*URGENT* Passing blood...squeaking

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Amy0204
We miss our sweet Oreo

Post   » Fri Mar 07, 2008 8:27 pm


Check this out - I think (if I'm reading this correctly), the exact opposite is true. Lactated Ringers are much safer than Saline solution when dealing with renal failure:

http://www.anesthesia-analgesia.org/cgi/reprint/100/5/1518.pdf

Based on what I read, bladder obstructions, e.g., stones, can lead to hyperkalemia. It's possible that the diet, NSAIDs, etc. only exacerbate it.

It sounds as if you're going to need that blood test to really confirm your suspicions. I hope you can figure out something that will make him feel better.

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Sef
Supporter in 2019

Post   » Fri Mar 07, 2008 10:19 pm


Josephine said she doubts that Zachary is hyperkalemic; that the signs are unmistakeable, and death occurs quickly. So...back to Square One.

Amy, I was thinking you said Oreo had only been on saline. Did I dream that? Maybe I had it all backwards. I looked on lots of renal websites on my lunch hour today, but it seemed to me that the information was conflicting and confusing. One site said "don't give LRS to patients that have compromised kidneys." Another site said that either saline OR LRS is fine (that might have been a feline website). One site said that patients with kidney failure can't keep potassium in their systems, so they need a potassium supplement. Another site said that kidney disease/kidney failure can lead to dangerously high levels of potassium in the system. ???

Vet said to try the saline this weekend, and then back to LRS on Monday. However, she was very frank with me and said, "Really, it's not going to make that much difference at this point." She really feels his body is shutting down. :(

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Amy0204
We miss our sweet Oreo

Post   » Sat Mar 08, 2008 12:01 am


I thought Oreo was only on saline, but after all this discussion, I'm starting to wonder. Whatever she was on, it was always the same. We never varied it. I'll go back thru my information and try to figure it out. I'm sure it's on the itemized bills.

I wonder if he could have peaks in his potassium without it being the full extent of hyperkalemia? In other words, he might have some of the symptoms, but not full blown pathology.

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Sef
Supporter in 2019

Post   » Sat Mar 08, 2008 8:57 am


Amy, I'd be greatly interested to know.

Mkkayla and I think Becky had mentioned about the potential for electrolyte over-load with LRS. I also found this information on Drug.com:
Solutions which contain potassium should be used with great care, if at all, in patients with hyperkalemia, severe renal failure and in conditions in which potassium retention is present.

Solutions containing sodium ions should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency and in clinical states in which there exists edema with sodium retention.

In patients with diminished renal function, administration of solutions containing sodium or potassium ions may result in sodium or potassium retention.
But on websites that talk about supportive care for renal failure in cats, LRS is mentioned overwhelmingly.

I don't know if this was just a coincidence or not, since so much is going on with Zachary's body right now, but last night he had the worst stools so far. This was after switching to the plain saline.

My *gut* is just to stick it out with the Ringers.

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mkkayla
Supporter in '14

Post   » Sat Mar 08, 2008 9:58 am


Josephine also mentioned it in an email to me when I started Bonnie on LRS, however Bonnie does not (as far as I know) have any kidney issues, we are using LR only-30 cc every day now (was 50-60 cc the first two weeks) to keep her kidney's flushed due to the potential kidney damage with gentamycin.

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Sef
Supporter in 2019

Post   » Sat Mar 08, 2008 2:20 pm


Mkkayla -- Can I ask what Bonnie's weight is? I have been giving Zachary 50cc's a day (25cc's 2x), but last night gave him an additional 10cc's right before bedtime when he had extremely loose stools and looked dehydrated.

He actually produced a semi-normal looking poop today (first in over a week).

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Sef
Supporter in 2019

Post   » Sun Mar 09, 2008 6:14 pm


Here is an interesting article I found, comparing the effects of Normal Saline vs. Lactated Ringers on renal function.

Zach had a pretty bad day today. I fear we're going to be faced with a heartbreaking decision very soon.

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somechick

Post   » Sun Mar 09, 2008 8:35 pm


I'm so sorry you're going through this, sef. :(

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Bugs Mom

Post   » Sun Mar 09, 2008 8:44 pm


Hugs to you and Zach Sef.

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Sef
Supporter in 2019

Post   » Sun Mar 09, 2008 8:52 pm


I appreciate it. We were literally ready to pick up the phone and call Dr. M, but husband said, "Let's give him another dose of Metacam, put him back in his cage for a little while, and see how he does." Put him back in his cage after more Metacam, and he ate, drank, and even went up to his hay loft and nibbled some hay. I wonder if the Metacam just isn't cutting it?

Somechick -- were you the one that suggested Buprenex?

I just feel like we're walking a thin line between prolonging this, vs. there might be something else that will make him more comfortable.

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JaneDoe

Post   » Sun Mar 09, 2008 9:03 pm


For what it's worth, Pippin tolerates Buprinex better than Metacam.

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Amy0204
We miss our sweet Oreo

Post   » Sun Mar 09, 2008 10:15 pm


Consider the buprinex or torb. Yes, they make the pig a little spacey. But they are good for pain and may give Zach some more time with you.

I did check our statements for Oreo, and all they said were 150cc subcutaneous fluids. I'm assuming that the bags hold the same amount, regardless of what's in them. I'll try to call the vet and get specifics for you.

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Sef
Supporter in 2019

Post   » Sun Mar 09, 2008 10:19 pm


Thanks, Amy. I'll be interested to see which fluids you used.

Tracis
Let Sleeping Pigs Lie

Post   » Mon Mar 10, 2008 2:31 am


I hope Zachary is having a good and restful night, and sending good thoughts.

So sorry that he did not have a good day.

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somechick

Post   » Mon Mar 10, 2008 11:53 am


I did suggest Bupronex. Henry was not on it at the same time as Metacam and it did not affect her gut. But it did make her a total zombie.

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Amy0204
We miss our sweet Oreo

Post   » Mon Mar 10, 2008 7:34 pm


I asked our pharmacist at the hospital where I work, today, about saline vs. lactated ringers. She said that they are both equally effective for hydration. BUT, the saline is obviously full of salt and in the event of renal problems in humans, saline would be contraindicated. She added that she couldn't speak for guinea pigs, but based on what I had said, would think the lactated ringer might be a safer fluid.

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Sef
Supporter in 2019

Post   » Mon Mar 10, 2008 8:18 pm


Thanks for checking on that, Amy.

I emailed Dr. W at K-State today, who has been kind enough to give me some long-distance feedback on Zachary's illness. Her suggestion was to try upping his fluids substantially -- from a total of 50cc's a day, to 80cc's. Either 20ml twice a day, or roughly 26c's three times daily.

I gave him his usual 25cc's this morning, and 35cc's when I got home from work. His eyes actually look a lot brighter this evening. Going to do 15-20cc's more before bedtime. She stated that, unless a pig has underlying heart issues (which he doesn't, that we know of), it is relatively safe to push that much fluid. Hoping this helps. I really do think he has been dehydrated, not just from the kidney issues, but from the very loose stools.

As I type this he is trotting around, demanding tomatoes. :)

I also upped his Metacam, but am not sure if this is a good idea or not. He was getting .1cc once daily; for the past couple of days, though, I have been giving him approx. .08cc's 2-3 times a day. It's definitely on the high-end, but he apparently tolerates Metacam well (and loves the taste), and I worry that any of the opioids will slow down his highly sensitive gut too much.

Fingers crossed that the increased fluids will make a positive difference.

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Becky

Post   » Mon Mar 10, 2008 8:26 pm


I have not had good experiences with Buprenex. Wait for someone like Josehine to chime in, but I'd up the Metacam before giving the Buprenex. It's exteremly powerful and had always made my pigs totally out of it, at the least.

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rshevin

Post   » Mon Mar 10, 2008 8:32 pm


Piggy was given 0.5cc of the metacam just lately. I titrated him up to that though, even though the vet didn't specify as it was such a HUGE jump from the previous 0.08cc, but it's worked.

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Sef
Supporter in 2019

Post   » Mon Mar 10, 2008 10:17 pm


I'm just majorly pissed at myself for not realizing that the soft stools were making him more dehydrated than he usually is. Why in the hell didn't I think of it??? We almost called the vet on Sunday when he seemed so miserable...dry, sunken eyes; lethargic; not eating. We thought that was it. Tonight he's a different pig.

Between the increased fluids and the upped Metacam, he felt spunky enough this evening to grrrrr at me when I pulled him away from his veggies long enough to wipe off his feet. Attitude! Yay!

I know he could have a bad day tomorrow, but for now -- it seems to have made him a lot more comfortable tonight.

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