Sub-Qs for Cory

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Sub-Qs for Cory

Post by MacCanda » Wed, 18 Feb 2004 08:56:16



Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
soon-to-be 18 year old Cory has to get sub-q fluids administered by me.  I know
you've all said it's no big deal after the first couple of times so I hope you
are right.  Tomorrow will be my first attempt.

Cory has been acting very tired and not eating much for about 3 days so I
called in sick today and took him to the vet.  Unfortunately, the "real" vet is
vacationing in the Bahamas and I got the relief vet.  All he did was give him
the fluids and do a UA and ***work, which is what I was planning on having
done anyway.  I won't get the ***work results until tomorrow but meanwhile,
this vet said Cory should be on 250ml per day...daily.  That seems really high
to me since we don't even know his BUN and creatinine yet.  I know it won't
hurt to do it for a couple of days and he seems perkier already since getting
300ml at the vet but I'm surprised at this dosage...going from no sub-qs to
that high of a volume.  I thought most cats got 100ml every other day or such.
I suppose it might just be a difference in the vet's philosophy and maybe when
the *** work results are back and the "real" vet reviews them, he will cut it
back.  I kind of hope so.  I hate to have to do it daily...for Cory's sake.  Is
there a standard for how high the BUN and creatinine should be before going
sub-q and what the dose would be?  It seems as though I read it once, at least
the point the values should be at before deciding to go that route.

I sure hope it works and that I will have my boy with me for a couple more
years...He's lost 2 pounds since September.  I'm thinking he might also need
his tapazole adjusted.  Who really knows what is causing his current problem;
hopefully the *** tests will give some answers.  I guess I better go reread
Helen's website.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://www.moonsgarden.com/

"One does not meet oneself until one catches the reflection from an eye other
than human."  (Loren Eisely)

 
 
 

Sub-Qs for Cory

Post by Cathy Friedman » Wed, 18 Feb 2004 09:19:09



Quote:
> Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
> soon-to-be 18 year old Cory has to get sub-q fluids administered by me.  I
know
> you've all said it's no big deal after the first couple of times so I hope
you
> are right.  Tomorrow will be my first attempt.

I had maybe 6 lessons first, at the vets' - by both the vet & sometimes a
tech, if she was really busy.  Each of the first 6 times or so debbie needed
fluids, I brought her to the vets' (only 4 min. form my house), & I'd get a
lesson.

My vet made me feel a whole lot better about the whole thing on my first try
(which actually took 2 tries, to get a correct stick; I completely missed
the first time!) by confessing that it took *her* 45 minutes just to get up
the nerve to get the needle into the cat on her first try, in vet school.
;-)  Hey, it only took me about 5 minutes of standing there, needle in hand,
before taking the plunge. <g>

I can't remember - have you ever read Peter Gethers' last book about Norton,
& how he was absolutely petrified of the whole deal, & refused to do the
fluids for the longest time, taking Norton to the vet all of the time
instead?  And then wound up sticking *himself* on an early try? <g>  But
even he eventually was able to do it.  ;-)

If your husband can help you (I'm pretty sure you're married, correct me if
not), it will make it a real piece of cake.  My earliest problem - when
getting the lessons at the vets', was handling all of the stuff - the
tubing,***-stop, bag, needle & its cover, the cat, etc. all w/ just my 2
hands.  Rather like a tangle of spaghetti, as my vet put it.  But after a
little while, even that was no prob - you hit a routine.

After a few weeks of giving the sub-Qs w/ no problems, all of a sudden, I
couldn't seem to get the needle in.  I went back to the vet (w/ Debbie in
tow), explaining that it sounded stupid, but it felt like I was hitting a
wall, instead of mere skin.  She said she's never exopereinced it herself,
but that lots of poeple who give fluids at home have come back to her saying
exactly the same thing.  So, she gave me another lesson, & that was that -
no more probs.

Quote:
> Cory has been acting very tired and not eating much for about 3 days so I
> called in sick today and took him to the vet.  Unfortunately, the "real"
vet is
> vacationing in the Bahamas and I got the relief vet.  All he did was give
him
> the fluids and do a UA and ***work, which is what I was planning on
having
> done anyway.  I won't get the ***work results until tomorrow but
meanwhile,
> this vet said Cory should be on 250ml per day...daily.

That's a helluva lot of fluids, IMO!  Esp. since he hasn't been on them,
until now.  I can maybe see 100 - 150mL/day, but even more likely - unless
he's very dehydrated, 100 - 150mL 2 times/week to maybe every other day.

Quote:
> That seems really high
> to me since we don't even know his BUN and creatinine yet.  I know it
won't
> hurt to do it for a couple of days and he seems perkier already since
getting
> 300ml at the vet but I'm surprised at this dosage...going from no sub-qs
to
> that high of a volume.

Same here.

Quote:
> I thought most cats got 100ml every other day or such.

Yep.  That was my experience, at any rate.  IIRC, it was 100mL 2x/week, then
gradually upped as time went by & her numbers became worse, till it was 150
mL each day - I think.  At the very end, 2X/day, but that was for a
relatively short time.

Quote:
> I suppose it might just be a difference in the vet's philosophy and maybe
when
> the *** work results are back and the "real" vet reviews them, he will
cut it
> back.  I kind of hope so.  I hate to have to do it daily...for Cory's
sake.  Is
> there a standard for how high the BUN and creatinine should be before
going
> sub-q and what the dose would be?  It seems as though I read it once, at
least
> the point the values should be at before deciding to go that route.

I honestly don't know - would have to look it up. I also have a feeling that
there may be different schools of thought on the best regimen.

Quote:
> I sure hope it works and that I will have my boy with me for a couple more
> years...He's lost 2 pounds since September.  I'm thinking he might also
need
> his tapazole adjusted.  Who really knows what is causing his current
problem;
> hopefully the *** tests will give some answers.

If his Tapazole needs adjusting, it should show up on the thyroid bw, & give
you direction.  Good luck, w/ the whole scenario.

Quote:
>  I guess I better go reread Helen's website.

Just what I was thinking! ;-)

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble")  Paul Simon

 
 
 

Sub-Qs for Cory

Post by Chery » Wed, 18 Feb 2004 09:29:12



16 Feb 2004:

Quote:
> Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
> soon-to-be 18 year old Cory has to get sub-q fluids administered by
> me.  I know you've all said it's no big deal after the first couple of
> times so I hope you are right.  Tomorrow will be my first attempt.

<snip>
Good luck Candace and many purrs that you both get used to doing this. And
many purrs for Cory to be healthy and helped by the fluids.

--
Cheryl

Trapped like rats. In a chia-pet.
MIB II

 
 
 

Sub-Qs for Cory

Post by MacCanda » Wed, 18 Feb 2004 09:46:21


<< Just what I was thinking! ;-)

Cathy >>

Thanks for the info, Cathy.  I was hoping you would write.  Yes, I do have a
husband and I'm sure he will help me...somewhat...but I would like to be able
to do it alone, if necessary, since he goes out of town once in awhile and I
would like him to be able to do it alone, too, since I'll be going out of town
in April for a week.  Years ago, I used to be a pharmacy tech in a hospital so
I don't mind handling the bag or the needles or the tubing; it's just the
sticking part I'm going to mind.  One time, about 20 years ago, I attempted to
give a poor stray kitty a vaccine, one of those OTC things, and the poor thing
shrieked.  I've never attempted to jab anyone since.

I remember you writing that you took the bag to the cat instead of vice versa.
What did you hang it on?  I've been looking around and there aren't many (or
any, really) places I can see to hang anything other than the shower rod and I
don't really want to do it in the bathroom.  I'd like to do it somewhere comfy
for him.  I wish I had an actual IV pole; I'm sure I could buy one if need be
but that seems drastic.

On Helen's website, it said sub-qs generally don't need to be started until the
creatinine hits 3.5-4.  Last time he had ***work, it was only about 2.8 but,
like I said, he's lost 2 pounds.  I'm pretty shocked about that because,
although he did feel lighter to me, I really couldn't see that.  It's odd,
though, because he was his old chatty, happy self until Saturday.  I guess I'll
just have to wait and see what is reavealed.

I just gave him 1/4 cyproheptadine to get him eating.  He seems perkier but
still not hungry.  That usually works so hope it does.

I sure didn't get the lessons you got, though.  The vet tech just briely showed
me, I didn't try it myself, and that was that.  They said they'd show me again
if I couldn't do it.

Thanks again for the info and the encouragment.  And, no, I never read the last
Norton book.  I read the first 2 but I just couldn't bring myself to read the
last even though you said it wasn't totally depressing.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://www.moonsgarden.com/

"One does not meet oneself until one catches the reflection from an eye other
than human."  (Loren Eisely)

 
 
 

Sub-Qs for Cory

Post by MacCanda » Wed, 18 Feb 2004 09:47:50


<< Good luck Candace and many purrs that you both get used to doing this. And
many purrs for Cory to be healthy and helped by the fluids.

--
Cheryl >>

Thank you very much, Cheryl.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://photos.yahoo.com/maccandace

"One does not meet oneself until one catches the reflection from an eye other
than human."  (Loren Eisely)

 
 
 

Sub-Qs for Cory

Post by Annie Wxil » Wed, 18 Feb 2004 11:22:51



Quote:
> Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
> soon-to-be 18 year old Cory has to get sub-q fluids administered by me.
...
> Candace

Best wishes for an uneventful sub-q administration and that Cory will be
doing fine and with you at least a couple of years more.
Annie
 
 
 

Sub-Qs for Cory

Post by Cathy Friedman » Wed, 18 Feb 2004 11:23:09



Quote:
> Thanks for the info, Cathy.  I was hoping you would write.  Yes, I do have
a
> husband and I'm sure he will help me...somewhat...but I would like to be
able
> to do it alone, if necessary, since he goes out of town once in awhile and
I
> would like him to be able to do it alone, too, since I'll be going out of
town
> in April for a week.

Yes, good idea then for each of you to be able to do it on your own.  Also,
I don't know if you hire a cat sitter for when you're both out of town, but
I discovered that my pet sitter does sub-Qs & whatever other meds are
necessary - that's also a helpful thing to have in the wings, if needed.

 Years ago, I used to be a pharmacy tech in a hospital so

Quote:
> I don't mind handling the bag or the needles or the tubing; it's just the
> sticking part I'm going to mind.

Well, then, keep my vet in mind, the first time she had to do it, hovering
w/ the needle for 45 minutes... <g>

 One time, about 20 years ago, I attempted to

Quote:
> give a poor stray kitty a vaccine, one of those OTC things, and the poor
thing
> shrieked.  I've never attempted to jab anyone since.

Ahhhh... but that was 20 years ago.  And may've been a pure fluke, right?

Quote:
> I remember you writing that you took the bag to the cat instead of vice

versa.

Yes, although this didn't dawn on me for a few months.  (Jeez!)

Quote:
> What did you hang it on?  I've been looking around and there aren't many
(or
> any, really) places I can see to hang anything other than the shower rod
and I
> don't really want to do it in the bathroom.  I'd like to do it somewhere
comfy
> for him.  I wish I had an actual IV pole; I'm sure I could buy one if need
be
> but that seems drastic.

At first I had the whole set-up in the bathroom.  Which was convenient for
me, but after a while I could sense Debbie tensing up whenever I picked her
up & carried her upstairs.  So... one night I decided to bring the goods to
her - where she was napping, & ta-da!  Much easier on her, & wasn't
difficult for me, either.  If she was on the sofa, I hung the bag from a
nearby curtain rod.  If she was in the kitchen, from the top of an open
cabinet door.  If she was out on the porch, I hung the bag from a large
staple sort of deal that used to be for*** rattan porch shades, or from
a cleat where the shades' cords were wrapped.

Quote:
> On Helen's website, it said sub-qs generally don't need to be started
until the
> creatinine hits 3.5-4.  Last time he had ***work, it was only about 2.8
but,
> like I said, he's lost 2 pounds.  I'm pretty shocked about that because,
> although he did feel lighter to me, I really couldn't see that.  It's odd,
> though, because he was his old chatty, happy self until Saturday.  I guess
I'll
> just have to wait and see what is reavealed.

I hope the bw will give you pointers, & that he feels better soon.

Quote:
> I just gave him 1/4 cyproheptadine to get him eating.  He seems perkier
but
> still not hungry.  That usually works so hope it does.

Debbie usually responded to the cyproheptadine w/in 20 minutes - half an
hour.  I can't remember the dosage, though - a quarter tab, a half tab??
Good luck w/ that.

Quote:
> I sure didn't get the lessons you got, though.  The vet tech just briely
showed
> me, I didn't try it myself, and that was that.  They said they'd show me
again
> if I couldn't do it.

Whoa - in that case, I'd feel pretty nervous, to tell you the truth.  I
think I got more lessons than most people get, but I felt I needed them, in
order to feel confident enough to do the job.  Otoh, after learning to do
sub-Qs, I found that giving Debbie Procrit injections later on, when she
became anemic, was *really* a piece of cake.

Quote:
> Thanks again for the info and the encouragment.

You're welcome; hope it helped, at least to a degree.

Quote:
> And, no, I never read the last
> Norton book.  I read the first 2 but I just couldn't bring myself to read
the
> last even though you said it wasn't totally depressing.

Right; it really wasn't.  Of course parts were sad, but overall, it was
written in the same light-hearted, fun vein that the previous two were, I
thought.  And IIRC, he stated that at the beginning - that he wasn't out to
depress people w/ the book. ;-)

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble")  Paul Simon

 
 
 

Sub-Qs for Cory

Post by MacCanda » Wed, 18 Feb 2004 11:42:02


<< Best wishes for an uneventful sub-q administration and that Cory will be
doing fine and with you at least a couple of years more.
Annie >>

I hope so, Annie.  Thank you.  

Candace
(take the litter out before replying by e-mail)

See my cats:
http://photos.yahoo.com/maccandace

"One does not meet oneself until one catches the reflection from an eye other
than human."  (Loren Eisely)

 
 
 

Sub-Qs for Cory

Post by Haile » Wed, 18 Feb 2004 20:06:34


Unfortunately this is not a reply or any advice because I've never been in
that boat yet. But I wish you good luck with your precious kitty!

What is Helen's website?
Thanks
Hailey

  I guess I better go reread Helen's website.

Quote:

> Just what I was thinking! ;-)

> Cathy

> --
> "Staccato signals of constant information..."
> ("The Boy in the Bubble")  Paul Simon

 
 
 

Sub-Qs for Cory

Post by Cathy Friedman » Thu, 19 Feb 2004 00:34:24



Quote:
> Unfortunately this is not a reply or any advice because I've never been in
> that boat yet. But I wish you good luck with your precious kitty!

> What is Helen's website?
> Thanks
> Hailey

http://www.felinecrf.org/index.htm

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble")  Paul Simon

 
 
 

Sub-Qs for Cory

Post by rinn » Thu, 19 Feb 2004 03:28:59


I wish you the best of luck. I don't have much knowledge about the BUN
levels and all, but this newsgroup has been WONDERFUL with all the advice
re:  subq's.  We are on our third week of giving Newman fluids.  We were
told to give him 150 ml twice a week. But in reading the replies and website
mentioned, we decided to give him 100 ml Mon-Weds-Friday (ok'd by vet). We
want everyone to get used to it, and don't want him to get too dehydrated in
between administrations.  I wonder if you can start with smaller amounts? It
took us 10+ minutes to get the first 150 ml in, because I wasn't sure of the
rate I should have it at, and my husband and I weren't talking enough to
each other and Newman to keep him calm and still.  But geez, after just two
weeks, Newman is a different cat. He had gone 3 days without eating, and now
eats his two full meals a day. Plus, his eyes look great and his fur is very
clean and fluffy. And he is even playing with his brothers!  It's terrible
to think how bad he must have been feeling before.
It does get easier giving them the fluids, so don't get too upset the first
couple of times.  This past time, I stuck the needle in too close to his
head and I swear I thought I punctured his brain!! But I just got another
needle and did it right.  Someone also suggested keeping the needles in the
freezer - I think they can only stay there a couple of days. I put mine in
after dinner so it is ready around 9pm for the adminstration.  And DON'T
reuse the needle, even if it is in the same session. I did this once and
could really tell it was duller.

We hang the bag from the top of the kitchen cabinet using one of those
door-hanger things. Then I bent up a hanger to use to hold the bag. I had to
work to get the contraption set up good so that the bag stayed level and we
could make sure we were doing it right.  I like administrating it on the
kitchen counter, where we are at waist level. I didn't want to do it where
he slept. He doesn't seem to association the counter with his medicine yet.

Also, I get the needles and Lactated Ringers from www.drsfostersmith.com.
My vet was charging $.85 per needle, the web site charges $.14/each for a
box of 100. Plus the lactated ringers were only $4.99 when I bought four of
them (my vet charges $13.99).  My vet has reasonable office and procedure
prices, but sky-high prescription prices for some reason!

I do think this website is the best www.felinecrf.org.  SO much information.

Again, thanks everyone for the information, and for pointing me to this
newsgroup.


Quote:
> Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
> soon-to-be 18 year old Cory has to get sub-q fluids administered by me.  I
know
> you've all said it's no big deal after the first couple of times so I hope
you
> are right.  Tomorrow will be my first attempt.

> Cory has been acting very tired and not eating much for about 3 days so I
> called in sick today and took him to the vet.  Unfortunately, the "real"
vet is
> vacationing in the Bahamas and I got the relief vet.  All he did was give
him
> the fluids and do a UA and ***work, which is what I was planning on
having
> done anyway.  I won't get the ***work results until tomorrow but
meanwhile,
> this vet said Cory should be on 250ml per day...daily.  That seems really
high
> to me since we don't even know his BUN and creatinine yet.  I know it
won't
> hurt to do it for a couple of days and he seems perkier already since
getting
> 300ml at the vet but I'm surprised at this dosage...going from no sub-qs
to
> that high of a volume.  I thought most cats got 100ml every other day or
such.
> I suppose it might just be a difference in the vet's philosophy and maybe
when
> the *** work results are back and the "real" vet reviews them, he will
cut it
> back.  I kind of hope so.  I hate to have to do it daily...for Cory's
sake.  Is
> there a standard for how high the BUN and creatinine should be before
going
> sub-q and what the dose would be?  It seems as though I read it once, at
least
> the point the values should be at before deciding to go that route.

> I sure hope it works and that I will have my boy with me for a couple more
> years...He's lost 2 pounds since September.  I'm thinking he might also
need
> his tapazole adjusted.  Who really knows what is causing his current
problem;
> hopefully the *** tests will give some answers.  I guess I better go
reread
> Helen's website.

> Candace
> (take the litter out before replying by e-mail)

> See my cats:
> http://www.moonsgarden.com/

> "One does not meet oneself until one catches the reflection from an eye
other
> than human."  (Loren Eisely)

 
 
 

Sub-Qs for Cory

Post by Cathy Friedman » Thu, 19 Feb 2004 04:04:05



(re: sub-Q fluids administration, w/ lots of snipping)

Quote:
> But geez, after just two
> weeks, Newman is a different cat. He had gone 3 days without eating, and
now
> eats his two full meals a day. Plus, his eyes look great and his fur is
very
> clean and fluffy. And he is even playing with his brothers!

That's great that's he's feeling so very much better! :-)

 It's terrible

Quote:
> to think how bad he must have been feeling before.
> It does get easier giving them the fluids, so don't get too upset the
first
> couple of times.  This past time, I stuck the needle in too close to his
> head and I swear I thought I punctured his brain!! But I just got another
> needle and did it right.

I was giving my cat her fluids out on the porch one summer night.  She was
lying on the floor, flush up against the screening, & I was thinking how
incredibly fast & easily the fluids were running that night...  when I
finally happened to notice that they were running out the screening on the
other side of her, watering whatever plants were down there!  I'd put the
needle in one side of her skin & right out the other - no *wonder* the
fluids were running so easily. ;-)

Quote:
> I do think this website is the best www.felinecrf.org.  SO much

information.

Yes, I completely agree.  Tons of info, well organized, & written for the
lay person.  IOW - *useful*.

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble")  Paul Simon

 
 
 

Sub-Qs for Cory

Post by Phil P » Thu, 19 Feb 2004 06:39:57



Quote:
> Well, after almost 2 years of being diagnosed with CRF and hyper-t, my
> soon-to-be 18 year old Cory has to get sub-q fluids administered by me.  I
know
> you've all said it's no big deal after the first couple of times so I hope
you
> are right.  Tomorrow will be my first attempt.

> Cory has been acting very tired and not eating much for about 3 days so I
> called in sick today and took him to the vet.  Unfortunately, the "real"
vet is
> vacationing in the Bahamas and I got the relief vet.  All he did was give
him
> the fluids and do a UA and ***work, which is what I was planning on
having
> done anyway.  I won't get the ***work results until tomorrow but
meanwhile,
> this vet said Cory should be on 250ml per day...daily.

That's the daily water maintenance requirement for an 8 lb. cat (60
ml/kg/day - 1 oz/lb/day) that isn't drinking or eating anything at all -
The cat's actual total daily fluid requirement is based on the replacement
needs to correct for dehydration + contemporary losses from
diarrhea/vomiting + maintenance - water obtained from the diet and free
drinking.

250 ml/day seems very high -  as if the vet is trying to use fluid therapy
like dialysis -- if this is done chronically, it could actually promote the
progression of CRF because it makes the kidneys work harder.

Here's a chart to help you calculate fluid requirements:

http://www.moonsgarden.com/

The most accutate method for calculating daily fluid needs is by weight
because the daily fluid needs aren't the same every day.  If I were you, I'd
by the best pediatric scale your finances can handle.  I have the Tanita
BLB-12 and 1583 Baby/Nusery Scale.  The BLB is graduated in .1 g but the
1583 is  more than sufficient and $400 cheaper:
http://www.moonsgarden.com/;or
http://www.moonsgarden.com/

That seems really high

Quote:
> to me since we don't even know his BUN and creatinine yet.  I know it
won't
> hurt to do it for a couple of days and he seems perkier already since
getting
> 300ml at the vet

Sure, intense fluid therapy will make a cat feel much better because it
promotes diuresis and lowers the concentration of uremic toxins in the
***.  Uremic toxins make the cat feel sick and queezy.  Intense fluid
therapy should be used only in a uremic crisis or during acute
decompensation.  Otherwise, daily (or chronic) fluid therapy should be used
*only* to prevent or correct dehydration.

but I'm surprised at this dosage...going from no sub-qs to

Quote:
> that high of a volume.  I thought most cats got 100ml every other day or

such.

Each cat has a different fluid requirement - but 100 ml/day or e.o.d. is
much closer to the average.

Quote:
> I suppose it might just be a difference in the vet's philosophy and maybe
when
> the *** work results are back and the "real" vet reviews them, he will
cut it
> back.  I kind of hope so.

I think he will, also - at least I hope he does!  If he doesn't, its time
for a second opinion.

I hate to have to do it daily...for Cory's sake.  Is

Quote:
> there a standard for how high the BUN and creatinine should be before
going
> sub-q and what the dose would be?  It seems as though I read it once, at
least
> the point the values should be at before deciding to go that route.

There's really no set number.  Other than a uremic crisis, chronic fluid
therapy should be initiated only in cats that are at risk of dehydration but
not before or as a simple form of dialysis.

Quote:

> I sure hope it works and that I will have my boy with me for a couple more
> years...He's lost 2 pounds since September.  I'm thinking he might also
need
> his tapazole adjusted.

His hyperthyroidism may have a lot to do with this.  If his thyroid function
changes - slows a bit - his BUN/Cr. will go up.  You may need to do a
juggling act and strike a delicate balance between an "acceptable" level of
hyperthyroidism and an "acceptable" level of azotemia.  Can be done -
That's the most important advantage of antithyroid *** over radioiodine -
CRF is a dynamic disease that's always changing - With antithyroid ***,
you can adjust thyroid function as CRF changes.

Keep the faith!

Phil.

 
 
 

Sub-Qs for Cory

Post by MacCanda » Thu, 19 Feb 2004 12:16:31


<< Sure, intense fluid therapy will make a cat feel much better because it
promotes diuresis and lowers the concentration of uremic toxins in the
***.  Uremic toxins make the cat feel sick and queezy.  Intense fluid
therapy should be used only in a uremic crisis or during acute
decompensation.  Otherwise, daily (or chronic) fluid therapy should be used
*only* to prevent or correct dehydration.

Each cat has a different fluid requirement - but 100 ml/day or e.o.d. is
much closer to the average. >>

Thank you, Phil, Laura, Cathy, everyone for your advice and well wishes.  This
is my update today.  

Fortunately, the "real" vet's partner, who was not there yesterday either
called me instead of the bonehead relief vet.  All of Cory's ***work is
normal or only slightly elevated.  His BUN is only 39 (down from 45 5 months
ago and his creatinine is 2.3 down from 2.8).  His USG was low, as to be
expected.  Everything else was normal altho his amylase was slightly elevated
but that can be attributed to his kidney disease, she said.

So...meanwhile, last night, Cory had 3 coughing episodes lasting about 3-5
minutes.  He never coughs.  I looked it up on Helen's site and coughing can be
a sign of overhydration.  I mentioned this to the vet's partner today and she
concurred that he was probably overhydrated.  She also reiterated that he has a
heart murmur (grade 1 out of 6) even tho the relief vet said he could not hear
it when I asked him and one especially does not want to overhydrate a cat with
a heart condition.  His coughing seems to have subsided now, 28 hours later, so
I'm sure that was the cause.  She said she also concurs that 250ml every day is
too high; she suggested 200 ml every other day but, in looking at these levels,
I'm thinking he may not need them at all or maybe 100 ml 3X a week at most.
Today he is eating pretty well and seems better but I'll have to see how he's
doing tomorrow.  If he seems to be not drinking enuf, I will go ahead and give
him 100ml or so but I don't want to tax his heart.

Additionally the bonehead relief vet did not order the ***work to test Cory's
hyroid.  How dumb is that?  Here we have a cat who has lost 1.5 pounds in 5
months, who is on tapazole, and the vet commented on that, and he still doesn't
order thyroid levels in the ***work?  The woman vet I talked to seemed to
find that rather shocking, too, although she didn't quite come out and lambast
him.  I'm sure, like regular doctors, they have that code where they protect
each other...esp. since this is the guy they hired for relief.  He looked to be
about 22, a big, strapping blond frat jock looking type that seemed full of
himself.  I'm pissed.  My poor cat could have had a heart attack or something.
The woman vet is going to call the lab and see if they still have some of
Cory's *** to test but I certainly assume this will be a free test for me.
The guy must be an idiot to not order a thyroid test on a hyper-t cat.

So, I realize what Phil said in that pure numbers don't determine the necessity
for fluids but, for instance, on Helen's site, she said fluids don't generally
need to be given until creatinine hits 3.5-4, which is a long way from where
Cory is.  Prior to a couple of days ago, he didn't appear dehydrated.  I just
hope he doesn't have yet another condition going on...it seems CRF, hyper-t,
heart murmur, is enough.  His urine is being cultured to see if he's developed
a resistance to the low level clavamox he takes to prevent chronic UTIs.

For today, he seems much improved, is eating, although he may still be feeling
the effects of 1/4 tab of cyproheptadine I gave him about 28 hours ago.  That
always makes him hungry...yet hyper.  He still doesn't seem his normal self,
however.

I will check out the chart you suggested, Phil, and thank you all.  Maybe my
kitty is still going to be with me for quite awhile.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://www.moonsgarden.com/

"One does not meet oneself until one catches the reflection from an eye other
than human."  (Loren Eisely)