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CRF & Fluids

Posted by petra (My Page) on
Wed, Aug 29, 12 at 19:35

Had to take our 18 year old kitty in for a blood test, his kidney values have decreased, he is borderline anemic, dehydrated and has a heart murmur. He has also lost weight but is always eating, so they did a thyroid test as well, the results of which we have to wait for. On the positive side, he did not have much protein in his urine, and he is quite lively and happy. I asked them to give him fluids which they did, and we discussed giving him fluids at home, depending on what the results of the thyroid test are (the vet said thyroid problems can make kidney problems worse and the kidney values might improve once the thyroid is being treated IF that is what he has). Anyway, has anyone here done fluids at home and how hard is it? I know there are CRF groups out there, but I don't want to sign up for anything yet. I am feeling kinda overwhelmed with having just lost a kitty and then having one diagnosed as diabetic and just having started with insulin and now likely fluids at home.


Follow-Up Postings:

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RE: CRF & Fluids

I know that a CRF diagnosis can be frightening and overwhelming, as can the idea of having to administer subQ fluids at home, but I assure you, the procedure becomes quite simple and routine with practice. It can be pretty nerve-wracking at first, though. If you can control your nerves and maintain a calm attitude, the actual skill involved is minimal. There are lots of tips and tricks to make subQ administration comfortable for both you and your cat, and there are a number of online tutorials and videos. Again, really not a big deal once you get some practice under your belt. Most cats, also, are surprisingly compliant - even those with a reputation for horrendous behavior during veterinary procedures - once they realize how much better the fluids make them feel.

I would strongly suggest you reconsider joining a CRF mailing list. I credit the largest and most active of those lists with providing most of my initial CRF education and helping me vastly improve the lives of my CRF cats over the last decade or so. The CRF lists contain members who are incredibly experienced and knowledgeable about this disease, some of whom also have access to the most highly regarded veterinary renal specialists in the world. Even if you choose not to actively participate in the list(s), the searchable message archives to which you will have access as a member are invaluable.

Another invaluable CRF resource is Tanya's website linked below. This site is considered the CRF 'bible' for many of us CRF caretakers. It contains comprehensive information on virtually every aspect of CRF and its associated conditions. Bookmark it and read and reread as much of it as your brain can handle. The more time you spend on Tanya's site, the more of it will eventually sink in. I've been using the site as my primary CRF resource for over a decade, and I still find myself returning to it constantly to refresh my knowledge and to access frequently updated information.

As far as CRF and hyperthyroidism are concerned, I believe you may have misunderstood your vet. Uncontrolled hyperthyroidism can mask renal failure in some cats by causing the kidneys (and everything else) to work in overdrive. This 'overdrive' effect can cause renal values in bloodwork to appear normal even when the kidneys are ailing, because the hyperT is forcing the sick kidneys to work harder. Once hyperT is properly managed and thyroid hormone levels have returned to normal, the 'overdrive' effect is eliminated, and the true condition of the kidneys will be restored and revealed in bloodwork. So, it's much more common for renal values to worsen after treatment for hyperT than it is for them to improve, esp. if renal problems are already evident in bloodwork before treatment for hyperT has begun.

Laurie

Here is a link that might be useful: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease


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RE: CRF & Fluids

I'd second everything Laurie wrote. Over the years I've given fluids to 3 older cats, including my 19 yr old who is still with me, as well as to my old collie and sheltie in their last years of life.

A vet tech at the clinic that treats my pets showed me how to give the fluids. I'd recommend asking for a similar demonstration. It was very instructive and helpful.

Sub-q fluid treatment made a big difference in my older pets' quality of life. I hope and trust it will help your kitty. Most pets have some degree of renal insufficiency when they reach old age, but they can still live in comfort with a little help. Good luck and let us know how it goes.


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RE: CRF & Fluids

ITA with everything Laurie posted too. The Tanya site is invaluable.

I am VERY bad with needles and we did sub-q for 6 years. It was only a problem for a short while until we got the hang of it and we knew what to expect from each other. I highly recommend doing it, it is so helpful and really not as bad as you might be thinking. The first couple of times we did it at home, I was shaking so badly when we finished (I really hate needles!), but within a week or two, it didn't seem like such a big deal- especially when we could see how much better she was doing.

I had a vet tech appointment where Muddy Kitty sat like an angel and the tech showed me the procedure. Muddy was never so well behaved again. She was a fighter in all things and getting fluids was no exception, she gave me some degree of grief every time for 6 years :^) DH could not hold her well, so we ended up with a restraint bag, which she and I both definitely preferred. We also used some picture tutorials online, and found those very helpful.

My girl also had hyper-t. It made life interesting. We spent a bit of time regulating things to a good balance, and that would happen from time to time. I was lucky to have a vet I liked and trusted, so just did what she told me to do, when she told me to do it.


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RE: CRF & Fluids

Thanks so much Laurie and Spedigrees!!

Yes, sounds like I misunderstood the vet re. the hyperthyroid, but I was somewhat overwhelmed at the time. We adopted Peanut when he was 3 months old and he just turned 18 last March. It was hard to hear that he is in renal failure. He is so much perkier today which I attribute to the fluids, so we are definitely going to do those. She gave him 200 cc's (I think it was cc's) and his body just sucked them up, so he must have been very dehydrated.

Laurie, thanks much for the link, I will check that website and will also look for some lists to sign up for.

spedigrees, how long have you been giving your 19 year old fluids? Does it deplete vitamins and minerals and do you have to supplement? Years ago, we had a beagle with CRF. He was diagnosed at age 13, and lived to almost 17. I used to cook for him because he did not like the renal diet, and there was no mention about administering fluids, but I wish that had been an option and I am glad we can do it for Peanut.


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RE: CRF & Fluids

Quasifish, I didn't see your reply before posting, thanks for taking the time to post your experience. So your kitty also had Hyperthyroid, what symptoms did you notice? The vet thinks Peanut might have it because of the heart murmur plus he is always hungry, but has lost weight. We have one who had hyperthyroid and had the radioactive procedure and his symptoms were a lot more pronounced than Peanuts, so I am not convinced Peanut has HT. But we'll see, the test results should be be back by Monday at the latest.

I watched the tech when she administered the fluids yesterday, she did 100 cc's on side of the back, and another 100 on the other. It did look quite easy and Peanut was not too wiggly. She just had me distract him when sliding the needle in and the whole thing took about 4 mins. She said his body was pretty much sucking the fluids up.


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RE: CRF & Fluids

A few more key points I didn't think to add last night ...

When your vet or vet tech teaches you how to administer fluids, make absolutely certain that they cover warming the fluids (absolutely CRITICAL for the cat's comfort and cooperation).

Needle size and manufacture can make a big difference in the cat's comfort. Most CRF caretakers prefer to use Terumo Ultra Thin Wall 20 gauge needles, which can be purchased inexpensively and without a prescription in most states from the link below. You can purchase IV sets inexpensively from the same source.

When administering fluids, the least physical restraint usually results in the most cooperation from the cat.

A couple of important notes re. hyperT ...

If your cat's Total T4 test comes back within the upper half of normal range, request a Free T4 by Equilibrium Dialysis to clarify her thyroid status. The upper half of normal range on a TT4 is considered borderline high and requires additional testing to rule out (or in) hyperT.

If your cat is confirmed to have hyperT (which I would expect to be the case, given the symptoms you have noted), ask your vet to start her on a very low dose of methimazole (1.25 mg twice daily). An unfortunate number of vets still use outdated dosing guidelines of up to 5 mg twice daily. In the last year, I have read reports of a number of cat deaths and near deaths from owners of hyperT cats who started their cats on those higher starting doses. There is absolutely NO VALUE in starting a cat at the higher dose, but there is substantial risk. The risk of potentially serious or life-threatening side effects is minimized by starting at a very low dose, retesting TT4 in 3 weeks, adjusting the dose slightly (if necessary), and continuing with the 3 week retest/dose adjustment schedule until euthyroid (normal thyroid hormone levels) is achieved. It is more expensive to take this slow, cautious approach to euthyroid, but it is by far and away the safest strategy for your cat.

One final note ... ALWAYS obtain copies of ALL lab reports from your vet. You will need them for reference when researching your cat's condition(s) online and when requesting relevant and helpful guidance on forums like this one. Also, by keeping track of your animals' lab results at home, you will very likely notice changes you want and need to discuss with your vet.

Laurie

Here is a link that might be useful: Thriving Pets (Terumo needles and IV sets)


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CRF and hyperT

Petra,

Just read your responses. In answer to your questions, cats lose B vitamins and potassium in urine, so it is common practice to supplement both in cats receiving fluids. Discuss this with your vet.

I, too, have had a cat with both CRF and hyperT (two cats, actually). It's a balancing act, but I'll go into that more fully when you have Peanut's thyroid results. Not all cats have all usual hyperT symptoms, and some have symptoms that are completely contrary to the norm. That said, excessive thirst, hyperactivity, strong appetite coupled with weight loss, diarrhea and/or vomiting, heart murmur, excessive vocalization, and aggression are symptoms often seen with hyperT. If a cat also has CRF, all bets are off in terms of interpreting symptoms.

Again, based solely on what you've written about Peanut, my money's on a positive hyperT diagnosis.

Try not to let all of this overwhelm you (MUCH easier said than done, I know). As you already know, hyperT is curable with radioactive iodine. CRF is quite manageable in many cats, esp. if the diagnosis is made early in the disease. There's a steep learning curve for both diseases, both you already have some experience with both. At least you're not starting your education from the ground floor. ;-)

Laurie


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RE: CRF & Fluids

laurie, thanks for the additional info. It does look a bit overwhelming, but we'll see how the thyroid test turns out. The vet tech did not warm the fluids, they were probably room temp. But I will certainly do that. I would think it would make them feel cold to not have the fluids at body temp.


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warming fluids

Petra,

You are quite right about room temp fluids. They are very chilling for a cat, and they can cause a cat to REALLY fight the procedure, or at least to really dread it. In fact, vets use room temp fluids to reduce a fever because they ARE so chilling.

The way I warm fluids is this:

I put the fluid bag and most of the IV line into my bathroom sink with the connections of the bag to line and line to needle anchored on the counter out of the sink with something relatively heavy (like a bottle of lotion) on the line to prevent the connections from slipping under the water (you do NOT want the connections to get wet). Then I fill the sink with hot water until it covers most of the bag and whatever line falls below the bag's level. I remove the bag and line from the sink when the sink water has cooled enough for me to comfortably dip and hold my wrist in it (same temp as baby formula you check on your wrist). If you have any question about the temp, it's better to err on the side of a little too cool rather than any too warm.

DO NOT warm fluids in the microwave. They will warm unevenly, and it's waaaay too easy to overheat fluids in a microwave.

Laurie


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RE: CRF & Fluids

No worries, we never replaced the microwave that broke 8 or 9 years ago. :o) Thanks for the sink warming tip, I will definitely do that. We want him to be as comfy as possible. As far as you know, is it true that this goes much faster when the cat is really dehydrated? That is what she said yesterday when his body just seemed to suck in the fluids.


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speed vs comfort

I suppose it would go faster if the cat was really dehydrated, but I'm careful at this point not to let that happen. It was a tough, slow learning curve for me with my first couple of CRF cats, and they suffered as a result of my ignorance. That was long enough ago now that I don't have much memory of such details as how long subQ administrations took.

I can tell you that needle size and placement make a difference in how quickly the procedure goes. So does whether or not the cat has a bunch of loose skin. Fluid admins always went quickly with my Noddy, who gradually lost 10 lbs when I decided that morbid obesity was not in his best interest. Years later when I had to start giving him fluids, all of that loose skin came in mighty handy as a fluid depository.

Fast fluid admins are not the goal. Fluid that enters the body too quickly can produce an uncomfortable fluid pocket, whereas fluids that enter a little more slowly tend to distribute over a wider, more comfortable area during admin.

Many vets use 18 or sometimes even 16 ga needles (harpoons) to speed up fluid admins - I assume to process patients out of the clinic as quickly as possible. But a 16 or 18 ga needle makes a bigger and potentially more painful hole in the cat than the smaller 20 ga. Again, speed is not the goal. Comfort and cooperation are.

Laurie


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RE: CRF & Fluids

Laurie, I should have phrased that better. What I meant is that I want to avoid him being so dehydrated that the administering of the fluid goes fast. It shocked me that his poor body just sucked the fluids up that fast. I want to make sure he gets enough fluids to where he does not become dehydrated. The vet said probably 200 cc's 2 times per week would be enough, so I thought since the tech said he was absorbing so quickly because he was very dehydrated the speed of absorption might tell me if he needs fluids more frequently or not. But from what you've written, that's probably not the case and they just used a big needle. I will be sure to ask for a 20 ga instead.


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RE: CRF & Fluids

For my cat I got the original setup from the vet, but soon started ordering all my supplies from the compounding pharmacist.

It was much less expensive for the same quality.

We hooked the setup onto a standing lamp next to a comfy armchair. I would sit in the armchair, snuggling the cat up with me in a towel, insert the needle and pet him while the fluids went in.

Treats followed each treatment, so he soon made a positive association and became very cooperative.

He got two extra, more comfortable years because of the fluids, and it was well worth it.


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RE: CRF & Fluids

Petra,

The more evenly hydrated you can keep Peanut, the better for him and for his kidneys. In that regard, it would be better to give him 50-75 ml of fluids every day than to give him 200 ml twice a week. Twice weekly fluids produces a "flood or drought" effect in his body. It's also safer to administer smaller amounts more frequently, because it is possible to overhydrate and internally "drown" a cat. I nearly killed one of mine that way.

It's especially important to be careful with fluids in a cat with a possible cardiac impairment. If Peanut's murmur is related to hyperT, it's very possible that it will resolve once his hyperT is properly managed. In the meantime, though, it's prudent to be mindful of the risk of overhydration. One way to help avoid this problem is to buy a digital baby scale if you don't already have one. Weigh Peanut immediately before fluid admin and again immediately after. Don't admin fluids again until he returns to his pre-admin weight. That way you won't be likely to admin more fluids until he has processed the last admin.

Don't buy needles from your vet unless your vet uses Terumo needles. Most vets use Monoject needles, which we CRF caretakers refer to as "kitty harpoons" because of their inconsistent quality of manufacture. Terumos are sharper and therefore less painful for the cat. See the link I provided earlier in this thread to a source from which to purchase Terumos.

Laurie


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RE: CRF & Fluids

Laurie, I did check that link and saw the Terumo needles. Looks like most people use 20's, though one wrote she uses a 21. Do you also buy your fluids from that link? If not, where do you purchase them? About how long does a liter bag last? Thanks for the tip re. fluid admin. If it's better for him, once a day is not a problem.
Petaloid, that's a good idea. I am thinking we could maybe hang it on a cabinet door while having him on the counter. I figured the vet prices would be much higher, they usually are.


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RE: CRF & Fluids

Petra, most folks use the 20 ga UTW (Ultra Thin Wall) Terumo needles because they have a fluid flow rate about as good as an 18 ga but with the smaller, more comfortable size of a 20 ga. I buy my needles and IV sets from that site, but I buy my Ringer's by the case (with a script from my vet) at a local pharmacy. It REALLY pays to call around to all of your area pharmacies and price a case of Ringer's. I get prices locally of anywhere from $24-50/case. Needless to say, I buy the lowest price. Oh, and when you get price quotes, make sure you know whether they're quoting a 10 bag case or a 12 bag case.

Ringer's is available in 500 ml bags and more commonly in 1000 ml bags. Regardless of whether or not you have finished a bag, you should discard it 10 days after you first took it out of its outer bag and inserted a line. Depending on how much fluid you give Peanut on a daily basis, that may mean some fluid waste by the end of 10 days if you're buying the cheaper (per ml) 1000 ml bags. If you find you're wasting too much, it may be more cost effective to buy the 500 ml bags. But the 500's are generally a lot more expensive per ml than the 1000's, so you'd have to be wasting a lot of fluid to make the 500's more cost effective. Again, just call around for pricing and see what works out best for you. Oh, and you may find that none of your local pharmacies stock Ringers (none of mine do). But they can all order it for you overnight if you request it.

The most commonly administered daily dose of fluids on the CRF mailing list is 100 ml, though plenty of cats get less than that. Rarely would a cat require more than 100 ml/day. How quickly you go through a bag depends on how much you're administering, and how much you're administering depends on how much Peanut needs. There are no hard and fast rules.

I've got to get out to the barn now, but I'll post again later with a picture and description of the setup I use to admin fluids.

Laurie


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RE: CRF & Fluids

Laurie, thanks so much for taking the time to post all of this info. I learned a lot already. And thanks for the tip to call around, we do have several pharmacies here, including private ones plus walmart, walgreens, CVS, etc.

Now I wonder why they gave him 200 cc's all at once, though in 2 different areas. Sounds like it might have been too much. Still haven't heard re. the thyroid test, she had to send it out and it may not come in til tomorrow.


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RE: CRF & Fluids

Don't worry, if Peanut was badly dehydrated, there was absolutely nothing wrong in giving him 200 ml at one time. It's just not an amount you'd be giving him every day.

When you get the thyroid results, be sure to get the lab's reference range AND ask which specific type of thyroid test was run.

Laurie


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RE: CRF & Fluids

We got the test results and all the thyroid values were perfectly normal. So, the weight loss and heart murmur are likely kidney and age-related. We are going in for a fluid demo Tuesday afternoon. I asked about the needles and they use 20 gauge, so that should be okay. She mentioned giving him 100 every day might be a better approach. She also mentioned a supplement called Aze-something (should have written it down, but had just come home when she called) that helps with binding toxins instead of letting the body secrete them, and makes them feel better.


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RE: CRF & Fluids

What are the thyroid results (including the lab's reference range(s)), and which thyroid test(s) was/were run? Do you have copies of all of his other lab tests that you could post here for us to see?

Your vet is recommending Azodyl. You can read up on it at Tanya's site and also here. While you're at Tanya's site, read up on Calcitriol, as well. Actually, a better Calcitriol reference is linked below. Calcitriol is most effective and beneficial for cats in early stage CRF.

Laurie

Here is a link that might be useful: Calcitriol reference


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RE: CRF & Fluids

I don't have the thyroid test results, she just told me they were perfectly normal over the phone. The thyroid test was a "comprehensive" thyroid test, it cost $55 by itself, so hopefully it was accurate. Don't have a copy of the regular blood tests either, but I know that phosphorus? was normal, sodium was high, Potassium was normal, and BUN was 3.5, and there was just a small trace of protein in the urine. I can ask for copies on Tuesday. From what she told me, he is likely in stage 3 because of the 3.5 BUN. But I will still read up on the calcitrol.


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RE: CRF & Fluids

Correction, Creatinine was 3.5., I just checked the printout for an IRIS website CRF stage paper she gave me and the creatinine was circled as 3.5, which makes him stage 3.


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RE: CRF & Fluids

Yeah, you REALLY need to get hold of copies of ALL of his lab results ASAP. You are confusing BUN with creatinine, for one thing. Also, you need to understand that the lab's reference ranges are based on what is considered normal for a healthy, adult cat. A CRF cat, however, is NOT healthy and is more often than not an aged cat. That means that the lab's "normal" ranges don't necessarily apply to Peanut the way they would to younger, healthier cats.

For instance, a CRF cat's phosphorus should be maintained in the lower half of the reference range, and his potassium should be maintained in the upper half of its reference range. Total protein in the upper end of its reference range probably indicates dehydration in a CRF cat. So, it is NOT ENOUGH to be told that Peanut's blood values are within "normal range". You need to know EXACTLY where they are and how that relates to his disease and health status.

Get those test results and post them here. We can tell you if there are specific values that should be discussed with your vet more fully.

BTW, one of my CRF girls has a creat around the 3.5 mark, and I started her on Calcitriol immediately. It's worth reading up on.

Laurie


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RE: CRF & Fluids

Hi Petra,
I know just how you feel looking back on your beagle's life and wishing fluid treatment was available back then. Our first cat, Paisley, lived to be 23 (a grand old age just like your beagle who made it to 17) but I always wonder if she would have been more comfortable in her later years with the help of fluid treatment. Still our two old timers had wonderful long lives. RIP

I have been dehydrated several times in my life, once from a virus and the other time travelling through Arizona in summer, so I can definitely testify that dehydration is not pleasant. In Arizona just drinking a lot of water, and in the case of the virus, being put on IV fluids, almost instantly banished the headache, nausea, and groggy feeling. Hydration is a marvelous thing!

My current cat, the 19 yr old, has been on fluids about 3 years now. She gets about 100 ccs once a week. I've had her blood tested a couple times recently and her numbers are quite good for a cat her age. Her predecessors, at the same age and older had much higher degrees of kidney insufficiency, and I believe they were prescribed larger amounts of fluids, and twice a week in their final years.

I had never heard of fluid treatment depleting vitamins or minerals, but I suppose it may. I have home cooked for all my pets since 2007, so my current kitty eats mostly chicken (finely minced) with calcium carbonate or ground eggshell, some digestive enzymes, vitamin/mineral supplement (for people but w/o iron), and a bit of taurine added.

My old cat Paisley was on the kidney diet, a homemade formula at the time, given to me by my vet. I remember it consisted of white rice, hamburg, chopped hard boiled egg and some other ingredients. But as time passed her appetite waned, and I fed her canned catfood and meat babyfoods instead. I think that the low protein kidney diet has been discredited in recent years, but however you look at it, it's more important to keep an old animal eating than worrying too much about what they eat. I wish my current kitty would eat a greater variety of foods, but she'll take a few bites of other meats or fish and then wants to go back to her chicken, so chicken it is!

I would second the advice to always use a 20 gage needle. I'm not sure why veterinarians typically use 18 g but this larger diameter needle is uncomfortable for the pet and I don't see that there is much difference in flow between the two. I used the smaller (20 g) needles for my dogs too, even my big collie.

Most people swear by the terumo needles, but I use the needles from my vet when it's more convenient than placing an online order, and as long as they are 20 gage, they seem to work just fine for my pets. I just haven't noticed the terumo needles perform that much better, but many people say they do.

Another caution about needles, is occasionally (not often) you might get a defective needle (it can happen with whatever brand needle you use). These defective needles have a tiny barb on the pointed end, only visible under a magnifying glass. If you try a needle and it absolutely will not puncture the skin, look at it under a magnifying glass in good light, or just discard it and use another. Some people on one of the CRF cats group told me about this and it saved me a lot of aggravation to know WHY the occasional needle just didn't work.

I take the simple approach and judge by symptoms as opposed to ordering very frequent bloodwork. My cat is doing very well right now, but if her appetite declined and she took a downward turn, I'd ask the vet if we could increase the amount and frequency of the fluids. If that didn't help her, or if she developed new troubling symptoms, then I'd ask for bloodwork. It's possible to over-think things like blood values and vitamin supplementation. But it's ultimately up to each pet owner to do what they feel comfortable with.

Good luck with Peanut. He's been with you a long time and hopefully he will be for more years to come. He's lucky to have you for an owner. Here's hoping he will surpass the 23 years of my beloved old Paisley!


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RE: CRF & Fluids

Petra-trust me, you are not alone in dealing with this type of situation. However there are many things you can do. My cat Trevor has had kidney failure for 3 1/2 years and looks and acts like a normal quite active cat. We switched vets after I learned so many things thru Tanya's message boards that I knew more than the vet I had about some issues. The new vet thinks Trevor looks 'remarkable' for a cat with kidney disease for so long. The single most important thing you can do is get signed up with the Yahoo group thru Tanya's site. There are ways you can either manage the emails or just go to their message board and read, read, read. You will learn so much. As to your immediate concerns
-get the NDC number off the fluid bag and take it to Walgreens to get a price on the correct product. I believe they run about $22 for a case of 12 vs $15.89 for one bag at the vets. I buy mine from Costco and they are even cheaper if you have a Costco nearby. You don't need to be a member to use the pharmacy
-the borderline anemia has to be addressed immediately. Let us know what the HCT is on the labs when you get them. This can be corrected most times with vitamins. Do not let the vet give you epogen for that if the HCT is above 17%. My vet wanted to at 24.9% and I ended up firing the vet because of that advice. Epogen can create new problems down the road. A first line of defense is to try and correct it thru vitamins if the HCT is high enough. Borderline would be high enough. Trevor went from anemia to a normal range on his next visit with vitamins alone. Read up on them on Tanya's site. We use Pet-Tinic twice a day and a vitamin B12 capsule once a day. You need a SPECIFIC kind of B12 spelled out on Tanya's site available cheaply at vitacost.com site. FYI-the fluids won't cause a vitamin deficiency-the B's are to assist the kidneys helping them produce red blood cells-they aren't doing it as well as they should and is causig the leaning towards anemia.
-the needles-I use Terumo as well however I much prefer the 18's over the 20's. I shouldn't say I prefer-the CAT prefers. The higher the number the slower the needle. Trevor prefers to get done and move on rather than sit another couple of minutes. A bit cheaper buying them elsewhere than the vet. I use thriiving pets to buy lines and needles. I suggest buying a box of each and let kitty determine the best option with those-they are inexpensive.
-I don't heat the fluids. I did start out doing that, but kitty didn't seem to care one way or the other.
-kitty has a heart murmur of a 2 on a scale of 1-6. I'm ignoring that for now. He looks and acts perfectly fine.
-one other thing you haven't mentioned-I believe all kidney kitties are put on pepcid (human kind from the drugstore). Has your vet mentioned that?
-one last thing-consider buying Tanya's book that just came out in August. Its on amazon or her site. I'm going to buy my vet a copy to loan to people of newly discovered CRF. It covers EVERYTHING!!


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RE: CRF & Fluids

Everyone, my sincere thanks for all the helpful info, and Peanut thanks you too. I am going to be able to avoid plenty of mistakes thanks to all the advice and helpful hints. Am going to print this thread so I can have it on hand to refer to.

Laurie, I will get copies of the test results tomorrow afternoon and post them here.

Spedigrees, that's encouraging. Peanut will be 19 in March, we adopted him when he was 3 months old. Pretty scary to have to accept he's declining, but it would be fantastic if he would make it to 23 like your Paisley. The vet said being a Siamese mix is in his favor as Oriental mixes tend to live long.

Lisa, thanks for the money saving fluid tip! I guess they require a prescription? Wow, $16 for one bag vs. $22 for 12, wow. I guess vets mark stuff up tremendously. I bought some liquid vitamins especially for aging/ill cats, called Spectrin. I will check on the CRF site if they are listed, if not I'll get him whatever is recommended. Here's the ingredient list for Spectrin, looks like it has all the vit B's.
Vitamin A (Palmitate) 750IU # Vitamin B1 (Thiamine HCI) 2mg # Vitamin B2 (Riboflavin) 2mg # Vitamin B3 (Niacin) 2mg # Vitamin B5 2mg # Vitamin B6 (Pyridoxine HCI) 3mg # Vitamin B12 (Cyanocobalamin) 12mcg # Folic Acid 15mcg # Choline (Choline Bitartrate) 5mg # Inositol 4mg # Vitamin C (Sodium Ascorbate) 60mg # Vitamin D3 100IU # Vitamin E (a-Alpha Tocopherol Acetate) 50IU # Iodine (Potassium Iodide) 45mcg # Manganese (Amino Acid Chelate) 2mcg # Selenium (Amino Acid Chelate) 15mcg # Zinc (Gluconate) 1mg # Glucosamine Sulfate 50mg* # Citrus Bioflavonoids 50mcg* # Boron (Amino Acid Chelate) 50mcg* # Betaine HCI 10mg # Taurine 120mg # Essential Fatty Acids (Lecithin, Flax Seed Oil) 65mg # Copper (gluconate) 30mcg* # L-Arginine 75mg # L-Citrulline 75mg* # L-Methionine 7mg # L-Cysteine 3mg* # Purified water, vegetable glycerin, citric acid, vegetable gum, potassium benzoate, potassium sorbate

The vet also said fish oil might be beneficial. She did address pepcid and suggested 5mg every other day.


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RE: CRF & Fluids

I'm looking forward to seeing Peanut's lab work. Be sure you get copies of ALL of his labs (blood, urine, thyroid, etc.).

There are folks on the CRF mailing list who have paid as much as $25/bag for Ringers from their vet. Nothing short of highway robbery. Many vets also charge several times more for needles and IV sets than you would have to pay online. A little shopping can save BIG! Yes, you will need to get a prescription for the fluids, and possibly the needles and IV sets if you live in a highly regulated state.

Read up on Vit. B12 on Tanya's site. B12 is probably the most important of the B vits, but it is not well absorbed through the gut. The best way to administer B12 is by injection. Fortunately, it can be injected directly into the fluid line during subQ fluid admin, so you won't need to stick Win a second time. As long as you give it during fluid admin so that the Ringers dilutes it, it doesn't sting at all (Win won't even notice it). Just be sure to buy IV lines with an injection port.

Spectrin probably won't provide enough potassium to make up for the potassium lost in urine once you start giving fluids. Win's current and future bloodwork will guide you in terms of her need for supplemental potassium, if any. You want her potassium blood value to be in the upper half of the reference range.

Fish oil is good for a variety of reasons, but don't use fish LIVER oil (like cod liver oil). Use fish body oil (if it doesn't have liver in the name, then it's body oil).

Tanya's site recommends a more conservative starting dose for Pepcid of 2.5 mg (1/4 tablet) once every other day. The intermediate dose (if the starting dose doesn't seem to be helping) is 2.5 mg once a day. Maximum dose is 2.5 mg twice daily.

Laurie


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RE: CRF & Fluids

Okay, I have the blood test results.

T4 was 1.68, ref range 1.2 - 3.6

Urinalysis

Leukocytes moderate
Protein = trace
PH 5.0
Specific gravity 1.020
Everything else was negative or normal

Blood Test:

ALB 3.1 Ref range 2.3 - 3.9
ALKP 34 Ref range 14 - 111
ALT 62 Ref range 12 - 130
AMYL 1332 Ref range 500 - 1500
BUN 46 Ref range 16 - 36
Crea 3.5 Ref range 0.8 - 2.4
Glob 5.7 Ref range 2.8 - 5.1
TP 8.9 Ref range 5.7 - 8.9
Na 170 Ref range 150 - 165
CL 132 Ref range 112 - 129

There is one more page with stuff like WBC, LYM, RBC, HGB and more, plus graphs. No idea how to read that or how to write it down.


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RE: CRF & Fluids

Thank you. I assume you didn't post ALL of the results above. Do you have values for potassium (K+) and phosphorus? If so, please post them. That other page you mentioned should also have an HCT or PCV value. Could you please post that, as well? The WBC would be helpful, too.

Laurie


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bloodwork

Elevated Total Protein (TP), chloride (CL,) and sodium (NA) are all indicators of dehydration. Dehydration can cause creatinine to elevate above its true level. It's important that you address Peanut's dehydration so that you can not only make him feel better, but also so that you can get a more accurate picture of the condition of his kidneys.

Have you started administering subQ fluids at home yet?

Laurie


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RE: CRF & Fluids

Yes, I took him in for fluids and a class on how to administer them this afternoon and left with the whole setup. She said to do them again Thursday and see how he does. We might do it every 2 days, or half the amount once daily.

Phos was 5.2, range of 3.1 - 7.5, K was 4.5 , range of 3.5 - 5.8.


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RE: CRF & Fluids

Oh, almost forgot, WBC, 9.97, HCT 28.44. There is no PCV though.


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Fluids

OK, that's great that you're all set to start giving fluids. I'll try to find the pic I took of my setup to show you what works for me and why it works.

Phos is higher than you'd ideally want it to be, but it may come down once you get Peanut properly and consistently hydrated. K+ is right in target zone. Ideally, you want to keep the K+ between 4.0-5.5. Watch it in future bloodwork, because once he's receiving fluids regularly, he may lose potassium in all of that extra urine he'll be producing.

What about his HCT or PCV, and his WBC. Can you post those values, please?

Laurie


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reference ranges?

Do you have reference ranges for WBC and HCT? Based on other labs' reference ranges I've seen for those values, I assume Peanut's WBC is mid-range, but HCT is borderline anemic.

Laurie


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RE: CRF & Fluids

Yes, I posted the WBC and HCT right above your reply.
It sounds like a lot of his values might be out of whack because of him being dehydrated? Hopefully, things will improve now that he'll get fluids regularly. Someone I know thinks we are nuts for doing this, their opinion is with an old animal you just put them to sleep if you suspect they are uncomfortable.


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not nuts!

You posted Peanut's values for WBC and HCT, but not the reference ranges. Could you please also post the reference ranges for those values?

Yes, my assumption based on the values you posted is that a lot of them are related to his current state of dehydration. I would expect most of them to come down once he is consistently properly hydrated. Creat probably won't return to normal range, but I wouldn't be at all surprised if it moves from Stage 3 down to Stage 2.

Now, you know to completely ignore the person who thinks you're nuts, right?

Laurie


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RE: CRF & Fluids

Yes, the person has been told off and will be ignored.

Sorry, I misunderstood re. the WBC and HCT. From what I can decipher, HCT ref. range is 24 - 45, and WBC is 5.5 - 19.5.


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RE: CRF & Fluids

OK, Petra, I finally found the pic of my subQ setup at home.

I sit with my back facing the lefthand wall with my legs stretched forward across the fronts of the chairs. I position the cat between my legs and the backs of the chairs, allowing the cat some room to move forward and backwards across the chairs. Between the lefthand wall, the chair backs, and my legs, the cat's only easy escape route is forward off the righthand side of the chair closest to the window ... and I can easily prevent that escape with one hand held gently across the cat's chest, if necessary. If the cat tries to climb over my legs, a raised knee can discourage him/her.

This method of passive restraint helps to prevent the cat from feeling the need to fight active restraint and promotes a much more cooperative attitude and behavior. Administering fluids right by the window also helps keep the cat distracted.

The bag is attached with a double-ended clip to a hanger that hangs from the curtain rod.

If you have any questions about my setup, feel free to ask.

Laurie


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RE: CRF & Fluids

Hi laurie, thanks for the setup pics, that looks pretty ingenious. Hubby hung the bag on the dining room lamp which works okay for now. Curtain rod would be easier and higher, but we don't have any in the house. We are all having a hard time with the fluids, it will take some getting used to. The 20 gauge seems to be easier on him but it's still difficult, he cries when the needle goes in. Hopefully it will get better, but if it doesn't might have to take him to the vet a few times a week instead.


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RE: CRF & Fluids

Hi Petra,

Hang in there. It WILL get easier, I promise. It just takes practice for you to hone your technique AND for you to figure out how to keep Peanut happy and comfortable during admins. Every cat has his own little quirks. You just need to figure out Peanut's.

A few more tips ...

Peanut will be more compliant if you don't make a big deal out of it. Try to do the admins in a spot where he's comfy. Once you get more comfortable with your technique, you should be able to do it wherever Peanut is napping. Have your husband hold the bag up, while you slide in next to the napping Peanut and slip the needle in before he even realizes what's happening. Yes, it really can be that easy ... with practice and a very calm attitude.

Make sure you're using Terumo UTW 20 ga needles. They really are sharper and more comfortable going in than any other brand.

Rub, pet, and scratch Peanut before you slip in the needle. If he anticipates the needle stick, he may tighten his skin (some cats can turn their skin to concrete!), making it much more difficult and painful to insert the needle. But if you spend a minute rubbing and scratching the skin between his shoulder blades (and his cheeks and chin, since most cats LOVE those areas), he'll relax his skin so that you can insert the needle easily and pretty painlessly.

Once you get the needle in, lift the skin above it and rotate the needle gently to make sure its tip isn't embedded in tissue. You want to make sure it's in empty space between skin and muscle.

During admin, do whatever Peanut most enjoys. Some cats love brushing or petting. Some like to eat food or treats. Some like to be left entirely alone and just sit quietly until the admin's finished.

Stay calm. It helps if you visualize placing Peanut's parched body under a warm, gentle waterfall. The warm water soothes his dryness and relaxes every inch of him. Keep that visual in your mind during admins, because that's in essence what you're doing for him. You're soothing and rehydrating his dehydrated body. He'll figure that out as soon as you relax enough to allow him to relax, as well.

Don't give up, Petra. You can do this. I know it's nerve-wracking right now, but like any other new skill, it just takes practice.

Laurie


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RE: CRF & Fluids

Yes, we'll keep trying. Giving insulin to the diabetic guy is a picnic compared to the fluids. But I know it will get easier, and I will order the Terumo needles if they might be easier on him. These needles don't seem to bother Peanut at the vet's office, but at home they do. He is probably so distracted there that he does not feel the needle.


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RE: CRF & Fluids

Peanut's almost certainly responding to your own tension. After you get more comfortable with the procedure and the larger needles, and you're able to maintain a relaxed, matter-of-fact attitude, Peanut will respond to that calming effect, as well.

BTW, you can buy portable, adjustable IV stands on eBay or Amazon or through any store that sells medical supplies. That would allow you to admin fluids wherever Peanut happens to be, and you could easily adjust the height of the bag.

Laurie


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RE: CRF & Fluids

How's it going, Petra? Any better?

Laurie


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RE: CRF & Fluids

Hope things are going well, Petra. I hadn't had a chance to catch up with this thread.

Our set up was to just hang the bag from a towel rod in the bathroom with a clip (I think they are called lanyard clips- like what mountain climbers use, but they are used now by everybody), and then have a nice rug on the floor where we would sit. We had to keep our bag set up in a plastic shoe box after we got our young cat, because he thought it was really neat to chew through the tubing. Storing it in a non-hanging position led to problems for us with the port on the side, though earlier we had some problems with those side ports leaking even when left hanging. We ended up finding IV lines that did not have that other port, and it worked much better for us.

When I had to give fluids to CRF cat's brother, he liked to sit in the bottom half of his carrier while we did it. He was the type of cooperative Laurie describes, and that you see on websites. I hope you can get Peanut to that point too, but I will contend that my Muddy kitty preferred to be restrained in a bag, which I don't think is a bad thing at all. I think of what we did with Muddy as being more like swaddling a baby so they can feel secure, rather than binding a cat to control it. She was definitely much happier and more relaxed in the security of her bag. I hope the smiley in my first post didn't come across as sadistic, I smile at the thought of Muddy because she was 7 lbs of spit and vinegar, and that cussedness is what kept her going for 6 years, and I love her for every ounce of grief she gave me in addition to the joy.

One more thing. You mentioned Azodyl. Instead of azodyl, we opted to buy a human probiotic complex from a health food store, that contained the same strains as are in azodyl (found this info online). We were able to reduce our costs from $30/month to $14 every 4 months. They key, if you decide to do that, is to make sure you buy a reputable brand so you can feel comfortable that you are getting a quality product.

I hope you and Peanut are doing great.


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RE: CRF & Fluids

Laurie and Quasi, thanks for asking. Things are going much better!! Hubby decided to try inserting the needle, and he is much more capable than I am. So, he will be the designated needle nurse. We are both looking forward to the Terumo needles, hopefully they'll be easier to use than the vet needles.

The "hanging the bag on the lamp" is working quite well. Doing both sides only takes around 8 mins or less.

Quasi, too funny about your tube chewing cat. Peanut loves to pinch flower stems so the flowers topple over. He would probably sabotage his own tubes if they weren't out of reach. :o) What brand probiotics did you buy, if you don't mind my asking?

I can't possibly tell you guys how much I appreciate all the replies and suggestions and tips and photos and help and encouragement you've given, it made this so much easier. Thank you from me and hubby and, most of all, Peanut. Here he is on his 18th birthday party, not too happy about the hat. I had to put it on him really quickly, and it was off about 2 seconds after hubby took the pic. :o)


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RE: CRF & Fluids

I'm so glad things are going better with the fluids. One little heads-up regarding Terumo needles. Since they are sharper than other brands, and they don't have that painful barb on the tip that some other brands sometimes have, they tend to slip out easily during admin. So have hubby keep a hand on the needle or line to keep it in place so that it can't slip out during admin.

Laurie

P.S. If it'd make Peanut feel any better about his birthday humiliation, I could post pics of several of my cats wearing birthday hats on a similar occasion. They weren't any happier about it than Peanut was.


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RE: CRF & Fluids

I KNOW seeing those pics would make Peanut feel a lot better! :o)
Thanks for the Terumo tip, I will let him know. We had some slippage the first time, so he has been keeping his hand on the needle. I sure hope the Terumo will be easier to insert.


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RE: CRF & Fluids

Ok, Peanut, these are for you ...

BooBoo

Feather

Noddy

Somer

Weasel

Sweet Sweet

Roxie (having absolutely NOTHING to do with having a party hat placed on her perfect little head)

Clearly, several of them imbibed in waaaaay too much "nip" during the festivities.


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RE: CRF & Fluids

Haha, Peanut feels better! But he wants to know why he wasn't invited to that party, especially if their was lots of nip. :o)
Too funny one of your pretties is called BooBoo. That's our 120 pound lab's name.


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RE: CRF & Fluids

Oh, I'm so sorry, Peanut, but that party was years ago. I do keep nip in the cabinet, though, so feel free to stop by for a good roll any ole time.

120 lbs??? That's a LOT of BooBoo (not to mention a LOT of lab)!


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RE: CRF & Fluids

Yes, he is a huge guy. Years ago, someone in the neighborhood moved and abandoned him. He was a stray for a couple of months before he wandered up our driveway (we found all of that out from the neighbors behind us after they noticed we took him in). We ended up keeping him because all the animal rescues in the area were full and animal control would have killed him after 48 hours.


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RE: CRF & Fluids

A very smart and very lucky boy to have walked up your driveway. How do they always seem to know where to go?


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RE: CRF & Fluids

Well, it did take him a while to figure it out. Or rather, to notice the huge "sucker" sign on our door. :o)


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RE: CRF & Fluids

Yeah, I know all about that sign. What I want to know is who's teaching all of these animals to read???


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RE: CRF & Fluids

Things are going well as far as administering fluids, we've switched to 100 ml once daily rather than 200 every couple days. Peanut is doing much better, he is much perkier and happier and more interactive. Yesterday, I picked up another bag of ringers from the vet and realized they charge $30 for ONE BAG!! I asked if there was a price break for a case, and was told, no, its a set price. I did find a mail order place and called the vet clinic to ask if the mail order place could call them to verify the prescription, but was told the vet does not deal with prescription verifications by phone. So I will have to shop locally and pick up a prescription when I find a place.


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RE: CRF & Fluids

$30.00/bag of LRS is obscene. I pay about $2.00/bag when I buy them by the case from my local Target Pharmacy. Just call around and price them at all of your local pharmacies. The prices in my area vary WIDELY, so price shopping is essential. Also, you may find that no pharmacy carries LRS in stock, but they can all order it for you if you request it.

Laurie


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RE: CRF & Fluids

$30.00/bag of LRS is obscene. I pay about $2.00/bag when I buy them by the case from my local Target Pharmacy. Just call around and price them at all of your local pharmacies. The prices in my area vary WIDELY, so price shopping is essential. Also, you may find that no pharmacy carries LRS in stock, but they can all order it for you if you request it.

Laurie


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RE: CRF & Fluids

Yes, I am going to start calling around tomorrow. I am really disturbed at that price, I know vets mark stuff up, but WOW!!


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RE: CRF & Fluids

Yeah, I think that may be the highest price I've ever heard charged for a single bag of LRS. I've heard of other CRF caretakers being charged $20/bag by their vet ... maybe even $25/bag. But I can't remember anyone being charged $30/bag before. I think my local pharmacies have quoted me CASE prices ranging from $23-45. When you do your price checking, make sure you ask how many bags are in a case (some brands are 10; others are 12) AND make sure they're pricing 1000ml bags (LRS also comes in 500ml bags).

Remember that when you purchase fluids with a prescription, you are buying ONLY the fluids. You will still need to purchase the needles and IV sets separately. I provided you with a link to Thriving Pets earlier in this thread. That's where I buy my needles and IV sets. If you purchase from Thriving Pets, use the discount coupon code "Tanya" at checkout for a discount on your order. You also get free shipping if your order totals at least $55.

I'm so glad that Peanut is doing better and that fluid admins are going well. It's truly amazing the wonderful effects fluids have on a CRF cat. Many CRF cats are dehydrated for so long before they start receiving regular fluids that they get used to feeling sick all the time. Once they're properly hydrated again, these cats quickly make the connection between fluid admins and feeling better. That's why even the most combative feline patients often learn to enjoy fluid admins. They just like to feel good.

Laurie


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RE: CRF & Fluids

Many thanks, Laurie. I will use that code. Do you know if the IV sets fit both Hospira and Braun lactated ringer bags? I checked on the website, but it doesn't say, unless I overlooked it.
Yes, Peanut is perking up so much. He was eating okay before, but is eating even more now. He climbs on the table every evening around fluid time, I think you are right and he associates feeling better with the fluid treatment. The 100 every day seems to be helping more than 200 every couple of days. Probably because it keeps him consistently hydrated.
I know, I am still flabbergasted by $30 a bag, that would cost us almost $100 per month. I wonder why they charge so much? I read vet clinics have had large declines in income because of economic conditions, but it seems to me raising prices to that extent is short-sighted because it's going to discourage even more people from using them.


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RE: CRF & Fluids

Petra,

IV sets and fluid bags are all standard the way they fit together, though the exact designs can vary a bit. Any set should work just fine with any bag. I would recommend, however, that you buy sets with an injection port, in case you need to add something during admins, like vit. B12. Here's a link to the sets I buy:

http://www.thrivingpets.com/index.php/iv-admin-set-dehp-free-hospira-12672-28.html

Who knows why some vets mark up prices so astronomically high. I suppose they think distraught pet owners are easy prey for price gouging ... and they're probably right about that.

Hey, have you noticed how incredibly soft Peanut's coat has become now that he's properly hydrated? That's the first thing most folks notice after starting fluid admins.

Laurie


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RE: CRF & Fluids

Thanks, that's good to know! I was afraid of buying a set that doesn't fit the bags.
I hate to think that of the vet, but I guess it makes sense.
His coat doesn't feel any softer, but it looks shinier and the dandruff is gone! I've also noticed his eyes look different, they almost looked sunken before.


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RE: CRF & Fluids

Success!! Thanks so very much for the Walgreen's tip. The first 2 pharmacies quoted $60 per case of 12, and Walgreens did as well. I then asked about the drug discount program and they told me $23 a case if I enroll Peanut in that. I ordered 2 cases, so we are going to be set for a while.


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RE: CRF & Fluids

$23 from Walgreen's vs $360 from your vet. I'd say you were very successful! I need to check with my local Walgreen's. They might even be a little cheaper than Target, though my Target will price match the lowest price I can find in town.


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RE: CRF & Fluids

Should be the same price at your Walgreens, hopefully. I was very surprised it went from $60 down to $23 with the enrollment. Well worth the $20 enrollment fee. The next closest Target, CostCo, Sam's, etc. are about an hours drive from us, so we are stuck with either Walgreens, CVS, or independent Drugstores. And the independent ones I checked with did not give a discount, though $60 for 12 is still a lot better than $30 for one.


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RE: CRF & Fluids

Actually, the cheapest price for LRS in my area is at an independent drug store (isn't even a discount program). But since Target Pharmacy will price match, and since the pharmacist as Target has been willing to order any med I needed for my animals in the past, I like to give him my business.


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RE: CRF & Fluids

Glad to read through the updates and see that you and Peanut are doing better.

My vet charged $28/bag and I like them very much otherwise, but that always seemed like highway robbery to me. Fortunately they were great about outside RX any way I needed it- made me wonder if they charged so much because they didn't want to provide the actual RX? (Somehow I doubt it though).

I found a local independent pharmacist who would get us the Braun ringers by the case. He had to special order everything and was unfamiliar with needles and tube sets, but he was so helpful. Later he became the go-to guy for our vet for fluid supplies. He sells bags, needles, and tube sets individually. He sells the bags individually for like $4. I thought that was great that he got into doing that, and that our vet was very supportive of having a local pharmacist who would manage that end of things. I miss having more small businesses like that this day and age.

Sorry to get so long winded, and so glad that you found a supplier and can keep this affordable.


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RE: CRF & Fluids

Quasi, your pharmacist sounds great. Even $4 per bag is so much better than $30. In our case, $72 per year vs. almost $1100, that makes a huge difference when you have several aging pets with illnesses. I would have liked to stick with an independent pharmacy, but with Walgreens charging so much less, had to go with them.
Laurie, I tried to use TANYA, but did not get a discount. Still lots cheaper than the vet prices, even without a discount. Amazing how things evolve, I would have never thought sticking needles and IV's into the critters would become routine.


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RE: CRF & Fluids

I just went and checked on the "tanya" discount. I had forgotten that there was a minimum order of $55 before the 10% "tanya" discount would apply. Sorry about that. But if you want to get that discount, you could try calling them and increasing your order to meet the $55 minimum, then requesting the "tanya" discount.

Yep, "routine" takes on a whole new parameter when dealing with chronically ill animals.

Laurie


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RE: CRF & Fluids

It's okay, the shipping was around $10, so not too bad considering the low price for the needles and IV sets.


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RE: CRF & Fluids

You should be all set for a while. Glad to hear things are going well!!!! Just wanted to mention-oral B12 is just fine as long as you get the right formulation. I can't seem to find the paper I have on it, but I will keep looking if someone is interested.. It has to be the superior form of B12 which is Methylcobalamin. The recommended Vitacost one is linked on Tanya's site. BTW I usually find the best price of Pet Tinic on amazon. Luckily Kitty likes the taste-its a liquid with a syringe. I can even squirt it in his mouth as he walks by LOL! Oh-one more thing-don't give another thought to the 200 unit dose of fluids Peanut received. My old vet had me giving Trevor 300 a day for Years-I had no idea that is abnormal!! Just had to get rid of that vet for that and other reasons! Now with new vet he gets 100 per day.


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RE: CRF & Fluids

Hi Lisa, you're lucky your kitty is easy to squirt. :o) It takes 2 of us to syringe Peanut, and he acts as though terrible harm is being done to him.

Wow, 300 a day, and presumably this caused no problems for him? The 100 a day is working quite well, I can't believe how much Peanut has perked up.

Re. the Terumo needles, they don't seem to be different from the 20 gauge Vet needles as far as comfort is concerned. For the next order, we are going to try 22 gauge.


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RE: CRF & Fluids

Petra, I'm so please that Peanut is doing well with the fluids. The difference in the 20 ga needles isn't huge, but the comfort is there by virtue of the fact that Terumos are manufactured with better quality control that avoids the painful "barbs" that are sometimes present on the tips of other brands. I've never used 22's myself, but I would expect them to have a substantially slower flow rate than 20's. If Peanut is very patient while receiving fluids, that may not be an issue, but if he gets impatient toward the end of the admin, you'd be best to stick with the 20's.

Laurie


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RE: CRF & Fluids

Hi Laurie, I guess we'll have to stick with the 20's then. He gets almost violent toward the end of the fluid admin, takes 2 of us to keep him from shedding the needle and running off. Have tried warming the fluids, that hasn't changed his mind.


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RE: CRF & Fluids

Petra-make sure you insert the needle with the hole in it facing upwards-the fluid will flow faster. You could tr a few 18's to see if Peanut prefers at faster flow. My cat does. After doing this for 3 years, I started wondering if I could train Trevor to come for fluids instead of me fetching him or bringing the fluids to him and hanging them on a window blind?? I started giving him 2 treats after each session (up till then he very rarely ever strayed from the rx diet). By the third day he came to me as soon as he heard me applying a clean needle, getting his B12 capsule out of the bottle, and getting the Pet Tinic!! He comes to me every day when I am getting ready eager to get things going!! I don't even have to call him LOL.


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RE: CRF & Fluids

Lisa, thanks for the needle tip, I told hubby and he will make sure the needle faces upwards tonight. Also thanks for reminding me of the treats, Peanut is a treat hog and I know Laurie mentioned up thread trying to distract him with food or treats during admin. I will definitely try that as I am the designated distractor and he is hard to keep in line toward the end of the fluid session. :o)


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RE: CRF & Fluids

Just wanted to update, we lost our Peanut on Tuesday, at the age of 20 years and 2 months. He was doing really well on the fluids, but he came down with what appeared to be an eye infection in December. It improved a little with triple antibio cream and lysine, but never fully cleared up.

Over the last few weeks, he lost a lot of weight though he was eating very, very well. Last week, his eye swelled up tremendously and did not respond to any treatment.

The vet felt a tumor behind his eye and said nothing could be done at his age and in his condition. We miss him so much, I can't look at his favorite chair because I expect to see him in it. Hubby is the one who gave him fluids every night and he is having a really hard time too. He was doing so well on the fluids, if it had not been for the tumor we probably would have had him for quite a while longer.


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RE: CRF & Fluids

Oh, Petra, I am so very, very sorry for your loss of Peanut. Cancer is such a horribly unfair disease. It comes on without warning and takes our beloveds in such insidious ways.

I am glad, however, that you had almost two good years with Peanut after his CKD diagnosis. Once they develop chronic illness, every day together takes on another level of importance and devotion. Peanut was so fortunate to have spent his life with you, and vice versa.

I wish you a peaceful grief.

Laurie


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RE: CRF & Fluids

Thank you Laurie. It's going to be hard to get used to Peanut's absence. He was with us through moves and job changes and thick and thin. I wish he'd stayed with us another 20 years. Here's a pic of him from just last year, on the back deck, enjoying the sun. He was doing really well.


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RE: CRF & Fluids

Peanut looks so much like my Mew in that picture. What a handsome boy! They sure do leave a big hole when they depart. Must be because they take sure large chunks of our hearts with them.

Don't worry. Peanut will stick around as long as you need him to. You'll catch sight of him out of the corner of your eye from time to time. They're sneaky little buggers that way.

Laurie


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RE: CRF & Fluids

Yes, they sure do.I guess it's good we outlive them though, that way we can make sure they are well taken care of all their lives. And hope you are right about the sightings, I would love that.


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RE: CRF & Fluids

I'm so sorry to read about your loss, Petra. It sounds like Peanut had a very long and happy life thanks to your excellent care. RIP Peanut kitty, you were a handsome cat!


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RE: CRF & Fluids

Thank you spedi. He had such a huge personality that the house seems empty, even with our also much loved other furries around. After almost 20 years of Peanut, it will take a long time to get used to his absence.


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  • Posting is a two-step process. Once you have composed your message, you will be taken to the preview page. You will then have a chance to review your post, make changes and upload photos.
  • After posting your message, you may need to refresh the forum page in order to see it.
  • Before posting copyrighted material, please read about Copyright and Fair Use.
  • We have a strict no-advertising policy!
  • If you would like to practice posting or uploading photos, please visit our Test forum.
  • If you need assistance, please Contact Us and we will be happy to help.


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