Subq fluids tips and tricks?

I really thought this would be easier to start doing, but it's not.

Toasty was the perfect patient at the vet's office earlier today. He sat as still as a statue while I gave him fluids under supervision by the vet tech. But then tonight at home it was a different story - he growled at me, jerked away, hissed, and after the third attempt, the needle came out and started spewing all over the counter.

Other than the standard Google directions, does anyone have any tips or tricks for giving subq fluids at home? I'll give it another go in the morning, but I'd like to not waste all of the needles that I brought home.

 

@Marje and Gracie made a video:
http://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.144366/

 

That's a great video, however it's nothing new from what I was told when at the vet's office. That's exactly how it went while we were there.

At home, however, as soon as I poked him with the needle, that's when he started growling and jerking (turning) around. I'll enlist some help for the next attempt.

 

This page is kind of long, but stick with it because Tanya's site is the best for CKD, of which giving fluids is an integral part: https://www.felinecrf.org/subcutaneous_fluids_tips.htm

I've given fluids regularly to 4 cats over the years. The 3 best just sit there like little angels. The 4th one was like Toasty. I had to burrito her in a towel, I sat on the floor with my back against the wall, and my legs stretched out straight with her nestled between them with light pressure. I think it also helped that I was in our smallest bathroom with the door shut. Much like giving insulin, it helps to acclimate -- go to that room, burrito him or whatever method you choose, give lots of praise, maybe some treats, and just let him go. Practice that a few times a day.

It sounds like you actually got the needle in, if that is when the kerfuffle started, had you warmed the fluids? That made a huge difference for the cat of ours that was like Toasty (the other 3 didn't care, so I just used room temp fluids for them).

If you got needles from the vet, then I am guessing that they gave you the 16 (or maybe 18) gauge harpoon needles. It's a delicate balance...the larger the needles, the faster the fluids flow and the quicker it is over with, and they probably gave you big ones. That might be the best for now because he isn't handling it well. BUT if Toasty is reacting at the time that the needle was inserted, then a smaller gauge needle (which actually has a BIGGER number, like 20 gauge), might help, but then the fluids go in slower and it takes longer.

Moral of the story, it might depend a little on when you think the problem starts. If Toasty just doesn't even like being restrained and/or still, then that is a different problem.

I'm sorry that I haven't followed Toasty's journey thus far, so I don't know if fluids are a short term or long term thing. If long term, then I assume it is for kidney disease, in which case I seriously do recommend that you spend time on Tanya's site. I think that Tanya's site is to kidney disease as FDMB is to feline diabetes. There are a lot of money saving tips there if you are doing this long term, or I can help with where I source everything as well. I can get an entire case of fluids (12 bags) for less than it cost me to get one "fluid therapy" kit (1 bag of fluids+10 needles+1 line set) from the vet. I do still need to buy needles and line sets in addition, but I can buy those cheap as well. I literally couldn't afford to keep our oldest girl on fluids regularly if I had to buy everything at the vet. I love our vet, but they know that I have to save money on supplies like this, specifically so that I can save our money for their actual veterinary services.

 

I did warm the bag just a bit. The first two tries, I didn't even get the flow started. He growled and turned which startled me. On the third try, yes, the needle got in but as soon as I started the flow, he growled again, jerked his head to look at me and then fluid went spewing all over the kitchen counter. I believe the needles are 20 gauge and I used a new needle for each attempt.

Toasty was diagnosed with diabetes about a year and a half ago, was on insulin for a month, but went OTJ because of diet change. I adopted him shortly after that and have been feeding him Fancy Feast for the past year. He recently stopped eating all of his food and lost a little weight. He was diagnosed with CKD via bloodwork just this week. His blood glucose was at 107, so my vet wants me to put my efforts towards fluids and a low phos diet.

I will get my husband to help hold Toasty for fluids in the morning. I was so confident and sure after success at the vets office that I could do it myself.

 

Yes, getting another set of hands should definitely help.

Another thought is based on the fact that kitties often do well at the vet's office because they are scared. Well, most of our kitties once they are in the kitty carrier, so IF you have the kind of carrier that opens on the top, you could put Pumpkin in the carrier and give him the fluids in there. [Another admittedly weird idea that I have had, but not actually had to resort to yet, would be to take kitty out to either the garage or even in your parked car -- somewhere they are still safely contained, but out of their element enough to be still.]

Let us know how it goes tomorrow, fingers and paws crossed for you!

 

I like this idea!!

 

Did your vet give your kitty a clean cardiac bill of health? Fluids can be problematic if there's anything cardiac going on. If the vet didn't get a pro-BNP (it's a blood test), you might want to ask about it.

 

That specific test was not done.

How are fluids kept up for kitties with heart issues?

Toasty is dehydrated and he needs the extra water intake to help flush his kidneys. He also hasn't been eating and is losing weight. The vet has now twice given him 100ml subq and when we get home, Toasty seems to be more interested in eating.

I am now very anxious about giving fluids at home and being that today is a holiday, he may not get any till Friday or Saturday, that is, if the vet can fit me in.

 

I had an older cat who had been diabetic for some time. There were other indications -- high blood pressure among them. Fluids are tricky with kidney and heart issues. I'm guessing your vet didn't think there was anything cardiac but it doesn't hurt to ask.

Also, be aware that fluids can drop the blood glucose level so it's important to get tests so you know how Toasty's numbers are responding in light of the fluids.

 

Well, he ate a bit of food, and drank a bunch of water from a fountain I just set up for him.

Then he threw it all up. ALL OF IT. It was a lot and it was a mess.

Not sure if I should continue to mess with him and try to get blood glucose readings and give him fluids or let him be for a while.

I have 2 hours and then I'll be gone the rest of the day for Thanksgiving. Also running on 2 hours of sleep and have been crying all morning... so...

 

Husband to the rescuse. Phew...

Toasty actually did better of the floor than up on the counter. Husband held him between his legs, with Toasty's butt in his crotch, hands by his head/neck givving gentle pets.

Toasty growled and wiggled the whole time, but we managed 50ml. Tried to give pets and treats after, though Toasty didn't want them. Hopefully he feels a bit better and eats some more.

 

The bathroom worked for me with a tricky cat. I would hang the bag on a shower curtain hook, with the on/off switch close to the floor. Then I would sit crosslegged on the floor with the cat facing outwards, directly into the corner where the tub met the wall.
It will get easier.

 

How much fluids are you giving?

Some cats are ok when you insert the needle but get very desperate of the time it takes to go through, you could also try giving the subqs using a syringe and an infusion set or an extension, I prefer the winged infusion set from terumo because the needle is smaller (3/4"), is gauge 21 which makes it thinner also but since you are using the syringe it passes the fluids very very quickly it takes two minutes and your are over

 

The dr suggested about 50ml 2x a day. They gave him 100ml at the office, so I am considering doing that once a day if it's difficult to do it twice.

We'll see how it goes the next few days and if it's still difficult, we'll see what the dr says about using a syringe instead.

 

How much does he weights ?

 

He is 9.8 lbs.

 

I have heard the EZ Iv harness is a good one. I haven't had to do that yet. I put don a heat reflective pad, in front of a hot air vent, with freeze dried chicken sprinkles on it. That has kept kitties in place when first trying fluids. Also did it in a bathroom with door closed, so she didn’t try escaping.

As for fluids and heart kitties, depends on the heart condition, but generally you don’t if there is risk of failure. You supplement food with water, and if lucky find a balance of a tiny bit of fluids. The amount of fluids Neko’s heart could take was zero. When she had just HCM, she was fine with fluids, then the heart condition progressed.

 

Your emotional state when giving fluids is just as important as your cat's emotional state at the time. If you're upset, it's going to upset him, so no, don't try fluids when you're in that state. If he needs them right away, it sounds from a later post like Hubby did well, so have Hubby do the fluids

As another poster did, I used the bathroom. I have hooks on the walls, so it was easy to put the fluid bag on a clothes hanger and put that on the hook or on the shower curtain rod. I put it where I can see it from the floor of the bathroom with a towel for me and kitty to sit on. Bathroom door is closed so kitty has nowhere to go, we're comfy on towel on floor, I pet and speak soothingly to kitty, make the skin tent, make the stick, and start the fluids. I also find the type of lines that have both the wheel and the pinch thing are better, the pinch thing is much easier for me, especially if kitty isn't into fluids - it's a small piece of plastic that pinches the line closed at the flick of a finger/thumb. I continue to pet the cat with one hand, and hold the other hand on their back and the line so it doesn't go anywhere. Some people have treats out the cat can eat while getting fluids, mine never wanted those, but chin/ear scritches to distract them helped. Terumo needles seem to be nice and sharp, so go in easily. It does take time and practice to find what will work for you and your cat. At the vet's office, they usually are good since they are scared. At home, you want to make it as uneventful/pleasant as possible for kitty and yourself so that both of you can be calm and just get it done.