Subcutaneous Fluids

Subcutaneous Fluid (SQF) Administration at Home

Subcutaneous fluids (SQF) are used in patients needing fluid support or therapy when IV fluids are not necessary or hospitalization is not possible. SQF can help prevent dehydration in patients not eating well and in those needing intermittent fluid therapy but not hospitalization (eg, patients with chronic kidney disease [CKD]). Mild dehydration cases caused by short durations of vomiting or diarrhea may also benefit from SQF. An added bonus to administering fluids at home is the reduced stress for your pet by not having to leave the house!

To start administering fluids at home, your veterinary team will send you with the supplies below.

Begin by opening the fluid line and attaching a new needle to the end.

Next, remove cap from the spike end of the fluid line, open fluid bag, and insert spike as shown below.

Next, turn the fluid bag over and let fluids run all the way through the line until no air remains in line, then close the line. It is best to do this over a sink to catch extra fluids coming from the line. The fluids are now ready to be administered! Start by choosing a nice, quiet place where your pet will be comfortable during the procedure. 
Next, remove the cap from the needle, make a tent in the loose skin between your pet’s shoulder blades and insert the needle parallel to their body, as shown below.

Now, open the line and make sure fluids start flowing. If they are not flowing, you may need to adjust the needle placement by pulling out slightly, pushing in further or adjusting the angle. 
Once flowing, you can allow the fluids to drip at their own pace, or squeeze the bag, checking the quantity used periodically until you have given the full amount prescribed.
When you are ready to remove the needle clamp off the line, pinch the skin around the needle, and pull out. Keep pressure on the insertion point for a couple minutes to help avoid letting fluids out of the skin. (A small amount of leakage is normal)

SQF FAQ’s and Troubleshooting

Even with the best education before you leave the practice, you may have questions about SQF administration when you and your pet get home. This handout should provide answers to your most frequently asked questions, make you feel confident, and help ensure treatments go smoothly for you and your pet.

THERE ARE BUBBLES IN THE LINE—WILL THEY HURT MY PET? Small bubbles in the line will not harm your pet. However, if you are concerned about them, simply open the clamps and allow fluid to run through the line until the bubbles are gone.

I PUT THE NEEDLE IN AND OPENED THE CLAMP, BUT FLUID IS GOING EVERYWHERE! WHAT SHOULD I DO? The needle may have gone through one side of the pinched skin and out the other, allowing fluid to flow through the hole created. This can happen if the tent in the skin is not high enough or if the needle enters at an angle rather than parallel to the pet’s spine. To resolve this problem, pull the needle back slightly and adjust the angle, or remove the needle completely and try again. The same needle can be used for 2 attempts. If a third attempt is needed, use a fresh needle.

THE FLUID IS NOT FLOWING IN THE DRIP CHAMBER. WHAT IS WRONG? First, make sure the line is open and not clamped. If the line is open and has not collapsed on itself where the clamp has been, adjust the needle by either moving it further in, pulling it back slightly, or adjusting the angle. If these methods are unsuccessful, create a larger space under the skin by pulling up on the skin tent.

THE FLUID I GAVE LAST TIME IS STILL THERE. SHOULD I GIVE THE NEXT DOSE? Do not give the next dose if the fluid has not been absorbed completely. Contact the veterinary practice because the patient may need to be examined and the dose volume or frequency adjusted.

THE DRIP CHAMBER IS FULL OF FLUID AND I CANNOT SEE THE FLUID DRIPPING. To remove fluid from the drip chamber, fill the chamber completely by squeezing it gently until it is as full as possible. Once the drip chamber is completely full, turn it and the bag upside down, and squeeze the fluid from the chamber back into the fluid bag.

Reference1. Gaitán-Fonseca C, Romo-Castillo D, Cerda-Cristerna BI, Pozos-Guillen AJ,Masuoka D. Res. 2015;3(1):1-5.