Any tips on giving sub-q fluids with less stress

Since Willow is feeling so badly, I think he's pretty much had it with getting fluids. He usually takes them fine, but now I'm barely getting 75 in him (Dr wants him around 200 at least per day).

Edited to correct my typing

 

Re: Any tips on givkng sub-q fluids with less stress

Are you warming the bag ahead of time? I place the bag in warm water bath to warm.

Needle goes bevel side up so fluids will flow faster.

I massage the area where the needle is inserted to help the fluids disperse without creating a big sack on top of shoulder. Lots of treats for kitty during the fluids. I also hold the bag in my hand and squeeze to make the fluids flow faster. Tucker usually got fluids and he did not move for administration so I did not need to hold him still, so I could massage the area and squeeze the bag. If you can do only one, squeeze the bag to make it go faster.

 

Re: Any tips on givkng sub-q fluids with less stress

This relates to the "throwing up blood" post from a couple days ago, right? Has he been eating at all since you got him home?
When you say you're only getting 75ml in him, is that due to him trying to escape while the needle is in his back?
I just finished a few minutes ago giving Bob his 2x per week 100ccs. I hate giving fluids. He doesn't fight it, but he just looks so depressed when he's laying there patiently waiting for the end of the treatment. He only tried to get away one time, and I'm on my 4th bag of fluids. I freaked out that time, and ever since then I worry he'll try to escape again.

I know that a couple weeks ago when Lori was having to give fluids to Tom, someone suggested thin-walled needles of a smaller gauge than what the vet usually gives you. I'm guessing you have the same harpoons I use (18 g) and from what was said in that thread, the thin-walled come in 20 or 22 gauge if I remember correctly. Just that might help make the situation a little bit less stressful on Willow. When I dose Bob, I sit on the floor with my legs around him, his face is towards the inside of my left knee. Once I get the needle in, I just rub him between the eyes and scratch him under the chin with one hand while maintaining the "tent" with the other hand. And I just talk to him and tell him that in just another couple of minutes he'll be eating fresh boiled shrimp. As soon as the harpoon comes out, he's telling me "alright, where's the shrimp?!"
Today, he got two shrimp.

I wish I had more advice for you. I feel bad for both of you. 200ccs is an awful lot fluid, and I can only imagine how hard it is for him to lay still for that long, or going thru it two or more times a day. Eventually, the fluids will make him feel so much better, but I would guess it's impossible to convince him of that right now.

Carl in SC

 

Re: Any tips on givkng sub-q fluids with less stress

Wow, squeezing the bag, that never even occured to me. Great idea.
I'll have to adjust my setup so I can try that the next time. Usually the bag is too far away from where I am sitting, and I can reach the shut-off valve but not the bag. Thanks for the tip!

Carl

One thing I was going to ask and forgot to - what kind of fluids is Willow getting? Are they just lactated ringers? Anything added to them? Someone posted that potassium (which is what is added to Bob's) can sometimes "burn" when it's going in. It could be that something in the fluids they gave you makes the experience harder for him to deal with.

 

Re: Any tips on givkng sub-q fluids with less stress

My only tip is to slowly stroke their head. Supposedly it mimics a mother cat licking them. I have found that it helps calm them - I give fluids to 2 cats, only one of which is a bit antsy during the treatment and it helps her.

The size of the IV set is also important, sometimes people don't realize that. I believe the best is 15 drops per ml., that's what my vet has me get. This is the one we use: http://www.thrivingpets.com/index.php/iv-admin-set-bbraun-v1402.html

 

Re: Any tips on givkng sub-q fluids with less stress

Yes potassium can burn if pushed too fast. It can burn both outside and inside a vein/sac and leave very tender areas for a day or two. If it's in a mix with other things, there's usually not enough to cause the burn. I may not know a lot about diabetes yet but I, unfortunately, know WAY too much about how potassium 'works'....

 

Re: Any tips on givkng sub-q fluids with less stress

The needles make a huge difference to my cats. I do not accept the kits from the vet with the 18ga needles; they are huge and must be terribly uncomfortable. I demand that they give me 22ga U.T.W. needles. Sure, it takes a bit longer for the fluids to drip in, but Shadoe is just too uncomfortable with the bigger needles. I still have to watch her so she does not slink away on her belly like she did once, but I do sit with her, pat her, and talk to her, plus give a few treats. She is sort of resigned to the fluids, but she always feels so much better after.
Another thing you can do is to split the fluids - 200 a day is way more than can be handled at once or even two drips. Maybe try to spread it out over 3 sittings a day; it will be easier for the heart, and much shorter and less uncomfortable sittings for the kitty.

 

Re: Any tips on givkng sub-q fluids with less stress

Can one buy fluids without a prescription?

And Gayle - what does U.T.W. stand for in 22ga U.T.W. needles?

 

Re: Any tips on givkng sub-q fluids with less stress

I think it is "ultra thin-walled". Outside diameter would be smalled than a normal walled needle. 22g thin is much smaller than a 18g.
Carl

 

Re: Any tips on givkng sub-q fluids with less stress

BJM, ultra thin wall

The 22ga UTW made a huge difference for Shadoe, like nite and day. She does not mind at all and may start to squirm around 75-100ml, but before, she looked uncomfortable with the 18ga and spent the entire sitting, waiting for a chance to slink away.

Oliver's skin is thick like a tire and even I cringed when piercing his skin with the 18ga.
The 22ga goes in smooth like butter. Even 20ga are better than the 18s, but say you want the 22ga UTW.
if you need to give alot of fluids every day, why not make it the least unpleasant experience.

 

Re: Any tips on givkng sub-q fluids with less stress

arggg big post and lost it..
Ok, well I agree with above stuff. The needles that are thinner walled are Terumos and they rock. Most vets have the monojects. I used 20g with Merlyn.
http://www.bricomedicalsupplies.com/CRFpage.html

http://weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

http://www.felinecrf.org/giving_sub-qs_giving_set.htm

What I used to do for Merlyn in the beginning was put a pillow down in the kitchen, and lure him there with a halo livalittle chicken treat. He would get one before, one (or 2) during, and one when we were done. I think it was the 3rd or 4th day, I put the pillow down in the kitchen, was looking all over for him and thought he was hiding..so I went looking for him and he was already sitting on the pillow waiting for me!

After a while I didnt need the pillow routine, i just went to wherever he was and did it. What helped with that (he hated being picked up) was getting an IV stand. I got it from a company that appears to be out of business but Brico does sell one too.

 

Re: Any tips on givkng sub-q fluids with less stress

Just a tip on squeezing the bag. Use a blood pressure cuff. One of the automatic ones for home use would probably work just fine. Just hit start and it will put pressure on the bag.

I noticed the vet tech was using something similar when she gave my Ivan 150 cc a couple of weeks ago. We suspected heat related problem (heat stroke, maybe).

Good luck,

Claudia

 

Re: Any tips on givkng sub-q fluids with less stress

The higher you hang the bag above the cat, the faster the fluids will flow.

I'm not a fan of squeezing....occupies too many hands.

 

Hard to read everything from my phone but I wanted to thank everyone for the responses and tips. Part if the issue is that he's so miserable that he's curling into a position that doesn't allow a comfortable area for me to insert the needle. Another part is the huge needle that makes me feel like I'm practicing for a side job as a body piercer, and lastly, he is now fighting it and trying to escape. I'm guessing once he's feeling a little better he'll settle back down some, but right now its unpleasant.

I'll read and respond more thoroughly when I'm home on the computer.

 

Fluids went okay tonight. Got about 100 in him, maybe a little more. I also found a better spot for giving fluids where I can hang the bag better and still reach it and him. For those who asked, it's Normosol-R. Also, he has eaten. He ate about a can and a half today (some with encouragement, but some completely on his own).

 

I also recommend the Terumo ultra thin walled needles. Venture tolerates them much better. You can check the felinecrf site for sources, but I've been very happy with bricomedicalsupplies.com -- great customer support. Also got my IV stand there and having that has made his sub-q's sooo much easier.

laur

 

Hoping that someone with experience with normasol sees this, because I am not familiar with it, or if it feels odd for kitties. It is really good that you were able to get 100 cc in him today. That's progress! Also great news that he's eating a decent amount. He should look like he feels better after a couple days of eating okay and getting fluids. With my Bob, he was doing great about 3 days into the fluid therapy, and that's when his appetite came back too. Good news!

Carl in SC

 

See this old post on Normasol-R.
http://www.felinediabetes.com/phorum5/r ... ?8,1230670

 

Thanks for the link Larry. Normosol is the only kind of fluids he's ever received at home, but never reacted this way before. Maybe he's just more miserable/sick this time and now it is messing with his tummy more? Not sure. He did much better with fluids tonight. I got all that I had intended to into him and he purred part of the time. I can tell he's really feeling bad though and as soon as we were done, I place him in front of his dish and he took a few bites and then went back into hiding.