TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 
 

ALL ABOUT SUBCUTANEOUS FLUIDS (SUB-Qs)

 

ON THIS PAGE:


What Are Sub-Qs?


Why We Use Sub-Qs


When to Use Sub-Qs


How Much to Give


If Your Vet Recommends Large Amounts of Fluid


How Often to Give


Will I Always Have to Give Them?


Ways of Giving Sub-Qs: Giving Set, Syringe, or Implanted Catheter/Skin Button


Implanted Catheter or Skin Button


Coping with Giving Them


When Not to Give Subcutaneous Fluids


 

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TREATMENTS


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Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence, Proteinuria)


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USA Cat Food Manufacturers


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UK Cat Food Manufacturers


2007 Food Recall USA


 

FLUID THERAPY


Intravenous Fluids


Subcutaneous Fluids


Tips on Giving Subcutaneous Fluids


How to Give Subcutaneous Fluids with a Giving Set


How to Give Subcutaneous Fluids with a Syringe


Subcutaneous Fluids - Winning Your Vet's Support


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Home > Fluid Therapy > Subcutaneous Fluids

 


Overview


  • Subcutaneous fluids are fluids given under the skin. This means they can be given at home.

  • In the USA and Canada, it is common to give sub-Qs to CKD cats to prevent dehydration. Unfortunately, sub-Qs are not routinely offered in most other countries.

  • This page explains the basics of sub-Qs, including when to start them, how much to give and how often.


What are Subcutaneous Fluids (Sub-Qs)?                                                                   Back to Page Index


 

Subcutaneous means under the skin; so subcutaneous fluids, commonly known as sub-Qs in the USA and subcuts in the UK, are a way of hydrating the cat by carefully introducing fluids under the skin. Instead of placing a slow drip of fluids into the cat's vein, as happens with intravenous (IV) fluids, the fluid is injected just under the skin with a needle. Giving sub-Qs only takes about five minutes and can be easily done by a trained layperson. The fluid then gradually disperses throughout the cat's body, and helps him or her to maintain hydration at the correct level. 

 

The fluids used are particular types of fluid with the correct balance of electrolytes (salts). There are various types of fluids available (see Tips on Giving Subcutaneous Fluids) and your vet can select the fluid most suitable for your cat. 

 


Why Use Subcutaneous Fluids?                                                                                         Back to Page Index


 

The cat is an unusual animal in that it has the ability to concentrate its urine, a little like a camel; this is believed to be a legacy of its African heritage. However, in cats with CKD, this ability gradually disappears, and cats then produce a very dilute urine: the urine looks weaker in colour, has little odour, and the cat will often produce copious amounts. 

 

This increase in urination leads the cat to drink more and more in order to try to avoid becoming dehydrated; and for a time the cat can manage to maintain some kind of balance. Eventually, however, the cat simply cannot drink enough to keep up with its urination rate, and dehydration (which doesn't only mean a loss of body fluids, but also of electrolytes necessary for proper function) occurs. Sometimes this becomes so severe that the cat crashes (i.e. becomes dehydrated enough to need IV treatment at the vet's), as happened to Thomas. 

 

Even if your cat does not suffer such a crisis, the ongoing low-level dehydration that accompanies CKD can be debilitating and uncomfortable; can cause toxin levels in the blood to rise; reduces blood flow through the kidneys, and the kidneys deteriorate even more. Human CKD patients have described dehydration and the accompanying high levels of toxins in the blood as feeling similar to a bad hangover. Therefore the purpose of sub-Qs is to keep your cat nicely hydrated, which in turn should help maintain kidney function and improve his or her well-being by removing that hungover feeling.

 


When To Use Subcutaneous Fluids                                                                                  Back to Page Index


 

Although sub-Qs can be of great benefit to cats who need them, not all CKD cats need them immediately. As mentioned above, the purpose of sub-Qs is to keep the cat hydrated enough to avoid dehydration occurring. However, cats with early stage CKD can usually drink enough to offset their increased urination, and thus do not become dehydrated even without sub-Qs.

 

Processing sub-Qs in itself places an additional workload on the kidneys, plus it can flush out certain nutrients, reduce potassium levels and raise sodium levels. In Staged management of chronic kidney disease in dogs and cats (2009), a Presentation to the 34th World Small Animal Veterinary Association World Congress, Dr David Polzin states "Because recent evidence suggests excessive sodium intake may harm the kidneys, recommendations for long-term sodium administration in any form should be carefully considered."

 

Giving too many fluids or too soon may also increase the risk of overhydration. This is a particular risk for cats with heart problems. Therefore it is best not to begin fluids until the advantages are likely to outweigh the disadvantages i.e. when a cat would become dehydrated without them.

 

Dr Katherine James of the Veterinary Information Network believes that this tends to happen and that most CKD cats will benefit from subcutaneous therapy once creatinine levels are consistently over 3.5-4.0 US (300-350 international). This equates to high Stage 3 of the IRIS staging system. If your vet thinks your cat's CKD is less advanced than this, and your cat does not appear dehydrated, then it is probably safer to hold off on sub-Qs for the moment.

 

However, there are exceptions, and a small number of cats with creatinine below 3.5 US (300 international) may need sub-Qs. This tends to apply to cats whose creatinine is below 3.5 US (300 international) but who previously had a higher level, usually at diagnosis. So if, for example, your cat has creatinine of 6.0 US (550 international) at diagnosis, but this gradually falls to 3.5 US (300 international), s/he will still probably benefit from regular sub-Qs. Cats with pancreatitis are prone to dehydration and may need sub-Qs even if their creatinine level is lower than 3.5 US (300 international).

 

Also, any time more water is going out than is coming in, sub-Qs may be needed short-term. Thus, a CKD cat who is a bit below par because of vomiting or diarrhoea causing dehydration, or who stops eating or drinking, may benefit from sub-Qs as a one-off - my vet gave sub-Qs to my non-CKD cat when she had severe vomiting and diarrhoea for this reason.

 


Amount of Subcutaneous Fluids                                                                        Back to Page Index


 

This is something you need to discuss with your vet, to decide what is right for your cat. When you see recommendations regarding the amount of fluid that a cat needs each day, be aware that often this is total fluid amount. Cats obtain much of their daily fluid requirement from their food and water (most canned food is around 80% water). Therefore Dr Katherine James of the Veterinary Information Network believes that generally speaking, cats do not need more than 100ml of sub-Q fluids a day, though there are exceptions, for example if your cat is particularly large or particularly small.

 

In Staged management of chronic kidney disease in dogs and cats (2009), a Presentation to the 34th World Small Animal Veterinary Association World Congress, Dr David Polzin states: "In patients with signs consistent with chronic or recurrent dehydration, long-term subcutaneous fluid therapy may be considered. Typically, a balanced electrolyte solution (e.g., lactated Ringer's solution) is administered subcutaneously every one to three days as needed. The volume administered depends upon patient size with a typical cat receiving about 75 to 100 ml per dose."

 

Based on what I have seen over the years, the average 8-10lb cat would usually be given around 100ml a day. Larger cats might need 125ml or even occasionally 150ml for cats who weigh 15lb or over, whilst smaller cats need smaller amounts, 50-75ml a day. Be cautious with cats with heart problems, who may have problems processing sub-Qs, and who may need smaller amounts, perhaps given more frequently, for example 50ml twice a day rather than 100ml once a day. Colorado State University College of Veterinary Medicine states "no more than 5 to 10 ml/lb should be given at each injection site" so giving 100ml in one place should not be a problem for a 10lb cat. Some people interpret this to mean it is safe to give 5-10ml/lb to a cat, but the link is referring to how much to inject in one place, not how much to give generally.

 

Since cats vary in their individual needs, you should seek your vet's advice on how much to give your cat, and start off gradually, and aim for the lowest level that will comfortably maintain hydration. If you live in a hot humid area without air conditioning, your cat might need more fluid than a cat in a colder climate. If your cat has a bout of vomiting or diarrhoea or is not eating, more fluids might be required in the short term to offset the fluid lost as a result of the crisis.

 

I suspect that some cats who have had severe crashes may possibly require more fluids than cats who are diagnosed early and whose CKD progresses gradually. Thomas wasn't a massive cat, but he still required 300ml a day to start with following his crash. Even after his creatinine level stabilised at 316 (US: 3.5), he still required 200ml a day, divided into two sessions, in order to maintain hydration.

 

The key words in the previous sentence are "in order to maintain hydration". If your cat's bloodwork worsens, this doesn't automatically mean that the fluid amount should be increased. Giving more than is needed to maintain hydration is a strain on the kidneys (see when to use subcutaneous fluids), can make a cat feel uncomfortable, and of course costs more.

 

When deciding on how much fluid to give, you need to monitor your cat for dehydration and check that the fluid is being properly absorbed. A pouch is normal, and it usually takes 6-8 hours for the fluids to be absorbed, though some cats take longer. Many people find the simplest way to monitor their cat's need for fluids is by means of a weighing scale: you can weigh your cat regularly and if his/her weight goes down, this may indicate dehydration; if the cat's weight increases, the cat may be retaining fluid and at risk of overhydration. Coco's Page has more information on how to do this.

 

If you have the level of sub-Qs right, your cat will no longer drink massive amounts of water.

 

If your cat's bloodwork improves, or your cat seems to stop absorbing the fluids, it may be that s/he needs fewer or no fluids. Ask your vet about reducing or stopping the fluids, but this should be done gradually so as to give your cat's damaged kidneys time to adjust. The same applies if your vet has prescribed fluids for a low numbers cat - ask about stopping fluids to see how your cat manages, but do it slowly.

 


If Your Vet Recommends Large Amounts of Fluid                                     Back to Page Index


 

Fluids are not a benign treatment and more is not always better - giving too much fluid can be dangerous. Unfortunately I have noticed that some vets recommend giving rather large amounts of fluid. In most cases this is not necessary, and in fact carries risks: it increases the sodium load on the kidneys, which may contribute to the development of hypertension, and in the worst case it may cause overhydration. Some vets claim that it is impossible to overhydrate a cat with sub-Qs, but if you give a 10 lb cat 300ml of fluids a day, that is the equivalent of giving a 150lb person 4.5 litres of water a day, far in excess of the amount most people (or cats) can process. I have heard from a number of people who have learnt the hard way about the risks of overhydration, and some of their cats sadly died as a result. In Renal disease (2006), Dr D Polzin states "Chronic subcutaneous fluid therapy can result in fluid overload in some patients, particularly when fluid volumes in excess of those recommended here are used. We have seen several cats given large quantities of fluid (200 to 400 ml/day) present with severe dyspnea due to pleural effusion. This condition can usually be avoided by reducing the volume of fluids administered." He mentions that the presence of metabolic acidosis increases the risk of pulmonary oedema in cats receiving fluid therapy..

 

Don't panic over this but do keep an eye on your cat when administering sub-Qs and watch for the warning signs of overhydration. See above for tips on gradually reducing the amount of fluid you give.

 

Colorado State University briefly discusses fluid therapy and assessing dehyration.

Coco's Page has information on calculating how much fluid is necessary, though please do not alter the amounts you give without your vet's knowledge and approval.

 


Frequency of Sub-Qs                                                                                           Back to Page Index


 

This depends to a large extent upon your cat's individual needs. The majority of cats receive sub-Qs every day. However, some cats on Tanya's CKD Support Group only need fluids 2-3 times a week; whilst a small percentage, like Thomas, become dehydrated very quickly without twice daily fluids (these cats are often cats who have suffered a severe crash at diagnosis). Discuss your cat's particular requirements with your vet, and aim for a consistent, regular approach.

 

It is usually better to give smaller amounts more often, e.g. to give 100ml every day rather than 200ml every other day. If you think about it, this makes sense - if your goal is to drink eight glasses of water each day, it is better if you drink eight each day rather than sixteen on one day and nothing at all on the next day - the same principle applies to sub-Qs.

 

I don't really understand why vets sometimes recommend sub-Qs once a week. It seems too infrequent to make any real difference. However, it can certainly be worth giving sub-Qs as a one-off to a cat who develops dehydration from vomiting or diarrhoea, or if you experience a heatwave and don't have air conditioning.

 

Every now and then, you may have to skip a sub-Q sesssion, perhaps because you are sick or your cat refuses to co-operate. Missing one session is not cause for concern with most cats, but aim for consistency overall.

 


Will My Cat Always Need Subcutaneous Fluids?                                           Back to Page Index


 

If you start fluids at the right time, i.e. only when they are necessary to prevent your cat from becoming dehydrated (which for most cats occurs once creatinine levels are consistently over 300 -350 (US: 3.5-4), then yes, your cat will probably always need them. However, there are always exceptions. Some cats may only need fluids to help them after a crisis (such as when they have severe diarrhoea or vomiting which makes them dehydrated), for example, particularly if they are young or if their bloodwork is normally reasonably good.

If you do ever try to decrease or stop sub-Qs, it is very important to do this slowly, because CKD kidneys cannot adjust to changes as easily as healthy kidneys.


How to Give Subcutaneous Fluids                                                                     Back to Page Index


 

There are two main ways of giving sub-Qs, either via a giving set or via syringe. Most people in the USA use the giving set method; people offered sub-Qs in the UK (very uncommon) are usually offered the syringe method. For those who struggle with needles, another possibility is to use an implanted catheter.

Giving Set Method


The giving set method is similar in some ways to an IV drip, except that you are placing the fluid under the skin rather than into a vein. You are also giving a smaller amount of fluid more quickly. You will need fluids, needles and venosets (IV sets). You use the venoset to connect the bag of fluid to the needle which is then inserted under the skin. The fluid bag is hung high, so gravity makes the fluid drip through the venoset and the needle and into the cat.

There are links to videos showing how to use this method, and photos modelled by Thomas's friend, Purr Box, on the How to Give Subcutaneous Fluids with a Giving Set page.

There are more tips on how to prepare and give sub-Qs here.

Syringe Method


With this method, you also inject the fluid under the skin, but instead of using a venoset (a tube which carries the fluid from the fluid bag to the needle), you remove the fluid from the fluid bag with a syringe, then attach the needle to the syringe and place it under the skin. You then gently squeeze the syringe so the fluid goes into the cat. This method means it is easier to know how much fluid you are giving and is also usually quicker. If you use this method, you will need fluids, needles and syringes.

There are links to videos showing how to use this method, and photos modelled by Thomas, on the How to Give Subcutaneous Fluids with a Syringe page.

There are more tips on how to prepare and give sub-Qs here.


How to Cope with Giving Subcutaneous Fluids                                                    Back to Page Index


If, like me, you have a needle phobia, you will be feeling sick at the mere idea. Yet I stuck a needle into Thomas twice a day for almost eight months, and it honestly does get easier. I used to dread it in the early days, far more than Thomas did; yet soon it became just part of everyday life, like brushing teeth. We were used to it, he was used to it - it took just ten minutes a day to give him his fluids and his medications.

 

Remember, you are doing this to help your cat. Cornell University College of Veterinary Medicine has a video on how to give sub-Qs which states "This might be THE most important thing that you can do at home to help your cat." If fluids are necessary, they can make an amazing difference to how your cat feels - it is like watering a plant in a drought and watching it bloom again. Once you see the difference that fluids make, you should be able to find the strength from somewhere. During the last twelve years I have heard of literally thousands of people who have regularly given their cats fluids; and I can only recall one person who was unable to overcome her needle phobia (she did not even try to give sub-Qs). So read Sandi's story below, check out the tips on how to give them here, take a deep breath and give it a go. If you'd like to have your hand held while you get used to it, join Tanya's CKD Support Group

Coco's page gives tips and also advice on the emotional side of giving sub-Qs.

Elisa and Samantha's page describes Elisa's routine for giving fluids to Samantha.

Some people are put off the idea of giving sub-Qs because their vet charges them a ridiculous amount for their supplies - the most expensive I heard of was US52 for one bag of fluid! Quite outrageous when you know that people in the US and Canada people can buy supplies very cheaply, paying only US$16-40 for an entire case of twelve bags! The Obtaining Supplies Cheaply page gives tips on where to find fluids and other sub-Q supplies at good prices in the USA, UK and Canada.

 

Sandi and Maz - Learning to Cope with Fluids


Here Sandi describes how she overcame her needle phobia and successfully gave Maz his fluids before she lost him in October 2007.

 

"I know that some of you are really nervous/uneasy about having to do SubQ's yourself, so I thought my story may help.

 

First, I have to say I am the world's biggest needlephobic person (don't ask what's it's like when I need blood taken!). So when Maz was diagnosed last October and I found out he had to be on Sub-Qs I cried for a day, out of fear of doing SubQ's and also because I thought I was losing Maz. Luckily a vet tech saw my tears and agreed to come to my house three times a week (I paid her $45 including supplies).

 

This went on for about six months. During that time though I would be the one to get Maz when she came over (he would always try and hide) and gently pet him while he was getting the fluids. I began to get used to seeing the needle go in and also through this group started learning a tremendous amount on making it more comfortable (warming etc). The tech started telling me I knew as much as she did about giving fluids and Maz would probably be more comfortable if I did it but I resisted, saying I just couldn't stick my baby boy. Well, in April she got a new job and there wasn't another vet tech who could come. So now, it would really be ALL UP TO ME! I was petrified but with the help of the tech, I just did what I had to do. I learned that heating the fluids made all the difference and that by giving Maz some treats, other than the first needle poke, he forgets all about the fluids and just likes getting treats (some Fancy Feast) and a lot of love. There are times he even purrs now!

 

I have to admit, I still don't like poking him (I take a minute or two to get myself psyched for it), then I gently let him know I'm going to give him his treatment, take him into the bathroom where his favorite towel and treats are waiting and go for it!

 

So please believe me when I say it's not as bad as it seems, read the posts on the group and the info on Helen's website and you will see in no time, you and your furbabies will be just fine!

 

Hope this helps!"

 


The Giftube, Endo-Sof Catheter or Skin Button                                             Back to Page Index


If you really cannot bear giving sub-Qs, or if your cat really fights them, you may want to consider whether to use an implantable tube. These products are implanted in the cat under anaesthetic, and thereafter the fluids are basically just poured in (though you should not give too much, of course).

The most commonly used tube in the USA is the Giftube. This stands for Greta Implantable Fluid Tube and is named after the patient, Greta, for whom the inventor created it. Having one fitted costs around US$200-300. There is a similar product called the Endo-Sof subcutaneous catheter (also known as the Cooks Catheter), which tends to be offered in the UK.

It can be hard to get your vet to agree to you doing sub-Qs at home in the UK, but if your vet does agree, it is sometimes on the basis of using one of these products. This is not ideal because the infection rate for these products is over 10%, which I find worrying. It is also extremely expensive, because a bag of fluid can only be used for one sub-Q session before it is thrown away (because of the risk of infection); plus many cats have to have two or more tubes implanted each year because of problems with the previous tube necessitating its removal. This is usually because the cat's body considers the tube to be a foreign body and may form a kind of membrane around it, which can prevent the fluids entering the cat's body smoothly. In addition, many cats find the tube irritating and scratch at it constantly, so they often have to wear a bandage or little sweater to hold the tube in place.

Therefore I would strongly recommend using standard methods and only using these products as a last resort. If you do decide to use one, please ensure your vet knows what s/he is doing: some people have discovered after the tube has been implanted that their vet has never implanted one before and their cat has basically been a guinea pig; I'd prefer to know that beforehand and be sure that my vet could help me deal with any problems that might arise.

There is another more recently introduced product called a Skin Button which uses a mechanism called hypodermoclysis. The Skin Button is a small circle similar in size to a coat button, and like a coat button, it has two parts, one on the top and one on the underside. Unlike the other two products, this can be placed with local anaesthetic rather than general anaesthetic. The skin is supposed to grow around the button and reduce the risk of bacteria entering. Unfortunately it carries similar risks of irritation to the Giftube and Endo-Sof catheter, and can clog easily. It costs roughly US$100 plus your vet's fee. It also requires the use of a special needle which increases the cost.

 

Mar Vista Vet has information on all three products, including photos of the skin button.

Hypodermoclysis: an alternative infusion technique (2001) Sasson M & Shvartzman P American Family Physician 64(9) pp1575-8 discusses the use of skin buttons in humans.

PractiVet - the Giftube manufacturer's website.

Dechra Veterinary Products has information on placement and usage of the Endo-Sof catheter.

Mila International is the site of the manufacturer of the Skin Button.

Norfolk Vet Products also make a type of Skin Button. This site is currently being remodelled and does not contain too much information.

Giftube Users Forum - for people using the tube or contemplating its use. This site is owned by Practivet and therefore puts a very positive spin on the use of the tube.

   


When NOT to Give Subcutaneous Fluids                                                                      Back to Page Index


Fluids are not always acceptable treatment, and should only ever be administered with veterinary approval. Subcutaneous fluids should NOT be administered to your cat if any of the following criteria apply:

  1. Your cat is so severely dehydrated that your vet considers intravenous fluid therapy (IV) more appropriate. In certain circumstances IV is the only correct treatment. If your cat has high bloodwork levels (creatinine over 7), s/he might benefit more from IV fluids initially, with sub-Qs provided once s/he returns home as needed.

  2. Your cat has a heart condition. Fluid therapy may still be possible but your vet must decide if it is appropriate for your cat, and determine the amounts and frequencies to be administered.

  3. Your vet has refused to agree to the procedure on other medical grounds.

  4. fluids from the previous session have not yet been absorbed.

  5. your cat is over-hydrated. This may be obvious, or your cat may feel "squishy", the way water in a plastic bag feels  - squishiness sometimes happens if a little air gets in with the fluids, and is not normally a problem, but if it happens consistently, your cat may need less fluid. Other symptoms of overhydration may include sudden weight gain, coughing and nasal discharge. See Symptoms for more information. Overhydration may be associated with a heart condition, but contrary to what some vets claim it can still happen in a cat with a perfectly normal heart. It is a good idea to weigh your cat regularly, to check for sudden or continous weight gain which may give early warning of a problem; or

  6. Processing the extra fluids in itself places an additional workload on the kidneys which can make the CKD progress faster; plus it can flush out certain nutrients, and giving fluids when they are not needed may increase blood pressure; so it is best not to begin fluids until the advantages are likely to outweigh the disadvantages. Dr Katherine James of the Veterinary Information Network believes that most CKD cats will benefit from subcutaneous therapy once creatinine levels are consistently over 300 -350 (US: 3.5-4). If your vet thinks your cat's CKD is less advanced than this, then it is probably safer to hold off on sub-Qs for the moment;

  7. My vet agreed to us doing fluids in part because she felt Thomas would not find them too distressing. You and your vet do need to take your cat's personality into account in deciding whether to go this route; but do not necessarily assume your cat cannot cope, many cats who ordinarily hate medication of any kind tolerate sub-Qs because they make them feel so much better. I would suggest trying them for a few weeks at least.  

  8. Many cats appear happier (more active and alert, with a better appetite) after sub-Qs. However, some may become lethargic for an hour or so afterwards. This is probably nothing to worry about, but if it happens frequently it may be that your cat is not processing the fluid very well, so I would ask your vet to check your cat for possible heart problems or fluid retention.

Back to Page Index

 

This page last updated: 20 September 2013

 

Links on this page last checked: 10 April 2012

 

 

The group is hosted on yahoo!groups, part of yahoo. It has its own address separate from Tanya's website. You can either click here or copy and paste this link into your browser:

 

http://pets.groups.yahoo.com/group/tanyas-ckd-support/

 

If you are already familiar with yahoo!groups, just click on the link and apply to join (and don't forget to complete the short questionnaire you'll be sent), but if you'd like to know more about how the group works, read on.

 

I own and run the group, but I am ably assisted by two moderators, Anne V and Anne A. They help with membership queries, approve messages, and do lots of boring admin stuff behind the scenes to help the group run smoothly for the members.

 

The group has various sections, including a photos section and a realtime chat function but for most people the most important part of the group is its message section. Basically, a member who wants support, vet recommendations, or to hear how others are coping with a particular problem, sends a message to the rest of the group. Other members then respond if they can. All messages sent to the group are stored in a message archive which members can search if they wish.

 

The group is private, i.e. messages sent to it are only visible to members, so people are not posting to the internet at large. The names of group members are also private, so nobody will know you are a member unless you choose to send messages to the group.

 


Joining the Group                                                                                                                        Back to Page Index


 

There are two ways to join the group, via the group's website or via e-mail:

 

How to Join the Group via E-mail


Just send an e-mail to

tanyas-ckd-support-subscribe@yahoogroups.com

You should then receive an e-mail in response asking you to confirm that you definitely want to join the group. Just click Reply and send.

 

If you join the group via e-mail, you will be able to send and receive e-mails to the group, but you will not be able to access the group website and read the message archives or look at the photos. If you wish to do that, you will need to set up a yahoo! ID by visiting the group website.

 

How to Join the Group via the Web


You can visit the group's homepage and follow the instructions. If you do this, yahoo!groups will help you set up your yahoo! ID, which gives you access to the group message archive etc. A yahoo! ID is not the same thing as an e-mail address.

 

Here are the steps to follow. Don't worry, this all sounds far worse than it is! You should find that in practice it all works more smoothly than it sounds when you're trying to explain it in writing:

 

Existing yahoo! ID

  1. Go to the group website: http://pets.groups.yahoo.com/group/tanyas-ckd-support/

  2. Click on the Join this Group button and you'll be taken to a Sign In to Yahoo! page.

  3. Sign in and link Tanya's Support Group to your existing account.

  4. Choose the e-mail address you wish to use for the group (see below).

  5. There is a little box for you to tell me why you would like to join the group. You don't need to be inventive or fancy, it's not a competition, it's just an extra check by yahoo!groups to keep spammers out.

  6. Choose your message delivery options (see below).

  7. Scroll down and click on the blue Join button at the bottom right of the page.

New yahoo! ID

  1. Go to the group website: http://pets.groups.yahoo.com/group/tanyas-ckd-support/

  2. Click on the Join this Group button and you'll be taken to a Sign In to Yahoo! page.

  3. Scroll down a little and click on the Create New Account button.

  4. On the next page you can create your new account. Some people are somewhat inventive in their responses, but in such cases it is important to remember what responses have been given in case the information is needed later to access the account. I can't see any of this stuff, it's entirely private between you and yahoo!groups, so I cannot help in case of later queries. 

  5. Once the account is successfully set up, you'll be taken to a Congratulations! page.

  6. Before you click on the Continue button on the Congratulations! page, untick the box that makes yahoo! your homepage (unless that is what you want).

  7. Also click on the Edit Marketing Preferences link below the Continue button. This takes you to another page where they helpfully opt you in to everything, so go through and set it as you wish.

  8. Then on the same separate page click on Account Info at the top of the page. You will be asked for your password again and taken to the Account Info page. Click on Profile and opt out of the various choices as you wish. The key thing is, you do have choices here, you can make things as public or private as you wish.

  9. Now click on the Continue button on the original page. You will be taken back to the group page to choose your membership settings.

  10. Choose the e-mail address you wish to use for the group (see below).

  11. There is a little box for you to tell me why you would like to join the group. You don't need to be inventive or fancy, it's not a competition, it's just an extra check by yahoo!groups to keep spammers out.

  12. Choose your message delivery options (see below).

  13. Scroll down and click on the blue Join button at the bottom right of the page.


Membership Settings                                                                                          Back to Page Index


 

There are various choices you need to make regarding your membership of the group. The most important are which e-mail address to use, and which way you read messages sent to the group by group members.

 

Membership Settings: Your E-mail Address


You need to decide which e-mail address you wish to use for the group. If you have created a yahoo! ID, yahoo!groups will normally have also set up a free yahoo! e-mail account for you based on your new yahoo ID. You can use this e-mail address to access the group if you wish, but it's not essential, you can use any e-mail address you wish. Since yahoo! is now scanning messages for advertising purposes (similar to gmail), I would recommend not using yahoo! e-mail if possible (though it would probably be better than using your work address for private stuff).

 

If you do not want to use your free yahoo! e-mail address, click on Add e-mail address to add a different one. Be aware, if you don't add a new address here, yahoo! will use the yahoo! e-mail address as a default address. So if you don't receive the membership questionnaire, it may well be because it's gone to your new yahoo! e-mail address.

 

If you ever wish to change the e-mail address you are using for the group, you can do that here:

http://pets.groups.yahoo.com/group/tanyas-ckd-support/join

 

Membership Settings: Message Delivery


This sets up how you will access messages that are sent to the group.

 

This is a pretty active group. If you're looking after your CKD cat, you want support but you probably don't want a full inbox all the time. To help you manage this issue, you have three options for messages, and you can switch between them all as you wish:

  1. Individual E-mails

  2. Daily Digest

  3. Web Only (No e-mail)

Individual E-mails


This is the default setting. If you apply to join the group via e-mail, you will end up with this setting. If you apply to join the group via the group's webpage, if you don't choose one of the other settings, this is the one you will end up with.

 

This setting means that as soon as somebody sends a message to the group, it is sent directly to your inbox. It's a good choice if you might want to know immediately if somebody has responded to you, or if you would like to store some of the group messages for your reference. It's also good for being able to quickly delete messages which don't interest you.

 

The downside is that this is a busy group, averaging 50-100 group messages each day, so your inbox can quickly get full. One solution is to create a folder to use for group messages. All messages sent to the group have a tag in the subject line [tanya-crf] so you can filter all messages from the group to a new folder using this tag if you wish.

 

With both individual e-mail and message digest options, you can also choose the format of messages sent to you (Display Format), either Fully Featured (html, pretty colours etc.) or Traditional (plain text).

 

Message Digest


This means that you receive e-mails from the group, but yahoo!groups waits until there are about 25 messages available and sends them to you all in one go. With this option, you would therefore only receive 2-4 e-mails a day from the group, but it means you have to wait for responses (though you can still check on the group website for messages) and it can be more difficult to find what you are looking for within each digest.

 

With both individual e-mail and message digest options, you can also choose the format of messages sent to you (Display Format), either Fully Featured (html, pretty colours etc.) or Traditional (plain text).

 

Web Only (No Mail)


This means that you receive no messages at all from the group. This is a wise choice if you are using a work e-mail address, or if you cannot cope with the group's message volume. With this system you simply go to the group's website and read the messages that interest you there. Even if this is not your usual choice, it can be helpful to use this option if you are going on holiday.

 

So make your choices, then click the Join button at the bottom right of the page.

 


Important: Membership Questionnaire                                                           Back to Page Index


OK, so you've successfully applied to join the group. However, there is one more thing you need to do in order to join. I want to protect the group members from spammers, so whichever way you apply to join the group, you will receive a short questionnaire asking:

  1. Your first name

  2. The country where you live

  3. Your CKD cat's name and age

You need to respond to this before your membership will be approved.

 

Please don't worry about saying "the right thing." This is not a test to see if you are "good enough" for the group, everybody is welcome here, whoever they are or wherever they come from, as long as they want to help their cat. This questionnaire is basically just to reassure us that you are a real person applying to join rather than somebody trying to sell stuff and spam the group, but it also enables us to tailor our responses to your group messages e.g. if we moderators know where you live, we will not suggest treatments not available there.

 

Please note, only the two Annes and I can see your responses to these questions. The group will not know anything about you unless you choose to introduce yourself.

 

Once you respond to the questionnaire, your membership application should be approved very quickly (most people are approved within two hours or less).

 

Occasionally the questionnaire goes missing. You think we haven't sent it, and we think you haven't responded! If we haven't heard from you five days after you apply to join, we will send you a reminder. Unfortunately, we can only use the address you've used to sign up for the group, so if you've accidentally used your new yahoo e-mail address without realising it (see above), you won't see either the questionnaire or our reminder. If you don't hear from us, please simply write to us at tanyas-ckd-support-owner@yahoogroups.com and let us know. Please respond to the three questions in your response and we will either approve you (if your membership is pending) or send you a personal invitation to join the group (if your membership application has disappeared into a black hole).

 


Messages                                                                                                                                          Back to Page Index


 

Message Options: Sending Messages


You don't have to post, you can just lurk if you prefer.

 

If you wish to change the name that appears on messages you send to the group, Yahoo! explains how you can do that.

 

Starting a Thread


  1. You can simply send an e-mail to ask your question by sending it to tanyas-ckd-support@yahoogroups.com.

  2. You can go to the group website, click on Post Message in the sidebar on the left, and then write your message there.

Replying to an Existing Message


Messages sent in response to another message on the group also go directly to the group, not to the individual to whom you are replying. Therefore if you wish to respond to a message somebody else has sent, you can simply click reply on your e-mail programme. If you reply via the group website, you can click on the message in the group archives, then click reply which is top left above the message.

 

If you're changing the subject, or replying to a Digest (which have the subject line of Digest No. xxx), please change the subject line appropriately to something more meaningful. And please remove everything except that to which you are replying.

 

If you wish to reply privately to somebody, you will need to press reply, then delete the group e-mail address and paste their personal e-mail address into the To: line if you are using e-mail. If you are replying via the group website, you will see a little envelope over on the right under the person's name. If you click on that, your message will go to that person.

 

Message Content


You are welcome to discuss anything relating to care of your CKD cat. We do have a few guidelines we ask people to follow though:

  1. Please do not refer to vets or vet clinics by name for legal reasons. Just say "my vet" or "Dr J".

  2. Please do not ask for money or other donations.

  3. Since this is a very busy group, we ask that condolences are sent privately to the bereaved group member. Certain other messages should also be sent privately e.g. short "me too" messages, off topic posts etc.

  4. Please trim your posts.

Moderation of Messages


When you first join the group, your messages will be moderated for a short while. This means that they will not reach the group immediately, but will first be read and approved by one of the moderators. We do this to ensure that:

  1. you are not a spammer;

  2. you are keeping to other group guidelines (e.g. not naming your vet publicly);

  3. you are trimming your messages appropriately.

If you comply with the group guidelines sent to you when you join the group, you will be taken off moderation quickly. The main reason people stay on moderation is because they do not trim their posts. So please read up on this in the group guidelines. If you get stuck, just ask for help.

 


Leaving the Group                                                                                                Back to Page Index


 

Some people decide to leave the group. Their cat may have died, or they may find the message volume is too much, or they simply decide it's not the place for them. Leaving is fine, but if you're thinking of leaving simply because you cannot cope with message volume, please consider changing your message options first, such as by going no mail. This means your inbox will not be full, but you can still reach out for support quickly when you need it.

 

If you are leaving because your cat has died, please consider joining our sister group, Tanya's Feline Loss Support:

http://pets.groups.yahoo.com/group/tanyas-feline-loss/

 


Conclusion                                                                                                            Back to Page Index


I do hope you've decided to join Tanya's CKD Support Group! It can give you support, it can give you hope. It can make you smile too - where else would people share your thrill at hearing that your constipated cat has pooped? (Believe me, when you've been dealing with CKD for a while, things like this are real triumphs which can absolutely make your day).

 

I personally read every message sent to the group. I don't respond to every post (my priority is running this website) but I do keep an eye on things and post occasionally if I can add to what has already been said.

 


Group Quick Links                                                                                               Back to Page Index


Some of these only work if you are already a member of the group.

 

Weblinks


Group homepage:                                                 http://pets.groups.yahoo.com/group/tanyas-ckd-support/

Managing your membership options:                  http://pets.groups.yahoo.com/group/tanyas-ckd-support/join

Messages archive                                                 http://pets.groups.yahoo.com/group/tanyas-ckd-support/messages

 

E-mail Addresses


Sending a message to the group via e-mail:        tanyas-ckd-support@yahoogroups.com

Group owner e-mail address:                                 tanyas-ckd-support-owner@yahoogroups.com

Joining the group via e-mail:                                   tanyas-ckd-support-subscribe@yahoogroups.com

Leaving the group via e-mail:                                  tanyas-ckd-support-unsubscribe@yahoogroups.com