9/8 Alice AMPS 322 +3.5 309 +8.6 176, PMPS 155 low potassium, kidneys, vet

Discussion in 'Lantus / Levemir / Biosimilars' started by AliceMeowliss (GA), Sep 8, 2020.

  1. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    https://www.felinediabetes.com/FDMB...am-474-pm-478-low-potassium-etc-again.234835/

    This morning (practically afternoon I guess) she:

    Still can’t have a bowel movement
    Is still showing neck ventroflexion/low potassium
    She is eating some. Since last night we’ve gotten maybe as much as 90 calories in her (that supports at least half her weight) and not nearly as much phos binder as she should have, but we are trying
    I’m calling the vet
    Last night I wondered if she needed to be euthanized yet, today I think she looks miserable but maybe there is some hope
    I am exhausted
    Her neck ventroflexion is making it difficult to do subq fluids

    0DC81CBE-5AC8-4A73-AFBE-8EE669A63B75.jpeg

    She is very listless. But I think potassium, fluids, and a bowel movement would help a lot. She can’t eat enough if she can’t poop. If she can eat enough her potassium won’t tank.

    on the bright side, ketones were negative last night. She will still get up and walk some, but now she wears out very fast.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

    Joined:
    Feb 19, 2012
    Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  3. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    Called my vet. I’m being squeezed in at 4pm.

    Their office is out of potassium gluconate. Where can I get some?

    There are multiple types of ondansetron (Zofran). The Cerenia doesn’t seem to be enough so I thought maybe I’d ask for a Zofran prescription. Do you use a liquid, or a pill? Does anyone know if it has a taste to it, if I get a liquid? Does anyone know dosing guidelines for a feline?

    I need to organize my brain and be prepared with some questions.

    So far I know:
    1. Help with subq fluids today
    2. Help passing stool (she has been straining in multiple attempts for about 18 hours now)
    3. ask about ondansetron/Zofran
    4. She needs potassium, if I can’t find it at a store, maybe another vet office will fill some for me if my vet calls them? How is potassium gluconate dosed?
    5. Probably need to get another bag of LRS for the rest of the week
    6. ????

    What else should I be doing or asking about right now?

    Also, Alice had a lot of bowel noises early this AM. I’m wondering if the Koha beef is causing discomfort. But she is actually eating it, so I don’t know what to do. I have to find another store to pick some up at locally. Yesterday I went off on the customers who walked out from the dog washing room with their masks hanging off of their faces and wouldn’t have completed my purchase of two small cans at all if I didn’t need so badly to try it out for her.

    I have 2.5 hours to get my brain organized for when I go in to the vet.

    This morning I completely skipped a doctor’s appointment I scheduled three months ago, because it was too much exhaustion to leave the house that early. I would never have gotten through the way of the day without that last nap.

    All night it is hard to sleep at all right now. So scared of what will happen if I’m not there for her at the right moment.


    Thank you very much to everyone who has answered questions and offered support. I keep trying to think about if it’s time for euthanasia but I just can’t kill her, not this easily. It seems too easy of an out and she is worth so much more. She’s still eating and drinking some. She needs her potassium up, her phosphorous down, more food, and lots of fluids, and maybe she would feel chirpy again.
     
  4. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    Thank you Carla, as always.
     
  5. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    At the vet right now. I think we are going to get her an enema after we do a round of subq fluids. Her neck ventroflexion resolved halfway through the drive to the vet. :p Of course her potassium is still low.

    my vet doesn’t know immediately who locally would have some potassium gluconate that they would fill for me.
    I asked about ondansetron and she suggested metoclopramide. She’s doing a little research for me. She mentioned another type of potassium I may be able to find at the grocery that I could try for now.

    Here she is all perked up now that she has to see the doctor.
    750DAF5D-C268-4D58-A9CF-FA31A2772036.jpeg
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Just like the cat to be better at the vet. :rolleyes: On the up side she is better.
    I just checked my favourite on line vitamin store and they have NOW potassium gluconate. Should be readily available.

    Ondansetron - get a generic - waaaaaaay cheaper but still fine compared to Zofran. Get a prescription for 4 mg tablets to filled at any local human pharmacy. Dosing is based on weight. My 8 lb girl is getting 2 mg up to 2 times a day, but you can go more frequently if needed.
     
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  7. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Have I lost it completely. What 8 lb girl? You have another??????
     
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  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    @Olive & Paula civvie, not diabetic, but with small cell lymphoma. :rolleyes: Hence the ondansetron when needed.
     
  9. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Didn't know you had another.
     
  10. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Prayers for Alice. :bighug: She certainly looks better in that second picture at least!
     
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  11. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    This was form Friday, and it’s just adorable:
    520D4155-9652-4F2A-BF47-DEF7F300CF4C.jpeg


    176 @ +8.6 yay! Under 200 is wonderful. Better for her kidneys.
    We have metoclopramide form the vet.
    Alice only took about 3.5 hours to have a bowel movement after her enema. Everyone kept warning me there would be a mess, but I just got one hard lump of poo. Rough on her but nice I’m not cleaning skid marks off the floor or something. (This actually happens with my moderate CH boy.)

    Anyway. I’m relieved things are looking up.

    Next I get to watch her BG like crazy because she IS back under 200, and sick. Her shots are at awful times, just before noon and just before midnight. I need to work that time back each cycle, and since moving the time up acts like an increase, would it be a bad idea to go from 0.5 down to a skinny 0.5? I’m sleepy tonight. I know the depot is still in play regardless of the dose tonight. I’m tired though, really tired. It’s time I find a chance for four uninterrupted hours of sleep. :coffee::coffee::coffee:
     
  12. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    Well her neck ventroflexion has returned! Luckily she is accepting the potassium gel supplement again.
    Shot 0.5u 10 min late. She had a decent appetite.

    -Oh! As I type... Her potassium level must reallllllyyy be on some critical line, because the ventroflexion just went away again!

    It’s kind of funny for her, it’s like a light goes on and her head comes back up. Like magic. She seems so despondent when she can’t lift it. Upset.

    I gave her the metoclopramide, I think all I have left to give tonight is the AB, thought I’d wait an hour.

    I hope her sugar stays at a safe level tonight. I need a window of time for sleep. Oof.
     
  13. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    And ventroflexion returns 12 minutes later. :facepalm:

    How long should it take for a potassium supplement to have some effect?
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Neko never showed signs of potassium deficiency, I think we got it soon enough cause she was getting blood work regularly for other conditions. So I can't help on the effect.

    For your shot time, what time do you get up in the morning? If you are shooting at midnight, you could always do a couple 15 hours cycles (or so) to get her back on a 6/6 schedule, or whatever works.
     
  15. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

    Joined:
    Jan 8, 2019
    what time I am up is very tricky to answer! Sleep has never been easy for me but always desired. :p

    I’m so nervous to do anything to risk her blood sugar getting higher because it makes it that much harder to get her hydration and potassium and kidneys and bowel movements and appetite all balanced. I guess I kind of figured I would try to do the 15 minutes a cycle moving things up, until I have another morning or night where I miss a shot and then I can reset.

    I was looking over some of Tanya’s CKD website and starting to feel pretty bad for how low her potassium keeps getting. Am I damaging her more? I know I can’t rush it or then her electrolytes would be off balance. It should get easier to manage he potassium level when she is eating enough and is properly hydrated, right? This is hard on her. The weakness, listlessness.

    How often did you get bloodwork done for Neko? I desperately wish I could check her potassium level low I check her blood sugar. Not knowing has me nervous. :nailbiting: But Alice really really really gets angry about blood draws at the vet.... :arghh:

    Sorry. I might be overtired adhd rambling, I’m gonna stop just in case. :)
     
  16. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    How low is the Potassium - what is the labs? Has she been checked for anemia?
     

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