TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 

        

 

 
 

HOW TO GIVE SUBCUTANEOUS FLUIDS USING A GIVING SET

 

ON THIS PAGE:


When Not to Give Subcutaneous Fluids


What You Need


How to Give Subcutaneous Fluids with a Giving Set


Links and Videos


 

Join

Tanya's CKD Support Group Today

 

HOME


Site Overview


What You Need to Know First


Alphabetical Index


Glossary


Research Participation Opportunities


 

WHAT IS CKD?


What Happens in CKD?


Causes of CKD


Early Detection


How Bad is It?


Is There Any Hope?


Acute Renal Failure


 

KEY ISSUES


Nausea, Vomiting, Appetite Loss and Excess Stomach Acid


Maintaining Hydration


The Importance of Phosphorus Control


All About Hypertension


All About Anaemia


All About Constipation


Potassium Imbalances


Metabolic Acidosis


Kidney Stones


 

SUPPORT


Coping with CKD


Tanya's Support Group


Success Stories


 

SYMPTOMS


Alphabetical List of Symptoms and Treatments


Fluid and Urinary  Imbalances (Dehydration, Overhydration and Urinary Issues)


Waste Product Regulation Imbalances (Vomiting, Appetite Loss, Excess Stomach Acid, Gastro-intestinal Problems, Mouth Ulcers Etc.)


Phosphorus and Calcium Imbalances


Miscellaneous Symptoms (Pain, Hiding Etc.)


 

DIAGNOSIS: WHAT DO ALL THE TEST RESULTS MEAN?


Blood Chemistry: Kidney Function, Potassium, Other Tests (ALT, Amylase, (Cholesterol, Etc.)


Complete Blood Count (CBC): Red and White Blood Cells: Anaemia and Infection


Urinalysis (Urine Tests)


Other Tests: Ultrasound, Biopsy, X-rays etc.


Renomegaly (Enlarged Kidneys)


Which Tests to Have and Frequency of Testing


Factors that Affect Test Results


Normal Ranges


International and US Measuring Systems


 

TREATMENTS


Which Treatments are Essential


Finding a Good Vet and Record Keeping


Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence, Proteinuria)


Waste Product Regulation (Mouth Ulcers, GI Bleeding, Antioxidants, Adsorbents, Azodyl, Astro's CRF Oil)


Phosphorus, Calcium and PTH (Calcitriol)


Miscellaneous Treatments: Stem Cell Transplants, ACE Inhibitors - Fortekor, Steroids, Kidney Transplants)


Antibiotics and Painkillers


Holistic Treatments (Including Slippery Elm Bark)


ESAs (Aranesp, Epogen etc.) for Severe Anaemia


General Health Issues in a CKD Cat: Fleas, Arthritis, Dementia, Vaccinations


Tips on Medicating Your Cat


Obtaining Supplies Cheaply in the UK, USA and Canada


Working with Your Vet


 

DIET & NUTRITION


Nutritional Requirements of CKD Cats


The B Vitamins (Including Methylcobalamin)


What to Feed (and What to Avoid)


Persuading Your Cat to Eat


Food Data Tables


USA Canned Food Data


USA Dry Food Data


USA Cat Food Manufacturers


UK Canned Food Data


UK Dry Food Data


UK Cat Food Manufacturers


2007 Food Recall USA


 

FLUID THERAPY


Intravenous Fluids


Subcutaneous Fluids


Tips on Giving Subcutaneous Fluids


How to Give Subcutaneous Fluids with a Giving Set


How to Give Subcutaneous Fluids with a Syringe


Subcutaneous Fluids - Winning Your Vet's Support


Dialysis


 

RELATED DISEASES


Heart Problems


Hyperthyroidism


Diabetes


Polycystic Kidney Disease (PKD)


Pancreatitis


Dental Problems


Anaesthesia


 

OBTAINING SUPPLIES CHEAPLY


UK


USA


Canada


 

SAYING GOODBYE


Saying Goodbye


The Final Hours


Coping with Your Loss


Other People's Losses


 

MISCELLANEOUS


Prevention


Research


Canine Renal Failure


Other Illnesses (Cancer, Liver) and Behavioural Problems


Diese Webseite auf Deutsch


 

SITEOWNER (HELEN)


My Three CKD Cats: Tanya, Thomas and Ollie


My Multi Ailment Cat, Harpsie


Find Me on Facebook


Follow Me on Twitter


Contact Me


Home > Fluid Therapy > How to Give Subcutaneous Fluids Using a Giving Set

 


Overview


  • This page shows how to give subcutaneous fluids using a giving set (also known as an IV administration set or a venoset).

  • Please be sure to read the Tips on Giving Subcutaneous Fluids page as well, to help you prepare so that the process is as simple as possible for both you and your cat.

  • If you are in the UK, you will probably be offered the syringe method instead. Please visit the How to Give Subcutaneous Fluids: Syringe Method page for more information.


When Not to Give Subcutaneous Fluids


Sub-Qs are not always appropriate and in fact in certain circumstances can do more harm than good. Do NOT give Subcutaneous fluids to your cat if:

  1. Your cat is so severely dehydrated that your vet considers intravenous fluid therapy (IV) more appropriate. In certain circumstances IV is the only correct treatment. If your cat has high bloodwork levels (creatinine over 7), s/he might benefit more from IV fluids initially, with sub-Qs provided once s/he returns home as needed.

  1. Your cat has a heart condition. Fluid therapy may still be possible but your vet must decide if it is appropriate for your cat, and determine the amounts and frequencies to be administered.

  1. Your vet has refused to agree to the procedure on other medical grounds.

  1. fluids from the previous session have not yet been absorbed.

  1. your cat is over-hydrated. This may be obvious, or your cat may feel "squishy", the way water in a plastic bag feels. Squishiness sometimes happens if a little air gets in with the fluids, and is not normally a problem, but if it happens consistently, your cat may need less fluid. Other symptoms of overhydration may include sudden weight gain, coughing and nasal discharge. See Symptoms for more information. Overhydration may be associated with a heart condition, but contrary to what some vets claim it can still happen in a cat with a perfectly normal heart. It is a good idea to weigh your cat regularly, to check for sudden or continuous weight gain which may give early warning of a problem.

  1. Processing the extra fluids in itself places an additional workload on the kidneys which can make the CKD progress faster; plus it can flush out certain nutrients, and giving fluids when they are not needed may increase blood pressure; so it is best not to begin fluids until the advantages are likely to outweigh the disadvantages. Dr Katherine James of the Veterinary Information Network believes that most CKD cats will benefit from subcutaneous therapy once creatinine levels are consistently over 3.5-4.0 mg/dl (USA) or 300 -350 µmol/l (international). If your vet thinks your cat's CKD is less advanced than this, then it is probably safer to hold off on sub-Qs for the moment.

  1. My vet agreed to us doing fluids in part because she felt Thomas would not find them too distressing. You and your vet do need to take your cat's personality into account in deciding whether to go this route; but do not necessarily assume your cat cannot cope, many cats who ordinarily hate medication of any kind tolerate sub-Qs because they make them feel so much better. I would suggest trying them for a few weeks at least.

  1. Many cats appear happier (more active and alert, with a better appetite) after sub-Qs. However, some may become lethargic for an hour or so afterwards. This is probably nothing to worry about, but if it happens frequently it may be that your cat is not processing the fluid very well, so I would ask your vet to check your cat for possible heart problems or fluid retention.


What You Need


 

Essential Supplies


These are the items you need:

  • Fluid bags

  • Most people use a type of fluid called lactated ringers solution (LRS) but sometimes other types of fluid are appropriate. See below for more on this.

  • Needles

  • You have to insert the needle into your cat to allow the fluids to flow into him or her. Ideally you want Terumo ultra thin wall needles.

  • Fluid administration set (giving set or venoset)

  • This enables you to attach the bag of fluid to the needle. The fluid flows from the bag through the administration set and into the needle and then into your cat.

Optional Supplies


These are optional but many people find them helpful:

  • IV pole

  • Some people find these helpful to speed up the process.

  • Scales

  • These can be helpful to measure how much fluid you are giving (100g = 100ml, about 4.5 oz).

  • Burette or buretrol

  • These items are used by some people to measure accurately how much fluid they are giving.

  • Calming or restraint method

  • Some cats do better when these are used. See below for options.

  • Baby food or other treats

  • Some people use these to distract their cats during fluids, others use them as a reward afterwards.


The Giving Set Method


 

This method, whereby the fluids drip out of a bag rather like into human patients on an IV drip, is the most comon way of giving sub-Qs in the USA and Canada. It has the advantage of being easier for one person to do alone, though may take longer than the Syringe Method. It can also be harder to tell how much fluid you are giving, though Tips on Giving Subcutaneous Fluids has some tips on how to do this.

 

Thomas's friend, Purr Box, who was diagnosed two months before Thomas, and who was also a gorgeous black cat, models receiving fluids via a giving set below. These photos were taken four years after her diagnosis: Purr Box's inspiring story can be found in the Success Stories section.

 

As you can see, Purr Box is not at all distressed. Some CKD cats like the fluids so much that they come and remind their humans if they are a little late giving them!

 

Please also read the Tips on Giving Subcutaneous Fluids page.

 

Left to right: the equipment you require is a Terumo needle, a venoset and Lactated Ringers Solution.

 

 

 

 

 

The first thing you will need to do is to insert the venoset into the bag of fluid. Before you begin to do this, close the wheel valve on the venoset as this prevents air from escaping from the bag. If air escapes, the bag will have a collapsed appearance and the fluid level will be difficult to read.

 

 

 

 

Remove the cap from the venoset spike.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Remove the cap from the bag of Lactated Ringers. Some brands will have a white tab that pulls off instead of the pictured clear plastic cap.

 

 

 

 

 

 

 

 

 

 

 

 

 

Force the venoset spike into the receptacle in the bag. This can require a considerable amount of force coupled with back and forth twisting.

 

 

 

 

 

 

 

Place the bag in a hanging position and then squeeze and release the drip chamber until the drip chamber is about half full. If it becomes too full, turn the bag upside down and squeeze the bulb in order to push some of the fluids back into the bag.

 

 

 

Remove the cap from the needle end of the venoset. Note that some brands have a Luer lock – a threaded collar that holds the needle onto the end of the line. If you are using a brand with a Luer lock, unscrew the protective cap, push the needle onto the Venoset and then thread the Luer lock onto the needle. If you do not like using a Luer lock it can be taped out of the way.

 

 

 

 

 

 

 

 

Push the needle securely onto the venoset. If you use a Luer lock, thread it onto the needle.

 

 

 

 

 

Here you can see the needle affixed with the Luer lock.

 

 

 

 

 

 

 

 

 

 

 

 

 

There is no need to apply alcohol to the cat's skin first. Critical Care DVM says "It is not necessary to “sterilize” the skin with alcohol prior to inserting the needle. In reality, wiping a little alcohol on the skin does not sterilize it, and the odor and feel of alcohol may aggravate your pet."

 

Pinch some of your cat's skin to form a tent or pouch. Hold the needle so the bottom end is the longer end - the needle looked at sideways will look like this:  ___\ or this:  l___. Holding the needle parallel to your cat's back, insert the needle smoothly into the tent you have formed. 

 

 It can be helpful not only to move the needle towards the tent, but also to raise the skin slightly to meet the needle. Ensure you have not pushed the needle through the other end of the tent - the fluid will leak if so. 

 

Once you are sure the needle has been inserted correctly, open the crimp wheel to start the flow.

 

Your cat may flinch slightly when the fluids first start going in - this may be because the fluids are too warm or too cold for the cat's liking, or the sensation can be a little bit of a shock at first. Treats are often well received when the fluids are running. In Purr Box's case, baby food makes for a happy cat.

 

When you have finished, remove the needle and pinch or massage the injection area for a minute or so - this will minimise the possibility of fluids leaking. Occasionally you will see a little blood when you withdraw the needle - this just means that you have nicked a small blood vessel and is usually nothing to worry about.

 

Put the sub-Q fluid back in your storage area until the next session. Put the lids back on the needles and do not use them again - you must be careful about disposing of needles, which are clinical waste, so the safest thing is to keep them somewhere safe away from children and your pets and ask your vet to dispose of them permanently for you.  

 

Please visit the Tips on Giving Subcutaneous Fluids page for more tips on how to give fluids and possible concerns that might arise during the process.

 


Additional Information and Videos


 

Here is a video from Dr J C Burcham showing how to give subcutaneous fluids. Video courtesy of DVM360.

 

 

 

You can find additional information, including some helpful pictures of the various methods of giving fluids, at the following sites: 

 

Sophia gets her subcutaneous fluids is very detailed, and is the most popular website about giving fluids on Tanya's CKD Support Group.

Mar Vista Vet has two videos about giving fluids:

Dr Mike Ontiveros has a video which shows how to prepare a venoset for sub-Q fluids.

Cornell University College of Veterinary Medicine has a helpful video on how to give sub-Qs, including how to cope with it. However, I would ignore the advice to use fluids at room temperature, most cats prefer warmed fluids.

Veterinary Partner also has photographs of using a giving set.

 

Back to Page Index

This page last updated: 23 July 2016

Links on this page last checked: 23 July 2016

Photos of Purr Box Copyright Rad H 2003, and used with grateful thanks.

   

*****

 

TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE EXTREMELY DANGEROUS.

 

I have tried very hard to ensure that the information provided in this website is accurate, but I am NOT a vet, just an ordinary person who has lived through CKD with three cats. This website is for educational purposes only, and is not intended to be used to diagnose or treat any cat. Before trying any of the treatments described herein, you MUST consult a qualified veterinarian and obtain professional advice on the correct regimen for your cat and his or her particular requirements; and you should only use any treatments described here with the full knowledge and approval of your vet. No responsibility can be accepted.

 

If your cat appears to be in pain or distress, do not waste time on the internet, contact your vet immediately.

 

*****

Copyright © Tanya's Feline CKD Website 2000-2016. All rights reserved.

 

This site was created using Microsoft software, and therefore it is best viewed in Internet Explorer. I know it doesn't always display too well in other browsers, but I'm not an IT expert so I'm afraid I don't know how to change that. I would love it to display perfectly everywhere, but my focus is on making the information available. When I get time, I'll try to improve how it displays in other browsers.

 

You may print out one copy of each section of this site for your own information and/or one copy to give to your vet, but this site may not otherwise be reproduced or reprinted, on the internet or elsewhere, without the permission of the site owner, who can be contacted via the Contact Me page.

 

This site is a labour of love, from which I do not make a penny. Please do not steal from me by taking credit for my work.

If you wish to link to this site, please feel free to do so. Please make it clear that this is a link and not your own work. I would appreciate being informed of your link.