Sub-q Question

[Jrs86]

Hi guys,
I just signed up to this website today, as my 10 year old, Binx, was just diagnosed with kidney failure yesterday. Of course I’m devistated, but many of the posts on here have given me hope and a positive attitude to tackle this as best Binx and I can. I was just shown how to administer the sub-q fluid last night and my vet is recommending 200ml twice a week for him. He’s also on an appatite stimulant, a laxaxtive, as he was constipated leading up to this, and aluminum hydroxide. He’s been drinking a lot of water and peeing a lot which is part of why I took him to see the vet in the first place. He first received the fluids Wednesday night (2 nights ago) and another dosage last night. I’m not sure how much he got Wednesday, but he got 200ml last night. My question is, should he still be drinking a lot of water after two sub-q treatments? Thank you

 

[artiemom]

Hi there, I am so sorry to hear about your sweet Binx.

I had to give my guy daily sub-q's, of 100 cc, and it was not for renal disease. It was for constipation; so I am going by my own experience.

I think 200 ml twice a week is perhaps not enough for him. I wonder if he needs sub-q's more often, every other day or everyday.. and at a lower amount than the 200ml.

He should not be drinking a lot of water if he is well hydrated.

Are you still feeding dry food? If you are able to, that has to go. Wet food is better for renal kitties; try adding a bit of extra water to the food.

Here are a few tips I found, and what people have advised me:

Warm the bag in a pan of water.. to a nice comfortable bath temp. Do not get the line wet ~~~ about 10-15 minutes.

Try giving the sub-q's when and where your kitty is relaxed. I hung up a hook at my guys sleeping spots. I used a white coat hanger to hold the bag, up high.

I found that using his cat tree, was a bit more challenging for him. He was more restless; but on the couch, and his tent, was easier.

I also ran out the cold fluid from the line, before I gave it to him. The cold does shock their system.

I also took a small hand towel, in case the needle came out or I had gone through the skin.

Keep praising you kitty by saying, "Good Boy"..

If you can get some ultra thin walled needles, those are the best. I used 20 gauge or 21 or even 22. The higher the number the thinner the needle; however, the SLOWER the flow.

I got mine from ThrivingPets.com

The Terumo needles were the best; unfortunately, the company discontinued them. If you can find them, they are at a premium, and costly.. who knows about shipment also...

Hopefully, these tips will help you..

I wish you luck,
((hugs))

 

[PushPurrCatPaws]

... He first received the fluids Wednesday night (2 nights ago) and another dosage last night. I’m not sure how much he got Wednesday, but he got 200ml last night. My question is, should he still be drinking a lot of water after two sub-q treatments? Thank you

Hello and welcome to TheCatSite -- I am so sorry to hear about Binx!

Regarding your question, I shouldn't think he should still drink a lot of water after the subQ's. Is he doing so?

 

[Jem]

My CKD cat still drinks even with the sub-q fluids, although he does drink less than he did after we started him on them. Your cat will drink if he feels the need, so don't stop him from doing so, but I wonder if the administration of the fluids should be tweaked to keep his hydration more even? For example, if he's getting 200mls twice a week, perhaps giving 100mls daily for a couple of weeks (just to bring his hydration up) then tapering it down to every other day still (100mls) on going would work better for him? I would really recommend speaking to your vet about the amount and how often you give it. In my experience, 200mls is quite a bit of fluid for one dose, at least long term.

My cat's CKD is advanced and he get's 100mls daily, this has been for over a year now.

Also, I'm not sure what you feed your cat, but hopefully you feed a wet/canned food diet. That will also help keep his hydration up, and usually has better overall ingredients, because there is no need for extra filler to make it into a kibble. It is usually better for on going constipation problems a well.

How are the fluids going so far? How is you cat (and you) handling them? I know it can be difficult at times. I hope all is going well. And like artiemom , I've got a few tips and tricks up my sleeve also, should you need some extra input.
I'm glad your kitty has you.

 

[artiemom]

I used a white coat hanger to hold the bag, up high.

I meant to say, WIRE coat hanger...

 

[PushPurrCatPaws]

My CKD cat still drinks even with the sub-q fluids, although he does drink less than he did after we started him on them. Your cat will drink if he feels the need, so don't stop him from doing so, but I wonder if the administration of the fluids should be tweaked to keep his hydration more even? ...

If my cat were still drinking a lot after 200 mls of subQs (which, to me, is on the higher end of any I've ever given to a cat in one sitting), I would be concerned.

Just to be sure, I'd have my vet check out if the right fluid solution & balance is being given to my cat,
Fluid therapy: Calculating the rate and choosing the correct solution

 

[Jem]

Just wanted to add one more thing, when it comes to his appetite, the fluids will help with that also. when the toxicity level goes up (because the kidney's don't filter as well) it will cause nausea. CKD cats are prone to not wanting to eat because of this. The fluids not only increase the hydration but keep fluid going thru the kidneys, to flush them out better.
I would recommend getting a variety of canned foods to help with his appetite. When cats gets nauseated, they will often associate the feeling with their food. So they might eat it in the morning or for a few days in a row, then all of a sudden turn their nose up at it. So I like to keep my cats food on a rotation so he never "tires" or associates his nausea to the food I give him. I have 5 different wet food options for him. In a few days, you will hopefully notice an improvement in his appetite and will not require the stimulant long term.
Also, if he has nit been eating well for the past while, that could also be one of the reasons for the constipation. If he's not eating enough food, he won't push what's in him very well or very fast. They need food to keep the motility going.
Once he eats more regularly, and especially if it's wet food, you hopefully will no need constipation aids.
I totally understand if the need is there, but when dealing with kidney disease, the less medication the better. You don't want the kidneys to have to filter more than they need to.
Were the medications the vet gave you for short term?

This is just a thought, and I would still ask the vet about his drinking but, I wonder if his continued drinking is because he's sort of hungry due to the stimulant but as mentioned above he's turned off his food at the moment because he still thinks it made him fell sick before? Has he started eating more yet?

Or it could be that it will simply take a few days for the fluid to hydrate him to the point where he feels it. It took almost a week for mine to show signs of improvement with drinking, eating and energy levels.

 

[Jrs86]

Just wanted to add one more thing, when it comes to his appetite, the fluids will help with that also. when the toxicity level goes up (because the kidney's don't filter as well) it will cause nausea. CKD cats are prone to not wanting to eat because of this. The fluids not only increase the hydration but keep fluid going thru the kidneys, to flush them out better.
I would recommend getting a variety of canned foods to help with his appetite. When cats gets nauseated, they will often associate the feeling with their food. So they might eat it in the morning or for a few days in a row, then all of a sudden turn their nose up at it. So I like to keep my cats food on a rotation so he never "tires" or associates his nausea to the food I give him. I have 5 different wet food options for him. In a few days, you will hopefully notice an improvement in his appetite and will not require the stimulant long term.
Also, if he has nit been eating well for the past while, that could also be one of the reasons for the constipation. If he's not eating enough food, he won't push what's in him very well or very fast. They need food to keep the motility going.
Once he eats more regularly, and especially if it's wet food, you hopefully will no need constipation aids.
I totally understand if the need is there, but when dealing with kidney disease, the less medication the better. You don't want the kidneys to have to filter more than they need to.
Were the medications the vet gave you for short term?

This is just a thought, and I would still ask the vet about his drinking but, I wonder if his continued drinking is because he's sort of hungry due to the stimulant but as mentioned above he's turned off his food at the moment because he still thinks it made him fell sick before? Has he started eating more yet?

Or it could be that it will simply take a few days for the fluid to hydrate him to the point where he feels it. It took almost a week for mine to show signs of improvement with drinking, eating and energy levels.

I decided to give him some fluids for the first time today but it didn’t go so well. I’m really nervous about doing it wrong and hurting him. I put the needle in and he chirped and squirmed the whole time and eventually hissed. I didn’t get much in him at all before I stopped. Maybe I grabbed more than skin when I made the tent? I scheduled an appointment for later today at my vet to have a tech watch me do it myself. Hopefully this will get my confidence up. Binx didn’t even squirm or make a sound when the tech first showed me how it’s done. Maybe because he was scared/stressed/ distracted by all that was going on in the back room at the vets? They’re using 18 guage needles, but I’m thinking of ordering 20 or 21 Termo’s frok thrivingpet.com. As for eating, I was able to get him to eat some wet food today for the first time. He finished all that I gave him which wasn’t very much because I didn’t think he’d go for it anyway. It was mixed with medication, so that’s good news since he doesn’t mind the taste. The food he’s getting is a kidney diet formula given to me by the vet, so hopefully that helps.

I’ve also read many posts on here about how their cats bounced back fairly quickly after their dose of sub-qs. Binx has little moments of energy but then quickly goes back to laying down. Hearing that your cat took a little longer to recover makes me feel better and gives me hope.

Thank you

 

[Jem]

Please don't be afraid of hurting him. For the most part, cats aren't bothered by needles. Don't worry either, you're not alone, I was so terrified, I almost thew up and shook really bad at first. It's awful to think you need to jab your kitty with a needle. I get it.
Some things to keep in mind though, that might make him squirm that has nothing to do with your technique...
Choose a place where he is comfortable and will want to lay down quietly. I was told that the more you try to hold them down the more they stress and try to get away. Do you have someone who can help you? A second set of hands can be very helpful in keeping kitty distracted. Wait until he is comfy, pet him a bit, before you put the needle in.
Was the fluid too cold? Make sure the fluid is slightly above room temperature. You can place the bag in some warm water for a few minutes before hand, or place a warm wet towel (wet towel, and put in microwave for 10 second increments until nice and warm) then place it over or put the bag on, it to warm the fluids a bit. The closer to body temperature the fluids, the less the shock to your cat.

When I go to insert the needle, I make sure to pull up as much slack as I can. I then make a dent in the skin I pulled up. Eventually, my thumb and middle finger are keeping the slack up while my index finger is keeping the dent in place. Right under my index, in the center of the dent, is where I quickly, and firmly (try not to hesitate) stick the needle. Having the dent there really helps with my aim, to go in straight.
Sometimes, if you go too slow, they will feel it more. And if you don't have a quick straight aim, you could potentially scrape the skin (cut them) before it goes in. (and YES, I've done it!)
As soon as the needle in in place, turn on the flow and start loving on your cat. Ours stays the most distracted if I vigorously scratch his chin, it's his favorite.
Not sure where your cat is health wise, but CKD cats tend to loos a lot of weight, as mine has. So he has a lot of excess skin. Because of this it can happen that the needle will actually "go thru". You'll know if this happens if you see the fluid streaming down. If this happens, just stop the flow and pull back the skin away from the needle point area, while holding the needle in place so it does not move. I've started doing this before I even turn on the fluid just to be on the safe side. (Because YES, I've done that too!) So I just make sure the skin is flat and there are no folds in it.
Sometimes you may also notice the the flow is not moving well or at all. It is usually because the needle point is pressed up against some tissue, stopping the flow. Simply pull back the needle a bit (don't pull it out) and slightly angle it over one way or the other. Better to do this than have to re-insert it again IMO.

I still encourage you to go back to the vet to get a quick lesson again, especially if it will help to ease your mind. But I just wanted to give you some tips on things that I encountered. We all do our best, and even with that, little mishaps can and probably will happen. Just please don't give up, it does get easier, even with the bumps along the way. And these little bumps don't mean you're a terrible caregiver. And even if Binx is uncomfortable till you get the hang of it, I'm sure you'll do great and find your groove. I'm pulling for you, you'll get it!!

 

[PushPurrCatPaws]

Jrs86 - How did your appointment go with the vet tech today, if you have done that yet?

Here is a search page you can explore,
giving cats sub q fluids youtube at DuckDuckGo

plus there are a lot of good threads on giving subQ fluids here at TCS but one that comes to mind is this one,
Feeling A Bit Nervous

Here's a general search:
Search Results for Query: sub q fluids | TheCatSite


You could also try to search TCS in a search engine, with something like this:

site:thecatsite.com sub q fluids​

Doing that might pull up a lot of older threads, prior to 2017-2018...
site:thecatsite.com sub q fluids at DuckDuckGo

 

[Jrs86]

The appointment went well, thank you. So much love and support on here, it really really helps a lot, thank you. The vet watched me do it on my own and she said I did everything just fine. I think she could tell I was nervous, but having her there helped big time. Binx didn’t react at all, other than wanting to get off the exam table which he always does anyway. But when I put my head next to his to comfort him, he rubbed his face against my chin and was purring, so that a great sign as to his comfort level. I still think being at the vet is a huge distraction for him so the little prick didn’t bother him. However, at home when he’s relaxed and in his environment, that prick stands out. Maybe for now. Tomorrow I’m going to have my mom or friend over to stand by while I try it on my own.

And thank you for the links, I’ve seen many of them. When I first got the bad news, I was up ALL night reading everything I could on the subject and found this amazing site.

So thank you again for your advice and support, truly.

 

[mrsgreenjeens]

Glad things went well with your "training session" with the Vet. Try to remember, you are NOT hurting him, you are HELPING him .

You've received all kinds of great tips already, but if you need more, here is another website that is my go to for most things kidney related: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat.

Oh, and I meant to tell you, with one of my kidney cats, every time we finished up giving him his sub-q fluids, he would immediately go to his water dish and drink up . I think for him maybe it was a comfort type think . I don't know, but he always did it.