Management of CRF

Subcutaneous Fluid Therapy

Giving Sub-Q Fluids to Casey
by Sandy and Peyton Carr

Set-up

The supplies that are usually needed for giving subcutaneous (sub-Q) fluids are a bag of Lactated Ringer's solution, a venoset, and a needle. These items can be purchased in bulk for substantial savings from Costco and other discount or online pharmacies (a prescription from your vet is generally required.) An 18 gauge, one inch needle seems to work well, providing a good flow and little discomfort to the patient. It is important to use a new needle each time fluids are given.

Remove the venoset and fluid bag from the packaging. Lock the venoset by rolling the wheel valve. This will prevent the fluid from flowing while you assemble the parts.

Remove the tab from the top of the fluid bag and insert the venoset, pushing it in firmly,as far as it will go.

Warm the fluids by putting the bag in a container of warm tap water. Since room temperature (at around 72 degrees Fahrenheit) is 30 degrees colder than a cat's normal body temperature, warmed fluids will feel much better to the patient.

When the fluids are lukewarm, hang the bag as high as you can. In this illustration, a hook has been installed on the inside of an upper kitchen cabinet door. A clothes hanger also works well and can be used anywhere. Pinch the reservoir to fill it approximately half-full.

Remove the protective cap and twist the plastic fastening nut so that it is loose. Put the needle on the end of the venoset and lock it in place by twisting the fastening nut onto the needle base. Remove the needle cap with a gentle twisting motion. Open the wheel valve and run the fluid through to get rid of the air in the tubing(some bubbles are okay.) Move the valve up or down to verify that the tubing is not restricting the flow where the closed valve was pinching it. Test the temperature by running some of the liquid on your wrist, similar to testing a baby's bottle.

Administering the Fluids

Place the patient in a comfortable position. Casey is very relaxed and cozy on the kitchen counter in his favorite cat bed. The more relaxed and confident you are, the more at ease the patient will be. Though it helps to have a second person to assist, this entire procedure can be done alone. Inserting the needle is the most stressful part of the process. To get the feel for "the stick", it may help to practice first on a fresh turkey or chicken from the supermarket.

To insert the needle, pull the skin up on the patient's back around the shoulder blades or just below. Your vet will show you the areas where it is best to insert the needle so that you can vary the site each time. Make a "tent" of the skin and, with the needle parallel to the patient's body, insert it open (hole) side up with a quick, smooth motion into the tent along the long axis of the fold.

A quick stick is less painful than a slow push but be careful not to do it so fast that you lose control or insert it too far.

Once the needle is in place, release the skin tent and open the roller valve on the venoset line. The fluids should begin to flow. If the drip seems slow, rotate the needle slightly while it is still inserted or gently tent the skin. This will sometimes improve the flow rate. You will begin to see a pouch forming as the fluids accumulate under the skin.

Eventually this process will become routine for both you and your cat. It should take just a few minutes to inject 150cc. Once the required amount of fluids has been administered, close the roller valve, remove the needle from the patient and twist the skin slightly to help seal the needle hole and prevent leaking. Occasionally you may see a tiny amount of blood or pinkish fluids leaking from the needle site. This is normal unless the bleeding does not stop quickly or seems excessive. Recap the old needle, replace it with a new one and refrigerate the fluid bag, leaving the venoset attached. The next time fluids are given, warm the bag and run out the cooler liquid in the tubing before inserting the needle into the patient.

The Feline CRF Information Center assumes no liability for injury to you or your cat incurred by following these descriptions or procedures.