Unable to inject my cat!

Hi,
My cat was diagnosed with Diabetes just last week.

I gave her first injection at the vets on Friday evening but have been unable to give any since!

She doesn't have much scruff to get hold of as she is overweight and she has very think fur (about 1/2 inch) so I am struggling to get hold of any.

I tried to inject her on the Saturday morning while she was eating but she was upset at me tugging on her and then furious when she felt the needle - I had a good few tries. On the vet's advice I left her alone for the rest of the day but I would give her a stroke and then a gentle tug on the scruff each time I passed in the hope she would get used to the feeling of that. I tried again last night Sunday, not while she was eating this time but while she was snuggled up next to me on the sofa. She tolerated me getting some scruff ready but then flinched and clawed and escaped as soon as she felt the needle!

I will probably need to get in touch with the vet again but it is quite a journey and she absolutely hates the car, so I thought I would see if anyone here has any advice before I put her through another vet visit (that would be 3 visits in 7 days!).

I feel pretty useless and exasperated and scared and worried for her....

 

Hello,

The first 2 times I injected I was not sure I got it in and knew that I could not inject again and that Jack needed insulin. The fur makes it difficult as I have very short (8mm) needles.

I shaved a spot on his back to get to the skin. It was more important that I was confident I got the shot in than what he looks like.

Maybe when I shave again, I will make a design !

I wish you all the best in your quest.

 

It doesn't have to be a thin pulled up bit, it can be a somewhat plump roll, including the fat. What you're trying to avoid is shooting into the muscle.

Also, any place you can pull up a roll of fur (with some fat), can work, not just the neck. Try around the shoulders with a kitty massage, or back near the hips.

After a while, you won't even need to part the fur to see the skin, as you'll feel it when the needle glides in.

 

Many thanks for your replies.

I have spoken with the vet again and am gearing up for tonight's dose. It does not come naturally to stick pins in one's cat!

I have been browsing a few of the posts here and it seems I have so much more to learn than learning how to inject...

I am on steep learning curve that is moving very quickly!

 

[Begin teacher voice]

Welcome to Feline Diabetes 101​

This course will prepare you to manage much of your cat's diabetes at home. Taking good notes and printing out or downloading infomation will help you study and apply the techniques you learn here to monitor your cat's glucose control, and sometimes, may assist you with other, common, co-occuring conditions.

What questions do you have?

[End teacher voice]
:smile:

 

How long are the needles on the syringe? you can get them in 1/2 inch (12.7 mm), 5/16 inch (8 mm) and 15/64 inch (6 mm). WIth a "fat' and the 6 mm needles there is no reason to tent, just stick and inject.
http://www.bd.com/resource.aspx?IDX=26973

 

Hello, and welcome!
(We 'met' on the Catchat forum :smile: )

I'm so sorry that Guinevere still isn't tolerating the insulin shots. That must be SO frustrating (and upsetting) for you...

I've tried (and failed miserably I'm afraid!) to find you a nice Youtube video of someone giving a cat an insulin shot; but every one I found suggested that, when giving the shot, it's necessary to insert the syringe and then pull back the plunger to see if there is any blood there. I don't know of anyone who actually does that 'in real life'!

I think, if Guinevere is feeling the needle, then you've possibly injected too deeply and hit the muscle below the skin. She could have felt that, and that may be what's put her off the insulin shots.
I know you wrote that she doesn't have much loose skin on her scruff. Does she have loose skin elsewhere on her body (along her flank maybe?) And does she tolerate being touched there? (Some folks do actually prefer to give shots into loose skin on the flank.)

Caninsulin is also available in a Vetpen format which some people say they find easier to use. I'll try to find a link about that for you.
Edited to add link to Caninsulin/Vetsulin Vetpen info: http://animalendocrine.blogspot.co.uk/2 ... -more.html

Eliz

 

My vet actually recommended NOT to grab any of the fat/skin. She recommended instead pulling up on the actual hair/fur (grip it close to the skin) as that lessened the chances of sticking the needle through the skin and into myself.

I'm not sure how your kitty is going to feel about that, but it might be more comfortable than pulling at the skin. My Tasha also has a lot of fur so it's hard to see what I'm working with. However, her skin is very thin and there's almost no fat as she lost a lot of weight. For us, that seems to create a nice firm grip and get us a nice spot to inject into while Tasha noms her dinner.

If that doesn't make sense, I can try to take a picture. Just stay patient and try not to become frustrated. We've all struggled with one part of this or another I think. You'll find a way that works for you and your kitty.

 

Hi Stacia, I've not heard of that technique. (And it's always useful to hear about techniques that differ from the usual 'tenting the skin' one: It's good to be able to give people options). I would love to see a pic of that....if Tasha will pose...(???)

 

If Tasha won't pose, Ripley (our Tubby Tabby with slightly shorter fur) will. I'll get a pic when I give them something to eat next.

 

Larry, Guinevere is in Europe. Most folks here have to use the specific Caninsulin syringes, although I notice that an innovative online supplier (VetUK) has started doing it's own U40 syringes a heck of a lot cheaper than the Caninsulin ones.

(The links below show VetUK's U40 syringes for price comparison (Caninsulin and VetUK's own brand))
http://www.vetuk.co.uk/veterinary-suppl ... f-30-p-295
http://www.vetuk.co.uk/veterinary-suppl ... 00-p-11335

 

Just take things at your own pace.
A diagnosis of feline diabetes (and learning to give injections etc) can seem quite overwhelming at first.
But everyone here has been where you are now and understands exactly how you feel.
It will get easier...

Big reassuring (((HUG))) to you,

Eliz

 

I DID IT! I have successfully just given my first injection at home.

I put her food down and was so determined that even when she pulled away as I grabbed her scruff, I just continued and put the needle in. She didn't even flinch at that and then simply continued to eat her fish.

This morning I was in tears with exasperation at my failures to achieve this and I spoke to the vet again to let him know that after 3 days I had not successfully managed even one dose! He was so matter of fact about the need to get the insulin into her system that I was absolutely adamant that this dose would go in. Perhaps she sensed the no-excuses attitude and reluctantly complied?

I feel much more assured after jumping this first hurdle - I truly hope this becomes second nature to us both.

Pulling up her fur rather than squeezing sounds a possibility that I will casually try later when we are snuggling up, and/or shaving a little area for a clearer pathway through her fur also sounds good.

I looked on the Feline Diabetes Forum and clicked on one of the diet links which said absolutely NO cat biscuits or cereals in food for diabetic cats and that raw meats should be fed. Each night my cat has her raw fish but has always eaten biscuits. I plan to decrease them now and then cut them out.

Does everyone else agree with this for diabetic cats - is this the way to go?

I am so grateful for all the replies and many thanks to Elizabeth and Bertie for directing me to this site from the CatChat Forum - I just posted on there too with the great news!

 

I am very happy for you. Congratulations!

I do remember the joy of a successful injection and although it has been only 30 days since that first "yippie", it still seems like a forever time ago. In time you will get as comfortable with it as I have and it will become 2nd nature.

Jack does not have much skin to pull on and as he has been getting better, he is starting to balk at the idea but I calmly tell him that WE HAVE TO DO THIS, there is NO option. A treat does help, they associate it over time. I think that me grabbing at his skin bothers him more than the needle. I have injected him 10 times and he never flinched. Of course he was sicker and probably not able to respond as well as he does now, but the needles are so fine, I don't think they feel that. I sensed though he could feel when I hit the plunger. Same as I get when I get the flu shot. A little pressure that we are not used to.


My older Samantha, when it comes to clipping nails, is different. No amount of soothing voice praises are going to convince her that her nails need to be cut. With being "Double Pawed", a hefty 15 lbs., and an attitude, there has been some blood spilt. ALL MINE! Anyway, she seems to respond better when I do not say a word. I think she gets the idea that with no talking going on, that her talking is not going to make a difference and she is right.

All the best!

 

I'm so glad you were able to do the injection! I think it's important to keep sort of gently grabbing up that skin from time to time - it will get both of you more comfortable with it, making her feel like it's less of an event and it'll make you quicker with it. I like to randomly tug at the fur in other spots too, just to keep her guessing.

Mine are only getting wet food and freeze dried treats now. Well, Ripley (non-diabetic) is still eating some old treats Tasha (diabetic) can't have.

I'm not sure how much you can see from these photos.




In both of these, I'm only holding onto fur, not any skin/fat. The red arrow points to the hairline, where the skin starts. Then the blue lines sort of outline a triangle tent that forms. It makes a really nice area to shoot into, at a 45 degree angle, so i don't have to worry about going through the skin or being too close to the muscle. I can get a firm grasp on Tasha and she doesn't mind it. I just wasn't sure how well you could see on either kitty so I took a photo with both. Ripley was pretty squirmy though.

Forgive my nasty hands - been scrubbing bathrooms this morning.

 

Stacia thank you sooo much for going to the trouble of photographing your cats for me - I'm touched!

I will certainly give that a go - it looks like it might be more comfortable for her but we shall see.

Re my previous post about cat biscuits/kibbles. I have just read somewhere that if you cut the biscuits out without reducing the dose of insulin, the cat can have a hypo attack which sounds very serious. Is it only for those who do the home testing (not ready for that one yet!) who attempt to control the diabetes with diet? My vet said to continue to leave her biscuits available all day for grazing on for the time being but to aim to switch them to diabetic ones later. I will be going back in a fortnight for him to test her so perhaps I should leave things as normal at least until then?

Here are some pics of the lovely Guinevere - the first one was last week when she was looking really poorly and her fur was all raggedy and second one was about 2 years ago aged 10yrs.

 

She's so pretty! Such lovely colors!

If you aren't home testing at this point, I wouldn't make any big food changes. I'm pretty new to all this but my understanding is that big changes to diet can drop the BG level by as much as 100 pts and an insulin dose by a unit or two depending on kitty. That's certainly enough to send kitty hypo. Until you're able to monitor, I would wait.

In fact, that was part of what made me decide for sure that we would hometest my Tasha - she was diagnosed with a level of 427 but on a dry food/high carb diet. In the week before we could start insulin, we did a lot of research (including reading here) and switched her to a low carb/wet diet. We also read about starting low and slow. Then to our surprise, our vet ignored all that and started Tasha's dose at 2 units without retesting her or even telling us to watch for hypo symptoms. I was so angry! We've since come to a bit of an agreement... But we immediately lowered her dose.

You'll get the hang of it. Some days I feel like I've been doing this forever. Some days it still feels brand new. We've only been at it now for a few weeks though.

 

Just saying welcome.
Guinevere looks somewhat like my diabetic Patches. My Patches is about 17

 

Hi Larry,

Thanks for the welcome, Patches looks a very kindly soul - 17 years old wow! Guinevere is a youngster then at 12 years?

Stacia, so you moved into home testing quite quickly? I'm not sure what Tasha's score of 427 means - all I know is Guinevere's reading was 25 (but 25 of what?) Thankfully, my vet did tell me that I should bring her straight to the surgery day or night if ever she appears "drunk" or listless although I didn't know then what would bring that on.

Guinevere's dose is 2 bars on the syringe (a very skinny syringe) and the vet told me she is starting on the lowest dose and that he would review it in a fortnight.

I have had a try at lifting her hair as shown in your pictures and she didn't mind me doing that at all so I will try that in the morning.

 

It sounds like you are using the european (Really non-USA) units. 427 is USA units. To convert, multiple the non-US by 18.

 

We started testing immediately. We did our first injection at the vet (2 units) but I wasn't happy with the dosing logic so I came home and we figured out the testing right then. Sometimes it goes better than others, even still, but I feel so strongly about it being important that we're all patient (Tasha included) and we make it happen.

And yes, your initial reading wasn't much different than ours based on Larry's conversion. You'd be 450 to our 427. But we made that huge diet change before starting the insulin, which is why I wasn't happy with the dose.

Definitely don't make big diet changes before being able to test and/or talking to your vet. But I'd try testing - Tasha's not known for her patience and she's been a gem about it. I bet you can figure it out with the right treats and technique.

 

Yay! Well done! :RAHCAT

Lovely pics of Guinevere there; she looks an absolute sweetheart... :smile:

Eliz

 

Thanks for the round of applause Eliz - I was indeed very proud of myself yesterday!

FUR LIFTING TECHNIQUE:
This morning's dose was a dream. I approached it matter of factly and tried the fur lifting technique (see photos from Stacia above if anyone new is wondering about it). Guinevere was more curious as to what I was up to this time while she was eating, rather than being angry or scared and I was able to actually see the insulin leave the syringe and go in - what a satisfying sight! This will be my technique now - no more pinching my poor cat!

What a difference a day makes when you reach out for help!

 

Tasha and I are so very excited this worked for you! And even more excited that you had another successful dose with the lovely Guinevere! Once you have the hang of injections, you can move on to conquering the testing. It's the same deal - just deciding you're going to do it and finding a way that works. We'll help you with it and some day you (and kitty) will wonder what all the fuss was about!

 

Hi Stacia - Another successful dose this morning although she did pull away a couple of times first now that she's onto me. I no longer speak about it to her beforehand or during as the matter-of-fact stance keeps me calm and assured and I guess she too is beginning to realise it just simply has to be done. Afterwards though, you would think she had won an Olympic medal with all the praise she gets! I might even stop this though and just make it a routine event with no pompoms!

I am certain I would still be struggling without this hair tugging technique - it makes it so easy to see where you are going with the needle and to be certain it is actually going in.

STRANGE MOVEMENTS!
Last night out of the blue, Guinevere started to sort of cough as if she had something stuck in her throat. She did this a few times before she stopped. I am wondering if this is some sort of symptom of a hypo as I have never seen her do this before - it was less of a convulsion and more like a cough and shaking of her head. She seemed okay and alert while she was doing it (I was silently freaking out!) and I then directed her to her biscuits just in case she had had too much.

I am eager to start the testing but am afraid to do anything different just yet until her check up in 10 days' time (or should I?) I have made sure that she is absolutely not getting a fraction more than her 2 units (even going under the bar just slightly) and I am encouraging her to eat enough - the hypo threat is terrifying!

We don't have Walmart in Ireland so I am wondering if anyone in Europe can point me to the name of the right testing kit to buy please (or should I buy the one you all have online)? Of course, I am dreading the new dramas that will unfold with this next step but shooting in the dark is beginning to feel a bit like Russian Roulette!

 

hi Guinevere,

Can you get hold of the 'codefree' meter on Amazon? I used it before I got the free alphatrak and was impressed, plus the test strips are cheaper. I can (if I'm allowed) send you some lancets through the post for it, and possibly some test strips though I did offer them to someone else and waiting for her to get back to me.

xx

 

Thanks very much Sweet Angel. I have put the Codefree in my Ebay watch list and will let you know if I decide on that one and thanks for the offer of some possible lancets.

It is in a kit with the option to buy extra strips and lancets. How many strips and lancets do you need a day?

There are two different types; one that is measured in "mmol" and one in "mg/dl". I have no idea what these mean!

I hail from London myself - now in the Irish countryside!

 

Hiya,

I'm thrilled that you and Guinevere are working out a way to get those insulin shots done. :smile:

Regarding glucose meters, another one that is popular with Brits (and I'm pretty sure is available in pharmacies in Ireland also) is the Accucheck Aviva. It only requires a small blood sample, and you may be able to get the test strips (the main cost of the whole 'hometesting' thing) on Ebay for around half the RRP.

I know hometesting sounds a bit of a 'big ask'. I was very reluctant to test Bertie intially because I was convinced he'd be impossible to test (that turned out to be SO not true)).
Like giving shots, it's a matter of 'finding a way that works'. And like anything new it can take a few goes to get the hang of it. But there are also people (and cats!) who seem to take to it like 'ducks to water'. Here's a link to some pics and info about hometesting from the Sugarpet website: http://www.sugarpet.net/bloodtst.html But DO ask any questions you want to. There are a lot of 'tips and tricks'...

"mg/dl" is the US form of measurement. "mmol' is the measurement in the rest of the World. To covert mg/dl to mmol you need to divide by 18, and vice versa.

Eliz

 

:shock:


I hope you have managed to find a good small animal vet. nailbite_smile

 

You two are doing amazing with the injections! Good work to you and Guinevere!

And the secret to hometesting is the same as the secret to anything else with cats - bribery. Tasha has finally started realizing test = treat so she comes right to the spot she has designated for testing. What, I thought *I* could designate a spot? No, she has chosen on the floor in front of the refrigerator. And then she bats my hand if the treats don't happen as she thinks they should. Guinevere will train you to test her in the way she sees fit as well.

 

Hi Stacia,

I thought home testing was going to be a daunting task but trust me it is not.

I am 35 days into testing/injections and it is relatively easy.

It is VERY important to test as you go so I hope you get a meter soon.

Just make sure to support the ear with a finger under it. I put on one of those Rubber finger guards. and then use the plunger. Make sure to warm the ear first. A cats ear is cold and not a lot of blood going through it. You get more blood easier if it is warm (I use a microwaveable bean bag (used in a heatwrap) works great.

Kevin

 

Hi Aine,
I was going to PM you to draw your attention to Guinevere's posts (because you've lived in Ireland also? (Or did I dream that...?!)) But you got there before I managed to do that.

Hugs,

Eliz

 

HI Eliz,

You didn't dream it!

I hope that Guinevere's got a good vet. It can be tricky to find a really good small animal vet in Ireland, especially outside the larger towns and cities. (Possibly why Guinevere's travelling so far for visits?)

 

I can relate to your troubles. Tommy is newly diagnosed. He is already a mean cat so now I have to grab him in a towel. I practiced shooting on an apple because I have to be fast. He doesn't struggle too much under the towel and the shot is quick.

 

Thanks for sharing this, Stacia, as well as the awesome pictures! Since Mikey was so tiny when he was first diagnosed, I wasn't able to tent the skin (not enough of it there) and I've always given Mikey what I would call "flat shots" and this explains what I do perfectly.

 

hi, hope things are going well.

When you're giving insulin you need 4 strips within 24 hours for the pre shot test and the test at the lowest point. (depends on the cat and the type of insulin). There's a post here with the info. I could 'lend' you my codefree long term if you like, and give you the lancing device and lancets. I'd only need it back if Angel needed regular blood testing after next July. I get free strips and lancets for the alphatrak for a year, wouldn't really be able to afford to use the alphatrak if Angel needed regular tests after that. I haven't heard from the other girl I offered the strips too so I could send you those too. PM me with your address if you'd like me to do that, I don't want anything for it unless the postage is going to be horrendous.

A lot of my early problems with home testing were to do with my attitude. Even now I don't always get a drop of blood first time, but because I know it doesn't hurt Angel I'm more chilled so he is too. I use the rice sock method. I do prefer the lancing device that came with the alphatrak, not sure if you can get hold of them on their own.

C x

 

Hi Sweet Angel, Stacia and all. I have had a few days off (maybe a week?) as my brain was so frazzled taking in all the new information. Once I was able to inject, I decided that was enough for now and have settled into the routine of that.

Guinevere continues to take her injections via the fur tugging method although she has become rather reluctant and pulls away. She knows, though, that she has to have it so I remain firm and calm until the job is done - what a change from the tearful terrified wreck I was a week ago!

We are back at the vets this Friday for her first check up after starting the insulin and I shall speak with him about home testing. I'm assuming she has settled a bit with her regular insulin as she no longer drinks as much as before - and is returning to her demanding, I'm in charge here, attitude!

I will admit to dreading this next step with the testing as I still don't understand it all and it seems so much to take in. I had a look at someone's spreadsheet on here and it freaked me out and I feared I would not be up to the job! It was after that that I decided to take a break from the boards!

Thanks very much for the offer Sweet Angel - that's so kind. I don't know how to PM you.

I am not in the depths of the Irish countryside. I'm in a small town but compared to London it is very rural.

I'll sign off again for now... but will be back very soon to bend all your lovely ears again!

 

You don't need your vet's permission to home test the blood glucose.

You need an inexpensive glucometer, such as 1 of the WalMart ReliOn Brands - Confirm, Confirm Micro, or Prime, matching test strips and 26 to 28 gauge lancets.
Avoid meters with True or Free in the name; they seem to have issues when testing on cats.
Read the instructions.
Practice on an apple (or grape or nectarine, etc), then test yourself.
Now you're ready to start working with your cat.
Get some low carb treats, such as plain freeze-dried meat or poultry.
Set up your testing area - a half bathroom works well to confine the wiggly cat.
Condition/train your cat - the first few times, go in the bathroom with the cat, say "Test time", sit down with the cat on your lap, massage the ears a bit, give the low carb treat, release the cat and open the door.

Take a thorough look at the ear. See the vein along the outer edge? You will use the lancet to make a small prick between the vein and the edge of the ear.
Push the test strip part way in the meter.
Brace the ear with a folded tissue, prick the ear, and snag the droplet on a clean fingernail.
Blot the ear with one hand while you push the strip all the way in.
Touch the absorbing edge of the strip to the droplet.
Record the results in your spreadsheet.

 

Guinevere's mum, I've pm'd you so all you need to do is reply though your user control panel.

I usually give Angel the Thrive freeze dried chicken treats as a bribe, (available through zooplus) they are 100% chicken so ok for diabetic cats. If your vet is supportive, get him/her to show you how to home test. I use a rice sock to warm Angel's ear, hold the ear as taut as possible against the sock then use the lancing device. Even if I hit a vein (and I sometimes still do) it doesn't hurt him, more like a scratch. I have the glucometer within reach and keep a gentle hold of Angel's ear so he doesn't shake it.

If you do want the codefree, I'll check and see if the lancing device for the alphatrak is available separately. It's so worth home testing, it means you can safely feed a very low carb diet and see if the diabeetes can be completely controlled by diet, then no more insulin! And if she still has high numbers go to your vet and push for a different insulin. If you were in UK I'd recommend the trial Angel is on.

C x

 

@Yong, photos above

 

Interesting. I was thinking of another picture I saw, somewhere.

 

Yeah I definitely saw one within the last two weeks. I think you're right that it was Steph. This is a good photo though.

I just gave him his shot, and I feel confident that I got it in. (Although I felt that way before, but I do feel more confident tonight) I was not exposing his skin, and I was surprised at how far down I had to dig to get to skin! I also, like someone in this or another thread, took comfort in seeing the syringe liquid empty into him. And I also held the syringe in for a count of 10.

Then for good measure, because I had him on my lap, when I put him on the ground I put my hand so that it wouldn't be anywhere near where I just shot him. I actually think I might have squeezed it out of him this morning by picking him up and an exact place where I'd just shot him.

 

Was it this one?

 

Steph found it. I'm sure Lois will still appreciate another picture, Chris

 

That is genius!! Yay on getting your first injection!! It will seem like old news soon enough. Head bumps

 

Chris and China, is that on the scruff? I can barely see a patch, her coloring is so uniform!

 

Yes....instead of making a "tent", I just grab some fur between my thumb and forefinger and then "roll" my wrist to gently pull the skin away from the muscle/fat layer and aim for where the break in the fur is.....it's a lot easier than making a "tent" and I give a lot less furshots too

 

If you want to "Tag" someone, put the @ sign in and then start typing their sign on name....a drop down menu should pop up for you to choose the right person

That way they (should) get an extra notification

Like @Lois and Java

 

I might try first on my "control cat" with saline from the Ringers bag. I'm fooling with Lily's fur now, she's perplexed.
It seems like it would be easier to do a through and through.
Thanks for the circle!

 

You go in at a 45 degree angle.....and as long as the skin is "pulled away" (and I know it sounds harsh, but I swear I'm just barely moving my hand), the insulin goes into the subQ layer where it belongs

 

Lily's being patient. I'll have to try it. It looks like the needle would go Into fascia or muscle, but clearly you've got this down and it's not doing that.

 

I started off doing the rolling technique but switched to tenting more. Maury started feeling the shots more with rolling. May have to switch back to rolling later, of course