Subcues for Dummies

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sef1268

Post   » Sun Oct 21, 2007 10:03 pm


I give up. I've given a number of sub-q's over the past couple of months, but STILL can't seem to get it right. Am I the only one who has so much trouble doing this? I've read the instructions, I've had my vet show me how, I've had the vet tech show me how, and I've had a couple of folks email me with tips. Why am I so friggin' subcutaneously challenged??

Tonight was Sebastian's weekly subcue, and I decided to let my husband hold him this time. I'm using a 25g needle, and it went in with no problem at all -- not even a jump or cry. I was just thinking to myself that this was going pretty well, when I picked up Bassy to go handfeed him after the injection, and discovered that he was bleeding a little. Is that normal? I haven't noticed that before, and it freaked me out. What would make him bleed?

Last week, I thought it was going exceptionally well (I was attempting to do it myself), when I discovered that the needle had pulled out at some point, and the towel was soaked in Ringers.

I've poked myself; dropped needles on the floor; early on, I did a subcue up around his neck area that resulted in Sebastian having little hiccups afterwards, and I rushed him to the vet in a panic (no idea what caused it; it stopped by the time we got there). As a result of the latter, I'm totally paranoid about administering it anywhere other than on his hips.

If I try to do the injections by myself, Sebastian ends up running around the table and kicking...it's very stressful for us both. If my husband holds him, it's even harder for me to see what I'm doing. And husband gets impatient and I get even more stressed. I've tried towels, a basket; I've tried distracting Sebastian with food. Nothing seems to make it any easier for either of us. It has reached the point where I start feeling anxious before each subcue, and I know Sebastian senses this. I have zero confidence in what I'm doing.

Would it be possible for some of you to post pictures of how you go about it?

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Amy0204
We miss our sweet Oreo

Post   » Sun Oct 21, 2007 10:08 pm


I don't have any pics to share, but I found that if I made a tent with the skin above her shoulders (not her neck, though) and slid in the needle at a very slight angle (almost parallel with her back but not quite, it went ok. I tended to try to push thru the fluids too quickly once in awhile, but got a lot of resistance from the pig. Frequently, I would have water leak out afterwards. Allison would stand in front of Oreo and hold her steady but out of my way (which took a few days to master), and I'd come at her from the side. Not sure whether this helps, but maybe you could post pictures of how you're doing it and we could critique.

I do know that it took me 5 days of doing it in a row, before I started to gain a little confidence. Doing it once a week would have left me anxious, too, because there's just not enough experience to build off of.

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Mum
I GAVE, dammit!

Post   » Sun Oct 21, 2007 10:49 pm


It sounds as if you've done all the things I've done :-p

Really it's a question of practice - and confidence.

The more you do, the better you get at it. Unfortunately - in my experience - the more you do on one pig, the harder it gets because they can see you getting ready for it.

However, the results are worth it.

(Have you managed to subcue your finger yet? )

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micmik326

Post   » Sun Oct 21, 2007 11:04 pm


I wonder if doing a subq on a guinea pig would warrant the same advice my instructor gave us for doing an IV on a human..."It's 10% skill and 90% confidence...if you can visualize youself doing it you WILL do it" I have never had to give a subq to a GP but it works for me when I do IVs. I've only done a few now and I get a little nervous to begin with but as soon as I visualize myself doing it and tell myself
"YOU CAN DO THIS" I relax and I get it. I repeat that phrase every time...10% skill, 90% confidence...You Can Do This!

It might not work for everyone but maybe it's worth a try. Good luck! You'll get it!

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Mum
I GAVE, dammit!

Post   » Sun Oct 21, 2007 11:09 pm


A glass of wine beforehand helps tremendously with the confidence :-p (Not such a good idea, though, when you have to do a subcue before breakfast!).

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sef1268

Post   » Sun Oct 21, 2007 11:35 pm


Yes! I've subcued my finger. Twice.

I was actually thinking of buying a bottle of Rescue Remedy to help me relax a little before I do it (never figured out if that stuff really works, or if it's largely psychological -- but it does seem to have a calming effect).

Mum, have you ever had a pig bleed a little from the jab site afterwards?

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Mum
I GAVE, dammit!

Post   » Sun Oct 21, 2007 11:38 pm


Yup, I've certainly had a little blood. Generally found on my shirt when I had to go somewhere :-p

It's all normal and part of the process. (Preferable not to have it of course, but it just seems to happen sometimes).

Truly, you really do have to take a deep breath or two and just go for it.

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Bugs Mom

Post   » Sun Oct 21, 2007 11:39 pm


Lady Bug just got her first ever sub-q on Friday from her vet. After watching the procedure and her squirming, I'd probably have a hard time ever doing one. I'm also alone so no one to hold her for me.

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sef1268

Post   » Sun Oct 21, 2007 11:54 pm


I started out feeling fairly confident about it. When my vet first showed me, she allowed me to do it while she watched. It seemed easy -- I used a syringe and a 22-gauge needle, and Sebastian let me give the injection with very little protest. I felt like it was something I could definitely do on my own.

First time I gave one at home by myself, though, it was totally different. He screamed bloody murder and I jabbed him in the wrong spot. That might have been one of the times I got my finger instead. It has been downhill since then. Now, all I have to do is make that little "tent" and Sebastian goes ballistic. He's great about meds, handfeeding, dental work...just about everything but this.

Do most of you feel that the winged infusion sets make subcues easier? (the only downside for me, is that they tend to pull out if I'm not careful about how I restrain him). Is there anyone who prefers using a regular needle?

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Amy0204
We miss our sweet Oreo

Post   » Mon Oct 22, 2007 12:25 am


I never knew you could use regular needles. The butterfly allowed me to control it better. I can't tell you how many times they fell out, which upset me to no end, since I was going to have to prick her again. And she squealed every time. Of course, I'd jump and that would knock the catheter needle out again...endless cycle.

I did make sure everything was ready to go before I'd bring Oreo into the kitchen, where we'd do this. And I set her up on a shirt that had the kid's smells...not sure whether this was good or bad. Since she wouldn't eat, I couldn't distract her with food.

I don't know whether this would work for subqs, but since she fought so hard about the syringe feeding, I developed a method of holding her, facing me, between my legs, while I sat with my legs up on the bed. Basically, she was laying on the bed and my legs were acting like a vice. You might be able to manage that with Bassy facing away from you (he wouldn't see you then). If you hold him secure, there, he can't jump or move. I don't know whether that would work, but it sounds worth trying.

I remember when I was a kid, my allergist (and a family friend), told me how they used to practice giving shots on oranges when he was in med school. I don't know how orange peel compares to guinea pig skin (I know it doesn't jump around or squeal), but maybe you could practice on something with a thick skin, just to get experience with that part?

Alibabble

Post   » Mon Oct 22, 2007 12:57 am


I've done all of those things before, including after I'd had way too much experience give SQ fluids. Sometimes a bit of bleeding happens, you've just nicked a little vessel. This usually happened when an unwilling Corey was holding for me and wearing a white t-shirt.

I found the butterfly catheters considerably easier than using just a needle. At first I even attached an extension set to the butterfly catheter to give me even more play in case the wiggling got out of hand.

If it makes you feel any better I eventually began to view the screaming as a positive sign. When Gavin was in renal failure I gave him daily SQ fluids and he screamed pretty much every single time. The only time he didn't scream was when he was feeling truly awful, I eventually thought of the struggling/screaming as a way to judge how he was feeling.

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RavenShade
Thanks for the Memories

Post   » Mon Oct 22, 2007 10:19 am


I used the butterfly needles. It seemed to help. The tubing allowed the pig to twitch without losing the connection. I put the pig on a towel on the table and Mr. RS held the pig with his hands. I got it all ready before I put the needle in. If the fluid was properly warmed, there was minimal jumping and complaining. If you don't warm the fluids, it's very uncomfortable for them. I warmed the fluid that I pulled from the bag into the big syringe under a hot tap. I didn't warm the whole bag. I also pushed the fluid in very slowly.

I put the butterfly needle in the above-described tent of skin between the shoulders, and tried to get it in a slightly different spot each time (a little to the left...a little to the right...).

I also found it helpful to bribe the pig with a favorite treat at the same time.

dribble

Post   » Mon Oct 22, 2007 3:24 pm


Mum, that glass of wine truly helps. :)

I gave subcues twice weekly for a long time, and the butterfly catheters were amazing! The vet ordered me a box of 50 cheaper than I could find elsewhere. One brand was definitely sharper than the other (can't remember which, though). With the dull brand there was a lot more pain. I too would warm the fluid in the syringe under warm tap water, or have it sit in the sunshine for a bit beforehand.

I think speed matters. If I was tentative it seemed to hurt longer. A quick jab seemed to hurt for less time. But regardless, I always got the "stink-eye of death" from my Maggie, so we would cuddle afterward. That also helped me see if she was leaking fluid. We would do the deed in a shallow Tupperware bin on the kitchen counter -- it had good light, was the right height, and had lots of places for me to sit my drink. :)

I don't recall ever seeing blood after a stick, but it has been a long time since I've done a subcue.

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sef1268

Post   » Mon Oct 22, 2007 7:24 pm


I have another fluid therapy question that isn't sub-q related, but I'm curious.

I found packets of Kool-Aid at the store this evening -- no sugar or artificial sweeteners added. The ingredients are: citric acid, malodextrin, calcium phosphate, ascorbic acid, and artificial flavor and coloring. One of the flavors (raspberry) has salt added, but the other two don't (the watermelon flavor, and the raspberry flavor).

Would these be safe to syringe as a hydration "treat" a couple of times a week? Any concerns with the malodextrin? Or salt?

User avatar
Mum
I GAVE, dammit!

Post   » Mon Oct 22, 2007 7:26 pm


You know, it may be all right, but I really hate to give such small animals anything even a bit iffy.

As a treat I'd pick something like Green Machine over that!

User avatar
sef1268

Post   » Mon Oct 22, 2007 7:32 pm


Well, I agree. What is Green Machine? Sounds intriguing!

Alibabble

Post   » Mon Oct 22, 2007 11:02 pm


One more thing. Use a fresh needle for each poke/session. It makes a huge difference, I can feel the difference between a fresh needle and one that has been used so I assume that the piggie definitely can.

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Mum
I GAVE, dammit!

Post   » Mon Oct 22, 2007 11:05 pm


If you're using butterfly sets then you'll always use a new one.

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sef1268

Post   » Tue Oct 23, 2007 10:08 am


Yes, I use a separate 21g needle to draw out the fluids and a fresh needle/butterfly for every session. I also use a new syringe each time (probably not necessary, but I'm paranoid about contamination).

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sef1268

Post   » Fri Dec 21, 2007 8:57 am


How do you know that you're getting the fluid warm enough? I never know how to gauge this. This morning when I gave Zachary his subcue, I had a smaller 12cc syringe and it warmed up relatively fast. I sprayed it onto my hand once and it didn't seem quite warm enough; ran it under the hot water for a few seconds longer and I thought it was okay. He seemed to do well with it, so I'm assuming it wasn't too hot or two cold

Is there a "rule of thumb" on how long to run it under hot water? (taking into account that not everybody's water is the same temp, of course!). Is it most guesswork? Does anybody have it down to a science?

My other question is, would 12cc's once a day be enough, rather than standard 15cc's? I really like the smaller syringe, but wasn't sure if this is considered "enough" Ringers or not. My vet has instructed me to give Zach subcues daily.

Oh, and -- for those of you who use infusion sets, do your guinea pigs ever manage to shake the needle OUT? I had major trouble with this w/ Sebastian, and want to figure out how to avoid it with Zachary.

Thanks.

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