? New member, first injection in the morning. Some questions...

My 17+ year old cat, Maggie, will receive her first injection, from me (first time injector), in the morning. She's had asthma since we took her in nearly 17 years ago. We had the asthma under control for many years, then just last year we found out she has high blood pressure (which has caused her to be nearly blind), CKD, and a slight heart murmur. She's been on prednisone or prednisilone 16 years and using Fluticasone almost that long. Just started amlodipine about a year ago. Supplementing with potassium and Vit. B complex for about a year, and B12 a few days ago.

Her blood glucose was 365, and she has a UTI. She was prescribed 1.7 units of Lantus every 12 hours, 30 minutes after a meal, and amoxicillin. I've been instructed to check her glucose 2 hours after the injection. I've read a lot here...so thankful for the support! I'm on info overload, and there's still so much more to read!

Question 1: To this point, I've fed her multiple small meals throughout the day, and now I have to divide it all into two meals separated by 12 hours. Any pointers on how to succeed? She LOVES to eat! Dry is her favorite, but about 1/3 of her total food is canned. I understand the importance to change to low carb, high protein canned, but vet wants to get the insulin regulated before that.

Question 2: Any general pointers for a successful first day on injections and glucose readings for a newbie?

Thank you.
Alicia

 

Answer to 1st question: most of us feed multiple small meals a day regardless of what we were told by the vet. Kitties are happier this way. Yes, low carb wet food is best and we recommend making the switch before starting insulin as it can have a significant lowering effect on blood glucose. The switch can be made on insulin but testing blood glucose at home would be an important monitoring tool. You don't have to wait 30 minutes after a meal to give Lantus. It's slow to take effect so most of us inject while the kitty is eating or right after.
2nd question:

• try to stay calm
• no, the shots and blood tests are not really painful
• yes, it will get a lot easier over time
• getting blood glucose under control will take time - patience is key
• testing before each insulin dose is important to keep your kitty safe
• testing about mid way between doses is important to know how low she's going
• once the UTI resolves, the BG can drop - another reason to have a good testing routine going.

Welcome Alicia and Maggie! You're in the right place for help and support.

 

Welcome Alicia and "extra sweet" Maggie!!

Your vet is wrong about a few things....One, continuing to feed a high carb dry food is like a human diabetic continuing to eat potato chips and wondering why their diabetes is still out of control....reducing the amount of carbs is the first thing to do!!

The twice a day feedings is also old school.....most of us feed multiple small meals because it's easier for the pancreas to deal with small meals than big ones, it keeps kitty happier and can help keep their blood glucose more stable

361 really isn't terribly high, especially for a cat that was tested at the vet (vet stress alone can add up to 200 points!) and with a UTI....once the infection is cleared up, that could come down considerably.

Learning to home test is vital....it's the only way to keep Maggie safe while you're learning all you need to know about treating her! If you live in the US, your local WalMart will have a Relion Confirm or Micro blood glucose meter that a lot of us use here. It takes the tiniest sample size and the replacement strips are affordable ($35.88/100)

Here's something I wrote up for others that needed help with testing...maybe it'll help you too! (substitute "her" for "him"...LOL)

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

 

Welcome Alicia and Maggie!

To be safe... most of us start with 1 unit and adjust from there in 1/4 increments... the 1.7 units your vet is suggesting is a bit high.
.

 

Thank you all for your answers and suggestions!

 

I'm also confused about the 1.7 units prescribed-- it seems like that would be extremely hard to measure accurately on U100 syringes, especially when you are just starting out. At best, you're only going to have half-unit markings on the syringes, and the distance between the marks is tiny (we have to "eyeball" 0.25U changes, but at least that is halfway between the marks). See the picture below, demonstrating 0.75U, for an example.



What kind of syringes are you using? Did your vet demonstrate how to measure 1.7U?

 

Hi Nan & Amber. You hit the nail right on the head! The vet didn't demonstrate how to measure 1.7U, and I didn't think to ask. It wasn't until I picked up the insulin and syringes, which are U100, that the pharmacist told me to use my glasses to pull 1.7U because the smallest syringe she had was U1oo, 3/10cc. I stopped by the vet on the way home, but she was out on a call. She's a country vet who makes house calls. The vet tech confirmed that I had the correct syringe, that there was nothing smaller.

For this morning's injection I pulled 1U plus a little less than what is shown in your picture.

 

My guess is that your vet did a calculation of some sort to come up with that dose. You can eyeball 1.5 u fairly easily if your U100 syringes don't have half unit marks. When it's time to buy more, try to find ones with half unit marks. Then you can eyeball 0.25 u if needed.

 

Welcome Alicia and Maggie