Wednesday, October 10, 2012

Giving Subcutaneous Fluids to Cat

Some of us have no human kids and think of our cats as 'real kids'. Ours are interactive and dog like, aside from the fact all but one hides from company! Some folks seem to own pets as an after thought and think of cats as dust mops with an attitude. I think it is all in how the cats are raised and treated.  Thus our cats are very sweet and interactive.

Smudge was diagnosed with multiple myeloma several months ago when blood tests showed very high globulin levels.  It does a plethora of  bad things to cats, even causing random intermittent blindness whic his sad to witness when it spontaneously hits. When this happens, her pupils dilate and she bumps into things but adapts, then it gets better.  Multiple myeloma is in the bone marrow and without expensive stressful tests, we have no idea how it is spreading.  It is affecting her kidneys for sure, in her eyes--thus the random blood pooling to cause blindness or fuzzy vision, then improves, and she is anemic ,showing that is is intensifying.

One thing you can do to greatly add quality to a cat's life is to give SubQs (short for subcutaneous fluids, subcutaneous meaning right below the skin, not in a vein!) every 3 days or as things progress, every day.  I now do fluids everyday. Many cats that have CRF (Chronic renal failure) are given SubQ fluids for years to control those issues.  It can start off stressful but after awhile the cats seem to get that this helps them. It's all in the owners attitude, too, to make this a bonding experience.

Wash the sink first, then put bag and tubes in there and keep adding warm water to keep temp at 100 degrees. For a full bag it takes 30 minutes to warm, then a half bag maybe 15-20 minutes.
Here, the bag is on cabinet door open or I keep it closed so I can read the numbers.
I stop the fluids from the bag. Then administer the B12 through the extra port,  turn the roller back on to continue the Lactate ringer. If cat is antsy, you might need another person to help but they must be calm. I've graduated to doing it all alone, thank goodness.
Smudge was never a fan of mine and is a real Daddy's girl. She was dropped off outside my apartment hallway door 15 yrs ago and I talked a neighbor, and now great friend, Christopher into adopting her. She has learned to trust me for this but is still a Daddy's girl.

When we first gave fluids, we tagged teamed her to hunt her down and put her on a bare kitchen table to give the Lactate Ringer.  She was not thrilled. One day, while he was gone for lunch, I put her in a clothes basket with a pillow and T-shirt that I'd heated in the dryer, for 5 minutes.  I also always warm up the IV Bag of fluids.  The vets do not do this---they don't have time I guess-- but it makes the cat more comfortable and Smudge even purrs during the process. So always warm the fluids. **NEVER WARM in a microwave! You can use a hot water bag or heating pad but that takes longer to warm things.

Smudge now hangs out in the basket, meowing when she wants food, to be brushed, hand watered, or cat treats! She has always been a Diva and still is. Remember, she loves hand watering! She will run to the loveseat (which means brush me NOW!) or to a gold chair which means "feed me treats NOW."

Cats body temperature is around 101, so I warm the fluids in the sink with a thermometer for 30 minutes, if the bag is new or nearly full. As it gets lower in fluids ,you can sometimes get buy with 15 minutes of warming.  REMEMBER to add hot water as the time goes by. I use a candy thermometer since I can't make candy or you can just add hot water  to the skin to keep the bag warm. Check some fluid on your wrist before you give the fluids to the cat.  It should feel comfortably warm but not hot. Also, let it run for about 10 seconds so you get the skinny tube line empty and can FEEL the warmth of the main IV bag on your wrist. Sometimes the fluids start warm then cool off. Warm the bag longer if possible.

There are many blogs/videos more detailed than this one on administering SubQ fluids to a cat , but I am just sharing my experience.  You have to make it relaxing for the cat and be relaxed yourself but trust me, the first few times you stick a cat is scary!! The veterinarian's office will show you how to do this the first time, or you can pay them a lot of money to do it for you if you are really too scared. You pinch up a scruff of the skin before poking. There are many photos and videos of this if you are needing to do this. Take a walk first or burn some incense or have a glass of wine to calm your nerves before doing this. And have good light and your glasses on to see.

The needles the vet gives you are harpoons, 18 gauge Monoject. I ordered online a box of 100 Terumo 20 gauged needles, UTW (Ultra Thin Walled) with a sharper point. The higher the number the smaller the needle. 20 gauge UTW works without adding much to flow time.  It takes about 5 minutes to get 150 ml if the drip is fast.  Depending on where the needle is, it may flow faster.  Keep an eye on the bag or mark it  with a felt marker where you need to stop. If you have a cat that refuses to stay still, you may have to choose larger needle to get fluids in faster,  but I didn't notice much diff in 20 gauge or the 18 from the vet's office but your mileage may vary.

* Order here, as they have great customer service. Needles are about $6.00  for box of a 100 and shipping about $5.00. Worth it for your cat baby!     Also read the reviews.

**Practice using needles on a lime or orange to get use to the feel. There will be slight resistance on the skin then it's super easy to put the needle in too far.  Thus with 100 needles, you have plenty to practice with. I found a piece of cut lime gave me a more realistic way than to practice on huge orange. But practice, practice, practice, ok?

 If you need to restick the cat, use a second needle.   The first few times, if the cat is fighting, you can just restick with the same needle due to time/anxious cat purposes, but it will dull the needle but you have to be practical.   Sometimes the fluids leak on the cat because the needle pokes through the skin and it's difficult to see in the fur until you see water running down the cat.  Try to just pull the needle backwards a tiny bit to fix this,  but sometimes you need to start over. I keep extra needles nearby and also change the needle right after you are finished so it's ready to go the next time.  This keeps any bacteria from working it's way into the tube line. We re-use the same tubing with 3 bags of the Lactated Ringer. A bag is $15. The complete tube set is $37.00!  We give between 100 to 150ml each day. Oh, and it goes without saying to wash your hands before starting any of this!

Lactated Ringer helps greatly with dehydration and constipation issues. The latter can be very serious with a cat so keep an eye on the litter box! Smudge got lethargic, stopped eating, stopped grooming and we thought we were doing to lose her. It was a constipation issue easily discoverd by our great vet (Dr.  Steven Sawdai)  on a physical exam.  He gave her a small syrine enema and it helped. Cats may vomit once or twice after an enema and this is normal.) SubQs can also help the heart and kidneys to work better, help with energy and appetite which is wonderful. I give a 1/2 cc of B12 once a week to help with energy/appetite and anemia issues Smudge has from the multiple myeloma.

We should get a video of this and may do so and add to this post. By the way, I have on tank top, turtleneck and huge, bulky sweatshirt because our house is 67. I have on a trendy top, the off white thingie, under my sweatshirt so that when I sit in these skinny, low cut jeans, I do not accidentally show extra skin. Same when bending over.

**If doing this SubQ administering alone, put the cat in a small room on a folded towel or blanke like a bath room or walk in closet. That way the cat can't run from you too far.

You also MUST have the IV Bag hanging at least 3 feet higher than the cat. This works with gravity and so the higher the bag, the faster the flow.  A kitchen cabinet is good or a shower rod or a coat rack.


maureen said...

great post for people who might experience this with their fur babies.

smudge is beyond blessed to have both you and c as guardian angels in her life. despite her diagnosis, she seems so peaceful and content in the pictures.

her gratitude for your kindness isn't going unnoticed or unappreciated.

you can tell she loves you dearly.

praying for complete healing for smudge, and for peace for you and c during this difficult time.


Sophia said...


Thank you so much for your kind words. As I said in the post, this has become a real bonding experience for a cat who never really liked me except when she wanted to be brushed while EATING (Another Diva tactic!)

Now, she actually sometimes purrs during her infusion.


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JoanneB said...

Thank you for sharing how you administered SQ fluids to your furry friend. Feeling discouraged tonight as my furry friend 'Samantha' fought and succeeded in not letting me give her fluids tonight. So I gave up :( .. think I will try your method with the clothes basket and warming the fluid a bit more. My kitty reacted every time I tried to put the needle in .. like I was hurting her more or something ... she'd jerk & the needle jabbed her a few times... this is stressful.

Sophia said...

It IS STRESSFUL the first few times. Did your vet have you do this in the office yourself? and yes the cats will not like it first and sometimes I did stick Smudge a bit...when you are doing it daily you have to make sure not to do the same spot....but be nice to may stick for a few seconds but the cat will learn eventually, they feel better afterwards.

I do know warming up the fluids helps a lot (I think I mentioned that can take 30 minutes or more w new bag) and I test a drop on my wrist. and the warm pillows and blankets...and under a warm light if possible.

You are learning to do a great you get confidence you will relax and so will your cat . . I hope. Best to you.