Giving Subcutaneous Fluids to a Dog
This information is not meant to be a substitute for veterinary care.
Always follow the instructions provided by your veterinarian.
In the photographs below, unless otherwise noted, the dog is facing to
your right.
Variations on these instructions exist. Always follow the instructions
provided by your veterinarian.
Supplies used in giving subcutaneous fluids will vary by manufacturer and
may differ from those pictured here.
Fluid given under the skin, subcutaneously (SQ), is absorbed into the
blood stream and can be used to correct or prevent dehydration. The most
frequent disease for which fluids are given is chronic kidney failure. Dogs
with chronic kidney failure pass large amounts of urine and may not feel
well enough to drink enough to prevent dehydration. The dog owner may give
subcutaneous fluids a few times a week to supplement the water the dog is
drinking in order to prevent dehydration and help flush waste products
through the kidneys.
Your veterinarian will prescribe a certain type of fluids and a volume
and frequency for administration to your dog. The most common fluid type
given to dogs with chronic kidney failure is Lactated Ringers Solution
(LRS).
There are 3 general techniques used to give SQ fluids:
- with a syringe and needle
- with a syringe, needle and flexible tubing called an extension set
- from a vinyl bag using a solution drip set
Most dogs tolerate being given subcutaneous fluids. You can give about
10-20 ml per kg of body weight (5 -10 ml per pound) in one spot (e.g. 50 ml
for a 10 pound dog) before you move to another location. It usually takes 6
to 8 hours for all the fluids to be absorbed. Check to see if the previously
administered fluids have been absorbed before giving more fluids. Even
though the fluids are given on the back, gravity will cause the fluids to
accumulate on the belly, so check for residual fluids on the belly before
you give more. Check with your veterinarian if the fluids are not being
fully absorbed.
Usually the skin is not cleansed before inserting the needle. If
the dog has a normal immune system, the few bacteria that are pushed under
the skin with the needle will be killed by the dog's immune system.
You can use alcohol on a cotton ball to make the hair lay flat so it is
easier to see where the hair ends and the skin starts. Alcohol takes about
30 minutes before bacteria are killed, so just swiping the hair with alcohol
is not an effective way to kill bacteria.
If your dog may have an abnormal immune system, for example is on anti
cancer drugs, then several patches of hair may be shaved and the injection
sites scrubbed with an antiseptic solution such as Novalsan or
Betadine
before placing the needle to prevent pushing bacteria under the skin.
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The thickness of a needle is
measured by gauge (g), the smaller the number, the thicker the
needle. An 18 gauge needle is thicker than a 20 gauge needle.
Needles may also be different lengths, one-inch and one and
one-half-inch are most commonly used.
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The plastic hub is the wide part of the needle that attaches to the syringe.
The hub of the needle is color coded by size, although these colors may vary
by manufacturer. 18g needles have a pink hub, 20g needles have a yellow hub.
20g needles are most commonly used to give SQ fluids although larger needles
(18g) may be used in large dogs and may be used to draw fluid from the
container of fluids. Smaller needles (22g) may be recommended for small
dogs.
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Needles are packaged in a rigid
plastic cover and wrapped in paper or plastic to keep them
sterile. Keep the needles in the original package until use. Do
not dispose of needles or syringes in the trash. Keep used
needles and syringes in a puncture-proof container and return
them to your veterinarian for disposal. Don't use the same
needle that was placed under the skin to draw more fluids from
the container of fluids or bacteria will be introduced into the
container of sterile fluids.
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If you use an 18g (pink) needle to draw from the solution container and a
20g (yellow) needle to give the fluids, it will be easier to keep track of
which needle to use. Keep the white plastic cap to place over the sharp
needle when it is not in use.
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Usually a large (60 ml) syringe is
used for fluid delivery. The syringe is often packaged in a
plastic case. If the syringe is to be used more than once, you
may want to keep the container. The plastic container is also
useful for placing used needles for disposal.
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The syringe has 2 parts, a barrel
and a plunger.
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The syringe is marked in
milliliters (ml) and ounces. The syringe is marked at 5 ml
increments (5 ml, 10 ml, 15 ml, etc.). Each line between the
numbers is 1 ml. The plunger has a domed end. The top edge of
the plunger is used to read the amount of fluid in the syringe.
This syringe contains 26 ml of fluid.
There is a small air bubble in this syringe. It is not
necessary to remove tiny air bubbles such as this one when you
are giving fluids SQ.
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Remove the needle from the
paper/plastic wrap but leave the plastic cover on the needle.
Place the hub of the needle firmly over the tip of the syringe.
Some needles and syringes have threads that screw together
(luer-lock). Remove the plastic needle cap just before use.
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Fluids are in plastic bags or
glass bottles. Bags of fluids come packaged in a plastic
wrapper. Remove the wrapper from the plastic bag just before
using. The fluid type that is most often given SQ is Lactated
Ringers Solution (LRS). Fluids do not contain a preservative,
so ideally they should only be used only once and then any
remainder should be discarded. Most veterinarians stock fluids
in 1,000 ml bags. This volume is larger than is usually given to
a dog at one time. You may be given instructions to draw fluids
from the same bag for a few days. See the
instructions below
for suggestions on how to prevent contamination of the bag of
fluids.
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The neck of the bag of fluids has
2 ports; the injection port that is covered with a rubber
stopper and a port covered by plastic (blue) in which the spike
of a solution set is inserted (discussed below). |
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Follow your
veterinarian’s instructions for handling the fluids sterilely so
the container of fluids is not contaminated, and you may be able
to use the same container of fluids for a few days if
recommended by your veterinarian. Clean the rubber stopper of
the injection port with an antiseptic solution such as Novalsan
(chlorhexadine) or Betadine
(povidone iodine) before inserting the needle, if more than one
puncture will be made through the stopper.
Alcohol takes about 30 minutes of contact before bacteria are
killed, so it is not a good solution to use.
Always use a sterile needle to draw fluids from the sterile
container. Do not use the same needle to give the fluids to the
dog, and then place that needle back into the fluid container as
it will become contaminated with bacteria from the skin.
If you use an 18g (pink) needle to draw from the solution
container and a 20g (yellow) needle to give the fluids, it will
be less confusing.
Never use a bag of fluids if it appears cloudy.
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Remove the plastic cap from the
needle and place the tip of the needle in the injection port. |
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The needle must be inserted into
the center of the rubber stopper. The injection port itself is
held so the needle is inserted straight
into the injection port. |
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This needle is properly aligned.
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This needle is placed off-center
and is puncturing the injection port. |
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Draw back on the syringe plunger
while holding the syringe barrel steady so the needle does not
pull out of the fluid bag. Fill the syringe to the volume
prescribed by your veterinarian. Do not fill a 60 ml syringe
past 50 ml as the plunger may accidentally be pulled out of the
barrel of the syringe, spilling the fluid.
If you used an 18g needle to draw from the bag, replace the
plastic cap, remove from the syringe, and set aside this
needle.
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Replace the 18 g needle with a 20g
needle. When you have given the first syringeful of fluids,
change back to the 18g needle to draw another syringeful. Then
change back to the 20g needle to inject the dog. Keep the
plastic caps on the needles as you exchange them. Use one new
18g and one new 20g needle each time you give fluids to your
pet; alternating needles between syringefuls of fluids. |
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Pinch up a fold of skin anywhere
along the neck or back using your left hand if you are
right-handed. Use your right hand to place the needle that is
attached to a 60 ml syringe, into the skin fold along the long
axis of the fold.
If you place the needle in the opposite direction, across the
skin fold, it is more likely that the needle will go through one
fold of skin and out the other fold of skin.
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Before injecting the fluid, pull back on the plunger of the
syringe. If air bubbles appear in the syringe, the needle has
gone through both folds of skin and you are sucking room air
into the syringe. Remove the needle from the skin and try again.
If you get blood, the tip of the needle is in a blood vessel.
Remove the needle and try again.
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Once you have checked that the
needle is correctly placed, let go of the skin fold and push the
plunger to inject the fluids.
The plunger can be pushed using one hand by holding the
syringe between your fingers and pushing the plunger with the
thumb of the same hand. The other hand can be used to steady
the syringe or comfort the pet.
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If this is difficult, hold the
syringe in one hand and push the plunger with the other. The
fluids can be injected as fast as you can push the plunger.
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If the needle is not directly
attached to the syringe, but is attached to a flexible piece of
tubing (an extension set) first, the dog can move around a bit
while the fluids are being injected. The extension set will be
packaged in a plastic/paper wrapper. Remove from wrapper, remove
the white plastic cap from one end and firmly place on the tip
of the syringe. Remove the cap on the other end and place into
the hub of the needle.
The two ends are different, the female end fits over the tip
of the syringe. The male end fits into the hub of the needle.
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The needle attached to the
extension set is inserted into the injection port
as described above for a needle directly attached to a
syringe. Draw the prescribed amount of fluids into the syringe.
Replace the 18g needle with a 20g needle and recap the 18g
needle with the plastic needle cap. Push some of the fluid
through the tubing to evacuate air from the tube, a procedure
called priming.
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The syringe containing the fluids is laid on the table.
Pinch up a fold of skin anywhere along the neck and back
using your left hand if you are right-handed.
Use your right hand to place the needle into the skin fold
along the long axis of the fold.
Pull back on the plunger of the syringe. If air bubbles
appear in the syringe, the needle has gone through both folds of
skin and you are sucking room air into the syringe. Remove the
needle from the skin and try again.
If you get blood, the tip of the needle is in a blood vessel.
Remove the needle and try again.
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Once you have checked that the needle is correctly placed,
let go of the skin fold and push the plunger to inject the
fluids. The plunger can be pushed using one hand by holding the
syringe between the index finger and middle finger and pushing
the plunger with the thumb of the same hand.
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If this is difficult, hold the syringe in one hand and push
the plunger with the other. The yellow X marks the site the
needle is entering the skin.
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When you are finished giving
fluids, if you are instructed to use the same syringe and
extension set for more fluids later, place a clean needle
covered by its plastic cover on the end of the extension set. |
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The third method to give SQ fluids
is to attach a solution drip set to a bag of fluids. Remove
the solution set from the plastic/paper wrapper. Both ends are
covered with plastic caps. After removing the cap, the male end
fits into the hub of the needle. The white spike is punctured
into the spike port of the bag of fluids after removing the
plastic tube that covers the spike.
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The spike port on the bag of fluids is covered by a blue
plastic cover. This cover is pulled off. The cover is tightly
covering the spike port and you have to pull firmly to remove
it.
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The white spike on the solution set is
pushed into the spike port. Hold the spike port in your left
hand to guide the spike straight into the port. If you push the
spike in at an angle, it may puncture the bag of fluids.
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Attach a needle to the other end of the solution set.
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The plastic tubing has 2 clamps
that must be opened to allow fluid to flow.
- The dark blue pinch clamp has a tapered slot, the tubing
is pushed to the widest part of the slot to open and pushed
to the narrowest part of the slot to stop fluid flow
- The light blue clamp is a roller clamp. Use your thumb
to roll the white disk up, toward the solution chamber to
open and in the opposite direction to close.
The fastest flow of fluids occurs with both clamps fully
open.
Before placing the needle in the SQ, open the clamps and let
fluid flow until the air is evacuated from the tubing.
You will see drops of fluid drop in the drip chamber when the
clamps are open. If the drip chamber fills with fluid so that
you cannot see the drops forming, turn the drip chamber upside
down and squeeze some of the fluids back into the bag.
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The skin is tented and the needle inserted along the long
axis of the fold. You cannot suck back to check for air so watch
the site at which the fluids are entering the skin fold to make
sure the hair isn't getting wet suggesting the needle is
incorrectly placed.
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The fluids can be dripped into the SQ space as fast as the
drip will go. The higher you hang the bag, the faster the fluids
will flow.
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You can also roll up the bag and
squeeze the fluids out of the bag for faster delivery. If you are
instructed to use the same fluids and solution set for more fluids
later, place a clean needle covered by its plastic cover on the end
of the solution set.
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Complications of SQ fluid administration can include:
- development of an abscess which will be a hard, painful lump that is
warm to the touch
- edema if too much fluid is given
- if the dog is severely dehydrated, the fluids will not be absorbed
Washington State University assumes no liability for injury to you or
your pet incurred by following these descriptions or procedures.
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