FLUID THERAPY

By Amy D. Shojai, CABC

The most important part of your cat's world is you, and as long as you remain a constant in his life, he can live with illness and infirmity and still be happy. Cats aren't concerned about having all their diseased teeth removed or losing their sight to glaucoma - they're just glad the pain went away.

"With the palliative realm you accept that [the condition] will progress, that quality of life is now reasonable, and so we'll prevent symptoms as long as we possibly can," says Nicole Ehrhart, VMD, MS, DACVS, an associate professor of oncology at Colorado State University

That might be the best possible choice for an aged feline at high risk for a radical surgery, for example, or for an animal whose cancer is too advanced for other options. It might also be an economical or ethical choice for owners who aren't interested in aggressive treatment and just want the cat to feel good during the time he has left. "Palliative options are minimal hospitalization, and minimal cost in many cases, with nursing care at home," says Dr. Ehrhart.

Fluid Therapy

"We've taught hundreds of people to give fluids at home, from the very young to the elderly, and I've not met anybody who could not learn the technique," says Susan Little, DVM, DABVP (Feline), a veterinarian at Bytown Cat Hospital, in Ottawa, Canada.

Fluid therapy is one of the main things you can do to make cats with kidney insufficiency comfortable, give them a continuous quality of life, and stabilize their disease. "It makes a tremendous difference," says Dr. Little. "It empowers people, too. Owners are doing something very powerful."

All the proper supplies are available from your veterinarian - the IV kit with the plastic line and large gauge needle, and appropriate fluids such as saline for kidney disease, dextrose (sugar) solutions to feed, or a balanced electrolyte solution for other conditions. Injecting fluid into the veins requires special training, but once your veterinarian demonstrates, it's easy to administer subcutaneous fluids - beneath the skin - to your pet at home. When your cat requires fluids regularly, it's not only less expensive to administer them at home, it is much less stressful for your cat.

• Warm the fluids to body temperature by running warm water over the bag. That makes the experience more pleasant for the cat.
• Suspend the bag higher than the cat, so that gravity helps the fluid run into the right place. You can use a coat hanger to make a holder that fits over the top of a door or cabinet.
• Spread a towel or favorite blanket, or set the cat's bed on a tabletop, to pad the surface for your pet to lie down and get comfortable. An ironing board makes a great treatment platform. He'll need to stay still for up to twenty minutes, so make the place as comfortable for you both as possible. A position in front of a window may help distract him. If he's too antsy, have a second person on hand to help manage him, or you can place him in a pillowcase or "cat bag" restraint or wrap him in a towel. Ask the veterinarian if a heating pad underneath a couple of layers of blanket is a good idea.
• Pets that need fluid therapy will have lots of loose skin, and you need to insert the needle so that the fluid drains into the space right under the loose tissue. Anywhere on the body will work, but the best locations to place the needle are right between the shoulder blades or right above the ribs. Use the same technique as described to give an injection. Grasp the skin with one hand and "tent" it-draw it up off the solid muscle. Then press the sharp end of the needle firmly into the skin, between where your hand holds the flesh and the solid muscle of the pet's body. You'll need to push pretty hard, because the needle has to be pretty large to feed enough fluid in, and cat skin can be tough. Push it at a horizontal angle level with the body until you no longer see any of the needle, but only the plastic head that houses the plastic IV line.

  Don't be surprised if the pet flinches a bit - but once the needle is in place, he should settle down and won't be much bothered by the therapy. Hint: alternate needle sites to prevent scar tissue from forming that may make subsequent treatments more difficult.

• Once the needle is in place, let go of the tented skin and let it fall back into place. Open up the release valve on the plastic line, so that the fluid begins to drain down and into the needle. Some cats object if the liquid flows too fast, so adjust the speed to accommodate the comfort of your pet. Watch the container of fluid until the amount your veterinarian recommends has been given. A severely dehydrated pet may need 30 milliliters per pound, while for other conditions, 10 milliliters per pound once a day may be enough.
• As fluid runs into the skin, you'll soon see the skin start to balloon with liquid. This does not hurt the pet, although it may feel a bit cool, and will tend to settle and spread out under the skin. The fluid will be gradually absorbed into the body and the balloon will deflate.
• Shut off the valve on the IV line to stop the fluid, and then gently remove the needle from your pet. It's normal for a small amount of fluid to leak back out of the injection site-especially when given over the shoulders. Giving Giving fluid over the ribs with the needle inserted downwards will reduce this loss. You can also help the injection site hole to close by rubbing and massaging the place. Offer your cat a scrumptious treat afterward to help associate the treatment with good things.

Comfort Zone

Ask your veterinarian about the new "indwelling catheters" designed for subcutaneous (beneath the skin) administration of fluid. Dr. Martin G. St. Germain of Practivet developed the administration unit, called the Greta Implantable Fluid Tube (GIF-Tube). The nine-inch silicon tube is surgically implanted just beneath the cat's skin and a small skirt of material is sutured in place to hold the tube steady. An injection port is attached to the outside portion of the tube. The veterinarian will change the port each month, but the tube itself can remain in place for up to a year. A needleless injector connects to administer fluids through the port. That allows you to give fluids to your cat without poking him with a needle.

Excerpted from:
Complete Kitten Care
2010 Second Edition, Amazon Kindle Publication
Chapter 4: Nursing Care

2002 & revision 2010 Amy D. Shojai, CABC

Amy D. Shojai, CABC is a certified animal behavior consultant, and author of 23 pet care books including Complete Kitten Care and Complete Care for Your Aging Cat. She's also the behavior contributor for cats.About.com and can be reached via www.shojai.com.

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