Intravenous Injection of Bears  (Disease Investigation & Management - Treatment and Care)

Veins which may be used include the sublingual (tongue), femoral, medial saphenous, cephalic or jugular veins. (B10.48.w43, B64.26.w5, B185.37.w37, B407.w18, D156.w2, J1.21.w7, P62.9.w1, V.w6, V.w90) 

• Opinions of the accessibility of the different veins varies. Different people have different preferences.

  Lingual

  • The most accessible veins are those on the underside of the tongue. (B407.w18, V.w91, V.w92)
  • Intravenous injections can be given into the sublingual vein. (B64.26.w5, J1.21.w7)
  • Catheters can be placed in the lingual veins for fluid administration. (J2.27.w3)
    • Use of catheters in these veins is not recommended unless other veins cannot be accessed. These veins are useful for injection of small volumes. (V.w6)
  • The lingual veins are preferred for "crisis access" for administration of emergency drugs, as they are large and easily visible on the ventral surface of the tongue. (D255.6.w6e, V.w6)

  Jugular

  • The jugular vein can be used (B185.37.w37, D255.6.w6e)
    • The jugular vein can be used in Helarctos malayanus - Sun bear.(J2.34.w4)
  • The jugular vein is highly accessible. (P62.9.w1)
  • The jugular and femoral veins are hidden by fat. (B10.48.w43)
  • The jugular veins are readily accessible, particularly if the fur over the vein is shaved. (V.w90)
  • Catheters can be placed in the jugular veins. (D156.w2)

  Femoral

  • Intravenous injections can be given into the femoral vein. (B64.26.w5, B185.37.w37, J1.21.w7)
  • The femoral veins are hidden by fat. (B10.48.w43)
  • The femoral vein can be used if the jugular is inaccessible (e.g. under drapes during surgery). (D255.6.w6e)
  • In small bears the femoral veins are accessible. (B407.w18)
  • Caution is advised in using the femoral vein for intravenous access as it is easy to puncture the femoral artery rather than the vein, risking intra-arterial administration. (V.w6)

  Cephalic

  • It is possible to locate the cephalic vein on the forelimb with practice, particularly in polar bears. (B407.w18)
  • The cephalic vein is the most easily accessible vein in Ursus maritimus - Polar bear and can be accessed without shaving the fur. (B185.37.w37)
  • Catheters can be placed in the cephalic veins. (B185.37.w37, D156.w2, J2.32.w3, P62.18.w1, V.w90)
    • The cephalic vein is easy to catheterise. (V.w90)
    • The accessory cephalic is the preferred site for short-term catheters. (D255.6.w6e)

  Sapenous

  • Opinions vary regarding the ease of use of these veins:
    • The medial saphenous veins are relatively easy to find and are more accessible than the femoral veins. (V.w6) 
    • Some practice is required to locate the saphenous veins, particularly in stout, short-limbed bears. (V.w90)
  • The saphenous veins can be used for placement of intravenous catheters. (V.w90)

Tongue (lingual) vein

• Pull the bear's tongue out one side of its mouth and let it dry in the air. (D249.w10)
• Hold the tongue firmly, with the underside of the tongue uppermost. (D249.w10)
• With the thumb of that hand, apply pressure across the vein at the base of the tongue to raise (distend) the vein. (D249.w10)
• Insert the needle, attached to the syringe, into the vein, at a 10 to 20 degree angle. (D249.w10) and with the bevel of the needle upwards (V.w5)
• Draw back on the syringe plunger to confirm that the needle is in the vein. If no blood appears, move the needle slightly backwards and forwards. (V.w5)
• Once you have blood coming back through the needle into the syringe, release the pressure on the vein. (V.w5)
• Inject the drug. (D249.w10)
• Once the drug is injected, remove the needle and place pressure over the puncture site with a finger (V.w5) (rub until the blood coagulates) (D249.w10)

Leg vein (femoral or medial saphenous on the hind leg, cephalic on the foreleg)

• Apply pressure to a vein on the lower leg, proximal to the intended injection site. (D249.w10, V.w5)
• Once the vein is distended, carefully insert the needle, bevel upwards, through the skin and into the vein. (D249.w10)
• Draw back on the syringe plunger to confirm that the needle is in the vein. If no blood appears, move the needle slightly backwards and forwards. (V.w5)
• Once you have blood coming back through the needle into the syringe, release the pressure on the vein. (V.w5)
• Inject the drug. (D249.w10)
• Once the drug is injected, remove the needle and place pressure over the puncture site with a finger (V.w5) (rub until the blood coagulates) (D249.w10)

Jugular

• Put pressure on the jugular vein near the base of the neck with your thumb to make it distend. (V.w5)
• Feel the position of the distended vein and trim hair in a 5 cm by 5 cm area over this.
• Swab the skin over the vein with sterile solution.
• Carefully insert the needle, bevel upwards, into the vein at a 10-20 degree angle, with the needle pointing towards the bear's head (away from where you are holding the vein - this removes any risk of a needlestick injury). (V.w5)
• Draw back on the syringe plunger to confirm that the needle is in the vein. If no blood appears, move the needle slightly backwards and forwards. (V.w5)
• Once you have blood coming back through the needle into the syringe, release the pressure on the vein. (V.w5)
• Inject the drug. (D249.w10)
• Once the drug is injected, remove the needle and place pressure over the puncture site with a finger (V.w5) (rub until the blood coagulates) (D249.w10)

• For injection of bears which are already sedated/anaesthetised.
• For the injection of reversal agents in anaesthetised bears. (B336.51.w51)
• In conditions where a long anaesthesia is anticipated, venous access should be prepared in advance of necessity, with catheter(s) inserted into one or more appropriate veins. (V.w6)

• For all veins in haired areas, clipping the hair makes it easier to find the vein. (V.w6)
• Which veins are most accessible may vary depending on the bear species, fat coverage, whether the area over the vein can be shaved, and the preference and previous experience of different individuals.

• The femoral vein lies deep in the leg, next to the femoral artery. There is a risk of directing the needle into the artery rather than the vein and giving the drug intra-arterially rather than intravenously. (V.w6)
• The jugular vein may not be easily accessible during an operation, particularly e.g. during dental surgery, due to drapes etc. (V.w6)
• The tongue veins may "blow" during injection. (V.w6)

• Needles of the appropriate sizes.

• Syringes

• Required medication.

• This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
• Personal preference and experience will affect which veins are easiest for a given individual to use for intravenous injections. (V.w6)

• Equipment required is readily available and inexpensive.

• Latex gloves should be worn during venipuncture to reduce any risk of infection. (D249.w10)
• Dirty needles and syringes must be disposed of properly (needles always into a properly marked sharps container. (D249.w10)
• 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 any country, drugs are unlikely to be specifically licensed for use in bears. 
  • In Europe the prescription cascade must be followed, and the client's informed consent should be obtained, whenever a drug is used which is not licensed for use in a given species. (B284.5.w5)
  • 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).