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#11
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Cat has CRF
On Wed, 22 Apr 2009 16:51:36 -0700 (PDT), cindys
wrote: On Apr 22, 6:24*pm, Kolbard wrote: I was unable to go today, but my mother took her to another vet today, in the hopes of getting her on an IV again, to see if it helped. *The vet took one look at her numbers and said, "Short answer, no, I can't do anything." *I've read of cats with numbers higher than these who survived; should I try every damned vet in town until I find one who's competant? ------------ BTW, I think your cat should have IV fluids ASAP since she is dehydrated. The cat will feel MUCH better once she is rehydrated. You can even be taught to do this yourself at home. I can't believe a vet would refuse to do this, no matter how grave the cat's condition. Best regards, ---Cindy S. She had IV fluids last week, but it didn't seem to help her more than a day. My mother decided to take her back to the vet who didn't want to treat her after seeing the numbers, and told him she wanted him to go ahead and do it anyway. He was hard-line negative. So, she took her back to the original vet and apparently she does know about phosphorus binders, she just didn't mention them before (???). I was she'd get her back on IV, but she gave her a SubQ and sent her home. She mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I want to try those. Someone somewhere, possibly here, mentioned Pepcid as an anti-nausea measure, but I don't know how much to give. Kolbard |
#12
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Cat has CRF
"Kolbard" wrote in message ... She had IV fluids last week, but it didn't seem to help her more than a day. ....because she probably didn't get enough fluids or for long enough. Once your cat is adequately hydrated, you should concentrate on increasing the excretion of the uremic toxins in her blood by increasing her urine output. Fluids alone are usually enough to cause mild diuresis (fluid diuresis) and flush out most of the uremic toxins- enough to shut down a uremic crisis. But since your cat's BUN/Cr/and/P are so high, fluids alone probably aren't enough. She probably needs a diuretic with the fluids (intense diuresis). Intesnse diuresis removes uremic toxins *much* faster. With fluids alone diruesis can take several hours to begin. As long as your cat doesn't have heart disease or hypertension, ID will probably shut down her uremic crisis fairly quickly. Her K+ is already way too low as it is- even without fluid therapy she urgently needs a K+ supplement. Fluid diuresis and especially intense diuresis will increase K+ excretion and depletion even further, so she *definitely* needs a K+ supplement *urgently*. My mother decided to take her back to the vet who didn't want to treat her after seeing the numbers, and told him she wanted him to go ahead and do it anyway. He was hard-line negative. That's probably because he has little or experience treating CRF in cats. A vet who knows anything about CRF in cats knows he should treat the ***cat*** not the numbers! So, she took her back to the original vet and apparently she does know about phosphorus binders, she just didn't mention them before (???). I was she'd get her back on IV, but she gave her a SubQ and sent her home. She mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I want to try those. Someone somewhere, possibly here, mentioned Pepcid as an anti-nausea measure, but I don't know how much to give. The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength* every other day (don't use any other formulation). If that doesn't help, the dose is usually increased to 1/4 tab every day. The maximum dose should not exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the 1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her from tasting it. Pepcid is very bitter- if your cat ever gets a taste of it - pilling will be a nightmare. I'm not a vet- I'm just relaying what worked for our CRF cats that were in a uremic crisis, so run this by a vet first. Best of luck Phil |
#13
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Cat has CRF
Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things? She was on the IV last Monday through last Wednesday, but I was hoping they'd keep her longer. I wasn't even aware her potassium was low. I was hoping she'd be back on the IV tonight, but they just gave her a SubQ instead. I tried syringing some food and AlternaGel, someone successfully. Unfortunately, I tried to syringe some more food a short while later and she threw it all up. She's so thin, I'm not sure she'll last much longer without nourishment. On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P." wrote: "Kolbard" wrote in message .. . She had IV fluids last week, but it didn't seem to help her more than a day. ...because she probably didn't get enough fluids or for long enough. Once your cat is adequately hydrated, you should concentrate on increasing the excretion of the uremic toxins in her blood by increasing her urine output. Fluids alone are usually enough to cause mild diuresis (fluid diuresis) and flush out most of the uremic toxins- enough to shut down a uremic crisis. But since your cat's BUN/Cr/and/P are so high, fluids alone probably aren't enough. She probably needs a diuretic with the fluids (intense diuresis). Intesnse diuresis removes uremic toxins *much* faster. With fluids alone diruesis can take several hours to begin. As long as your cat doesn't have heart disease or hypertension, ID will probably shut down her uremic crisis fairly quickly. Her K+ is already way too low as it is- even without fluid therapy she urgently needs a K+ supplement. Fluid diuresis and especially intense diuresis will increase K+ excretion and depletion even further, so she *definitely* needs a K+ supplement *urgently*. My mother decided to take her back to the vet who didn't want to treat her after seeing the numbers, and told him she wanted him to go ahead and do it anyway. He was hard-line negative. That's probably because he has little or experience treating CRF in cats. A vet who knows anything about CRF in cats knows he should treat the ***cat*** not the numbers! So, she took her back to the original vet and apparently she does know about phosphorus binders, she just didn't mention them before (???). I was she'd get her back on IV, but she gave her a SubQ and sent her home. She mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I want to try those. Someone somewhere, possibly here, mentioned Pepcid as an anti-nausea measure, but I don't know how much to give. The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength* every other day (don't use any other formulation). If that doesn't help, the dose is usually increased to 1/4 tab every day. The maximum dose should not exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the 1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her from tasting it. Pepcid is very bitter- if your cat ever gets a taste of it - pilling will be a nightmare. I'm not a vet- I'm just relaying what worked for our CRF cats that were in a uremic crisis, so run this by a vet first. Best of luck Phil Kolbard |
#14
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Cat has CRF
On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P."
wrote: Her K+ is already way too low as it is- even without fluid therapy she urgently needs a K+ supplement. Fluid diuresis and especially intense diuresis will increase K+ excretion and depletion even further, so she *definitely* needs a K+ supplement *urgently*. I just checked the test results page, and the listed normal range for K+ is 3.7-5.8. Hers was 3.8 at last test. Are these supplements readily available from vet clinics? Kolbard |
#15
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Cat has CRF
On Apr 23, 1:18*am, Kolbard wrote:
On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P." wrote: Her K+ is already way too low as it is- even without fluid therapy she urgently needs a K+ supplement. *Fluid diuresis and especially intense diuresis will increase K+ excretion and depletion even further, so she *definitely* needs a K+ supplement *urgently*. I just checked the test results page, and the listed normal range for K+ is 3.7-5.8. *Hers was 3.8 at last test. *Are these supplements readily available from vet clinics? Kolbard ---------------- Yes. You can get the potassium supplement in the form of Tumil K (which is a pill), a powder (Vet Solutions Renal K+ plus, which supposedly has a beef flavor, but my cats hated it), or as a gel (don't get any gel other than Vet Solutions Renal K+ - there is a different gel which has a horrible smell and flavor). If your vet doesn't carry any of these, they are easily accessible on the internet from any number of sources. http://www.amazon.com/Renal-K-Potass..._bxgy_k_text_b Under the circumstances, I would have them shipped next-day air. If I were you, I would go with the Vet Solutions Renal K+ gel. I used to use this gel, and it worked out well. I currently use the Tumil K pills for my cats only because the pills are cheaper, and I don't have a problem pilling my cats. You can put the gel on your cat's paw, and she will hopefully lick it off. If she doesn't, you can measure it into a large oral syringe and squirt it in her mouth. The normal dose is 2.5 mL (1/2 teaspoon) twice daily. BTW, I am stunned that the price is only $7.99 + 6.16 shipping (regular ground) from Medivet (sold through Amazon.com). My vet used to charge me $21 for the same thing! At this price, I may return to the gel. Best regards, ---Cindy S. |
#16
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Cat has CRF
"Kolbard" wrote in message ... Thanks for the advice, Phil. My biggest concern here is how can I get the vet to do all these things? At this point, I wouldn't waste time trying to find a general practitioner that's experienced in treating CRF. I think you should consult a an ABVP or ACVIM specialist ASAP-- if not sooner. I don't think you should wait another second. If you live within range of a veterinary school, you should give them a call. Most veterinary colleges have nephrologists and urologists on staff and are fully equipped to handle uremic crises. If not, do a search for an ABVP feline specialist in your area: http://www.abvp.com/FindDiplomate.aspx If you can't find an ABVP Diplomate in your area try: ACVIM Board-certified Veterinary Specialist in Your Area http://www.acvim.org/websites/acvim/index.php?p=3 She was on the IV last Monday through last Wednesday, but I was hoping they'd keep her longer. I wasn't even aware her potassium was low. (From a recent post) "Serum potassium levels are a poor indicator of total body stores of K+ since 95% of the total body stores of K+ are contained in the cells (intracellular fluid- [ICF]). If the K+ level is low in the blood (extracellular fluid [ECF]- its *definitely* low in the cells. Your cat is borderline hypokalemic. When serum K+ is low the body will draw K from the cells to maintain adequate serum K+ levels. This is why potassium depletion in the cells can occur long before the onset of hypokalemia. Serum K+ levels should be kept in the upper half of the normal range because the ECF K+ pool is so much smaller, tiny shifts between ICF and ECF can affect serum K+ levels tremendously." If your email is a working address, I'd be happy to send you a paper on the importance of K+ in cats with CRF. Its called "Renal Disease in Cats" The Potassium Connection" by Steven Dow and Martin Fettman. I was hoping she'd be back on the IV tonight, but they just gave her a SubQ instead. I tried syringing some food and AlternaGel, someone successfully. Unfortunately, I tried to syringe some more food a short while later and she threw it all up. She's so thin, I'm not sure she'll last much longer without nourishment. Pepcid should help control nausea- although she'll probably need the high-end dose, and/or metoclopramide (Reglan) which also controls nausea- its a little stronger than Pepcid and works a little differently. Along with the 1/4 tab of Pepcid, I include 1/4 tab of cyproheptadine in a #4 gelcap (they fit). Cyproheptadine (Periactin), is an antihistamine which acts like an appetite stimulant in cats. Best of luck, Phil On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P." wrote: "Kolbard" wrote in message .. . She had IV fluids last week, but it didn't seem to help her more than a day. ...because she probably didn't get enough fluids or for long enough. Once your cat is adequately hydrated, you should concentrate on increasing the excretion of the uremic toxins in her blood by increasing her urine output. Fluids alone are usually enough to cause mild diuresis (fluid diuresis) and flush out most of the uremic toxins- enough to shut down a uremic crisis. But since your cat's BUN/Cr/and/P are so high, fluids alone probably aren't enough. She probably needs a diuretic with the fluids (intense diuresis). Intesnse diuresis removes uremic toxins *much* faster. With fluids alone diruesis can take several hours to begin. As long as your cat doesn't have heart disease or hypertension, ID will probably shut down her uremic crisis fairly quickly. Her K+ is already way too low as it is- even without fluid therapy she urgently needs a K+ supplement. Fluid diuresis and especially intense diuresis will increase K+ excretion and depletion even further, so she *definitely* needs a K+ supplement *urgently*. My mother decided to take her back to the vet who didn't want to treat her after seeing the numbers, and told him she wanted him to go ahead and do it anyway. He was hard-line negative. That's probably because he has little or experience treating CRF in cats. A vet who knows anything about CRF in cats knows he should treat the ***cat*** not the numbers! So, she took her back to the original vet and apparently she does know about phosphorus binders, she just didn't mention them before (???). I was she'd get her back on IV, but she gave her a SubQ and sent her home. She mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I want to try those. Someone somewhere, possibly here, mentioned Pepcid as an anti-nausea measure, but I don't know how much to give. The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength* every other day (don't use any other formulation). If that doesn't help, the dose is usually increased to 1/4 tab every day. The maximum dose should not exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the 1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her from tasting it. Pepcid is very bitter- if your cat ever gets a taste of it - pilling will be a nightmare. I'm not a vet- I'm just relaying what worked for our CRF cats that were in a uremic crisis, so run this by a vet first. Best of luck Phil Kolbard |
#17
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Cat has CRF
On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P."
wrote: "Kolbard" wrote in message .. . Thanks for the advice, Phil. My biggest concern here is how can I get the vet to do all these things? At this point, I wouldn't waste time trying to find a general practitioner that's experienced in treating CRF. I think you should consult a an ABVP or ACVIM specialist ASAP-- if not sooner. I don't think you should wait another second. If you live within range of a veterinary school, you should give them a call. Most veterinary colleges have nephrologists and urologists on staff and are fully equipped to handle uremic crises. If not, do a search for an ABVP feline specialist in your area: http://www.abvp.com/FindDiplomate.aspx If you can't find an ABVP Diplomate in your area try: ACVIM Board-certified Veterinary Specialist in Your Area http://www.acvim.org/websites/acvim/index.php?p=3 I just checked and there aren't any close to me. The closest is maybe 5 hours away. All I can hope for is that the vet agrees to put her back on IV. I hate feeling so helpless, being at the mercy of the vets here. Kolbard |
#18
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Cat has CRF
On Apr 23, 6:30*am, Kolbard wrote:
On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P." wrote: "Kolbard" wrote in message .. . Thanks for the advice, Phil. *My biggest concern here is how can I get the vet to do all these things? At this point, I wouldn't waste time trying to find a general practitioner that's experienced in treating CRF. *I think you should consult a an ABVP or ACVIM specialist ASAP-- if not sooner. I don't think you should wait another second. If you live within range of a veterinary school, you should give them a call. *Most veterinary colleges have nephrologists and urologists on staff and are fully equipped to handle uremic crises. If not, do a search for an ABVP feline specialist in your area: http://www.abvp.com/FindDiplomate.aspx If you can't find an ABVP Diplomate in your area try: ACVIM Board-certified Veterinary Specialist in Your Area http://www.acvim.org/websites/acvim/index.php?p=3 I just checked and there aren't any close to me. *The closest is maybe 5 hours away. All I can hope for is that the vet agrees to put her back on IV. *I hate feeling so helpless, being at the mercy of the vets here. --------- I don't understand why they would refuse. If nothing else, it's money in their pockets to treat your cat. Please continue to keep us updated. Best regards, ---Cindy S. |
#19
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Cat has CRF
"Kolbard" wrote in message ... On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P." wrote: "Kolbard" wrote in message .. . Thanks for the advice, Phil. My biggest concern here is how can I get the vet to do all these things? At this point, I wouldn't waste time trying to find a general practitioner that's experienced in treating CRF. I think you should consult a an ABVP or ACVIM specialist ASAP-- if not sooner. I don't think you should wait another second. If you live within range of a veterinary school, you should give them a call. Most veterinary colleges have nephrologists and urologists on staff and are fully equipped to handle uremic crises. If not, do a search for an ABVP feline specialist in your area: http://www.abvp.com/FindDiplomate.aspx If you can't find an ABVP Diplomate in your area try: ACVIM Board-certified Veterinary Specialist in Your Area http://www.acvim.org/websites/acvim/index.php?p=3 I just checked and there aren't any close to me. The closest is maybe 5 hours away. That's not that far under the circumstances- considering your cat urgently needs correct and immediate treatment. All I can hope for is that the vet agrees to put her back on IV. I hate feeling so helpless, being at the mercy of the vets here. Do you have a car? How far do you live from the nearest vet college? Phil |
#20
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Cat has CRF
On Thu, 23 Apr 2009 18:07:10 GMT, "Phil P."
wrote: "Kolbard" wrote in message .. . On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P." wrote: "Kolbard" wrote in message .. . Thanks for the advice, Phil. My biggest concern here is how can I get the vet to do all these things? At this point, I wouldn't waste time trying to find a general practitioner that's experienced in treating CRF. I think you should consult a an ABVP or ACVIM specialist ASAP-- if not sooner. I don't think you should wait another second. If you live within range of a veterinary school, you should give them a call. Most veterinary colleges have nephrologists and urologists on staff and are fully equipped to handle uremic crises. If not, do a search for an ABVP feline specialist in your area: http://www.abvp.com/FindDiplomate.aspx If you can't find an ABVP Diplomate in your area try: ACVIM Board-certified Veterinary Specialist in Your Area http://www.acvim.org/websites/acvim/index.php?p=3 I just checked and there aren't any close to me. The closest is maybe 5 hours away. That's not that far under the circumstances- considering your cat urgently needs correct and immediate treatment. All I can hope for is that the vet agrees to put her back on IV. I hate feeling so helpless, being at the mercy of the vets here. Do you have a car? How far do you live from the nearest vet college? Phil We took her back to the vet to get her back on IV (and mention the diuretic), but they couldn't IV her because she's still swollen from the SubQ shot yesterday. Kolbard |
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