I did it!! Sub-q'ed my kitty

This link might help with the timing of various needles:  http://www.zzcat.com/CRF/supplies/AboutNeedles.htm

With my boy, I started out using the 18g x 1".  Now that he's lost considerable weight and his skin seems more fragile, I switched to the 20G x 3/4".  He doesn't flinch (as much) and I don't poke through the other side of the tent (as much).  I've looked at purchasing the thin walls since my vet doesn't supply them, but have yet to do so. 

Thanks for the info and link, what I'm gathering is that the ultra thin wall needles are for cats with very thin skin where poke-thru-and-thru could be a problem. Maybe I'll stop at the vets on the wat home and see if they will give me a couple of 20G ones. she's used to the 18's, has been getting them at their office for a long time - but they are pros. I'm SO NOT.

I'll go check out that link, will also cool the needle. I thought I warmed the fluid last night, but just sort of felt the bag until it felt like my temp. Thanks for the advice!

I suppose I'm going to try to do it right when I get home - my vet's office is open until 7 so if I fail, I'll call and grovel to see if they can squeeze me in before closing, I can tell she needs some fluid - she did last night. They have so many techs there, hopefuly one will take pity if need be.

cocheezie said:

 
People have differing views on how contaminated is "too" contaminated. Some people will change the needle if it comes out. Some people will just stick it back in. (One vet actually told me I could use the same needle a couple of times - didn't follow that advice.)

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Same here... our vet said we could reuse the needles.   My ex-wife even stuck her fingers all over it before jabbing it in.  I couldn`t believe it.   I said aren`t you going to at least rinse it with alcohol.  She was like `what for?`  What a slob...

Wasabipea said:

 
Thanks for the info and link, what I'm gathering is that the ultra thin wall needles are for cats with very thin skin where poke-thru-and-thru could be a problem.

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No, the TW and UTW needles have larger inside diameters because the wall is thinner which obviously allows faster flow rates given equal outside diameters.   In other words - the thicker the wall - the higher the impedance to flow.

I haven`t looked but I am guessing the TW and UTW are quite a bit more expensive due to a tighter manufacturing process and perhaps stronger alloys being used.

Ak, ok - that makes sense. I stopped at the vet's to get some 20G last night (they use monoject), thinking that might be easier and thought I had the perfect setup at home. Cooled the needle, warmed the fluids... It was a disaster. Worse than the night before. She was fussing and wiggling and crying every time that needle got close to her. Plus, I don't know if this is possible - but it seems like she is somehow tensing up her back muscles because I can't get a decent tent at home (at the vets, we can tent so large that I could nap in there).

And me being one person, and trying not to poke myself or the cat while keeping her somewhat still... I don't know how I can do it. Especially when I'm not experienced enough. At the vet's office she is the perfect patient, settles into meatloaf position, doesn't move or wiggle of flinch until it's all over. at home, NOTHING LIKE THAT. I honestly think she's rather go to the vets.

I don't want to give up, but at this point I'm *this* close to totally losing my temper (she's adopted a whole host of bad behaviors lately that are irritating the heck out of me, but I'm not punishing or anything because I know she's sick) - but anyway, losing my temper would ruin the fluid "experience" when at least she is still good at the vet's

Maybe I'll try it in my car. That might throw her out of her comfort zone enought to get thru it. At least until I can gain more confidence/experience. Take her out there in the carrier and remove the lid and let her stay in the bottom part. Hm... now that I think about it, that might be worth a shot. (pun not intended - lol) I don't think she'd try to bolt from my carrier in the car.

I have to constantly remind myself that I am smarter than her, most of the time.

 The car is worth a try. Cats tend to hunker down when placed in an unfamiliar or not-their-usual environment.

It will be slightly harder to tent, but you could try putting a harness on the cat and attaching it to the carrier so that it is harder for her to leave. Cats like to leave.

I just took her into the vets tonight, they were busy so I just let them do their thing. I think she is declining though, she used to watch me with big eyes and talk to me when we went in the car... now she doesn't really look at me and looks almost worried - which makes me wonder if she is thinking she might not come home.

Back to the thread of euthanaia at vets office vs. home. Its really strange how her behavior has changed.

"Cats like to leave" lol, yes that is true! We get home and i open the door to her carrier and she just trots away. I don't even think she has a destination, just trotting away is fine haha.

Zoneout, I can't believe your ex had their fingers all over the needle and then used it. No problems occurred from that?

She'll feel a bit better once the fluids have kicked in. You said earlier that you thought she was dehydrated.

I hope so. Got her 100 ccs and made an appt in 3 days in case I can't do it again.
Really the important part is getting them in her regardless of who does it, but I'm not giving up.

Wasabipea said:

Zoneout, I can't believe your ex had their fingers all over the needle and then used it. No problems occurred from that?

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Not that I noticed immediately, cats do get into fights and get scratched and bloodied so they can fight off any invading bacteria.... however its something I would want to avoid if possible.  Hard to be surprised at how uncouth my ex is.   She actually has a single fork in the kitchen that she uses to scoop out the cats canned food - she hasnt wahed it in a month.   It just sits there on the counter with caked on wellness all over it.

Wasabipea said:

I hope so. Got her 100 ccs and made an appt in 3 days in case I can't do it again.
Really the important part is getting them in her regardless of who does it, but I'm not giving up.

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Have you tried duct tape?  

Think of a cat as human in terms of how they feel when they are sick and equate this to your cat at all times. In terms of intelligence they are fairly simple compared to most humans and don't always understand what is up or what you are doing. Their nature is to hide when they are sick and to show no weaknesses which means they may ignore you and hide. Nothing is meant by this because they are hardwired to hide when they are sick and when they are sick they may not want any attention. My guy is 19 and he has a host of issues and there are times when he just hides under my bed and wants to attention. This makes it hard to give drugs and sub-q's from time to time but he is really old and he doesn't always feel good so I have to keep this in mind. I don't think he resents what I have to do but he doesn't always understand it. He accepts the sub-q's and pain meds for arthritis because I think he can feel the difference but he has not interest in anything else.

I would make sure you are using as small of needle as possible, I use the UTW 20 x 1" needles which work well. I change the needle every single time it punctures the skin whether it worked or I was bailing on an attempt. I give him drugs using a needle and it the same thing, one poke for one needle and nothing more. Each time the sub-q is done I also swap out the needle before I store the sub-q until the next time. I heat his sub-q bag up to 92 - 98 degrees, I found he twitched when I had the temps up at 99 so I have been slowly dropping it to 92 - 96. Today he got one at 96 degrees and no issues and he purred right through it.

I don't freeze the needles or get them cold, they are heated up with the sub-q so mine are closer to body temps. I gently massage his skin and see where there is loose skin around the area that would be covered if I could get a saddle on him. My guy is very gentle and comes to get a sub-q knowing full well what is going to happen almost every time. I am lucky that he will lie mostly on his side so it is usually easy to get some extra skin. I don't know a better way of saying it other than you have to be one with that needle. You need to play with your cats skin when he/she is not getting a sub-q and make tents as you are petting her and picture in your minds eye what it is like inside and how the needle is supposed to enter her body. This will make it easier to get the needle into her smoothly and reduce stress on both parties. For the most part cats can't really feel the needle so you are not hurting her most of the time although there may always be incidents. As long as the tip of the needle is not running across the skin or poking into the muscle or whatever is under the tip then it is usually smooth and painless.

All you need to do is to get used to it and it comes fairly quickly with practice as long as the needle is going in properly. What I do is gently massage the skin to find a loose area and then make sure you can form a good pocket. Try to keep as calm as possible and talk to the cat in gentle tones or maybe tell it what you are doing whether it is going well or not. You may want to try taking a shot of something before you do it for the first few times to help calm you or talk to your vet about pain meds to calm the cat. My guy gets 0.20ccl of Buprenophine twice a day for arthritis twice a day and I try to give him his evening dose about 30 minutes before the sub-q at least. You cat may or may not be in pain but it might help her/him keep calm in the learning stages of this procedure.

Once I have the needle in I rest the needle on his back running inline with his spine and then let the tent slowly settle out. Once everything is in place I start the sub-q with really slow drip and check if there are any leaks. If there are I gently try to massage the skin to help form the pocket or pull the needle back slightly and that usually fixes it. If all is well I slowly turn up the speed in stages and end up cranking it as fast as it will got to reduce the time with the needle in his back. Once it is done I pet him and talk to him for bit and then get him a few of the worst cat treats just because he loves them. Because of his issues he no longer gets any cat treats other than these after the sub-q. He does get the dehydrated meat cat treats but given the choice he would go to the crappy ones first every time.

Some people wrap the cat up in a towel and leave the area around where the sub-q is going to be which makes it easier to control the cat. You can also put her between your knees with her head pointing away from your body with you kneeling on the ground and do it this way. The needle can point to the head or tail so this would not be an issue but I use this method when I need to get drugs in his mouth. Keep all involved calm and try different methods until you find the one that works for you.

Sadly enough you will have failures but keep the goal in mind and that is helping your cat as much as possible. You may or may not be able to do this in the end but from what I have read I think you can. The fact that you are trying means you can do it but you have to push yourself as much as you can to make it work. You cat feels so much better after this and it will get easier once you get the hang of it and like my cat yours will most likely start to come for one because they know much better they feel after it is done. If you are getting dirty looks now then it will change once the routine is down and as your cat feels better you will be forgiven. My cat was in a really hard place when everything started to fail and two years later (at 19) he doing pretty good and giving him a sub-q every other day and then every day made a huge difference to him.

You have to make sure you are not pumping too much liquid into the cat which can also do harm. My guy is just over 7 lbs and the max for him is 100ml a day or 150ml every second day which is the most he gets. He needs it once a day now and if I get half or more into him and then have a failure of some kind I just leave it for the day. This makes a huge difference to him with his IBD and renal failure and I can tell he still feels pretty good a lot of time. Once he stabilized he has his ups and downs but when this all first happened he was a wreck and there were a lot of failed sub-q's but after time it gets easier and your confidence gets a lot better and it is easier. In the end you are doing it for your pet which a lot of people wouldn't even try so hopefully you can make it work. All you can do is try though and hope it all works out but in the end you have to do what is best for the cat. If I had to fight my cat every day to do this and it was really stressing him out I think I would have him put down. I am lucky that it all worked out and I can maintain his health and hydration so hopefully it is the same for you.

Thank you for your thoughtful post. She has been getting sub-q's at the vet's office for years off and on, she knows exactly what to expect there and she sits still and lets them do their thing, no problem.

I think the idea of tenting now and them, even when I'm not planning on giving fluids is a good idea just so she gets used to the feeling in the home environment - she snows exactly what it means at the vets. And massaging her, but she's not crazy about having her back rubbed on a good day, she prefers if I just rest my hand on her back - maybe gentle stroking.

While I did a successful administration at the vets office, I think I may have botched the first one at home by releasing fluid between the layers of skin, from what I understand that can be quite uncomfortable for the cat and she filed me under "she has no idea what she's doing", which made the second attempt even more difficult. I usually keep the used needle on the tip just to keep it clean and unexposed, and change it out right before I (try) to get it in.

In her defense, the first time I tried, she did meatloaf position for me and didn't fuss at first... but I kept accidentally contaminating the needle and having to change it, it was taking a while and I was getting flustered.... and then when I finally did it... I think the fluids were flowing into her skin rather than into the pocket.

Yesterday morning I rolled out of bed thinking I would catch her all groggy and give it a shot then... but when I got downstairs (groggy also) - I could tell she was bright eyed and had been awake for a while. I quickly bagged that plan.

I try to warm the fluids, I don't have a thermometer - just go by how warm they feel, not cold - but definitely not warmer than my skin temp.

Now that she is feeling better (she had a case of diahrrea which was making her miserable which had cleared up for now and she is much happier), hopefully she'll be more agreeable. I took her to the vets last night because I didn't want to risk another botch-up and knew she need some juice. She got 100ccs.

I will try again over the weekend when I'm not so tired and irritated from working all day, and don't feel so rushed. She naps most of the afternoon, so that's her mellow time and might be a good time to catch her off guard.

Next attempt will be better lighting, cheater glasses (much to my chagrin), and possible a relatively unfamilair enviroment which would give her less desire to bolt.

Thank you again for your thoughfulness and understanding. I'll keep posted on our Sub-q adventures. I really feel like I have to tackle this. A few successful "home runs" and hopefully she will be as easy as she is at the vets, they always comment on how cooperative she is.

zoneout said:

 
Have you tried duct tape?  

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lol, think she loves me now? that would be the icing on the I Hate You cake!

I forgot to mention one point for not using a needle more than once, it dulls them on each use and this also makes it uncomfortable. The tips are very thing and actually start to bend over and get dull on each insertion so you really should change it each time you puncture the skin with it. I have also drawn blood a few times, not sure why and it doesn't seem to hurt but you don't want to re-use. I use nothing twice, the entire sub-q is thrown away when it is done and each needle that punctures the skin once. If you rub it on the skin it is okay to use but if you actually stick the needle in the skin it should be disposed of.

If you are taking her to the vet to get a sub-q then you should be having them walk you through it each time to get supervised experience while doing it yourself. There is nothing better than doing it with someone you can continually ask questions. Ask if it would be okay to bring your own rig and try to use it as you would at home and let them charge you for the time. It is hard to do because it is not natural sticking things into living things and you have to train yourself to get over it. The first time for me was a constant string of 'sorrys' as I did the insertion and he did not flinch.

Patience is the key with cats, you pretty much have to wait until she is ready for it once she is used to it. My guy gets one once a day and he comes to where I am and lets it happen because he is used to it now. I am waiting for him to come around so I can give him his pain meds but he needs to eat a lot so it is only a matter of time. My guy naps in the afternoon as well and I always wait until he is done before I give him anything and just wait him out. When I checked on him not too long ago he was dead to the world and didn't wake up so he is in a deep sleep.

Keep up the gentle massaging and if you can get the pocket sitting correctly then you shouldn't have the issue getting the needle in correctly. Use the vet more if you are still not sure about the proper insertion and have them critic you but make sure you are doing the work. Another thought to keep her still is to use a leash and kneel on the strap so she can't move and try it that way. It may be hard to get some extra skin but it is a thought.

One of the main things to think about when giving the fluids is STOP STRESSING. I know it is hard but you cannot approach your cat with a nervous energy. Get your stuff together and warm your fluids, clear your line where ever the cat is find the highest thing you can hang the fluids from and do the fluids with the cat on the floor. So you want a straight line from the bag to the cat. Insert the needle without moving your cat. just pick up a small amount of skin and insert the needle bevel up pointed away from the head in the direction the hair grows and hold a tiny bit of the skin up until the area fills with fluids and you never need to hold with more than just the fingers that are on the needle base. Use nothing larger than a 20 gage. A 22gage would be better. You can also get a pressure cuff from the vet that you can pressurize a cuff around the fluids that will force them in quicker. But it will still be quick as long as the position is right. But don't try to hold your cat down when you do it. Cats hate being held. And anything you do, do it confidently

Quiet said:

 
One of the main things to think about when giving the fluids is STOP STRESSING. I know it is hard but you cannot approach your cat with a nervous energy. Get your stuff together and warm your fluids, clear your line where ever the cat is find the highest thing you can hang the fluids from and do the fluids with the cat on the floor. So you want a straight line from the bag to the cat. Insert the needle without moving your cat. just pick up a small amount of skin and insert the needle bevel up pointed away from the head in the direction the hair grows and hold a tiny bit of the skin up until the area fills with fluids and you never need to hold with more than just the fingers that are on the needle base. Use nothing larger than a 20 gage. A 22gage would be better. You can also get a pressure cuff from the vet that you can pressurize a cuff around the fluids that will force them in quicker. But it will still be quick as long as the position is right. But don't try to hold your cat down when you do it. Cats hate being held. And anything you do, do it confidently

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Very true!  I am lucky that first cat I ever needed to do fluids on was so sick she did not move at all unless I moved her(she is FINE! now but never figured out what happened minus a reaction to being under but even that does not seem logical)  Cats are forgiving.  Have treats and make it something pleasurable as can be.  If you think the cat is going to dart turn the fluids off so you do not have a wet cat  

Well, again. I have done it sucessfully at the vets office - so I know I can.

I started at home with an 18 guage needle, and after that failed attempt when by the office for so 20 guage needles. when I used the 20, she would let out a cry every time the needle came close to her - I couldn't tell if it was touching yet. but when I gave up and broke down the setup, I noticed the tip of the needle looked almost bent downward - it could have been a damaged needle and it was hurting her.

I'm currently coming at her with not just stress energy, but sad and mournful and somewhat defeated energy all around because I think I finally have to acceot the stomach cancer disanosis that was given to me. I've been in denial but she is declininig and doesn't have that much longer and I'm torn whether to keep trying to do this at home, or stick with the routine that she knows for her last days. I think the end is fairly near, and I'm beside myself with sad since we just lost the best cat evet to cancer not a couple of months ago.

I want to be strong, but I'm pretty defeated with trying to get her to eat, plus giving her propectalin for diarrhea, plus her daily maintenance meds and trying to get a grasp on the fluids... it's all for what? She's dying and watching her decline is breaking my heart - she is a shell of the cat she used to be and I'm trying not to stress her. She's used to getting the fluids in the vet's office, she knows what to expect in the carrier and the car ride - she knows fluids are at the end, and then she comes home.

I don't want to give up but in all honestly I'm a basket case with watching her slowly die and her "brother" (not related but grew up together) just got PTS at the end of May for cancer too. They were best buds for 18 yrs, and he was the best cat - just a good boy and a love and never any trouble. not a mean bone in his body. I just realized that he was the grounding element in the house since it's just me and my kitties, I'm super emotional and Roni is emotional... he kept us all grounded. Weird that a cat can do that.

I don't want to wimp out, but all this is hitting me really hard the past day or so, it's hard for me to be strong right now.

Oh well, I'm rambling. I guess the bigger issue on my mind now is how am I goig to know when to put her down. I don't want her to suffer. I would assume fluids help tummy cancer kitties feel better... does anything make them feel better?

Sorry for the downer post when eveyone is just trying to help.

Honestly hun go with the vet.  I can feel the stress from your post of just how you feel about doing it at home.  If she is happy enough going and you have a way to get there then do that.  

You have enough to worry about.

I WOULD keep a setup at home for if there is a day you can not make it in. If down the road you want to try again or she does not take the car rides as good you can always see how it works then.

Far as the end.  You know her habits and what her normal routine is. Watch for changes of her withdrawing and giving up more and more. If she can not look out window that used to be HER thing or if she just hides out as opposed to her normally lounging on furniture.  Getting grumpier and more often(from the pain).  It has always been easy for me to tell at the end but the transition to that point can be very hard when they have good/bad days.  When they start getting more bad then good or when the bad days are REALLY bad IMO you know.  

I always say I rather do it to soon and it be peaceful then to late and it be an ER vet trip.  When you know the last day you also have the luxuary of spoiling them while they can still reasonably enjoy it.

You aren't wimping out at all.  Just do whats best for your kitty and yourself, try to enjoy the good days that you have left with your kitty.