Administration of supplemental fluids can benefit dogs with a number of different medical conditions. Most commonly, fluid supplementation is recommended for dogs with kidney disease. Although the idea of giving fluids may initially be intimidating, the doctors and staff at the Animal Clinic at Thorndale encourage you to consider learning this technique. It is very normal to feel some anxiety about this but we believe that you will find that it is not nearly as difficult as it would seem. The potential benefit of subcutaneous fluids to your dog will make it well worth your time to learn this simple technique. We can schedule and appointment with you and your dog for a hands-on lesson.
Supplies
The equipment consists of a bag of IV fluids, an IV drip set, and a needle. The IV drip set is a simply a tube which connects the fluid bag to the needle. Although it initially seems complicated, you will soon become very comfortable with the procedure described below.
Connecting the Fluid Line to the IV Bag
Remove the outer, protective bag from the inner IV bag.
- Remove the IV set from its packaging.
- 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.
- Holding the IV bag inverted, pull the protective covering from the exit port on the bottom end of the IV bag. This will expose a hole that will accept the pointed end of the IV set.
- Push the pointed end of the IV set into the open hole of the IV bag. It must be seated firmly to prevent leaks.
- Be certain the rolling clamp or slot clamp on the IV tubing is closed and then invert the bag and hang it from the top. (The lock on a new IV set is often in the open position.)
- Gently squeeze and release the bulb at the top of the drip set until the bulb chamber is about half full with fluid. If you have inadvertently over filled the bulb, remove the bag from the hook and invert the bag with the attached IV tubing and squeeze some of the liquid back into the back. You will want a air space above the liquid in the bulb so you can see the fluid dripping from the bag.
- Remove the protective cap from the lower end of the IV set, but do not discard it. Do not permit it to become contaminated. IT SHOULD NOT TOUCH ANYTHING.
- Open the locks (roller and clamp) on the tubing and then hold or suspend the IV bag; fluid should flow freely.
- Be sure that all air bubbles run out of the tubing.
- Close the lock on the IV line by rolling the roller downward.
- Remove the protective cap on the lower end of the IV set.
- Break the protective covering around the needle so that the open wide end (not the sharp end) is exposed. Do not permit it to become contaminated by allowing it to touch ANYTHING.
- Remove the protective cap from the lower end of the IV set, and place the open end of the needle on it. Screw it on to seat it firmly.
Insertion of the Needle
Insert the needle just under the skin in one of several locations that has unusually loose skin. These are:
– At the level of the shoulder blades, just to the right and to the left of midline
– At the level of the back legs, just to the right and to the left of midline
Subcutaneous Fluids Administration
– Choose a location where you will treat your dog. This may be on a table, counter top, on the floor or in your lap. The size of the dog will determine a suitable location.
– Hang the IV bag about 3 feet (1 meter) above the level of your dog’s head.
– Place your dog in the treatment location. Be sure both of you are in a position that will be comfortable for about 5 minutes. The end of the IV set should easily reach your dog.
– Pick up a roll of loose skin in one of the above locations.
– Lay the point of the needle at the base of the roll of skin with the needle horizontal and pointing to the dog’s head. This assumes that the dog is in an upright or standing position.
– Advance the needle slightly forward while pulling the roll of skin backward. That should place the point of the needle under the skin. You will feel it “give” as it enters
– Release the roll of skin. The point of the needle should remain under the skin.
– Grasp the IV set lock in one hand. Begin the flow of fluids by rolling the roller upward. If the fluid is leaking out, the needle may have gone completely through to the other side. Gently pull it back a little.
Amount of Fluid to Give
The veterinarian will tell you how much to give for your specific situation. If you are using two locations to give the total amount, you should give half of that amount in each location.
When you have given the recommended amount, complete the following steps:
– 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.
-Remove the needle from the skin and replace its protective cap.
-PLACE A NEW, STERILE NEEDLE ON THE DRIP SET AS SOON AS YOU ARE THROUGH. This keeps bacteria which were picked up on the old needle from migrating into the fluids. If you wish, you may return used needles to our hospital for proper disposal.
– Store the equipment in a safe place until the next fluid administration.
General Considerations
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 dog. Many animals will taste the alcohol and begin to drool.
Most dogs tolerate this procedure quite well. However, if the fluids are unusually cold or hot, they may be uncomfortable. Ideally, they should be stored at about body temperature. However, as long as they are at room temperature most dogs are fine. Do not refrigerate them.
As the fluids are running, a lump will form under the skin. Do not be alarmed; this is a pocket of fluid that will be absorbed over several 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.
There is no problem is 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 dog may experience mild discomfort for a couple of hours, but no real harm will occur. The body will eventually absorb the air. This is NOT like air going directly into the blood stream which can be fatal.
Troubleshooting
What to do if the Fluids Stop 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 position of the needle until the fluids flow freely.
What to do if the Fluid Runs Slowly on Subsequent Treatments
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.
What to do if the Fluids become Cloudy in Appearance
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 dog, a serious infection may occur under the skin.