Subcutaneous (subq or SQ) fluid administration is the term used to describe giving fluids into the space under the skin (subcutaneous tissue) from where it can be slowly absorbed into the blood and body.
This is a very useful way of providing additional fluids to cats and helping to manage and prevent dehydration. The amount or dose of fluids given will be determined by your vet. A general guideline that vets follow for maintenance is 10 ml per pound of cat per day. Cats with heart disease are given less. Some vets prescribe daily fluids, and some vets prescribe fluids every-other-day or a couple of times per week. The type of fluid that’s given subcutaneously will be determined by your vet. You can learn about the different fluid types and some of the pros/cons of each from FelineCRF.org.
There are two different methods for delivering subq fluids. The most common method is to use the “drip bag” or “gravity” method. Subq fluids can also be administered using the “syringe method”
Be sure to check out the troubleshooting page if you encounter any problems with giving fluids to your own cat.
What You Will Need
I’ve included direct links to where I’ve purchased these products from, in case you need ideas on where to go to get them.
|Product||Method Used WIth||Where I’ve Purchased|
|Lactated Ringers 1000 ml (See this page & pay $25 for a whole case)||Both||Walgreen’s Pharmacy, Thriving Pets, Chewy|
|IV Line||Drip||Thriving Pets (anything except the 30 inch line from this page will work)|
The Braun lines DO NOT have separate injection ports for giving additional meds. The other lines do.
|Syringes – 60 ml Luer Lock||Syringe||Thriving Pets, Blowout Medical|
|Extension lines||Syringe||Thriving Pets|
|Winged Infusion Sets (Butterfly needles) 21g 3/4″||Syringe or Both||Thriving Pets, Blowout Medical ( SV21BLK)|
|Terumo Needles (if not using butterfly needles)||Drip or Both||Med-Vet, Thriving Pets|
|18g Needle (for drawing fluid into syringe from bag)||Syringe||MedLab Supply, Thriving Pets|
|IV Pole*||Drip||Vitality Medical, Amazon|
* recommended, but not strictly required
Check out Choosing and Buying Needles if you need more information on how needles are sized and what all the different numbers on the labels mean.
Shopping for subq fluids supplies can take a little bit of practice and planning. If you are just getting started with giving fluids to your own cat, do yourself a favor and purchase your first kit directly from your vet. The vet will provide you with the fluid bag, line, and needles. They may even attach the line to the bag for you.
The fluid bags used in this process require a prescription. As far as I know there isn’t anyplace where you can buy them, in any country, without a prescription. There may be some less-than-reputable sources, but as this is something being injected directly into your cat I would strongly advise against attempting to use any fluids that can be acquired without a prescription.
Helpful Pages and Articles
How to Give Subcutaneous Fluids with an IV Giving Set has really good instructions on the basics of how to give fluids using the Drip Bag method.
Weird Stuff We Make is another very popular site with information on giving fluids.
FelineCRF also has some great tips on patience during the process. And additional tips are on the same site in the pull-down menu on the left “Basic Caregiving”. The first, “Philosophy and Technique” has been very popular over the years.
How to Give Subcutaneous Fluids with a Syringe has good instructions on the basics of how to give fluids using the Syringe method.
Drip Bag Tips and Tricks
FelineCRF.org has a lot of great tips to get you started.
When using this method it’s important to “prime” or “bleed” the line with fluids before the start of each session. “Priming” the line is simply running fresh fluids through the line before poking the needle into your cat. The fluid you’re “wasting” in this step is a very small amount – typically 10 ml or less. Priming the line before each session removes any air bubbles that developed in the line between the previous session and now. And, if you’ve warmed your fluids, priming the line gets rid of the cold fluid in the line and replaces it with warmed fluid.
Here are some good videos on different topics relating to setup and administration of fluids that are also very helpful.
TIP: Before you spike your bag, double check the roller clamp on your line. You want the clamp to be “closed” or in the “off” position before spiking the bag. If the clamp is in the open position you might accidentally drain air out of the fluid bag, causing it to collapse. If your bag collapses the lines for measuring fluid volume will not be accurate. A collapsed bag can be fixed, but they’re best avoided in the first place.
Safely removing and replacing the needle at the end of a session is just as important as the setup. Here’s a short video on how to change the needles.
This video has been very very helpful to many, many members of Tanya’s CKD Support Group:
For cats who do not like to sit still during fluids, there is an EZ IV Harness you can try.
You can also try mimicking the EZ IV Harness, as shown in the following video.
And there was also a discussion on DVM360 that has another alternative to the EZ IV Harness.
Giving fluids in an open-top carrier, box, or laundry basket helps some cats feel more comfortable in the process.
Adding additional medications during a subq fluids session is somewhat common. Here is a video demonstrating how to do that (a broken arm is not required for this to work).
Dr. Sophia Yin has some great tips on training your cat to accept injections.
Injection training works for small shots like insulin for diabetes but is also good to practice for subQ fluids.
Here is a video on training your cat to accept injections:
Where to hang the bag?
It’s easy to hang the bag if you are in the bathroom using a shower rod, or have a hook conveniently placed on your walls. But, what if you don’t have those things or your cat hates the location where those things exist? An IV pole can be a great solution, but if you don’t have space to keep one then you might need to get a little creative.
One member of Tanya’s CKD Support Group had this idea:
From the start, one of the biggest stumbling blocks has been location. I just don’t have a good spot where Smokey and I can sit calmly while the bag is hanging somewhere above us. Or even in front of us.
Yesterday, I put of one of the big Command hooks on my sloped ceiling. (The hook has a weight limit of 5 lbs, which is plenty.) Then I got a 24 inch extender hook from a garden shop–the kind used to hang potted plants.
Add in 12 inches for the bag and 6 feet for the line, and I’ve got plenty of room to maneuver. And the bag is hanging high enough that gravity kept the flow rate nice and fast. Smokey got just under 100 ml in about 4 minutes.
The bag hangs down far enough that I can get a pretty decent idea of how much she’s gotten. And she seems to like things better without me squeezing the bag and just pushing the fluids into her super-fast.
Total cost for this project was maybe $10
Syringe Method Tips and Tricks
The syringe method is my favorite method for giving fluids. You can read about why I feel that way here. I will admit, the internet was woefully lacking in good resources when it comes to using the syringe method. So much, in fact, that I decided to do something about it!
I realized that my original videos didn’t fully cover what you need to know about setup for the syringe method, particularly if you need to add additional medicines, so I made one video that explains that whole process for you.
Cat, who starred in my demonstration video, is one of those cats who is so calm in the process that he does not seem real. Because not every cat is as calm as he is, I decided to also share the experience of giving fluids to another of my cats, Muffy, beginning with her first-ever session.
Muffy’s second attempt at fluids was also filmed. There was a 10 day gap between these videos during which Muffy was hospitalized with a pretty bad urinary tract infection and kidney infection.
After about one month of receiving subq fluids daily, here is Muffy’s progress with the process.