Painful response when plunger is pushed?

Hi all,
I saw there was another message today about a squirmy cat at injection time, but I wanted to ask a more specific question. Boots has done great taking his insulin shots for about a month, but recently he has decided he wants them no more. I noticed that occasionally he would whip his head back or vocalize after I pushed the plunger on his tiny needle, with its tiny 1 unit of Lantus. I don't think I'm hitting a muscle, and I warm the syringe in my armpit for at least a few minutes before administering it. (I used to leave the insulin out for 30 min before prepping the syringe, but that seems like a bad idea. Not sure if the armpit trick isn't doing it?)

Lately he has figured out what I'm up to, and sometimes responds even to the needle going in (was not a problem before), or the skin pinch. (How is he feeling the needle some times and not others?) Shooting while feeding doesn't go well, and now shooting after feeding isn't going well. I think if I can figure out what's causing the discomfort with the injection itself, he will eventually behave again. Any thoughts?

Thanks in advance for your kindness.

 

Hey, I had the same thing with Dixie. She was doing great with the insulin injections into the sides of her scruff. Then, I decided to also do it into her shoulder. That worked too for a while, but then she started to do the same thing as Boots. She would make a noise at injection time and would run away under the bed. Once that running-away routine starts, it is hard to stop . She would even know that the shot was coming and would run away prematurely. I just closed all the doors and started giving her the insulin shot a bit earlier on (so before she had finished all her food), and I stopped shooting into her shoulder and just stuck with the scruff. After a week or so, she got used to it again and didn't cause any problems.

She still occasionally vocalizes when I insert the needle. Have you noticed that sometimes Boots' skin is really easy to pull up, and sometimes it is tough? I think I read on the forum that when cats are stressed out, their skin will go more taut. And when they are relaxed, their skin is loose. Some days, it is hard to pull up her skin. And other days, it is sooo loose and the needle goes in like butter .

Also, are you making sure to minimize the number of times you use the needle tip? For instance, if you double-dip the needle into the insulin bottle or if you poke Boots, then have to pull it out and readjust, then poke again, it can really blunt the needle. A few times I have had to just get a new needle because once the first one is blunted, it is very hard/impossible to inject with.

Are you rotating your injection sites? Or do you do it at the same spot each time?

 

Aww, poor Dixie. Yes, I definitely notice that sometimes it's hard to get a good "tent" or whatever. Interesting about stress, hmm.

You just taught me something about the needle tip. Yes, occasionally I do double dip into the insulin bottle trying to get the dose just right after bubbles, etc. I will try to avoid this and see what happens. I also do try to rotate injection sites and generally poke where I can get a good skin pull, which is not always easy! But he won't let me near his hind quarters, so it's generally toward the shoulder blades. He also has skin polyps so I'm working around those as well.

Thanks for the response!

 

Yeah definitely avoid dipping back into the insulin bottle! I used to do that as well before I learned that we aren't supposed to. That small switch has made the injections a LOT smoother overall.

I did double-dip the needle earlier this week for the first time in a long time because I was getting frustrated with all the air bubbles (my insulin bottle is almost empty). When I went to inject Dixie, I couldn't even get it in and had to start over again with a new syringe. The needles blunt very quickly! Here is picture I have seen posted around here that shows how bad the needle can get:


Also, there is a correct position to hold the needle. I think you want the bevel of the needle to be up. There is more explanation about that here: https://felinediabetes.com/injections.htm

 

Thank you for the link. And that picture, egads!

 

It's better not to inject in the same area all the time. Cats can develop injection site Sarcoma http://www.abcdcatsvets.org/feline-injection-site-sarcoma-2/

 

Tips for Getting Rid of Bubbles:

* Draw up about 1 - 1.5 units more than the dose you need (e.g. if giving a dose of 1 unit, draw up 2 - 2.5 units of insulin).

* Hold the syringe with the needle pointing upwards.

* Flick the side of the syringe with a sort of upward motion toward the needle to move any bubbles up to the top of the barrel. If there are several small bubbles, try flicking the side of the barrel until the small bubbles 'pop' and form a single larger bubble (easier to remove).

* Try to centre the single bubble directly under the needle if possible. (Easier to shift than when it's stuck to the side of the barrel.)

* Keep the syringe needle pointed upwards and express most of the excess insulin. This should remove the air bubbles.

* Finish by doing the fine adjustment to set the required dose. Using a corkscrew motion makes it easier to set the plunger in the right position.


Mogs
.

 

Thank you Mogs, I almost missed your reply.

 

Watch also for the bevel side of the insulin needle, and which way it is facing before you insert into the fur. It pulls the skin more if you inject with the bevel side down, you want it pointing upward, it will be a smoother poke.