Subcutaneous injections for cat=Beyond frustrating
April 23, 2015 7:42 PM   Subscribe

My cat was diagnosed with kidney disease and as of this Monday she's supposed to get 100ml of sub q fluids for the next 3 weeks every day and then they want to do another blood test. Monday was a breeze because we did it at the vet's with the vet tech showing me how to do it. She administered 50ml and then I did the remaining 50ml. Buffy, my cat, was so compliant. Not a peep out of her.

Not so on Tuesday when I tried to give her the fluids. She did not like the needle, but after a second attempt, I managed. Wednesday the same thing. I ended up splitting the doses because she pulled the needle out, and I couldn't bring myself to poke her again and she was getting rapidly animated at my strange behavior of trying to poke her with a big needle.

Tonight, I just tried it while she was lounging next to me on the couch, and the needle definitely hurt her this time, so I stopped. I grabbed a new needle and made a couple of more attempts to grab some skin, but she kept turning around to look at me. I don't think I have the heart to make another attempt. I'm a nervous mess. It wouldn't be so bad, at least I think it wouldn't, if I had someone to help me and be there for emotional support. My boyfriend will be over on the weekend, but I'm on my own for the rest of the week.

I have no idea how I'm going to manage this, and I feel like a huge failure when I see all these websites making it look like it's a simple procedure because it's not for me.

I'm actually thinking of taking her the vet to have them do it, but I have no idea how much that'll cost, and I've already spent over $300 on vet visits and supplies.

Does this get better?
posted by hazel79 to Pets & Animals (29 answers total) 3 users marked this as a favorite
Call your vet and ask them if they'll help. When I was working as a tech there were several times that people would come in and I'd assist them with this (or just do it for them). So long as they had appointments and we weren't in the middle of anything, it was no big deal and we didn't charge them (like you, they had already paid a bunch for all of the bloodwork and supplies, plus it didn't require any time from an actual DVM).

That said, I always worked at an independently owned place not a chain, so YMMV, but it is absolutely worth a call.
posted by Ufez Jones at 7:47 PM on April 23, 2015

hazel79: "Does this get better?"

YES. I am creeped out by needles and had hysterics in the vet's office when I learned to do it. After a week or so it was pretty routine. It is tough to do solo -- you need a second pair of hands to hold the bag and turn things on. A makeshift IV stand will help. Restrain the cat to hold him still; the needle is big and does hurt going in, doing it all at once instead of needle multiple punctures will hurt the cat less, even if you have to HOLD him in place for a while during the procedure.

It also helps to present an immediate reward after the fluids -- we gave a spoonful of baby food chicken.

hazel79: " I grabbed a new needle and made a couple of more attempts to grab some skin"

Are you doing it in the scruff? That skin should be pretty easy to grab.

It's also okay to go a few more times to the vet (yeah, as Ufez Jones says) in the first couple of weeks while you get the hang of it ... even if you do have to pay for a few appointments, you will figure it out after you have a little help and a few more practice runs. Some people do just take their cat to the vet's Every. Day. because they don't want to do the fluids at home.

The hardest part is honestly getting good at putting the needle in -- developing good aim and learning how much pressure you need to get it in smoothly. (Honestly I just got cold all over just thinking about popping that needle in, and I did it for my cat for more than six months!) It definitely takes practice, and don't feel bad that it's taking you some practice to learn! Nurses and vet techs take weeks and weeks poking people/animals with needles to learn before they graduate ... you're in a stressful situation with your cat and trying to learn in one day! With a little practice, you'll be a pro.
posted by Eyebrows McGee at 7:54 PM on April 23, 2015 [3 favorites]

Sub-q fluids are HARD! The vet techs who showed me how to do it made it seem sooo easy, then it was a total mess at home. Do you have someone who can help you, at least in the beginning? IIRC it really requires four hands unless you're a pro.
posted by radioamy at 7:55 PM on April 23, 2015

Finding the right spot seems to be a difficulty for me. All the videos I've watched show them grabbing this huge scruff of skin, but I never seem to manage that. I'm not sure if it's just because I'm afraid of hurting her and am not grabbing hard enough. I may call my vet tomorrow and see if I can have them do it a couple more times.
posted by hazel79 at 8:03 PM on April 23, 2015

Does this get better?

I never exactly got blase about it, but I got better and faster and more confident*. I took the Linus into the bathroom and would kneel on the bathmat and tuck the cat between my knees - I'd have everything all ready, with the (warmed!) saline bag hanging on the towel rack and a fresh needle loaded and I'd just scruff him and insert it as quickly and steadily as possible, and then flick open the valve. Do go to the vet for more lessons and some pep talks/hand-holding - it's a scary thing when you've never had to do it before, but you can learn it and it will get easier.

*I stabbed myself with the needle a couple-three times, and it really doesn't hurt - that thing is sharp! I mostly would only realize I'd stabbed myself because I'd notice I was bleeding on the poor cat.
posted by rtha at 8:05 PM on April 23, 2015 [2 favorites]

It does get better. It sucks to think you are practicing on your beloved kitty, but you can't really hurt him, and you'll get better quickly. It sounds like you are doing this on your own -- do you have anyone who can help you? I found that it really helped to have one person to hold the cat, and another person to stick the needle in and operate the switch on the fluid line.

If you are doing this by yourself, try using a binder clip to scruff the cat so you have both your hands free to handle the needle and turn on the fluid as quickly as possible.
posted by OrangeDisk at 8:12 PM on April 23, 2015 [1 favorite]

Like Ufez Jones says, it's totally fine (if inconvenient) to take her in to the vet's to have them do the injections for you. It's very hard to do with one person. They will either do it for free or have a nominal (like $10) "Injection Fee".
posted by Rock Steady at 8:13 PM on April 23, 2015 [1 favorite]

Oh, I've been exactly where you are! I ended up doing these treatments twice a week for over a year and YES it does get easier! My cat definitely took his cues from me and the calmer and more matter-of-fact I was the calmer he was. At the beginning I was so tentative about the whole thing because I was afraid of hurting him but with practice it really does get easier--mechanically and emotionally. Do go back to your vet and ask for help--that's what your vet is there for. Plus, once you can see how much better your cat feels after each session it makes it a bit easier. Good luck--it never gets fun, but it definitely does get easier.
posted by bookmammal at 8:16 PM on April 23, 2015 [1 favorite]

I called the vet crying the first time I tried to do fluids, it was emotionally tough and I was clumsier than the vet techs. It did get much easier. I eventually found it was easiest to offer her some wet food to eat while I administered fluids. She'd sit still to eat (rather than trying to walk or jump away) so that was much easier. I found the scruff worked best, she'd flinch if I tried to administer the fluids elsewhere. So I'd do right side, left side, middle so it wasn't always in the centre.

I also watched videos on youtube of people demonstrating how to administer the fluids and that helped too.

I also had a terrible start when I had to give a different cat insulin and both times I told myself I'd try it for a month, and by the end of the month, it was so much easier for each.
posted by haunted_pomegranate at 8:21 PM on April 23, 2015

Thanks to everyone. You all made me feel much better. I'm going to give my vet a call tomorrow and see if I can take her in for another demo and some tips.
posted by hazel79 at 8:22 PM on April 23, 2015 [3 favorites]

Sounds like you have a good plan. I just wanted to say, you are not alone. With my last cat, I would be reduced to a sobbing mess every time I had to give her pills, which sounds like a much easier task than injecting subcutaneous fluid. My only consolation was that even the vet found it difficult to pill her. I don't know whether it says more about the cat or the human but I think sometimes there's just such a strong empathetic bond between us and our pets that doing this kind of thing is really, really hard. Hang in there.
posted by Athanassiel at 8:50 PM on April 23, 2015

My husband and I had to do this for years with our cat, with him (and sometimes his mom) holding her while I did the needle. Here are some tips:

-- try a butterfly needle at the end of a flexible tube which attaches to the syringe, if your cat is very squirmy this will help to keep the needle in as she moves around.

-- practice "tenting" the skin without inserting a needle. Pick up the scruff between two fingers and look how it creates a triangle, like a tent. The middle of this triangle is where you want to put the needle.

-- hold the needle parallel to kitty's back as you insert it into the tent of skin. That way you won't insert it too deeply, and it will rest comfortably as the fluid goes in.

-- use a wide bore needle for faster flow

-- hang the bag from a nail on the wall or other handy object, one less thing to have to fuss with

-- definitely get the tech to help you the first several times, and give you more pointers. Everything gets easier with practice!

-- pix of your kitty pls :)
posted by Koko at 9:43 PM on April 23, 2015 [2 favorites]

1) You can practice. Sit down with the cat, in the place you will actually be doing the fluids, practice getting your handful of loose skin, and feed the cat treats and talk to her. You don't have to actually insert the needle for the practice sessions.

This will help you get better at finding the right section of skin (you can try different places!), and it will get the cat used to being handled this way so she may not feel the need to constantly try to look around at what you're doing.

Practice a lot. You can even brush her. Your goal is to get a new routine in her mind of going to sit quietly with you in the special happy place where she gets petted and treated, so she has no real reason to be worried or suspicious.

2) Is there a chance there's a nice cat-friendly neighbor who could help you? Ask a favor, make a friend. Bonus: possible future cat sitter.

3) You could even experiment with feeding the cat while she's getting fluids. Treats, or a bowl of food. If she's as into food as some cats I know, she might not even notice other things going on.

4) People with difficult cats tend not to make those videos that make it look sooooo easy.

5) You can also build trust with your cat by spending a little more non-medical time with her -- probably not necessary in your case, but I thought I'd put that out there just in case it helps.
posted by amtho at 9:47 PM on April 23, 2015

I'm sorry that you're having to go through this, sending good thoughts to your kitty.
posted by nephilim. at 11:17 PM on April 23, 2015

How often are you changing the needles? I had to do this for my cat, and the older a needle was the less easily it would slip in. I'd change needles after 3 uses at most.
posted by EmpressCallipygos at 3:37 AM on April 24, 2015

I had to administer subq fluids for over a year to my (alas) now-deceased female cat, who was up to 150 ccs at the end. Some additional thoughts:

1) Some cats just won't tolerate this at all, so you shouldn't feel bad about having to ask the vet to do it.

2) While being pricked by the needle is obviously going to be annoying to your cat, they aren't as sensitive in the scruff region as you might think. (I suspect that they're more irritated by all those fluids trickling under their skin.) An "ow" response means that you may have hit a muscle.

3) It really helps to get the cat accustomed to receiving fluids at the same time and in the same place. If the cat already has a preferred spot to sleep, you might try there; my cat was on the bed all the time, so I just attached the bag to a nail on a nearby wall.

4) Definitely try to associate fluids with something the cat likes--lots of petting, treats, whatever works.
posted by thomas j wise at 4:11 AM on April 24, 2015

I made an appointment with the vet today, so she won't be too happy but the vet is only a 5 minute drive away so luckily it's not terribly traumatic for her.
posted by hazel79 at 7:45 AM on April 24, 2015

Your profile doesn't say where you are. If it happens to be Denver, I'll come over and help you. I'm on my third "kidney cat." Do warm the saline bag a bit ... the cold saline is what they really don't like. Also calm down if you can, be relaxed. Your cat is picking up on your anxiety.
posted by cyndigo at 8:54 AM on April 24, 2015 [1 favorite]

You can absolutely do this! It does take practice, and you will improve over time: we gave 150ml saline DAILY to our kitty for more than a year, and it really extended the quality and quantity of her life (a little bit of extra fluid really helps the kidneys). Setting up the bag before grabbing the kitty, always doing it in the same place (we used the bathroom) so that it's a ritual is good, too.

N'thing that the kitty is picking up on your upset/anxiety also, but once it's established that this event is finite, kitty will relax (and so will you!). Good luck, you can do this.
posted by Pocahontas at 9:41 AM on April 24, 2015

I've had to do this and I have advice! YAY! Unfortunately it's the opposite of what someone else here suggested, but I consider this vital.

The number one thing that changed the difficulty level of this was getting Terumo ultra-thin needles. My (beyond awesome, cat-only) vet didn't have any and I only learned about them searching through crazy cat forums. Ultra-thin will decrease the flow rate some compared to regular vet needles, but the comfort of my cat was worth the extra wait. He didn't flinch with them going in, and this was a cat I had major struggles with previously. Give them a try. I ordered mine online and suffered for a few days with the ones my vet gave me, but then it was night and day. I changed them after every session (but not every poke, if he managed to wriggle out of my lap).

General advice things: I poked all the way through his skin one time, with the needle coming out the other end of his scruff. I freaked out like no tomorrow, he had no idea it happened. Fear not! Cats are tough little things. I know when they're sick it can feel like they're made of glass and you're loathe to do anything to make them feel worse, but it does get easier.

Terumo needles. #1.
posted by erratic meatsack at 10:35 AM on April 24, 2015

I went through this with one of our kitties. It definitely gets easier.

I turned to Tanya's website constantly for advice. She has a page on sub-q fluids, with links and lots of advice, including a section on how to make it easier. In that section, she recommends using the very thin Terumo needles, as erractic meatsack also recommended. We used the thin needles, and it makes it much easier to pierce the skin -- like going into butter.
posted by merejane at 11:12 AM on April 24, 2015

For some kitties, this can be tough, even when done by veterinary professionals. It's easy to understand - there's a poke, the fluid may be cold, there's this weird heavy pocket on top of their back.

One thing you can try is from Dr. Sophia Yin's amazing repertoire of low stress handling techniques - the kitty burrito. Using a bath towel, it is pretty easy to fold it around your kitty cat so that you are protected from claws, you can access the scruff region, and the kitty is less stressed.

You may also consider warming the fluids before injecting them by putting the fluid bag (not the line) into a container of warm water and allowing it to equilibrate. Your cat may be more comfortable if the fluids are closer to body temperature.

I also second everyone suggesting you get some pointers from your vet! They should be able to give you enough needles so that you can use a new one for each injection. You don't want to innoculate the subcutaneous space of a cat that is already ill, and your vet really has plenty of them to give you.
posted by Seppaku at 9:51 AM on April 25, 2015

It will get easier! It is hard to do with one person. If you have a cat-loving friend or family member near by, ask them for help. My husband held the cat and I inserted the needle; I don't think we would have been successful without both sets of hands. The first night was really awkward -- it took forever, I had to poke the cat multiple times, and the fluids went everywhere... It was rough. We watched a few YouTube videos before we did it again and the second night was so much easier. After a week or so, it was a breeze. You can do this and it will get better.
posted by whatideserve at 10:20 AM on April 25, 2015

If you do get the hang of the injecting part, but find that your cat does not want to sit still while the fluid goes in, you could try the EZ IV Harness. We did not use it wiith our cat; he was pretty mellow, and usually did not mind sitting still while the bag emptied. But I have read good things about it on message boards, in posts by people who have tried it.
posted by merejane at 11:08 AM on April 25, 2015

You can do this! I've found that the most comfortable way for me to hold my Topper while I'm giving him fluids is to sit on the couch and tuck him up against my right side. (I'm right handed, if you're left handed do the opposite.) Pinch the scruff with my left hand and place the needle with my right, then move my left hand to hold the needle steady between his shoulder blades and keep it from sliding out while I circle my right arm around his side and place my hand on his chest. This keeps him trapped on all four sides, plus my hand on top so he really has nowhere to go, and I can stroke his face and chest with my right hand to help keep him calm. Be smooth, quick and confident and ALWAYS give treats when it's done. My cat is very food oriented, so he actually begs for his daily fluids now just so he can get the treats.

As far as equipment goes, I use a microphone stand and a coat hanger to hang the fluids on and make sure to hang the fluids a foot or two higher than the couch so the fluid flows faster. I also use the 18 gauge needles for faster flow, as the actual poking doesn't really seem to bother him. Also, change the needles with every stab. Even if it slides out before you're done, change the needle before re-inserting to minimize the risk of infection. Tanya's website really helped me get through the initial stages of dealing with chronic kidney disease. It's been about a year and a half since we almost lost my Topper to unrecognized dehydration, but he's doing great now and just a few months away from his 20th birthday!

P.S. Love that your cat's name is Buffy! If anyone can get through this, Buffy can!
posted by platinum at 1:42 PM on April 25, 2015

Oh, and check your local pet stores and pharmacies for sub-q fluids and supplies instead of buying them from your vet. I discovered a nearby pet store carried them for a third of the price!
posted by platinum at 1:45 PM on April 25, 2015

Well, I managed to get them in her today though she was super peeved, so I gave up after about 50ml. I made another attempt at the final 50 just now with a couple of changes. I put her on my bed, one of her favorite spots ever and did warm the fluids though I think they might have still been too cold for her(I'll have to work on that), and managed to get the final 50ml in her. She was a bit irritated with the tail swishing back and forth, but she seems to be over the insult and is curled up on my lap right now.

I think I will get the smaller needles, though. These monoject they gave me are huge.
posted by hazel79 at 4:31 PM on April 25, 2015

I have to give my cat Gina sub-q fluids, and she is what the vets like to call a land shark, yet she and I have the fluids down pretty good. My biggest thing is that I administer the fluids in a bathroom. It is a neutral area to her and also it is set up to make it easier on both of us, free of distractions and also, inescapable. I hang the bag of fluid from a hook on the door. In the beginning I would put her in the bathroom and leave her alone with some treats for some time and let her calm down, but I don't bother with that anymore; she knows what's going on. I sit down on the floor and hold her between my legs with her facing away from me so I can do it without any help from another person. With the fluids hung so high it usually only takes a couple of minutes to get 100ml into her. When it's finished I spend more time pinching and massaging the injection site to make sure the fluids don't leak back out. If I can do it, you can do it. I hate needles and just the thought of jabbing Gina initially made me ill, but it saved her life and she is back to being a spunky little fireball so it is worth it.
posted by jenjenc at 7:37 PM on April 25, 2015 [2 favorites]

can i just say that this thread saved my sanity. my SO and I last night gave up after poking our poor kitty 10 times; today i followed the recommended tips and now we have a fluid full cat! God this sub-Q stuff can be stressful for all
posted by angrycat at 3:03 PM on January 12, 2016 [1 favorite]

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