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Thread: Esbilac, Pedialyte, and other non-urgent why's

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    Default Esbilac, Pedialyte, and other non-urgent why's

    Hi,

    I always learn a ton from you guys, and I was hoping you could help me learn more (I'd like to eventually get my rehabbers license and join the nuttiness, and I always like to learn the why's behind great advice!)

    Things I am curious about:

    1. I have seen that you aren't supposed to continue pedialyte beyond 24 hours. Why? Is it just because it doesn't provide enough nutrition/calories on its own?
    2. Pedialyte powder is now available in little single-serve packets in stores (or maybe it has been for a while and I just haven't noticed!) Does anyone have experience using it? I was thinking it would be handy to keep a packet or two in my bag, since I always seem to find babies when I am out and about (and living in nyc, I don't have a car--otherwise I would stash a bottle!)
    3. Why shouldn't you mix pedialyte and formula? I have seen it recommended for humans, so was curious why it was a major no for squirrels
    4. Is all rodent block the same (or decent)? I've never been able to find any of the recommended ones in my local pet stores, and HHPs blocks don't keep for long (which is part of why they are so fresh and delicious, I'm sure!), so I want to make sure there aren't any kinds that I absolutely should be avoiding (or ingredients I should watch out for)
    5. What is the current state of debate on esbilac vs fox valley? I see FV in the sticky, but it seems like lots of people are using esbilac. Is that just because in an emergency esbilac is quicker to get?

    Finally, is there a book on squirrel/wildlife rehabbing you guys could recommend for the exam and just general knowledge? Or just keep lurking and learning? If there isn't, you should write one!

    Thanks as always!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    See red below

    Quote Originally Posted by Fenchurch View Post
    Hi,

    I always learn a ton from you guys, and I was hoping you could help me learn more (I'd like to eventually get my rehabbers license and join the nuttiness, and I always like to learn the why's behind great advice!)

    Things I am curious about:

    1. I have seen that you aren't supposed to continue pedialyte beyond 24 hours. Why? Is it just because it doesn't provide enough nutrition/calories on its own?
    A - You CAN offer Pedialyte and other hydration fluids beyond 24 hours, and frankly, you SHOULD. You should NOT offer ONLY Pedialyte/hydration fluids solely for more than 24 hours.

    2. Pedialyte powder is now available in little single-serve packets in stores (or maybe it has been for a while and I just haven't noticed!) Does anyone have experience using it? I was thinking it would be handy to keep a packet or two in my bag, since I always seem to find babies when I am out and about (and living in nyc, I don't have a car--otherwise I would stash a bottle!)
    A - yes this is a good idea. I always have some sort of hydration and emergency supplies on hand

    3. Why shouldn't you mix pedialyte and formula? I have seen it recommended for humans, so was curious why it was a major no for squirrels
    A - You should NOT mix the formula with the Pedialyte (as in, instead of water). I believe there was a study done at one point and it indicated that the proteins in the formula got screwed up. Someone else is going to have to provide the specifics. HOWEVER, I've been advised by at least 6 senior rehabbers and even vets that there is absolutely no problem with mixing the formula as instructed, then in a different container mixing the hydration fluids and then pulling some of both up in the syringe to feed. They don't have separate compartments in their stomach for different kinds of fluids, so as long as they are both mixed according to their specific instructions many people do use this practice. It is a better practice to offer extra hydration in between the formula feedings...this way they are getting a full calorie load and the extra hydration...best of both worlds.

    4. Is all rodent block the same (or decent)? I've never been able to find any of the recommended ones in my local pet stores, and HHPs blocks don't keep for long (which is part of why they are so fresh and delicious, I'm sure!), so I want to make sure there aren't any kinds that I absolutely should be avoiding (or ingredients I should watch out for)
    A - No they are not all the same. HHB's keep just fine in the freezer. They are available ONLINE only. Kaytee, Mazuri, Zupreme and Harlan Teklan (I think they are using a different name now) are also widely used and I believe it comes down to ease of availability and personal preference.

    5. What is the current state of debate on esbilac vs fox valley? I see FV in the sticky, but it seems like lots of people are using esbilac. Is that just because in an emergency esbilac is quicker to get?
    A - WELL! Esbilac used to be great, then it got bad and we all went to FV 32/40, then the 32/40 got bad and the Esbilac got good so we all went back to the Esbilac. This year though we've been seeing some problems with the Esbilac again...babies are stopping up, bloating, or simply won't eat it and in those instances we've gone to Goats Milk or some combination of GM and Esbilac. As of this moment in time, Esbilac is still the go to until they are 4 weeks of age and then FV 20/50.

    Finally, is there a book on squirrel/wildlife rehabbing you guys could recommend for the exam and just general knowledge? Or just keep lurking and learning? If there isn't, you should write one!

    Wild Mammal Babies - The First 24 Hours and Beyond, 3rd Edition

    Thanks as always!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Awesome; thank you!!!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    I found this online last night when looking for more info on gray squirrel rehab:

    http://www.animaladvocates.us/squirrelmanual.pdf

    Has quite a bit of info, but I don't know if it's been updated at all since it was written in 2004.

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Thank you, MM. FINALLY the correct information being given on rehydration and pedialyte/hydration fluids!!!! This should be a sticky. As you know, the incorrect info being given on TSB concerning this subject has long been a concern for many of us. THANK YOU!!!!!!!!!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    I can certainly do a sticky about the Pedialyte/24 hr confusion, no problem. I had no idea that people were reading it as "STOP using Pedialyte ALTOGETHER after 24 hrs", but I do understand how that happened.

    Fenchurch you've gotten perfect answers from Milo's Mom . Here's my question: you're in NYC Did we meet at the Rehabber Party in Brooklyn a few months ago? (I'm Maura from the Bronx )
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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by island rehabber View Post
    I can certainly do a sticky about the Pedialyte/24 hr confusion, no problem. I had no idea that people were reading it as "STOP using Pedialyte ALTOGETHER after 24 hrs", but I do understand how that happened.

    Fenchurch you've gotten perfect answers from Milo's Mom . Here's my question: you're in NYC Did we meet at the Rehabber Party in Brooklyn a few months ago? (I'm Maura from the Bronx )
    Thank you! I think I got confused on the pedialyte reading it in various threads--a case of telephone! Thank you for clarifying!

    Nope, didn't meet at the rehabbers party--I'm not anywhere near a pro/official. I just keep an eye on the wild squirrels/pigeons/random crows and other guys in my neighborhood, so tend to pick up a few a year and bring them to more capable hands!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by UDoWhat View Post
    Thank you, MM. FINALLY the correct information being given on rehydration and pedialyte/hydration fluids!!!! This should be a sticky. As you know, the incorrect info being given on TSB concerning this subject has long been a concern for many of us. THANK YOU!!!!!!!!!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    From Sara Rowe SQUIRREL TALES
    A MANUAL OF INFANT CARE FOR BEGINNERS
    http://www.squirreltales.org/

    And another link to add to the confusion.
    https://thesquirrelboard.com/forums/...ing-a-squirrel






    HYDRATE THAT BABY!

    In addition to warmth, the most important first treatment you will give the baby squirrel you have found is rehydration. Any baby has encountered trauma by being separated from Mama: the separation may have been a few hours, or days. The younger the baby the greater the risk of dehydration and if you do not rehydrate you will lose it. Even the healthiest looking babies should first be rehydrated. Most people immediately give the new baby milk of some kind. DON'T DO IT. A baby will not starve to death over a 24-hour period, but it can surely die of dehydration. Rehydrate first. I repeat: Do not start the baby immediately on formula, rehydrate first.

    Why is rehydration so important? Water is essential for the digestion of food and enables the body to perform other functions that sustain life. Rehydration defined is a period of time wherein no food is given and electrolyte fluids are administered to repair damage from dehydration, refill reserves, and re-establish body chemistry. The extent of rehydration is based on the extent of dehydration.

    Rehydration and digestion are mutually exclusive processes; they cannot be achieved at the same time.
    When food and water are introduced to the stomach, the water in the stomach is not used for digestion: the stomach makes a demand on the cells of the body to give up fluids to digest the food; the cells will give up fluid no matter how little the body has at the time of demand, leaving the body further depleted. The water in the stomach is not absorbed until it reaches the small intestines, after the digestive demand has been made; what is absorbed then, is not enough to repair and refill, so a downward spiral ensues with each feeding: food causes digestive demand followed by more fluid depletion followed by more severe dehydration, ending in death in a few days if not immediately.

    There is absolutely nothing gained and much damage done by combining rehydration fluids with formula in a feeding. This is a fairly common practice and is not rehydration. At the end of a rehydration period using electrolyte fluids, when body function has been restored, formula can be introduced with a large volume of plain water not electrolyte fluids,to increase water reserves and allow the body to slowly adjust to the digestion of food once again.

    Without initial rehydration, you will have a thin, dry, grayish little mummy, too weak to lift its head, instead of a precious, fat, round, wet, pink baby. If you have already given formula, then stop immediately and start over with rehydration.
    Again, rehydration and digestion cannot take place at the same time so rehydration has to be accomplished before food is given.

    Remember that rehydration is a temporary measure meant to address deficiencies and should not be continued indefinitely.


    Pink babies should be given a couple of feedings of plain water during the day to make sure their hydration stays up. I recommend a water feeding first thing each morning and one before you go to bed.

    Not only should a regimen of rehydration be initiated before food is given, for a length of time and volume depending on the extent of dehydration, but the proper fluid must be used. Gatorade is not a rehydration fluid; it is designed to keep athletes hydrated. Gatorade has a high salt content, which promotes fluid retention and may cause diarrhea when given inappropriately. Pedialyte is the best oral rehydrator available to the public, with Lactated Ringers best but not generally available to the public.
    Hydration Instructions

    Choice #1: Use fruit flavor Pedialyte, an infant rehydration fluid available to the public in drug and grocery stores. Pedialyte is designed to replace lost body fluids and electrolytes. DO NOT MIX PEDIALYTE WITH FORMULA.

    Choice #2: Lactated Ringers by subque injection (the best rehydration fluid because the formulation resembles blood chemistry, and if the animal is unresponsive and cannot drink, the only method of rehydration). Injection has to be given by a vet. Lactated Ringers can be given orally as well as by injection. Injected fluids should be followed with oral fluids when the animal is able to drink. A note: if this baby needs injected fluids from a vet, be sure that all the vet does to the baby is give the injection of fluids. Vets are not academically trained about wildlife, their needs, or the situations under which we find these babies and all too frequently they never even consider rehydration. The situations they encounter with domestic pets are very different from what we encounter with wildlife. I have heard many tales of vets taking a baby into the back of the clinic, filling it up with formula instead of injecting fluids as they were asked to do, and the animal is dead very soon afterward. Take this paper with you if you do go to a vet, to give yourself some credibility for what you are asking him or her to do.

    Choice #3: Homemade rehydration fluid: 1 qt. Water, 1 tsp salt, 3 tsp sugar. This is meant only for situations wherein, for some reason, you cannot get pedialyte or lactated ringers. It is not a full electrolyte solution, but is better than nothing.

    How long to Rehydrate and How Much Fluid to Give: How long to rehydrate depends on the amount of dehydration. To determine amount of dehydration and how much fluid to give, do the following:

    Do a skin turgor test - pinch up the skin along the spine behind the shoulder blades then watch how the skin relaxes. If it returns fairly quickly to flat, then the baby is only mildly dehydrated - rehydrate for 6 hours, then introduce formula diluted with plain water; if it returns slowly but consistently to flat, then the baby is moderately dehydrated - rehydrate for 8 hours, then introduce formula diluted with plain water; if it stays in a peak you have a very dehydrated baby, a life threatening situation - rehydrate for 12 or more hours, depending on the baby's positive responses, or take the baby to a vet for a subque injection of lactated ringers, then continue with oral fluids at home, followed by introducing formula diluted with plain water. Repeat the initial test several times to get an average of the readings, then rehydrate accordingly. Give all the oral fluids the baby will take every 30 minutes if they only take a small amount, and every 1-1/2 to 2 hours if they take a large amount. Do not fear to over hydrate orally; you are far safer in giving a large volume of oral fluids than you are in cutting short the amount or length of time of rehydration. One can over hydrate by subque injection, so I recommend caution there. As far as amounts go, that depends on the age of the baby since an older baby can take in more volume than a younger one can - just give as much as you can get the baby to take every time you offer the fluids, and offer them frequently.
    Assess the baby's general condition - ask yourself: does the baby look thin with hip, ribs, and backbone showing? Does he have an appetite or not? Is he lethargic? Unresponsive? Is he cold, and if he is warm in his nestbox, does he cool off immediately when he is removed from that environment? Is he weak, unable to hold onto your fingers? Are his general body color, gums, and tongue grayish (a healthy baby is very pink)? Is he urinating well or not? Is the urine clear or somewhat yellow and thick? In a very dehydrated baby, you will find all of these symptoms, but a baby can be slightly dehydrated, showing only a few of the symptoms to a lesser degree, or none at all to the inexperienced eye. To be safe, always rehydrate based on your best assessment of the amount of dehydration. Count on that some degree of dehydration will be there.

    Positive responses to rehydration: You will see a remarkable difference in your baby. A rehydrated baby will gain weight on fluids, be eager to eat, responsive rather than lethargic, have a strong grip, elastic skin, and will urinate copiously. His body temperature will be stable. Urine will be clear (fox squirrels do have a more yellowish urine naturally but there should be plenty of it).

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    To lessen the confusion, I would stick with the expert wildlife Veterinarian, Dr Erica Miller, who wrote the rehydration protocol for the NWRA and the IWRC. She also wrote the Rehydration/Hydration chapter in "Wild Mammal Babies, The First 48 Hours and Beyond".(WMB) This book is quoted from sooooo many times on TSB.

    Dr. Miller is an expert Wildlife Veterinarian and I took the opportunity to discuss the sticky on rehydration from TSB. She was concerned about the misinformation and incorrect information riddled throughout the article. She was also perplexed about how this article even pertained to the teaching of how to rehydrate baby squirrels. She did mention that if the only rehydration fluid available in an EMERGENCY situation is Gatorade IT CAN AND SHOULD BE USED at a 50% dilution rather than plain water and NEVER SUGAR WATER.

    She explained further that rehydration means replacing electrolytes in the body which allows every cell in the body to properly function. Salt in rehydration fluids is the electrolyte that is necessary to rehydrate the cells. Sugar water does not contain electrolytes. It cannnot rehydrate.

    I really don't understand why we would further confuse the rehydration issue when it is so important to save so many of the babies we see on TSB suffering from dehydration. Please read the article written by DR. Miller in WMB on pp 49-59 in both the 2nd and 3rd Editions. It is the protocol used by many rehabilitators to rehydrate their babies. Since dehydration can be a life threatening issue it is important for TSB to give sound advice based in expert veterinary medicine.

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    I don't have the time to read the hydration protocol in the book now,
    but this subject has been brought up many times for years.

    I do think that I tried to find how long pedialyte could be given in the WMB book
    and never found it.

    I also never heard of feeding pedialyte and formula together.

    I did search a while back and today, and found this thread from Leigh,
    and her concern about giving too many electorlytes.

    I'm just trying to give the best advice possible, but I need to know what that is.



    From Henry's

    **VERY IMPORTANT**

    Never feed formula or food to a dehydrated baby
    Never mix rehydration fluids with formula. Give fluids separately, in between formula feedings.
    Don't give Pedialyte for more than 24 hours (too much sodium). Use homemade rehydration fluid instead.

    #1 Rule when feeding a baby squirrel: GO SLOW!
    http://www.henryspets.com/2-rehydration/[/QUOTE]

    Quote Originally Posted by 4skwerlz View Post
    Pedialyte contains a lot of sodium, and should never be fed for more than 48 hours under any circumstances. The purpose of the rehydration fluid is that body fluids contain a balance of sodium and other electrolytes plus water, so when you rehydrate you can't just give plain water. However, if you give too much Pedialyte then you tip the electrolyte balance the other way, and actually cause worse dehydration. Esbilac contains all the electrolytes needed and there is no need to add Pedialyte for a healthy baby. In fact, adding Pedialyte to the formula will upset the electrolyte balance and lead to dehydration. I don't know about adding Pedialyte to formula for a dehydrated baby, but I thought they should be at least partially rehydrated before feeding and then Pedialyte given between feedings.

    1 liter Pedialyte = 1,036 mg sodium

    1 cc Pedialyte = 1.04 mg sodium

    The daily requirement of sodium for a 70-gram baby is 5 mgs. Since 5 cc's of Pedialyte contains 5 mg sodium, you can see how easy it would be to overdose, especially in a small baby.

    The daily sodium requirements for different weight babies goes like this:

    Weight of baby/Requirement of sodium per day
    14 g-------1 mg
    28 g-------2 mg
    42 g-------3 mg
    56 g-------4 mg
    70 g-------5 mg
    84 g-------6 mg

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    I read the section in WMB this afternoon.

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by Milo's Mom View Post
    I read the section in WMB this afternoon.

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    I promise I am trying to understand,
    and not be argumentative.
    What is the point in this?

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    • Sorry to thread-jack here but I feel we need to be giving advice from a Veterinarian that is an expert on this. Dr.Miller has written the Rehydration protocol for the National and International Rehabilitator's organizations. She is a trusted by wildlife vet who literally wrote the book on this subject.

      Also, listed in the advice from Leigh below is the daily requirement for a healthy baby. Dr. Miller explains that a dehydrated baby would need replacement fluids plus the normal daily maintenance requirements as their electrolytes are depleted and in need of anywhere between 8-12 % more fluids over a 3 day period to counteract the deficiency based on the determined % of dehydration. This is explained in WMB Rehydration chapter on the aforementioned pages. Rehydration is a formula not a guess. The protocol by Dr. Miller is a 3 day rehydration plan. She does say that a 4th day may be needed due to on going losses such as vomiting, diarrhea, etc

      *Pedialyte can can be given safely 3-4 days - WMB p.59
      *Feeding formula mixed with pedialyte (rehydration fluid) - WMB p.60 , p 62
      *Replacement fluids must be given in ADDITION to daily requirements - WMB p 59

      I in no way want to be argumentative or disrespectful but we have needed to work on this issue for too long so we can give the best possible advice.




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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by Nancy in New York View Post
    I promise I am trying to understand,
    and not be argumentative.
    What is the point in this?
    Your prior response said that you've never heard of Pedialyte and formula together and you also said you didn't have time to read WMB at this time. I happened to read it and happened to see where WMB said you could feed them together so I took a picture to show you that it said it. It was an attempt to help you understand where it came from since your short on time, that's all.

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by Milo's Mom View Post
    Your prior response said that you've never heard of Pedialyte and formula together and you also said you didn't have time to read WMB at this time. I happened to read it and happened to see where WMB said you could feed them together so I took a picture to show you that it said it. It was an attempt to help you understand where it came from since your short on time, that's all.

    No Betsy, I meant what is the point of feeding them together.
    I appreciate you showing me where it was. Thank you!

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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by UDoWhat View Post

    I in no way want to be argumentative or disrespectful but we have needed to work on this issue for too long so we can give the best possible advice.[/INDENT]



    Absolutely! I think we all strive to give the best possible advice.
    From the Pedialyte site:


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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    Quote Originally Posted by Nancy in New York View Post

    No Betsy, I meant what is the point of feeding them together.
    I appreciate you showing me where it was. Thank you!
    Sorry, I did not see this last evening. As per the packages of some electrolyte solutions and WMB it is a method used to transition them from hydration to formula.

    Nancy, please understand I am not saying people should or should not do it, I am simply sharing what's been shared with me by many professionals and experts in the field (rehabbing and wildlife veterinary medicine). It was also taught at ALL of the conferences I attended this year...WRNC, Call of the Wild (VA), which also had 2 days of IWRC training, and NWRA in the beginning of March.

    We all refer to WMB as the "Rehabber Bible" and here at TSB we strive to follow it as closely as possible. I do realize that there are mistakes in the different versions (heck Metronidazole isn't even in the 3rd edition!), but this is Rehydration 101 and it's pretty standard across the board; I'm inclined to think WMB is pretty accurate, in this instance.

    The one thing we also have to remember is that when we use Pedialyte we are using a product made for humans in wildlife. The formulas for wildlife are vastly different than those made for human infants...

    Since we are on this subject of hydration I think maybe it would be good to discuss the use of Lactated Ringers Solution in severely compromised littles, as well. The Lactate is a base for the Ringers Solution and it has been found to be extremely hard on the kidneys and liver in compromised babies and the trend is now to use Normal Saline. All of the vets that I've worked with for wildlife stay away from the LRS and they've all been using NACL. There are a few instances when LRS was used, but those were for very specific instances, only.

    What I would like to see from this entire conversation is the encouragement of finders to properly hydrate babies before AND AFTER starting formula. Regardless what they are using. Complete rehydration cannot be achieved in 24 hours, it takes days. Honey water in between feedings doesn't cut it, you MUST have salt; as it acts as the electrolyte and the body MUST have it. If there is a grave concern about the amount of salt in the Pedialyte dilute it with some water for days 2, 3 and maybe 4. The honey water is sugar and it can actually cause dehydration due to the sugar drawing water into the gut.

    Having just been through kidney issues with Ellie , I will share that I was told to use hydration formula, specifically for the salt content, as it helps the kidneys. I was shocked and asked for clarification at least 3 times because I was so worried about the salt. The vets exact words "the salt will help her kidneys".

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  30. 2 TSBers pass along the fuzzy thanks to Milo's Mom:

    Mel1959 (05-02-2017), UDoWhat (05-01-2017)

  31. #19
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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    The pedialyte instructions are meant for human formula. I am not sure how that translates to canine puppy formulas but I suppose it could. I think we are all trying to give the best advice and since the mixing of Esbilac and pedialyte is recommended by a Veterinarian in WMB it is safe to do....at least. Whether we agree with this mixing method or not, it can be safely done. I personally do not mix formula and pedialyte myself. It does clump. I know many MD rehabbers who do and they have raised literally 1000's of baby squirrels over the years with seemly no ill effects. So in the interest of disclosure .... I suppose each one of us should decide for ourselves what is best for our babies. That is what it is about in the long run.

  32. 2 TSBers pass along the fuzzy thanks to UDoWhat:

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  33. #20
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    Default Re: Esbilac, Pedialyte, and other non-urgent why's

    I have read and reread the methods of hydrating. I personally will not mix hydration fluid and formula. It doesn't make sense to me so I don't do it. It is absolutely up to the individual rehabber and I think that just has to be the way it stays. The less we tell finders to do the better. In the moment, they need to get the baby to a rehabber and if not, simply hydrated and then begin feeding. It is so hard to even be sure it is the correct formula that is being used that when we say it is okay to mix with something it seems dangerous to me. Keeping it simple is the way to go IMO. Hydration fluid and then formula is as simple as it gets.
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  34. 4 TSBers pass along the fuzzy thanks to SammysMom:

    astra (05-01-2017), lennysmom (05-01-2017), Mel1959 (05-02-2017), Nancy in New York (05-01-2017)

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