? [New Member] DKA happening now, on feeding tube; can't afford 4th hospital stay in 2 months

[Diane Tyler's Mom GA]

Does Zofran need to be given on an empty stomach? The bottle says it does, but the doctor said it doesn't. I gave Princess Zofran about 10 minutes after giving her the 2nd snack (25 mls) and she threw up

Tagging
@Bron and Sheba (GA)

@Suzanne & Darcy

@Wendy&Neko

@Princess Tortilla
If you don't get a response I googled your question and found this
Ondansetron ( Zofran ) is generally given to cats by mouth in a liquid or tablet form, with or without food. When given on an empty stomach, if vomiting or nausea is noticed, you should give the future doses with snacks or meals.

 

[Bron and Sheba (GA)]

Does Zofran need to be given on an empty stomach? The bottle says it does, but the doctor said it doesn't. I gave Princess Zofran about 10 minutes after giving her the 2nd snack (25 mls) and she threw up

It is better to give it before you feed her and let it take effect for 30 minutes before feeding.
If the vomit was within 10 minutes of giving the zofran that she threw up and you think she threw up the zofran, then you can repeat it.

 

[Bron and Sheba (GA)]

Mid-afternoon update here:

Princess is still looking terrible and either sitting in the corner and not moving or hovering over her water bowl and getting her chest soaked. In the past, we would have checked her into the ER by now as we know these are her DKA signs.

I've seen her wobble over to the litter box to pee a little bit, but I haven't been able to get enough liquid to test for ketones today. I've now removed 95% of the litter and hope to have some liquid to test soon.

Her Libre readings keep coming up "HI" which means the BG is above 400, but it's impossible to see the exact number. Yesterday at the vet, it came back in her blood test as 600.

I've been able to keep up with the feedings every 2 hours (she's had 2 meals plus 1 snack so far - about 140 calories). I've been flushing her etube with water during and in-between feedings, but I want to make sure I'm giving the right amount of water. Is there any guidance on that? I want to give her enough fluids but not make her throw up.

Can you take her to your normal vet and get her bloods checked to see if she needs something extra and maybe get some subQ fluids into her?. It does sound as if she needs vet care and her electrolytes looked at. I know you can’t afford ER but maybe the local vet can help you during the day.
We do have another kitty in the same position as you and she is taking her kitty to the vet during the day and bringing her home at night. It’s not ideal but better than nothing.
If we can see a ketone result, it will help a lot.

 

[Bron and Sheba (GA)]

Did the vet check her bloods yesterday and do you know if they checked the potassium?
Also as she is anaemic that won’t be helping.
I saw in the SS that you got negative ketones in the urine at 7pm…was that today?

 

[Princess Tortilla (GA)]

Did the vet check her bloods yesterday and do you know if they checked the potassium?
Also is she is anaemic that won’t be helping.
I saw in the SS that you got negative ketones in the urine at 7pm…was that today?

Yes that was today and sorry I meant it was +7 after the AM shot. I was able to test it again about 2 hours later and it was negative again.

Yesterday the vet said electrolytes looked OK but they're having us continue the potassium supplement that was originally prescribed (2x/day).

I'm wondering if there's anything I can do for the anemia at home. I googled and found some answers about iron supplements but also another answer saying anemia in cats is rarely due to an iron deficiency... I don't recall exactly but I think the vet said there isn't much we can do at home, just that we'd have to do more extensive testing to find the root cause of it.

It is better to give it before you feed her and let it take effect for 30 minutes before feeding.
If the vomit was within 10 minutes of giving the zofran that she threw up and you think she threw up the zofran, then you can repeat it.

Sounds good. I do think she threw up the zofran, so I gave it again and will try giving food again soon.

 

[Bron and Sheba (GA)]

Yes that was today and sorry I meant it was +7 after the AM shot. I was able to test it again about 2 hours later and it was negative again.

Yesterday the vet said electrolytes looked OK but they're having us continue the potassium supplement that was originally prescribed (2x/day).

I'm wondering if there's anything I can do for the anemia at home. I googled and found some answers about iron supplements but also another answer saying anemia in cats is rarely due to an iron deficiency... I don't recall exactly but I think the vet said there isn't much we can do at home, just that we'd have to do more extensive testing to find the root cause of it.


Sounds good. I do think she threw up the zofran, so I gave it again and will try giving food again soon.

I’m not very experienced with anaemia but I have an idea that B vitamins can help but probably only if it is mild. I’ll tag @Wendy&Neko as she may know.
If the electrolytes were ok and negative ketones today, then I am wondering what is going on. Maybe she is just recovering from the DKA….so I would continue with the extra food, giving her fluids and testing for ketones.
Did the vet do a test for pancreatitis? It would have been a separate test called an fPL test?
Did you give the bupe today?

 

[Wendy&Neko]

Do you have the blood test results? Is there a HCT or PCV? Those are used to measure anaemia. Which can be caused by multiple things. Did the vet have a suggestion why she was anaemic? Lots more on it here: http://www.felinecrf.org/anaemia.htm

 

[Bron and Sheba (GA)]

How are things going?
Have you managed to give more food and has she kept any down?

 

[Princess Tortilla (GA)]

I’m not very experienced with anaemia but I have an idea that B vitamins can help but probably only if it is mild. I’ll tag @Wendy&Neko as she may know.
If the electrolytes were ok and negative ketones today, then I am wondering what is going on. Maybe she is just recovering from the DKA….so I would continue with the extra food, giving her fluids and testing for ketones.
Did the vet do a test for pancreatitis? It would have been a separate test called an fPL test?
Did you give the bupe today?

I heard back from our vet and she advised us to lower tonight's dose back to our usual 1 unit (from 1.5) due to the bouncing. And she actually recommended we lower the feedings since she's been vomiting so much. I gave bupe twice today - morning and night - but it didn't seem to make a difference like it did the first day I gave it :/ ... not sure why. Princess is still lethargic and is staying leaning over/into her water bowl which is really concerning me.

I'm not sure what kind of testing they did for pancreatitis but the vet confirmed it.

 

[Princess Tortilla (GA)]

Do you have the blood test results? Is there a HCT or PCV? Those are used to measure anaemia. Which can be caused by multiple things. Did the vet have a suggestion why she was anaemic? Lots more on it here: http://www.felinecrf.org/anaemia.htm

Thank you for the link. I don't have the blood test results but can request them. She said they would need to do more extensive testing to identify the root cause

 

[Bron and Sheba (GA)]

heard back from our vet and she advised us to lower tonight's dose back to our usual 1 unit (from 1.5) due to the bouncing.

@Princess Tortilla
PLEASE DO NOT LOWER THE DOSE DUE TO THE BOUNCING. She needs that insulin to combat the ketones! I can't believe the vet said that!
The bouncing is not caused by the dose of insulin, it is from the drop to 60 yesterday. Lowering the dose will not effect the bouncing but it will certainly effect whether ketones can form again.

And she actually recommended we lower the feedings since she's been vomiting so much.

I would also disagree with your vet here as well. I thought you had already reduced the amount you were giving. To reduce it further would be very unwise in my opinion.
I would make sure that she has enough cerenia and ondansetron so that she doesn't vomit.
Don't wait unit she vomits to give it. Give it routinely for the next several days.
I would push for some A/D hills wet food as well. it is well tolerated and cats like the taste. And it is absolutely fine for diabetic cats. Yes it is a bit higher in carbs at 13% but getting food into her and getting her to eat is far more important than carb content at this point.

 

[Princess Tortilla (GA)]

PLEASE DO NOT LOWER THE DOSE DUE TO THE BOUNCING. She needs that insulin to combat the ketones! I can't believe the vet said that!
The bouncing is not caused by the dose of insulin, it is from the drop to 60 yesterday. Lowering the dose will not effect the bouncing but it will certainly effect whether ketones can form again.

I'm confused.. maybe I can add some detail to this: she dropped to 60 after we increased the dose from 1 to 1.5 units. So the vet's saying due to the Somogyi effect, her body overcorrected and became hyper. However, we did give 1.5 units two times after that initial drop to 60, and her readings have been HI and she hasn't come back down.

Her 2 ketostix were negative for ketones today so I'll make sure I keep testing as frequently as I can.

We're still tube feeding all of her meals. Unfortunately she has no interest in eating orally. I will definitely be keeping up with her regular doses of cerenia and zofran.

 

[Bron and Sheba (GA)]

o the vet's saying due to the Somogyi effect

I'm sorry to keep contradicting your vet but there is no such thing as somogyi effect in cats. I can go into that more later but haven't got time atm

However, we did give 1.5 units two times after that initial drop to 60, and her readings have been HI and she hasn't come back down.

The reason she has not come back down yet is because she is bouncing, which was explained earlier. Bounces can last from 1 to 6 cycles. There is nothing you can do about bouncing except wait them out. Reducing the dose does nothing for the bouncing except give the cat less insulin.

I am sure you are torn between wanting to believe your vet and wanting to believe me. So I know you are in a difficult position.
However I can only tell you we get a lot of post DKA kitties here and are very successful in helping them get better.
Most arrive here with no post DKA care instructions from their vets.

Unfortunately she has no interest in eating orally.

This is very very common in post DKA cats so don't get disheartened about that. Just keep up the antinausea meds and the tube feeding and every so often try her with something she normally likes.
If she also has pancreatitis she has a double whammy as not wanting to eat is one of the main symptoms with pancreatitis.
Please consider at least going back up to 1.25 U in the morning dose.
And remember it is enough food, enough insulin and treating the infection or inflammation that treats DKA.

 

[Diane Tyler's Mom GA]

. So the vet's saying due to the Somogyi effe

Please listen to what Bron is telling you and not your vet, I agree with every thing Bron is telling you.
I have copied this for you to read

There is actually no such thing as Somogyi effect in cats. Don’t know why vets often quote it.
Here is information @Sienne and Gabby (GA) wrote about Somogyi :
Simply put, no.
This is a soapbox issue for me. I'll try to be succinct. The term first appeared in 1938 and was named after Michael Somogyi. It was based on a very small sample of humans and urine glucose was being measured. The "research" (if you can call it that) appeared in a local St. Louis medical publication - not a major medical journal. The results have never been replicated and have been contested in recent years. Consequently, the entire idea of Somogyi in humans is controversial. There's an article in Wiki that is a decent summary as it relates to humans.

With cats, there hasn't been any research let alone research with new insulin such as Lantus and Lev that are pharmacologically very different from what was available in 1938. I haven't a clue why vets continue to contend that a cat is in "chronic Somogyi rebound" when a cat may be bouncing off of a low number or fast drop. With humans, the recommendation is typically to decrease the dose in order to alleviate the problem What we've seen repeatedly is that when a caregiver does this, the cat stays in high numbers (because you're not giving enough insulin) and you end up wasting a good deal of time as a result of working the dose back up.

As long as you are systematically increasing the dose according to the protocol, you won't be giving too much insulin.
Here is an explanation of Bouncing:

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

[Diane Tyler's Mom GA]

I agree with Bron to push for the Hills A D Wet Food. If your vet has it just tell him or her you want to try a can. It's your cat

 

[Princess Tortilla (GA)]

@Bron and Sheba (GA) @Diane Tyler's Mom

ahh wow ok, I will read through this again later and consider. For now, two other urgent issues have come up:

1. Her Libre sensor just stopped working out of nowhere and is saying I need to replace it. I have requested a new one with the vet but who knows how long that will take and I don't really trust it anymore. I haven't done BG testing any other way and I see there are a bunch of options. Is there one you can recommend I go out and get in the morning? (it's middle of the night here)
2. Princess is slumping into her water bowl and I don't want to take the water away but I'm really worried she's going to face plant into it and pass out and drown. Her chin, chest, and front paws are all soaked from doing this but I can't get her to move away from it. What should I do? I'm reading other threads here of this behavior reported but not sure what people have done about it. I also just gave her cerenia mixed with 8 mls of water through her etube and she threw it up...

 

[Bron and Sheba (GA)]

Her Libre sensor just stopped working out of nowhere and is saying I need to replace it. I have requested a new one with the vet but who knows how long that will take and I don't really trust it anymore. I haven't done BG testing any other way and I see there are a bunch of options. Is there one you can recommend I go out and get in the morning? (it's middle of the night here)

I would get a ReliOn Premier meter from Walmart in the morning along with some test strips and a box of 100 lancets size 26 0r 28 and some cotton balls.

Princess is slumping into her water bowl and I don't want to take the water away but I'm really worried she's going to face plant into it and pass out and drown. Her chin, chest, and front paws are all soaked from doing this but I can't get her to move away from it. What should I do? I'm reading other threads here of this behavior reported but not sure what people have done about it. I also just gave her cerenia mixed with 8 mls of water through her etube and she threw it up...

Oh dear! I'm sorry she is still vomiting. Can you retry the cerenia with less water?
When did she last have any ondansetron? If it is 7 hours, she could have another dose of that as well as the cerenia.
I would take her to the vet first thing in the morning and ask for a cerenia injection. She may need those daily for a little while if the vomiting doesn't settle down.
Regarding the sitting beside the water...this is common. Maybe make sure the depth of the water is low
I would also ask the vet to give her some sub Q fluids in the morning and ask them to let you give them at home daily. Lots of care givers do this.

 

[Bron and Sheba (GA)]

Ill be around for the next 3 hours thenIi can ask someone else to help you if you need it so you need not feel you are alone.

 

[Princess Tortilla (GA)]

@Bron and Sheba (GA) thank you so much for the help. I’ll try to get her in to our neighborhood vet in the morning.

going to try to get some sleep for now

 

[Bron and Sheba (GA)]

@Bron and Sheba (GA) thank you so much for the help. I’ll try to get her in to our neighborhood vet in the morning.

going to try to get some sleep for now

Are you going to try and get some antinausea meds into her first

 

[Princess Tortilla (GA)]

We spoke to our vet this morning and she told us to give 1.5 units so we did that and she also said since her ketone tests have been negative (they were also negative at the checkup on 1/5) there is possibly something else going on with her likely related to the anemia. We’re currently en route to the hospital to get full bloodwork and a repeat ultrasound to look into the anemia. She was anemic the first and third hospital stays but not the second.

This morning I was able to successfully give her the zofran, cerenia, buprenorphine, insulin, 30ml of slurry, and the potassium supplement.

I’m really worried about her and hope we don’t have to keep her there overnight again.

I’m going to ask for sub q fluids to take home and for some hills. If she’s getting food through the tube I’m wondering why it’s being suggested we ask for Hills? Is it to entice her orally?

wish us luck…

 

[Bron and Sheba (GA)]

The Hills is easier to tube feed as it is a liquid. Also cats like it. Main reason is because it is a recovery food and a liquid

 

[Bron and Sheba (GA)]

Please give us an update when you can.
What’s happening about testing the blood glucose? Are you getting another libre fitted or are you going to test yourself. Very important something is worked out as we need to see those BG numbers

 

[Princess Tortilla (GA)]

On the way home from the hospital now… she has elevated kidney values and is very very dehydrated. They said she isn’t in DKA and she doesn’t have pancreatitis right now. BG at 500.

We decided to hospitalize her so they can get her hydrated and run more tests on her kidneys. It’s possible those results indicate a bad prognosis it’s also possible those tests don’t give us answers… But it sounds like kidney disease on top of difficult diabetes. I’m so worried about her not being able to recover and have a good life after this

 

[Wendy&Neko]

I'm sorry to hear the news. If she's dehydrated, that could make the kidney values worse. Giving her fluids should help. Keep us posted.

 

[Bron and Sheba (GA)]

I am sorry to hear this. I did wonder if something else was going on. But that is really good she is not in DKA and doesn’t have pancreatitis.
If she is very dehydrated, the kidney values can look really bad, but once she is better hydrated and the kidneys given a few days to recover, they can look much better, so wait and see what they are like after being on a drip for a day or two. I have seen this happen with other kitties. So give it time.
And cats with both diabetes and kidney disease can live for years with the appropriate care.
Im glad you decided to leave her there and get her well hydrated. Please keep us updated with her progress. Vets can sound very pessimistic but don’t give up on her and don’t let them talk you into putting her to sleep without exhaustion every avenue. Sometimes vets take this road as the easy option.

 

[Princess Tortilla (GA)]

Progress is looking poor.. things got worse overnight… they diagnosed her as HHS which based on my research sounds like there’s a low recovery rate. On top of that, kidneys are still not looking great. Electrolytes are off, i think high sodium and low potassium. They’re doing a blood transfusion today and I think more tests on her kidneys. There was a lot communicated over the phone it got so overwhelming but overall it would be a lot more money for a low chance of recovery and a difficult life for Princess.

We definitely don’t feel pressured by the team of doctors to make a decision in any direction. But at this point we’re coming to terms with the reality that she likely won’t recover from this. She would need ideally a week more in the ICU which we can’t afford, and if/when we do bring her home it’s likely she’ll be back in the hospital again soon.
I’m absolutely heartbroken and dreading the next call from the hospital. I feel that we’ve done everything we possibly could do and have pushed our financial boundaries way past our limits.

 

[Deborah & Muffy(GA) & Wendall]

Your situation sounds similar so here's my story. A few years ago I took a diabetic posted on this board. Four days later Chance crashed very badly - dehydrated, wouldn't eat, lethargic. I gave something for nausea, syringe fed and he vomited. Gave sub-q fluids but it wasn't enough to correct dehydration. He needed to be on an IV so was admitted to the hospital. Based on blood panels and urinalysis, it appeared he might have been brewing a kidney and/or UT infection and the stress of moving to a new home tipped him over the edge into DKA. His WBC was high, potassium and sodium were really low and electrolytes, kidney and liver values were all out of whack. He was flat, too weak to move and unable to raise his head. The vet cautioned that he may not survive the night and only gave him a 50-50 chance of recovering if he did.

When I visited the following day he was mostly unresponsive, didn't open his eyes or react to being touched. After 3 days in the hospital Chance was somewhat better and blood panels improved. His survival odds were increased to 70-30 but he was still weak and not eating on his own. I'd been through this before so brought him home and syringe fed a/d and baby food, and kept dry Instinct available. He also needed sub-q fluids, antibiotics and supplements.

Committed home care is critical to recovery and maintaining hydration is at the top of the list. One of the first things they do for sick cats at the vet is give fluids. Dehydration can make a cat go downhill really fast and since you've been through this before, tell your vet you want fluids to have at home. Tube feeding can be a life-saver but putting too much liquid orally into an already sick cat's stomach makes them feel even more nauseous and likely to vomit. Sub-q fluids are absorbed slowly and leave room for food. I've found that to be true for cats that have kidney disease, pancreatitis or recovering from DKA. I would urge everyone with a diabetic cat to have sub-q supplies on hand and know how/when to use them. Thriving Pets has everything needed.

Administration sets: https://thrivingpets.com/products/iv-admin-set-bbraun-v1402

Terumo needles (smaller, sharper, preferred by cats):
https://thrivingpets.com/products/terumo-needles-thin-wall-21-gauge-1-inch-box-of-100

Lactated Ringers fluids - need a script for this or your vet may sell you a bag:
https://thrivingpets.com/products/lactated-ringers-inj-usp-1-liter-bags

Liqui-Tinic is a vitamin/iron supplement that may help with anemia and is safe for diabetics. Amazon has it: https://www.amazon.com/Liqui-Tinic-Flavored-Vitamin-Supplement-Puppies/dp/B00152C8MK

 

[Bron and Sheba (GA)]

Oh I am so sorry to read this. I do hope they can do something. Deborah has written a very good post above.
Are they giving her IV fluids and correcting the electrolytes imbalance. I’m sure you are feeling overwhelmed and upset.
I do hope they can help her. Please let us know how she goes.

 

[Diane Tyler's Mom GA]

I'm sorry to read this, all I can do is say many prayers for her and hope things turn around . You definitely did and still doing everything you can. My heart goes out to you ♥ Whenever you can please update up

 

[Princess Tortilla (GA)]

Thanks everyone for the continued support and advice. I really appreciate it.

We picked Princess up from the hospital tonight, and she seems to be a lot brighter. We're obviously happy to see her in better spirits, but are cautiously optimistic. This has happened before where she leaves the hospital feeling better but a few days later needs to go back. The main thing is the hospital's ability to keep her on an IV drip the whole time she's there. We still don't know what mysterious underlying disease/factor is triggering her to go back into these intense diabetic crises... the doctors have deemed her a particularly difficult case of diabetes.

Luckily the IV drip helped the dehydration/kidney injury caused by dehydration. Her kidney values went down, but they still diagnosed her with chronic kidney disease.

She just ate half her dinner orally (!!) which was so great to see. I'm going to see if she's interested in eating more before tube feeding a little, but I don't want to overwhelm her stomach tonight. I know the Hills urgent care food has been recommended here, but I've asked multiple doctors about this and they all think it's too fatty for her and might cause diarrhea. They said she's fine with the Purina Pro DM food, and recommended using baby food to entice her.

I asked again about subq fluids to bring home, and the doctor who discharged us said she'd have to get approval from another doctor who wasn't present at the time to give them to us. We'll follow up with them about this tomorrow.

I also asked for a recommendation on a glucometer, and the doctor recommended the Alphatrak, saying it's widely used in hospitals and was one she personally had used on her diabetic cat. Any thoughts on that one vs the Relion that was previously mentioned in this thread? I plan to order one of these on Amazon ASAP.

It's been such an emotional rollercoaster these last few days. I'm so happy she's home. I reeeally hope this was the last hospitalization she needed to get her diabetes on track.

 

[Wendy&Neko]

Great news that she's home again and feeling like eating. I really hope they get on letting you give fluids at home.

The test strips for the Alphatrak are too expensive. The meter is pricey too. Plus you can only get the test strips at the vet (when they are open) or on line. Hard to get backup in an emergency. Stick with the Relion. Back when I started here, it was the days before the AT was heavily marketed to vets, and everyone, including vets, used human meters. People here are much more used to human meters and our dosing methods are based on them.

 

[Deborah & Muffy(GA) & Wendall]

So relieved to see your post! And that's wonderful that she's eating on her own - getting hydrated makes a huge difference. Sweetie, you really need the sub-Q fluids. I cannot stress this enough. Princess was severely dehydrated and could easily back slide. Given her history, your vet should already know this. Chance got fluids daily for at least a week after coming home from the hospital. I'm actually pretty liberal with fluids anyway and get them by the the case. If your nitwit vet refuses to let you have them, I'd be happy to send you some along with some needles and IV admin line.

You don't need the expensive glucometer/strips that the vet recommended. Get thyself to Walmart for a Relion. I've been caring for diabetic cats for almost 20 years and have always used a human meter.

 

[Princess Tortilla (GA)]

@Wendy&Neko @Deborah & Muffy(GA) & Wendall

Thank you for the thoughts on the glucometer! I'm not near a Walmart, but can order the Relion on Amazon. Does this kit look like it has everything I need?

Re: fluids - yeah, I don't know why they've been so hesitant to let me take the sub-q fluids home. I think I remember them saying something about it affecting her heart (?)
We just got home from the hospital 2 hours ago, and she's already taken many trips to her water bowl and has been hanging out there for longer than she should be. They had her on an IV drip the whole time there. I'm not sure why it's so hard to keep her hydrated at home...

 

[Princess Tortilla (GA)]

I'd be happy to send you some along with some needles and IV admin line.

thank you so much for the offer! You are too kind. I'll follow up with them about this in the morning and let you know what they say

 

[Bron and Sheba (GA)]

I’m so glad to hear an update on Princess Tortilla. I second the ReliOn meter. Make sure to get lancets size 26 or 28 gauge. You will also need some cotton balls to put behind the ear when testing but can get those from a pharmacy.
Also second sub Q fluids. Also good for kidney issues. It’s true you need to be aware of any heart issues but if they were giving her them there should be no issue. Just check the amount per day.
Crazy not wanting to use the Hills a/d. Oh well! It’s called recovery food for a reason.
Keep us posted

 

[Diane Tyler's Mom GA]

Does this kit look like it has everything I need?

Yes everything you need those 50 test strips will go fast
You can pick up from Walmart The Relion Premier Classic meter and test strips

https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103. 9 dollars

https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197. 17.88 for 100



Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

A video one of our members posted, she is using a pet meter ,strips too expensive plus you have to code it
A human meter is just fine, most of us use human meters ,that's what our numbers are based on
When you get your meter can you add the name of it to your signature and spreadsheet


VIDEO: How to test your cat's blood sugar

Here is another link to read
This is a link to one of our posts on home testing.

 

[Deborah & Muffy(GA) & Wendall]

Can't throw a rock around here without hitting a Walmart. The beauty of a Relion is the strips are less expensive and Walmarts are everywhere, except apparently where you are. I've mostly used a Contour and get test strips on ebay.

Her heart, huh? Well, she was getting fluids in the hospital so ... As long as Princess doesn't have a heart condition and you don't over-hydrate there shouldn't be a problem. One of my cats started getting fluids when she was 16 (kidney kitty that had to be hospitalized for dehydration) and had them every day for the next 5 years while she ate her second breakfast. That Princess is already hanging out at the water bowl tells me she's not recovered yet and is going to need sub-q fluids for awhile. Please don't wait on that. Make sure the vet knows she's already seeking water and you'd rather not have to hospitalize her again. You are competent and capable and there's help here if you need it.

If you've never given fluids before, here's a good tutorial:
http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

I looked up HHS because it's so uncommon I'd never heard of it and I've been on this board for 19 years. Sounds similar to DKA and treatment is pretty much the same with fluid therapy being critical.

 

[Wendy&Neko]

I think I remember them saying something about it affecting her heart

That's an important detail. Have they heard a heart murmur? My girl was getting fluids for her kidneys but went into heart failure because of it due to a heart problem. She had had a clean echocardiogram 6 months earlier. She did recover from that heart failure. I understand being cautious if there is any concern about heart problems.

 

[Princess Tortilla (GA)]

@Bron and Sheba (GA) @Diane Tyler's Mom @Deborah & Muffy(GA) & Wendall @Wendy&Neko

As long as Princess doesn't have a heart condition and you don't over-hydrate there shouldn't be a problem.

No heart condition reported, I think they mentioned a risk to the heart if we over-do it. But sounds like I should be able to get guidance on the right amount to give. I just gave her crushed Zofran mixed with 8 ml of water through the e-tube and she threw up 15 mins later I was able to put the pill in her mouth after, but I don't want to rely on just the e-tube + water for hydration. As I write this, she's sitting by her water bowl with her head hanging over it...

So I can just call up my local vet and ask for subq fluids? They're not updated on her situation but I can kick that off.

The beauty of a Relion is the strips are less expensive and Walmarts are everywhere, except apparently where you are

Ha, yeah I'm in NYC and there are actually no Walmarts here! But I've ordered that kit I linked on Amazon, which should be coming tomorrow. I'll order some extra strips too and the lancets.
She's been reading HI on the Libre for the last 12 hours, so I'm eager to try the ear prick method.

 

[Diane Tyler's Mom GA]

Hi Tiffany, yes your local vet should have the sub q fluids , I used to give them to Tyler's brother for kidney disease. Not hard at all to give. Sending prayers for your precious girl.

 

[Princess Tortilla (GA)]

Hi Tiffany, yes your local vet should have the sub q fluids , I used to give them to Tyler's brother for kidney disease. Not hard at all to give. Sending prayers for your precious girl.

Thank you <3

 

[Princess Tortilla (GA)]

Hi Tiffany, yes your local vet should have the sub q fluids , I used to give them to Tyler's brother for kidney disease. Not hard at all to give. Sending prayers for your precious girl.

OK so our local vet will see us tomorrow first thing for a checkup and demo for the subq fluids!
Until then I hope she can stay hydrated with the water that's mixed with her tube food and the water she's been drinking on her own.

I've just been giving her tap water (the same water I drink).. we live in NYC so the tap water is perfectly fine to drink.. but now based on some googling, I'm wondering if I can improve this for her by filtering it or giving her bottled spring water. Do you think this would make a difference?

 

[Diane Tyler's Mom GA]

OK so our local vet will see us tomorrow first thing for a checkup and demo for the subq fluids!
Until then I hope she can stay hydrated with the water that's mixed with her tube food and the water she's been drinking on her own.

I've just been giving her tap water (the same water I drink).. we live in NYC so the tap water is perfectly fine to drink.. but now based on some googling, I'm wondering if I can improve this for her by filtering it or giving her bottled spring water. Do you think this would make a difference?

I wouldn't do that, I would wait until your vet gives them to you
I also know they have 2 size needles you can use one is bigger and make the fluids go in quicker and one is smaller which make the fluids take a little but longer .
Perry was calm so I would use the bigger ones to get it done faster ,he wouldn't fight me
I would put him on the kitchen table, it was against my wall , put him in a towel. Then I would get one of those hooks I think they were the 3M plastic hook and put it on the wall and then hang the bag on it. It has to be up high so the fluid could come out
I'm sure your vet will show you everything

 

[Princess Tortilla (GA)]

I wouldn't do that, I would wait until your vet gives them to you

Ok great! Thank you

 

[Diane Tyler's Mom GA]

@Princess Tortilla
The ones like these they sell them in any supermarkets all different sizes

 

[Princess Tortilla (GA)]

@Princess Tortilla
The ones like these they sell them in any supermarkets all different sizes

gotcha - I have some at home I can use. Thanks for the tip! Will let you know how it goes tomorrow

 

[Diane Tyler's Mom GA]

This is what in the sub fluids
Injectable fluids come in various forms, but only a few should be used for subcutaneous administration. Lactated ringers, 0.9 percent saline, Ringer's, Normosol-R, and Plasmalyte are most commonly used

Also my vet gave me a tip, the fluids will be sort of cold, so she told be to lay the bag in some sort of container with warm water so it doesn't feel that cold to the cat.
I layer the bag in a dish pan, the ones you wash dishes in until it felt a little bit warm.
Yes let me know how it goes and ask the vet for the 2 different size needles
After I gave the fluids I would just throw away the needle and put a new one in so it's ready to go for the next time
@Princess Tortilla

In case you want to watch a video here

 

[Deborah & Muffy(GA) & Wendall]

OK so our local vet will see us tomorrow first thing for a checkup and demo for the subq fluids!
Until then I hope she can stay hydrated with the water that's mixed with her tube food and the water she's been drinking on her own.

Perfect, I was just going to suggest that!

As far as the right amount, some vets will say 200 mls or whatever a couple times a week. That's too much at one time and can leave the cat thirsty the rest of the time. It's better to give less but more often. The goal is to maintain hydration so the cat doesn't have to drink much which will improve her appetite and help her heal.

Diane gave you some good tips and I'm going to add mine. I do infusions on the kitchen counter and use a big S hook that came from a garden center to hang the fluids from the top of the cabinet, but a wire clothes hanger works as well. Cats prefer fluids at body temperature so I warm them in a big bowl of hot water for a few minutes. Give her a towel to lay on and put some food in front of her as a distraction. Sassy, the old cat I referenced before, learned to come for her fluids because of the food.

 

[Princess Tortilla (GA)]

This is what in the sub fluids
Injectable fluids come in various forms, but only a few should be used for subcutaneous administration. Lactated ringers, 0.9 percent saline, Ringer's, Normosol-R, and Plasmalyte are most commonly used

Also my vet gave me a tip, the fluids will be sort of cold, so she told be to lay the bag in some sort of container with warm water so it doesn't feel that cold to the cat.
I layer the bag in a dish pan, the ones you wash dishes in until it felt a little bit warm.
Yes let me know how it goes and ask the vet for the 2 different size needles
After I gave the fluids I would just throw away the needle and put a new one in so it's ready to go for the next time
@Princess Tortilla

In case you want to watch a video here

Perfect, I was just going to suggest that!

As far as the right amount, some vets will say 200 mls or whatever a couple times a week. That's too much at one time and can leave the cat thirsty the rest of the time. It's better to give less but more often. The goal is to maintain hydration so the cat doesn't have to drink much which will improve her appetite and help her heal.

Diane gave you some good tips and I'm going to add mine. I do infusions on the kitchen counter and use a big S hook that came from a garden center to hang the fluids from the top of the cabinet, but a wire clothes hanger works as well. Cats prefer fluids at body temperature so I warm them in a big bowl of hot water for a few minutes. Give her a towel to lay on and put some food in front of her as a distraction. Sassy, the old cat I referenced before, learned to come for her fluids because of the food.

very helpful, thanks so much!

I'm still worried about her drinking so much water today.. she threw up just now about 90 minutes after her last tube feeding of 30 mls that was given to her over the course of an hour. In the past it seemed like I was tube feeding her too quickly which was making her vomit, but observing her now, she is drinking SO much water herself that I feel like there's just too much water in her little stomach for her to handle... should I try taking away the water bowl for periods of time?

edit: maybe worth adding that at the end of her tube feeding I gave her 0.9 ml of clavamox (an antibiotic we just started at home today - pretty sure they gave this to her at the hospital too) that says to give with food