Flower has the feeding tube in and is slowly getting used to it. She also still has the IV catheter in her left paw, and I think she'll feel a little better (and more nimble) when that comes off. At first she had the cone/hood on so that she wouldn't chew at the bandage on her paw, but now she is either so tired to care or has gotten used to it so we leave the hood off. She still sleeps more than usual.
We began feeding on Friday evening and this went okay. She vomited a little bit before the feeding, which seemed to be mostly saliva. It was a little thick and "drooly" but also mostly clear; there seemed to be little food or bile in the vomit. Varr helped me with the first feeding and we got through it fine. Flower didn't like it much, but she was still getting used to it at that point. No more vomit that night and a little urine in the litter box.
Saturday morning we missed. I was at work in the morning and if I had realized how much food she needed for the day I would have done her first feeding in the morning. But I waited until the afternoon. We tried the first feeding and I didn't set everything up just right so I ended up with a little too much food including the meds mixed in. The metronidazole is an antibiotic that is mixed separately from the prednisolone (steroid) and the lexotinic (iron supplement), so I had two portions of food. The first step is a 10 cc flush, followed by food (mixed with prednisolone and lexotinic). Then I plugged the feeding tube and refilled the syringe with the second portion of food (mixed with metronidazole). After feeding this to her, I gave Flower her dose of amoxicillin and then flushed with 10 cc more water. After all of this, she was pretty disgruntled and she threw everything up within 5-10 minutes. I should have thought more about the total volume before hand which probably was very near to 60 mL. I need to be more aware of the total volume of everything going in when mixing and preparing the different portions.
The second feeding on Saturday happened about 2 hours after the first one. I paid attention to the total volume and used a little less food as well. I mixed the meds into the appropriate portions and delivered a total volume of 40-45 mL. She kept this food down fine and continued to sleep through the afternoon.
In order to try to get her full compliment of food in for the day, but in a shorter period of time, I decided to try smaller feedings spread out into more intervals. This also has the effect, however, of delivering a larger total volume of water to her during a given time period. I chose 3 hour intervals; Flower would be fed at 7:30, 10:30, and 1:30. The first two of these should be food only and the last one should include her second daily dose of meds. After the 7:30 feeding she threw up a little: maybe 5-10 mL within 10 minutes. I was nervous about the rest of the feeding after this but I decided I needed to try anyway. At 10:30 the feeding went very well and after 20 minutes I was content that she wouldn't throw up. I decided to try to sleep and relax before the 1:30 feeding. At 11:30 Flower woke me up when she vomited again. This was more than the first, but I didn't get a good look at the amount. It seemed to be about 1.5-2 times the volume of the first. After this, I decided not to follow-up with the scheduled 1:30 feeding but to wait until morning. After Flower threw up, she went to the litter box and urinated. Then she went to Varr's room and I let her sleep in there for awhile. At 3:30 I woke up and went to retrieve her from Varr's room and bring her back into my room. We slept the rest of the night more-or-less soundly. I woke up briefly because she was making some odd sounds which I could not distinguish as snoring or burping, but I eventually got back to sleep.
Sunday morning: Ashley came over to help me this morning. Last night I developed a method to help keep all of the food warm and prep the medications as well. I also came up with a schedule to divide the portions up and to avoid having to deliver multiple portions of food mixed with different medications at the same feeding. I have a pan of water on the stove with a thermometer in the water. The heat is on the lowest setting which keeps the water between 100ºF and 120ºF. I mix Flower's food with water in a ziploc bag, which I can then keep warm until feeding time in the hot water. I cut a hole in the bag and dump the food directly into the syringe. This way I can monitor the volume a little more closesly. Then I deliver the medication into the syringe, with the food and shake well. For the water flush, I simply use warm tap water from a bowl. This morning's feeding consisted of 1/6 of can of Hill's A/D, prednisolone, and clavamox (amoxicillin). The total volume of food and prednisolone was 16 mL with 1 mL of amoxicillin administered separately. I used a 10 mL flush before and after the food for a total volume of about 37 mL.
I am going to try to continue with several small portions today every three hours. I may reduce the flush slightly in order to keep the total volume down.
