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Administering SQ Fluids Print E-mail
Written by Administrator-GL   
Tuesday, 10 November 2009
Article Index
Administering SQ Fluids
Page 2

A basic course on how to set up and use a Ringers Lactate IV bag and IV set up for SQ Fluid Replacement for Goats

IVSet used with Ringers Lactate

Click on these two images to see enlarged version- Opens up in new window

Lactated Ringers Solution used for IV and SQ fluid therapy

 

There are a few ways to administer SQ fluids  to your goat. One is via a large syringe and slowly  administering it under the skin in multiple locations for absorption into the system - this method is repeated a few times per day, the same method but instead of using the syringe directly (in cases of a goat who may be likely to move while administering), a short  needle extension tube is used between the needle and syringe for  more control along with a butterfly needle (also known as a winged infusion set) and by SQ drip when a goat is not as mobile and more likely to allow a slow drip over a period of hours.

Basic SQ/IV Ringers Equipment and Set up of the Ringers bag and tubing

 Open Ringers Lactate outer Bag Opened Tubing Kit
 This is a typical Bag of Lactated Ringers or Ringers Lactate. If you decide to wamr the fluid in this bag - Leave it in it's Outer bag for this (shown here in outer bag)
 This is a typical IV Tubing kit, some may look slightly different depending on what brand your vet carries. They are all basically the same- a Spike for inserting into the Ringers Bag, drip chamber,  a tube, a clamp,roller clamp (or both) , needle attachment end, and possibly  medication ports.
 Ports on Ringers Lactate Bag Remove protective cap from Tube Port
 This is a close up of the injection port, where if you were going to add additional medications or glucose 50%  to the ringers, this is where you would put the needle to add it.  And the Spike port where the spike from the  tubing kit is inserted.
 Alll bags look a bit different, but all are basically the same. All will have a cover or end cap on the spike port that needs to be removed first.  This shows the cap being removed.
 Insert IV tubing Spike into Tube port on Bag Connected  IV Tubing kit to Ringers Lactate Bag
 Remove the protective cap form the spike and insert it into the spike port, you may need to twist it as you push - making sure it is fullyinserted. DO NOT touch the spike with your hands or touch anything to this, it needs to remain sterile.
 This explains all the connections and what they are for- sometimes it gets confusing especially with a sick goat upsetting you.
 Roller Control on IV Tubing

 Needle Placement on Goat for SQ Fluid Therapy

 

 This is the roller clamp, down is closed and up is open,  adjust it to slow or quicken the drip- you will see the speed of the drip in the drip chamber. If your tubing has a clamp as well make sure the clamp is not slid closed.
 This is a photo with marking arrows of where I place the needle,  in order of how I move it if I need to move it. you can use both sides of the goat. The needle goes just under the skin parallel to the goat, I face the needle  toward the goat's head. 

 Squeeze the drip chamber to allow fluids to fill to begin drip

Squeeze the drip chamber to allow fluids to fill to begin drip

 Shows drip control roller clamp up is open, down is closed - adjust as needed

Shows drip control roller clamp up is open, down is closed - adjust as needed

Using a Large Syringe to administer SQ fluid therapy to your goats

Syringe Explained
Needles used for SQ  fluid therapy
 Showing parts of the Syringe, USe a 30ml or 60 ml sterile syringe- This is a Leur Slip syringe, but you may also use a Leur Lock (wehere the needle twists into the syringe tip)
 Here are the 2 sized needles to use, the 18ga to remove the fluid from the bag and a sterile  20ga1 inch needle for inserting into the goat- you can keep them seperate by the color of the hub.
 Drawing out fluids into syringe Punctured Syringe port
 Slowly withdraw  some of the ringers lactate into the large syringe, until you have the amount you want  or need. Best to use as many syringes as you will need all together and line them up  so you don't make the goat wait to refill. 
 Be careful you do not allow the needle to go through the plastic on the ringers bag like this- it will make the bag leak and contaminate the contents so the solution will no longer be sterile.
 Insert Needle into syringe needle port on Ringers bag Draw up and measure fluid, remove air bubbles
 Close up of how to insert the needle into the needle port on the ringers bag. This is also where you would add meds if you are adding anything to the ringers.

 This shows some fluids drawn up into the syringe and a bubble that needs removed.

 

 Insert the needle into the goat the same as if you were doing a drip- same location and  administer the fluids very slowly until you see a fluid bump- you can move locations for the comfort of the goat.

If the goat becomes overhydrated (too much fluid is given), blood potassium levels may become too low, causing muscle and heart abnormalities. Signs may include weakness, constipation, rapid breathing, and increased heart rate. Overhydration may also cause fluid to accumulate in the lungs (pulmonary edema) and increase the workload for the heart. Signs may include increased or rapid breathing, coughing, or wheezing. If you notice any of these signs, stop fluid therapy and contact your veterinarian immediately. May be a fatal situation in severely weak animals.


 So what IS SQ Fluid Therapy and How do I do it?

Fluid given under the skin, subcutaneously (SQ), is absorbed into the blood stream and can be used to correct or prevent dehydration. The most frequent disease for which fluids are given is chronic kidney failure. Pets with chronic kidney failure pass large amounts of urine and may not feel well enough to drink enough to prevent dehydration. Oral injuries may also result in the need to administer fluids. In any case , owners may need to give subcutaneous fluids a few times a week to supplement the water the pet is drinking in order to prevent dehydration.

In the event your pet needs fluids we will prescribe a certain type of fluids, a volume and frequency for administration to your pet, and demonstrate this procedure for you. The information provided here is intended as supplementary information; we do not recommend fluid administration for healthy pets.

Are there any alternatives? I don’t really want to do this.

This is a normal reaction for most people. Giving injections is outside the comfort zone for most everyone outside the medical professions. However, fluid administration is not nearly as difficult as it sounds. The benefits provided to your pet will make it well worth your time to learn this technique. After we demonstrate and you make an attempt, if it is more than you feel comfortable with, we will be happy to schedule fluid administration for your pet by our staff.

How is the equipment assembled?

The equipment consists of a bag of IV fluids, an IV administration set, and a needle. The IV set is a tube which connects the fluid bag to the needle. The following steps should be followed:

1. Remove the outer, protective bag from the inner IV bag.

2. Remove the IV set from its packaging.

3. The top end of the IV set has a large, pointed end with a protective cap. Remove this cap, but do not permit it to become contaminated. IT SHOULD NOT TOUCH ANYTHING.

4. Pull the protective covering from the exit port on the bottom end of the IV bag. This will expose a hole which will accept the pointed end of the IV set.

5. Push the pointed end of the IV set into the open hole of the IV bag. It must be seated firmly to prevent leaks. You may have to twist it to get it to go in sufficiently.

6. Close the lock in the middle of the IV tubing by moving the roller. (The lock on a new IV set is often already in the open position.)

7. Gently squeeze and release the bulb at the top of the drip set until the bulb chamber is about half full with fluid.

8. Open the lock (roller) on the tubing and then hold or suspend the IV bag.

9. Remove the protective cap on the lower end of the IV set, but do not discard it. Do not permit it to become contaminated IT SHOULD NOT TOUCH ANYTHING. Fluid should flow freely.

10. Be sure that all air bubbles run out of the tubing.

11. Close the lock on the IV line by rolling the roller downward and replace the protective cap on the lower end of the line.

12. Break the protective covering around the needle so that the open end (not the sharp end) is exposed. Do not permit it to become contaminated. IT SHOULD NOT TOUCH ANYTHING.

13. Remove the protective cap from the lower end of the IV set, and place the open end of the needle on it. Seat it firmly.

Where is the needle inserted?

Insert the needle just under the skin in locations that have unusually loose skin. The most comfortable and safest for the pet are just over each shoulder blade. This area is located at the top of the front legs about ½ inch from the midline. You may also use the skin in the flank area.

How is the needle inserted?

1. Choose a location where you will treat your pet. This may be on a table, counter top, or in you lap.

2. Hang the IV bag about 3 feet above the level of your pet’s head.

3. Place your pet in the treatment location. Be sure both of you are in a position that will be comfortable for about 10-15 minutes. The end of the IV set should easily reach your pet.

4. Pick up a roll of loose skin over either the right or left shoulder blade.

5. Lay the point of the needle at the base of the roll of skin with the needle horizontal and pointing to the pet’s head. This assumes that the pet is in an upright or standing position.

6. Advance the needle slightly forward while pulling the roll of skin backward. That should place the point of the needle under the skin.

7. Release the roll of skin. The point of the needle should remain under the skin.

8. Grasp the IV set lock in one hand. Begin the flow of fluids by rolling the roller upward.

Note: It is not necessary to sterilize the skin with alcohol before inserting the needle. In reality, wiping a little alcohol on the skin does not really sterilize it, and the odor and feel of alcohol may aggravate your cat.

What should I expect as the fluids are running?

Most pets tolerate this procedure quite well. However, if the fluids are unusually cold or hot, they may be uncomfortable. Ideally they should be stored at body temperature or warmed by placing the bag under running hot water. If you warm them, test the temperature of the fluids on your forearm, as you would do for a baby’s bottle. However, as long as they are at room temperature most animals are fine. Do not refrigerate them.

As the fluids are running, a lump will form under the skin. Do not be alarmed; this is the fluids.

What if air bubbles are carried under the skin?

There is no problem if a few bubbles of air are injected under the skin. If quite a bit of air gets under the skin, you may feel a crackling sound when you push on the skin, and your pet may experience mild discomfort for a couple of hours, but no real harm will occur. The body will eventually absorb the air.

What if the fluids quit running?

This often happens when the end of the needle moves against the skin or the underlying tissue. Do not remove the needle; rather, gently reposition it until the fluids begin to flow again. Experiment with the needle’s position until the fluids flow freely.

How much do I give?

We will determine in advance how much fluid you will give for your pet’s specific situation. As a rule, the average sized cat should receive 150-200ml of fluids at one time. The prescribed amount is placed in the locations mentioned above over each of the front legs or at the flank.

What do I do when I have given the prescribed amount?

1. Stop the flow of fluids by rolling the roller in the IV set lock downward firmly. If you do not close it well and the bag is left hanging fluid will drip.

2. Remove the needle and replace it with a sterile needle.

3. Store the equipment in a safe place until the next fluid administration.

Is there anything different about giving fluid on subsequent treatments?

The administration is the same. The fluids are less likely to be contaminated by bacteria from the skin if you discard the needle at the end of each administration. Replace it with a sterile needle before you put the fluids away. Before discarding the old needle, replace the protective cap on it so someone will not be stuck. You may return it to our hospital for proper disposal.

I tried to give fluids but the flow was very slow. What should I do?

When you are finished giving fluids, you should close the lock firmly. However, closing the lock firmly may crush the tubing so that fluid will not flow well on subsequent use. If this happens, move the lock to another place on the IV tubing, and open the crushed area of the tube by pinching it with your fingers.

How long until the lump of fluid is gone?

It will take about 2-4 hours for all of the fluid to be absorbed. In some cases, it might even be up to 6 hours. If absorption is slow gravity may cause the fluids to migrate downward. They could move under the skin of the front or rear legs. However, if this happens, they will still be absorbed.

I have used this bag for several treatments and now the fluid is cloudy. What does that mean?

If any cloudiness or discoloration occurs, do not use the bag. It usually means that the fluids have become contaminated with bacteria. If you administer these fluids to your pet, a serious infection may occur under the skin. 

Parkway Animal Hospital

 

Continue for some videos of administration of  fluids to cats and a rabbit- I have not yet taken a video of administration to a goat but I will next time I need to administer fluids.  

You will see that each person does it different and  you will notice slightly different IV setups. 

BUT this gives you a good idea how to do this and what to expect.  It really is not all that hard.  :)

Go to Videos Now



Last Updated ( Tuesday, 10 November 2009 )
 
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