My kitty, after receiving sub-Q fluid therapy for 2 years just developed cellulitis and air bubbles (gas given off by bacteria) under the skin near the injection site and is currently on antibiotics (Clavamox).  The vet said it could come from the air (bacteria in the air - air space at the connection point of the needle & tubing).  I always ran the fluid through the needle to get the air bubbles out when starting a new bag, but I didn't run the fluids through the line/needle to get the air bubbles out EACH time I administered fluids.  I use new tubing every fourth bag, as instructed, and I never put a used needle back on the tubing.  The one vet tech even told me a little air was no problem??  Apparently, there may be...

Kitty is off the fluids (8 days off) till the vet checks him for air pockets under the skin again.  I understand the cellulitis is very painful.  He's drinking a barrel of water, but he looks good, is social, and is following his normal routine.

The vet said cellulitis can sometimes develop in kitties on long-term fluids, but it is rather rare. 

...Just thought I'd let others know about this...

 

He went in for a 4-month checkup on his kidneys/blood pressure/CBC, and the vet got an extremely low platelet count and a higher than normal leukocyte count (could indicate an infection) back on him.  (She asked if he got into rat poison or ate a dead mouse that was poisoned!!  Yikes -- 2007 PF recall nightmares all over again!!)  And, we were away on vacation hearing this report!! 

The vet didn't suspect the food, but I immediately told my house sitter to stop the canned food, save the cans, and pull the frozen pureed salmon and chicken from the freezer to feed him.  I also sent him to the store for another brand of canned food.  Those of you who went through this in '06 - '07 can imagine my thoughts at hearing the words rat poison!

She also found a wood tick around near the injection sites.  Yikes.  I noticed a slight bump the last time I did fluids, but assumed it was a little scar tissue from 2 years of injections or a scab from all the punctures in that same general area.  I never imagined a tick because my indoor boy was only out one time this year -- weeks ago for a quick walk around the house.  Now, I assume the tick was probably on the dogs or the wood we carried into the house.  We are not in a wood tick area at all, especially this early -- so unusual...

When she asked for a recheck for another platelet count (came back normal the 2nd time -- poor sample handling?? -- probably a clot of blood was missed, even with a visual count for verification), she was feeling between his shoulder blades and felt "crackling," "grainy" skin, similar to bubble wrap.  That's how she described it. 

Yes, the area is supposed to be painful to the cat, but my boy didn't seem to be painful that I (or the house sitter) could tell and sat for his fluids (although he's always wanted to leave before they're finished).  He acted normal -- purring, rubbing on legs, sitting in the window, good appetite, jumping up on laps to be petted, etc.  No redness or fur loss in the area, at least on my babe.  The way to tell seems to be skin texture, pain in the area, plus lab results that indicate an infection from what the vet said.

I can't feel any difference in skin texture myself, but this is 3 days after he started antibiotics.  Thank goodness we actually had a person staying at the house while we were gone so he could be taken to the vet again.  We were in panic mode when we heard about the extremely low platelet count and the mention of rat poison because there's nothing like that around here.   I'm glad she needed to do a re-test or we wouldn't have known about the cellulitis.

I was told to throw out the bag of fluids, tubing, and to start fresh once he resumes fluid therapy.  Kitty goes back to the vet on Friday.  From now on, I'll run the fluid through the entire tubing/needle EACH time I do the fluids.  I'm wondering if I should also rub the injection site with alcohol before starting each time.  I'll ask.

Sorry for the rambling.  I'm trying to do 20 things at once, including running in and out to collect fecal samples from the two dogs and keeping whose poo is whose straight.  So far, they're not cooperating at all, and I'm running in and out with them, trying to encourage them while it's raining.  My female likes to stay inside when it rains.  They have their annual checkups today, along with heartworm tests...  This seems to be "Pet Week" for us!     Wish me luck!  I hope my info can help others who are giving fluid therapy to their pets.

Thank you for giving us such detailed information regarding what to look for and how the diagnosis was made.  We just started fluids on one of our senior cats recently.  We use the syringe method rather than the drip method, but I do flush the air out first until fluid and air comes out the needle twice, once when filling the syringe and again before inserting the needle into my cat.  Still, there are always tiny air bubbles in the fluids. 

Purringfur, sorry to read that you kitty is having a problem. Prayers and hopes for fast recovery.

Mandycat,

I'd appreciate any guidance you have to offer.

When I withdraw fluids from the bag, they start bubbling up in the 60 mL syringe.  Some are still there even after 10 minutes while I warm the syringe in water.  I use a new 18-gauge needle each time on the syringes for withdrawing fluid from the bag.  I then cap the needle and put the full syringe in a bowl of warm water that I use a thermometer to gauge.  I actually overfill it so I can drain some of the fluid out with the bubbles.  There is usually an air bubble at the needle end of the syringe, which is easy to ease out, but I can see tiny, tiny bubbles throughout the fluid in the syringe.

I used to do subcutaneous insulin on Pepper. In that case I would tap on the syringe to get the bubbles to the top and push them out.  Tapping on these big syringes doesn't do anything to move the tiny bubbles.

Once fluids are warmed, I remove the cap from the needle, force fluids and bubbles out, and then remove the 18-gauge needle and discard.  Then I open a new 19-gauge winged Terumo and attach it to the syringe, push out more fluid before administering fluids to Elvis.

I'm reusing the syringes at this point and there is no way to clean them, but vet people assure me that only the fluids get inside the syringes, so they cannot be contaminated.  I'm still not comfortable with that part of it, reusing syringes.  They come in plastic cases and I don't know whether to air dry them or return them to their cases.  Ideally would be to purchase a supply of them IF vet would give me an prescription, or maybe I could get him to order me a supply of them.  Haven't asked yet since I won't be able to buy any supplies for a couple weeks.  Have enough needles and fluids until then.  Only using 2 syringes a week as we're not able to administer 2 at a time and he is staying hydrated.

Thank you.  Will try this tomorrow.

Yes, it's when I'm withdrawing fluids from the bag that it causes turbulence and bubbles to form.  I have a hard time withdrawing it and I have to use a lot of force.  If I go too slow, it feels like the fluids are being sucked back into the bag.  Can't tell if that is what really is happening, but it pulls the plunger back towards the bag.

I'd like a photo of that.   

That definetly would make some picture