Sub-Q Fluid Therapy for Cats with CRI or CRF: Subcutaneous Fluids to Treat Chronic Renal Insufficiency in Cats

Chronic renal insufficiency, a common and eventually fatal illness among older cats, can be slowed down significantly with Sub-Q fluids. CRI Cats that receive Sub-Q fluids have far better quality of life and usually live longer.

How It’s Done

Owners inject fluids into the scruff of the cat’s neck using a home injection kit comprising an IV fluid bag, tube and needle. While Sub-Q does not repair kidney tissue, CRI cats receiving fluids live longer and feel better.

Although it sounds intimidating, as these pictures indicate, it’s actually quite a simple procedure and a veterinarian can provide guidance and training, working with the owner for the first few injections until the owner is comfortable doing it alone.

Sub-Q fluids are given anywhere from once a week to daily, depending on the severity of the CRI and the cat’s tolerance of fluids. Directly after injection, most cats have either a “camel hump” on their back or a water pouch on their tummy or leg. This can last for up to 24 hours, but may recede more quickly.

Preparations

Ideally, you’ll have a two-person team so that one person can distract the cat with toys, food, or pats while the other does the injection, but the procedure is manageable with one person. When administering Sub-Q fluids at home, first check for holes in the IV bag by gently squeezing it—a hole means that the fluid is contaminated.

Fluids can be heated slightly by running warm water (body temperature) over the bag to make the injection more comfortable for the cat. Fluid should not be warmer than tepid as this could be dangerous, so owners who choose to warm fluids should be very careful not to warm them too much. A microwave should not be used because it heats unevenly.

Hanging the bag high above the cat helps the fluid flow more quickly. Very squirmy cats can be wrapped in a towel to prevent them from accidently dislodging the needle. Staying calm during the procedure will help your cat to stay calm as well.

Have a favourite treat or food on hand to give to the cat during or immediately after the injection to create a positive association with the procedure. Cats that know they will soon receive a reward tend to be better behaved.

Common Mistakes

Mistakes many people make when first administering Sub-Q fluids include accidentally pushing the needle right through and out the other side or jabbing themselves with the needle. Also, if the owner accidentally hits a muscle, the cat will react and the liquid flow will stop. With a bit of practice, the procedure gets much easier and mistakes are less likely.

Getting Rid of Used Needles

Dispose of used needles in a sealed container that is labelled so that no one will accidentally open it up and stick themselves. Needles should never be used more than once, and if the needle becomes contaminated (you accidentally drop it on the floor or the cat squirms and it falls out), start fresh with a new needle.

Further Reading

Aug 22, 2008 5:46 PM

Guest :

I did the second subtucaneous fluid treatment with the help of my husband to my very ill old cat tonight and got so nervous about the fluids that were simply coming out and back to the towel he was sitting on. He does not like the procedure. I am used to giving insulin shots and had very little trouble, but with this procedure I feel like giving up. Any help?

Aug 22, 2008 7:12 PM

Jennifer Copley :

One of my cats requires fluid injections every night, and I was very intimidated by the procedure at first as well, but I've become used to performing it and it's relatively easy now.

Do you know why the fluid is leaking out? Is the needle not all the way in, or has it gone right through and come out the other side? Or did the cat struggle during the procedure, dislodging the needle? These problems are really common - everyone I know who has administered sub-Q fluids has experienced one or more of them at some point.

If the cat is inclined to struggle, you can wrap a towel around his body, leaving just his head and neck free, which helps to keep the cat still when you're doing the procedure alone. If the needle has gone right through or not in far enough, you can start over with a fresh needle. It's just a matter of practice to get the right level of force - far enough in but not too far.

Cornell University College of Veterinary Medicine offers a very comprehensive instructional video for administering sub-Q fluids: http://partnersah.vet.cornell.edu/fhc/subcutaneous-fluid-therapy

The Mar Vista Animal Medical Center also provides video of a veterinarian doing the procedure, as well as briefly covering some of the common problems: http://marvistavet.com/html/subcutaneous_fluids.html

I hope that helps. It does get easier with time to do this.