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How to administer iv fluids

There are different ways to administer SQ fluids, but using a ‘drip bag’ (the bag containing the fluid for administration) and a length of ‘drip tubing’ attached to a needle which is placed under the skin is the most common method. Most cats tolerate being given SQ fluids tremendously well.

Where does the fluid go in a cat’s kidney?

The fluid flows from the bag through the administration set and into the needle and then into your cat. Some people find these helpful to speed up the process. These can be helpful for measuring the amount of fluid you are giving. These items are used by some people to measure accurately how much fluid they are giving.

Can you give IV fluid to a cat with kidney disease?

IV fluid is not for everyday usage, however, because it overworks the already damaged kidneys. Cat renal disease in its acute stages can be treated by a few days on an IV, but you should otherwise avoid unnecessary treatment. Drastic forms of fluid treatment should only be used in order to stabilize your pet.

What causes fluid imbalances in CKD cats?

Fluid Imbalances in CKD Cats. For most CKD cats, the main problem is volume changes in the form of dehydration. Occasionally a CKD cat will also have problems with content changes or with distribution changes (the latter is often associated with concomitant heart disease ).

When to use subcutaneous fluids in a cat?

Once the cat is stable, subcutaneous fluids (sub-Qs or sub-cuts are commonly used for maintenance purposes. Introduction to fluid therapy (2008) Dr S DiBartola states “The subcutaneous route is convenient for maintenance fluid therapy in small dogs and cats.”

What to do if a cat has fluid in the kidney?

Additionally, a fluid sample from around the affected kidney may be taken for further evaluation. Perirenal pseudocysts are usually not life-threatening and some cats need no treatment whatsoever. Otherwise, the fluid is surgically drained from the capsule, especially when the cat’s abdomen is distended.

What does it mean when a cat has a kidney cyst?

Perirenal Pseudocysts in Cats. A perirenal pseudocyst is a condition in which fluid accumulates in a capsule surrounding the kidney, causing the kidney to enlarge. However, it is not technically a cyst because it lacks a true membrane covering.

Where are the kidneys located in a cat?

The kidneys are bean-shaped organs inside a cat’s abdomen. They’re not very big, but they pack a powerful punch in maintaining a cat’s health.

How to start subcutaneous fluid administration in cats?

Begin the flow of fluids by rolling the roller upward. NOTE: Some cats are more cooperative if they are placed in a box not much larger than the cat. A cardboard cat carrier is often the correct size. Other cats prefer being held in a towel that covers their head during the procedure.

You or your child will be going home from the hospital soon. The health care provider has prescribed medicines or other treatments that you or your child need to take at home.

IV Treatment at Home

IV (intravenous) means giving medicines or fluids through a needle or tube (catheter) that goes into a vein. The tube or catheter may be one of the following:

Home IV treatment is a way for you or your child to receive IV medicine without being in the hospital or going to a clinic.

Why You Need IV Medicines at Home?

You may need high doses of antibiotics or antibiotics that you cannot take by mouth.

  • You may have started IV antibiotics in the hospital that you need to keep getting for a while after you leave the hospital.
  • For example, infections in the lungs, bones, brain, or other parts of the body may be treated this way.

Other IV treatments you may receive after you leave the hospital include:

  • Treatment for hormone deficiencies
  • Medicines for severe nausea that cancer chemotherapy or pregnancy may cause
  • Patient-controlled analgesia (PCA) for pain (this is IV medicine that patients give themselves)
  • Chemotherapy to treat cancer

You or your child may need total parenteral nutrition (TPN) after a hospital stay. TPN is a nutrition formula that is given through a vein.

You or your child may also need extra fluids through an IV.

Receiving Intravenous Treatments at Home

Often, home health care nurses will come to your home to give you the medicine. Sometimes, a family member, a friend, or you yourself can give the IV medicine.

The nurse will check to make sure the IV is working well and there are no signs of infection. Then the nurse will give the medicine or other fluid. It will be given in one of the following ways:

  • A fast bolus, which means the medicine is given quickly, all at once.
  • A slow infusion, which means the medicine is given slowly over a long period.

After you receive your medicine, the nurse will wait to see if you have any bad reactions. If you are fine, the nurse will leave your home.

Used needles need to be disposed of in a needle (sharps) container. Used IV tubing, bags, gloves, and other disposable supplies can go in a plastic bag and be put in the trash.

Problems to Watch For

Watch for these problems:

  • A hole in the skin where the IV is. Medicine or fluid can go into the tissue around the vein. This could harm the skin or tissue.
  • Swelling of the vein. This can lead to a blood clot (called thrombophlebitis).

These rare problems may cause breathing or heart problems:

  • A bubble of air gets into the vein and travels to the heart or lungs (called an air embolism).
  • An allergic or other serious reaction to the medicine.

Most times, home health care nurses are available 24 hours a day. If there is a problem with the IV, you can call your home health care agency for help.

If the IV comes out of the vein:

  • First, put pressure over the opening where the IV was until the bleeding stops.
  • Then call the home health care agency or the doctor right away.

When to Call Your Health Care Provider

Call your health care provider if you or your child has any signs of infection, such as:

  • Redness, swelling, or bruising at the site where the needle enters the vein
  • Pain
  • Bleeding
  • Fever of 100.5°F (38°C) or higher

Call your local emergency number, such as 911, right away if you have:

  • Any breathing problems
  • A fast heart rate
  • Dizziness
  • Chest pain

Alternative Names

Home intravenous antibiotic therapy; Central venous catheter – home; Peripheral venous catheter – home; Port – home; PICC line – home; Infusion therapy – home; Home health care – IV treatment

References

Chu CS, Rubin SC. Basic principles of chemotherapy. In: DiSaia PJ, Creasman WT, Mannel RS, McMeekin DS, Mutch DG, eds. Clinical Gynecologic Oncology. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 17.

Gold HS, LaSalvia MT. Outpatient parenteral antimicrobial therapy. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 53.

Pong AL, Bradley JS. Outpatient intravenous antimicrobial therapy for serious infections. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 238.

IV fluid administration may be necessary in some instances, when a dog is severely ill and there are no alternative options. The subcutaneous fluid administered may contain nutrients, medication and serum, which will be necessary to heal the pet. The treatment may be administered at a clinic or at home.

When Are IV Fluids Needed?

The administration of subcutaneous fluids may be needed in a number of instances such as:

  • Liver or kidney disease, when you need to control what your dog eats and allow the organs to rest and recover
  • The dog is unconscious and needs to be fed
  • The pet is severely dehydrated and immediate hydration is needed
  • The dog is hypoglycemic
  • When the dog has severe anemia
  • During and after surgery, especially if the surgery is more complex

The amount of fluids administered will depend on the dog’s condition and the type of fluids that will be administered. The treatment may be needed for a couple of hours, or for a number of days.

How to Administer IV Fluids

Typically, IV fluids will be administered at a vet clinic, but you may also need to learn how to apply the treatment. You will have to purchase equipment which includes:

  • The IV fluid bag
  • The IV set, which is the connective tube that will make the link between the IV bag and the needle
  • A sterile needle

The IV fluid bag will be removed from the protecting package; there is a cap at one end of the bag. The cap will have to be removed, but you need to make sure it will stay sterile until you introduce the IV set. The IV set will have to be pressed in the hole of the IV bag. Make sure there are no leaks, so that all the fluid will enter the dog’s system. Introduce a needle in the dog’s back (in the shoulder blade area) or another area with loose skin. Connect the IV set to the needle.

Possible Complications

While administering IV fluids is typically safe, there may be a few side effects such as:

This IV maintenance fluids calculator computes fluid requirement for children and infants based on their weight and 2 different formulas for fluid rate. In the text below the form you can discover, amongst other indications, the formulas used and an example calculation.

Other Tools You May Find Useful

■ Sodium Deficit in Hyponatremia Calculator

■ Parkland Formula Calculator for Burns

■ Pediatric Systemic Inflammatory Response Syndrome (PSIRS) Calculator

■ IV Flow Rate Calculator

How does this IV maintenance fluids calculator work?

This health tool estimates the fluid requirement in the case of pediatric patients based on the formulas beyond the Holliday-Segar nomogram and the 4 – 2 – 1 rule.

The only requirement in the IV maintenance fluids calculator is to input the weight of the pediatric patient in either kg or lbs. Given that the formulas use kg as standard weight unit, lbs will be transformed to kg.

Weight based dosing of fluids has proven to be most accurate as total body water relies on weight.

Please note that the calculator cannot be applied to newborns (0 – 28 zile after full term pregnancy), therefore the minimum weight value to input is 3.5 kg.

In order to calculate the daily volume, the following formulas are applied:

Weight Fluid Maintenance By Holliday-Segar Nomogram
3.5 – 10 kg 100 mL/kg
>10 – 20 kg 100 mL/kg for the first 10 kg, then 50 mL for each kg past 10 kg
>20 – 65 kg 1500 mL plus 20 mL for each kg past 20 kg
>65 kg 2400 mL

The fluid rate in mL/hr = Daily volume / 24

The 4 – 2 – 1 rule has the following indications:

Weight Fluid Maintenance By 4 – 2 – 1 Rule
3.5 – 10 kg 4 mL/hr for each kg
>10 – 20 kg 4 mL/hr for each of the first 10 kg, then 2 mL/hr for each kg past 10 kg
>20 – 65 kg 60 mL/hr plus 1 mL/hr for each kg past 20 kg
>65 kg 105 mL/hr

This calculator allows determination of maintenance fluids for pediatric patients, however, past, current and prospective hydration statuses need to be taken in consideration and given the consequences of under dosing (dehydration, renal insufficiency) and over dosing (edema, fluid overload) the calculations may need to be adjusted.

At the same time, specific patient pathology, such as renal conditions or burn injury need to be accounted separately.

As a rule of thumb, water loss (and water requirement) is function of caloric expenditure and the total daily water requirement to replace insensible and urinary water loss in hospitalized patients is approximately 100 mL/ 100 kcal/day.

Example of a IV fluid calculation

These are the two methods for calculating pediatric maintenance fluid rates, applied in the case of a child weighing 26 kg.

1) Daily volume formula: (100 mL for each of the first 10 kg) + (50 mL for each kg between 11 and 20) + (20 mL for each additional kg past 20 kg) = 1,000 mL + 500 mL + 120 mL = 1,620 mL.

Fluid rate = 1,620 / 24 = 68 mL (67.5).

First 10 kg with 4 mL/hr, the following 10 kg with 2 mL/hr and the rest of 6 kg with 1 mL/hr = 10 x 4 + 10 x 2 + 6 = 66 mL/hr.

Maintenance fluid therapy

Fluid therapy is instituted in order to preserve the normal volume of body fluids and their electrolyte composition. The two components are homeostasis preserving maintenance and repletion.

The first replaces the ongoing losses of water and electrolytes due to physiologic processes (respiration, sweat, urine and stool) while the second corrects deficits caused by illnesses and physiologic abnormalities.

Intravascular fluid balance (essential for cardiac output optimization and tissue oxygenation) is influenced by three types of circumstances:

Usually fluid loss takes place at a normal rate, however, febrile infants and children have a greater transcutaneous evaporative water loss.

Total water loss is broken into three components:

■ Respiratory loss: 20%;

■ Transcutaneous loss: 30%;

The most common cause of dehydration in pediatric patients is diarrheal fluid loss. In these cases, depending on the maintained serum sodium level (normal range between 135 – 145 mEq/L), electrolyte loss can vary from isotonic to hypo-osmolar.

References

1) Meyers RS. (2009) Pediatric Fluid and Electrolyte Therapy . J Pediatr Pharmacol Ther; 14(4): 204–211.

This review will provide details how to insert a peripheral IV.

IV insertion is a vital skill nurses must learn in order to provide patient care. IV (intravenous) lines are used to administer medications, fluids, and blood products.

Steps on How to Insert an IV

1. First, gather supplies and perform hand hygiene.

  • IV starter kit
  • Extension set
  • IV catheter
  • Saline Flush
  • Curos cap
  • Gloves

How to administer iv fluids

2. Next, prepare the supplies.How to administer iv fluids

  • Opening packages
  • Prime saline flush and remove air bubble
  • Flush extension set with saline flush
  • Rotate IV catheter and reseat (if recommended by manufacturer)
  • Prep any labeling
  • and other prep as designated by your facility.

3. Then determine what vein you will be using for the IV insertion.How to administer iv fluids

5. When all the steps above are complete, perform hand hygiene again, and don gloves.

6. Place the tourniquet on the patient’s arm.How to administer iv fluids

7. Clean the IV insertion site thoroughly with Chloraprep by starting in the center of the insertion site and working outward in a circular motion. Clean for 30 seconds and let the site completely dry.How to administer iv fluids

8. Stabilize the vein with your non-dominate hand by slightly pulling the skin taunt below the insertion site, taking care not to touch the area you just cleaned.How to administer iv fluids

9. Hold the IV catheter at its base with your thumb and index finger with the bevel of the needle up in your dominant hand.How to administer iv fluids

10. Tell the patient to prepare for a sharp sting and insert the needle in the vein at about a 20 degree angle.

11. Watch for a flash of blood that will begin in the cannula and progress to the IV catheter’s chamber. This tells you that you’re in the vein.How to administer iv fluids

12. Next, slightly (about 2 mm) advance the needle into the vein some more. Then thread the cannula into the vein by sliding it off the IV needle. It should thread (or advance) into the vein with ease.

13. Take your non-dominate hand’s index finger and apply pressure above the insertion site to occlude the IV. This prevents blood from leaking out of the IV catheter.How to administer iv fluids14. Remove the tourniquet.

15. Attach the extension set onto the IV cannula’s hub by twisting it on securely.How to administer iv fluids

16. Aspirate for blood return from the IV site with the syringe of the saline flush. This demonstrates the IV is in the vein.How to administer iv fluids

17. Then flush the IV site with saline (3-5 mL) using a push-pause flushing technique. For example, you will push in 1-2 mL of saline and pause, and then repeat until the desired amount is flushed in. This creates a turbulence within the cannula and helps clear the line of any blood that may be present in the cannula.How to administer iv fluids

  • Note any swelling at the site or pain reported by the patient…this could indicate the IV is not in the vein.

18. Then clamp and disconnect the syringe. NOTE: The clamping and syringe disconnection sequence varies depending on the type of cap that is used on the extension set. Follow your hospital’s protocol and the manufacturer’s guidelines for the clamping sequence. Examples of clamping sequences:

  • Neutral displacement cap: usually no clamping sequence is required, you can simply flush, clamp, disconnect syringe etc.How to administer iv fluids
  • Positive displacement cap: flush with saline, disconnect the syringe, and then clampHow to administer iv fluids
  • Negative displacement cap: flush with saline, clamp, and then disconnect the syringeHow to administer iv fluids

19. Secure the site with the dressing provided in the IV starter kit (please see the video above for complete details). Label the site, if required. Then secure a Curos Cap on the extension set’s cap. This helps protect the site from infection.How to administer iv fluids

20. Dispose of supplies per protocol, doff gloves, perform hand hygiene, and then document.

VNA Home Health offers specialty services that include intravenous (IV) therapy for home health patients. As part of this service, VNA makes all necessary arrangements for medications and IV equipment.

Our IV program includes intravenous therapy for the following patient care needs and conditions:

  • Total parenteral nutrition
  • Antibiotic therapy
  • Steroid therapy for MS patients
  • Colony stimulating factors
  • Chemotherapy and nausea control
  • Hydration
  • Pain management
  • Central line catheter maintenance
  • Hyperemesis
  • Specialty infusion for chronic disease management

To deliver the quality our patients deserve, our registered IV nurses are specially trained in infusion drug administration and line maintenance. They follow national standards of practice established by the Infusion Nurses Society and are highly skilled in clinical monitoring of IV therapy. VNA’s IV nurses also have extensive experience teaching patients and their regular caregivers how to administer medications intravenously.

Many of our IV team RNs are certified by the Intravenous Nurses Certification Corporation and hold the Certified Registered Nurse Infusion (CRNI®) credential, the only nationally recognized and accredited certification in infusion nursing. To ensure best practices and up-to-date services, our RNs’ skills in IV therapy are revalidated annually.

To find out if you qualify for IV therapy services from VNA Home Health, please read our home health qualification guidelines. Additional admission requirements for IV therapy services include:

Intravenous (IV) fluids are a common way to administer fluids to dogs at the veterinary hospital. They are commonly used for any cause of dehydration and for conditions such as kidney disease and any cause of vomiting and diarrhea. We will tell you what intravenous fluids are and how they are administered.

Fluids are critical to dogs. A loss of just 10 percent of body fluid can cause your dog severe illness. It is most important, therefore, that you replace the lost fluids and correct dehydration.

Fluids can be given in a number of ways. In a hospital setting, giving fluids through an intravenous catheter is the most common method. There are other methods to administer fluids especially in emergency situations, fluids are sometimes administered into the abdominal cavity but this is relatively uncommon. Your dog can also receive fluids subcutaneously, in the area just under the skin and on top of the underlying muscle. Some pet owners learn to do this routinely at home if needed and recommended by your veterinarian.

Your dog will stay at the veterinary clinic when receiving IV fluids. Intravenous fluids allows a dog to get immediate treatment for dehydration.

What Type of Fluids Are Used for IV Fluids in Dogs?

Injectable fluids come in various forms. Lactated ringers, 0.9 percent saline, Ringer’s, Normosol-R, and Plasmalyte are commonly used. Fluids containing dextrose or sugar solutions are also given, depending on the underlying condition being treated. Supplements such as potassium or vitamin B is common added to the fluids. Drugs may also be added such as metoclopramide to help control vomiting.

How Are Intravenous Fluids Given to Dogs?

The most common leg and vein used to administer intravenous fluids is the cephalic vein which is on top of the front leg below the elbow. Other veins can be used such as a vein in the rear leg called the saphenous vein. It is generally only used when the front leg cannot be used for some reason. Other veins such as the jugular vein in the neck can also be used – most often for critical patients or patients that are extremely dehydrated.

To administer IV fluids, the veterinarian or veterinary staff generally clips the hair over the vein to be used and disinfects the skin. A sterile intravenous catheter is inserted. The catheter itself is a flexible soft plastic that stays in the vein. The fluids line is then connected to the catheter through which fluids are administered. The catheter is then taped and bandaged to the leg.

How Much IV Fluids are Given to Dogs?

The amount of fluid given will depend on the weight of the pet, the condition being treated, and the pet’s level of dehydration. A common measurement is in milliliters (ml) per hour. For example, a typical 10 pound dog may receive anywhere from 12 to 30 ml/hour. The rate may be higher and given as a “Bolus” which refers to a high volume in a short period of time in emergency cases.

Do Dogs Need to Be Sedated with an IV Catheter?

Dogs generally do not need sedated to have an IV catheter placed or while it is in place. Most dogs tolerate the IV fluids administration very well. Some dogs will require an Elizabethton collar (E-collar) to prevent them from chewing on or removing the IV catheter.

I hope this gives you more information on what intravenous fluids are and how they are administered to dogs.

Doing this procedure at home can relieve stress and save money

How to administer iv fluids

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Diarrhea and/or vomiting can cause dehydration. Fluid therapy replaces both fluid and electrolyte loss in sick dogs. Hospitalization with intravenous (IV) fluids is the best way to correct dehydration. This is especially true for critically ill dogs. However, not all pet parents can afford hospitalization and some dogs have mild dehydration that may not require hospitalization. In these two scenarios, pet parents may be able to administer fluids at home.

When sick pets are treated with fluids at home, instead of fluids being administered through an IV, they are given subcutaneously (SQ). This is less expensive than hospitalization, and allows the sick dog remain in a familiar surrounding. However, for critically ill pets, SQ fluids rarely substitute for the benefits of IV fluids.

Fluid Therapy Materials

The proper supplies for giving SQ fluids at home are available from your veterinarian. Usually this consists of a specific kind of plastic tubing, large bore needles, and a bag of fluids such as saline for kidney disease or a balanced electrolyte solution for dehydration.

Administration of subcutaneous fluids requires training. Your veterinarian or veterinary nurse will demonstrate how to give fluids. Once you are comfortable with this procedure, you can safely attempt treatment at home.

Prepare for Treatment

Puppies that need fluid therapy can be lethargic and lack energy to protest treatment, but some dogs will struggle with remaining calm during the procedure. Here are some recommendations to make the treatment easier for both you and your dog.

If the fluid is cold, this can be uncomfortable for your dog. Warm the fluids to body temperature by running warm (not hot) water over the bag for a few minutes.

Suspend the fluid bag higher than the pet, so gravity helps the fluid run more rapidly. You can use a coat hanger to make a holder that fits over the top of a door or cabinet.

Use a towel or favorite blanket, or the pup’s bed to pad the surface where your pet can lie down and get comfortable. Your pet needs to stay still for up to 20 minutes, so make the area where your treating your puppy as comfortable as possible.

Positioning your dog near a window may help give your dog something to focus on other than what you’re doing. Having a second person to help gently restrain your dog is helpful. Play some calming music to help relieve stress.

Ask the veterinarian if a heating pad underneath a couple of layers of blankets is a good idea.

How to Give SQ Fluid Therapy

You need to insert the needle through the skin so the fluid drains into space right underneath where it's placed. The best locations to place the needle is between the shoulder blades.

  1. Grasp the skin with one hand and gently "tent" it upwards, drawing the skin up from the underlying muscle.
  2. Press the sharp end of the needle firmly into the skin, between where your hand holds the skin and the solid muscle of the pup’s body. You need to push firmly to enter through all layers of the skin.
  3. Push the needle horizontally, level with the body until you no longer see any of the needle, but only the plastic head attached to the tubing. Your dog may flinch or squeal a bit, but once the needle is in place, it should settle down. Tip: Alternate needle sites to prevent scar tissue from forming that may make subsequent treatments more difficult.
  4. Once the needle is in place, let go of the tented skin and let it fall back into place. Open up the release valve on the plastic line, so that the fluid begins to drain down and into the needle. Some pets object if the liquid flows too fast, so adjust the speed to accommodate the comfort of your puppy.
  5. Watch the container of fluid until the amount your veterinarian recommends has been given.
  6. As fluid runs under the skin, you’ll see the skin start to balloon with liquid. This does not hurt the pet, although it may feel a bit cool to the touch. The balloon of fluid will slowly settle and spread out under the skin.
  7. Once the appropriate amount of fluid is administered, shut the valve on the plastic line to stop the flow of fluid. Gently remove the needle from your pup by backing it directly out from the skin. It’s normal for a small amount of fluid to leak back out of the injection site. The fluid will gradually be absorbed and the balloon will deflate.

You can help the reduce the amount of fluid that backs out of the site by gently massaging the area where the needle was inserted. Praise your puppy and rub its ears or chest throughout the procedure (whatever makes the pet feel most comfortable) to help associate the treatment with a pleasant bonding experience and, hopefully, a speedy recovery.

Just that really. I suffer from severe abdominal migraine (all the fun of migraine head with added stomachs issues) I can’t, literally can boot get any fluids in.
My stomachs stops working as my migraine starts so anything I take orally comes back violently, also void bowels and bladder.
And I sweat. I have to wear towels (bath sheets) to wick up the sweat my body gets rid of all fluid.

I can manage the pain for a short time, I get two nasal doses prescribed per month (really need the injections but GP said to manage on spray) but dehydration killing me.
I’ve been blue lighted (both GP calls not me) twice to a+e but while the need to be sure it’s migraine and check for other stuff I’m being tortured by the noise and light.
Eventually after they rule out other stuff they stick me a bag of paracetamol, give the Tristan injection and anti hermetic and I can start to sleep it off.

This happens every 11 weeks and I’m so scared of being sent to a+e I can’t call the GP (my practise is closed so we use the co op service) I’m desperate.

Can I buy a bag of fluids and I’ve paracetamol and administer myself? Even if I have to be shady (needs to be a legit source) I’ve tried enemas and they are currently my only option.
I can’t even take oral melt tablets because they don’t melt I’m too dehydrated.

Any suggestions on what I can try without hospital?

My spelling is atrocious.
Apologies, I’ve a bad head.

even if you knew how to cannulate, you need 2 hands to do it, so no, I don’t think so

Thanks Newt that was my fear. It’s my DF who is in his seventies who has to care for me and he couldn’t do it.
I swear I’m ready to ram the hosepipe up my jacksie

Are you under a migraine consultant? Two things come to mind – one is to max out the migraine treatments including ruling out food triggers (under Dr supervision) and using things like acupuncture, Botox maybe? Secondly, they could advise on a care plan for you if you get a migraine – eg. Paramedics might be able to give you IVs at home? Or similar.

Sounds awful, sorry this happens to you.

rectal paracetamol should be OK and GP could prescribe

Thanks Universal it’s such a fucking liability I can’t do anything without pissing or vomiting it’s ridiculous!

I’ve tried botox privately, I looked better but no relief and acupuncture bizarrely gave me wind.

I’ve only access to locums or extremely harried GP from another practise so I did those privately.

A care plan sounds like just the thing I need. It’s terrifying going ae as well as mortifying knowing I have a headache. People whizzing past having been in accidents make me feel such a fraud.
I cry (dry sobs I run out of tears) and shout for my Dad. at my age.
Not that I blame them but a young porter asking my DF has she always been a Daddy’s girl makes me feel more of a twat.

God that sounds awful. Probably not helpful, but you do absorb water by being in it. A bath? Sorry, given your pain that's such a trite solution, but possibly might ease things?

That sounds fucking awful!
Can you get referral to consultant for care plan? This by pass none existent gp ‘service’.

Your veins will get crappy if you are dehydrated even if you could cannulate yourself, so I imagine that wouldn’t work very well.
It sounds like your doctor doesn’t really get how miserable you are so this may be of limited use as advice but I have a friend who has a chronic condition called POTS and she needs IV fluids to stay stable and it would be both inconvenient and painful for her to go in 3 times a week for infusions, so she has a port in her chest which she can do herself to set up her own fluids.
As I said this might be extreme and not the direction your doctor is thinking of, but there are solutions.

@FannyWisdom handhold from me, i know how awful migraine can be sadly cant set up ivs at home unless it has been organised by drs and usually overseen by them.

When you do see your gp / and or neurologist would you consider asking them about organising for a link up with the "local domicillary nursing acute intensive team" who are different than district nurses who usually co-ordinate with local gps.

They are a team of nurses who follow the prescriptions written by the dr and they report directly back to the ward dr on your symptoms and they (nurses) come to your house with portable drip stand and all the paraphenelia and set up what the dr has written you up for.

(they basically do their drugs round for you in your home as its complex and needs IVs and being in hospital isnt going to benefit you as you know what it is and the noise and light is pure torture)

So in this case, im guessing like above tripan injection, anti emetic and start IV paracetamol for better pain relief cover and possibly a bag of fluids. They may visit a couple of times a day to administer IVs and monitor situation.

Hold on in there, could you tolerate to suck Mr Freeze type ice lollies to get small amounts of fluid in

Any idea why this happens every 11 weeks? No need to answer now

If you do end up going to hospital, eyemask, earplugs, note book, pen, – put earplugs in to block noise, put eyemask on, put note on pillow to say you are wearing earplugs or they will "observe" you are sleeping when you are not.

Thanks guys you are making me feel less of a lingered!

It’s shocking how fast it comes and the way I handle the pain is no surprise they need to check for stuff.
Last time they wouldn’t proceed until I had a lumbar puncture. My eyes wouldn’t dilate when they checked for response so it was the right call but I could I would have crapped myself.
The CT scan alone feels like the labours of Hercules.
It must cost them a bomb and be irritating.
I’m going to e-mail the GP at our covering practise tomorrow and insist we try for a care plan.

And get me some suppositions.

It seems to help Bucking when I’ve sweated for a few hours I’m freezing because I’m wet but a warm bath stops me shivering so maybe I am sponging some up.