Been over 24 hours and gabapenten isn’t wearing off

[FeebysOwner]

Chewy was the best price, or at least the equivalent, for all of Feeby's stuff, except the needles, which they did not stock any that I wanted. I also got them from shopmedvet, it was about $7 for 100 needles, but they also charged a $10 shipping fee - I was OK with that in order to get the needles I wanted. Some of the companies that offer needles do want a prescription for them - but as noted above shopmedvet did not. Another reason I wanted to use them. My vet did not stock thin walled needles, so the first few times Feeby got fluids it was with whatever they gave me. Also, ultra thin walled by Terumo, through shopmedvet, are no longer labeled with the 'ultra' but they claim they are the same needles.

If your vet will deal with Chewy, it makes the process simpler. The only thing I did, the first couple of orders, was follow up with the vet once Chewy was to contact them to get the prescription to make sure they followed up on their end. Once the ball was rolling, I didn't need to do that again.

I am sure you will have more questions, and I know the folks on this site - me included - will do all we can to help answer them.

 

[AbbysMom]

Just to add, my vet wouldn't deal with Chewy directly, they wrote out a prescription that I had to mail to Chewy before they would ship the fluids to me.

Same here. I get the fluid and lines from Chewy and these needles -

Terumo Needles Ultra Thin Wall 20 Gauge 1 inch Box of 100

Thriving Pets also does not require a prescription for the needles.

Abby uses Phosbind when she will eat it. She's been off it now for at least a few weeks.

Good luck. Let us know how you make out tonight.

 

[DeesCats]

I did forget to mention the fluid line set up, also called a Primary IV set was purchased from Chewy and also needed a prescription.

 

[Draco]

the vet was so patient with me. She spent time with me answering my questions and helping me out. Her assistants were awesome too. I’m grateful for that.

Cassie was so patient with me letting me practice on her since we agreed not to stress Monet out any more. Not a single complaint from her.

But Monet? He was good for the first minute of the fluids. He got annoyed, the needle fell put since I wasn’t holding it. He got most of the fluids. I also gave him a B-12 shot too. Now he won’t let me near him without hissing and growling at me. I hope he will understand I’m trying to help

the bloodwork isn’t good. Numbers are bad. The vet said if I did nothing he would be gone within 2 weeks it’s upsetting seeing how fast this progressed. I really hope the fluids helps. I have an appt for Saturday for a follow up and hope the numbers go down.

I think the more important numbers are as follows. I can give more if needed
Cystatatin is 158
Creatine 9.5
Phosphorus 10.5
Potassium 3.4
Specific gravity of urinalysis- 1.012
Thyroid is in range at 2.5

 

[FeebysOwner]

Did you ask the vet about the phosphorus binder? That is the only number you listed above, besides the creatinine, that is out of whack. The urine specific gravity is low, but that is very common in CKD cats.

Monet will likely be OK by tomorrow, if not sooner. The calmer you are before starting the process, the better he will respond. Set up all the 'gear' for the sub-Q fluids, including hanging the bag where you can easily see the line markers on it without having to stand up. Make sure the switch on the fluid line to turn on and off the fluids is in close proximity to your hands, so you don't have to move to switch it. Settle Monet, and yourself, in whatever place is best for the both of you. Take a deep breath to relax. Once everything is ready to go, insert the needle and gently hold it in place, using your other hand to switch on and off the fluids.

I doubt you will need to do another B-12 shot before you are back at the vets, but for the future, if you have a Y-port on the sub-Q fluid line, you can insert the B-12 there and avoid sticking Monet other than when you give him the fluids.

 

[Draco]

Did you ask the vet about the phosphorus binder? That is the only number you listed above, besides the creatinine, that is out of whack. The urine specific gravity is low, but that is very common in CKD cats.

Monet will likely be OK by tomorrow, if not sooner. The calmer you are before starting the process, the better he will respond. Set up all the 'gear' for the sub-Q fluids, including hanging the bag where you can easily see the line markers on it without having to stand up. Make sure the switch on the fluid line to turn on and off the fluids is in close proximity to your hands, so you don't have to move to switch it. Settle Monet, and yourself, in whatever place is best for the both of you. Take a deep breath to relax. Once everything is ready to go, insert the needle and gently hold it in place, using your other hand to switch on and off the fluids.

I doubt you will need to do another B-12 shot before you are back at the vets, but for the future, if you have a Y-port on the sub-Q fluid line, you can insert the B-12 there and avoid sticking Monet other than when you give him the fluids.

She did recommend Phos-bind which I have. She even went as far as to research how much to give him and called me back with the answer (one full scoop once a day)

B-12 is once a week, thankfully.

I have everything set up in my bathroom. As much as I'd like to have him on a couch or some place more comfortable, I know he'll run and escape. He'd be confined to the bathroom. I laid down towels for him and hooked the bag on a hanger above on my medicine cabinet knob. Everything laid out, attached and ready to go. He just got annoyed after a minute into it. And he hates me still, not letting me pet him. It hurts I hope he'll adjust and accepts it soon.

 

[epona]

She did recommend Phos-bind which I have. She even went as far as to research how much to give him and called me back with the answer (one full scoop once a day)

B-12 is once a week, thankfully.

I have everything set up in my bathroom. As much as I'd like to have him on a couch or some place more comfortable, I know he'll run and escape. He'd be confined to the bathroom. I laid down towels for him and hooked the bag on a hanger above on my medicine cabinet knob. Everything laid out, attached and ready to go. He just got annoyed after a minute into it. And he hates me still, not letting me pet him. It hurts I hope he'll adjust and accepts it soon.

How is he with food? I'm on a very similar journey with my elderly boy Jakey right now, stage 4 CKD (also reacted very badly to gabapentin btw, I started reading this thread thinking I would be giving advice about that aspect) - we've been doing SubQ fluids at home for a month now, and we get it done while he's got his face in his food bowl, he barely even notices being injected. He is very food-motivated though, which helps with a lot of aspects of his care.

I was terrified at first about giving him fluids, I had a needle phobia and was scared I'd do it wrong, or it wasn't going to go well - but it's going OK and we've all got used to it as part of our routine, it only takes a few minutes every other day.

Best wishes to you and your lovely cat.

 

[fluffpaws]

When I had to administer fluids to one of my diabetic cats,I had someone hold her ,while I gave her the fluids.It was much easier for me that way and once she realized the fluids made her feel better she seemed very willing to accept the treatment on a regular basis.Do you have anyone who could help you with Monet ?

 

[Draco]

How is he with food? I'm on a very similar journey with my elderly boy Jakey right now, stage 4 CKD (also reacted very badly to gabapentin btw, I started reading this thread thinking I would be giving advice about that aspect) - we've been doing SubQ fluids at home for a month now, and we get it done while he's got his face in his food bowl, he barely even notices being injected. He is very food-motivated though, which helps with a lot of aspects of his care.

I was terrified at first about giving him fluids, I had a needle phobia and was scared I'd do it wrong, or it wasn't going to go well - but it's going OK and we've all got used to it as part of our routine, it only takes a few minutes every other day.

Best wishes to you and your lovely cat.

Unfortunately Monet isn't motivated by food lately. I did give him treats while giving him the fluids but he didn't seem very interested in it. I need to work on getting his appetite back. I wish he was easily distracted by food!
I was scared too about messing up, but after practicing on Cassie it was pretty simple. But she's extremely easy going. Monet isn't, which makes it harder.

When I had to administer fluids to one of my diabetic cats,I had someone hold her ,while I gave her the fluids.It was much easier for me that way and once she realized the fluids made her feel better she seemed very willing to accept the treatment on a regular basis.Do you have anyone who could help you with Monet ?

I'm glad to hear that she accepted the treatments! I hope the same for Monet. And unfortunately, I have no one to help me. I have to do my best on my own. I'm sure I'll figure it out.

 

[iPappy]

I have a cat that gets fluids for CKD. She has an appointment next week to see how her numbers are.
The fluids really made me nervous at first, but the better I got at them, the better Sarah responded. She will actually lay in my lap now and let me do things that way, but every now and again halfway through the fluids she'll be like "OK bye" and try to bolt. Several times I've lost the needle and had fluids all over the floor! I just try to eyeball it and make sure she at least gets the majority of them.
When to give fluids when it comes to meal times was never really discussed. I think if you just do what works for your schedule, it will be fine.
Sarah was raw fed for most of her life and a year or so ago decided it wasn't for her, so she was given Fancy Feast. I was fine with it and she seemed to love it, and gained a bit of weight on it. I recently tried her on a few cans of Weruva Wx (a very low phosphorous food) and she LOVES IT! Her favorite is the hydrating pate style (it almost has the texture of pudding, or a thick-ish baby food.) They also have another chicken variety that is more like shreds, as well as a few fish varieties but she isn't a fan of fish. I picked up a few cans locally, and when I realized she was going to continue to eat it, I ordered quite a bit from Chewy.

The good news is, once Monet gets some fluids in him, he might start to feel better and be more food motivated. One of Sarah's first symptoms was not wanting to eat, which is very strange for her as she's always been a big eater (she's also hyperthyroid.) I noticed her teeth had some tartar, so the vet was called and that's how we figured out that the kidneys were causing the lack of appetite, not the teeth. After a few days of fluids, her appetite woke back up.

 

[Meowmee]

Unfortunately Monet isn't motivated by food lately. I did give him treats while giving him the fluids but he didn't seem very interested in it. I need to work on getting his appetite back. I wish he was easily distracted by food!
I was scared too about messing up, but after practicing on Cassie it was pretty simple. But she's extremely easy going. Monet isn't, which makes it harder.



I'm glad to hear that she accepted the treatments! I hope the same for Monet. And unfortunately, I have no one to help me. I have to do my best on my own. I'm sure I'll figure it out.

So sorry about Monet’s kidneys etc. It seems like you have all the information you need etc. And he is on the right meds etc. four of my cats have had CRF. Tess actually went into total kidney failure, and she was the first who had this. But she also had HCM and congestive heart failure and the Lasix had damaged her kidneys. She was hospitalized for about two or three days with IV fluids and various medicine and she survived it.

By some miracle, she was able to tolerate the fluids very well, which is very unusual for a cat that has congestive heart failure. Restarted the sub, Q fluids and they were given once per day. Her anemia was very severe though, and that was what causes all of her organs to fail in the end. She was on Epogen for that so if Monet is getting in that range you could ask about Epogen. I don’t remember if you said anything about that.

Byron had kidney disease, but it never actually progressed to actual kidney diseases. I recall he did have high blood pressure so he was put on high blood pressure meds and then also phosphorus so it could be that his kidney values were creeping up. I think at the end we might’ve been doing a little fluid for him, but I don’t have a good memory of that now. In the end so he died from negligence and I believe there was something else besides the kidney disease going on, but they never figured out what it was.

Wizard, and Sybil both had kidney disease as well, they were in their late teens when it happened and so was Byron.
Wizard was given fluid and he had anemia so he was given Epogen and B12 shots. He also developed lymphoma around the same time he was treated for that. Fortunately he tolerated the steroid very well, it did not make his kidneys worse… he was prednisilone. in the end, it was the cancer that caused him to go to the bridge.

Sybil had earlier CRF, which was diagnosed at a relatively low creatinine like Wizard’s was. She was put on a fairly aggressive fluid sub queue at home. Unfortunately, she also had advanced HCM which we didn’t know about at the time. And it caused her to go into congestive heart failure, which hastened her death. So from now on, I will be much more careful about the amount of fluid I give any of my cats because even if they don’t have HCM too much subcutaneous fluid can cause them to go into congestive heart failure. Sybil cardiologist eventually said she’s not allowed to get any fluid and not allowed to use her asthma inhalers because of her heart. However, her kidneys stayed relatively stable through all of this. Her kidney disease was not really advanced at this point when it was diagnosed or not what would consider to be advanced, although if you look at the ranges, anything over 1.6 for a cat is high- 1.6 is already considered to be early kidney disease.

Wizard had several times where he would go to the Dvm for week days to get intravenous fluid. He was being followed by an excellent Dvm, who was on top of everything, doing bloodwork all the time and he was very good at managing both the kidney disease and the cancer etc. mostly though he was given it at home by me subcutaneously he tolerated it very well and I even have a video of me giving him the fluid. I will try to post that later however I did not do a very good job of filming it because I was giving him the fluid and filming it at the same time, lol.

One thing you wanna make sure of is to get big a tent area under their skin and as you push the needle in you need to pull back their skin a little bit at the same time because it’ll be less likely to pop through another side- when that happens you’re going to see fluid coming out because the needle went through.

I’m sure Monet will adjust to all of this and he’s going to start realizing that it makes him feel better.

* I always ordered everything in bulk ones from Dr. Foster and Smith and sometimes from the pharmacy. With Wizard I found out it was a lot cheaper to order it from I think CVS or walgreens, but it might’ve been one of the other ones. I actually got him a health card and he received a discount in a case of fluid. I used to get the lines and needles at dvm, bu for later cats I got the lines with the fluid too. Needles were always from the dvm, the pink ones which were smaller gage.

Recently I discovered again that people meds are significantly cheaper at people pharmacies, than at dvm, who vastly overcharge, especially using good rx coupons. I saved thousands that way medicating my 3 boys for toxoplasmosis. Get rx from dvm and looks up coupons online. Pick the cheapest pharmacy.

* If he gets x dose per day, you can break it into two doses which will be easier on him maybe and also avoid fluid overload on the heart. We did that for Sybil, but she had to taken off all fluid due to chf.

 

[Draco]

iPappy Meowmee thank you both for sharing your experiences. It does give me a bit of hope that he will take to the treatments and eat more. I'm sorry you guys had to go through all of that as well. It isn't easy at all.

I saw Weruva food on Chewy and considered getting it. Maybe I'll see if I can find some locally to try so I won't have a whole case to waste if he doesn't want it. I have cans that he refused to eat that I have to donate sooner or later.

If people meds are cheaper, then yes, I am going to talk to my vet about that and see what she suggest and how to get it. Anything to save money is a plus, though, these treatments aren't TOO bad. it's $45 ish for 10 day supply at the vet (plus cerenia and B12 which added up to 100, those are a month supply) But eventually the costs will add up. He's dang lucky I finally got myself out of debt and can afford it lol

I'm going to the vet later to pick up smaller needles to see if he'd tolerate it better. Im also going to ask for liquid version of anti-nausea meds. he refuses to let me pill him. He hadn't had his thyroid meds in a number of days either since I just didn't want to fight him on it. I tried pill pockets and his favorite snacks but he'd eat around it and drop the pill. the stinker.

I'm just sad that he didn't come to bed either and I didn't get my morning snuggles. Its hard.

 

[neely]

I saw Weruva food on Chewy and considered getting it. Maybe I'll see if I can find some locally to try so I won't have a whole case to waste if he doesn't want it. I have cans that he refused to eat that I have to donate sooner or later. I'm just sad that he didn't come to bed either and I didn't get my morning snuggles. Its hard.

When Carleton struggled with eating we tried switching to Weruva and he loved it. Like you we bought it locally to try several different flavors. Most pet stores and pet chains sell it, we found it at Petco, Pet Supplies Plus and Petsmart. You can do a search on-line or even call the store before you go. Once we saw how much he liked it the Petco employees told us what day they get their delivery. He could only eat certain pates so knowing when they got their shipment really helped.

Yes, it is hard when they don't come to bed but hopefully the meds will help Monet perk up. Sending special thoughts.

 

[silent meowlook]

You can get the thyroid meds in transdermal form.

 

[Draco]

I ordered Weruva Phos-Focused food to try. Along with freeze-dried treats and raw toppers to hopefully entice him to eat something. Hopefully he'll like the food like the others here

I called the vet about the transdermal. it'd have to be sent to a compound pharmacy and she said it can be expensive. I'll try again to shove the meds in his mouth.

 

[silent meowlook]

Be sure to warm the fluids before giving. Try putting him in the carrier and taking the top off to give the fluids. Use 20 gage needles and hang the bag as I high up as you can so it goes quicker. I do my cats fluids on the floor and hang the bag at the top of the door frame.

Get the meds you need compounded into transdermal for the ones that can be. Wedgewood pharmacy is good and fairly reasonable.

Give Cerenia 2 hours prior to other medications. If he will eat it, divide the phosphate binder to give with all food.

Nausea is present with kidney disease, so always give Cerenia or ondansetron.

The vitamin B12 can be given in the port of the IV line so you don’t have to stick him twice. Set it up prior to giving the subcutaneous fluids.

Have several options available for him for litter and water. So he doesn’t have to travel far if napping.

With my cat, I didn’t bother stressing him with repeat vet visits and blood draws once he was at that stage because I already knew I was doing everything I needed to do and short of dialysis there weren’t other options for care. So maybe his numbers got worse but knowing that wasn’t going to help him. If that makes sense.

You can get a transdermal appetite stimulant if needed.

Don’t forget about pain. If he is painful he won’t do well. True that everything goes through the kidneys but it doesn’t matter because if in pain, he won’t do well. That said, never use any NSAIDS like Metacam. And if using a medication like buprenorphine use a micro dose. Like 1/4 or even 1/8 of the amount prescribed.

Watch for any signs of constipation. Although he has to eat in order to poop..

 

[silent meowlook]

I wouldn’t do raw as his immune system is very compromised with the kidney disease and that can leave him open to bacteria that is in raw. A healthy cat cat hopefully fight that off but not a sick cat.

 

[rubysmama]

He hadn't had his thyroid meds in a number of days either since I just didn't want to fight him on it. I tried pill pockets and his favorite snacks but he'd eat around it and drop the pill. the stinker.

I've been reading your thread, and hoping for the best for Monet.

About his thyroid meds, instead of hiding the pill in an entire pill pocket, try breaking off a small piece of pill pocket, just enough to wrap around the thyroid pill, and then maybe coating the piece of pill pocket with crushed Temptations or Fortiflora. That worked for Ruby.

If that doesn't work, and he likes Temptations, here's a video that explains how to actually hide a pill inside a Temptations treat. I tried that at first with Ruby, and it worked, but eventually was able to go with the easier method of just a piece of pill pocket wrapped around the pill.

 

[Draco]

Be sure to warm the fluids before giving. Try putting him in the carrier and taking the top off to give the fluids. Use 20 gage needles and hang the bag as I high up as you can so it goes quicker. I do my cats fluids on the floor and hang the bag at the top of the door frame.

Get the meds you need compounded into transdermal for the ones that can be. Wedgewood pharmacy is good and fairly reasonable.

Give Cerenia 2 hours prior to other medications. If he will eat it, divide the phosphate binder to give with all food.

Nausea is present with kidney disease, so always give Cerenia or ondansetron.

The vitamin B12 can be given in the port of the IV line so you don’t have to stick him twice. Set it up prior to giving the subcutaneous fluids.

Have several options available for him for litter and water. So he doesn’t have to travel far if napping.

With my cat, I didn’t bother stressing him with repeat vet visits and blood draws once he was at that stage because I already knew I was doing everything I needed to do and short of dialysis there weren’t other options for care. So maybe his numbers got worse but knowing that wasn’t going to help him. If that makes sense.

You can get a transdermal appetite stimulant if needed.

Don’t forget about pain. If he is painful he won’t do well. True that everything goes through the kidneys but it doesn’t matter because if in pain, he won’t do well. That said, never use any NSAIDS like Metacam. And if using a medication like buprenorphine use a micro dose. Like 1/4 or even 1/8 of the amount prescribed.

Watch for any signs of constipation. Although he has to eat in order to poop..

Thank you for the advice. Im going to warm the bag this time and see if it helps. Im going to pick up smaller needles from the vet later and see if he's more comfortable with that.

Bringing another litter box closer is a good idea, I'll do that. no idea where to put it but I'll figure it out. he has a bowl of water in every room of the house along with a fountain too.

I've been reading your thread, and hoping for the best for Monet.

About his thyroid meds, instead of hiding the pill in an entire pill pocket, try breaking off a small piece of pill pocket, just enough to wrap around the thyroid pill, and then maybe coating the piece of pill pocket with crushed Temptations or Fortiflora. That worked for Ruby.

If that doesn't work, and he likes Temptations, here's a video that explains how to actually hide a pill inside a Temptations treat. I tried that at first with Ruby, and it worked, but eventually was able to go with the easier method of just a piece of pill pocket wrapped around the pill.

I've tried smaller size pill pockets and other treats. He's just really uninterested in food right now. Abbysmom was generous to share some fortiflora and he turned away from that too. I'll have to keep trying.

All in all Im not feeling very optimistic right now. I will keep trying, keep doing everything I can. hope for the best and prepare for the worst.

 

[Meowmee]

iPappy Meowmee thank you both for sharing your experiences. It does give me a bit of hope that he will take to the treatments and eat more. I'm sorry you guys had to go through all of that as well. It isn't easy at all.

I saw Weruva food on Chewy and considered getting it. Maybe I'll see if I can find some locally to try so I won't have a whole case to waste if he doesn't want it. I have cans that he refused to eat that I have to donate sooner or later.

If people meds are cheaper, then yes, I am going to talk to my vet about that and see what she suggest and how to get it. Anything to save money is a plus, though, these treatments aren't TOO bad. it's $45 ish for 10 day supply at the vet (plus cerenia and B12 which added up to 100, those are a month supply) But eventually the costs will add up. He's dang lucky I finally got myself out of debt and can afford it lol

I'm going to the vet later to pick up smaller needles to see if he'd tolerate it better. Im also going to ask for liquid version of anti-nausea meds. he refuses to let me pill him. He hadn't had his thyroid meds in a number of days either since I just didn't want to fight him on it. I tried pill pockets and his favorite snacks but he'd eat around it and drop the pill. the stinker.

I'm just sad that he didn't come to bed either and I didn't get my morning snuggles. Its hard.

Sending you and Monet etc. big hugs It is certainly not easy dealing with these illnesses. The fluids etc. will definitely be cheaper than $45 per 10 days if you order a case from a pharmacy just research it….drugs like Zofran, etc. will be cheaper if your vet gives you RX and you get the good RX coupon and go to the pharmacy as long as it’s a people medicine just look it up on GoodRx, and you can see prices at various pharmacies, then pick the lowest price. Always try to get RX for the maximum amount with refills to make it easier on yourself.

I would buy a few different cans locally and just see what he likes. They told me with my kidney cats so just get them to eat whatever they wanted to. They didn’t recommend special diets or low protein necessarily. My cats usually had other illnesses going on at the same time, most of them I did give them the phosphorus binder. I don’t think I did it with Sybil or Wizard for some reason. I can’t remember why not now.