FIP Georgia > treatment info > injections

FIP Georgia: doing GS injections

Where to inject 🔗

Here's a diagram showing the recommended areas for the injection, along either side of the spine, and a photo of a kitty who's been shaved in those areas. (Some parents find that if they shave the kitty like that, it's easier to see what they're doing with the injections, and easier to detect and clean up any leakage. Shaving is optional, and totally up to you.) You should rotate among multiple spots in those marked areas, to give each spot time to recover between injections.

How to inject—basics 🔗

See Other supplies for information on needles and syringes. You'll use two needles for each injection: one to draw from the vial, and a fresh one to inject, because the first one will have become dulled when you push it through the rubber stopper on the vial:

It's a subcutaneous injection. If you haven't done those, your vet may be willing to give you a lesson. You form a "tent" by pulling up on the skin (or by grasping the base of the fur), then inject into the open space beneath the skin within the tent, holding the syringe almost parallel to the body, angled slightly downward. You can pull up quite firmly—more so than you might think—without causing discomfort. A bigger tent gives you a bigger target, and also more room for the injected liquid to disperse in without coming back out the injection site.

Cats vary in how they react. We recommend beginning with no restraint, and adding restraint only to the extent your kitty demonstrates a need for it.

Some do best with no restraint at all—with those, you can stealthily inject from behind while they're busy eating or otherwise distracted and they barely even notice. Churu purée or similar treats often work great.

One minimal escalation is simply to drape a towel over your kitty's head. Sometimes just not being able to see (or be seen) will relax them and help them feel secure.

Another simple escalation, especially helpful for those doing the injections solo, is to apply a clothespin or "chip clip" to the kitty's scruff. Some parents report that significantly reduces resistance to being injected.

Some kitties will need to be held by one person while another injects. In this video (starting at 2:33), Dr. Uri Burstyn demonstrates several techniques for safely and comfortably immobilizing a kitty ("Squish that cat!"). See also Figures #1-3 on this web page for a secure method of holding a kitty still: with one hand, hold the scruff and tilt the head back, and with the other hand, hold the hind legs (with a finger placed between the legs).

Finally, some kitties do best when restrained in a purrito wrap or grooming bag. Although some kitties become frantic when bagged, others find it soothing. The purrito wrap has a slit providing access to the injection area, and the grooming bag has a zipper that runs along the top and can be opened from either the front or the back. If you're injecting on the kitty's front half, unzip partway from the front; unzip from the back if you're injecting on the back half. There's a velcro enclosure that goes around the neck and will keep the kitty securely in the bag even when the bag is unzipped from the front.

Again, try first with no restraint, and escalate to the other techniques only as your kitty shows them to be necessary. And do your best to remain calm and relaxed—the calmer you are, the calmer your kitty will be.

As treatment progresses and your kitty becomes healthier and stronger, they may resist the injections more vigorously. Many parents find gabapentin, given two to three hours before the injection, helpful to calm the kitty. If you'd like to try that, ask your vet for a sedative-level prescription. (Most kitties are given 75-100 mg.)

Here are some videos demonstrating subcutaneous injections on cats:

• How to administer anti-viral drugs by subcutaneous injection—Dr. Niels Pedersen, UC-Davis
• How to Give Your Pet an Injection Under the Skin—Dr. Mary Beth Morgan
• Administering Subcutaneous Injections—Ingrid Johnson (Animal Planet)
• Treat FIP - with SubQ injections—The Hutto Feline Catio
• Injection Procedure—Penny Pie
• How to fill syringes for FIP Treatment—Aggie Fights FIP!

How to inject—special considerations for the first few injections 🔗

The beginning of treatment places demands on the kitty's body (increased heart rate and oxygen flow) that may be challenging if they start out extremely sick. It's very rare, but we have occasionally seen a kitty have a reaction similar to a sugar crash in the hours after one of the initial injections. Please be sure your kitty has eaten before each of their first few injections, and try to have on hand some Karo syrup or a 50/50 sugar/warm water solution, and a heating pad.

A minute or so of vocalizing immediately after each injection, due to the stinging sensation, is normal, as is marked sleepiness in the hours after the first few injections. But if your kitty exhibits any of these signs:

• extreme lethargy (distinguishable from normal sleepiness in that a lethargic kitty will not respond to being touched, or to hearing their favorite treat bag opened, and may be unable to stand or hold up their head)
• respiratory distress (rapid breathing, at over 50 breaths per minute; labored breathing; open-mouthed breathing)
• gums that are pale and lose their usual pink color, becoming whitish, grayish, or bluish
• temperature below 99° F.

Please remain in close contact with us immediately after your first injection. These complications are, again, very rare, but are dangerous when they occur.

How to inject—finer points 🔗

• Add backpressure to help draw from the vial: If you find it difficult to draw the solution from the vial, you may find it easier if you inject some air first. Before inserting the needle into the vial, draw as much air into the syringe as you will be drawing liquid. Insert the needle and inject the air into the vial. That will create backpressure to help push the solution down into your syringe.
• Get all the solution out of each vial: When you've drawn out as much as you can the usual way, you can remove the metal ring (snip it with wire cutters or wrestle it off with pliers) and pop off the rubber stopper, so your syringe and needle can reach the bottom of the vial and suck out whatever is left. It adds up over the course of twelve weeks.
• Avoid wastage in the needles: After withdrawing the needle from the vial and before switching needles, pull back on the plunger to draw any solution in the needle down into the syringe, so it doesn't get discarded with the first needle. After switching needles, push most of the air back out, but you can leave a small amount (up to 0.1 mL) in the syringe. That way, when you do the injection, that air will push the last of the solution through the needle, so you end up with air rather than GS in the second needle, too.
• Ensure the tip of the needle is in the subcutaneous space: When you insert the needle, the tip can sometimes poke through the far end of the tent or one of its sides. It can be difficult to see when that has happened, especially if you haven't shaved your kitty. If you don't notice, when you depress the plunger the solution will all land outside your kitty's body. Some of the videos recommend "aspirating" to avoid that problem (pulling back slightly on the plunger and checking for air in the syringe). Another option is just to wiggle the syringe slightly after inserting, to check whether the tip of the needle is moving freely. If you did poke through the far end of the tent, the tip will be stuck in your kitty's skin; similarly, if you had inserted at too steep an angle and poked into your kitty's muscle, the tip would be stuck in the muscle. If it moves freely, then you know you're in the subcutaneous space.
• Learn your kitty's preference for injection speed: For many cats, it works best to get the painful part (the actual injection of the acidic medicine) over with as quickly as possible by depressing the plunger all at once, but for some, it works better to do it slowly—over, say, 5-10 seconds—which may keep the discomfort below the pain threshold. You should experiment to see what works best for your kitty.
• Learn your kitty's preference for GS temperature: Some parents report that chilling the filled syringe in the refrigerator for a few minutes before injecting seems to reduce the discomfort. Conversely, some others report that warming the syringe in their hands before injecting reduces the pain. It's not clear why either of these practices would help, as the pain is due to the acidity of the solution, which isn't affected by temperature, but you can try varying the temperature of the syringe yourself and see how your kitty responds.

How much to inject 🔗

You can try using this dosage calculator, if you like. We can help set it up the first time you use it and provide a special link that will bring up the calculator with the dosage and the medicine concentration already filled in. Then you can just modify the weight as needed, and see the corresponding injection size ("liquid dose").

If you find that comfortable to use, you can do that. And of course you're always welcome to confirm with us, or just report the weight in your treatment chat and ask us to calculate.

FIP Georgia > treatment info > injections