Subcutaneous Fluids Question
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ra7751
Well-Known Member
Hi Bill,
Adding sub-q (as well as IV or IO) fluids will sometimes decrease the oral intake of water. It all depends on how dehydrated the animal is, renal function and diet. The type of fluids....hypertonic, isotonic or hypotonic....will also have an effect on oral intake. Most vets automatically use Lactated Ringers no matter the situation but we also use Sodium Chloride from time to time. NOTE:There are versions of Lactated Ringers that include Dextrose.Dextrose should never be used sub-q on any species. We normally calculate fluids at 5% of body weight per day in rescue. And hydration also has to include the water found in greens.
That amount of fluids BID is not a lot....much more of a support dosing than anything else. I will give you a hint on making things easier...for you and Jack. I suspect since you use a domestic vet that you were taught the "drip" method. Much too slow. Ask your vet to provide you a supply of 12" butterfly catheters (21g)with a supply of appropriately sized syringes with a luer lock( I normally use either 35ml or 60ml syringes). This will allow you to "push" the fluids in quickly. I can run a large amount of fluids in just seconds. You can also make one punch and administer several syringes of meds...just unscrew one syringe off the catheter and screw on another. The flexible catheter also provides "wiggle" room and prevents tearing of the skin should he move quickly. This is a wildlife trick that allows us to quickly administer fluids and/or drugs sub-q with a much lower stress level for the animal.
As far as appetite...why is he on fluids and is he on any other meds? Many antibiotics will suppress the appetite as will pain and stress. If things get bad, a one time injection of a vitamin, B Comp, will usually help that situation.
Randy
Adding sub-q (as well as IV or IO) fluids will sometimes decrease the oral intake of water. It all depends on how dehydrated the animal is, renal function and diet. The type of fluids....hypertonic, isotonic or hypotonic....will also have an effect on oral intake. Most vets automatically use Lactated Ringers no matter the situation but we also use Sodium Chloride from time to time. NOTE:There are versions of Lactated Ringers that include Dextrose.Dextrose should never be used sub-q on any species. We normally calculate fluids at 5% of body weight per day in rescue. And hydration also has to include the water found in greens.
That amount of fluids BID is not a lot....much more of a support dosing than anything else. I will give you a hint on making things easier...for you and Jack. I suspect since you use a domestic vet that you were taught the "drip" method. Much too slow. Ask your vet to provide you a supply of 12" butterfly catheters (21g)with a supply of appropriately sized syringes with a luer lock( I normally use either 35ml or 60ml syringes). This will allow you to "push" the fluids in quickly. I can run a large amount of fluids in just seconds. You can also make one punch and administer several syringes of meds...just unscrew one syringe off the catheter and screw on another. The flexible catheter also provides "wiggle" room and prevents tearing of the skin should he move quickly. This is a wildlife trick that allows us to quickly administer fluids and/or drugs sub-q with a much lower stress level for the animal.
As far as appetite...why is he on fluids and is he on any other meds? Many antibiotics will suppress the appetite as will pain and stress. If things get bad, a one time injection of a vitamin, B Comp, will usually help that situation.
Randy
ra7751
Well-Known Member
I would suggest getting the butterfly catheters....much easier and safer for the animal. You should be able to push 35ml in just a few seconds.
If you are dealing with sludge, you might ask your vet about using Sodium Chloride unless he/she feels there is a need for LRS.
Baytril is pretty much ineffective against much of anything....same with Sulfa drugs. I would really consider doing a CBC with EC titer. That will provide a lot of information. There are only a few labs that can titer EC so you have to request that. Another diagnostic is to perform a procedure called a cystocentesis. It involves inserting a needle thru the abdominal cavity and pulling a "virgin" urine sample directly from the bladder....a much better sample for testing.
Randy
If you are dealing with sludge, you might ask your vet about using Sodium Chloride unless he/she feels there is a need for LRS.
Baytril is pretty much ineffective against much of anything....same with Sulfa drugs. I would really consider doing a CBC with EC titer. That will provide a lot of information. There are only a few labs that can titer EC so you have to request that. Another diagnostic is to perform a procedure called a cystocentesis. It involves inserting a needle thru the abdominal cavity and pulling a "virgin" urine sample directly from the bladder....a much better sample for testing.
Randy
MagnoliaDee
Well-Known Member
Hope you all don't mind me asking a couple q's here as well on the subject.
Randy... my vet has us using the butterfly needles to inject fluids into Jacub. Currently we are doing 50 ml once a day... but I'm wondering if it's enough, as his poops are pretty dry. When he was at the vets on July 31st he weighed in as 3.8 lbs. Using your 5% calc. Can you tell me how much fluids should he be getting?
Also, for how long can one administer fluids? Jacub is on his side 24/7 at this point, not able to get up, and I'm not sure when that will change (treating stasis and head tilt).
You mentioned that you can mix meds and fluids. We have to give Jacub Pen G and fluids once every other day... so currently we've been giving two needles... can this be combined? We've been doing them a few hours apart, as I didn't want to flush or dilute the Pen G.
Randy... my vet has us using the butterfly needles to inject fluids into Jacub. Currently we are doing 50 ml once a day... but I'm wondering if it's enough, as his poops are pretty dry. When he was at the vets on July 31st he weighed in as 3.8 lbs. Using your 5% calc. Can you tell me how much fluids should he be getting?
Also, for how long can one administer fluids? Jacub is on his side 24/7 at this point, not able to get up, and I'm not sure when that will change (treating stasis and head tilt).
You mentioned that you can mix meds and fluids. We have to give Jacub Pen G and fluids once every other day... so currently we've been giving two needles... can this be combined? We've been doing them a few hours apart, as I didn't want to flush or dilute the Pen G.
ra7751
Well-Known Member
To calculate fluids you take the weight in kg and you can divide by 20 or multiply by .05. In your case,formulating would go for about 85ml of total hydration per day. I think what your vet is doing is a support dosing.....and I feel the amount your vet is suggesting is appropriate. If your rabbit is on his side, that makes him prone to Pulmonary Edema so you would want to closely manage the fluids to prevent fluid from building in the chest. That can walk you into more problems. And remember that any water he actually drinks as well as fluids contained in greens also count toward the total hydration. Keep in mind that this calculatedamount is the baseline we use for animals coming into rescue. Actual amount of fluids is determined by the hydration level of the animal. That is best measured by the amount of urine produced. Judging by your comments about your rabbit...I would stick with your vet's instructions.
Couple of things with injections....don't stick them any more than you have to, use the smallest gauge needle possibleand combine meds when possible. In the case of Penicillin.....buffering with fluids helps with two things. First, refrigerated Penicillin is very thick so warming up the dose and putting it in the fluids will make it easier to inject. Next, Penicillin burns like H-E-double hockey sticks and buffering will cushion the burn. And many injectables can cause necrosis at the injection site. Penicillin is one along with Baytril (and most of you know I do not like Baytril). I always try to do injections once a day if at all possible. In this case, load a couple of syringes. Do it all at once. I have had a line of syringes loaded with fluids and meds and administered them all with one punch. You also need to move the injection sites so as to not cause scar tissue. Any place you can scrff skin you can sub-q. I start high on the shoulders on either side of the spine and moving down, varying sides of the spine and including the flanks.
I am thinking your rabbitis being treated foran ear infection. But the fact he is on his side really concerns me. Just wondering, does his left rear leg seem to have anydifficulty? Does he have nystagmus (darting eyes)? What is his rectal temp? Has a blood chemistry been performed? I think something more is going on here. I would be really interested in more details since head tilt is one of "my things" and I might can offer some information that very few vets have regarding tilt. If you are interested, please PM me.
Randy
Couple of things with injections....don't stick them any more than you have to, use the smallest gauge needle possibleand combine meds when possible. In the case of Penicillin.....buffering with fluids helps with two things. First, refrigerated Penicillin is very thick so warming up the dose and putting it in the fluids will make it easier to inject. Next, Penicillin burns like H-E-double hockey sticks and buffering will cushion the burn. And many injectables can cause necrosis at the injection site. Penicillin is one along with Baytril (and most of you know I do not like Baytril). I always try to do injections once a day if at all possible. In this case, load a couple of syringes. Do it all at once. I have had a line of syringes loaded with fluids and meds and administered them all with one punch. You also need to move the injection sites so as to not cause scar tissue. Any place you can scrff skin you can sub-q. I start high on the shoulders on either side of the spine and moving down, varying sides of the spine and including the flanks.
I am thinking your rabbitis being treated foran ear infection. But the fact he is on his side really concerns me. Just wondering, does his left rear leg seem to have anydifficulty? Does he have nystagmus (darting eyes)? What is his rectal temp? Has a blood chemistry been performed? I think something more is going on here. I would be really interested in more details since head tilt is one of "my things" and I might can offer some information that very few vets have regarding tilt. If you are interested, please PM me.
Randy
MagnoliaDee
Well-Known Member
PM sent... thanks Randy!
ra7751
Well-Known Member
You may get some blood every now and then....looks bad with a white rabbit. And yes it is possible to leak fluids from the previous stick. That is what makes it difficult to give fluids to an animal that has been pawed by a cat...put it one place and it shoots out somewhere else.
Randy
Randy
