Newbie on Vetsulin, having trouble with injections

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Renate, Sep 15, 2020 at 9:10 PM.

  1. Renate

    Renate New Member

    Joined:
    Tuesday
    Hi all,
    My cat Sid was diagnosed September 1st and has been on one unit of Vetsulin twice a day. She is a very touchy and sensitive cat and generally doesn’t tolerate anyone handling her or fiddling with her body (she likes to cuddle but ONLY on her own terms-she needs to come to you). Testing BG has been ok but we are having a lot of trouble with her injections. She hisses, swats, growls, and is generally uncomfortable even before the injection is given. I’ve watched videos on proper technique and was shown how to give the injection by our vet, so I don’t think the technique is bad. But she just hates it and is tolerating it less and less as time goes on. We are giving her treats before and after, trying to distract her with food, giving her love and pets, etc. it’s just not getting better. I would appreciate any advice r anyone with a similar experience. Thanks
     
  2. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi @Renate
    Sometimes it can happen that a shot goes a bit awry for some reason (maybe the needle goes too deep one time and pricks the flesh underneath) and then the kitty can get a bit nervous about getting more shots. This 'usually' resolves quite easily once the caregiver has clocked up a few 'good' shots, and the cat's confidence is restored. This is actually not uncommon, hence my mentioning it. But this may or may not be what's going on with your kitty.

    It is interesting that she is OK with testing BG, but not with the insulin shots. These are 'similar' processes in a way (both needing the cat to remain still for a short period while they get pricked), so I wonder why the shots are different....
    A few questions to think about...
    You say 'we' are having trouble giving the shots. Are there two of you giving the shots together, and is that the same with the BG tests...?
    Are you more anxious about giving the shot than you are about testing the BG?
    Are you rolling the syringe barrel in your fingers for a few seconds to take the chill off the insulin before giving the shot?
    Are you pulling back on the syringe plunger to check for blood before giving the shot? (If you are, don't, there's no need to do that...)
    Are you using a fresh syringe for each shot?
    Are you injecting the scruff or in loose skin elsewhere on the body?

    Are you using U40 syringes? Is it possible to get U40's with shorter and/or finer needles where you live? ....If not, then switching to U100 syringes can be a game-changer for some people, because the needles tend to be shorter and finer. But these need to be used with a 'conversion chart' so that you draw the right amount of U40 insulin into the U100 syringe.

    Regarding the shot technique, are you using the 'tenting' technique? You 'probably' are because most people do. But it is not the only technique...
    With my first diabetic I couldn't get on with the tenting technique at all. My cat was a fidget and would suddenly move. That made it hard for me to give the shot, and meant that I accidentally pricked him sometimes. So I used another technique that worked better for us.
    I'd grab some loose skin on the scruff with the fingers and thumb of my non-dominant hand, and then pull it up and sort of tip that upward slightly. Then I gave the shot almost directly downwards into the skin that I was holding in my hand, about mid way between fingers and thumb. This had two advantages. Firstly it meant that I could give the shot even if he moved a bit, as long as I was holding onto that handful of skin. And secondly it meant that I no longer pricked him because the depth of skin that I was holding in my hand was greater than the length of the needle.... If that makes sense...?

    Another possible thing to try is a bit of 'desentization'. For example, at times when you are not trying to give a shot, and maybe when your kitty is in a cuddly mood, you can stroke the kitty, and then just very gently pull up some skin on the scruff, just for a second, and not enough to stress her. Then immediately give a treat, and leave her alone to enjoy that. If she's OK with that, then you can also try pulling up some skin and quickly poking against the side of that 'tent' with the tip of your little finger, and then, again, just give a treat and try to leave her with a 'happy'. If she's OK with that, you can try the same thing with a capped syringe instead of with the tip of your little finger. And with kitties that like their chin scratched it's also possible to scratch the kitty's chin with the capped syringe. This can help to make the syringe 'ordinary' and non-threatening

    Is your kitty food-motivated? If so you may be interested to see the little video below where a vet is using 'desensitization' and 'counter conditioning' techniques to get a cat used to injections.


    ...One more thing... Very occasionally a cat will resist insulin shots if it doesn't need them... Strange but true... How are your kitty's blood glucose levels..?

    Eliz
     
  3. Renate

    Renate New Member

    Joined:
    Tuesday
    Thank you so much for your reply. When I say we I mean my daughter and myself. I am the one testing BG although when she US home she will do it. It’s hasn’t been a problem for either of us. My daughter gives her the shots. But I have given her the shots before and she has acted the same way. Yes we are more anxious about the shots but that’s because she’s acting the way that she is. No to rolling the syringe, will try that. Yes using a fresh syringe each time, no I’m not pulling back on the plunger, yes injecting into the scruff, yes to the U-40 syringe. The vet said no downwards shots so I/my daughter has been scruffiness her and injecting at more of a 45 degree angle Will try the downward technique you mentioned. Unfortunately she’s not very food motivated, unlike my other cat.
    Do you think we should buy the U-100 syringes? It seems to be the actual needle prick that’s bothering her.
    Her BG levels are all over the place. This morning she was 68. Just tested her now at 4:20 pm and she’s the highest she’s been, at 502
     
    Last edited: Sep 16, 2020 at 8:45 PM
  4. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Renate, 68 is too low for a cat on Vetsulin. When first starting, never shoot below 200, and if she drops lower than 90 she needs a reduction. I would cut her dose in half, 0.5 units. Some cats do not need very much insulin at all. The 502 this afternoon was a "bounce", it's a defense mechanism in the body that dumps excess sugar in the system to protect itself from low numbers and/or fast BG drops. When the body dumps the extra sugar, it sends the BG sky-high.

    Could you do me a huge favor and set up a spreadsheet and signature? If the spreadsheet is too much I can ping a moderator to do it for you. We can keep track of her numbers that way. I do worry for all the Vetsulin kitties, it's really not a good insulin for them and has a lot of hypoglycemic potential. It would mean a LOT if you lowered the dose to keep your girl safe.

    Spreadsheet Instructions
    Signature Instructions

    As for for the syringes, yes, I found the U-100s are much more comfortable in cats. You could go to Walmart at the pharmacy and purchase some 8mm 30 or 31 gauge syringes, they will be more comfortable. If you do, there is a conversion chart you will have to follow.

    A couple basic things I'm hoping you already know, but if not - Vetsulin needs to be given 30 minutes prior to injecting. Food must be on-board already because it hits hard and fast, as you saw from today. You also want to give small meals throughout the day, especially early in the cycle where Vetsulin is at its peak action. It often peters out 3-5 hours after injecting, so it's not a very good insulin to use (it's designed for dogs - outside the US, it's called "Caninsulin"). Your girl will feel a lot better on Lantus or Prozinc, they are gentle, long-acting insulins. Lantus in particular stabilizes BG rather quickly.
     
    Elizabeth and Bertie likes this.
  5. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi Renate, as Elizabeth says in her post above that 68 is too low a number for a cat on Vetsulin... (And if you are using a pet meter then that is getting into hypo range...) ...This is triggering the body to release its own stored glucose to raise the blood glucose level. This helps protect against hypoglycemia. But the body will not be able to do this indefinitely. Once the body's own stores of glycogen/glucose become depleted there will not be enough to release into the bloodstream to save the kitty from hypo risk...

    The 68 means the insulin dose is too high, and should be reduced immediately in order to keep her safe from hypo...
    As I said in my reply further up the thread, occasionally cats will resist insulin shots if they know they don't need them, and this 'may' be the case with your kitty... Perhaps she is able to make an association between the insulin shots and the low blood glucose...

    How many hours after the insulin shot did you see that 68? And did you get a pre-shot test...?
    What dose of Vetsulin are you giving at the moment?

    Eliz
     
  6. Renate

    Renate New Member

    Joined:
    Tuesday

    I can try to do those things but I would appreciate a moderator as I am not tech savvy. Thank you.

    Just a note—I did not give her an injection yesterday morning when she was 68. She normally gets shots at 7am and 7pm. That morning at 6:30 she did not want to eat so we obviously did not give her the insulin. Around 10:15 I tested her and she was 68. That was with no insulin on board. Then at 4:30 yesterday I tested her again and she was 502. So not sure what’s happening there. She did get insulin that night at 7:00 though because she was so high. She has never had a reading that low before. All of her other readings have been at least 220-550.

    Our vet is pushing vetsulin. I already brought up changing to a different insulin but he wants to see how she does on this first. Yes, I do know the basics of Vetsulin. She eats 30 min prior to shot and also gets small meals every few hours. Usually she’s a good eater.

    I ordered the U100 31 gauge needles and have already looked at a conversion chart. Thank you all for that advice and I hope it helps.

    For reference, she is on 1 unit of Vetsulin 2x a day.
     
  7. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Pinging @Bandit's Mom for you - could you help Renate set up a spreadsheet please and thanks? :)

    It sounds like she does not need 1 unit of insulin. Her body was reacting to the low number (68) and dumped extra sugars into the system to protect herself from hypoglycemia, which is why you got the 502 later. I would lower the dose if I were you to keep her safe.

    This is the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. It specifically states that Prozinc and Lantus are recommended for cats, and Vetsulin is only suitable for dogs. Your vet SHOULD be following these guidelines but most vets simply aren't aware it exists. I would show it to him and if he still refuses start vet-hunting. You want someone that's up to date on feline diabetes, or at least willing to work with you on it.

    Are you feeding a low-carb food as well? Food should be under 10% carbs (most of us use Friskies Pate or Fancy Feast Classics but there's many options available). With a 68 already it sounds like your girl wants to get off the juice asap. Many cats can become diet-controlled.

    Glad to hear you're getting new syringes, I think it will make it a lot easier on her during shot-time. I am eager to see what her pre-shot readings are.

    Excellent!
     
    Bandit's Mom likes this.
  8. Renate

    Renate New Member

    Joined:
    Tuesday
    Tonight her pre-shot reading was 441 and it seems like that is the trend. It does vary though, from 250-500. Yes we feed Fancy Feast, Tiki Cat, Sheba, and Weruva, all pate food that is no carb or low carb. She likes her variety with foods and doesn’t eat one brand for too long before I have to change it up. No more dry food. I do cave occasionally and give her two or three of the Temptations crunchy treats after a shot because that’s the only treat she really eats. I can’t imagine those two treats do a ton of damage.

    I will bring up the diabetic management guide for cats to my vet and see if he is willing to give us a new script for a different insulin.
    Thank you for your help and advice.
     
  9. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    It could be multiple things - from bouncing to just losing duration, since Vetsulin doesn't last very long, so by shot-time the insulin is long used up.
    Food choices are fabulous! I'm not sure how much Temptations would affect BG, I know most members avoid them but I couldn't tell you. If she likes the crunch though you could get PureBites, freeze-dried chicken or turkey that's a big hit with kitties.

    Fingers crossed!
     

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