| Summary Information |
| Type of
technique |
Health
& Management / Disease
Investigation & Management / Techniques: |
| Synonyms and
Keywords |
SQ
injection, subcut injection |
| Description
|
This page has been prepared for the "Hedgehogs:
Health and Management" Wildpro volume, and is designed for the
needs of the following species: Erinaceus europaeus - West European Hedgehog
Before
performing any clinical technique, the associated legal
and ethical considerations should be consulted, knowledge of the
potential complications/ limitations/ risk
should be gained, and the level of expertise and qualification required must be ascertained.
A detailed description of fluid therapy is available. (See: Fluid Therapy for Hedgehogs)
Consult the pages in combination, as necessary.
- The subcutaneous route it the most frequently used injectable route
for fluid therapy and drug administration in the hedgehog. (V.w26)
- Subcutaneous injection can be performed in the conscious or
anaesthetised hedgehog.
- General anaesthesia is not required for the technique.
Injection Site:
Technique:
- Ensure that all equipment is available prior to starting the
procedure.
- Ensure adequate restraint of the patient; subcutaneous injection can be performed in the conscious or
anaesthetised hedgehog.
- Select an injection site without gross contamination
(e.g. visible mud, faeces).
- Cleaning of the site is essential if the
hedgehog is heavily contaminated.
- Preparation of the surgical site is
complicated in comparison with other mammals by the presence of spines.
- Some authors may recommend disinfection of the site with
surgical spirit prior to injection.
- Select an appropriate needle size (gauge and length)
and syringe size for the
hedgehog casualty.
- A 21-23 gauge, five-eighths inch hypodermic
needle may be used for subcutaneous injection in the hedgehog. (V.w26,
V.w44)
- A small area of skin should be raised by elevating a few spines by
hand or using a pair of soft forceps. (B228.11.w11,
B284.6.w6,
B291.12.w12,
V.w26,
J138.60.w1)
- The needle can then be inserted orientated into the subcutaneous tissues of the
fold of skin which is formed (parallel to the body surface (B291.12.w12))
- Draw back on the barrel of the syringe to make certain
that the needle is not in a blood vessel.
- Deliver the injection slowly but steadily, checking for leakage around needle.
- Large volumes of fluids can be given at a slow
continuous rate using an infusion pump.
- Large volumes of fluids should be split by injection at
multiple sites to avoid excessive skin distension at a single site and
to increase the efficiency of absorption.
- If an injection has been given on one side of the body,
the next injection should be given on the other side.
- Check the patient for evidence of pain or discomfort if conscious
during the injection, alternatively continue to carefully monitor the
general anaesthetic.
- Withdraw needle slowly upon completion. If leakage
occurs, attempt to apply pressure to the injection site with
cotton wool, although the presence of spines may make this difficult.
- Carefully massage the site, where possible, to ensure
optimal distribution of drugs.
- Check for bleeding from the injection site and apply
pressure to aid clotting if this occurs.
- Clean any excess blood from the area after clotting has
been achieved.
|
| Appropriate Use (?) |
- This is the most frequently used injectable route for fluid therapy and drug
administration in the hedgehog. (V.w26)
- Medications can be quickly and easily administered in
the conscious hedgehog via the subcutaneous route.
- The subcutaneous route is the most commonly used for warm fluid administration to
hedgehog casualties on arrival. (J60.1.w1,
P8.3.w2,
V.w26)
- Larger volumes can be given than by the intramuscular
route (See: Intramuscular Injection of Hedgehogs)
- Large volumes of (isotonic: 270-310 mOsm/l) fluids can be given quickly and
easily.
- Fluid types often selected for the subcutaneous route include
dextrose/ saline or Hartmann's solution with 5% added Duphalyte®
(Fort Dodge Animal Health) solution. (P8.3.w2,
V.w26)
|
| Notes |
- Manufacturer's data sheet recommendations should be followed as to the
recommended rate of drug administration (subcutaneous, intramuscular,
intravenous).
- Limited tissue trauma if volumes are appropriate.
- Fluids given by this route must be isotonic (270-310 mOsm/l).
|
| Complications/ Limitations/ Risk |
- Subcutaneous fluids are absorbed slowly over a period of several
hours. However, large volumes divided between several sites can be given
at the same time. (B150.w1)
- Subcutaneous fluid absorption rates can be particularly slow in
shocked patients with
collapsed peripheral perfusion.
- Reduced efficacy in casualties with poor peripheral circulation
(peripheral vasoconstriction) due to shock, hypothermia or severe
dehydration. (D92)
- Large volumes of fluids may be uncomfortable or painful
on injection.
- Multiple sites may be needed to deliver needed large
volumes.
- Skin necrosis and ulceration may occur if irritating drugs are used.
- Over-distension of the skin with fluids may disrupt the
local blood supply
and therefore decrease the rate of fluid absorption.
- Care must be taken not to puncture the body wall and
give an accidental intraperitoneal injection.(J138.60.w1)
|
| Equipment / Chemicals required and Suppliers |
- Appropriate sizes of needles and syringes.
- Required fluids/drugs.
|
| Expertise level/ Ease of Use |
- Procedure should only be
undertaken by an individual with appropriate clinical training and practical experience;
this would usually be someone with veterinary training.
|
| Cost/ Availability |
- Inexpensive unless expensive drugs
are being used.
|
| Legal and Ethical Considerations |
In some countries there may be
legislation restricting the use of this type of technique to licensed veterinarians. For
example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides,
subject to a number of exceptions, that only registered members of the Royal College of
Veterinary Surgeons may practice veterinary surgery." (See: LCofC1
- RCVS Guide to Professional Conduct 2000 - Treatment of
Animals by Non-Veterinary Surgeons) Use of Drugs
(Medication):
- Many drugs are not registered for use in particular species and care should
be taken in their use, with proper regard for possible toxic effects. Consideration should
be give to relevant legislation regarding the use of drugs.
- In the UK, guidelines regarding the use of drugs are set out in the Royal College
of Veterinary Surgeons Guide to Professional Conduct 2000: (see: LCofC1
- RCVS Guide to Professional Conduct 2000 - Choice of Medicinal Products).
|
| Authors |
Becki Lawson (V.w26) |
| Referee |
Debra Bourne (V.w5),
Suzanne I. Boardman (V.w6),
Tiffany Blackett (V.w44) |
| References |
B150.w1,
B228.11.w11,
B291.12.w12,
J15.21.w1,
J138.60.w1,
P8.3.w2,
D92,
V.w26,
V.w44 |