Subcutaneous

Question: How often should a cat recieve subcutaneous fluids for? Dehydrated cat due to illness last week so the vet gave her subcutaneous fluids. He told me to come back in 3 days. Is this normal or should she have it every day.?He says she absorbed quite a bit of fluids and left her on it for 15 minutes. At the moment she isnt drinking her own water this is why she had this type of drip.

Answer: Once every few days is fine, but every day is fine too as long as the cat is urinating OK. Subcutaneous fluids is just an alternative way for the cat to receive water when it won't drink. It also helps to push fluids through the kidneys when there are kidney issues as well. Any excess fluids the cat doesn't need for hydration will be urinated away. Depending upon whether your cat is too weak from the illness or if this is a respiratory illness, once daily may in fact be too frequent. You can always ask your vet if you should bring the cat in more frequently for fluids, would it be any more helpful than every 3 days. Most vets will be happy to explain why more frequently may be better or worse for your cat.

Question: Why are the buttocks a good place to administrate subcutaneous insulin? I've read administering subcutaneous insulin must be done in places known for their adipose tissue, such as: forearms, lower back toward the sides, internal and external part of the thighs, abdomen, and the buttocks, which I'm told to be the best way to inject insulin. What metabolic advantage do buttocks have in comparison with other adipose areas?

Answer: Adipose tissue is just a fancy way of saying fat that lies underneath the skin. The buttocks actually are the site of last choice for injection, as they are the area of slowest absorption. First choice is the abdomen, about 2 inches from the belly button. Next choice is the thigh, the outer portion at least 4 inches from the knee and 4 inches down from the crease where leg meets body. The third spot of choice is the arm, the region between the shoulder and elbow, on the outside. This is a bit tough to do one handed, and you have to be careful you are indeed doing a subcutaneous delivery. Final spot is the buttocks, the upper outer portion. The thing is you want fatty tissue, but you want to consider what sort of physical activity that part is going to get shortly after the injection as well. Muscle use will increase the absorption rate in most cases- although having a lot of adipose tissue, like in the buttocks, can also slow it down some. So if your sugar is high, you would likely want to do an abdominal injection rather than a buttocks one. But if you planned to go play tennis, you would not want to inject your racket arm. You also would want to avoid the legs if you planned to go for a jog or long walk. Also, if you needed to take your insulin but wanted a slower aborption rate, the buttocks would be your choice spot- providing your glucose level didn't need to come down and you weren't planning to eat very soon. You pretty much learn your own rates of absorption over time, and can choose your site better according to need and site rotation requirements.

Question: How can I tell if my stomach is made up of visceral fat, or subcutaneous fat? I've been reading about visceral fat, the deadly fat that wraps around your organs, and how dangerous it is. I want to know how I can tell if my big stomach is made up mostly of visceral or subcutaneous fat. I do have a big stomach, I'm 215 pounds and I'm 5'4, but it seems to be mostly soft fat, not the hard round belly you see on old men. Does this mean my fat is mostly subcutaneous?

Answer: Its still fat so you want to get rid of it.

Question: cat receiving subcutaneous fluids that throws up right after administration? I have a 15 year old cat with chronic kidney disease that I give subcutaneous fluids twice a week. Randomly in the last month she has started to throw up every time after I give her the fluids. My vet doesn't seem to have any answers. Has this happened to anyone, and do you know why this is happening?

Answer: My suggestion would be if you are not a member of this group, join it and post the question on there: http://pets.groups.yahoo.com/group/Feline-CRF-Support/ yahoo discussion list for people whose cats have kidney disease. Does the vet think she is already to the point that she is unable to absorb the fluids? could it be somehow related to her heart? and what about giving smaller amounts of sub-q fluids but daily?

Question: When doing subcutaneous injections in your stomach? Hi there, when you do a subcutaneous injection in your stomach, and the needle starts to come out while you're fiddling with pushing the plunger, so you push the needle back in, will that cause the injection area to be painful afterward? If the needle starts to come out, should I not push it back in, just stop it from coming out any further and keep injecting?

Answer: yes just push it back in, you need the insulin after all. In future, try holding the syringe with one hand and push in the plunger with the other hand, then it will stay in place.

Question: Where can I get a Xray image of subcutaneous emphysema? I have to describe the plain xray appearance of subcutaneous emphysema for a university presentation. Does anyone know of any good websites that contain xrays of this pathology? There are a handful of Xrays which came up on google images but any further leads would be appreciated.

Answer: I looked for some images of some sub-Q for ya, but couldn't find a whole lot either. I did find this site which had an xray pic. http://content.nejm.org/cgi/content/short/342/18/1333?query=prevarrow Sorry-I have some textbooks with some pics, but that doesn't help you any! :) Hope this helps some!

Question: How do I burn subcutaneous fat? I am a sophomore boy and quite athletic. I am a runner and run a sub 5minute mile. I lift at the gym and am in good shape but i have a thin layer of subcutaneous fat around my stomach, how do i lose this? I also can't do interval training because it I am doing summer training for cross country and it may cause me to peak too early.

Answer: Do more cardio and eat less calories.

Question: What is the effect of taking something that is supposed to be taken subcutaneous buccally? Lets say instead of injecting myself with something, I take a pill form (that doesn't work orally) and administer it to myself buccally. Would it have more of an effect? Most of the pill is wasted if I take it orally.

Answer: It probably won't have very much of an effect. You swallow it with your saliva. It will penetrate through your buccal mucosa as ineffectively as through your gastric or intestinal mucosa, that's why it had to be given sub-c.

Question: What are the best (easiest to insert and least painful) syringes to use for subcutaneous injections? This is for Sandostatin/Octreotide injections.

Answer: I would think they would do that at the Oncologist office or your cancer center but as far as pain and needles, I think a 22 or 23 gage is about the best for a blood draw or injection. If you want an IV, I would go for the 21 gage because anything smaller just won't work. Phlebotomy is an unappreciated skill. The first thing you get or encounter is blood work. And it's painful, sucks and also sets the tone for your entire visit.

Question: Has anyone heard of a cat having adverse side effects after subcutaneous fluids had been administered? He'll be 19 yrs. old next month. Developed constipation last month . Vet administered subcutaneous fluids several times. The last time he received fluids, his belly became enlarged . I took him to UC Davis . The vet said that fluids were not being absorbed into his system but would not refer to improper administration by the local vet.

Answer: I've had three cats who we gave subcutaneous fluids to at home. Sometimes the fluids move from the back to the side but this is simply movement of the fluids under the skin. The whole idea of subcutaneous fluids is to put the fluids between the skin and the underlying tissue - fat and muscle. A few times with Digby, the fluids sort of slide down to his side, but not underneath to his abdomen. Why was the vet giving fluids subcutaneously instead of intravenously? Usually a vet will use IV instead of SQ. I don't really see how fluids given subcutaneously at the shoulders could move to the abdomen AND cause a problem. The rate at which the fluids were absorbed into the cat's system (into the tissues and the blood vessels) may be different for fluids under the skin at the abdomen, but that would only effect the length of time needed for the dose to be absorbed, it shouldn't cause any other problems. The procedure is quite simple - you hook up the IV tubing with a needle and attach it to the IV bag containing the warmed fluids - usually Lactated Ringers Solution. You pull up a very large tent of skin at the shoulders - the saying goes that for a insulin injection you pull up a 2 man tent and for subcutaneous fluids you pull up a 6 man tent - and then you insert the needle into the door of the tent, horizontally and parallel to the back. You then open the valve, grab the IV bag and squeeze as hard as you can to put the fluids, usual dose is around 100 ml, under the cat's skin as fast as possible. Squeezing the bag is referred to as "pushing" the fluids - you've probably heard someone on a medical show say something like "100 ml LRS push" - they mean that want the patient to get 100 ml of Lactated Ringers Solution as quickly as possible by squeezing the bag of fluids to force the fluids out and into the patient. Once the needle is in place, all the cat feels is the fluids coming in but you still want to get it done as quickly as possible. I can push 100 ml of fluids safely under a cat's skin in about 30 to 45 seconds. When you get the fluids in, you pull out the needle, hold it up high while you close the tubing valve and let the cat jump off your lap. That's the entire procedure. I don't see what can go wrong with it. If you give more fluids, the bulge will take longer to subside as the fluids are absorbed. If you were to put the needle in with a downward angle, you would hit the underlying tissue and the cat would clearly tell you that it hurts. The biggest problems you can have are to push the needled through both "doors" of the tent and wind up spraying the fluids on the cat's fur or getting a leak where the fluids come out along side of the needle. In both cases you know about them very quickly because a lot of fluid that is supposed to be going into the cat is winding up on your lap or on the table or wherever the cat is standing or laying during the procedure. I don't see that your vet did anything wrong. The fluids simply shifted position as they were absorbed. One other problem is that sometimes you have to wiggle the needle around a bit to get a clear path for the fluids. Now, you can give way too much fluid - either intravenously or subcutaneously - and this can lead to problems such as poor or slow absorption or buildup of fluids in the thorax, lungs, or abdomen which could lead to serious problems. That is about all I can think of that might case any problems and the only serious one is the administration of a lot more fluids than the cat should get. I think that is about the only negative thing that can happen - too much fluids resulting in fluid buildup in the abdomen, lungs, or thorax. I would think that the vet at UC Davis would have said something about that if fluid buildup was present anywhere in the cat's body. They, just like doctors, are not going to express a negative opinion of another vet without more to go on than you were probably able to provide. However, I don't think there was any conspiracy to protect the other vet. If it was me, I'd really want to know why the fluids were given SQ instead of IV as most vet do it. It could simply be that the vet didn't want to go with the extra invasive nature of the IV needle in a vein if more than one dose of fluids were going to be done over a few days time. But then again, putting in a "line" and leaving it would actually be less invasive than doing multiple SQ fluid injections. I'd also be curious why he did not perhaps try an enema to clean out the rectum and relieve the constipation. How soon after the subcutaneous fluids which enlarged his "belly" did you take him to UC Davis? How long did it take for that last SQ dose to be absorbed?

Question: how safe or unsafe is it to give Sandostatin LAR after only 1 subcutaneous 'test dose'? study protocol orders - for an octreotide naive patient- one subcutaneous dosage of 100mcg, wait an hour, then give an LAR 20. Many here are not comfortable skipping a 2 week SC start, like what is normally done. Has anyone given an LAR on essentially the 1st day of Sandostatin treatment?

Answer: I too generally give the two-week startup dose first, but I believe many skip quickly ahead, largely based on the general safety and lack of side effects with this drug. Blessings

Question: Is a 5-way horse vaccination given subcutaneous or intramuscular? I have only ever vaccinated dogs, cats and small animals, they are all done subcutaneously (I work at a vet), so how about horses? I would like to vaccinate my horse to save $200 that my vet charges to come out for an exam and vaccination. Please any tips.

Answer: Intramusclar: 1. Secure your horse with a sturdy halter and lead rope with a quick-release knot or crossties. 2. Clean the injection site (any large,muscular area) using your grooming brushes to remove dirt, dust and debris. 3. Take out your vaccine, syringe and needle. Attach the needle to the syringe with the plunger completely down and insert the needle into the bottle. Pull the plunger out to draw the necessary amount of vaccine from the bottle. Read the directions to determine how much to administer. IM vaccines can be given in any area with a large muscle mass. The neck is recommended. To start, run your hand flat against the grain of the hair along the crest, shoulders and jugular groove to draw a central "triangle" with your thumb where you will safely inject the horse. 5. Pick an area on the neck within the triangle where you will give the injection. Hold the syringe in one hand while you stroke the area with the other hand. 6. Pinch the skin on the horse's neck to draw the horse's attention away from the poke and tighten the skin. Hold it until you are done vaccinating the horse, using one hand to give the shot. 7. Insert the needle into the muscle in one quick, steady motion. Some needle-shy horses might find it easier if you "bump" their neck a few times and then stick the needle in. (Patting thier neck hard) 8. Before injecting the vaccine, pull back gently on the plunger to check for blood. If your vaccine turns pink you've hit a blood vessel. Pull the needle out halfway, push the syringe at an angle and push it back in to redirect the needle and check for blood again. 9. Once you have determined the vaccine will go into muscle, push the syringe plunger down completely. Use the finger holds on the syringe to bring your fingers together. Don't push the syringe while you push the plunger or it will be harder to inject. 10. When you have injected the entire contents of the syringe, pull the needle straight out and release the fold of skin. Place your thumb over the injection site and press firmly for a couple seconds to stop any bleeding. Then firmly rub the injection area to encourage the vaccine to distribute.

Question: Have any of you given your cat subcutaneous liquid injections? Any tips? My Siamese is old and her kidneys are not what they once were. To flush toxins from her body, she'll need fluids given daily to her subdermally. The vet gave me ringers sol'n. Can I also include glucose or liquid protein subdermally when injecting the fluids? Thanks! We appreciate your knowledge.

Answer: No, nutrients must be delivered intravenously, and are not suitable for subcutaneous injection...find a comfortable spot where you can hang the Ringers' bag so you can have two hands to control, hold and love her while she gets her fluids...and give her some extra love from me!

Question: Maximum and Minimum amount for Subcutaneous and Intermuscular Injections? Any know the maximum and minimum amounts for a subcutaneous and intermuscular injection? also if possible what you need to look for when giving the injection?

Answer: Depends on specific drug and your allergic reactions. There are no general amounts for any human.

Question: Are there pain receptors and other 'information' cells in the human subcutaneous fat layer? Does fat contain heat and cold receptors? Is there any part of the brain specifically for controlling the fat layer? Or, is the fat essentially just like a nutrient fed blanket under our skin to protect us?

Answer: No. This is why people with full thickness (3rd degree) burns don't scream in agony. - The nerves in the outer layers have been burned and the fat layers are exposed - which contain no nerves, hence no pain.

Question: What is the best way to repair subcutaneous scar tissue?

Answer: Vitiam E and aloe

Question: I have given my cat subcutaneous fluid injections for over 1yr. How not cause pain from scar tissue? His kidneys are failing and the injections keep him alive. One possibility is a surface anesthetic, but I have to find/get access to one. Any ideas on this (or anything else). His name is Legs.

Answer: Consult with your vet before applying any topical anesthetic. You don't want to put additional burden on the workload for your cat's kidneys and anything applied to the skin might be absorbed into his system. Besides, an anesthetic doesn't stop scar tissue from forming. I had to do the same subcutaneous fluids for three of my cats. Just try to pick a different spot each time so you don't keep hitting the same area. And may I suggest a marvelous group? Join a Yahoo group called "Feline Crf." They have enormous knowledge and you can usually get a ton of help right away, not only on subcutaneous fluids but also on potassium, phosphorus binders, food, etc., that will add months or maybe even years to your pet's life.

Question: What happens immediately following a subcutaneous transposition of the ulnar nerve?

Answer: The surgeon may recommend physical therapy to help regain strength and motion in the arm. The results of the surgery are generally good. If the nerve is very badly compressed or if there is muscle wasting, the nerve may not be able to return to normal and some symptoms may remain even after the surgery. Nerves recover slowly, and it can take a long time to know how well the nerve will do after surgery. Recovery after elbow surgery depends on the procedure used by your surgeon. If you only had the medial epicondyle removed, you'll have a soft bandage wrapped over your elbow after surgery. Therapy can progress quickly after this type of surgery. Treatments start out with range-of-motion exercises and gradually work into active stretching and strengthening. You just need to be careful to avoid doing too much, too quickly. Therapy goes slower after ulnar nerve transposition surgery. You could require therapy for three months. This is because the flexor muscles had to be sewn together to form the new tunnel. Your elbow will be placed in a splint and wrapped in bulky dressing, and your elbow will be immobilized for three weeks.

Question: Have you ever had a dog or cat on subcutaneous fluids for kidney failure? My friend has a dog who was diagnosed with kidney failure. They decided to put her on subcutaneous fluids--which, from what I understand, is sort of an old-fashioned dialysis. When they decided to try this, they knew it was just a life-prolonging method and not a cure. They asked several people how long the dog could be expected to survive on this protocol but never could get a straight answer. My question, then: If you have had a dog or cat on subcutaneous fluids, how long did they live? I realize that it will vary depending on the level of kidney damage, but they would be interested to know other people's experiences. To communicate the same information to anyone else, my friends' dog has been getting these fluids once a week for almost a year. Occasionally if she starts acting weird they'll give it to her more often. She started with a kidney diet, but she hated it so much she now just eats regular dog food. Thank you for your answers, especially those of you who answered out of knowledge or experience. I have showed the responses to the dog's owners. They have been working with their vet, who never said anything about the dog continuing to suffer. To me, she does not appear to be suffering and the owners agreed. However, I think they may mention this to their vet and continue to observe if her quality of life is deteriorating. I was hesitant to use the phrase "life-prolonging method" since I know it does hint at prolonging a suffering animal's life for the owner's peace of mind. However, I meant it in contrast to a cure--not as way of saying that the animal was suffering as its life was prolonged.

Answer: I've been through this with my elderly cat and my mother-in-law also went through it with her cat. Her cat tolerated the treatment better than mine and lived about 2 years. Mine hated the treatment and struggled and was also a bit older when treatment started. She lasted only about 6 weeks. So it depends. At one year, your friend's dog is doing about as well as can be expected. My vet indicated that gradual kidney failure is not painful - and based on my experiences I agree with my vet - so I disagree with the first poster. The only problem I had was my cat hated the treatment because she did not like to be held in the first place. My mother-in-law's cat considered it a social time and was fine with it.

Question: Should I bring my cat back to the vet for subcutaneous fluid injections? My cat, who is 13, was dehydrated and I took him to the vet on Friday. The vet said he needed fluids so I left him there all day to receive them. She said he still needed more so I brought him back the next day to receive the subcutaneous injection, which ballooned-up his belly. He seems okay and the vet said to give him a week to see how he is doing. I don't feel she was very helpful because she didn't tell us to come back for more or what we should do for him...that is why I've found myself here looking for answers. I bought him one of those running water bowls where the water flows down the little hill (if you know what I am talking about, great!). He's been drinking like crazy!!! So even though he seems good I just wanted to know if I should take him back for another sub-q. Thanks. My cat was having diarrhea for a bit on and of and that is what caused the dehydration. I had blood work and urinary testing done. The blood work came back fine but she said he may have a UTI so he is on antibiotics for the week.

Answer: Why was he dehydrated? Did he go missing or is it a medical condition? Its difficult to tell you unless know more about what happened. If he is drinking lots of water then he shouldn't still be dehydrated anymore and so keep a watch on him and see how he goes, return next week for a check up. If he is drinking lots but seems still ill then it may mean there something else occuring such as Diabetes or kidney failure. If he stops drinking all together then return sooner. You will need to judge it for yourself and see how he is, if all is good then see the vet again next week, but if he hasn't improved or gets worse then see them sooner. Remember you can always see another vet and get his history faxed or emailed to the new vet surgery.