You don't want to do it, she doesn't want you to do it, but you have to do it. How to give your cat subcutaneous (sub Q) fluids to greatly improve their quality of life.
Meet Cleo. The cat I always thought was a Siamese but then found out is actually a Burmese but THEN found out is actually a Siamese. Confusing I know. My vet thought she was a Burmese for a while based on the shape of her head but we finally decided she was an applehead Siamese (also known as a traditional Siamese.)
Several years ago Cleo just seemed "off" so I took her to the vet. I found out Cleo had a dreaded cat disease. Chronic Renal Disease. Although vets insist on calling it "Chronic Renal Failure" which sounds much more ominous. When my vet told me this news my eyes grew to the size of pumpkins and welled up. I thought he was gently telling me little Cleo would be dead by week's end. She lived for another 2 ½ years before I made the decision to be in a horrific amount of pain so she didn't have to be.
Make no mistake about it, renal disease is ominous, but it doesn't necessarily mean your cat is going to drop dead within weeks or even months. With medicine and treatment Cleo lived a happy life for over 2 years after her diagnosis. But she wouldn't have without Subcutaneous Fluids.
Renal Failure in cats means their kidneys aren't working at 100%. The worse the condition, the less the kidneys are working. A cat with chronic kidney disease will drink a lot and pee a lot. In fact they pee out so much of their fluids that they dehydrate themselves.
If you've ever been dehydrated you know how awful that feels.
One of the things you can do to make your elderly, chronic renal (kidney) disease cat happier and healthier is by giving them subcutaneous fluids. At home. By yourself. Even though you're terrified.
Your vet will let you know if this is a good option for you. Don't just go out willy nilly and start jabbing your cat with needles and filling them with fluids.
I did this every other day for about the last year of Cleo's life and after a somewhat inelegant introductory period, we both got quite good at it. We don't like it. But we get through it with as little pain and biting as possible now.
Why do it? When a cat gets to the end stages of chronic renal disease they don't feel well. But these fluids make them feel much better. So when the vet said I could do this for her at home I had a little fainting fit, tried to bite him and then asked him to show me how to do it. Her vet was Dr. Mark who you might remember from my chicken related Ask Dr. Mark posts.
Like I said, the first few tries were a bit of a shitshow, but Cleo and I got the hang of it.
Table of Contents
How to Give a Cat Subcutaneous Fluids
Remember, always use a new needle and keep your fluids at room temperature so it's more comfortable for the cat.
- 18-20 gauge needles.
- Hang your fluid bag a couple of feet higher than you will be with your cat. I used a coat hanger.
2. Remove the cap from the end of the tubing.
3. Press your needle (with the protective cap still on) onto the nub.
4. Twist the plastic nut a couple of twists to hold the needle in place.
5. Remove the protective cap on the needle.
Needle Choice Options
You can use an 18-20 gauge needle on your cat.
- With the 18 gauge (which is larger) your fluid therapy will go more quickly.
- With a 20 gauge needle (which is smaller) it is less painful for the cat but will take longer to administer the fluids through the smaller hole.
6. Find the open hole on the needle. This should be inserted facing up into the cat.
7. Put your cat where you'll both be comfortable. You'll need to keep your cat in place. I like to squish her between my legs on the floor near her favourite heating vent. Other people will sit their cat in the corner of a chair or couch to keep them from squirming away. Putting them in a very small box could work as well. Cats like boxes, they feel safe in them and it would help stop them from crawling away.
8. Hold the needle in your dominant hand with the hole facing up. With your other hand pull the cat's skin up by the scruff around her shoulder blades, forming a tent.
9. DECISIVELY insert the needle (with the hole side up) into the tent of skin. Don't hesitate. The first few times it'll be gross and scary and shocking and you'll hear the skin crunch and all sorts of awful things. You want the needle to go in the pocket of air between the skin and her muscle.
10. Release the scruff and let the IV fluids flow by rolling the wheel upwards.
11. Pet your cat to help make the experience a more pleasant one.
12. Your vet will let you know how much fluid to give your cat but chances are it'll be 100 ml if you have an average sized cat. When injected 100 ml looks like the size of a small orange on the back of the cats neck.
13. Once enough fluids have been administered (check the size of the lump on the cats neck and the fluid line on the IV bag) you can stop the flow of IV fluids by rolling the wheel down, remove the needle and pinch the cat's skin for a minute to stop the fluids from leaking out.
14. Remove the needle by putting the protective cap back on and unscrewing it. Replace the blue protective cap to keep the line clean.
15. Everyone gets a treat! Seriously. You and the cat. Treats for everyone.
How long does it take for a cat to absorb subcutaneous fluids?
It only takes a few minutes to give your cat subq fluids but it will take them a while to absorb all those fluids.
Most cats will absorb all the fluid within a few hours. You'll know when the fluids have been absorbed when the lump of fluid where you gave the injection has flattened.
If the lump of fluid seems to move (down your cats neck, back or to their shoulders) don't worry about the migration. It sometimes happens. The fluids will still be absorbed normally.
Can you give a cat too much subcutaneous fluids?
It IS possible to over hydrate so don't immediately think if some is good more is better. It's not. Only give the amount of fluids as recommended by your vet. Too much subcutaenous fluids can cause hypertension and cats that have heart problems can develop fluid buildup in the body.
Fluid buildup in a cat with heart problems can become a medical emergency. So to reiterate; only give the amount prescribed by your vet.
What does subcutaneous fluids do for cats?
Obviously the reason for giving fluids is to hydrate the cat. For cats with renal failure, their kidneys go through more fluids than normal (the cat pees a lot). You can lead a cat to water but you can't make it drink so giving fluids under the skin is the best way to help rehydrate them.
Subq fluids provide the cat with the extra fluids they need to feel well.
- The cat feel will feel better in general (the way you do when you're hydrated)
- The extra fluids will help slow down the progression of chronic kidney disease (renal failure)
- Fluid therapy is immensely helpful for chronic constipation, a side effect of renal failure. They'll help your cat poop. And you know how much better you feel if you poop.
Need more instruction? K, here I am giving Cleo her fluids.
Cats breeds prone to CKD
- Russian Blue
- Maine Coon
How to prevent renal failure in cats
You can help reduce the chances and severity of renal failure in any breed of cat.
- Keep their teeth cleaned and cared for. Gum disease and teeth issues contributes to renal failure in cats. A lot.
- Feeding food that's high in phosphorous will increase the chances of the disease and the faster advancement of it. Feed your cat high quality food from day one. And if they're diagnosed with chronic kidney disease immediately switch them to a food made specifically for renal failure cats.
- Toxins eaten by a cat (poisons, antifreeze, pesticides) may not kill them immediately but can cause a cat to develop chronic kidney disease.
- Indoor cats have a lower risk of renal failure because of their more limited exposure to toxins.
Even knowing Siamese are predisposed to this disease, and knowing how painful it was to hear the diagnosis and eventually have her put to sleep I still want another traditional Siamese cat. Desperately.
Cleo came to me when her owners discovered they were allergic. I can't remember who they were and have no idea where they got her, but if I knew I'd have another Siamese right now.
Immediately following this treatment, Cleo got 3 Temptations treats and I got a whiskey. Cleo always felt much better a few hours after her fluids. I usually feel a bit wobbly after mine.
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Thank you Karen for this information, as we have started to have to give Mickie our russian blue cat fluids daily, its vary scary, he will be sixteen this coming October.
Hi. It is scary but you'll both get used to it and it'll make him feel much better. :) ~ karen
Omg. I love the comment of it being shit show. We have 20 year old Siamese that started fluids in the Spring. Hubby and I didn’t want to hurt her so it made the whole process worse. We “think” we finally have it down to our way of doing it. Spoke the Vet and she said “whatever way works”. I am with you about the scotch. Sorry to hear about your fur baby passing. Can’t imagine it, but again ours is 20, so I am hoping for as much time as willing. Thanks again for the article
The last years with a sick pet are so stressful! She went on for quite a while from the fluids though, so that was great! Good luck. :) ~ karen!
Hello, Karen. We have an 11 year old cat that was diagnosed with K/D. We have been taking her to the vet every week (almost a month now) to get her Saline Sub-Q Fluids. I can't seem to get an answer from the vet office as to why she is thirsty when we bring her home, this truly bothers me tremendously. Our cat has decided not to drink water on her own and I am now administering to her approx. 50- ml's of water using a 1 ml syringe, it's exhausting! Yes, I know it's not a lot of water and she does need to drink more but... it's impossible to give her more water when she decides to lock her jaw! can you help me please? Thank you. :)
Hi Lily. I'm sorry about your poor cat. I'm not a vet and only speak from my own experience as a cat owner, but I would think not drinking is definitely an issue. It sounds like she's developed an aversion to it. Bring the issue up with your vet again and be firm about it. The only thing I would suggest is to get a water fountain. Something like this one. It might entice her to drink. My mother's cat will ONLY drink from either a running tap or a water fountain. ~ karen!
Thank you, Karen for your prompt response. We did get her a water fountain four days ago, all she does is look at it and walk away, not interested. I think she has become accustomed to me giving her syringes of water throughout the day, I can only hope for the best going forward. Thank you, again. :)
Hi, Karen, I'm wondering about the Sub-Q-Fluids my vet is giving my cat weekly, maybe you can assist me here. After Sub-Q-Fluids are given to my cat and I bring her home she wants me to giver her water with the syringe that I have been using to keep her hydrated. Does this sound normal to you considering she is getting Sub-Q-Fluids, is it the salt content in the bag that's causing her to want water when I bring her home? Thank you, Karen
Hi, I was hoping you could tell me what were the levels of BUN and creatinine in Cleo when she was diagnosed with CKD? Did you give her fluids every single day for an year? What kind of food did you give her? My cat refuses the eat almost anything. He has cardiomyopathy too so he takes other madications as well. Thank you.
Hello Karen. Your article has given me such reinforcement - thank you for the clarity and precision. I can do this! No, I don't like that first moment of placing the needle, but knowing it's in her best interest, it gets done. She's not particularly cooperative after a few minutes, but I do what I can. So far, we haven't made it to 100mg at one go (we are in France, this is the recommended amount. But I think it's a standardized quantity everywhere).
Our 18 year old European/tabby cat has advanced renal failure, and was failing fast the other day. After the first subcutaneous hydrating, (2 days ago at the vets) she bounced back and is managing well. Quiet, but eats, drinks, and lies in a favored and warm place all day. Goes outside to do her business (we want her to live as normally as possible, so no litter box yet).
Her blood test results are off the charts - the vet said many cats don't survive at those levels, but she's doing alright, and not suffering.
I've so far managed one attempt at the subcutaneous hydration on my own, without the vet's assistance, and with the yellow needle (smaller) - she stayed still for about 4-5 minutes then walked away, but I couldn't measure the amount taken in (and there was no sizeable lump). She's always been cantakerous, so there's no coaxing or dominating that will change her mind - the vet said cats with an attitude tend to have less quality care because they are so difficult (medications like pills, even crushed - out of the question). She had to be sedated at the vets to take blood test, so first perfusion was done there (while still sedated). Can't sedate her regularly... I'll keep tryingwith this home hydration because I saw what a difference the perfusion made after just one time. We know that eventually the decision will have to be taken for having her put to sleep, but not until she's no longer comfortable. So, we will just enjoy her and be grateful for the time we have with her. I'm just trying to maintain her quality of life without causing undue suffering, so that attitude will help us make the sad decision when it's necessary.
I wish all of you the best who have to deal with caring for your beloved animals - we've been fortunate to have had them in our lives. Thanks for reading this.
Hi Deborah. I'm glad I could help. Good luck with your tabby. I know how hard it is at first. Just do what you can and what your cat will let you. :) ~ karen
Thank you for this! The shit-show comment really hit home! Fortunately, not literally, because that would be really gross. Thankfully, I've gotten better over the course of the past few weeks of 100ml every 48 hours and seem to have found a routine that works well for me and Gateway (most of the time, anyway). Sharing it here in case it can help someone else.
Warming the bag in hot water so it's closer to his body temperature has made a big difference. I've found a very simple "I.V. harness" online that has eliminated the need for me to grow 2 more hands, and puree treats that come in tubes help tremendously! They not only keep him occupied, but now both of my cats now associate the fluid bag with treats. So, on fluid days, I put a towel down on my bed to catch stray puree, put some music on, and we have a treat party!
Aww, Carol, I love this! I may have to do this for my male cat at some point. We’re not there yet, but I’m trying to do my homework in advance, so I can be prepared if/when it happens.
And I just wanted to thank you for that awesome idea of liquid food treats. It’s especially perfect for this particular cat, because LOVES purées. My female likes her canned food on the firm side, but every once in awhile, I get a can that’s really soupy. My girl turns her nose up at it, but my boy is in heaven with soupy cans. Lol. 😄
Your suggestion was more than just a good idea. It actually helped alleviate a huge fear I had. Because I’ve been worried about how I would keep him from trying to get off my lap or wherever I’m doing it. The thought of the needle cutting him if he struggled really scared me.
But your suggestion completely eliminated my fear because the puréed treat is the perfect DISTRACTION to keep him still. Plus, he’s a slow eater (he licks everything to death), so I bet the fluids would be done before he even finishes eating it. 😄
Same here. The EZ IV harness is a life saver. Jackson the Cat still doesn't love it. But the purree treats are given it when the needle happens. So he expects it now.
I can't recommend that harness enough. I just scatter treats on the floor and he walks around and I follow him with the bag.
I am so glad I found this...today we went for out teaching appointment for our 16 year old cat, Envoy, and I felt confident enough to do it the first time with the tech's guidance. Of course, the needle came out the first poke but got it in the second time. He'll be getting 150 ml twice a week which I know I can do now!
Good luck Cyndi! After a few tries you'll both get more comfortable with it. ~ karen!
Thank you, Karen, for the FRANK and honest way you addressed all the scary, terrible, squeamish, and cringy things, AS THEY REALLY ARE, instead of minimizing it and using comforting words. Something about the honest and frank way you addressed those things and gave voice to our fears had such a calming affect on me, and I’m sure others.
Either way, we’re going to have to face those things. But at least now, thanks to your blog, we know, in advance, what to expect, and we will not feel alone. ❤️
Aw, thanks Valerie! I remember being so determined and so utterly terrified the first time. Good luck when the time comes! You can do it. ~ karen!
Thank you for you instructions and you experience! I’m on week 3…only 50mg 2 times a week….still having a bit of a hard time, I feel like every other time goes well….it’s just so nerve racking. Scruffers will be 16 in June, and the best cat I have ever had….. but boy this is not easy at all…I know it’s so great to give him fluids, and I will get the hang of it sooner or later!!! I won’t give up!
This is a wonderful explanation but in the dog kidney group 18 gauge needles are known as harpoon! I personally use 22 gauge. It takes a little longer but it's easier on both of us.
Thank you so much for this post. We found out that our 16.5 year old kitty is in renal failure on Friday. They gave her subcutaneous fluids at the vet, but our vet is suggesting putting her to sleep. It’s Sunday and she is feeling better. She has not stopped eating, and is again demanding food on her schedule. She cuddled with us and slept between us in bed last night, for the first time in weeks, but I don’t know how long this will last.
She looks so young, has no other issues, but I don’t know when to call it. Am I’m keeping her through treatments for us instead of for her?
How did you know when it was enough and time to let her rest? We are really struggling.
Thank you again for your post. It helps so much.
I learned a lot and felt your love for your fur baby. I can totally relate. Thank you very much! You helped me help my fur baby!
Glad to help, good luck! ~ karen