EMERGENCY-need help for Fred-100ml fluids (CRF)-breathing

HI
Fred's blood sugar had been great all year, in the 200s consistently, and I dropped his dose to .5+ unit, then end of September it got worse and for the past 3 months it was high all the time 400s, 500s and HI. I have been giving fluids since June--vet advised 150ml per day, but then went to another vet who said half that or do it every other day. I ended up going tiwht 75/100ml day but then noticed he would frequently go limp after getting fluids--hind legs, only temporarily, but couldn't stand.

I took him to new vet and Potassium not low, CRF number back to what they were in June, afte rhaving improved from fluids in Augu--but I was now giving him less fluids.

Anyway, the past few weeks I've been giving him 25-50ml fluids and that seems to be ok, no limpness. One night 10 days ago he had some weird breathing, and I wondered if it was breathing on the lung. It went away.

Suddenly the past week or more he's been haviang great numbers 200s, 100s, consistently--I upped the dose to 1.5- from having been hovering at around 1+, made abig difference.
I dropped the fluids to this amount, things looked good.

Then tonite I gave Fred 100ml, only because he was dehydrated looking and I had only given him 25ml yesterday.

Then shortly after I took hiim to litter box and he went limp, then he evacuated, poop and peed while limp. Then he started breathing heavy with mouth/teeth open, that wheezy thing. My other kitty, ARtichoke, who died, fred's borther had that once after fluids 5 years ago. I knoew it's not good.

I held hiim kind of panicking not knowing what to do, trying to get on all these crf and db boards to ask, and then called and emergency vet and all they said was no adivce but bring him in if there is concern. In the meantime Fred was on my lap and getting back to normal.

He only ate one can (not even) of 3oz wellness both yesterday and today--which is very unusal he normally has 2 and never has hunger issues.

Now, about 30-45 minutes after this episdoe he is fine. He is looking alert again (eyes not staring/glassy), his head and ears have perked up. I have him in his kitty bed with a heating pad on top (on top of a light blanket), and I have him propped up slightly--so his head and lungs are higher than the rest of body--figure that makes sense...

now I wonder...should I take him in? I'm inclined not to. He just had blood tests one month ago and I think the prob was def. too much fluid.

TOMORROW I was going to do a Reiki Level I training so I could do some healing on him--with a woman in Nyack, NY who specializes in Reiki for animals. I really needed that sill TONITE!!!

anyway, any advice much appreciated
thanks
Martica and a tired out Fred

 

Fred is now purring, eyes sleepy looking, more back to normal, but still weak. But his breathing is sounding normal and he's purring. I've propped him up on a pillow so his head and lungs are above heart level.

 

what kind of insulin are you using?

 

was the 100 ml insulin ?

 

David, Martica is referring to Subcutaneous fluids given to cats who are dehydrated. That's what the 100 ml is. It's a bag of fluid, lactated ringers (like on tv), that is given in just below the skin.

It appears that the fluids is messing with Fred's system. Martica, I'm sorry I can't help, but I'm going to try to contact a few people to have a look at this thread.

 

Marticia,
Hang in there. I have never been in that position so I don't know what I can do. Hopefully someone can help.

 

Could the 100ml SubQ be affecting his electrolyte levels temporarily and causing an imbalance of sorts? Would that possibly cause this type of situation? Maybe his body cannot tolerate a full 100ml at a time and needs his fluids split into two equal daily treatments? {grasping at straws here}

~M

 

Hypokalemia

It sounds to me like a potassium imbalance occurred. Perhaps a temporary one, which is why is numbers were normal at last vet check. 100ml all at once just might be too much for the fella.



*flaccid paralysis & respiratory depression* - sure sounds like what Fred experienced.

http://en.wikipedia.org/wiki/Hypokalemia

Read article for more complete information.

snip:

Signs and symptoms

Mild hypokalemia is often without symptoms, although it may cause a small elevation of blood pressure,[2] and can occasionally provoke cardiac arrhythmias. Moderate hypokalemia, with serum potassium concentrations of 2.5-3 mEq/L, may cause muscular weakness, myalgia, and muscle cramps (owing to disturbed function of the skeletal muscles), and constipation (from disturbed function of smooth muscles). With more severe hypokalemia, flaccid paralysis, hyporeflexia, and tetany may result. There are reports of rhabdomyolysis occurring with profound hypokalemia with serum potassium levels less than 2 mEq/L. Respiratory depression from severe impairment of skeletal muscle function is found in many patients.

Some electrocardiographic (ECG) findings associated with hypokalemia are flattened T waves and prolongation of the QT interval. The prolonged QT interval may lead to arrhythmias.

 

No idea if this is Fred's problem or not (also grasping at straws): Gwyn has several heart conditions, so we can only give fluids in limited amounts; otherwise, it'll put too much strain on the heart and could cause problems. Has had any heart problems, or had his heart looked at recently?

Also: are you warming the fluids up before you administer them? Cause I would think that a bolus of room temperature fluids could be a big shock to the system, more so than some fluids that are nicely warmed up.

 

Hi Martica,

I am very worried that Fred has a heart condition. In a cat with a normal heart, fluids in that amount shouldnt cause the symptoms you are seeing. Merlyn had Kidney issues and heart issues and balancing the fluids for both was very hard, because too much subq isnt good for heart kitties.

I would take him in today, IF you can find an ER that has cardiac specialist who can do a cardiac ultrasound. He needs to have his heart evaluated as soon as practical, and I would not give him any amount of sub qs that you have noticed symptoms with.

http://www.felinecrf.org/symptoms.htm#fluid_buildup

 

Martica, I'm worried and think Fred needs to go in. You know where I work, you could go there (I'll be at work tomorrow not today though) or there is a new place in Queens but they don't have a cardiologist (if that turns out to be the problem). Only AMC and FAVS have cardiologists. Anyway, Fred needs to go somewhere today for a chest x-ray and a blood test checking his electrolytes and kidney values.

Let me know if I can help any other way. Please do take him in now, though, and update us later.

 

Hi Martica

You know that this episode and the previous one are not normal, and collapsing and breathing trouble for any reason indicate a major problem. WHat was his potassium? If you are getting low-normal potassium levels I'd still suspect hypokalemia. You're using insulin which pushes potassium out of the blood, and you're giving fluids. Also suspect are B vit deficiencies (thiamine), heart problems, anemia, hypertension, and even spinal disease can cause pain and weakness if part of the body is suddenly balanced differently. I wish he'd gone in immediately upon having the episode as some of this could have been "caught" easier, but since he didn't, I'd mention all of these things to the vet when you see him/her today. If he were my cat I'd also schedule an echocardiogram with a cardiologist (not a traveling internist, some vets have an internal med specialist come into the office to do) for sometime in the next few days, no later. An appt tomorrow might be difficult to swing, but you can always have your vet call to say it's urgent, or tell the receptionist that the cat is having episodes of dyspnea and can s/he please call the cardiology dept to see if they will fit you in.

 

Hi everyone,
thanks Jess for your offer. Yesterday (Sat) fred and I went out to Nyack for a Reiki training, and Fred has some Reiki done on him. He really loved it and is doing totally fine. I did not take him to the vet this weekend for this reason. I gave him the fluids on Friday night and had that episode and have not given any since. I think I am going to give a tiny amount tonite--like 25 ml. He's doing well and blood sugar numbers are good and he's eating normally and purring a lot. But yes, have to get it all checked. I just know it's all going to cost 1000 bucks or more for new blood tests and echo, etc. Sigh. Why do they charge so much for this stuff?

I guess I"m curious, let's say he does have a heart problem--what does that mean they will do to him? Does it mean I just reduce fluids? OR add some drugs? If he has high blood pressure (which he has not in the past) then does he go on a bp drug?


PS has anyone else noticed how easy it is to press save instead of SUBMIT? Seems like the SUBMIT button should be bigger if possible.

 

I know it's expensive but the sooner you get him treatment for a heart problem the better he'll feel and you'll have direction on how much, if any, fluids you can give.

Sundance had hypertension and she was on blood pressure medication twice a day. It was not diagnosed early enough so her retinas detached and did not re-attach... so she remained blind. When a cat's retinas start detaching, they have about two weeks before it's permanent... So, if you suspect high blood pressure, check it out - that test is only about $30. The amlodipine was compounded in a liquid for us. Once treatment started, she went from 220 at dx to 145 a week later... and her BP remained there until she died. So I know that stuff works. And after treatment, her eyes looked better even though she could not see with them.

 

oh yikes, that's frightening! ok I'll go. (in NYC all the tests are more expensive, my last bp test in June was 90 bucks I think---even though it's 1 vet tech and takes 5 minutes)