How to administer meds with sub-Q fluids

FeebysOwner

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Here I am again. I want to give Feeby her B-12 injection via her sub-Q fluids. I know about the y-port that is included on most lines from the sub-Q fluid bags, mine included. But I am having trouble finding instructions/videos that show the process in detail. Anyone have thorough instructions or videos that show how to do this? Thanks!
 
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FeebysOwner

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Thanks, but no. It does not address how to add meds to the sub-Q fluids through the y-port. it mentions it, but that is all.
 

catdad61

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Are there rubber stoppers or plastic screw on connectors at the y port?
This may help. It's for nursing but the procedure is the same.
Med Admin
 
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Antonio65

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I would add supplements and vitamins to sub-Q's to my sweet Lola, but I would use a different technique than the bag and line that most people here use.
I would use large syringes and butterfly needles, with RL in them. It was easy to add anything to the fluids prior to the injection.
 

BellaBlue82

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I've added fluids through the Y port before for Nico. When he was sick he was on various medications and the vet was gracious enough to prescribe them as injectable so it would be easier to administer. She showed us how to do this at one the visits and it was a life saver. We used a 1cc 25G syringe to inject via the Y port once we had his IV inserted. The ringers bags I used didn't have any rubber caps, it was just like the rubber stopper on an injectable bottle of medication that you could puncture through with the needle.
I don't know if that is helpful but I hope so!
 
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FeebysOwner

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Are there rubber stoppers or plastic screw on connectors at the y port?
This may help. It's for nursing but the procedure is the same. Med Admin
Thanks, the video did help some. I wasn't sure about stopping the flow in the line before injecting the med into the y port. Still not completely clear about that, but I will continue to watch more videos when I can find them. It appears it is rubber stopper on the y port, I couldn't find anything to unscrew.
 

BellaBlue82

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Ah, I see what you mean. Our vet instructed us to get the IV placed, open the line so that the IV is flowing, and then inject through the rubber stopper while the IV is flowing. She also recommended letting the IV flow a bit more after the injection so it clears the lines and pushes all the medicine through. Don't be afraid if there is some resistance with the rubber stopper, we had to give a pretty good "shove" to get the needle in.
Don't inject the B-12 before the line is placed though, I tried that once and sadly the force of the injection pushed it out the other end (before I had the IV placed) and it leaked out the other end even with the line clamped! Womp womp lol. Cleaning up B-12 is not the greatest. 🤦‍♀️
 
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FeebysOwner

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Our vet instructed us to get the IV placed, open the line so that the IV is flowing, and then inject through the rubber stopper while the IV is flowing. She also recommended letting the IV flow a bit more after the injection so it clears the lines and pushes all the medicine through.
That is exactly the kind of information I was looking for! It sounds like I can inject the B-12 at any point in time during the administration of the 100ml of LR, preferably while there are still more fluids to finish so the line is cleared! Thanks, again!

EDIT: one more question (hope you don't mind). I have insulin needles, gauge 25 for when she was receiving the B-12 before the sub-Q fluids were started with her. Would these needles be 'tough' enough to push through the rubber stopper on the y port?
 
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catdad61

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The 25ga needles should work. Just be careful to push straight into the stopper. It'll help keep the needle from bending, they are smaller than the ones I've used for that purpose. And as was pointed out, the rubber stoppers are tough to get through. The reason to pinch the IV line is to prevent the medication from backing up the IV line, but if you're infusing the entire contents it isn't really necessary. Flushing the line with fluid after the B12 is just to make sure all of it is administered and not have left in the tubing. Hope this helps.
 
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FeebysOwner

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The reason to pinch the IV line is to prevent the medication from backing up the IV line, but if you're infusing the entire contents it isn't really necessary. Flushing the line with fluid after the B12 is just to make sure all of it is administered and not have left in the tubing.
Oh wow! The sub-Q bag is 1000 ml, so used 10 times. So, I do need to close off the line when inserting the B-12 into the y port then? I guess you re-open the line after watching the B-12 drain out of the y port and finish the 100ml of fluid? Does simply running the finish of the fluids 'flush' the y port, or is there another step needed - like syringing fluid through the y port after the B-12 is drained?
 

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Oh wow! The sub-Q bag is 1000 ml, so used 10 times. So, I do need to close off the line when inserting the B-12 into the y port then? I guess you re-open the line after watching the B-12 drain out of the y port and finish the 100ml of fluid? Does simply running the finish of the fluids 'flush' the y port, or is there another step needed - like syringing fluid through the y port after the B-12 is drained?
I used to administer Nico's B12 similarly... He was getting 100 ml a day, so we did 10 times each bag as well. I usually didn't pinch the line if I already had his IV placed, as long as you push the plunger on the needle steadily. I used to do a nice even pace and I would watch it flow through the IV line to make sure it wasn't back flowing, but also that I got his entire dose in. I don't think I ever encountered any issues with this method, and it appeared all the B12 (and his anti nausea med which was injectable too) cleared the line pretty quickly. I never had to syringe any fluid back through the Y with this method either.
 

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Oh wow! The sub-Q bag is 1000 ml, so used 10 times. So, I do need to close off the line when inserting the B-12 into the y port then? I guess you re-open the line after watching the B-12 drain out of the y port and finish the 100ml of fluid? Does simply running the finish of the fluids 'flush' the y port, or is there another step needed - like syringing fluid through the y port after the B-12 is drained?
I would pinch the line while administering the B12, just to ensure it's all delivered. Yes, just flushing the line with the remaining fluid will flush out the line. Nothing further needed.
 

silent meowlook

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Hi. sorry i didn't have time to read all the replies so this may have been said.

Where you attach the needle to give the fluids, the needle that goes into the cat, There should be a small rubber stopper that comes off of the IV line. The part that goes from the cat to the fluid bag. Before you give the fluids, draw up the amount that you need of the Vit. B12. Usually it is 0.5 cc. and sremove any air from the syringe just like if you were going to inject it. Take the rubber stopper that I mentioned above and grasp it with one hand with the stopper towards the ceiling. With the other hand hold the syringe after removing the cap and stick the needle into the very center of the stopper. It is hard to see but there is a small circle on the stopper and you need to stick the needle right in the middle of it in a straight line so it doesn't go through the line ad out the side. Then you get your cat to do the fluids. After giving almost all of the amount of fluids that you are supposed to, hold your cat and the needle with one hand while still giving the fluids and with the other hand push the plunger into the iv line. I will sometimes do this by pushing the sryinge against the floor if it is a bigger syringe. A small syringe I can usually inject with one hand. Watch the IV line for the pink color of the Vit b12 to dissapear and then you are done.
 
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FeebysOwner

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sorry i didn't have time to read all the replies so this may have been said.
Yeah, it pretty much already has been said, but never hurts to have it repeated. One or two deviations from most of the others, if I understand you correctly. I presume you are proposing to insert the B-12 syringe needle into the y port 'ahead of time' and waiting until the sub-Q fluids are close to done before pushing the syringe plunger on the premise that I am doing all this without the help from a second person? If not for that reason, then I am not sure why I wouldn't do as others have suggested and wait until the fluids are nearly done and then insert and inject the B-12 at the same time.

The other deviation is whether or not to stop the flow of the sub-Qs while injecting the B-12 into the y port. Some say to do so because it will prevent the B-12 from entering the line above the y port. Others don't seem to think that is necessary. This is a 1000 ml bag that will be used over 10 days, which could have implications on 'to stop or not'.
 

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You can add the B12 anytime before the fluids finish as long as there is enough fluid left to flush the tubing out. Pinching the line is only important if you are administering a large volume of medication to prevent if flowing up the tubing and being diluted in the fluid bag and thereby reducing the amount of medication administered. But with small volumes, like 0.5ml pinching the tubing isn't necessary. I usually used medications in the 10 - 50ml range on my human patients and usually intravenously not sub-q, where pinching the IV line was recommended.
 

Joey's mom

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Thanks, but no. It does not address how to add meds to the sub-Q fluids through the y-port. it mentions it, but that is all.
The B12 was liquid, the tech inserted it into the port without any difficulty. That's wonderful you are able to administer the fluids. I had to take Joey on a daily basis for 2 yrs.
 
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FeebysOwner

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The B12 was liquid, the tech inserted it into the port without any difficulty. That's wonderful you are able to administer the fluids. I had to take Joey on a daily basis for 2 yrs.
If/when you ever have the need for sub-Q fluids, have the vet techs show you, and I am pretty sure you can do it. I am not saying it isn't a bit nerve wracking every time I insert the needle, but other than that, the whole process isn't really bad at all. Injecting the B-12 into the sub-Q y port was the process I had trouble wrapping my head around until everyone here helped. I also gave Feeby B-12 injections at home before she went on sub-Q fluids, so maybe that helped me adapt to as well.
 

Joey's mom

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If/when you ever have the need for sub-Q fluids, have the vet techs show you, and I am pretty sure you can do it. I am not saying it isn't a bit nerve wracking every time I insert the needle, but other than that, the whole process isn't really bad at all. Injecting the B-12 into the sub-Q y port was the process I had trouble wrapping my head around until everyone here helped. I also gave Feeby B-12 injections at home before she went on sub-Q fluids, so maybe that helped me adapt to as well.
Problem is I have severe crippled hands with limited mobility, no problem using my finger tips to type but I can't get a good grip on things, nor hold a pen to write comfortably. All those I know who had to administer the fluids were able to do it without any difficulty, they would send photos of their cats standing still. All my cats were fighters, even before I acquired limited use of hands, I was never able to pill them without difficulty. Thanks for responding.
 
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