Why on earth can I not WARM UP a Ringer's Bag?

[missbliss]

I am so upset now - it was in a pot of hot water for at least 20 minutes - warm to touch but the SubQ was ice cold and my poor cat was shivering - I had to stop it. I just want to cry.

 

[Morpheus1967]

Can someone explain this to me? I am very confused by this post.

 

[clpeters23]

Can someone explain this to me? I am very confused by this post.

For cats which require subcutaneous fluids, warming the bag of Lactated Ringers solution makes it more comfortable for the cat.

 

[Morpheus1967]

For cats which require subcutaneous fluids, warming the bag of Ringer's Lactate solution makes it more comfortable for the cat.

Thank you!

 

[Jcatbird]

Try sort of massaging the bag as it is in the water to move the contents around. The outer part tends to get warm but the middle maintains the cold. I have even put a bag under my coat to get it warm when I had no other Avenue. It takes much longer but I can tell when it finally swishes around enough to be my body temperature. Maybe that would be a good way to test it after the warm water to make sure it isn’t cold.

 

[artiemom]

When I was doing Sub-q's with Artie, I took a 4 quart pot, put the lactated ringers bag in it. I filled it with hot tap water, and let it sit for 10-15 minutes. The water was still a warm, when I took it out.

I kept the IV line outside the pan. I then ran an entire line length of fluid, out; BEFORE I stuck Artie. I need had any issues.

I hope this works. I was giving Sub-Qs daily to him.

 

[Antonio65]

I am not sure that warming up a fluid bag and letting it cool down afterwards, then reheating it and again cooling it down is good for the integrity of the fluid itself.
It is my belief that the heat/cool cycle may deteriorate the structure and effectiveness of these fluids, especially if it Ringer's Lactate.
I never did that.

I would only warm up the amount of fluid to be injected, not the whole bag/bottle.

 

[missbliss]

Try sort of massaging the bag as it is in the water to move the contents around. The outer part tends to get warm but the middle maintains the cold. I have even put a bag under my coat to get it warm when I had no other Avenue. It takes much longer but I can tell when it finally swishes around enough to be my body temperature. Maybe that would be a good way to test it after the warm water to make sure it isn’t cold.

Oh swishing it. Let me try that. Will report back. Thank you.

 

[missbliss]

I am not sure that warming up a fluid bag and letting it cool down afterwards, then reheating it and again cooling it down is good for the integrity of the fluid itself.
It is my belief that the heat/cool cycle may deteriorate the structure and effectiveness of these fluids, especially if it Ringer's Lactate.
I never did that.

I would only warm up the amount of fluid to be injected, not the whole bag/bottle.

That's what I thought too. Argh. Cat-ch 22. Thank you. Mati has a propensity to get cold/hypothermia - this would help her. Otherwise I'm just adding to her discomfort which I would not want to do under any circumstance. I've heard from a few sources that it should be warmed though. What's in it - electrolytes - question for the nerds - do electrolytes degrade when heated?

 

[missbliss]

When I was doing Sub-q's with Artie, I took a 4 quart pot, put the lactated ringers bag in it. I filled it with hot tap water, and let it sit for 10-15 minutes. The water was still a warm, when I took it out.

I kept the IV line outside the pan. I then ran an entire line length of fluid, out; BEFORE I stuck Artie. I need had any issues.

I hope this works. I was giving Sub-Qs daily to him.

Thank you. The line is problematic - will run it out.

 

[missbliss]

I am not sure that warming up a fluid bag and letting it cool down afterwards, then reheating it and again cooling it down is good for the integrity of the fluid itself.
It is my belief that the heat/cool cycle may deteriorate the structure and effectiveness of these fluids, especially if it Ringer's Lactate.
I never did that.

I would only warm up the amount of fluid to be injected, not the whole bag/bottle.

How do you separate what you need from the bag - do you inject sub-q from a syringe? How?

 

[silent meowlook]

What I do is, take a large bowl and fill it with warm water. I place the bag upside down so the part where the line is inserted is up and not in the water. I leave it there for about 5 minutes, then dump the water and refill with more warm water. Sometimes I will let the warm water trickle over it in the bowl, so the water stays warm. After about 10 minutes of doing this, I remove the bag from the bowl and dry it with paper towels. I then remove the needle and open the clasp or unroll the roller so the fluids can flow out of the line. I let it run until it is clear of the old fluids that did not get warm. I put my new needle on and then I am good to go. Always remember not to touch the end of the line to anything when you are clearing the line.
Something to remember is that the fluids in the line will cool very quickly. The fluids will also cool as they run through the line. So, keep that in mind when you are deciding on temp. Of course, it is always better to cool than to hot.
If I am in a hurry and don't have all that time. I will just take of bowl of very warm water and set it next to the cat and put part of the line into the very warm water, so it heats the water up before it gets to the cat.

 

[LTS3]

I suggest that you contact your vet and ask how to best warm up the bag of fluids and how to draw out just enough fluids with a syringe to give so you're not wasting the whole bag.

There's some general sub q fluids tips here: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Subcutaneous Fluids

 

[Antonio65]

I've heard from a few sources that it should be warmed though. What's in it - electrolytes - question for the nerds - do electrolytes degrade when heated?

Of course it should be warmed, it helps a lot.
Especially when you have to give your cat a large volume of fluids, warming them up reduces the risk of hypothermia, and also helps the cat's body absorb those fluids more effectively and quickly.
I cannot be sure that those electrolytes degrade with heat/cool cycles, but I'm pretty sure that those cycles aren't good for any medical product.

How do you separate what you need from the bag - do you inject sub-q from a syringe? How?

Exactly.
I would use two syringes for my cat. Over here, where I live (Italy), those fluids come in bags, or plastic or glass bottles. The one I would purchase from my local pharmacy was in 500 ml glass bottles, like THIS ONE.
The cap of this bottle is sealed with an aluminum seal, you tear the seal off and you see the rubber cap that can be pierced with a needle several times. So I would just aspirate two 60-ml syringes of this RL with a G18 needle.
I would seal the nozzles of the syringes with two spare needles and put them into a jug of hot water from the tap for 5 minutes. This was enough to have both the syringes at body temperature.
Then I would use a butterfly needle G21, I would put the needle on the first syringe, inject the fluid in the back of my cat, when the first syinge was done, I would double the butterfly line to prevent the fluid still in it from coming out and any air to go in, then I would use the second syringe.
This procedure is much quicker than letting the fluids drip from the bag, everything was done in less than 5 minutes, the cat receives much less stress.
I did this for over 10 years, every other night, or even every night.

 

[di and bob]

Never put the bag in the microwave, that can create dangerous hot spots. warm it in a bowl of warm water and run a little out on your inside wrist to make sure it isn't TOO hot, but just right. Emptying the line right before giving is a great idea too, You might get her a cat heat pad to sit on to warm her up quickly too, she would like that!

 

[missbliss]

Of course it should be warmed, it helps a lot.
Especially when you have to give your cat a large volume of fluids, warming them up reduces the risk of hypothermia, and also helps the cat's body absorb those fluids more effectively and quickly.
I cannot be sure that those electrolytes degrade with heat/cool cycles, but I'm pretty sure that those cycles aren't good for any medical product.



Exactly.
I would use two syringes for my cat. Over here, where I live (Italy), those fluids come in bags, or plastic or glass bottles. The one I would purchase from my local pharmacy was in 500 ml glass bottles, like THIS ONE.
The cap of this bottle is sealed with an aluminum seal, you tear the seal off and you see the rubber cap that can be pierced with a needle several times. So I would just aspirate two 60-ml syringes of this RL with a G18 needle.
I would seal the nozzles of the syringes with two spare needles and put them into a jug of hot water from the tap for 5 minutes. This was enough to have both the syringes at body temperature.
Then I would use a butterfly needle G21, I would put the needle on the first syringe, inject the fluid in the back of my cat, when the first syinge was done, I would double the butterfly line to prevent the fluid still in it from coming out and any air to go in, then I would use the second syringe.
This procedure is much quicker than letting the fluids drip from the bag, everything was done in less than 5 minutes, the cat receives much less stress.
I did this for over 10 years, every other night, or even every night.

I think I understand. We are in Israel in the boonies on top of everything else - so hard to get anything. The last bag of Hartmann's was brought by a traveling vet. I msged him to ask when he'd be round these parts again and he doesn't know. There is literally no one in the radius of at least 40 km's where I can get Ringer's let alone those cool glass bottles you're sourcing in Italy. Need the 60ml syringes as well - been getting syringes and needles as they come from various sources, but never 60ml. Those definitely would come in handy. Do you inject the whole 60ml in a one go shot or in increments? It sounds like a good alternative to standing drip by slow drip. Less stress is a very good thing. Thank you.

 

[missbliss]

Never put the bag in the microwave, that can create dangerous hot spots. warm it in a bowl of warm water and run a little out on your inside wrist to make sure it isn't TOO hot, but just right. Emptying the line right before giving is a great idea too, You might get her a cat heat pad to sit on to warm her up quickly too, she would like that!

Thanks - no fear of microwaving - we don't own one, never would. Heat pad is a great idea - maybe I can source one somewhere.

 

[Antonio65]

I think I understand. We are in Israel in the boonies on top of everything else - so hard to get anything. The last bag of Hartmann's was brought by a traveling vet.

I would have thought that in Israel there was plenty of technology and stuff.

Do you inject the whole 60ml in a one go shot or in increments? It sounds like a good alternative to standing drip by slow drip. Less stress is a very good thing. Thank you.

I would inject the 60 ml in steps, 5-6 ml at a time at a rather slow rate, wait 3 to 5 seconds, and again 5-6 ml. So, I believe a 60 ml syringe would go in a little more than a minute and a half.
A few seconds to switch to the second syringe, and again the same process.
As I told you before, everything was over in less than 5 minutes, from putting the cat on the sofa, sterilizing the site of injection, administering the fluids, and giving her some pets because she had been a good girl

 

[silent meowlook]

In the Vet hospitals the IV fluids are stored in an incubator There was a study done finding no adverse effects from warming the fluids provided it isn't done in the microwave. I will see if I can find that study and link it here if I can.