9/6 Alice no AMPS/Shot +13.5 342 PMPS HI ...9/7 cont. AM 474 PM 478 low potassium etc again

https://www.felinediabetes.com/FDMB/threads/9-5-alice-amps-132-5-87.234763/

Today didn’t work out properly. Having fatigue and brain fog stuff, somehow I missed her AM alarm, got a test in, got in feedings with her powder d aluminum hydroxide that came in, so we are done using the Maalox now, did not get her fluids done, I’m unsure if I should do them tonight then be off schedule, I still have to give multiple oral meds, plus find somewhere on her body to shoot her insulin. I don’t like to shoot insulin too close to when the fluids are done. I have trouble renting further back on her body than the sides, and when I do her fluids they slip down the slide.


So I am a mess today. Alice’s meow is hoarse, typical when her sugar is higher. Does this mean she is dehydrated?

she is active today though, interested in food. Probably because her BG is high, though.

she hasn’t pooped. She needs to. I need to figure out a way to encourage bowel movements without using miralax or anything else that can dehydrate her. It stinks because that was working. Everything bad for her kidneys was helping her IBD, the Koha kangaroo food, everything. She doesn’t like eating the ziwi with the phos binder in it.

I keep having to put fortiflora or Imuquin on ever meal or she barely eats. At what point is that going to backfire on us?


So tonight I have to figure out what meds and other things to give and do for her and then tomorrow fix it and get back on schedule. Tonight at least I finally get to move her shot back to 9 instead of 10.

 

It happens. It's called gravity.

Glad the powder came in. It's much better for Alice than the Maalox.

To check for dehydration, do the tent test. If the skin falls back in place quite quickly, she is hydrated. If the skin takes a bit of time, she is dehydrated. And check her gums. See if they are moist or tacky.

 

Oh gosh now I’m having another cat problem
One of my cerebellar hypoplasia cats, Gizmo, the mild one, just had discolored red-tinged eye discharge. A big gooo of it in the inside corner. He wouldn’t let me see his eye. This is new, since getting these boys in February I haven’t had any eye problems, and they were checked out by the rescue before I met them.
So I ran and gave Alice her foood and insulin and ran back to check him and the fluid has mostly gone, he’s still not comfortably with that eye, but I don’t know what happened. He and his brother have argued a little the last day, maybe he got scratched? He’s acting okay now. Except squinting that eye a little.
I’ll take any opinions. We can’t honestly afford to rush off to the emergency vet. We would do it if it meant saving his eye of course. It doesn’t seem that emergent now, but a a few minutes ago it was startling.... I don’t know.

My plate is too small and too full today.




Can I give Alice the AB and nausea med and Mirataz now too, after having her food w/ the phosphorous binder?? Should I be waiting? She is on so much stuff. It gets confusing.

Should I do maybe 50mL tonight so I can still try to do another 50-100mL tomorrow noonish?

 

so, I know why the fluids slip down the side, it makes sense and all, but what I don’t know is if it will affect where the depot is in her, wherever she has had her insulin, if it slips down around that spot? I always rotated sides, right and left on either side of her scruff, for insulin. Subq is going in scruff of course. I’m having trouble getting enough skin to tent up on the flank to shoot insulin there though. Struggling. It’s the way her body is I guess.

 

As long as you don't give fluids the same time as insulin.
Or give the insulin shots on one side and the insulin (at a different time) on the other.
And then switch the next day. It would have to be marked on your calendar what days get what needles.

 

Well wait, how would I give the subq fluids on the side? We are barely used to using the scruff. And that needle is so much bigger.

 

There should be room for the subq needle. I gave Rover subq fluids using his backbone as a guide, inserting (if I remember correctly) near the top of his rib cage with the needle pointing towards the head. If you shoot to one side, the fluids "should" go down that side. Mostly his fluids went down his leg.

Do remember that it has been sometime since I gave fluids. Check a couple of videos for needle placement.

 

Thanks. I’ll have to research that further another day. It’s true I’ve noticed it goes down around the top of one leg or the other. Maybe I’ll see if there’s a pattern which side.

I’m having trouble deciding if her scruff-pulling dehydration test is... well how much should it bounce back to normal.... her blood sugar is over 500 so I honestly expect she probably IS dehydrated. How long after the insulin would you wait to do subq? Hmm. I tried to shoot a little further back. I’m trying to find somewhere I can pull up her skin. I’ll keep working on it.


I just got all her medications in/on, Veraflox, Cerenia, and Mirataz.

So all that is left are some fluids. Maybe wait another thirty minutes...?

I also need to figure out who to ask to find out if she can safely have any miralax.... or maybe I should bring back pumpkin or try psyllium husk.....?

Oh, and I need to find another food she can eat. She isn’t motivated enough for the ziwi and it gets gluey once you add water or the aluminum hydroxide.


Sigh.

 

I am not sure about miralax given the recent potassium issues? I would consult your vet first.

 

See, I wonder if trying to use the miralax actually contributed to her dehydration, potassium drop, and renal crisis now.... but I don’t know what else to do. That part was working well, if only I could keep her hydrated and keep her electrolytes balanced!

If she doesn’t poop she won’t eat, if she doesn’t eat she will have worse problems with all her organs, kidneys liver heart, all of it.... and if she doesn’t eat I can’t give insulin.

too many issues now. It’s just so complex.

 

Lots of hugs for you! I’m not sure what to safely recommend

 

Egg yolks can help motility: https://www.foodfurlife.com/best-manage-hairballs.html#/

 

Thanks. I’m sorry my memory is great sometimes and other times I need things repeated about twenty times.

 

I came into the bedroom, sat on the bed, Alice came up, but she just laid there and stared for awhile, without moving. After a couple minutes of pestering she is raising her head and looking around. I watered down her food earlier, can’t get her to eat really, just lick it.

I can’t decide what I’m supposed to do for her right now, what does she need. Something seems off.

 

HI @ +4.25.... wondering about possible ketones? Going to dig around to see if I have any ketostix. They are somewhere but I moved.

 

She doesn’t look well.

 

Sending prayers.

 

Terramycin Ointment maybe a good idea for that little ones eye to prevent and infection

 

Here's a few tips I learned with all Ollie's meds.

If your vet will give you cerenia injectable (can be pricey but it's a 10 ml bottle) you can give it in the subq fluids line. Push in slowly and make sure you are holding Alice down as it still burns but not as much as giving injection outright.

If using mirtz for appy stimulant, get transdermal so you can rub it in ear.

Psyllium husk give in last meal of the night since your not giving any others meds overnight.

I don't know if you work but if you don't give subq fluids +6 or +7 and it won't interfere with insulin. Or give right before you go to bed.

If an AB is involved I gave +10 (Ollie's was once a day).

Ollie got meds every hour for the first 3-4 hrs with AM insulin. one mid day med. Then started again 1 hr before PMPS and last med at +4 (there much less meds at night).

I also printed out blank ss page and write glucose readings on normal line and on next line wrote what med she got. That's why you see the times written under the + numbers at top of page. I kept the page on counter with her meds. Then only put the numbers in ss as I was told not to use 2 lines as it was for numbers only. But I couldn't use the remark column on my phone and I needed to keep track of it all.

 

@Olive & Paula
Thank you I for the schedule help.


Today I crashed out early AM again, so I’m still off on Alice’s short schedule, shot a half unit at noon, “AMPS” (if you can ball it that at noon ) was nearly 500. Between now and 7:30 am she has developed ventroflexion of her neck again which means her potassium is pretty low. Gave more potassium gel. The problem though is just that she didn’t eat enough yesterday.

will be having a friend come by my IV stand and clamp person in 2-3 hours, will give 100mL fluids.

this is so much right now. I don’t want her to be hospitalized but I wish she could be, at the same time. Maybe for a couple days. Fluids and monitoring and insulin and everything coming in to her via tubes. Would be nice. Sigh. Just enough to get her stable enough that I could do the rest. Enough that maybe she would feel well enough to eat enough, etc.


Someone on the IBD group found me a CKD list that has the Koha beef LID on there. I can find that, I think I can get it, should I switch her right now or keep trying to just feed ziwi?

I am so tired today. I’m sorry I haven’t started a new thread. I just realized today I had it labeled as 9/5 but this was for 9/6.

I just need to keep feeding and giving fluids and meds and supplements, right? Sigh.

 

I'm sorry you're having such a challenging day - both you and your kitties.

I do hope things improve for you all soon !

Hang in there

 

So I haven’t made a new post for today and I’m just so tired. Sorry for not making a new thread.

earlier this afternoon when I tried to do her subq fluids, she was laying funky because her neck ventroflexion is back. Then she moved right after I started the fluids. I had to pull out. I changed the needle and tried again and got maybe 40mL in. Maybe. But I noticed she had bled a little onto her fur from the first attempt. What is the likelihood I caused some kind of damage I need to worry about more?


I just feel like I can’t do this well enough for her right now, I don’t have all the tools she needs. I want to have her hospitalized but it’s too expensive. I keep asking her if this is just it, but she doesn’t tell me she is ready to die, just that she feels poorly.

 

It sounds like when she moved the needle may have nicked her a little bit and caused her to bleed. I'd keep the area clean and put some Neosporin on it to help it heal if you have some. Hang in there. A lot of time things look better the next day. Sending prayers.

 

I'm sorry you're struggling extra tonight. I have no recommendations I can offer, just my support.

 

Can I still give fluids later in the same area? Is it safe? I don’t know the exact spot where the needle was that time.

 

This evening she had a bowel movement. It was dried out and rock hard but at least she passed something. I got some light reading started on how her phosphorous binder works. Understanding the dosing better helps me. I’m struggling to figure out how to give it, she doesn’t like it on the food so I’m syringing it, but she hates anything syringed, and she’s already getting other meds that way.

After some panicked posting on IBD and CKD Facebook groups I have found it looks like the Koha LID beef may be the most kidney-friendly + diabetic-friendly + IBD-friendly..... so I went out and bought two 3 oz cans to try. She was happy to eat it and since then has had maybe 40kcal, which makes me happy. I’m unsure fully if she will handle the beef as well but she has to eat something and this is my best guess so far.

Her sugar was still up in the 400s when I tested at +8.5.

I am trying to figure out some details, like how to measure or break up her aluminum hydroxide when she needs feedings more often than something easy like 4 times a day. Her dose is 1/2tsp per day. If she has some phos binder and then eats again 30 min later does she need more? What is the window of efficacy?

I need to give her antibiotic separately from the binder. When is a good time to give it? Is it two hours before and two hours after giving AB? How much of a margin of time does she need around when she gets her AB versus when she gets food w phos binder?

IBD—how much is it going to mess her up switching to the beef? Should I try to sneak in some ziwi lamb?

When is a good time to give fluids again?

 

Also negative for ketones earlier, caught some pee, yay!

She just got into the litter box and tried to have a bowel movement but couldn’t.

She just lays there miserable. I don’t think I can fix this by myself. I wish I could hospitalize her for a day or two to get her fluids and potassium and other things fixed. Sigh.

Also she now hates the potassium gel. I need a different potassium supplement.

 

I used potassium gluconate. It had a bit of a "sandy" texture, but softened if mixed in with water and food and sat for a little while.

Can you give fluids on the opposite side of where you did before? That should work.

I don't think I gave antibiotic separate from binder. You do have to give probiotic two hours apart from antibiotic.

I hope the beef will be fine with her. Most people with IBD kitties are on a few different proteins.

 

With her neck ventroflexion now, I’m having a hard time getting her into a position where my inexperienced self can safely get the needle in and feel like I’m not doing something wrong.... and that’s just trying to use the scruff. I honestly don’t know how to give it on the side?

I’m calling the vet in the morning. We’ll see if she makes it through the night. I guess.

 

I meant the other side of the scruff.

 

From the head pointed back towards the tail?

Eta: sorry if I’m just dense here.

 

She still can’t poop. I know she wants to and I feel so bad for her and her tiny little body that has to work so hard to try.

I got some more food (Koha beef) with water and some of her aluminum hydroxide in her. She’ll drink and even eat or lick some if I hold the bowl in front of her face, right now. She’s still motivated....

I don’t want to give up on her if she can get better. Sigh.

I’ll be contacting the vet tomorrow. I need to figure out what my questions are and what I need to address exactly. I always get there and am so disorganized mentally. I’m that way when I’m not there, too, I suppose.

Also where to find potassium gluconate? Since she doesn’t like this supplement gel anymore. I don’t even know what my tiny vet office has in stock. They are limited. Is that a prescription thing?

eta: emotions and stuff. I’m scared to nap in case she gets sicker and dies alone... or needs me. Trying to allow myself two hours.

 

Sending prayers.