Elderly CKD Cat Jakey Has Progressed to Needing Fluids (IV outpatient followed by regular SubQ at home)

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epona

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I would look into doing it with the line because it is so much easier and you can do it solo.
For sure if we struggle with this we will request that equipment - I was surprised we weren't doing it with drip line but we're happy to give this a go first.
 

Meowmee

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Did his first lot of SubQ at home today.
Vet wants him to have 120ml a week for now and see how he gets on with that, 3x 40ml spread across the week works best for us and our schedules, so we're going with that for now. We're giving syringe and butterfly needle method a go.

I think I'd struggle a bit doing it solo - simply because I have arthritis in my hands and keeping the cat still (even though we're feeding him during, he does tend to move around naturally when eating), the needle in place, and operating the syringe requires a bit more manual dexterity than I possess, but my husband used to be a nurse and it's really good to have him in control of the needle end of the proceedings.

We got most of it in where it was supposed to go before Jakey finished his meal and went hold on what's going on here then and managed to disengage from the needle - I'll know to feed him a bit more and keep a bit more of a firm arm around him next time. Most of it went in and that is better than nothing so we're happy enough with that as a first attempt.
That is great😀 it’s always good to have an extra set of hands when you’re doing this. I have a video somewhere of me giving Wizard his fluid which I will try to find. Wizard was really an angel and he basically just sat there without me even holding him lol 😹 I don’t think he was as good a patient as your Jake is at the DVM though.

If you make a video of this, I would like to see it because I don’t think I’ve ever done it with the butterfly needle syringe. I’m not sure what that is exactly.
 

G-Factor

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I did sub-q fluids for a bit with my CKD cat. I remember watching a video and somebody stated, "Imagine you are giving this to a very large cat (big cat like a lion), you probably wouldn't just walk up and stick them with the needle". I found it was a process. Get the cat into a relaxed state, make him/her feel comfortable. Lots of pets and love. Get some of their favorite treats and associate this with the process (I found some new treats that he never had before and only gave him those treats while getting sub-q). Make the quick injection then keep him/her occupied with lots of love and attention, while giving them treats until the fluids have been fully administered. This seems to work best for me.

Best of luck.
 
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epona

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Thanks G-Factor G-Factor - my Jakey is extremely food motivated, but he'd finished his bowl of food before we'd finished giving him the fluids - I'll check what other treats might be suitable as an after-dinner snack to keep him occupied for that last 10ml of fluids and to reward him for sitting still!
 

silent meowlook

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When I give my cat SQ fluids, I warm the bag first upside down in a pan of warm water. By upside down, I mean that the top of the bag where the connection to the line, or where you insert the needle to withdraw fluids is not in the water, but sticking out.

I use a venoset. It is a line that is inserted into the stopper of the bag. This way is much more sterile because the line in only inserted into the bag one time. If you are constantly using a needle to withdraw fluids into a syringe, then you are making multiple holes into the bag and increasing the chance of bacteria entering the bag.

I find the highest place I can in the house. I use my front door hinge. I hang the bag there and let the line fall to the floor. I undo the wheel clamp and clamp with the simple clamp that will be closest to the floor and the cat, when I bring the cat over.

Using a line instead of the butterfly will go much quicker, as the line is much wider than the line on the butterfly. I bring the cat to the fluids and sit on the floor. I insert the needle pointing away from the head and unclamp the simple clamp nearest to the cat.

I watch the drip of the chamber coming from the bag between the line and the bag to make sure it is flowing. It usually is pouring in a straight line. When I feel the fluid bubble get to the appropriate size and look up and it appears to be at the number I want on the bag, I clamp the line and remove the needle. I let the cat run away and neither of us discuss it again that day.

For me to give 100mls it takes about 45 seconds to a minute tops. It is easy. Once the needle is inserted, I can hold it with just one hand. I also don’t have to screw around with the stupid syringe which will undoubtedly move the needle some when I press the plunger.

I think it will be much easier for you with the line. I don’t know why anyone would use a butterfly set up for this.
 
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epona

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I think it will be much easier for you with the line. I don’t know why anyone would use a butterfly set up for this.
Yeah I think I'll contact the vet surgery and ask the head nurse about this, we were sent a load of info including a video about how to give fluids using a line so we were surprised when we were doing it with syringes and butterfly needles - it needs more than 1 pair of hands to do it this way, and also as the larger syringes are difficult to operate if you have stiff/painful hands (that is a 2 hands on just the syringe operation, no hands left over for holding the cat, holding a treat, or holding the needle in place), so we are using multiple 20ml syringes and reinjecting with a fresh butterfly needle for each (so 2 syringes/butterflies per session), which doesn't seem ideal.

It also takes something like 10 minutes to get the fluids (40ml per session) injected, what with swapping syringe and needle halfway through, by which time Jakey is full of food and looks up from his bowl starting to wonder what we are doing to him (and being highly food-driven, the best way to go about it is when he has a bowl full of food in front of him as he is completely focussed on that until he is full).

I wonder whether we are doing it this way due to the relatively small amount being given per session, that might be more difficult to control 40ml vs 100ml that some of you refer to using a line - anyway that's raised the thought in my head and I'll ask about that.

Thanks everyone for your input.
 
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silent meowlook

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The 1 liter fluid bags are marked with numbers for each 100 and lines in between the numbers for the 50 mark. I give my cat 50ml at a time. It is easy to figure out how much to give once you get used to the size of the lump the fluids make.
 

FeebysOwner

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Some of the bags do not have 50ml marker lines, but it is pretty easy to see when it reaches halfway. A little more or less each time isn't going to be problematic. When I gave Feeby 100ml for each session with a 20 gauge needle (Terumo thin walled needles, 20x1" are one of the best, IMO) it only took maybe 3-4 minutes, so giving 40 ml (or 50) will be pretty quick. She also didn't often get a lump with the fluids, so not all cats do. Even with a line, two people makes it easier, especially for watching the fluid amount and ensuring the needle stays in place - even more so if you feed Jakey too. Feeby learned she would get treats right after each fluid session, but every now and then she would squiggle a bit, or want to change her position in those 3-4 minutes.

I don't know what type of fluid container you use now, but going forward with the fluid bags/lines, they generally come in either 500ml or 1000ml. You would be best off with the 500ml because of how long it will take you to get through one. I used one 1000ml bag over the course of 10 days, which is supposed to be on the high end of how long one can use a single bag before disposing of it and opening a new one. Even at 50ml per session, you will be using a single bag for ~3 weeks. But, I have no doubt that not everyone follows that guideline and have no issues with not doing so. Could be something to ask your vet about. When using bags, always turn the bag upside down to warm the fluid, so that the ports are not submerged.

You might also ask if you should change out the line with any one given bag. The bags I ordered had two ports on them, so if you do need to switch lines during the time you use one bag, you can use the second port.
 

silent meowlook

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Hi. I have used fluid bags for up to a month with no problem. Most vet hospitals keep them in house for up to a month and those are used in multiple patients.

It may not be a lump but you can always feel the area where the fluids have been administered.

I prefer one person to two as I think it frightens the cat having more than one person.
 
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epona

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We got a 1000ml bag because apparently there's a supply/distribution problem with bags of fluid in the UK at the moment (we're having all sorts of issues with both human and animal drugs and medical supplies and have been for a couple of years - we've only personally been impacted by lack of my husband's ADHD medication, but also HRT and far more worryingly, insulin, have been in short supply, although that hasn't affected us)

So we were given what was available.
 

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You're reminding me of when Poppycat (rest his marvelous little soul) needed at-home fluids after his triaditus.

He was a long big cat. Initially he was literally too weak to care what we did to him. I forget the equipment but I was the cat wrangler/holder and my partner was the needle operator. As time went on, he was recovering and starting to get quite a bit stronger, and he started to definitely care LOL. I got accidentally poked with a needle at least twice, but of course the end result of his health was so worth it.
 
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silent meowlook

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I use 1000 ml bags of lactated ringers for my cats fluids. Been doing her fluids almost daily or twice a day for 3 years with no problems. My cat Rusty, who I miss everyday, I gave daily fluids to as well for 3+ years without incident. At every vet hospital I have worked at including specialty, 1000ml bags were used as well.

If you can have someone watch the fluid line on the bag for you so you don’t give to much.
 
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epona

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I am pleased to report it's actually going really well so far - we've got the time down a bit better (just due to learning the process and getting used to it), so he's now still face down in the food bowl by the time we've got the 40ml in and doesn't even notice anything going on beyond the rim of his bowl :D

He's regained a lot of energy and is more alert, more strength in his hind legs, pestering me more for attention, eating better, and his coat has gone back to being silky and soft and gorgeous. For a while there before he went in for IV fluids he seemed like he was on the way out, so this is all very welcome - for just a few minutes of effort from us 3 times a week to give fluids - well worth it.

I have noticed he has a bit of a licking session on his side about an hour after we've given fluids, but I am led to believe this is somewhat normal and just because the sensation of having fluid under the skin can feel a bit "odd" and is nothing to worry about (he is terrible at grooming himself usually, he's a bit of an oddball tbh, so it's just noticeable if he has a wash at all).
 
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fionasmom

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You are doing a wonderful job! This is a much bigger accomplishment than you probably realize. I would also guess that there is a sensation after the fluid are given and that he is reacting to it.
 
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epona

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Just the fact that he is mithering me right now to hold his paws (I might have mentioned that he is a bit of an oddball!) is a massive improvement on where he was 2 weeks ago - I honestly thought that when we were taking him to the vet for that appointment that it might be for the last time, because he clearly wasn't doing well.

This has given me my cat back :)
 
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epona

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I am so happy for Jakey and you!!! He may be a bit of an oddball, but that's OK!!
He is just so unlike a typical feline in a lot of ways.
He had a really difficult birth and wasn't breathing and had to be given CPR, which might account for his clumsiness.
He's also OSH which is a breed with some peculiarities compared to other breeds or Domestic cats.

He likes his paws held and pesters me to do so.

He is on me ALL the time I am here. He wasn't when Sonic (his half-uncle) was alive, because Sonic was on me ALL the time I was here and didn't let Jakey on ALL the time, Sonic was in charge but since Sonic died (and we both still grieve for him, Sonic and Jakey were inseparable from the moment they met, were never apart, and I am sure Sonic's death after 15 years basically joined at the hip caused Jakey so much stress that it set off his kidney disease) Jakey has pretty much lived on my lap since.

He is very clumsy, I have seen him tread on his own leg while trying to stand up and wondering why he can't stand up.
I have seen him fall off pretty much every surface in our flat, it used to give me the fear when he aimed for the top of the bookcases when he was younger because at least half the time he wouldn't make the jump and would go splat into the side of the bookcase and slide down.
So he has some minor issues with stuff like normal feline grace and balance and he's not very bright compared to most cats, bless his little heart.
He is the sweetest, most affectionate, thing - he loves everyone and everyone loves him. Vets and vet nurses love him, he's so sweet when he is at the vets even if he is a bit scared. Even my mum who is not a cat person loves him.
 
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FeebysOwner

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He is the sweetest, most affectionate, thing - he loves everyone and everyone loves him. Vets and vet nurses love him, he's so sweet when he is at the vets even if he is a bit scared. Even my mum who is not a cat person loves him.
This is a testament to Jakey - and to the care you have given him!
 

fionasmom

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He sounds like a little sweetheart. I did wonder about his breed from the earlier pic that you posted as he looks like a much thinner version of my flame point boy. After having had to put on a jacket and gloves to give Lily her much needed meds this morning, a loving little boy like Jakey sounds like a dream.
 
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