TIPS ON GIVING CATS SUBCUTANEOUS FLUIDS
Laurie 2023
We’re all terrified the first time we attempt to give sub-q fluids, but they can make our cats with just about any health issue feel better. When there is vomiting or diarrhea (as in pancreatitis or IBD), both of which contribute to dehydration, sub-q fluids can create an enormous difference in how they feel: dehydration makes any illness worse! Finally, sub-q fluids can be critical for cats with CKD or constipation. Sub-q fluids are under-used in chronic constipation, where “hyper-saturation” helps prevent the drying of stool that isn’t moving properly through kitty.
Of course, how much fluid and how often fluids should be given should be determined by your vet. In cats with high blood pressure and/or heart disease, make sure you discuss the appropriate use of fluids with your vet, as fluids are contra-indicated.
If your vet agrees your kitty would benefit from sub-q fluids, anyone that’s given them understands the fear factor. The biggest misstep by most is rushing into it. We get it into our heads this must be done immediately, but doing it right is often far more important. We don't want to stress our cats and thus we don't want to stress ourselves. This is the first, most important part of giving fluids in my experience: proper preparation with the goal of getting kitty to look forward to it. YES. You heard that right! How? Read on!
Tips for getting YOU ready to give your cats fluids:
Identify where you will give fluids. A small room, like a bathroom, is typically best. If kitty moves around, the confined area helps.
Practice poking the needle. Take one of the needles from the set, and poke it in an orange a few times. The key is to feel comfortable doing it quickly: the faster you poke, the less it hurts your kitty: over-and-done-with means all your kitty felt was a really quick “pinch” and nothing more.
THE NEEDLES. You can order smaller guage (read "thinner") needles than the 18g needles the vets usually send home with you. (In needle measurements, the higher the guage, the thinner the needle). Many prefer using 21 guage needles, Terumo thin wall needles are often recommended. I personally use the one inch long, 20 guage needles. The thinner the gage, the longer it takes for the fluids to drip through. I like the trade-off of thinner but still pretty quick with the 20 guage. I order from vetRXdirect or Amazon.
MAKE IT FUN! OK - you’re thinking - fun? Yep! It’s “special time” with your kitty, away from the hustle and bustle of every day. Your closet or the bathroom - whatever small space you've chosen - is cozy, it’s warm, and you are paying attention ONLY to your kitty. Bring treats if your kitty is eating and enjoys them: brush or pet your cat if they love that. Whatever motivates your cat, this is alone time, happy time, where kitty gets 100% of your attention and things she loves. Start with treats, brushies or pets, no fluids. Get your kitty looking forward to this time.
HAVE A SET ROUTINE. Pick a time you will be pretty consistently available for however frequently you'll be giving fluids, whether daily or not. Cats LOVE routine. So do your best to be consistent and establish a routine where you can have this alone time with your baby at (roughly) the same time every day (or however often it will be), if your schedule allows. Cats learn routines quickly, and this helps them look forward to this time with you. You will need 15 minutes or so to prep the fluids, the room, and another 5 to 10 with your kitty to give the fluids.
CALM YOUR FEAR. The best way to do this is sing! Your cat doesn’t care less about the quality of your voice, and singing slows your heart rate. Not necessarily immediately, but within a few minutes. Sing anything. I make up words to the few tunes I know, and my cats don’t care if what I sing makes sense or rhymes. They do care that I am calm. When you notice your heart rate rising, start singing, and sing until your heart rate slows down.
USE PRAISE. There is no such a thing as too much praise. When your heart rate is calm, then talk, talk, talk out loud - softly and gently, explain everything you’re doing and why. This is going to make her feel so much better! And constantly praise her every step of the way: she’s a good kitty for being carried to the bathroom, she’s SUCH a good kitty for listening to you sing, she’s SUCH a good girl for .... every little thing while you go through this process of getting fluids into her.
Tips for Getting Your Kitty Ready for Fluids
If the fluids aren’t crazy urgent, start with the routine. Establish the place and time, and start bringing kitty there for treats (or whatever motivates her) and alone time. Or will it be pets? Brushing? Whatever it is, same time, same place, get the happy associations and the routine down before even starting the fluids. The point is to have your kitty already enjoying going to where you will give fluids.
During this time, you can get your kitty used to the new sensation she'll experience: having the skin between her shoulder blades pulled up ("tented") and poked. This will feel like a quick pinch. So after a few days of setting the routine, start getting her used to the feeling of “tenting” her skin, so that sensation isn’t new or a surprise. Pull up her skin between the shoulder blades. There's a lot of extra skin there, you’re not hurting her! After a day or two of this, give it a quick strong pinch! The fewer the surprises, the easier the transition to the fluids.
If you’re going to use a harness, whether an official EZ I.V. Harness ( https://www.ezivharness.com/ ) or the Ace Knee Strap (see #5 below), start putting this on your cat during “happy cozy time,” to incorporate this as part of the routine.
Now that you’re ready, tips for giving the fluids:
1) SET UP FIRST. Start 20 minutes or so prior to the alone time. Get things set up BEFORE you bring kitty into the place you’ll give the fluids:
2) WARM THE FLUIDS. Fill a clean sink or very large bowl with hot water. Place the bag of fluids in there (not any of the spongy stuff that allows needles to be put in the bag or where the drip goes) to warm them first. I give it 10 minutes, dump the water from the bowl/sink, refill it with fresh hot water, turn the bag over, and give it another 10 minutes when the bag is new. Not everyone will have this kind of time, but do give the bag of fluids at least 10 minutes in the hot water bath.
3) ATTACH THE NEW NEEDLE AND RUN WARM WATER THROUGH THE LINE BEFORE YOU DO ANYTHING ELSE. Warming the fluids without having the warm water all the way down to the needle defeats the purpose of warming the fluids! You want that warmer water as the starting point for the drip.
4) MOVE THE DRIP CONTROL WHEEL towards the needle end of the line, not near the bag. It's unlikely you're like a vet tech, standing up near the bag with kitty on a table. You need to be able to reach the drip rate control wheel. You'll need to move it a bit each time, as it "crimps" the line and water won't flow unless you move it and pinch the line a bit to uncrimp it.
5) HANG THE BAG. When fluids are warmed, I put the hole at the top of the bag through a sturdy hanger, and place that on a high door hook or the shower curtain rod. Our smallest bathroom is larger than the length of the fluid line, so if kitty is wandering around, she can pull out the needle. I need to be able to grab the hanger and move it if kitty is moving around.
6) Consider using something to secure the line on your cat. (And you can get your kitty used to the feel of whatever you choose while you’re setting the routine and establishing the “happy time.”) There are expensive harnesses designed specifically for giving fluids, and those may work for you, the link to the EZ I.V. Harness is above. My cats do not like harnesses, not being used to them (or collars), but I found something that works quite well and is easy to use: the Ace bandage adjustable knee STRAP. If you’re in the U.S., they should be available at any local pharmacy: https://www.amazon.com/ACE-Adjustable-Americas-Satisfaction-Guarantee/dp/B006AR36NK/ref=sr_1_3_a_it?ie=UTF8&qid=1549039789&sr=8-3&keywords=ACE%20knee%20strap&fbclid=IwAR0HUZ2IOzT1iK5Qy4bilgzf6UWW2OFGwQDL4Mf5WFN2Bhzu8QZCla_vRJQ
Just secure it around your kitty's middle. Take the line, cap on, and pull the line under it, all the way to that Y joint (where many of us put B12 through during giving fluids) that’s 6 inches or so up from the location of the needle. Pull that Y joint underneath the strap, and secure he line by pulling it back so that "Y" joint sits against the edge of that strap with part of the Y under the strap. This leaves a good amount of line for you to work with to get the needle into the tented skin at the shoulder blades AND means the needle will remain in place if your kitty moves around. You can practice this several times during “happy cozy time” before actually putting the needle in and giving fluids.
7) INSERTING THE NEEDLE. To insert the needle (sing if your heart rate steps up!), pinch the skin between your kitty’s shoulder blades, pull up. That’s it! I’ve learned to poke the needle at an angle down into the “tent.” If you go at it from the side, or parallel to the cat, you run the risk that you poke the needle out the other side, and the fluids drip down her fur rather than under the skin. If this happens, just pull it out, give yourself and your kitty a few seconds to "reset," and try again.
8) THE DRIP RATE. Once the needle is in, use the little wheel on the line. Scroll it down VERY slowly. You can see how quickly or how slowly it is releasing water by watching the drip rate up at the top - from the bag dripping into the little “container” up at the top: you want just one drip visibly coming out at a time: this is VERY slow, and you may see your kitty’s back ripple at first, just a reaction to the sensation. But it’s warm and not rushing in there. Then slowly increase the rate of the drip - you’ll find you get comfortable at full open, but you don't need to go there your first session. But even then, always start slowly, and then slowly increase it to fully open. Kitty doesn't notice it as much when it starts slow and the rate of movement into the skin increases slowly. Once you’re more comfortable and kitty is used to the process, it takes just a few minutes to get 100ML into kitty with an 18 gauge needle. As discussed above, the smaller the needle, the longer it takes at full flow rate as the needle constricts the rate of flow. What works best for you and your cat will be up to you and your cat!
9) TREATS FOR TIME. If your cat is eating and enjoys treats, broths, churu, tuna water - whatever - distract kitty from the fluid drip by giving any of these. Mine love churu and Fancy Feast broths. But there are so many things on the market now, take the time to find out what your kitty tolerates and enjoys. Treats that take time to lick up work really well. By the time it takes my cat to slurp up a few tablespoons of diluted tuna water, the fluids are done!
Remember: sing, talk to your kitty, praise her frequently, constantly talk - or sing - to tell her what you’re doing and why.
This is all about your confidence. The calmer you are, the calmer kitty will be. SING!!!!!!!!!!!!!!!!
We’re all terrified the first time we attempt to give sub-q fluids, but they can make our cats with just about any health issue feel better. When there is vomiting or diarrhea (as in pancreatitis or IBD), both of which contribute to dehydration, sub-q fluids can create an enormous difference in how they feel: dehydration makes any illness worse! Finally, sub-q fluids can be critical for cats with CKD or constipation. Sub-q fluids are under-used in chronic constipation, where “hyper-saturation” helps prevent the drying of stool that isn’t moving properly through kitty.
Of course, how much fluid and how often fluids should be given should be determined by your vet. In cats with high blood pressure and/or heart disease, make sure you discuss the appropriate use of fluids with your vet, as fluids are contra-indicated.
If your vet agrees your kitty would benefit from sub-q fluids, anyone that’s given them understands the fear factor. The biggest misstep by most is rushing into it. We get it into our heads this must be done immediately, but doing it right is often far more important. We don't want to stress our cats and thus we don't want to stress ourselves. This is the first, most important part of giving fluids in my experience: proper preparation with the goal of getting kitty to look forward to it. YES. You heard that right! How? Read on!
Tips for getting YOU ready to give your cats fluids:
Identify where you will give fluids. A small room, like a bathroom, is typically best. If kitty moves around, the confined area helps.
Practice poking the needle. Take one of the needles from the set, and poke it in an orange a few times. The key is to feel comfortable doing it quickly: the faster you poke, the less it hurts your kitty: over-and-done-with means all your kitty felt was a really quick “pinch” and nothing more.
THE NEEDLES. You can order smaller guage (read "thinner") needles than the 18g needles the vets usually send home with you. (In needle measurements, the higher the guage, the thinner the needle). Many prefer using 21 guage needles, Terumo thin wall needles are often recommended. I personally use the one inch long, 20 guage needles. The thinner the gage, the longer it takes for the fluids to drip through. I like the trade-off of thinner but still pretty quick with the 20 guage. I order from vetRXdirect or Amazon.
MAKE IT FUN! OK - you’re thinking - fun? Yep! It’s “special time” with your kitty, away from the hustle and bustle of every day. Your closet or the bathroom - whatever small space you've chosen - is cozy, it’s warm, and you are paying attention ONLY to your kitty. Bring treats if your kitty is eating and enjoys them: brush or pet your cat if they love that. Whatever motivates your cat, this is alone time, happy time, where kitty gets 100% of your attention and things she loves. Start with treats, brushies or pets, no fluids. Get your kitty looking forward to this time.
HAVE A SET ROUTINE. Pick a time you will be pretty consistently available for however frequently you'll be giving fluids, whether daily or not. Cats LOVE routine. So do your best to be consistent and establish a routine where you can have this alone time with your baby at (roughly) the same time every day (or however often it will be), if your schedule allows. Cats learn routines quickly, and this helps them look forward to this time with you. You will need 15 minutes or so to prep the fluids, the room, and another 5 to 10 with your kitty to give the fluids.
CALM YOUR FEAR. The best way to do this is sing! Your cat doesn’t care less about the quality of your voice, and singing slows your heart rate. Not necessarily immediately, but within a few minutes. Sing anything. I make up words to the few tunes I know, and my cats don’t care if what I sing makes sense or rhymes. They do care that I am calm. When you notice your heart rate rising, start singing, and sing until your heart rate slows down.
USE PRAISE. There is no such a thing as too much praise. When your heart rate is calm, then talk, talk, talk out loud - softly and gently, explain everything you’re doing and why. This is going to make her feel so much better! And constantly praise her every step of the way: she’s a good kitty for being carried to the bathroom, she’s SUCH a good kitty for listening to you sing, she’s SUCH a good girl for .... every little thing while you go through this process of getting fluids into her.
Tips for Getting Your Kitty Ready for Fluids
If the fluids aren’t crazy urgent, start with the routine. Establish the place and time, and start bringing kitty there for treats (or whatever motivates her) and alone time. Or will it be pets? Brushing? Whatever it is, same time, same place, get the happy associations and the routine down before even starting the fluids. The point is to have your kitty already enjoying going to where you will give fluids.
During this time, you can get your kitty used to the new sensation she'll experience: having the skin between her shoulder blades pulled up ("tented") and poked. This will feel like a quick pinch. So after a few days of setting the routine, start getting her used to the feeling of “tenting” her skin, so that sensation isn’t new or a surprise. Pull up her skin between the shoulder blades. There's a lot of extra skin there, you’re not hurting her! After a day or two of this, give it a quick strong pinch! The fewer the surprises, the easier the transition to the fluids.
If you’re going to use a harness, whether an official EZ I.V. Harness ( https://www.ezivharness.com/ ) or the Ace Knee Strap (see #5 below), start putting this on your cat during “happy cozy time,” to incorporate this as part of the routine.
Now that you’re ready, tips for giving the fluids:
1) SET UP FIRST. Start 20 minutes or so prior to the alone time. Get things set up BEFORE you bring kitty into the place you’ll give the fluids:
2) WARM THE FLUIDS. Fill a clean sink or very large bowl with hot water. Place the bag of fluids in there (not any of the spongy stuff that allows needles to be put in the bag or where the drip goes) to warm them first. I give it 10 minutes, dump the water from the bowl/sink, refill it with fresh hot water, turn the bag over, and give it another 10 minutes when the bag is new. Not everyone will have this kind of time, but do give the bag of fluids at least 10 minutes in the hot water bath.
3) ATTACH THE NEW NEEDLE AND RUN WARM WATER THROUGH THE LINE BEFORE YOU DO ANYTHING ELSE. Warming the fluids without having the warm water all the way down to the needle defeats the purpose of warming the fluids! You want that warmer water as the starting point for the drip.
4) MOVE THE DRIP CONTROL WHEEL towards the needle end of the line, not near the bag. It's unlikely you're like a vet tech, standing up near the bag with kitty on a table. You need to be able to reach the drip rate control wheel. You'll need to move it a bit each time, as it "crimps" the line and water won't flow unless you move it and pinch the line a bit to uncrimp it.
5) HANG THE BAG. When fluids are warmed, I put the hole at the top of the bag through a sturdy hanger, and place that on a high door hook or the shower curtain rod. Our smallest bathroom is larger than the length of the fluid line, so if kitty is wandering around, she can pull out the needle. I need to be able to grab the hanger and move it if kitty is moving around.
6) Consider using something to secure the line on your cat. (And you can get your kitty used to the feel of whatever you choose while you’re setting the routine and establishing the “happy time.”) There are expensive harnesses designed specifically for giving fluids, and those may work for you, the link to the EZ I.V. Harness is above. My cats do not like harnesses, not being used to them (or collars), but I found something that works quite well and is easy to use: the Ace bandage adjustable knee STRAP. If you’re in the U.S., they should be available at any local pharmacy: https://www.amazon.com/ACE-Adjustable-Americas-Satisfaction-Guarantee/dp/B006AR36NK/ref=sr_1_3_a_it?ie=UTF8&qid=1549039789&sr=8-3&keywords=ACE%20knee%20strap&fbclid=IwAR0HUZ2IOzT1iK5Qy4bilgzf6UWW2OFGwQDL4Mf5WFN2Bhzu8QZCla_vRJQ
Just secure it around your kitty's middle. Take the line, cap on, and pull the line under it, all the way to that Y joint (where many of us put B12 through during giving fluids) that’s 6 inches or so up from the location of the needle. Pull that Y joint underneath the strap, and secure he line by pulling it back so that "Y" joint sits against the edge of that strap with part of the Y under the strap. This leaves a good amount of line for you to work with to get the needle into the tented skin at the shoulder blades AND means the needle will remain in place if your kitty moves around. You can practice this several times during “happy cozy time” before actually putting the needle in and giving fluids.
7) INSERTING THE NEEDLE. To insert the needle (sing if your heart rate steps up!), pinch the skin between your kitty’s shoulder blades, pull up. That’s it! I’ve learned to poke the needle at an angle down into the “tent.” If you go at it from the side, or parallel to the cat, you run the risk that you poke the needle out the other side, and the fluids drip down her fur rather than under the skin. If this happens, just pull it out, give yourself and your kitty a few seconds to "reset," and try again.
8) THE DRIP RATE. Once the needle is in, use the little wheel on the line. Scroll it down VERY slowly. You can see how quickly or how slowly it is releasing water by watching the drip rate up at the top - from the bag dripping into the little “container” up at the top: you want just one drip visibly coming out at a time: this is VERY slow, and you may see your kitty’s back ripple at first, just a reaction to the sensation. But it’s warm and not rushing in there. Then slowly increase the rate of the drip - you’ll find you get comfortable at full open, but you don't need to go there your first session. But even then, always start slowly, and then slowly increase it to fully open. Kitty doesn't notice it as much when it starts slow and the rate of movement into the skin increases slowly. Once you’re more comfortable and kitty is used to the process, it takes just a few minutes to get 100ML into kitty with an 18 gauge needle. As discussed above, the smaller the needle, the longer it takes at full flow rate as the needle constricts the rate of flow. What works best for you and your cat will be up to you and your cat!
9) TREATS FOR TIME. If your cat is eating and enjoys treats, broths, churu, tuna water - whatever - distract kitty from the fluid drip by giving any of these. Mine love churu and Fancy Feast broths. But there are so many things on the market now, take the time to find out what your kitty tolerates and enjoys. Treats that take time to lick up work really well. By the time it takes my cat to slurp up a few tablespoons of diluted tuna water, the fluids are done!
Remember: sing, talk to your kitty, praise her frequently, constantly talk - or sing - to tell her what you’re doing and why.
This is all about your confidence. The calmer you are, the calmer kitty will be. SING!!!!!!!!!!!!!!!!