Giving Subcutaneous Fluids at Home

There are numerous circumstances under which a patient may require fluid administration under the skin in the home setting. Any time extra fluids are needed to insure hydration, subcutaneous (under the skin) fluids are generally easy for pet owners to do at home and help their pet. This type of home therapy can be short=term or, in some cases such as chronic kidney failure,  ongoing for the rest of the animal’s life. 

The Things you’ll Need:

Needles

Needles are color coded according to the bore size of the needle. The higher the number, the smaller the needle bore. Most fluids are administered with 20 gauge (usually pink), 18 gauge (usually olive color), or 19 gauge (usually kelly green) needles. The smaller bore needles are less painful to your pet; however, the fluid flow will be slower. The larger bore needles produce a faster fluid administration but furing initial insertion, may be more objectionable to the patient. After it’s under the skin, though, larger bore needles make administration easier. Talk with your veterinarian about the needle size that is most appropriate for your pet.

Needles come either with a twist-off plastic seal or in a paper and plastic envelope which can be peeled back. Needles are sealed in one of these ways to maintain sterility. The needle hub, which is clear plastic or metal, slips or twists onto the end of the drip set. After giving the fluid, the needle should be removed for disposal and a fresh capped needle should be attached to prevent exposing the line to bacteria. Needles should be used only once and then discarded appropriately (see below).

Your veterinarian likely has an appropriate disposal company contracted to remove medical waste; if so, ask the clinic if you can return the syringes there.

You can probably also bring them to your local pharmacy, as many pharmacies perform this service. Check to see if your local pharmacy will take care of this.

Drip Sets

The drip set is the long plastic tubing that connects the fluid bag to the needle. Drip sets come in different sizes according to drop size. For efficient fluid administration, you want a size no smaller than 20 drops per cc. The larger the drop size, the faster the fluid administration will go. (The more drops per cc delivered by the drip set, the smaller the drop size; for example, a microdrip delivers 60 drops per cc. The larger the number on the drip set, the smaller the drops. You want a smaller number on the drip set for a larger drop size. We recommend 10 or 15 drops per cc.)

There will be a small clamp of some kind on the fluid line that will enable you to open and close the line. For subcutaneous fluid administration, the line will either be closed (when not in use) or all the way open (when fluids are given). Sometimes the tubing kinks slightly when it has been pinched closed for a while. You may use your fingers to re-open the line and move the clamp to a different area on the tubing so as not to keep pinching (and thus deforming) the same area of tubing. To avoid making a mess, you may want to close the clamp before hooking up the line to the bag or just be quick to close the clamp afterwards.

The drip set will have a small chamber towards the top where you can see how fast the fluids are running. You will want the fluids to run as fast as possible so as to finish the task quickly. If the chamber completely fills with fluid, you will not be able to see the drip flow. To remedy this problem, invert the set, squeeze the chamber slightly so as to allow some air into the chamber, turn the set right side up and open the flow so as to expel air from the fluid line.

If the drip set is not connected to the bag of fluids when you purchase your set up, the drip set can easily be connected. The fluid bag will have a seal of some kind when is pulled off to open the bag and the sharp point on the end of the drip set is inserted here. Be sure to hold the fluid bag so that the open end is pointed up; otherwise the fluid will drain out of the hole and make a big mess. In the photo on the right, the connecting port is vertical with a white plastic cap that can be pulled off and the pointed part of the drip set would be pushed in. Do not confuse this with the round rubber injection port that is on the front of the bag. Also, be aware drip sets come out of their bag or box in an open position so as soon as they are connected to the bag and the bag is inverted, fluid will run out the end until you close the drip set clamp.

You may discard your drip set with the empty fluid bag in the regular trash as long as the needle has been removed for separate disposal as described below.

Fluid Bags

There are many types of fluids. They come in glass bottles as well as plastic bags. At our hospital, we mostly use one liter plastic bags which have demarcations printed on the side every 100 cc. Be sure you know how much fluid to administer and where on the bag the desired level at the end of administration will be. If you like, ask the technician to mark the bag in pen.

Fluid bags may be given to you already connected to the drip set or they may be purchased separately. When purchased separately, they are often enclosed within another plastic bag to ensure sterility. A small amount of moisture between the two bags is normal and does not indicate a leak in the fluid bag.The OutcomeWhile it may feel overwhelming at first, pet owners and most pets acclimate very well to home fluid therapy. And the extra hydration may make a significant different in helping your cat or dog recover from an illness or can be used indefinitely to slow progression of chronic diseases.

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