Administration of Subcutaneous Fluids at Home

            Many of our patients require periodic administration of fluids under the skin (subcutaneous or SQ) for a variety of metabolic conditions.  Some clients elect to have the fluids administered here at the hospital which we are more than happy to do.  However, many clients are willing and able to administer these fluids at home, saving time, money, and stress on the pet.  Prior to at home administration of SQ fluids we like to instruct the owner on how to do this.  We can set aside time for one of our technicians to demonstrate the process for you and your pet in one of our exam rooms.  Don’t forget to bring your pet!  At this demonstration visit we will supply you with the following materials:

1. bag of fluids - usually Lactated Ringers solution or 0.9% Sodium Chloride, either 1000 ml (1 liter) or 500 ml (1/2 liter)
2. administration set - long clear plastic tube to connect the bag of fluids and the needle and has a rolling white plastic clamp to regulate the rate of flow
3. needles - usually 18 gauge (green end cap)

            The actual procedure for administering fluids under your pet’s skin is really very simple.  With a little practice we find that most clients become quite proficient.

1. Have everything you need ready to go.  Make sure that you have a new, sterile needle in place.  Some people like to attach a new needle as soon as they finish the procedure.  Others like to attach a new needle just before the procedure.  Either way is fine as long as you are consistent so that you know that the needle you are using is sterile.
2. Suspend the fluid bag from a cabinet, the ceiling, a lamp or other elevated location.  You can fashion a hanging hook from a coat hanger.  Keep in mind that the greater the distance between the bag and the pet the faster the fluids will flow.
3. Make the administration of SQ fluids as positive an experience as possible.  Pick a quiet location where both you and the pet can be comfortable.  Take a few minutes to calm your pet with your voice and gentle contact.  Offer the pet a small treat at the time of the procedure.
4. Place the pet in your lap, on the floor, or on a table, whichever is most comfortable for you and your pet.
5. Grasp the skin over the shoulder blades so that it makes a triangle or tent.
6. With the opposite hand grasp the needle at the base and direct it towards the pet’s head.
7. Quickly insert the needle through the skin staying perpendicular to the skin.  Visualize your target as the empty space created by the skin tent.
8. Hold the needle in place, allowing it to lay flat along the pet’s back.
9. Note the starting position of the fluids in the bag.  If necessary you can mark starting and ending points with a marker or with tape.  The numbers on the bag of fluids represent 100s of milliliters.  So if the fluid level drops from 100 to 200 on the bag you have administered 100 ml to your pet.
10. Open the clamp on the administration set by rolling the plastic wheel upwards allowing the fluids to flow through the tubing and into your pet.
11. You should be able to see the fluids flowing from the bag through the cylindrical clear plastic chamber at the top of the administration set.  If the chamber is completely full of fluid, turn the bag upside down, squeeze the plastic chamber and then release until there is sufficient air in the chamber.
12. If the fluids are not flowing quickly you can gently reposition the needle under the pet’s skin until a solid stream of fluids is seen in the chamber.
13. If fluids begin running off of your pet’s skin you have likely run the needle completely through the skin and have come out the other side.  DO NOT PANIC!  Stop the flow of fluids by rolling the wheel clamp down thereby pinching off the plastic tubing.  Reposition the needle under the skin.  Restart the flow of fluids.
14. Once the fluid in the bag has reached the final target volume, stop the fluids by rolling the wheel clamp down thereby pinching off the plastic tubing.
15. Pinch the skin around the needle and gently remove the needle from the skin.  Continue to pinch the skin for several seconds to encourage the hole in the skin to close.  It is normal for a small amount of fluid to leak from the hole in the skin.  This fluid is sometimes colored pink by a small amount of blood.
16. Carefully recap the needle.
17. Congratulations.  You have successfully administered subcutaneous fluids to your pet.
18. If your pet ever shows signs of difficulty breathing, coughing, or open mouth breathing – discontinue giving the fluids and call the clinic.
19. Repeat the administration of fluids according to your veterinarian’s directions.  These individualized directions are summarized below.
     

            If you ever have questions regarding any of the above information, please do not hesitate to contact us.  Visit us online at www.WhiteBearAnimalHospital.com.

WHITE BEAR ANIMAL HOSPITAL                           OTTER LAKE ANIMAL CARE CENTER
          1909 East County Road E                                                     6848 Otter Lake Road
       White Bear Lake, MN 55110                                                       Hugo, MN 55038
                  (651) 777-1393                                                                  (651) 426-8871