Providing Fluids

I decided to explain some of the basic ways that we provide fluids and medications to animals that are hospitalised. And figured l would pop up some photos of animals l have got catheters in. I remembered to take photos of 2 of the puppies l do not usually bother to take photos iv catheters are so routine. The kitten was so pathetic looking l had to take a photo.
The iv catheter is hidden in the blanket on the second pup l wanted to show his size and forgot the leg.
I am lucky that because of the emergency work l see so varied an array of patients in size and type.

On admit most animals have an IV catheter placed so we can give them fluids and certain medications directly into the vein. The smaller animals can be a nightmare to get an iv catheter in. The problem with the smallies is that there is no decent handles on them to grab. They generally wriggle a lot and your fingers trying to raise the vein are somehow always in the way.

Puppies are usually the worst, as they get better they often end up with a buster collar on or they chew out their iv. If the nibbling has not been noticed this brings the “It is your turn to go play with the little git” comments.

You can give fluids various ways. Into the scruff off the neck but not much at a time, it takes a long time to absorb and it often hurts.
Birds are crop fed via syringe and a special long curved sort of blunt feed ended needle.

Interperitoneal (into the abdomen) but in the youngsters it is always nerve racking that they may move at the wrong point and are so small everything so tight.

In rabbits iv catheters are generally placed in the ear. I have never liked ear veins they are so fiddly and easy to damage. We tend to pop on some local anaesthetic cream but the rabbit still jumps at just the wrong moment. And no matter how much you clip the hair is so fine it is almost impossible to totally remove so you have it covering the area you need to see.
As an added bonus we often need to syringe feed a lot of rabbits. Some take it well others cause more stress damage to their mental health than the good of getting food into them can do.

For the very young animals there is the syringe feed. You can be sure you get these in when you are rushed off your feet. And it is never a quick job. First they hate the syringe, they hate the replacement milk. To fast the milk goes into their lungs and they risk inhalation pneumonia, then there is peeing and pooping them. And often after you have done this they want more food as there is now more room so the repeat takes place, usually after the second lot they will sleep. If they are gluttons and love the syringe and replacement milk then they try and gulp it and scream when you decide they have had enough for that feed. So you end up taking even longer as they want more and won't settle.

The bird and the rabbit ear l admit to borrowing from the web as l have none handy l will place the rabbit ears onto my need to photo list. The other patients in these photos survived and were discharged, enjoy the awww factor.

Puppy with Haemorrhagic Gastro Enteritis (vomiting and shitting blood)

Another HGE Puppy with a pen leaning against him to show size

Abandoned Kitten Being Syringe Fed


Rabbit Ear Clipped for Catheter into Vein

Crop Feeding

Drips and Drops

I really need to learn to say no to work. I was rung up Sunday at 16:30 in the afternoon and said ok to working the 17:30-03:30 shift and as we were so busy l didn’t leave till 04:30.
Just as well l went in as from 22:00 there were 2 of us nurses and a vet with no auxiliaries, so we had to do their jobs the laundry, bins, cleaning and reception, phones as well as our own jobs.

I ended up doing the anaesthetics and assisting the vet on ops, l took x-rays (nurses job generally), did dressings (nurses are better at dressings than vets), placed drips, took and ran blood tests and the odd bit of inpatient ob’s to help when l got a chance.
The other nurse did the inpatients, a bit like painting the forth bridge never ending.
The rest of the jobs we shared between us. The 02 alarm has a fault on and at one point l ended up laughing hysterically, leaning against a wall as the other nurse marched like the honey monster snarling in frustration towards the alarm to slam it with her hand for the 10th time or was it the 15th l lost track.

We had a couple of major operations like removing a collar buckle from a stomach. The dog got bored and ate his friend’s collar FFS talk about a pimple brain!
“Duh l am bored wonder what l can do, l know l is gonna eat your collar”
His friend joined in and ate the studs and other bits of the collar that fell on the floor. After all it was his collar so fair is fair, x-ray showed they were moving through his intestines.
That was the op that ended late then l had theatre and prep to clean and mop post op, l refused to pack the kit though just slung it into the cleaning fluid to soak.

A pyo, the uterus fills up with pus and it is life threatening. Why oh why do people not get their bitches neutered when they are puppies. They would avoid the £700+ bill, the misery and illness of the animals.

Add that to the usual night time crop of x-rays of dog and cat RTA’s or accidents and temporary support dressing (if possible) till the patient is operated on.
Stitch up wounds, gastro enteritis - joys of Christmas dinners, blocked bladder cats and renal failures.
Wound breakdowns – Listen people use the sodding buster collars they are there for a reason, don’t sit and watch your pet chew the bloody wounds.
A rabbit, a couple of birds some medical cases and oh 2 Parvo dogs in isolation.

It added up to a fun round of work yourself silly night. Think it was 36 inpatients with 32 on drips. Not the busiest of nights but more than enough to keep us going without a break as we had so few staff. If one more dog pulled, ate or disconnected its drip line then there was going to be a group of hysterical staff on duty. Drip lines can be the bane of our lives. If you have a “Bad Drip Night” you know things are just going to go downhill.

At one point l had 5 redrips waiting for me. I tend to prefer dripping to holding and the other nurse on was happy with that as she prefers holding to dripping.
I had the locum vet holding earlier in the evening. He is a Jelco person. And is to bloody slow when we need to motor. Being male he can hold and talk but not drip and talk and l felt that taping his Irish mouth shut was a bit extreme as being the only other option.

There is 2 main makes of iv catheters (canulas) we all tend to use Surflo or Jelco. I have had to get used to Jelco with locuming about but generally if you can use one sort you will screw up the other. I am in the hate Jelco camp.
The other type is winged catheters. These have little wings next to the cap to suture them in. Not something you do with animals we chop them off.
We tend to use these for rabbit ears. Yes rabbits do need iv fluids and we give it via their ears. I also hate doing rabbit ears. We put a local on their ears but it never properly works. They jump at just the wrong second. The skin is so thin and veins so tender it is all done by hope.. “hope l am in this ***ing time”.
For those who understand sizes, 27 or 26 (purple, yellow) rabbits, puppies and kittens, 23 (blue) cats and small dogs, 21 and 18 (pink, green) bigger to huge dogs.

One Jack Russell broke 2 buster collars and chewed out 2 lines. The little git got a shock when his teeth descended on the 3rd line though. I left his buster collar off and he thought Christmas had come again, stupid vet nurse. I won that round though, l sprayed the line and dressing with bitter spray.
I also placed the drip into his back leg vein. This can be a difficult one to get, but often patients will tolerate it better here. The vein is very wobbly and the stylet on the catheter bounces off it, you have to give a hard jab but not to hard so you go straight through the vein and blow it. The hind legs are a difficult shape (The vein goes diagonally towards the back of the leg just above the animals hock from front to back, run your finger round your pets leg there and you will see what l mean about shape, lumpy, bumpy and a rounded leg.)

There was a lot of short legged dogs last night, again a nightmare to drip. We call the short front legs, Queen Ann legs. The veins are very loose and wobbly, run in weird shapes around the legs and are a nightmare to find let alone drip. These dogs tend to wriggle a lot often try and bite as well and there is no decent handles on them to grab.

The drip lines used where l was disconnect part way up. This is useful when you have dogs to walk and swop lines for some reason or trying them off drips for a bit. The down side is that they can come apart and when this happens blood flows out till it clots. The clot happens fairly fast but not fast enough that the bed is not a blood bath (blood mixed with the fluid leaking out of the bag spreads well).
To sort it you disconnect the whole line and flush the blood this comes out like a hard long worm, then reattach everything. Change the bed, which was probably cleaned about 10minutes before when they peed or pooed on it.

Then there is the restless walkers, round and round till your drip is one long snarling twisted mess and pulls out the leg. Mind you not that it was dripping anyhow. Even if you manage to untangle the drip line before it pulls out they damage it with the tight twists. We were to busy though to give hourly boluses. At least there was only one “walker” and she was a non critical dog, being a recovery and going home the next day, we ended up taking her drip out.

I was so glad to get home last night and climb into bed forgot to drink my coffee. I fell asleep while trying to decide if l should reach a finally warming up arm and hand out to the cold air to grab the mug.