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Sub-Q

post #1 of 21
Thread Starter 
Jack has CRF, he was throughly flushed for 2 days at the vet about 2 weeks ago, his blood numbers were 120 urea and 6.5 creatinin, those dropped in half with the massive IV flush for 2 days. After the flush he had a bunch of giddy up back in his step, but over the last 2 weeks he has slowed down again so we are going to start doing Sub-Q fluid therapy, the vet taught me how today.

He injected 180 ML to start with and we are going to continue that every 3rd day for now and see how that goes, we are using a BIG syringe. I had only read about the IV drip bag, but that takes a lot longer than the syringe so I opted for the syringe. Jack hardly seemed to care about the needle, but with the syringe there is 3 holes made instead of one for the drip bag.

So, who uses what and why?
post #2 of 21
Coco has Crf but she has not started Sub Q's yet.
She drinks alot of water on her own.
Coco has a kidney panel in a few weeks and we will see about sub q's then.
Stripe had Sub a week.Q's but the vet did it.
She would get them 3 times
post #3 of 21
I use a drip bag for Furrari. It's how my vet started us. Furrari is really easy to handle and lays still, purring away, while the fluids drip in.

I hadn't heard of using a syringe for sub-qs until now.
post #4 of 21
I've done sub-Q's on Cleo for about 6 years now. I've always done the bag method. I also used the bag for my parent's cat, Samson. From what I've gathered from the CRF support site, it appears the IV bag is more popular here in the U.S., and the syringe method is more popular in the UK. I use an 18 ga Terumo needle, and it takes approximately 2 minutes to get 100 ml in Cleo. She actually seems to enjoy her fluids. She purrs throughout the entire process.
post #5 of 21
Quote:
Originally Posted by jackbombay View Post
Jack has CRF, he was throughly flushed for 2 days at the vet about 2 weeks ago, his blood numbers were 120 urea and 6.5 creatinin, those dropped in half with the massive IV flush for 2 days. After the flush he had a bunch of giddy up back in his step, but over the last 2 weeks he has slowed down again so we are going to start doing Sub-Q fluid therapy, the vet taught me how today.

He injected 180 ML to start with and we are going to continue that every 3rd day for now and see how that goes, we are using a BIG syringe. I had only read about the IV drip bag, but that takes a lot longer than the syringe so I opted for the syringe. Jack hardly seemed to care about the needle, but with the syringe there is 3 holes made instead of one for the drip bag.

So, who uses what and why?
I used to have a CRF cat and I gave subQ fluids on a regular basis, by bag.

I've heard that some people give it by syringe but never really inquired on it. So when you do this, are you drawing the fluid you're giving, FROM a sterile IV fluid bag or where are you getting the fluids from? You'd be using a brand new syringe each day you give the fluids, right? - because it would no longer be considered 'sterile' after you've use it (that to me would get costly).

I'd much prefer to poke my cat once as opposed to 3 times in one session. Giving it directly from the fluid bag doesn't take all that long, if you hang the bag high enough I'd hang it on a nail on the wall.

Also, they say it's better to give smaller amounts more frequently as opposed to a larger amount less often......as the kidneys get more of a consistent "boost".

You'd need to use a new needle each time you're poking the skin (not sure if you do? vets might not teach this)....because to reuse the same needle for multiple pokes:

a) increases the risk of infection at the site because that initially 'sterile needle' is no longer sterile once it's been used....

and

b) just the act of the needle piercing the skin can really dull the needle. It generally isn't 'visible' to the naked eye, but needles are only intended for single-use.
post #6 of 21
With the several cats I've had over the years with crf, I've always used an iv bag, and highly recommend, if you do ever try this, that you use the ultra-thin wall Terumo's..marked difference from the Monoject needles most vets use.

I made sure to warm the fluid first (by resting the iv bag in a pot of warm water - being careful to not contaminate the rubber ports or area where the tubing inserts into the bag0, and to have good height of the bag in relation to my cat.

Patrick would always know a treat was coming when we were done, and just sit there patiently...it would take just a couple of minutes to infuse 100 cc which is the amount I would give.
post #7 of 21
Quote:
Originally Posted by the_food_lady View Post
I used to have a CRF cat and I gave subQ fluids on a regular basis, by bag.

I've heard that some people give it by syringe but never really inquired on it. So when you do this, are you drawing the fluid you're giving, FROM a sterile IV fluid bag or where are you getting the fluids from? You'd be using a brand new syringe each day you give the fluids, right? - because it would no longer be considered 'sterile' after you've use it (that to me would get costly).

I'd much prefer to poke my cat once as opposed to 3 times in one session. Giving it directly from the fluid bag doesn't take all that long, if you hang the bag high enough I'd hang it on a nail on the wall.

Also, they say it's better to give smaller amounts more frequently as opposed to a larger amount less often......as the kidneys get more of a consistent "boost".

You'd need to use a new needle each time you're poking the skin (not sure if you do? vets might not teach this)....because to reuse the same needle for multiple pokes:

a) increases the risk of infection at the site because that initially 'sterile needle' is no longer sterile once it's been used....

and

b) just the act of the needle piercing the skin can really dull the needle. It generally isn't 'visible' to the naked eye, but needles are only intended for single-use.
This also crossed my mind! If you were drawing the fluid off a bag each time, you'd need to use a new needle each time to prevent contaminating the bag. When you give fluids from the bag via an IV admin set, all you need to do is change the needle after each use, and it's ready for the next time. There's no risk at all of contaminating the bag, since you only introduce the IV administration set once at the initial spiking. As an OR nurse, the idea of sticking a needle repeatedly into the fluid bag goes against all my years of training in sterile technique!
post #8 of 21
Thread Starter 
Good points, some of them I have answers to, or the vet gave me his opinion on at least.

He said to use one needle to draw fluid from the bag, and never use it on Jack so that will keep the bag sterile. The needle for Jack can be used for a few sessions according to him, but will get dull and need replacing every 3rd session.

To be totally honest when I saw the size of the syringe I figured it held 100cs and would only have to use it once so there wouldn't be any additional "pokes" compared to the bag. But then as he was showing me how to do it he obviously filled the syringe 2 more times than I had figured. Seeing as there is 3 pokes instead of one I think I'm going to get a bag set-up tomorrow.

Jack is always willing to lounge on my lap for, ohhhh, as long as I'm sitting down really, especially if its a little chilly in the house.
post #9 of 21
Here's an absolutely awesome link that shows step-by-step instructions for giving sub-Q fluids.

http://www.weirdstuffwemake.com/weir.../catjuice.html

Here's a link to the Terumo needles. I think they're much sharper than the Monoject needles that most vet supply. I highly recommend them. Jack will thank you!

http://www.thrivingpets.com/products...mStockId=392N2

Good luck to you and Jack!!!
post #10 of 21
Thread Starter 
Quote:
Originally Posted by Pookie-poo View Post
Here's an absolutely awesome link that shows step-by-step instructions for giving sub-Q fluids.

http://www.weirdstuffwemake.com/weir.../catjuice.html

Here's a link to the Terumo needles. I think they're much sharper than the Monoject needles that most vet supply. I highly recommend them. Jack will thank you!

http://www.thrivingpets.com/products...mStockId=392N2

Good luck to you and Jack!!!
We've decided to go the bag method, and I'm going to order up some of the terumo needles. The needles from the vet are monoject, and they are 16 gauge instead of 18, and it seems as though 20 gauge might even be appropriate for smaller cats that need less fluids, but Jack is not small.

The last couple days Jack has been hanging out in the corners of the room, facing the corner, odd for him, but the sub-q today has perked him up. Right now he is at his usual post by the woodstove with his sister at her work station on the right

post #11 of 21
Hmm...his sister is obviously a very hard worker...she's just sacked out!
post #12 of 21
I currently do not do any sub-q at home, but have done it both ways. At home I have always used a bag, and actually prefer a bag. At the shelter, I have used a suringe on kittens. I have always given adults 50 - 150 CC's so I can't imagine doing that without the bag. Kittens are differnt because they are so small.
post #13 of 21
One of my RB kitties, Simon, had kidney disease. He laid down and purred while getting his fluids (through a bag) - I was more nervous than he was!
post #14 of 21
Thread Starter 
First time by ourselves today, he was not too stoked on the big needle, but hung out on my lap for 150 cc's. The bag is plenty high, and with the big needle 150ccs went in quite fast. The smaller (sharper) terumo needles will be here today or tomorrow which I'm sure he'll like.
post #15 of 21
Quote:
Originally Posted by jackbombay View Post
First time by ourselves today, he was not too stoked on the big needle, but hung out on my lap for 150 cc's. The bag is plenty high, and with the big needle 150ccs went in quite fast. The smaller (sharper) terumo needles will be here today or tomorrow which I'm sure he'll like.
Good for you..it will get easier with time, you'll have the whole thing down to a quick routine
post #16 of 21
My cats dont have kidney problems, they have liver problems. Arthur was getting sub-q fluids for a few weeks. Its been a little while now but Im pretty sure he was getting about 150-200ML every two days. I put the needle in, ran in the fluid (doesnt take long at all if you hang the bag high...maybe 5minutes) and he was all set.
post #17 of 21
Thread Starter 
Quote:
Originally Posted by Pat & Alix View Post
Good for you..it will get easier with time, you'll have the whole thing down to a quick routine
Pretty easy really, I hope that he starts to associate the "feeling better" effect of the sbu- with the sub-q, not that he resisted much/any, but if he could look forward to it a bit I wouldn't mind.

I'm surprised how quick the effects are, IMO he is somewhat dehydrated most of the time, an hour or so after the sub-Q his behavior was already going from "hang out in the corner in bun position" to hanging out on a kitchen stool and being social. I'm pretty sure the sub-q doesn't dilute/flush the toxins out of his blood that fast which leaves dehydration, AKA "slightly hungover all the time, which has to be pretty miserable :-/

We plan on 150ml every two days, if hes pretty down by that second day we'll think about 100ml every day
post #18 of 21
I give my 17 year old, Toby, 200 ccs every third day. I warm the fluids, same as Pat & Alix. I also use an 18 gauge, but they are the Monoject. I'll be curious to hear what you think of the Terumos. I always do it in the same place, with the bag hung on a curtain rod. I use a clothes hanger to hang it, which works pretty good. And like the others have said, a new needle every time. I've only used the bag for adult cats, syringe for kittens.

I've had some that were difficult to manage during the process and I needed a second person, but Toby is easy to handle. I always give him a soft food treat afterwards, which he has come to expect.
post #19 of 21
Quote:
Originally Posted by Pat & Alix View Post
With the several cats I've had over the years with crf, I've always used an iv bag, and highly recommend, if you do ever try this, that you use the ultra-thin wall Terumo's..marked difference from the Monoject needles most vets use.

I made sure to warm the fluid first (by resting the iv bag in a pot of warm water - being careful to not contaminate the rubber ports or area where the tubing inserts into the bag0, and to have good height of the bag in relation to my cat.
I just wanted to second this advice. When we used Terumo needles it worked SO much better, and the cat seemed less upset. We also would warm the fluids in a pitcher of warm water before use. I bought a 100 count box of them when I found out about them for my CRF cat years ago and I just finished the last of the needles for my Golden this fall.
post #20 of 21
Ooooh, glad to know about the Terumo needles. I had no clue about alternatives!

Sassy La Rue is given 150 ccs two out of three days via IV and 20 gauge needles. She doesn't like the insertion of the needle but once it's in, she's fine and purrs away. I didn't know about the warming of the fluids but I was going to make a coozy for the IV bag, to keep it warm while it's in the bathroom.
post #21 of 21
Thread Starter 
Jack didn't complain nearly as much with the 18 gauge terumo needle compared to the 16 gauge monoject, but he still doesn't like it. Purring? Not a chance, at this point I'd like it if he just didn't go and hide under the bed :-( He NEVER does that, I went to town for a bit and I actually can't find him now :-( :-(
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