HAPPY UPDATE! ...Bonbon has severe kidney disease. Tips on giving fluids, please?

Am so sad. New diabetic kitty, Bonbon, who seemed to be doing so well, has just been diagnosed out of the blue with severe kidney disease. The vet said she's never actually seen kidney values this bad! ...Apparently, back in November when she was taken into the rescue her kidney values were deemed to be "not a concern".... It's all such a shock....

Anyway.... Thinking about how to do the best for her, and a vet is coming to the house tomorrow to show me how to give fluids to her. ...I know that quite a few of you have done this for your kitties. Any tips on how to do this on my own? Yesterday it took a vet and a nurse to do it, and even then it looked like a bit of a struggle...

Thank you in advance, dear people... xxx

 

Oh I’m so sorry for the diagnosis! I’ve had to give fluids to a few of my cats. Most were good about it, but others not so much. Be sure to have everything ready to go. I sit in a chair in the bathroom, door closed so no disturbance from the other cats. I hang the fluids from a robe hook, put the needle and run some fluid through the line to be sure all’s well (i have had a few bad needles) Also be sure you can reach the shut off valve from your position. Then I get the cat, sit him on a large towel on my lap. The towel is so I can wrap it around him if he struggles too much. The first few times I usually forget something,but after a few times I get the routine going and you will too. Here’s a video to help
http://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.144366/
And I think @JanetNJ knows of a good one too.

 

Thanks so much for the advice, Sharon. ...Bonbon isn't a lap cat, and she struggled on the nurse's lap yesterday, and seemed more comfortable being held on the floor in the end. Do you think there's any possibility of my being able to give her fluids while she's on her favourite armchair, or something like that...?

 

Sure as long as you can keep her still. Do you know how much the vet wants you to give her? Sometimes I gave smaller amounts to start and worked up to the max amount vet wanted given.

 

Years ago, I gave 1 of my kitties fluids 3 0r 4 times a week for several years. The first few times I thought could never do this. After a while it gets routine, be sure to check the lines while giving fluids. One time I thought no fluids had come through because I could not see the fluids coming through the lines, but when I looked at the bag I could tell that fluid was gone.

I took a wooden board and laid it on the bathroom sink for the kitty to either lay or stand on and hung the bag of fluids off clothes hooks. After a while you will find out which way is comfortable for you & your kitty. This in the beginning seems bad, but after a while you will think this is not so bad. Good Luck and I hope it makes your kitty feel better.

 

My setup was similar to Sharon’s but I put Neko on a heat reflective pad on the floor in front of the hot air vent. Plus I had a handy supply of freeze dried chicken crumbles to keep her occupied. Often she would stay on the pad after we were done and I was gone. My second best spot was in my sunroom. Bag was on a hanger over the door, Neko was in her favourite bed in the sun. I brought everything to her.

Best of luck.

 

Elizabeth I am so sorry to hear this. Does Bonbon have an infection that could have elevated the numbers?
I used to give Sheba fluids too. I was anxious at first but it was the thought more than the actual procedure. Being organised beforehand is the key I think and keeping Bonbon occupied with a few treats. And as Wendy said, I too took everything to Sheba, I didn’t try and resettle her in a new spot to do it.
The fluid goes through quickly so it is only a few minutes. I always marked the bag with a marker where I wanted it to stop.

 

I used to give Zimmy cat nip while he had his fluids. He was such a good boy. Died April 1st two years ago.

Here's a great video.

 

Can

you post the labs? There's a great Facebook group called Cats with Chronic Renal Failure. Very knowledgeable.

 

Thank you all SO much. What would I do without you lot..?

I'm a bit of a nervous wreck this morning. But I am so grateful for all the info you've given and will go through it all in detail when I've calmed down a bit....and when my eyes have stopped leaking... (Breathe, breathe, breathe....)

She does (or did) have a high temperature, Bron.

Vet is going to email them today, I think, Janet. But she says she's never seen values this high. And it's come on so fast. Vet was asking if there were lilies in the house (no), or whether she might have had access to anti-freeze (no).... Can't think of anything she's had access to that the other cats haven't...

Thanks again, lovely people...

 

I'm glad you've posted here to ask for advice, Eliz - as we always say to others, this board is such an amazing source of support.

I'm no expert but what does seem strange is how this has come on so fast and the values are so very high. Bonnie had seemed to be doing so well, and wasn't it only a few days ago that her bg dropped "like a stone" I think was your expression? I know that infection could normally elevate bg but I wonder if that was the start of all this. Is there any possibility that infection, or allergy as the vet seems to be guessing, could be playing silly games with all sorts of things? Bonnie has been there with you for a good while there I know, but is there any value in looking round her room to see if there might be any other potential allergens? Have you taken anything out of cupboards? Has Chris brought something different into the house recently? Just trying to think this through as it is the suddenness that seems rather mystifying...

Anyway - stay positive. I know you will do whatever you can for your lovely little girl. Tell her that the might of FDMB is willing her on! Take care and I will pop over very soon...

 

• Poisons, which are the most common cause of acute renal failure. Antifreeze, toxic plants like lilies, pesticides, cleaning fluids, and certain human medications are highly poisonous to your cat’s kidneys. Even a single tablet of ibuprofen can lead to her kidneys shutting down. Check around your house and garage for these substances and make sure your cat can’t get into them.

Found this on another site... worth considering???

 

Thanks, Diana. I've been wracking my brains trying to think of anything she might have come into contact with....
She lives almost entirely in the conservatory, and doesn't even move around much... 'Get on armchair. Sleep. Go to water fountain. Go back to armchair. Wash. Sleep. Go to litter tray. Nibble food. Cuddle catnip pillow. Wash. Sleep...' She's only ventured out into the living room a few times and for a few minutes, and always monitored.
There are no plants in the conservatory. We use animal-friendly cleaners as much as we know how to (and none of the other cats are affected...). All the craft stuff is in cupboards shut away. There's nothing else....

 

Yes I thought so. But it's still a mystery that all this has come on so suddenly and I can't help wondering if it's an acute kidney issue rather than a chronic, severe one which surely would have been building up for ages...do cats go from "no cause for concern" reports to "end-stage kidney failure" in a matter of weeks...? Something doesn't quite add up in my - ok, uneducated - mind. If I were you I would post on as many sites as possible to see if anyone else has any thoughts about this - the Facebook group that Janet mentioned seems a good place tp start...

I've also just read that another sign of kidney disease is low body temperature, and you say Bonnie has a fever???

I'll keep thinking!

 

http://veterinarymedicine.dvm360.com/differentiating-between-acute-and-chronic-kidney-disease

 

Is she on am oral antibiotic? Hopefully between that and the fluids the toxins will flush.

 

All fingers and paws crossed for this!!

 

As for potential toxins, be sure whatever you’re feeding isn’t on a recall list. If it’s a kidney infection, I think I read here that those take a longer round of AB’s than a UTI. Not sure how that’s diagnosed though. Good luck with the fluids giving lesson. I know you’ll Ace it! Keep us posted.

 

How’s Bonbon?

 

Hi Sharon, so sweet of you to ask about her.

Bonbon doesn't 'appear' to be any worse so far, and seems comfortable.
Thanks to cerenia and mirtazapine she is eating a little better (but still not great).
My attempts to give her fluids are very 'hit and miss', literally! While I can get the needle into her I'm having trouble finding 'pockets' to get the fluids into. The vet has said that she's not the easiest cat as she seems to have some adhesions (?) under the skin. But we keep trying... I did give her a day off from me attempting to do it, and got a vet nurse to come to the house to do it yesterday. It was rather nice, because I had a day of just being able to be Bonbon's friend, and a break from looking for a good opportunity to stick a needle in her...
(It's funny, I can still remember thinking that insulin shots were hard, haha!)

We're still waiting for the results of the urine culture, and that's expected on Monday.

The vet is now leaning more toward thinking this is an acute kidney injury. But the cause remains a mystery...

It's been really difficult to know what to do because the prognosis was so poor initially.
The vet suggested 3 options. The first was to hospitalise her for 3 - 4 days, but with no way of knowing if this would improve the outcome at all.
The second was to do subQ's at home, and give meds to help nausea, stimulate appetite, and also address any pain, etc; so as to improve the quality of the life she had.
The third was to do neither of the above and just wait, spending time with her, and euthanizing her when the time came.

Given the extremely poor prognosis I opted not to hospitalize. She'd spent two and a half months in a cage at the rescue shelter, and during that time had two short stays at the vet as well. It was a stressful time for her.
She's now been here two months, and has recently started to seem really settled and happy here. And if her life is going to be short then it seems to me that the life that remains to her should be as settled and happy as possible. ...I'm endlessly second-guessing myself though about whether I've made the right choice...

The vet is happy for me to manage Bonbon's diabetes as seems appropriate. My strategy at the moment is just to try to keep her below the renal threshold (which she mostly is) without risking her dropping too low. I'm dosing conservatively because I know her response to the insulin may change as her kidneys worsen.
So, that's where we are...

I have finally stopped crying (at least for the time being). In the days and nights following the diagnosis I just cried and cried; and to an almost embarrassing degree for a woman of my advanced years.... ...It's been a very long time since anything affected me this much...

Eliz

 

Dear Elizabeth
I do understand how you feel. When Sheba’s blood results suggested CRD I was devastated and cried. I adjusted her diet and she remained stable until she died from pancreatic cancer almost three years later. Her CRD results were not severe but the shock of even hearing those CRD words puts terror into most of us I am sure. I do hope that Bonbon improves with your care and I think you did the right thing not subjecting her to more time in a cage. She is a very lucky girl to have found you
Do take care of yourself. Sending a plane load of strong Aussie vines to Bonbon.

 

(((((Eliz))))) the whole of FDMB is behind you and willing you to master the fluids knack and help Bonbon to feel better. We can all understand your distress, that's for sure... it is always upsetting when our babies are poorly, and Bonbon's kidneys dx came so out of the blue... I agree with Bron, it's the shock that you're dealing with as much as anything; you'd been doing so well with getting her diabetes under better control. I'm sure we would all be taking the same route as you as far as the vet's options are concerned and tricky though it is, it is better than nothing at all.
I really hope you will remember to look after yourself even more than usual with this now to manage... try to get good sleep and a good diet.
Big hugs, dear Eliz xx

 

I too agree you did the right thing brining her home to treat. I recently had a sick kitty and the vet wanted to keep him over the weekend. I refused because I felt confident treating at home and that’s because I knew I had this board to refer to if needed. I know I don’t have to tell you that we are here for you if you have questions or just need moral support!

 

For you and BonBon:

 

Well, it looks like Bonbon may have a kidney infection.
The urine didn't show any red/white blood cells under a microscope (as is usually seen with infection apparently), but did culture positive in the lab. So the vet says the infection may be in the kidney but not the bladder. ...We're now day 3 into a 20 day course of antibiotics....

Yesterday was a pretty challenging day. I'd given Bonbon a very conservative dose of insulin, but even so, her blood glucose dropped like a stone, completely unexpectedly. It was crazy. It went into free-fall for a time. And DH and I were both giving glucose into her mouth in the end to stop the drop just as she dropped into the beginning of hypo range. ...She was OK (but hungry!). But it was quite scary, not least because it was so totally unexpected.
...I thought her blood glucose would skyrocket after that, but it didn't... And that was strange too.... (I don't know if it's something to do with the kidney failure).
I didn't dare give her insulin last night. Skipped this morning too, and decided to raise the no-shoot number. Her blood glucose has been up and down all day (without insulin). Really weird.....

 

I don't know the science behind it, Eliz, but I'm never surprised to see bg dropping either gradually or rapidly when there's some kind of kidney issue going on. I had experience of that with my Tom. I was elated when his bg started dropping from the very high numbers he always had, until I learnt it was due to failing kidneys. There is an explanation for it but I barely understood it at the time, let alone now ten years on.

Let's hops that the antibiotics will clear up the infection so the overall picture starts to become clearer. I know this is far from easy for you but I also know that Bonbon couldn't be in better hands.

Hugs...

 

Glad you caught the BG drop and were able to stop it! Hopefully the kidney infection is the problem and once cured, Bonbons kidney values will improve.

 

How is Bonbon today?
I do hope the antibiotics help clear up any infection and improve the kidney numbers.
Sending more strong Aussie vines.

 

Well, since Bonbon has seemed to be sort of stable, and fairly settled over the two weeks since she first became sick, the vet suggested having some more diagnostics done. She had ultrasound yesterday. And the conclusions are that she has some major issues with her kidneys...
One is small and shriveled, and probably not functioning at all (probably caused by oxalate stone blockage/damage apparently). The other kidney is about twice the normal size, trying to compensate for the failed kidney. But the large kidney also has the beginning of damage.

I feel really sad for her. She's been though a lot. But in a way I think, on an emotional level, it's actually easier to deal with now; we're no longer 'guessing' what's wrong with her, and hopefully we can move forward with trying to make her remaining time as happy and pleasant as possible.

She'll continue on anti-nausea meds, appetite stimulant, antibiotics for a while, and subQ fluids (whether I give them or someone else does!). We may also try some painkillers, as the vet suspects she may have some pain...
And I need to find ways to manage her diabetes better. She had been doing really well up until this episode. But she's become really sensitive to insulin and needs far smaller doses than previously. It's a long time since I've measured teeny weeny doses and my old eyes are protesting somewhat, even though I use a big magnifying glass, haha! (Getting old is no fun.... )

The vet has taken bloods again too to see if her kidney values have improved at all with the fluids that she's been having. But generally she does 'seem' a bit happier overall.
So, that's where we are... Thanks so much for your kind thoughts and words, dear ones. You are such sweeties...

 

((((((Eliz)))))) I know how hard this is for you but maybe you're right - now that you have a clearer idea of what you're dealing with, things may settle into some sort of routine and you can get on with doing the best you can and giving her loads of love and TLC.

I do think this is one of those situations where a poor little kitty in desperate need of care finds herself with the "right" person. You have a wealth of experience of caring for cats at all stages of their lives. I too feel sad for her, that maybe she isn't going to make a total recovery and have a whole new life ahead of her - but she can still feel safe and loved with you and hopefully enjoy at least some quality of life, which is more than some poor kitties would have in her situation. Your comment that she seems to feel happier overall is a good sign that the fluids and antibiotics are helping her - long may that continue.

Sending big hugs!

 

When Colin was diagnosed with acromegaly, I knew he wasn’t going to live to a ripe old age. I was sad, but Once I came to terms with it, then I knew what needed to be done to make whatever time he had the best it could be. You’re doing a great job with Bonbon, she knows she’s loved and really that’s the most important thing. Fingers crossed the bloodwork comes back better and sweet Bonbon has lots of happy years ahead of her.

Maybe something like this can help with the teeny doses
https://www.bd.com/en-us/offerings/...tion/bd-magni-guide-insulin-syringe-magnifier

 

Eliz, I don't know how I missed this post but I'm guessing I kept bypassing because I have no knowledge/help to share regarding kidney issues and giving fluids. I always think of Bertie when I think of you and I guess I read the title but no further because I didn't recognize Bonbon's name.

In any case, I just wanted to offer my support too. Bonbon could not found herself a better kitty Mom and no matter what the future holds, she is in a loving caring home getting all the attention she needs and deserves. I am sending boatloads of hugs for you and tons of healing vines and scritches for Bonbon.

 

UPDATE! ...Great news for Bonbon! Her recent blood test shows her kidney values have returned to almost normal!

The vets were astonished and delighted, and said they'd only seen this happen once before. ...That one functioning kidney seems to be doing a good job...
It looks like the problem may have been caused by a stone blocking the small kidney, and causing urine to back up. But the stone looks like it's dropped into the bladder. And there is now no infection showing in the urine culture....
She's always going to be vulnerable in that area. And we now know that she can hide pain very well, as she must have been in great pain, but wasn't showing it.... But the vets think she has a good chance of living a normal life... They're going to write about her in their newsletter.

Can't quite take it in yet. And will be keeping a very close eye on her for a while....

She went into the garden yesterday for the first time. She just went a couple of meters from the back door, and then came back in. But today she's gone out again and explored a lot of the garden, sniffing everything, and watching butterflies and insects buzzing about. It was lovely to see her sitting out in the sunshine. Didn't know if she'd ever get that chance.... Then when we came indoors we got the call from the vet with the good news.
I think I will sleep well tonight for the first time in quite a while...

 

Oh my..... happy tears of joy at this glorious news! Give that brave little girl some scritches for me and to you! I can only imagine what a relief this is!

 

So happy for little Bonbon and of course you, Eliz! Just shows what good, loving care can do.
I'll be there in half an hour with a bottle of bubbly haha!

 

Oh rats I wish I wasn't so far off. I'd love to share a toast!

 

We can have a "virtual" party!

 

Thank you! HMMMMM! Good! CHEERS!

 

WOOT!!!!
And CHEERS!!!!!!

 

This is such wonderful news, Elizabeth! Cheers (sips virtual champagne)!

 

Happy dance! Happy dance!
That is great news Elizabeth.
I am so happy for you and Bonbon.
Early in the morning here but I’m raising a glass of virtual champagne too