subQ thoughts

[skylerlark]

I'd had my cat on subQ 100 mils per day. The vet had recommended 200 every other day but cat badly affected by this overload. I was then sent for a phosphorous test, which at that time came pretty close to normal. That vet had told me to double his subQ intake to twice per day before I could get him on IV as they didn't do 24 hr care.

If I remember correctly, that's when his problems began. He eventually flopped out and I'd rushed him to 24 hr vet where he was admitted for IV for 8 days. His BUN reduced from 154 to 111 but his creatinine increased by 3 points. An ultrasound showed he's just 70% kidney function left, which I already knew.

I've now been told (by IV vet and my local clinic) to administer 120 TWICE per day. I feel I'm going around in circles. What's the worst that could happen if I didn't administer any more today? He's eating wet renal food, if that stopped then of course I'd know. But afraid of dehydration/konking out overnight.

Any advice greatly appreciated.

 

[sivyaleah]

Maybe someone at Tanya's CKD group could help with this? If you don't already know the website, it's the most comprehensive place to get advice for this disease. There is a private group affiliated with it which is very active.

My boy is gone for years now but I never removed myself since who knows if I'll need to be there again (seems likely since it's pretty prevalent in older cats). I only remember we had to be careful with the amount of SubQ he could receive as he also had a slight heart murmur - we landed on only 2x a week and he did well on that schedule.

Website
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

Link to group join:
support groups.io Group

 

[FeebysOwner]

If you are not familiar with the above noted web site - this is the section on sub-Q fluids -
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Subcutaneous Fluids (felinecrf.org)

 

[silent meowlook]

Hi. The best thing to do is check his hydration. If he is dehydrated give him some if he is not then maybe wait and consult your vet when they are open and explain this to them.

Before giving any SQ fluids make sure the prior fluids are absorbed. You know where you gave them last, feel that area for any that haven’t been absorbed. If not absorbed, don’t give more.

If you’re concerned about.fluid volume overload. you can give 1/2 as much. 60 mls.

I sometimes skip my cats fluids. Sometimes she hides or runs away, other times I am to tired. I haven’t had a problem doing that yet, but your cat’s numbers are very high. So you really shouldn’t skip unless giving them will do more harm than good. Hope this makes sense.

 

[skylerlark]

Hi. The best thing to do is check his hydration. If he is dehydrated give him some if he is not then maybe wait and consult your vet when they are open and explain this to them.

Before giving any SQ fluids make sure the prior fluids are absorbed. You know where you gave them last, feel that area for any that haven’t been absorbed. If not absorbed, don’t give more.

If you’re concerned about.fluid volume overload. you can give 1/2 as much. 60 mls.

I sometimes skip my cats fluids. Sometimes she hides or runs away, other times I am to tired. I haven’t had a problem doing that yet, but your cat’s numbers are very high. So you really shouldn’t skip unless giving them will do more harm than good. Hope this makes sense.

 

[skylerlark]

I've just given him your suggested 60 mils. He was very hyper this morning, restless pacing about, which he did when receiving 200 per infusion all at once. It can't do any harm, it's the vets here don't use logic. It's a nightmare. I had one vet put one of my dogs on IV and then declare an ultrasound had shown no kidney left at all!

Thank you again for this. I'll see how he is in the morning.

 

[skylerlark]

If you are not familiar with the above noted web site - this is the section on sub-Q fluids -
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Subcutaneous Fluids (felinecrf.org)

Thanks. I read that entire section and came away even more confused. Hardly any of it pertains to my particular cat. I have no idea why two vets have recommended (ordered) such high doses. But I've taken Silentmeow's advice and given him half the dosage (60 mils) this evening and must just wait to see if he's improving. He was extra hyperactive this morning, as when I'd been told to give him 200 mils all at once. So we shall see.

 

[FeebysOwner]

I read that entire section and came away even more confused.

I am sorry it made things more confusing for you. If you summarize all that was addressed, the consensus would be that 200ml is likely too much. It would be impossible for the information to cover every cat's individual situation, but it does at least discuss things to consider and give guidelines as to what some of the experts consider appropriate about sub-Q administration.

 

[skylerlark]

I am sorry it made things more confusing for you. If you summarize all that was addressed, the consensus would be that 200ml is likely too much. It would be impossible for the information to cover every cat's individual situation, but it does at least discuss things to consider and give guidelines as to what some of the experts consider appropriate about sub-Q administration.

Thankyou. It did rather go into a lot about the stages of renal disease in ALL cats caused the confusion. A simple chart (as this vet's clinic has) would make things much easier. My cat is Stage 4 and 4.6 kgs, how much should he be receiving?

In any case, I've halved the ridiculously high 240/257 (highest I saw on Tanya's was 150 total per day) to 60 mils two times per day. He's not hyper and is eating. So must be doing something right. He's also on Semintra every evening. He sleeps most of the time and is very affectionate so can't ask for more than that.

As an aside, I'd asked a neighbour what she'd thought of the situation regarding vets here and she said 'I mostly don't listen to them, I just use their medical equipment' Smart woman.

 

[Twylasmom]

I’m hopeless with conversions to kgs, but a basic way of figuring out how much to give is 10 ml per pound per day. Of course that varies depending on stage of disease. The amount your vet prescribed seems really excessive.

 

[silent meowlook]

What you can also do, since your cat is stage 4 is if the amount you’re giving goes well start adding 20 mls onto it. So, 80 and 80. Of course I have to say discuss this with your vet. But only you know the best option there.

 

[FeebysOwner]

My cat is Stage 4 and 4.6 kgs, how much should he be receiving?

I am not sure there can be a simple chart that states: 'if your cat weighs xx kg and is in Stage 4, then you should give xx ml of sub-Q fluids. Stage 4, which just off of creatinine alone, means your cat's creatinine is consistently over 5.0 mg/dl (440 µmol/L) is most likely going to require more than a cat in a lesser stage just by very virtue of the lack of kidney function to enable them to better clear out toxins through urination. But, as you know, the adage is: 'treat the cat, not the numbers'.

FWIW, my cat, Stage 3 with a creatinine of 3.5 (~300 µmol/L), weighs almost 13 pounds (5.9 kg) and gets 100 ml of sub-Q fluids a day. However, according to Tanya's web site, she might not really need sub-Q fluids. She was started on them because her creatinine jumped to 5.1 and after 2 weeks it came down to 3.7. After 2 months on sub-Q fluids, she reached 3.5 which is where she was in January, before the jump. So, I think she has benefitted from them - to a degree - but am considering lowering them a bit at this point. My problem is that her CKD is only one of the health issues she has, and so looking for signs to know if she would benefit from a lesser amount will be difficult at best.

I would suggest, as was previously mentioned, that you 'play around' with the amount - especially if you are able to detect signs in your cat that would enable you to see what amount on which he does better or worse.

You could consider asking opinions from the CKD io forum (support groups.io Group), which you can join for free. They will want you to provide them with blood work results, what meds/supplements your cat is on, and any information you feel appropriate to add to that data. They seem to think Feeby is OK with 100ml sub-Q fluids. I do feel they are a bit 'overly enthusiastic' about the care of these cats - but they also have/have had many cats do well for years on their beliefs. They often use Tanya's web site as a reference but they also share their own personal experiences.

 

[skylerlark]

What you can also do, since your cat is stage 4 is if the amount you’re giving goes well start adding 20 mls onto it. So, 80 and 80. Of course I have to say discuss this with your vet. But only you know the best option there.

He was much better on the 60 mils, but this morning only ate a little kibble and wouldn't touch the renal food so I syringed some Chu Chu Cat Booster Smoothie into him. I'll try upping the subQ to 70 this afternoon (although think I overdid it yesterday afternoon as he was a tad hyper afterward, and am nonplussed as to why he crashed when giving him 100 two times per day (vet had said 200 every other day and he went berserk).

Pointless consulting any vet here, none of them appear to know either what they're doing AND give different answers. This country is notorious for it's lack of critical thinking. Thailand aka LaLaLand.

 

[skylerlark]

He's slept almost all day, it's now 3 pm here, but there's been a hurricane so not surprising, although he now wants to go outside.

I'd hand fed him some of his Senior Cat kibble (piece by piece, won't eat it otherwise, so he will eat then ), so, so far today he's had 10 mils of Chu Chu booster syringed into him together with another 15 mils of renal food slightly watered down with warm water. I'll try with some more after this afternoon's subQ.

Second thoughts on upping yesterday's dose which only made him hyper but not eat. And your saying 10 mils per pound at his 10.141 lbs would make around 60 mils about right. I doubt anything higher will be beneficial, given last evening's hyper activity but not eating by himself.

Btw, he's also on Semintra for his hypertension and Proteinura, if that makes a difference. I did post on the support group you linked but heard nothing so far apart from a spreadsheet. Ugh.

 

[heatherwillard0614]

Ok I'm going to be straight with you I know absolutely nothing about cats and sub q fluids.
This being said I dont understand how he would become hyper as a side effect of too much sub q fluids. Can you explain this please because I am thinking he is starting to feel better maybe and that's why he is getting hyper?? And what do you mean by hyper exactly? Running around wanting to play?

 

[skylerlark]

Ok I'm going to be straight with you I know absolutely nothing about cats and sub q fluids.
This being said I dont understand how he would become hyper as a side effect of too much sub q fluids. Can you explain this please because I am thinking he is starting to feel better maybe and that's why he is getting hyper?? And what do you mean by hyper exactly? Running around wanting to play?

Extremely restless. No, not wanting to play. Running up and down and around the house. I know about as much as you do about subQ fluid composition except it contains minerals. Perhaps this video will help explain. Although this cat has his own personal physician and I have a bunch of boneheads each giving me different advice which is why I'm on this site.