2 Weeks into Daily Injections-I'm Nervous!

We've been doing daily injections of Lantus for almost two weeks now, testing three times daily to find the correct dosage. Right now we're at 1.5 units each day. The past couple of days, he's gotten very aggressive with us when we test in the morning and give the shot. As soon as I even remotely touch his skin with it he jerks and scratches. This scares me terribly that I'm hurting him and even more so when he jerks. Our vet has us doing it between the shoulder blades, shaved the area so we could check each time for blood. We feed him and the other three cats of our clan twice daily with Friskies Classic Pate, no dry food is given anymore. They get fed after his morning test and injection, then again about 12 hours later.

Plus today, he tested at 299 blood glucose. I've asked my husband to really keep an eye on him, I'm a little nervous he'll have a hypoglycemic episode while I'm gone for class and work. Is there something I'm doing wrong all of a sudden? His fur wasn't wet so I don't think we're going through a different layer of skin aside from the shaved area. Could it be because he's hungry? He's definitely become ravenous and a bit more demanding for his food, he gets a little extra to gain the weight he lost before being diagnosed. I definitely would love some peace of mind or instruction for what I could be doing wrong. I'm going to the vet tomorrow morning since they're closed today.

 

You can move around the injection site to places with loose skin you can pick up and tent for injection. A bit off to the sides of the spine and around the shoulders is where I give it.

Lantus has a pH around 4, which means it is acidic. This may sting a bit and could be the reason for his irritability.

Also, be sure you only injecting under the skin and not into the muscle. It is more uncomfortable when you inject into muscle and the Lantus may not work properly there.

What kind of glucometer are you useing? We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WallMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

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Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

 

We have a Google documents spreadsheet grid we use to record glucose test values, insulin doses, and notes about how the cat is doing. If you set up and maintain one of these, you can share it a view only mode that will let others give you feedback on what they are seeing.

Instructions are here.

Understanding the spreadsheet/grid:

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

I've used the Relion Confirm for home testing, gotten better at pricking the ears with lancets. He would jump each time I used the lancet device so I just do it by hand. It doesn't seem like I'm injecting into the muscle. Today as soon as I barely touched him with the point he growled and jumped. The second time I tried it was already in his skin and he jumped again and started scratching at us.

Not so worried with the different reference ranges, so thank you for those. I'll still have my hubby keep an eye on him just in case.

 

I worry about this happening with my kitty because He loves me so much I don't want him to change on me! But I am a week and a half in and this is what I do, I feed him twice a day so when he gets food he is very excited. Once he starts eating he is all into it, I pet and scratch his back so he just thinks im petting him. I then grab a little skin softly and tent it up and give the shot under the skin. He doesn't even notice really.

When testing the blood on his ears he mostly is ok. Sometimes he looks a little annoyed but he gives me kisses right after.

 

Do you give him a treat after the test and injection? I was really worried that my timid little Tink would grow to hate me. But instead, he quickly started coming to ME for his test because he LOVES the crunchy freeze-dried (100% meat) treat he gets after. I use "PureBites" freeze dried treats, which are 100% fish, or turkey, or chicken, etc. depending on what flavor you get. Being nothing but meat (and a very small amount), it has no effect on his numbers, but BOY does he LOVE it. Several pet stores sell them, but so does Amazon.com where I get all my cat food anyway. That might help him start associating it with something positive (give it immediately, no waiting, so he knows its connected to the poking) and stop being so aggressive.

 

We definitely give treats each time we test/inject. I've been needing to look around for some proper treats for him that wouldn't have a big effect on him. I've tried letting him eat to test him but he kept stopping and back up, maybe it'll be different...I don't know. He still loves me terribly and loves to cuddle at night. We'll try to change a couple variables and see if it helps. Would it be better to just give him breakfast and try doing everything after or duriing his meal and see of he's just being impatient for food?