Daily injections of insulin for your cat? The thought may at seem
daunting, but with practice the injecting of insulin in your cat will
become second nature. These instructions will give you the information
you need to perform injections of cat insulin with confidence.
Pre-Injection
Establish
a pleasant routine: You
should be injecting at about the same time every day. Begin with petting
or grooming or maybe even a low-carb, high protein treat. (Or
a tiny amount of anything they love.)
At first, keep the syringe hidden or disguised. Cats do not have the clearest
eyesight, so you have some leeway here. As long as the syringe is not
initially in my hand ( I hold it sideways by the barrel in my mouth!),
Austin is OK with my approach. After the cat becomes used to the routine, you probably won't have to do this. Many cats can be trained by verbal commands to come get their shots.
If hiding the syringe while you play is too hard, consider using the
CAPPED syringe to rub all over your cat. Austin liked to have his face
scratched with it, but I do have a little trouble getting him to leave
the syringe alone once I uncap it for the injection.
Get
on the same level as your cat:
you down on the floor, cat up on a bed or counter, or in your lap. Do
not assume a threatening posture (e.g. looming over the cat.)
Make
yourself comfortable:
Get
into a comfortable position, and make sure your body is in a position
relative to the cat that makes injection easy. For example, if you plan
to inject in the neck with your right hand, make sure the cat is facing
toward your left or at a right angle to you.
Performing
the Injection
Keep your movements smooth.
Tent
the cat's skin: Grasp
the cat's skin between your thumb and index finger (fingers about an
inch apart) and pinch firmly to tent the skin. The pinch will also help
numb the area. Most people use the skin from between the shoulders up
to high on the neck, but you can try the hips, too. Most people, including veterinarians, make the mistake of injecting the insulin into the scruff of the neck. This area has a very poor blood supply and insulin absorption is thus rather erratic from this area. Use an area further back around the hips or flank or, ideally, on the sides of the stomach. Try to rotate sites also, because repeated injections in the same site can cause a "granuloma" or knot of tissue that has poor blood supply (which means the insulin isn't absorbed well). Below are pictures of Jock, a hairless Sphynx cat, receiving an injection. The first photo shows tenting of the skin and the second photo shows injection into the abdomen near the navel. (If you use the abdomen or chest, avoid the nipples and the navel.) Notice how unconcerned Jock is about Sabina putting a needle into him and Sabina's good technique. (Thank you, Steve, for taking these pictures and letting us use them! More pictures of Jock getting his injection with an insulin pen are here.)
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Tenting the skin |
Injecting |
Try to see the skin to make sure you actually stick the needle into the skin. Giving the injection to the hair is called a "fur shot!" Doesn't help the cat much! Austin is long haired, so I try to brush
aside his hair to expose a bit of his skin prior to the pinch. This
is where he starts to get suspicious, but I often do the pinch several
times before I actually inject.
Once
you are ready to inject, try to be as quick, smooth, and
confident as possible. (Practice makes perfect!)
If
you have more than one cat, consider going through this routine with
the non-diabetic first, doing a pretend injection only, but letting
your diabetic cat see the syringe near the other cat. Always the sucker,
Austin would get jealous of the attention being given to Eugene and
come running when I'd do this.
Use
correct Position: Hold
the syringe almost parallel to the cat's spine. You want the insulin
to be injected just under the skin (subcutaneous) NOT into the muscle,
which hurts! Make sure the bevel of the needle is UP. This ensures
a clean, quick puncture instead of a drag through the skin. |
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Be Quick, Confident:
Do the puncture quickly. Most of the pain nerves are at the very surface
of the skin and once you get past them things improve. Remember that a relatively firm pinch works to help numb the area. The very small size (gauge) needles available now hardly are felt at all by the cat, even without pinching the area. Once the needle is through the skin
you can slow down a bit.
Follow
Up:
Once you are through, give the cats lots of hugs, kisses, praise, and
maybe another tiny treat.
Last updated 4/28/05
Tips
from our readers
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I
have a friend who is an RN, and she had advised me to hold the fluid-filled
syringe in my fingertips to warm up the insulin for a couple minutes
prior to injecting it, as the insulin temperature from the refrigerator
is very bothersome to human patients and warming it up makes it easier
to take. Also, use the ultrafine needles.
(Cindy Rinehart)
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We
had a terrible time with Scooter when we tried to inject using the
'tent' method, which was taught to us by the animal health technician
at the local vets office. On a subsequent visit with the Vet, himself
an owner of a diabetic cat, he displayed a different technique which
works VERY WELL with Scooter, and she displays much less reaction
and definitely less pain.
The
technique is to pinch some of the skin (for me using my left hand)
between your thumb and forefinger (trying to avoid grabbing muscle
underneath) and ROLL your hand sideways (for me, rolling my hand over
to the left)pulling the skin over your finger...this makes the cats
skin MUCH TIGHTER than pinching it up into a tent, and the tighter
the skin, the easier the needle penetrates without pulling.
The
technique literally meant the difference between night and day, success
and failure in our commitment to do what needed to be done to keep
Scoots going. Just thought it worth sharing, some people might find
it makes the difference for them.
(Pat and Shelley and Scooter)
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As
you fill the syringe, it is important to make sure that there are
no big bubbles in the syringe (some of the itty bitty ones just don't
go away). This is crucial, considering the very small dosages that
many of us are using 3 units from a 100 unit/mL product like Humulin,
is only 3/10 of an milliliter; just a drop. You want to make sure
that kitty gets the full dosage. Usually, pulling back on the plunger
slowly, avoids big bubbles. If you get a bubble, push the plunger
back in and try filling the syringe again. Sometimes, it takes more
than one or two tries.
I
highly recommend that the syringe be used only once. The syringes
are designed for single use (I used to work for a company that made
disposable syringes). It is the best way to be sure that you are not
contaminating your bottle of insulin with and that kitty gets a fresh,
sharp needle with each injection. Needles do get dull and develop
burrs which can make shot time a little more difficult. Used syringes
are best disposed of in a "sharps" container; drugstores
that carry insulin should have them and they are relatively inexpensive
($2-$3); just ask the pharmacist for it. The filled containers can
be turned into the vet for proper disposal (incinerated, at least
in California). A hospital or doctor's office may also be willing
to help with proper disposal.
(Rikki)
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I
do have one trick my fiance taught me about the injections (he's a
physician so that has certainly helped!!): Hold the syringe with your
ring and middle finger and keep your index finger on the "handle"
by the plunger and use the syringe like a dart. Once the needle is
in it's a very simple thing to just lift your index finger onto the
plunger and inject! You may already know this, but it was news to
me!! I'd never given a shot and was more than overwhelmed at the idea
of doing so!! This technique has made things much easier and the syringe
is kept very stable so it doesn't hurt Isaac at all. You've also got
a really good grip on the syringe so there's no way to mess it up
as long as you keep a little forward pressure on the syringe.
(Cynthia)
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My
12 year old cat was diagnosed two years with diabetes. It took time
to develop a routine he would tolerate. In the beginning, I tried
to catch him off guard to give the injections. But he seems to tolerate
it better if he knows he is getting the injection. I began a routine--feed
him, give him a few minutes to groom himself after eating, then fill
the syringe and let him see it and then give the injection and pet
and praise him after the injection is given. It seems to have developed
a level of trust. Prior to that, when I tried catching him off guard,
he was always weary of me when I approached him. Each cat is different
and it just takes time to learn what they will tolerate. I give two
injections daily, so I also began the routine of giving the a.m. injection
on his left side and the p.m. injection on the right side so I was
not giving shots in the same place. Also, when he was first diagnosed
before the insulin level was regulated, there was a problem with him
urinating in inappropriate places. For a time, I restricted him to
one room and then after the insulin level was regulated he went back
to using the litter pan. In the beginning, it is quite frustrating,
but given a little time and effort, you both can adjust to it. I'm
glad I toughed it out.
(Chery Smoth)
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