From:
Celia Clinkinbeard
Date: 2002-01-17 22:54:00 UTC
Subject: [Ferret-Health-list] How to decrease
sodium
Let me clarify lest you think my vet has some very strange
ideas--the lupron was for recurring adrenal, not a part of her
treatment for this crisis--he went ahead and gave it to her in
the hopes that treating the adrenal would help in general,
too.
And I did just get her to eat 30 cc of duck soup. Took some
coaxing, but once she started she was okay.
Celia
----- Original Message -----
From: Celia Clinkinbeard
To: Ferret-Health-list@yahoogroups.com
Sent: Thursday, January 17, 2002 10:26 PM
potassium/raise sodium
I need some ideas on how to increase Cokie's
Sodium/Potassium ratio! (She is 8 yo, bilateral adrenal, on
florinef and pred for years, previously well controlled
insulinoma, chronic kidney failure, hypertrophic
cardiomyopathy) She has been very sick for over 2 weeks.
She was brought to the vet very listless and unable to walk,
and with a tooth infection. The tooth infection was treated
and resolved, but her sodium/potassium ratio was 19, and her
glucose was 49. We increased her florinef from 0.47 cc/day
to 0.48 cc/day (from 0.0141 mg/day to 0.0144 mg/day), and
increased her pediapred from 0.55 cc twice a day to 0.6 cc
twice a day (from 0.74 mg twice a day to 0.8 mg twice a
day). She also received a lupron shot (vet thought it
wouldn't hurt and might help), and an IV port. We gave her
1cc 0.9% NaCl fluids with 5% dextrose IV every 3-5 hours
(less often overnite) for a week. (We had to decrease it to
every 5 hours due to breathing problems, even with extra
lasix).
She was greatly improved--alert, inquisitive, and could even
get out of bed occaisonally and walk for a few feet (even
with the port). But at the end of the week her values were
still off. Her glucose was 59 and her ratio was improved,
but still off-- (sorry I didn't get the numbers). Her
BUN/creat was okay, and she was well hydrated. We increased
her iv fluids to flush out the potassium, and she
dramatically worsened. So we backed off to every 4 or 4 1/2
hours yesterday. (Her breathing is fine at this level.)
Now she's better than she was with fluids every 3 hours, but
she's still worse than she was at the beginning of the week.
And she refused to eat tonight for the first time.
She's also on cephalexin (sp?) to avoid infection with the
port, and I've been giving her crushed lactinex--she won't
eat yogurt. It hasn't helped much with the runny poops, but
I don't know what dose to give so I may not be giving
enough.
Bottom line--is there any other way to get her Na/K ratio
back to normal? Doesn't it seem like we could increase her
florinef and/or her pred? Why wouldn't adding salt to her
food help? Why would her potassium go up in the first
place?? (it was 6.47 mmol/l the first time she was checked,
with a range of 4.6-7.6)
I know she is seriously ill, but I was so happy when she
showed so much improvement!! And now she's regressed...
My vet has been wonderful, but we go back to see him
tomorrow, and I'm afraid he's going to say he's out of
ideas...
Any ideas out there???!
Thanks for listening!!
Celia
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