Subcutaenous fluids in dehydrated cats

RE: Subcutaenous fluids in dehydrated cats

Selena Carnell — Mon, 29 Jun 2015 17:10:13 GMT

We have an exernal OOH provider, but vets tend to prefer that the animals stay over night without fluids or go home and comeback the next day. When we do sc fluids we can put 250ml in over the course of the day and split it in to 4 doses. They do look like an elephant lol. We use fluids lots in other animals but they very rarely get sent to our OOH provider which is about 5 miles away. they go home with the line in and come back in the next morning. and are reattached to drips. I does seem to have benefit - but when you have a new grad going on about how crap the practice is, it does make you question what you are doing sometimes.

RE: Subcutaenous fluids in dehydrated cats

Mark Hedberg — Mon, 29 Jun 2015 16:54:42 GMT

S/c fluids are by no means a waste of time. Certainly they're slower than IV, but the uptake is still very good. The key is not to use small dribbles - run it in until you've got a LARGE lump of fluid. The cat should look like it's got a fist under the skin. (yes, that sounds awful, but I am talking about an emergency situation here with a patient as dry as a newspaper.)

No, of course it's not perfect, and if you can get IV access, of course 100% go for IV - but if you can't, and the cat needs fluids to get the BP up to get a cath in - go for it.

Anecdote: 3 years of working with psycho feral cats in the middle east; the effects of the fluids can't be overstated! (Hot desert country, cats dried out like a lettuce leaf in no time at all when they were ill!)

Generally the fluid lump was gone in an hour or two. (Sometimes even quicker, but that was rare!)

IP I don't generally like because of the possibility of increased fluid pressure on the diaphragm while it's absorbing. I have no scientific paper on that, however.

RE: Subcutaenous fluids in dehydrated cats

Sarah Bolton — Mon, 29 Jun 2015 15:55:54 GMT

We have a vet here who is doing her internal medicine cert. She also says that giving subcut fluids is a waste of time. If fluids can't be given IV then she prefers to give them IP. I think that IV fluids are certainly warranted in animals with severe dehydration. I guess what perhaps you need to ask is how can we make fluids overnight safer if that is what the concerns are? Do you have a drip pump? Do you use burettes? Could you take them off IV fluids for the evening if necc?

RE: Subcutaenous fluids in dehydrated cats

Sal the 1st — Sun, 28 Jun 2015 20:34:22 GMT

another thought has struck me - what is the ooh cover like? or even staff availability during the day to watch these cases? if you have night staff or overnight cases are sent elsewhere then ivft tends to be more popular not only because of its benefits to the patient but because there are staff on hand to watch out for any problems. If the ooh cover on an evening is down to people not being on site and coming in to do routine checks at various times then yes s/c could be safer than risking say a pump failing (and lets face it some of them can fail even if you look at them the wrong way they are that sensitive) or over infusing on a giving set , or as OP mentioned your patient playing cats cradle with the line and strangling itself into the bargain. Is it this causing concern and making s/c fluids seem a better option over i/v? Sometimes there are reasons for doing things a certain way that aren't entirely obvious until people sit down and talk them through .

RE: Subcutaenous fluids in dehydrated cats

elaine elder — Sun, 28 Jun 2015 20:02:08 GMT

I agree with above subcut fluids have a place for mild dehydration or where there are no other option due to cats behaviour or cost. However to use it routinely isnt ideal. Fluid therapy isn't all about correcting dehydration it's about maintaining/ increasing blood pressure and correcting acid base balance and electrolytes. In poorly patients, such as blocked bladder cats with acute renal failure, you can not give the large volumes of fluids or at an accurate rate if given subcut. I believe fluid therapy is one of the most powerful treatments available to us and we shouldn't be shy to use it!

RE: Subcutaenous fluids in dehydrated cats

Rachael_24 — Sun, 28 Jun 2015 19:08:14 GMT

I wouldn't agree with the vet as I don't believe that s/c fluids are completely useless. They have their use in some cases where IV access cannot be gained such as in tiny kittens. I use them a lot in exotics as well - all rabbits, guinea pigs, rats, etc having a GA is given s/c fluids as routine.

However, to completely avoid the use of IV fluids in cats strikes me as very odd. IV fluids are reliable and allows the correction of dehydration quickly whilst s/c fluids are slow to absorb. You say that the s/c fluids are tolerated well but this technique is known to cause discomfort and so for those patients needing long term fluid therapy I can't help but think that IV would be better.

RE: Subcutaenous fluids in dehydrated cats

Sal the 1st — Sun, 28 Jun 2015 11:19:43 GMT

we use s/c if we can't get an i/v because the cat is so far gone its the only way to get some fluid into it. We would also use in the case of a cat that you cannot get near to get an i/v in normally - ie a feral under GA whose signs tell you it is lacking but is in no way a candidate for i/v because you need to get those fluids in quick before it wakes up and then they can be absorbed slowly. I have seen good results from s/c fluids (including my own cats) so would never rule them out completely.

not quite the same but I know when I worked one place we had a massive parvo outbreak we used to have iv clinics (because the kennels were crammed and we couldn't take anymore cases) and the not so sick used to come in for fluids until either their condition improved or deteriorated to the stage they then needed admitting -presuming something else had either died or gone home and left a kennel space. You only had so much time you could spend per dog and if you couldn't get an i/v quickly you ran it s/c - it saved lives.

I feel everybody has something to learn no matter how long or short a time they have been qualified we can all learn from each other - and new grads don't know everything yet (and no disrespect is intended by that comment) and longer qualified well maybe there are a few new tricks out there to be learnt - but somewhere is a middle ground where everybody can be reasonably happy I hope

RE: Subcutaenous fluids in dehydrated cats

Steph Worsley — Sun, 28 Jun 2015 10:43:29 GMT

i use s/c fluids as an ongoing treatment with ckd cats (train the o up) but not for animals that have come in to stay, unless it is a complete last resort and you can't get an iv in because they are too crispy.