One more: 2%?

wasabipea

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Beleive it or not, I work with a building full of engineers and even they are having a tough time with this conversion. (I'm the lone graphics artist - not math is SO not my thing). Any clue what the approximate 2% ccs for 7.5 lbs? The guys at work came up with 70 ml, but that seemed too low.

My vet's office was administering 200ccs of fluids to an 18 year old, 7.5 lb health compromised cat every other day / 3 days. I think that was too much since I could still see the fluid in her leg 12 hours later, and her balance was off and she didn't seem happy. What would be other symptoms of over hydration, and would this affect her heart murmur?

I understand you can't give me an exact figure but for a cat that size, now that I am administering the fluids at home - I"m leaning towards 100ccs every other day. This is what my gut is tellling me, nothing else.

The fluid administration is partly for kidneys (with her creatinine in / near normal levels, the early stage CKD is somewhat under control) - I"m also just giving them to her for a boost of energy (with a B12 injection into the fluids once a week).

I suppose finding the right mix of fluid amount and frequency is a guessing game in the beginning?

Sorry... a bit off the kidney topic, but it is related since it's a symptom of a host of other issues - and finding the balance is questionable with all going on with her.

Thank you again!

Wendy
 

dr kris

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Alright, back from clinics, back at home, kids in bed and beer in hand. Let’s do this!

Wendy! Lol - you are not the only one to have a tough time with the conversion. It is typically for me to double or triple check my numbers before doing anything with a needle and a cat!

Let’s run through your numbers:

7.5 / 2.2 = 3.4kg

3.4 x .02 = 0.068 x 1000 = 68ml

So 70ml is your 2 % amount (for anyone looking at that and it’s all greek, dont worry, it’s explained in detail in the video, along with a quick look up chart to save you the math).

It seems ridiculously low, doesn't it? Especially compared to 200ml. I would need a reason to give 200ml on a regular basis to a 3.4kg cat. Like I cant get a fever down and I can’t use anti-fever drugs. Or I am calculating their actual fluid losses and it really exceeds 100ml a day. But it’s a dose that I would never set and forget. In the clinic (and at home), I'm constantly adjusting. It’s a dance. Zack (my cat in the video) does this, so I do that with his fluids. This week, this flares up, so the frequency changes. Or, he’s going through this problem, so I change his fluid mixture. Always trying to match it to his needs. You are right - there is subjectivity involved.

In my career, I’ve given cats up to 400ml (SQ amphotericin for debilitated cryptococcus afflicted cats which i saw a tonne of in Vancouver), all the way to tiny 15ml kitten doses, and everything in between. Sick cats, fat cats, fractious cats, street cats and the prince and princesses!  Cat’s with heart murmers, cats with confirmed heart disease, feverish cats, diabetic cats, and cats with a multitude of issues (like my own Zack).

Cat’s are more susceptible to over hydration. That much is true. Especially with heart disease. After giving thousands of doses, I have only seen really bad (life threatening) effects from over hydration when mistakes are made giving IV fluids. I’ve never seen it with SQ fluids using my 2 % and 5% guideline. I’ve seen  a bit of confusion online (people explaining the negative effects of over hydration by IV fluids and attributing the same bad things that can happen if using SQ fluids). The biggie is pleural effusion (water in your chest surrounding your lungs). I see pleural effusion about once a week. I saw one today. It was heartbreaking for the family. You never want to see that in a cat, especially when they get older. But you know what I’ve not seen yet? Meeting a cat with pleural effusion that was given regular SQ fluids at home. Im sure it can happen, but my incidence rate is in the low .000x percentages.

The most telling thing I find with confirming the right amount of fluids was your observation - behaviour. My cat is the same way - it is like a boost of energy after the SQ fluids! There is a perk in his step. Waggle to his walk. Then an eventually run up from the litter box like a bat out of hell. For me, twice a week get’s Zack there.

If your vet is cool with you doing fluids (FYI "if your vet is cool with your doing fluids" - this will be my obligatory statement in all my posts that you go over all this stuff with a vet who has actually put hands on your cat) you can try backing off your fluid rate closer to 70ml. If or when the boost of energy goes away, you will know what his minimum requirement is, then bring in back up before that boost of energy goes away (either in quantity or frequency).

I hope that ramble helped Wendy!

k
 

zoneout

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Beleive it or not, I work with a building full of engineers and even they are having a tough time with this conversion. (I'm the lone graphics artist - not math is SO not my thing). Any clue what the approximate 2% ccs for 7.5 lbs? The guys at work came up with 70 ml, but that seemed too low.

Thank you again!

Wendy
 
 Score one for the
geeks at the office.  (sorry...couldnt resist)
 
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wasabipea

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Thanks for the detailed reply Dr. Kris. I'm trying to keep it around 100ml every two or three days, and go from there. I do think 200ccs every other day is too much, and wsn't being absorbed properly. she went to jump from my bed to my nightstand the other day - maybe a foot and a half - and missed and fell on the floor. she's always been very agile.

So she has been getting carted to the vets office and they just taught me an at home fluid regimine (for the eighth time) - I did it successfully threre but she is a good little thing and sits patiently, nary a mew or a fuss... but last night at home was a different story. I haven't given up yet, I think I need to find a brighter set up (and a box with higher sides, for sure).

Yes 70ml does seem low - but if that's what it ism that's what it is. I don't want to over fluid her, plus she is battling a case of the runs - Pro-Pectalin isn't helping like it has in the past. I don't know if too much sub-q could be contributing to that as well.

Anyway, so glad you are around for the week, I'm sure you will hear from me again. I'm going to start a new thread for my next question so I don't get all scattered and mixed up - easily done!

Zoneout - lol, yes very funny. They were making me laugh tossing out phrases like "volumetric density" and whatnot. I was amused at how befuddled they were - but my adorable band of goofy geeks got it right!
 I'll have to let them know.
 
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