Helga's sub-cutaneous injections

After her hospitalisation at the vet on Monday for fasting for 4 days, Helga returned with advice from The Animal Clinic's Dr Dawn Chong that we start her on sub-cutaneous (under the skin) fluid injections to be done 2-3 times weekly at 150ml 0.9% saline each dose. This is especially important when she refuses to eat, and is also good maintenance for her kidney function which is already on the decline from her last visit.

The S-C injections need to be done at home, so I learned how to do it from the vet-techs at the clinic. Cat-angel Catherine bought infusion kits, 18g by 1inch needles, and 500ml bags of saline over to our foster home for Helga (and taught us how to use them), as well as made a cash donation to cover Helga's hospitalisation fees.

Our first two attempts at S-C injections were a learning curve. The first time round we weren't sure if we had injected correctly, and after trying on her sides and then her back, I realised that it was easiest to do the injection on her back because I could monitor if there was any back flow or leakage. The second time around Helga ran away after 100ml of saline infusion because I didn't restrain her enough. I checked in with Dr Chong if 100ml was okay and she replied saying that since Helga is small in size, 100-150ml is ideal, not any more than that.

So onwards to today, our third attempt, and I successfully managed to infuse her with 150ml of saline. Here is a video of my amateur attempt at S-C injections (if you are experienced with this and can tell me if I am doing something majorly wrong please leave a comment to let me know so we can improve).



It is quite heartbreaking to see that she is in pain because of the injections and it takes some bravado to administer this - our heartfelt admiration for those who have sick cats to care for requiring injections (renal failure, diabetes) that you need to carry out on a regular basis. 

I laid a peepad on the floor beneath Helga because during our first S-C injection attempt at home, Helga peed on the floor and we couldn't tell if it was the saline leaking out from her skin or otherwise, which also prompted me to change to injecting her on her back even though there is lesser loose skin there, so that if any fluids leak I know if it's Helga peeing or otherwise.

The needles are used once and then covered and discarded in a resealable jar (as per Catherine's advice) to seal, wrap and dispose of safely.

The video doesn't show this - but when starting on a new bag of saline, once the apparatus is fit together, it needs to be opened (the green seal at the end of the tube) to let it flow so that there are no air bubbles trapped in the saline when injected under the skin. The bag also needs to be hung high so that gravity can speed up the flow of the S-C injection. All this knowledge also imparted by cat-angel Catherine who is a nurse. (The workings of the S-C injection is the same as for humans, only that for humans we do not reuse infusion sets, and we alcohol-swab the needles, tube and injection site.)

And so, this is the reality of kidney failure. Persian cats have a heredity towards it, and Helga probably had a lifetime pre-abandonment of eating table-scraps (obvious sign being her bad teeth) - nutritional food really makes a difference. And water. Please make sure your cats are taking in enough of it, and if not, buy a water fountain, or feed them wet food everyday alongside their dry food to ensure they are getting enough hydration.