Subcutaneous Fluids

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.
red dog
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).

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.
fluid in a plastic bag with "tear here" labeled on it 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.

the spike port and injection port of a fluid bag 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).

solution drip setup

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.

 

removing the blue plastic cover from the spike port

 

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.
 

inserting the white spike into the bags spike port.

 

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.

 

 

white spike correctly inserted and needle attached to other end of solution set

 

Attach a needle to the other end of the solution set.

labeled parts of the solution set 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. 

 

tenting the skin and inserting the needle

 

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.

 

dog with needle inserted and drip bag hanging next to him

 

 

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.

 

rolling up the fluid bag 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. 

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