice) on Casey. We had a small BM today that didn't seem to cause too much straining. I found that mentioned on another forum(s) about constipated cats.
I think I'm also going to have my vet do another urine culture for infections. I can't find anyone else who's cared for a CRF pet that had them urinating 1-2x an hour! Other literature suggested that a 2-week dose of ABX isn't enough to kill off the infection (we did ABX 2 months ago). I know a lot of that frequency is her trying to pass stool and at those times she passes tiny amounts of urine, so I can't be for sure exactly which trip to the box is for what. Poor kitty.
Oh, regarding urine samples. Is it horribly bad or unsafe for the vet to use a needle to get urine directly from the bladder for the most accurate test? That was done once a long time ago, but Casey was much younger and not sick at the time, so I didn't think much about it. Now, I worry.....
Thanks so much.
Tracey
Re: 20.5 y/o in CRF questions
No, a cystocentisis (needle) is the best way to get an uncontaminated sample. Urine changes quite quickly when exposed to air and temperature, so the cysto is quick and the tests can be run immediately after collection. Having said that, it's not always possible with a cysto if the cat has an empty bladder, is overly stressed, or extremely thin, etc.
It is true in some cases with the antibiotics, but not all. It depends on the infection, location of infection, type of infection, and kitty's overall health status. Yes, a urine culture and sensitivity is a good idea since you might have a more resistant bacteria that may require a stronger antibiotic. Renal patients and diabetic patients are more susceptible to UTI's, as are any cat who has a prior history of infections or blockages. This is why prescribed diets are ideal because they help keep the urine pH in balance.
Yes, once you insert the needle just enough that the skin "sticks" and the needle stays in place when the fluids are started, you don't have to insert it further (watch the end of the needle to make sure fluids aren't flowing back out, if they are, the needle isn't inserted correctly or far enough). As a matter of fact, if you insert it too far, you'll find the fluids flow very slow. In a severely dehydrated cat, or older cat who doesn't have much fat under the skin, you still need to be careful because the skin tends to be very thin and tender. This is why you want a very thin needle but still allows for fast flow of fluids.
It is true in some cases with the antibiotics, but not all. It depends on the infection, location of infection, type of infection, and kitty's overall health status. Yes, a urine culture and sensitivity is a good idea since you might have a more resistant bacteria that may require a stronger antibiotic. Renal patients and diabetic patients are more susceptible to UTI's, as are any cat who has a prior history of infections or blockages. This is why prescribed diets are ideal because they help keep the urine pH in balance.
Yes, once you insert the needle just enough that the skin "sticks" and the needle stays in place when the fluids are started, you don't have to insert it further (watch the end of the needle to make sure fluids aren't flowing back out, if they are, the needle isn't inserted correctly or far enough). As a matter of fact, if you insert it too far, you'll find the fluids flow very slow. In a severely dehydrated cat, or older cat who doesn't have much fat under the skin, you still need to be careful because the skin tends to be very thin and tender. This is why you want a very thin needle but still allows for fast flow of fluids.
..........Traci
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TabBaldwin
- Posts: 12
- Joined: Sat Jul 22, 2006 9:26 pm
Re: 20.5 y/o in CRF questions
Thanks, Traci.
Gosh, I don't think her bladder would be full enough for a needle-acquired sample since she voids so often and her puddles are smallish (depending on her hydration status). I'll discuss with my vet about it.....
Good news on the constipation issue--the Miralax is working.
Thank you so much for your time and help!
Tracey
Gosh, I don't think her bladder would be full enough for a needle-acquired sample since she voids so often and her puddles are smallish (depending on her hydration status). I'll discuss with my vet about it.....
Good news on the constipation issue--the Miralax is working.
Thank you so much for your time and help!
Tracey
Re: 20.5 y/o in CRF questions
A cysto is ideal, for the main reason it is quick, and affords the best uncontaminated fresh sample. But, it is not prudent with an empty bladder. Sometimes, manual expression of the bladder will produce enough for a testable sample, otherwise, the vet may suggest leaving kitty at the clinic for a couple hours to see if she will produce.
You can also collect a sample at home, if you are careful and can get it to your vet promptly for testing.
Use an empty clean litterbox, place only a paper towel in it, or "no-sorb" crystals your vet might have to send home with you, as soon as kitty produces, collect the urine with a syringe, (if using paper towel, wring the towel of urine and collect the urine) place the syringe in a plastic baggie or clean container, seal, place in fridge until you can get it to your vet for testing. Within a few hours is best because temperature and timing can affect the results.
You can also collect a sample at home, if you are careful and can get it to your vet promptly for testing.
Use an empty clean litterbox, place only a paper towel in it, or "no-sorb" crystals your vet might have to send home with you, as soon as kitty produces, collect the urine with a syringe, (if using paper towel, wring the towel of urine and collect the urine) place the syringe in a plastic baggie or clean container, seal, place in fridge until you can get it to your vet for testing. Within a few hours is best because temperature and timing can affect the results.
..........Traci