How to Administer Subcutaneous Fluids

Jul 2, 2012 by Dr Cindy McManis    No Comments    Posted under: Tips & Advice

Administration of supplemental fluids can benefit cats with a variety of medical conditions. Most commonly, this is recommended for cats with kidney disease. We recommend that you learn this technique for your cat. Don’t be alarmed – it is normal to feel apprehension about this. Giving injections is outside the comfort zone for most everyone outside the medical profession. However, fluid administration is not nearly as difficult as it sounds and often easier than orally medicating. The benefits provided to your cat will make it well worth your time to learn this simple technique.

What equipment is involved?

The equipment consists of a bag of fluids, a drip set, and a needle. The drip set is simply a tube that connects the fluid bag to the needle. You will eventually become comfortable with the steps involved.

1. Remove the inner bag from the outer protective bag.
2. Remove the drip set from its packaging.
3. Pull the protective covering from the exit port on the bottom end of the fluid bag. This will expose a hole that will accept the pointed end of the drip set.
4. The top end of the drip set has a large, pointed end with a protective cap. Remove this cap, but do not allow it to become contaminated. IT SHOULD NOT TOUCH ANYTHING.
5. Push the pointed end of the drip set into the open hole of the fluid bag. It must be seated firmly to prevent leaks.
6. Remove the protective cap from the lower end of the drip set, but do not discard it. Do not allow it to become contaminated. IT SHOULD NOT TOUCH ANYTHING.
7. Close the lock in the middle of the drip set tubing by moving the roller. (The lock on a new drip set is often already in the open position.)
8. Gently squeeze and release the bulb at the top of the drip set until the bulb chamber is about half full with fluid.
9. Open the lock (roller) on the tubing and then hold or suspend the fluid bag; fluid should flow freely.
10. Be sure that all air bubbles run out of the tubing.
11. Close the lock on the drip set line by rolling the roller downward.
12. Remove the protective cap on the lower end of the drip set.
13. Break the protective covering around the needle so that the open end (not the sharp end) is exposed. Do not allow it to become contaminated by allowing it to touch ANYTHING.
14. Remove the protective cap from the lower end of the drip set, and place the open end of the needle on it. Seat it firmly.

How is the needle inserted?

Insert the needle just under the skin in one of several locations that have unusually loose skin. These include:

• At the level of the shoulder blades, just to the right and to the left of midline.
• At the level of the back legs, just to the right and to the left of midline.

What is the correct technique?

1. Choose a location where you will treat your cat. This may be on a table, countertop, or on your lap.
2. Hang the fluid bag about 3 feet (1 meter) above the level of your cat’s head.
3. Place your cat in the treatment location. Be sure both of you are in a position that will be comfortable for about 10-15 minutes. The end of the drip set should easily reach your cat.
4. Pick up a roll of loose skin in one of the above locations.
5. Lay the point of the needle at the base of the roll of skin with the needle horizontal and pointing to the cat’s head. This assumes that the cat is in an upright position.
6. Advance the needle slightly forward while pulling the roll of skin backward. That should place the point of the needle under the skin.
7. Release the roll of skin. The point of the needle should remain under the skin.
8. Grasp the drip set lock in one hand. Begin the flow of fluids by rolling the roller upward.
9. NOTE: Some cats are more cooperative if they are placed in a box or bed not much larger than the cat. A cardboard cat carrier or regular cat bed are often the correct size.

How much fluid should I give each time?

You will be given instructions by the veterinarian that tell how much to give for your specific situation. As a rule, the average sized cat should receive 100-150 ml of fluids at one time. If you are using two spots, you should give half of that amount in each location.

When you have given the prescribed amount, complete the following steps:

1. Stop the flow of fluids by rolling the roller in the drip set lock downward firmly. If you do not close it well and the bag is left hanging, fluid will drip out.
2. Remove the needle from the skin and replace its protective cap.
3. PLACE A NEW, STERILE NEEDLE ON THE DRIP SET AS SOON AS YOU ARE THROUGH. This keeps bacteria that were picked up on the old needle from migrating into the fluids. You should properly dispose of the needles in a sharps container.
4. Store the equipment in a safe place until the next fluid administration.

What other tips do I need to know?

It is not necessary to “sterilize” the skin with alcohol before inserting the needle. In reality, wiping a little alcohol on the skin does not really sterilize it, and the odor and feel of alcohol may aggravate your cat. Many cats will taste the alcohol and begin to drool profusely. Most cats tolerate fluid administration quite well. However, if the fluids are unusually cold or hot, they may be uncomfortable. Ideally, they should be at about body temperature. However, as long as they are at room temperature most cats are fine. Do not refrigerate them. As the fluids are running, a lump will form under the skin. Do not be alarmed; this is the pocket of fluid that will be absorbed over several hours. If absorption is slow, gravity may cause the fluids to migrate downward. They could move under the skin of the front or rear legs. However, if this happens, they will still be absorbed.

There is no problem if a few bubbles of air are injected under the skin. If quite a bit of air gets under the skin, you may feel a crackling sound when you push on the skin, and your cat may experience mild discomfort for a couple of hours, but no real harm will occur. The body will eventually absorb the air.

What to do if the fluids stop running:

This often happens when the end of the needle moves against the skin or the underlying tissue. Do not remove the needle; rather, gently reposition it until the fluids begin to flow again. Experiment with the needle’s position until the fluids flow freely. Twisting the needle will change the position of the bevel. This may be all that is needed.

What to do if the fluid runs slowly on subsequent treatments:

When you are finished giving fluids, you should close the lock firmly. However, closing the lock firmly may crush the tubing so that fluid will not flow well on subsequent use. If this happens, move the lock to another place on the IV tubing, and open the crushed area of the tube by pinching it with your fingers.

What to do if the fluids become cloudy in appearance:

If any cloudiness or discoloration occurs, do not use the bag. It usually means that the fluids have become contaminated with bacteria. If you administer these fluids to your cat, a serious infection may occur under the skin.

Dr Cindy McManis

Dr. Cynthia McManis received her Doctorate of Veterinary Medicine from Texas A&M University in 1985. She developed her interest in cats during her first year post-graduation. She began to actively pursue more education and information regarding feline health care and joined the Academy of Feline Medicine in 1989. When the American Board of Veterinary Practitioners approved feline practice as a specialty board in 1995, she was in the first class to sit for the exam. She is 1 of 90 board certified feline practitioners in the country at this time. Dr. McManis founded Just Cats Veterinary Services in 1994.

Outside of her clinic cases, she is a feline internal medicine consultant for Veterinary Information Network, a web based resource for veterinarians all over the world. She has also served on several committees within the American Association of Feline Practitioners and the American Board of Veterinary Practitioners (ABVP). She established an ABVP residency site at Just Cats in 2008 and mentors new graduates as well as seasoned practitioners who are interested in achieving ABVP certification.

Dr. McManis is an avid triathlete and is constantly training for races. She completed her first Iron Man in May of 2012. She is owned by 2 home kitties- Amante (“Monty”) and La Mariquita (“Mari”), and 2 hospital kitties- Momma Kitty and O’Malley.

Just Cats Veterinary Services
1015 Evergreen Circle
The Woodlands, TX 77380

Phone: (281) 367-2287
Email: vets@justcatsvets.com

Website: http://www.justcatsvets.com/
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