First time giving insulin

[Summers Mom]

Hi, my cat Summer was diagnosed with diabetes the last of August. Her numbers have not been extremely high so it gave me a little time to educate myself on Feline Diabetes. I have been testing her bg at home several times a day since i found out. I use a relion prime meter. I am comfortable with testing but as the day gets closer to giving Summer insulin, i am nervous. I am going to be using Lantus. I think i will start her out on o.5 unit 2 x a day. Summer is on raw diet and has been almost her whole life. Since she is on raw i read that a lot of people don't give high carb canned food if they go too low because it upsets the GI tract. So i would i just use honey or syrup? And another couple things i am not sure about is how to actually draw the insulin into the syringe the proper way. And lastly, how to give the shot. I will be giving the shot in the flank or side of belly. When inserting the needle in to Summer, do i push the plunger and release the insulin after i see that the needle is in OR do i insert the needle and pull back on the plunger to see if there is no blood then insert?? I am just not sure. And what are the best videos to show me about giving the shots? Thank you all. I truly appreciate you all and this forum.

 

[Noah & me (GA)]

How to actually draw the insulin into the syringe the proper way. / I first loosen up the syringe by drawing the plunger up and down a tiny bit. Push the plunger all the down. See the rubber seal on the vial? You'll be making a new hole in the seal so the first time might feel a little stiff. With the vial tipped so that the seal is facing down (this depends on how much is left in the vial) push the needle into the vile and slowly draw back the amount you need. You don't want any air in the syringe, start again if you do. Practice makes perfect. I leave the syringe in the vial until I get what I want, never put a used syringe in the vial and never squirt insulin back in after the syringe has been pulled out.

When inserting the needle in to Summer, do i push the plunger and release the insulin after i see that the needle is in OR do i insert the needle and pull back on the plunger to see if there is no blood then insert? / I can't completely answer that with words, didn't your vet show you? I have never had blood on a syringe. I hope another member can either tell you or post a link to a YouTube video, there should be lots of video help.

Sorry for what I left out. You should have had all this demonstrated to you at your clinic.
We will NOT abandon you, I promise.

 

[Noah & me (GA)]

Try this. This is a link to YouTube but not one specific video. Find the ones most helpful and bookmark them.
https://www.youtube.com/results?search_query=giving+insulin+to+a+cat

 

[Summers Mom]

Thank you for you reply. I use two different vets and neither of them have not bothered to show me anything. They know very little on Feline Diabetes and have been no help. I have learned everything i know from This forum and from reading. I just watched the video here on the forum about drawing up insulin in to the syringe. I am just nervous about the actual first couple of shots. Do you pull back on the plunger when you insert the needle Before the injection OR do you just insert and inject?

 

[Summers Mom]

Try this. This is a link to YouTube but not one specific video. Find the ones most helpful and bookmark them.
https://www.youtube.com/results?search_query=giving insulin to a cat

Thank You for this! I did watch some of those earlier as a matter a fact. Some helped better than others. Thanks again!

 

[Noah & me (GA)]

Thank you for you reply. I use two different vets and neither of them have not bothered to show me anything. They know very little on Feline Diabetes and have been no help.QUOTE]
Well that's friggin typical! You're in a better place now.

 

[Chris & China (GA)]

Do you pull back on the plunger when you insert the needle Before the injection OR do you just insert and inject?

You don't need to pull back to check for blood....just insert and inject

The needles in today's syringes are very short and designed to put the insulin into the correct area under the skin.....Older syringes were longer and "might" get into a vein, but the ones we use don't go that deep so it's not a problem

 

[JanetNJ]

Thank you for you reply. I use two different vets and neither of them have not bothered to show me anything. They know very little on Feline Diabetes and have been no help. I have learned everything i know from This forum and from reading. I just watched the video here on the forum about drawing up insulin in to the syringe. I am just nervous about the actual first couple of shots. Do you pull back on the plunger when you insert the needle Before the injection OR do you just insert and inject?

Don't pull back on the plunger,,,, Poke it in (hold the side of the syringe). Then push the plunger.

 

[Noah & me (GA)]

There's something else the vet should have told you, this might be why you asked about blood on the syringe. An insulin injection is a subcutaneous injection meaning the needle just goes under the skin, NOT in a vein. One way of making this easier for nervous first-timers is to tent the skin. YouTube thinks I mean tinting the skin so no help there. What you do is pinch a small pouch of skin and fur between your fingers, you don't want just skin, you want some meat in there. This will not hurt the cat and now you won't feel like you're going to stab him somewhere. The mistakes happen if you grab too small a chunk and the needle goes in one side and out the other. We call this a fur shot, a complete miss. It's not the end of the world, you'll either see the insulin squirt across the room and/or feel a wet spot on the cat. The danger is you have to be sure you missed, you definitely do not want to inject him twice. I hope that helps knowing you don't have to get "right in there".
Is there another clinic where you can book a 30 minute appointment for a lesson. This is something a vet technician can show you so you'll save some money not booking doctor time. Are you comfortable yet with your meter and getting blood from the cat's ear. No matter what your vet told you, you HAVE to test the cat's blood sugar before deciding how much insulin to give. That's what lancets, test strips and the meter are for. That is something that YouTube can help you with. It's not as painful as it looks. Good luck, please promise to keep asking us questions no matter how silly they sound or if something just isn't working out for you.

 

[Summers Mom]

There's something else the vet should have told you, this might be why you asked about blood on the syringe. An insulin injection is a subcutaneous injection meaning the needle just goes under the skin, NOT in a vein. One way of making this easier for nervous first-timers is to tent the skin. YouTube thinks I mean tinting the skin so no help there. What you do is pinch a small pouch of skin and fur between your fingers, you don't want just skin, you want some meat in there. This will not hurt the cat and now you won't feel like you're going to stab him somewhere. The mistakes happen if you grab too small a chunk and the needle goes in one side and out the other. We call this a fur shot, a complete miss. It's not the end of the world, you'll either see the insulin squirt across the room and/or feel a wet spot on the cat. The danger is you have to be sure you missed, you definitely do not want to inject him twice. I hope that helps knowing you don't have to get "right in there".
Is there another clinic where you can book a 30 minute appointment for a lesson. This is something a vet technician can show you so you'll save some money not booking doctor time. Are you comfortable yet with your meter and getting blood from the cat's ear. No matter what your vet told you, you HAVE to test the cat's blood sugar before deciding how much insulin to give. That's what lancets, test strips and the meter are for. That is something that YouTube can help you with. It's not as painful as it looks. Good luck, please promise to keep asking us questions no matter how silly they sound or if something just isn't working out for you.

Thank you and I promise I will keep asking questions! The reason I asked about pulling back on plunger before injection of insulin is because I watched a video that showed that. But I know not to do that. I did watch some videos that did show how to tent the skin like you mentioned. I live in a rural area and all the vets around here are the same. I know just about as much and sometimes more than they do! Lol. I read slot and research alot and of course this message board has helped me more than anything! Yes, I test my cat Summer everyday, several times a day since she has been diagnosed back in the last of August. Her numbers are starting to creep up so I have got to start her any day. I am trying to wait for the weekend so my husband can help me for the first few times. So when I tent her I just inject in to the tented skin, right? I have done sub q fluids before on another one of my cats. I'm guessing the insulin goes just under the skin like the sub q fluids? Is that correct? And when I test summer before her Amp shot and pmp shot and she is below 200, I skip the shot? And if she test high in between shots do I feed some of her raw diet to her? And if she reads low give her honey or syrup? Someone on here that feeds raw said alot of the raw feeders don't give the high carb canned food because it upsets the cats GI. So I guess I would just use the honey. Thank you so much. And yes, it would be a God send if I had someone to help show me but unfortunately I dont. My vet kept telling me that Lantus wasn't glargine!! I finally had to tske a picture of Summers lantus and show him before he believed me!! Lol. The vets here are in it for their pockets only.

 

[Noah & me (GA)]

I live in a rural area and all the vets around here are the same. So when I tent her I just inject in to the tented skin, right? I have done sub q fluids before on another one of my cats. I'm guessing the insulin goes just under the skin like the sub q fluids? Is that correct?

Yes, it's basically the same injection you've done before. That's a relief. This is coming from someone that grew up on a party line, end of a gravel road, middle of nowhere so I'm not a city-boy snob. You have what I call a farm vet. He's probably got a 22 behind the door for euthanasia and just doesn't get why you don't get a "new" cat. I say nuts to him. This is what the internet was meant to be and you'd be pretty much screwed without it.

 

[Noah & me (GA)]

Wanna know the world I grew up in? This says it all. I went from this to MRI's for cats in just 50 short years!

 

[Nan & Amber (GA)]

Hello and welcome!

You've already gotten a bunch of good advice from others, so I'm mostly saying hi. I did take a look at Summer's spreadsheet-- she definitely needs insulin, but her numbers really don't look bad for a newly-diagnosed diabetic. Maybe because her diet is already good? Was there some kind of event that might have triggered the diabetes? Your signature says she has very thin skin that tears, which makes me think there's a chance she's a Cushing's cat. I don't know much about that condition, but others around here do-- I'm just mentioning it as something to put on your radar, just in case (it's not all that common, so I doubt your vet as you describe him would pick up on signs or know what to do if he did).

For right now, though, I think your plan of starting with 0.5U 2x/day is an excellent one. If you haven't already, you can start taking a look at some of the insulin-specific information in the stickies on the Lantus forum-- it's a big and very active part of this community, there is a wealth of information in both the stickies and in the people that hang out over there.

Lastly, Summer is beautiful! Those eyes!

 

[Mandy & Rex (GA)]

Welcome!!

I encourage you to start posting in Lantus & Levemir forum where there are many pros that can guide you when you start giving insulin. Kudos on setting up the spreadsheet!

 

[Summers Mom]

Thank you all for you great advice!! I really don't know what I would do without you all! Thank you!

 

[Summers Mom]

So I am planning on starting Summer on insulin on Saturday being that's when I will have help with my husband for the first few times. I am nervous because her skin is so thin. Yes she more than likely has Cushing disease but I haven't gotten a true diagnosis on it. I haven't done so because it doesn't matter if she has it or not because I have already planned not to treat the Cushing disease if she does have it. I just don't want to put her through taking chemo drugs. Being Summer has been on a raw diet all her life, if she drops low in numbers, do I just give her a little syrup or honey? I heard from other raw feeders that giving the high carb can causes GI troubles.
So here are my questions :
1. Do I give syrup or honey if she drops low and what to do after I give her syrup?
2. When starting insulin, how often do I test after the Amp shot?
3. Do I need keystone strips in Summers diabetic box?
4. And how low of numbers would you not shoot??
5. What to do if high numbers show in mid cycle before pm shot?
6. How long after the pm shot do I need to test her and keep a close eye on her to make sure she is safe before heading to bed?

I promised I would ask questions so here they are! I have done sub q fluids before but it just makes me nervous because of Summers thin skin. And I have been making her raw food real soupy because her skin seemed like it was sticking together like she could be on the dehydrated side. She seems fine and is eating really well other than her dirty looking fur and her peeing outside her 2 litter boxes at times and her always being hungry. I value you all and this message board and just don't know what I would do without yall. So thank you all in advance! P.s. I was thinking of 0.5 unit 2 x a day. What do yall think?

 

[Chris & China (GA)]

1. Do I give syrup or honey if she drops low and what to do after I give her syrup?

You give a couple of drops and then test again in 20-30 minutes.....and then again in 30 minutes...and again an hour later.....so that you continue testing for 2 hours from the time you had to intervene with high carb food or syrup. IF she drops too low again, that 2 hour clock starts over

2. When starting insulin, how often do I test after the Amp shot?

At least around +5 to +7, but if you can get tests at other times, that's even better. Getting a +2 in a lot of cats can help indicate what will happen later in the cycle (but not necessarily on such a new cat)

3. Do I need keystone strips in Summers diabetic box?

It's always a good idea to have them around and to test occasionally, especially if she goes into higher numbers. Ketones are a lot easier to deal with if they're caught early.

4. And how low of numbers would you not shoot??

At first, if you get a Pre-shot under 150, you should stall, DON'T feed and post for help. Test again in 20-30 minutes to see if the number comes up on it's own without the influence of food

5. What to do if high numbers show in mid cycle before pm shot?

Nothing....Never shoot again

6. How long after the pm shot do I need to test her and keep a close eye on her to make sure she is safe before heading to bed?

Varies from cat to cat, but getting a +2 (+3 works better for some cats) can act like a crystal ball in a lot of cats. The +2 should be about the same as the PS.

If it's higher, it could indicate the beginning of a bounce and those are the times it might be fine to take a break on testing

If the +2 is lower than the PS, that's your "early warning" that you need to get more tests in later because she may be on a mission that cycle.

As you gather more data on Summer, you'll learn more about how she reacts to both insulin and food

I was thinking of 0.5 unit 2 x a day. What do yall think

Sounds like a good plan to me!!

 

[Summers Mom]

You give a couple of drops and then test again in 20-30 minutes.....and then again in 30 minutes...and again an hour later.....so that you continue testing for 2 hours from the time you had to intervene with high carb food or syrup. IF she drops too low again, that 2 hour clock starts over



At least around +5 to +7, but if you can get tests at other times, that's even better. Getting a +2 in a lot of cats can help indicate what will happen later in the cycle (but not necessarily on such a new cat)



It's always a good idea to have them around and to test occasionally, especially if she goes into higher numbers. Ketones are a lot easier to deal with if they're caught early.



At first, if you get a Pre-shot under 150, you should stall, DON'T feed and post for help. Test again in 20-30 minutes to see if the number comes up on it's own without the influence of food



Nothing....Never shoot again



Varies from cat to cat, but getting a +2 (+3 works better for some cats) can act like a crystal ball in a lot of cats. The +2 should be about the same as the PS.

If it's higher, it could indicate the beginning of a bounce and those are the times it might be fine to take a break on testing

If the +2 is lower than the PS, that's your "early warning" that you need to get more tests in later because she may be on a mission that cycle.

As you gather more data on Summer, you'll learn more about how she reacts to both insulin and food



Sounds like a good plan to me!!

Thank you so very much!!!