Painful insulin shot

My kitty, Rocky, is being evaluated for Acromegaly. He is at 7 units of Vetsulin and climbing. It seems that now, when I give him his insulin, he is really uncomfortable and today, he even hissed, although I broke the shot into two (well - HE sort of did that ). What am I doing wrong? Any advice?

 

Are you lifting the skin away from the muscle? If the needle touches the muscle it hurts.

Most of us use human syringes with fine needles (31 gauge).

If you are using U40 syringes for Vetsulin, the gauge is probably 28, which is a bigger diameter (ouchier)

The human syringes are U100, so you would need to use a conversion chart to use with U40 insulin.

U40 is weaker (40 units per milliliter) than U100 insulin (100 units per milliliter)

The conversion is 2.5x

So 1 unit of U40 insulin in a U100 syringe would be 2.5 u marks

 

Hi there and welcome,
It looks like you are brand new to the FDMB - yes? If you don't mind me asking, and so we can help you better, can you tell us a little bit about Rocky?

When was he diagnosed and long has he been on insulin? Which ones, and how have you advanced the doses? What does he eat? Do you test his blood glucose at home? What does he look like, size and build, eating & drinking habits? Roughly, what part of the world are you from? What has your vet told you ? Has he had any other medical problems? When and where did they send his blood?

Have you changed type of needles lately or anything about how you shoot? U 40 Vetsulin syringes only come in one length and fineness, which is 29 gauge, I believe. Most kitties barely feel the injection, so it makes me wonder if something else is going on.
There are thinner (31 gauge) human insulin syringes available for U100 insulins , (vetsulin is a u40 veterinary insulin) but the unit markings are a different size and therefore a conversion chart must be used to get the correct dosing. I have never done that so I can't give you the links.

Has your vet discussed the Vetsulin product alert that was posted in Oct or Nov 2009? If not you can check the Vetsulin website for information. Many here are transitioning away from Vetsulin as a result.

many others will be along, so any info would be helpful! Welcome

 

There are videos on injection technique at www.prozinc.us which might help you. Check it out. BTW this is one of the insulin choices some new cats are trying as a replacement for Vetsulin.

The other good choices are Lantus and Levimir which you can read about. If he turns out to have acro, most moms choose lev (I think) because it doesn't sting when injected in larger doses.

 

A little about Rocky :
He is almost 16 years old. He has renal issues that have been going on for years. I give him fluids every other day.

Rocky was diagnosed initially as diabetic in April of 09. He was put on Lantus glargine. The diabetes went away after 2 months and came back in January. We started him back on the Lantus but it didn't seem to be effective. His BG kept going up and at one point, when I took him into the Vet - his insulin was over 1000! That's when the Vet switched to Vetsulin.

Rocky's BG has bounced all over the place, mostly high and the Vet bagan to suspect Aromegaly. I am taking him into the Vet on Monday for the test. We are sending the blood back to Michigan, maybe, instead of using the local labs as intermediaries and pying the extra fees.

Rocky and I live in Denver. The Vet has spoken with me every day, including her days off, with regard to his insulin, etc. I do home test and use the Alpha Trak which I like.

Through all of this, Rocky's lab values (BUN, Creatine, etc) have stayed stable. He weighs a little over 13 pounds and holding.

I have looked at the video about giving teh injection. Numerous times. I can't understand how before, I could give him an injection and no problem and now there is.

Thank you everyone for your replies. And your help. :razz:

 

Hi Rocky's Mom.

The only thing I know about Vetsulin is that it's been recalled and really shouldn't be used anymore. Most (but not all) of the high dose cats use Levemir. Have you tried different injection sites? I think you can inject anyplace you can get a good "tent" (not completely sure about that).

You're really lucky to be in Denver. CSU is the only place in the country that "treats" acromegaly. Get your tests done (send directly to MSU...also, get both IGF-1 and IAA) and if positive, have your vet call Dr. Lunn at CSU. My Boo is one of the kitties that has been successfully treated. She's been off insulin now since September.

Out of curiousity...does Rocky snore? Do his feet look bigger than normal? Potbelly, protruded forehead, or underbite? Not all cats show physical symptoms, but we always like to ask new people. Browse through this forum - Nancy & Code posted a link to a recent article on acro.

 

What syringes are you using with your vetsulin? If you bought the u40 syrinnges they are 28-29 gauge, and with lantus you would have been using 31 gauge, which are finer. find the conversion chart and try using the u 100 syringes. Lots of people do that, I'm just not one of them so. The info is probably in the "health links" forum.

The other thing is I've noticed that if I drop the syringe or inject it in the vial twice, or in his skin twice , the needle tip is bent and it is much harder (and painful) to inject. I know that is probably too simple to be the answer but...

The other thing could just be emotional, maybe it hurt once and now he is resistant. Maybe you could get some sort of special new treat, and reward him with it, like dehydrated chix breast, (if he likes them, Ive found them cheaper in bigger bags marketed for dogs) and some people give it when they are busy eating.

If it turns out he is acro, some people have thought that their kitty was in pain from the tumor (headaches). When I'm in pain , I'm cranky.

 

Hi -
Just to answer a few more of the questions that you all asked:
1. Rocky snores, he has for years. But he doesn't have any of the physical signs of acro that you asked about.
2. Rocky is not cranky at all except sometimes when he gets the insulin shot. And, after getting a lot of fluid in him for the SQ fluids he gets. Then, he is just restless, not really cranky. Rocky is a lover - he rides around on my shoulder or sits in my lap for hours!
3. I use the Vetsulin syringes (U-40).
4. I am "warming up" the Vetsulin now, rolling it, and that has seemed to help somewhat, although the last unit or so of the injection he gets uncomfortable.


Thanks again to everyone who replied to this sring - I really do appreciate it.

 

I just noticed you are having the blood drawn Monday. That means if you bug them you may find out late friday afternoon.

Cody doesn't have any of the obvious signs either, except maybe a potbelly, but that fluctuates with the megacolon.
did you find that new article on acro? The bit about the lower teeth protruding was pretty interesting- cody does have that (after I looked)

http://www.sciencedirect.com/science?_o ... 58b97d9ea5