random bits

[cellio]

I wonder how subcutaneous fluids are processed. If my cat isn't eating/drinking enough I can give him fluids, which don't enter through the mouth, but they exit the normal way -- which means somewhere inside the cat they enter the GI tract. My vet probably already thinks I'm weird, so I may as well ask her. :-) (What actually prompted this is the observation that, it appears, a dose of fluids can stimulate his appetite, almost as if the fluids were clearing out some blockage or something -- but how could they? And anyway, there shouldn't be any blockages; he had a blocked bile duct a few months ago and they both cleared it out and installed a much-larger bypass.)

We have an invitation for seder for the first night, from a fellow congregant. This is good; Dani knows the family, so he won't be among strangers, and they like to sing, and they're the sort of people who don't race through the haggadah to get to the meal. So everyone's happy -- yay! Second night is odd: as a Reform Jew I don't see the need for two-day yomim tovim, and Dani is secular, but he's used to two nights from his family (necessity of parental divorce) and I don't mind, so I may yet try to find us something. (I said "well, there's always Chabad" and he said "let me know how that goes for you", so I guess not that since the point would be to do something for him.) He's still opposed to just holding one ourselves.

My rabbi will be leading a trip to Israel at the end of this year. I'm thinking seriously of going. I'd like to see some of the place, and I'd love to do it with my rabbi -- so there'll be, y'know, some religious content, as opposed to just being a tourist. I'll have enough vacation time to do it, since most of the fall holidays have the decency to land on weekends this year, and a bonus I'll be getting at work removes any doubt about being able to afford it. It sounds like this will be a family-friendly but not family-obsessed trip; i.e., I won't feel like e fifth wheel. So I don't see a down-side here, and I think it would be an exciting experience.

Short takes:

This comic reminded me of some cats I've known...

Hold my beer, a look at washroom multitasking (not safe for work), from brokengoose.

Comments

[jhayman.livejournal.com]

A dehydrated cat is one thing, a cat with a little renal failure is another, and that's the usual reason for giving fluids.

The s.c. fluid is absorbed slowly and in the interstitial, then intravascular spaces, expanding blood volume among other things. The dilute plasma is easier for the failure kidney to process. The cat excretes the metabolites that have been building up and causing, among other things, loss of appetite an thirst. Hey, presto! The cat eats.

Failing kidneys mean toxins increase in the blood and the cat loses its appetitite (and urge to drink). Giving fluid means the cat can pee out the toxins and gets its appetite bad.

This may miss a few bits along the way, but that's essentially it. FWIW, the cat will also tend to be drowsy with renal failure -- until you give it fluids.

[spiritdancer]

What she said :-)

It also works well for dehydrated cats (or sick cats in general), as they tend to lose their appetite when they don't drink (probably as a result of metabolites/wastes that the kidneys normally excrete building up in the body. Cat's kidneys are remarkably efficient, but they still need water to work!

As an aside, the other thing I tend to give sick cats that aren't eating is a B Viitamin injection, as they require B vitamins in their diet, and they are water soluble so the amount in the body goes down pretty quickly if they are not being taken in. And the first sign of this deficiency? Lack of appetite :-/

[cellio]

Thanks. (There's more about Erik's history in a reply below.)

B vitamins: yes, my vet gave him a shot of that when he was there two weeks ago and it seemed to make a big difference pretty quickly. I wonder if that's something I can do on my own, or if I can just lace his food with B vitamins on an ongoing basis (before he loses interest, thus taking out the conventional delivery system) to keep it from getting that bad.

Hmm. Maybe they should put B vitamin in the fluid bag?

[spiritdancer]

Unless it's for use in the very short term, we don't put the B Vitamins in the fluid bags, as they are light-sensitive (IIRC, they break down with UV exposure or some such).

Some of the cat nutritional supplements have extra b vitamins added (Nutrical and the like). I did have one cat that the specialist who saw had the owner giving B vitamins at home as part of it's treatment, but that was a while back.

[cellio]

Ideally (I suppose), the bags/delivery systems would provide an interface for mix-ins -- a place between the bag and the end of the tube where you could inject drugs or vitamins in liquid form, for instance.

Remember that I'm an engineering-type, not a medical-type. :-)

[cellio]

Thanks.

Erik has a diagnosis of cholangial hepatitis. The first sign of trouble was an X-ray some years back that showed a little calcium in his kidneys, but he doesn't have kidney problems as best I understand it. (His calcium levels have been high on every blood test since then.) In late November he got very sick and had to have surgery for what turned out to be a blocked bile duct (they thought they might have to take out the gallbladder, but didn't); while they were in there they did biopsies and both confirmed the hepatitis diagnosis (it'd been speculative before) and reported pancreatitis. He got lots of antibiotics after that, and since the hepatitis is an ongoing problem my vet has suggested just "pulsing" antibiotics every several weeks. (He also takes ursodiol.) I'm a little unclear on the status of the pancreatitis -- was that acute or is it chronic? Must ask vet.

The s.c. fluids entered the picture in mid-February when he again stopped eating. (That had been the initial problem in November.) They sent me home with a bag and told me to hit him every two days; his appetite picked up after that and they eventually had me down to once a week, then "as needed". Giving him fluids does seem to jump-start his appetite (based on limited observations). Could I be looking at the beginning of kidney problems too and that's why it works that way? (My vet once said that indicators of kidney problems don't show up in blood tests until there's something like 75% failure.)

Fun with Kidneys

[brokengoose.livejournal.com]

I recently took my dog to an internist because of a heart murmur. He looked at the records and said that there was a decent chance that the kidney problems could be causing the heart problems. He dropped into medical jargon too quickly for me to follow, but I gather that kidney problems are 1) unlikely to show direct symptoms 2) hard to conclusively prove through normal tests and 3) tend to stress the rest of the system, turning minor problems (the heart murmur in my case) into major ones.

On the other hand, I'd assume that problems with almost any internal organ would stress the rest of them to some degree.

In my dog's case, it looks like the kidneys probably weren't the problem, but they do seem to be a bogey-man of sorts for veterinarians. If I followed what I was told, I can understand why: given something that causes odd problems but can't be easily tested, it'd be tempting to either ignore it or blame it for everything.