From:
"Meryl Faulkner"
Date: 2009-03-04 06:52:34 UTC
Subject: [ferrethealth] Xena: kidney failure : stable, improved BUN, but now problem giving sc fluids
To: ferrethealth@yahoogroups.com
Xena, (original post 9282)is hanging in there so far (kidney failure). But now I have a problem giving sc fluids. Have looked at various sites describing sc fluid admin, but do not see a help with my particular problem.
Recently (for about the last week) I've had trouble giving her sc fluids. Occasionally I have had a problem geting the needle in place so that I can get the fluids in. Mostly I've moved the "butterfly" needle (I change between 21g and 19 g since I can't decide which works best)until the fluid goes in fairly easily and forms a bump between her shoulders or (more often)just behind them. This evening I did get fluids in but it looked like it was near her rt shoulder she seemed uncomfortable and I had to stop when I got to 20 mls. She now is getting tricky to subcu, and a couple of times she has seemed agitated/irritated even when fully involved in drinking her soup and starts to feel the fluid go in. Of course I've become more nervous as a result. I try to vary the position of the tented skin - but sometimes I get a bad reaction (she squirms), then sometimes she barely notices. Today at noon I had to give up, I got the needle in, started putting fluid in and she got tremendously
agitated, more so than on previous occasions, quit eating, and when I tried to suspend/support her chest so that her back has slightly curved, she still struggled and I had to give up. I don't know - since occasionally her back has had a little blood stain - whether she now has a sore patch,(there are no obvious lesions/scabs) or whether my nervousness has become obvious to her. Is there another site (sides, flanks) that I could try? I don't want to keep poking and really get her agitated, but the area near her scruff now seems to be more difficult to get the needle in smoothly. It may be just me, but now I'm paranoid about giving her fluids. Any tips would be welcome.Further forward toward her neck?
An update though on Xena's blood work and general health. Her urine is pretty profuse and just slightly yellow. She drinks a lot occasionally, but when I do succeed in giving the 30 cc of sc fluids twice daily she drinks less. Her wt is still 2.2 pounds and some of her past blood chemistries are as follows:
1/21 (first diagnosed with chronic renal failure)BUN 162 (norm 10-33), Creatinine 7.4 (0.2-0.8) Phosphorus 14.0 (4.2-8.5)Calcium 6.7 (7.7-11) Potssium 6.0 (4.3-5.8)
1/22, 1/23 iv fluids daytime, 1/24 half a day
1/24 BUN 115, Creat 6.0, Phosph 10.9, Ca 7.8, Potassium 5.5
Sub cu fluids 20-22mls twice daily until 1/30
1/30 BUN 139, Creat 6.0, Phosph 11.9, Ca 7.0,Potassium 6.1
Subcu fluids upped to 30mls twice daily to 2/24
2/24 BUN 108, Creat 4.8, Phosph 11.1, Ca 7.1, Potassium 6.2
Her CBC has not been great - even last November she had low Hematocrit of 24, red blood cells 3.98 and a hemoglobin of 6.6.
The vet commented on 2/24 that her gums looked paler than before. Her values had dropped gradually until 2/24 to Hct 18.2, rbc's 3.85, HGB 5.7
She otherwise seems stable for now - sleeps, runs and climbs upstairs to the bedrooms when she is harassed by the other ferrets.Just wish I could be more adept(or she could be more cooperative) at the subcue fluids.
Meryl
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