sub q fluids....Please Help

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Yeah, Lori, if your nurse friend is available, trying once more tonight would be a good idea. Good for Tom, and it'll make you feel more confident tomorrow instead of stressing about it and losing sleep.

Carl
 
Lori, did you see the links I posted? What happened when you tried the second time exactly? Is Tom squirming away? Crying? What helped with my GA Tabriz was setting up a routine. I had a nice comfy place where I always gave the fluids, to include a nice fluffy towel to lie on. The pictures I provided show the way to tent and well as ways to deal with a squirming cat. Take a deep breath and try again in a little while. If Tom is very dehydrated, he does need the fluid. If you can get help this go around, that would also help build your confidence too. You can do this!
 
he lets me get the needle (harpoon!) in without much fuss...then about 10 seconds of juice goes in and he crys and trys to walk away. i panic and pull out the syringe, it squirts every which direction...i put finger over it to stop it, i scream OUCH and see blood. finally i turn off fluids.
the thing with tom crying....he tolerates pain very very very well so if he crys something is wrong.
dr. called.
all the blood came back good :shock:
red count a little low
amyalyse a bit elevated.
i'm soooooo confused.
he ate some ff volutarily tonight (fish and shrimp) and his hard kibble.
i'll go see if the nurse is home.
 
See if you can get him to lay down on a soft blanket, belly down. Then sit next to him, with your legs like a corral around him. The trick is to try to get his feet under him so he doesn't try to get up and walk away.

You say he starts crying once the fluids start to go in... you may not have it tented enough, or the needle is in far enough so that its hitting resistance at the end of the tented part. Try maybe pulling the needle back just a bit. You're right, it's a harpoon, so it's plenty long enough to pull out a 1/4 or 1/2 inch and still keep the tip under skin. Also, I go about an inch to one side or the other of his spine just behind the scruff. Usually the right side because of the direction he's facing (to my left).

Carl
 
Karen is right.....not too fast. The only time Kitty reacts is if I push too hard.

You really can do this!

Could Tom have Pancreatitis--- did they mention that ?
 
Bless your heart. Wish I lived close by so I could help. It gets easier. The kitty harpoons are awful. If you have to do this long-term, order some nice sharp Terumo needles. They make a much smaller hole in the cat and are much sharper than the usual ones vets use. The Terumos have a thinner wall so they make a smaller hole than other needles of the same gauge. I used 19G ones on Tabriz and sometimes the 20G, but the smaller the gauge (larger the number) the slower the fluid flow. Though 19G were bigger, Tabriz wasn't a very patient cat so he appreciated being finished faster than having to wait. I use 20G ones on Shaikha since she's less of a squirmer.

The key is tenting, but placement is also important. Tabriz seemed to feel most comfortable when I gave him fluids between the shoulder blades. Flanks were not good for him at least. You make the tent and just ensure the needle goes into the tent itself, rather than into the muscle. You do need to be firm with him though and try to get him to stay put. Initially it is a little shock when the fluids go in (especially if they are not warmed first -- if they are the right temperature, they barely notice them) so that may be why you are getting the reaction too. Try to keep the needle in because it will go all over if you pull it out. Don't put your finger over the needle! There is too much pressure with fluid to stop flow that way anyway. Use the wheel to stop the flow or the little clamp they usually have on the line. I usually gave fluids sitting on the floor with Tabriz between my legs on a soft towel, so even if fluids spilled it was easy to clean up. Initially when you do this you will see a definite fluid pocket, but over time the skin will loosen up some and you'll have a much less defined area where the fluids go in. If you check out the links at Tanya's site she gives a lot of great pointers. Giving lots of love before, during, and after fluids also helps. Tabriz usually purred the whole time once I got my technique down.

A low red count could be caused by any one of a number of things. How low was it? Anemia can make them feel yucky and make appetite poor, but usually only if more severe (say less than 20% PCV).
 
yes, a 'snap' blood test for pancreatitis was mentioned.
fwiw, i like this dr. but he like all the others is not all so up to date or smart.
tom registered bg's over 200....i commented it must have been vet stress as he has been topping out at 110 for weeks. no no the vet said...this is about normal for a diabetic :roll: whatev's.....
 
Karen,

lori and tom said:
I am using the bag now...and he is supposed to get it everyday. 150 units.....
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I think she's using the IV now rather than the syringe, although she said "syringe" last post.
With the flow set wide open on my bag o' ringers, 100 cc's takes probably 3 minutes, although it seems like 20.

Carl
 
gosh, i don't know what 'ringers' are???? i have a bag, i hang it high...
the first time he got syringes. my neighbor gave it to him (she's a nurse) before our vet visit cuz he was so dehyraded looking. now we are on the bag. i'm not sure what all the terminology is...ringers and such.
i just have a bag, a long tube with stop gaps, and a harpoon.
 
lori and tom said:
yes, a 'snap' blood test for pancreatitis was mentioned.
fwiw, i like this dr. but he like all the others is not all so up to date or smart.
tom registered bg's over 200....i commented it must have been vet stress as he has been topping out at 110 for weeks. no no the vet said...this is about normal for a diabetic :roll: whatev's.....
Click to expand...

If you suspect pancreatitis, I'd suggest getting spec fPL test and sending the blood off (must be done fasting!) rather than the snap test. The snap test will only tell you if Tom's in the definite area, and with pancreatitis there is a gray area where cats can be but still have it. The number is important, but the snap test won't give that. The snap tests's one advantage is it gives you a reading right away but will only detect cats that have very high levels of the enzyme. The problem with pancreatitis is that the spec fPL test will only come up positive if they are actively having a flareup, but a cat can still have it but the test will look either borderline or normal. I'm glad this vet is thinking to test this though. Any cat with diabetes that "ain't doing right" for no obvious reasons probably ought to be tested for pancreatitis in my opinion.
 
Lori,
"ringers" are lactated ringers. Just a solution different than the saline solution you're using. Mine just happens to have potassium added to it because that's what Bob needs.
Lactated ringers is commonly what some vets and some wildlife rehabbers use to rehydrate animals. Same setup - bag of clear fluid you hang, a half mile of tube with a shutoff valve of some sort in the line, with a big old needle at the end.
Your nurse friend happened to have saline solution which also can be used to rehydrate.
Carl
 
the bag of solution i am using now has all kinds of electrolyte things in it.
just spoke to the nurse walking by with her 5 dogs.
she's coming over in the morning for coffee and subQing Tom!

And the really really really good news...TOM JUST ATE RABBIT! this is a healthy meal. he ate his rabbit and purred.
so today he actually did pretty good,
he had about a handful of crunchies.
1/3 cup of fish and shrimp fancy feast.
a wee bit of tuna and water.
and about an ounce of rabbit.
I hope this is not another 'teaser' and maybe he's on the mend.
I get so excited when he eats and then get let down when it's a singular incident.
EATING VIBES Tom....eating vibes eating vibes eating vibes....fall asleep to that dear sweet tom cat...eating vibes.
 
Joanna! Thank you for stopping by. Tom has been having a terrible time, just horrible.
And Wendy, thank you for your suggestion.
This vet is very nice...but not anywhere near as wise as the wisdom i get from all of you...thank you.
 
lori and tom said:
gosh, i don't know what 'ringers' are???? i have a bag, i hang it high...
the first time he got syringes. my neighbor gave it to him (she's a nurse) before our vet visit cuz he was so dehyraded looking. now we are on the bag. i'm not sure what all the terminology is...ringers and such.
i just have a bag, a long tube with stop gaps, and a harpoon.
Click to expand...

This link will help. Look at the pictures of the pinch and wheel clamps: http://www.fabcats.org/owners/kidney/subcutaneous/info.html

Lactated ringers is a type of IV solution that is buffered.
 
wendy i recognize the whole gig, but mine is called normosol R mulitiple electrolyes.
think it's any good? i'm gonna google it.
 
lori and tom said:
wendy i recognize the whole gig, but mine is called normosol R mulitiple electrolyes.
think it's any good? i'm gonna google it.
Click to expand...

What I've been told about normosol is that it can burn, which may account for Tom's reaction when he's getting it. The R type has no dextrose, which is good. Any fluid you get should NOT contain dextrose as that can cause infection when given subQ. Lactated ringers is the type that most people seem to give because of the buffering. I did a google search and found this on the archives here: http://www.felinediabetes.com/phorum5/r ... ?8,1230670
 
I can vouch for the burning as I poked myself with the harpoon and got the solution in my finger.....and yes it burns like salt on a wound!
 
Can you call your vet to see if you can get plain lactated ringers (no dextrose)? That would probably be much appreciated by poor Tom. If it burns for you, imagine how it feels to him having it under his skin in a pocket. Ouchie! Some of these fluids are fine for using IV, but they are not as fun to use for subQ administration. If your vet can't get it, he can also call in a prescription to a pharmacy. Walmart has pretty good prices on fluid, but you can check around. If you get it at a place like Walmart though, you have to order a full case at a time. If this is a temporary thing, your vet can probably get a few bags pretty quickly.

The improvement you've seen is likely due to the fluid you've gotten into him so far though. It is amazing how much fluid can perk a dehydrated cat up. Dehydration makes them feel pretty lousy. Good to hear he chowed down!
 
I can't help it, I laugh everytime you call it a harpoon :lol: But seriously, I hope that the fluids help Tom, and I'm glad that his bloodwork came back ok. Hopefully the fact that he ate his bunny rabbit (sniff :cry: ) is a good sign that he's on the road to recovery! :YMHUG: :YMHUG:
 
Calming and healing vibes comin’ out to you and Tom. Hopefully he’s on the mend now and things will improve for you both.
:YMHUG: :YMHUG: :YMHUG:
 
Charliemeow said:
I can't help it, I laugh everytime you call it a harpoon :lol:
Click to expand...

Have you seen those needles? Seriously, you'd call them harpoons too. :shock: I got the usual 18G Monojects from my vet when I started subQ fluids for my renal failure cat and I was scared to poke my poor GA Tabriz with it. Most renal failure groups call those needles harpoons because they leave a huge hole in the cat. I was more than happy to relegate them to the cat supplies drawer when my nice thin-walled Terumos arrived! Tabriz was glad to see them go too! :lol:
 
Well, I successfully sub q'ed tom this afternoon. All by myself for the first time.
He was very good, only tried to soldier crawl away once, but I respected when he clearly told me he'd had enough. Think I got 100u's in him. Vet suggested 150 daily.
I was surprised to see he was pretty dehydrated looking this morning as he ate his dinner last night. But I see he ate nothing of what was left out for him overnight.
Today, by 4:30 our time he is still working on his first can of ff (2/3's thru) supplemented by a small amount of crack.
I really don't know what to think. Everyone is asking if he's feeling better. He has always seemed ok. The eating is better but not enuf yet. His blood work was all good with a slightly low rbc and slightly elevated amylase (?)
I hate that he has come to not enjoy the pokey poke like he used to. He is upset with the GREAT BIG POKE and has decided on a NO POKE POLICY.

Oh, and I received a gift from my boss's husband. A big coffee mug that states "Cat's like Obedient People"
Well, everyone knows that!!!!

Hugs,
Lori
 
Yay Lori! :RAHCAT

Did you manage to get hold of plain lactated ringers or are you still using the Normosol? Tom will get used to the subQs as you get better with technique and develop a routine. If you have to keep this up longer term, I'd suggest looking into getting a box of Terumo 19 or 20 gauge needles. If Tom is less patient, then go for the 19 gauge ones. Though they sound like they are not much smaller than the 18G ones vets usually dispense, they are thinner and much more sharp too. It makes for a more comfortable session for everyone. I order mine at Brico http://www.bricomedicalsupplies.com/CRFpage.html, but there are other places online such as Thriving Pets. You will need a prescription to buy them, though, but your vet should provide this if you ask.

The dehydration and lower appetite suggest to me pancreatitis. Did you test for this yet? Another option in the interim is to try an anti-nausea drug such as ondansetron. That usually will do the trick in getting appetite back to normal. Pain or nausea will throw off a cat's appetite, as will dehydration itself.
 
Not to put too fine a 'point' on it Lori, but fluids are given in mls ( Milliliters), not "u"'s.

U's are for insulin. If you gave 100u's of fluid, that would only be 1 ml of fluid a tiny amount.

A ml is the same as a cc (cubic centimeter).
 
hey, do you know what gauge needles you are using for the sub-q's?

wonder if i might have some smaller ones i could send you some of. I bought a box of the size several people here recommended way back when Spazzie needed them regularly before her chemo treatments. I'm pretty sure I have some of them left but would have to look when I get home to make sure and to make sure what size they are. I know my vet gave me the 18 gauge which neither Kitty or Spazzie cared for so I ordered some online that were better. I thought i got them from thriving pets but i know i didn't have to have a prescription for them though to get them. they may have changed that rule since i bought mine.
 
ok, let's see. the vet only gave me 6 needles, so no bag to look at. I am reusing the first one over and over...is that bad?
Ok with my galses I can see it says...monojet 18X1A.
Sooooo, do I need better?
Tom does really well with Pain. He is a tough Tom. It's not me being insensitive...far from it. Tom let me know what he can take and what he can't.
And I listen.
So cindy if you have something better, yes.
And we are staying with the normosol as it seemed to go down well with the nurse.
Pancreatitis...some say CRF....I don't know. The vet is only as smart as his google searches I'm afraid....but nice and that is different for us.
Still for anyone that read about Tom's nervous breakdown...how can I possibly get him again? Both of those diseases are treated by diet right? Basically nothing they can do?
I had the feliway and it just did nothing for him.
I have buprinol injectables in case he gets pain.
I hoped the subq would help.
I still do.
 
NO! Do not reuse needles. They get much less sharp and hurt as a result: http://www.caninediabetes.org/pdorg/bd_needle.htm. Use a new needle every single time. A box of 100 costs about $6.00. What blood tests did they do for Tom? Did they test for pancreatitis? What about kidney function? For that, you'd need readings on creatinine and BUN at the minimum. Creatinine is the most important number but having a figure for BUN is also helpful as you can use it to determine whether a GI bleed is present. With the mild anemia, that could be caused by one of those or kidney problems, but pancreatitis could do it too. I would suggest you switch to lactated ringers though as normosol does burn. What you don't want is getting Tom afraid of subQ sessions, so tough or not, if they don't hurt, he'll be more cooperative.
 
that's 18 gauge needles and i want to say what i have is 20 gauge perhaps but am leaving shortly to go home so i'll check for sure. if so, i'll bring some and mail them to you tomorrow.
 
lori and tom said:
ok, let's see. the vet only gave me 6 needles, so no bag to look at. I am reusing the first one over and over...is that bad?
Ok with my galses I can see it says...monojet 18X1A.
...
Sooooo, do I need better?
I hoped the subq would help.
I still do.
Click to expand...


Somebody already said, but I'll reenforce - you don't want to re-use the needles. One time, and then straight to the "sharps" container.

Yeah, the 19 or 20 gauge needles will be a little easier on Tom.

Keep hoping. It will help soon. With Bob, I could tell after the 1st treatment that he felt better. But at the same time he got the sub-q fluids, he had also been given an injection of Adequan by the vet, so he should have felt a whole lot better. The first time or two I did the sub-q fluids at home, there wasn't a huge improvement, but after that, it was obvious Bob felt better within a hour or less after getting treated. Give Tom a couple days. I think you'll see an attitude improvement and just the way he moves around will show you he feels better. And he will associate the "torture" with the end result of feeling better, just like when you first did ear pricks and insulin shots. He'll resist less, or quit resisting and just put up with you.

Carl
 
Lori dear Lori....I had not seen your posts until now. I have two renal kitties getting subqs.

First...ditch the normosol and get lactated ringers solution. If you buy a prescription card at Walgreens for about $20/year, you can buy a case of 1000 ml bags for $22. MUCH cheaper than the vet. I like th BBraun DEHP free bags.
Second...go to thrivingpets.com and order Terumo ultra thin wall 21g needles. Yes...it might take a scootch longer but to tell you the truth, i can get 125mls of LRS in Gus in less than 5 mins and he purrs the whole time.
Third...also ata thrivingpets.com you can get the IV set ups for the BBraun for about $2/each; you don't need the ones with the port. I think the ones I get are V1402.

Thrivingpets.com is fast.

Don't use those harpoon 18g...they hurt like hell and normosol stings.

Sending healing vines to Tom Tom and love to you.
 
ok, computer at home wouldn't work last night so here i am back at work this morning.

i did have 20 gauge Terumos and brought some to work with me. will address the package right now and get them out to you in today's mail. priority so it should be to you pretty quick.
 
u iz da bestest mz cindynmousie...now mai mama won torchur mai wit da harpoon no mor. i iz fureva gratful 2 u n mousie.
lord thomas
 
Cindy + Mousie said:
ok, computer at home wouldn't work last night so here i am back at work this morning.

i did have 20 gauge Terumos and brought some to work with me. will address the package right now and get them out to you in today's mail. priority so it should be to you pretty quick.
Click to expand...

I have also sent Lori a few 20ga Terumos.

Filled the rest of the space in the box with rice socks !!!
 
so thankful.
I skipped his sub q for the day....so far. just want him to have that comfy needle.
todays diet so far...3:30 afternoon.
a few licks of tender beef and chicken ff with water added.
2 bites of raw rabbit.
1 temptation
and 4 or 5 kibble.
all totalled, maybe 1 ounce of food.
It's a slow day.
But he finished off quite a bit of food in the middle of the night if I am to believe it was really him.
Thinking...did a rodent get in and eat this????
 
Cindy, Karen and Sheila,
WOW! What a difference that 20 guage needle made. I'm so glad I waited for it and did not subQ him until it got here. He let me brush him WHILE he was being juiced up...he purred thru-out. It was like magic. And this is with the normosol, unheated (not warmed) fluid.
My tom is like a soldier, a real tough marine if you will. He does not require the extra steps in compensating for pain. The smaller needles were enuf for him.
I am not insensitive to my guys needs, once again, I just know my Tom. I give him an abundance of creature comforts and more....but after all the serious fights he's been in, he truly is ok with a bit of discomfort. He's a mans man. A Lord amoung Lords, A warrior and a Hunter. He's a Lion and a Tiger. (except when going to the vet :oops: , then he completely falls apart....melt down)
Those things are not what I am god knows...but they are what Tom is.
 
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