Caturday Saturday

 MARLEY:  Im getting used to this kidney treatment thing.  That doesnt mean I like it, but we cats are pretty good with routines.  TBT reaches down to me to give me  scritchies a lot, but I have gotten good at guessing when he is reaching down ta pick me up for the stabbies.  On the other paw, he has gotten better at reaching for me when there really isnt anywhere to go.  So I guess we are even on that.

He stabbed himself for the 3rd time Thursday, which also seems fair enough.  After all, Ive been stabbed more often than that (2x a week for about 2 Big Moons now).  Though I suspect my scruff is less sensitive than his fingers.  And he has by inserting that (bad werds) needle from different directions, so I dont feel itchy in one place.  Truth to tell, I can hardly feel it after a few minits.  And he feeds me right afterwards.  That helps too.

The special food is good.  I like it about as much as the regular stuff.  I kinna miss the crunchy kibbles though.

He hasnt taken any pictures of me getting stabbed.   He says he will try to set the cameras to automatic to see if that works.  So, since I dont have any pics of that yet, I'll just leave you all with a couple nice normal ones for today.

Unthankful Thursday, Thankful Thursday

MARLEY:   Well actually it was yesterday, but I am still not happy taday either!  I went ta the vet.  TBT put me in the open-top carrier (which lately means I get water injected) and I don't mind that too much since I stay at home.

But this time it was the vet!  I was upset to be in the car.

I was a good kitty and stayed quiet all the way there.

The place is kinna fancy.  Nice decor.  Kitty pictures on the walls too.

TBT said they needed some blood ta see if my new "kidney care" diet and the water injections were helping my health.  OK, I want to be healthy..  

But I was a Very Bad Kitty when the vet took me to "The Back Room".  I hissed and spit, struggled, and even pulled the needle out and made a mess of their table and my furs!  So they had ta clean me an I dint like that either.

When they brought me back ta TBT, I grumbled/mumbled/growled...

Well, look, I hadn't been fed in 15 HOURS!  I had been carried around in a strange place.  I'd been stabbed...  You wouldn't be happy either.

TBT:  I don't know what triggered his anger this visit.  He is usually quite calm and subdued at the vet.  In fact, he was so upset when they brought him back to me that he would even stop growling when I talked to him.  Well, some visits go better than others...

When we got home, I fed him immediately.  I'm really glad he loves the Hills's kidney care canned food and the Royal Canin "Renal T".  The vet says a lot of cats don't like it.

In spite of how upset Marley got this vet visit, there is some good news.  First, being kept away from kibble for a month, he has lost 5 ounces.  His BUN has gone from 63.7 to 46.7 (a very good improvement).  His creatinine did go from 2.4 to 2.8 and that didn't bother the vet much.

In fact, she suggested not needed to test him again for 6 months.  However, I'll be watching his weight, observing how much he eats (I weigh The Mews every couple of weeks anyway), and will schedule a blood panel again at 4 months at the most.  Maybe 3 months.  

But for now, it seems like the special diet and the sub Q injections are helping him quite a lot.  

Mancat Monday

MARLEY:   I have my very own fluidization station at home now.  Not that I love getting stabbed, but actually I barely feel it.  At least I don't have to go the the vet place and listen to barky dogs and lots of strangers talking.  I mean, the place is NOISEY an SMELLY an I don't like that.

So, if I have to get the little stabs, it is easier on me to have TBT do it at home!

TBT set up a special place fer that, an that is somewhat reassuring.  I can learn to live with a routine.  Same place, every few days, same trusted Bein.  An I don't have ta fear that he might be taking me somewhere ta leave me there.  This is my 3rd place (The Shelter, The Lady, and TBT), so after all, it always could happen again!  I worry about things like that.

But I don't understand anything about what TBT is doing, so I better let TBT explain it.

TBT:  Marley seems calm in the top-opening carrier as long as I don't drag it to the car.  So I start by putting him in there with the top closed just for a minute or so.  I need to have him in place while I get things ready.

Here, you can see the carrier (which in this case is just to prevent Marley from moving around later.

I attached a picture-hanger hook to hold the fluid bag up high (it drips faster higher up).

I also used a shot-glass to hold the needles and some cotton balls.  The cotton balls are a gentle way to apply pressure at the needle insertion and also in case there are a few drops of blood on removal.  It also holds used needles.  I need to collect them for safe disposal, so I might as well do it in batches rather than one at a time.

I watched the vet technician do the injection several times.  Then I did it once myself at the vet while she watched.  I announced each step so she could correct me if I got any part out-of-order.  She did not have to correct me.  But she did show me the best way to uncrimp the drip line where the clamp was (which, almost oddly, is a tricky part of the procedure).  

So I felt ready to try it at home.  And I already have 2 improvements in mind for the process.  First, the vet technician uncrimps the line after the needle is inserted.  it occurs to me that a 2nd temporary crimp below the existing one would allow me to uncrimp the drip line at the "standard" crimp which would be easier than doing it while the needle was in Marley.  

I have a tiny brass clamp designed for Very Small Projects.  That would not be on the drip line long enough to cause a crimp on its own.

Second, I'm supposed to give Marley 100 ml of fluid.  It takes a few minutes, and I can lose track.  So I used a marker to put a spot next to each 100.

Actually, there is a 3rd improvement.  The vet had Marley on a Wed&Sat schedule.  I shifted it to Mon&Thurs.  Why?  Those are trash pickup days and easier to remember!  Every trash day, Marley gets his fluids...

So here's the procedure I am following...

Clamp the drip line with the mini-clamp further down the drip line.  Move the standard clamp an inch toward the fluid bag and massage the drip line crimp enough to open it fully.  Open standard clamp on drip line.  

Put Marley in the carrier and close the top.

Open a new single needle packet.  Remove protective cover and replace previous needle with a new one  (holding it above the clamp so it doesn't drip).  Set aside.

Open top of carrier.  Pull up the scruff of Marley's back shoulder skin.  Insert needle bevel side up very flatly as to not touch flesh.  And try to use a slightly different spot each time.

Remove my own secondary clamp from drip line.  Observe that drips are dropping well from bag to the observation cylinder.

Gently hold cotton ball on needle insertion site (and it helps keeping him from moving).

When fluid level in bag reaches marked line, close standard clamp.  Remove needle from Marley (but leave it on the drip line as it caps the drip line), keeping cotton ball in place 30 seconds to assure there is no bleeding.

Lift Marley out of carrier and give him a few treats while I tell tell him what a brave mancat he is when I put him on the floor and then let him run away to grumble for a few minutes.

I have another thought.  The drip line seems to be about the same as my aquarium air tubing.  The clamps on the drip tubes are annoying.  The aquarium air tubes have easy screw-open valves.  Why can't the cat fluid drip lines have the same?  No crimps to massage open then...

I'll have to sketch that out to show to the vet and ask if there is something wrong with my improvements.

But aside from that, what do you who are doing sub Q injection think of my set-up and procedure?   I'll make any changes that seem better.

BTW, several commenters asked about Marley's numbers.  His most recent (which closely matched his previous) were BUN 63.7 (should be 15-32) and his creatinine was 2.4 (should be 0.8-1.8).  The vet resisted describing the "seriousness" of those numbers.  What do you think?

Easy Like Sunday

TBT:  Or maybe not, I'm not sure.  I brought Marley to the vet yesterday.  It's a good thing I started early!  I had the carrier with the top door open and ready and put him in it.  But the front door wasn't securely shut, so off he ran...  

Under the bed headboard.  Its a bookcase-style headboard, so there is a foot of overhang.  The Mews all love it under there.  Safe, secure, private.  And damn hard to get them out from under!  I had the bedroom door closed, so he couldn't escape the room, but he can run around the bed in a circle.  

So I used a dry mop to push under until he finally gave up and moaned a bit.  He knows I won't give up.  

So I got him in the PTU again (securely) and off we went to the vet.

And THE GOOD NEWS IS:  I did the fluidation procedure myself with the technician watching every step.  I even added a step (marked the level of where to stop the drips, which the technician thought a really good idea).  

Hung the bag, replaced the old needle (which has to be left on as a cap to the drip line until a new injection), pulled up his scruff and inserted it beveled side up and flat to assure no tissue penetration, held my finger on the ineedle, unclamped the drip line (moving the clamp to a slightly different spot to uncrimp the drip line), and made sure it was dripping at a decent speed).

At the 100 ml marked spot, reset the clamp, pulled the needle out and held a tissue on the spot in case of bleeding.  Put the plastic cap over the needle.  Told Marley "he was a brave mancat", and looped the drip line over the bag.  And closed the PTU.  End of procedure...

The staff congratulated me.  They said they had seen worse on first attempts (and none better).  Hurray!

It is straight-forward enough after a couple of observations.  The clamp on the drip line (and uncrimping the previously pinched part) was actually the most difficult part.  

Marley did his part, just sitting in the PTU calmly.  I asked the technician about "uncalm" cats and she said sometimes it takes 3 people.  So cheers to Marley, too.

I'll take a pic of the home fluids drip set-up when I get it set up.  

Thankful Thursday

TBT:  An apology and several different subjects today...

First, sorry for not showing new pics lately.  I just haven't begun using the new camera yet, and there seems little point in taking bad-color ones with the old.  Its the same camera model, I guess I just haven't felt like taking any again yet.

Second, I took Marley to the vet again for sub fluid injection.  It is amazing how he knows I plan to.  To my knowledge, I do nothing different in the morning, but somehow he knows.  And he finds places almost impossible to get him out of!

Behind the wine cooler is a favorite spot.   It is cluttered on top and next to a plant stand that is awkward to move.  And I can't lift him one-handed from an angle anyway.  He hid there last Saturday but I "worried" him out of there. Yesterday, he went there too, but got away when I started to move things.  So he ran behind some drapes behind a large cat tree.  I pulled him out slightly, but then he grabbed the base of the tree with all claws.  

It was like trying to pull rope out of a block of ice!  I eventually managed to loosen one paw at a time, but neither of us were happy about.  Marley is a kind and peaceful cat, but I'm sure it was all he could do not to strike out at me.

I was planning to try the injection myself under supervision yesterday, but felt too shaky about it.  Not "mentally" shaky;  physically shaky.   So maybe next time.  It would be good to do it at home.  Then, I could just pick up Marley while he was calm.

Third, it feels like life is just generally falling apart.  Oh, I don't mean I'm dying or anything (I hope).  But hand and arms and ankle muscle cramps are getting routine, and topical rubs are not helping as much as they used to.  Sometimes, it is hard to prepare dinner or type.  I feel fine other than the muscle cramps.   

But obviously I need to see a doctor.  Having lived alone 50 years and being (as one doctor said) "obnoxiously healthy",  I don't actually have much experiences with either illnesses or more general physical problems.  I should probably have some serious screening.  Cancer, heart, blood, nutrition, etc.

But I also mean The Mews (and this is mostly about The Mews).  It is total coincidence, but having multiple cats with serious problems is a struggle.  Ayla dying of starvation and having to be assisted Over The Bridge before things got unbearable was both sudden and hard.  The emergency clinic vet did an exam, took x-rays, and did a blood panel and couldn't actually find anything specifically wrong.  He gave her an electrolyte injection and provided a pill and some oral medication for appetite stimulation.  

He said if that if those didn't help Ayla begin to eat again in 2 days, nothing probably would.  And it didn't.  So I had to bring her back for a last vet visit.  Having to build a memorial box for her will be difficult too.

Marley needing injections 2x a week for life will also be hard.  Stabbing a dear pet routinely will not be easy.  The calming treats the vet gave me for Laz don't seem to have any affect.  Thankfully, the serious medication will arrive later today.  I sure hope those help.  Lori is becoming more and more distressed by Laz's brief attacks.  Marley is upset hearing cat fights.

Let's just say I've had better times...  And sometimes things just don't go the way you expect.  I suppose I just can't adjust to changes and problems the way I did once.  

I think I need to start taking more pictures.  That seems like a positive thing to do.  Cats when they are happy.  Plants in flower.  Ripening tomatoes.  Birds at the feeders.  Etc...

I initially titled this "Thankful Thursday" out of habit.  And there isn't a whole lot to be very thankful about.  Alyla is gone, Marley has to be stabbed 2x a week, Laz needs sedation meds for the foreseeable future, and Lori doesn't understand why her BFF attacks her sometimes.  So I changed it to "Thursday Thoughts" because "Thankful" didn't seem to work.

  -----------

But I can end on a positive and thankful note.  The vet gave me 4 cans of Hill's Science Diet canned "Kidney Food" that should provide enough protein for him but ones that make it easier on his kidneys.  And a non-expiring presciption for that and a Royal Canin variety that I can fulfill at several places.

They warned me I might have to very gradually blend it in to his accustomed food because most cats don't accept it at first.  So I had only mild hope.  But I decided to see how he would react to it and put a unmixed spoonful in a bowl while Laz and Lori were outside.  He LOVED it just as it was!  Even turned the bowl upside down to lick for spillage.  And asked for more! 

I gave him more.  Marley now has a new favorite food.  It is "chicken and stew" and there are 2 cans of "beef and stew".  Well I'll see if he likes that one, tomorrow.  And we will try the Royale Canin as well.  Variety is good.  And anything to help his health... 

So it is "Thankful Thursday" again...  You take what you can of the good things and focus on those.  If Marley likes new his healthy food, that is good.  Hoping that the Laz medication will help him calm down is good and that would mean Lori would be happier too.  There are possibilties for bringing peace and happiness to the household, and I will stay focussed on those.

The 3 are my proper focus now...