Nursing Cats and Dogs 3

Intranasal meds

vaccines, drugs (local: anesthetics, decongestants; systemic: antiseizure)

Intranasal problems

sneezing, infection (modified live vaccine)

Intranasal technique

tilt head, instill slowly (back and forth between nostrils until med is administered)

Intratracheal benefits

rapid absorption, especially useful in emergencies

Intratracheal Delivery Methods

ET tube (endotracheal), Catheter, Percutaneous (use caution when doing this can cause damage)

Intratracheal technique

intubation, restraint (anesthesia, unconscious), tube goes between arytenoid cartilages, instill drug

How much of a drug should be administered when giving it intratracheally?

2x what the IV dose would be

Rectal topical administration

enema: medications & never phosphate solutions

Forms of rectal medications

tablets/suppositories, liquids (via tube)

mammary topical uses (species)

bovine (mostly), ovine, caprine

Indication for mammary

mastitis

mammary technique

empty udder (may dilute meds if full), clean area, medicate (cannulas, tomcat catheters)

Transdermal patch meds

hormones, analgesics (fentanyl)

Transdermal patch technique

clip hair, make sure area is dry, wear gloves (to apply and remove), hold patch on for 1 min (allow body heat to activate it), staple patch in place

Cautions when using transdermal patch

don’t touch, avoid heat pads, prevent removal, don’t remove and replace

How to label transdermal patch

strength of drug, placement date, date when patch should be removed

Locations for parental meds

intradermal, sub-q, IM, IV, intraperitoneal, Intra-arterial, intraosseous, spinal

Intradermal

into the skin (not on)

Intradermal uses

allergy test, TB test

Intradermal technique

avoid hard scrub (+/- antiseptic), small needle (25-27 gauge), dermal penetration (resistance on injection), monitor reaction

Sub-Q advantages

simple (well tolerated), easy to teach, large volumes can be given slowly, meat producing (no damage)

Sub-Q disadvantages

slower absorption (bad for dehydration & shock), irritating (depending on the solution)

Sub-Q meds

vaccines, fluids (mild dehydration, supplementation), drugs (check label)

Where do vaccines in cats go?

no interscapular, go as far distal in the legs as you can

Sub-Q technique by hand

tent skin, swab (with alcohol), insert needle (parallel to tent), aspirate (if you get blood, reposition), inject slowly

Sub-Q technique with drip set

same as by hand but needle is connected to fluid bag and gravity is used to administer fluids

Locations for IM

Lumbar epaxial (small animal), hamstring, quadriceps, triceps, cervical (never in small animals)

Advantages of IM

increased vascularity, faster absorption, poor solubility

Disadvantages of IM

small volumes, vital structures (sciatic nerve), pain, muscle damage

Lumbar epaxial

between wing of the ilium and dorsal spinous process of lumbar vertebrae

IM technique lumbar epaxial

restraint, palpate location, swab, insert needle (perpendicular), aspirate, inject slowly, maybe massage

IM technique hamstring (not biceps femoris)

restraint, palpate muscle, swab, put needle in caudally (avoid sciatic nerve), aspirate, inject slowly, maybe massage

IM technique quadriceps

not common, palpate muscle, swab, insert needle perpendicular (avoid femoral nerve), aspirate, inject slowly, maybe massage

IM technique triceps

not common, palpate muscle, swab, insert needle perpendicular, aspirate, inject slowly, maybe massage

IV locations 

cephalic, saphenous, jugular, others

IV advantages

rapid onset, large volumes, can give irritating solutions slow

IV disadvantages

short duration, laceration potential, access problems (shocky animals)

rule of thumb for IV meds

IV meds aren’t opaque unless its TPN or propofol

IV Equipment

needle/syringe, butterfly, catheter (irritating solution), drip set

IV Technique

as with phlebotomy, restraint, start distal, occlude vein, expel air bubbles, swab, insert needle, stop occlusion, inject, hemostasis (ALAIT)

Intraosseous locations

crest of ilium, trochanteric fossa, proximal humerus*, proximal tibia*

Intraosseous equipment

intraosseous cannula (stylet), specialized (BIG, osteoport, power drivers)

Intraosseous advantages

rapid access (very small, exotic, failure of IV), rapid onset, large volumes, can do irritating solutions

Intraosseous disadvantages

painful insertion (use local anesthetic), +/- infection

Intraosseous technique

surgical prep, +/- local anesthetic, only 1 attempt (use different bone if fail), stab incision, bore motion, wrap when embedded

Intraosseous contraindications

sepsis, fracture

Intraperitoneal indications

difficult access (very small animal for IV, IO), peritoneal dialysis

Intraperitoneal advantage

rapid absorption ( > Sub-Q)

Intraperitoneal complications

organ puncture, peritonitis (irritant vs. septic)