confused, need help

[Priya&Missy]

Hi all, my kitty just started insulin a few days ago and her numbers have been pretty high still. She’s on 0.25 units twice a day. I’m wondering if I’m handling the insulin incorrectly or shooting wrong.

I’m using the Lantus solostar pen. I take it out of the fridge, remove the cap, turn it upside down, insert the syringe, and draw up 0.25 (I looked at pictures to make sure it looks correct). Then I’ve been turning my cat over on her side and lifting a piece of skin on her stomach and inserting the syringe, although I do it vertically instead of horizontally. I know it isn’t going through the skin. Maybe I’m using less than 0.25, the dose is too low, or she isn’t absorbing it properly. I’ll keep working on my spreadsheet and adding more data so I have a week of information but it doesn’t look good so far.

When I used a vial of Lantus in the past, I was told to warm it up and roll it gently in my hands; is that what I need to do with the pen too? I haven’t been.

 

[Justin & Sebastian]

Welcome to the club

I've never heard of a need to warm up the Lantus. I have heard the opposite, that it needs to stay cold or it goes bad faster. I'm not familiar with pen usage however I can say that Lantus has a very distinct smell and if it's not getting in properly you would be able to feel it and smell it on the fur.

What was the glucose at when she came out of remission? There's a thing called bouncing where when the glucose gets to lower numbers than they're used to, the liver dumps stored glucose and the numbers shoot up. So if the diagnosed glucose was fairly high and the lower 200s are new, that could be happening. It's hard to tell with so little data, but when you see numbers that are relatively flat, or are going up instead of down in the middle of the day, there's a good possibility of a bounce. And I see that on what you have so far. You got a good curve on the first cycle but then afterwards it's flat or rising. A bounce can take several cycles to clear, especially in the beginning, so that's what might be happening right now.

It could also just be too small of a dose, since .25u is fairly small. Have you looked over the dosing protocols and decided if you're doing SLGS or TR? You still need to hold the dose for a couple more days either way so you can determine what's going on, so you've still got some time to get things sorted out. How much does Missy weigh?

Also, are you testing for ketones? For a cat that's hitting 300+ numbers I would highly recommend getting some Ketodiastix urine test strips and testing daily for ketones. As long as ketones aren't showing up and the cat doesn't have a history of DKA, you've got a little more wiggle room.

 

[Priya&Missy]

Welcome to the club

I've never heard of a need to warm up the Lantus. I have heard the opposite, that it needs to stay cold or it goes bad faster. I'm not familiar with pen usage however I can say that Lantus has a very distinct smell and if it's not getting in properly you would be able to feel it and smell it on the fur.

What was the glucose at when she came out of remission? There's a thing called bouncing where when the glucose gets to lower numbers than they're used to, the liver dumps stored glucose and the numbers shoot up. So if the diagnosed glucose was fairly high and the lower 200s are new, that could be happening. It's hard to tell with so little data, but when you see numbers that are relatively flat, or are going up instead of down in the middle of the day, there's a good possibility of a bounce. And I see that on what you have so far. You got a good curve on the first cycle but then afterwards it's flat or rising. A bounce can take several cycles to clear, especially in the beginning, so that's what might be happening right now.

It could also just be too small of a dose, since .25u is fairly small. Have you looked over the dosing protocols and decided if you're doing SLGS or TR? You still need to hold the dose for a couple more days either way so you can determine what's going on, so you've still got some time to get things sorted out. How much does Missy weigh?

Also, are you testing for ketones? For a cat that's hitting 300+ numbers I would highly recommend getting some Ketodiastix urine test strips and testing daily for ketones. As long as ketones aren't showing up and the cat doesn't have a history of DKA, you've got a little more wiggle room.

The blood test at the vet showed a glucose of 417. Before that she was consistently hovering around 80 when she was in remission. She’s been on a low carb wet diet the entire time but the diabetes came back from a two week trial of steroids for cancer. She’s off the prednisolone now but the numbers have stayed high.

The reason I’m doing 0.25 units is because in the past 1 unit and 0.5 unit was too much and landed her in the hospital several times so I’m worried about it happening again. I’m starting slow but I’m willing to increase if necessary.

Missy is 7 pounds. I haven’t tested for ketones. I’m gone for most of the day because of work so I can’t be around to test several times except on my days off, but I’m trying to figure out a pattern as best as I can

 

[Olive & Paula]

Welcome. Lantus is a depot insulin, this means it has to build the depot first, so with each shot kitty gets some and depot gets some. It takes about 3 days for this to happen so you might not be seeing full effect yet, that's why you hold initial dose for 7 days.

You don't roll lantus and only have to let it sit at room temp for about 5 minutes and that is more for comfort for Missy.

Also you can give injection in side while Missy is actually eating, it might be more comfortable for Missy.

 

[Priya&Missy]

Also thinking my test strips might be kinda old or the meter isn’t working properly (I’ve had it for over 2 years). Waiting for some new strips in the mail and hopefully I’ll feel more confident that I’m getting accurate numbers.

 

[Priya&Missy]

Welcome. Lantus is a depot insulin, this means it has to build the depot first, so with each shot kitty gets some and depot gets some. It takes about 3 days for this to happen so you might not be seeing full effect yet, that's why you hold initial dose for 7 days.

You don't roll lantus and only have to let it sit at room temp for about 5 minutes and that is more for comfort for Missy.

Also you can give injection in side while Missy is actually eating, it might be more comfortable for Missy.

She growls if I touch her while she’s eating! Okay I haven’t been rolling it but I’ve been using it straight out of the fridge so it’s cold. Thank you, I’ll hold the dose for 7 days and see what happens.

 

[Justin & Sebastian]

How long ago was the steroid trial? 417 is fairly high and if that was going on for a bit and the 200s could be causing the bouncing.

7 lbs is fairly small so a smaller dosage is appropriate. Past dosage is important but you potentially have to start from scratch and work back down. But it's definitely smart to play it safe. Like I said I'm not familiar with pens but how fine can you get the dosing? Might need to get some calipers to help but when dealing with such small dosages, and knowing that 0.5u was too much at one point, you might want to consider doing smaller increases if necessary, like going halfway between 0.25 and 0.5 to 0.375

 

[Jill & Scooter]

Hi and welcome! It sounds like you are drawing up the dose just right. It’s not necessary to roll the pen before you draw your dose up. Other insulins will settle a little and need to be rolled, but Lantus doesn’t do that. It’s also not necessary to warm it.
You are off to a great start testing. As Justin said, Missy hasn’t been on Lantus long enough to know what she will do. .25 is a lower dose than what is usually started with, but maybe your vet had a reason for it.
Keep testing and see where Missy is in a few more days. It’s recommended to hold the starting dose for 5-7 days. Keep posting and the very knowledgeable people here will help with dosing and anything else!

 

[Idjit's mom]

Priya, good morning to you and Missy. Would you consider getting a ketone meter so that you can test Missy's blood for ketones instead of trying to get a urine sample? Some of our members use the Keto Mojo or the Nova Max. There are other brands out there also, I'm sure. The ketone strips are spendy, but you would have the peace of mind knowing the ketone values.

The ReliOn Confirm and Micro meters from Walmart have been discontinued (groan) and it's dicey to try to find the correct strips for them. The Arkray Glucocard 01 is the same meter/strips but they are discontinued also. Some members have found strips here and there, but the supply is getting thin. You may want to consider getting another meter that you can readily get strips for locally.

 

[Priya&Missy]

How long ago was the steroid trial? 417 is fairly high and if that was going on for a bit and the 200s could be causing the bouncing.

7 lbs is fairly small so a smaller dosage is appropriate. Past dosage is important but you potentially have to start from scratch and work back down. But it's definitely smart to play it safe. Like I said I'm not familiar with pens but how fine can you get the dosing? Might need to get some calipers to help but when dealing with such small dosages, and knowing that 0.5u was too much at one point, you might want to consider doing smaller increases if necessary, like going halfway between 0.25 and 0.5 to 0.375

I took her off the steroids August 7 because a blood test revealed a glucose of 256 and the oncologist agreed it wasn’t a good idea for Missy to be on them. I’m using a syringe with the pen the same way you would with a vial so it’s the same in terms of dosage. I’m able to see a halfway mark between 0 and 0.5 pretty well, I think... haven’t tried a magnifying glass or anything.

 

[Priya&Missy]

Priya, good morning to you and Missy. Would you consider getting a ketone meter so that you can test Missy's blood for ketones instead of trying to get a urine sample? Some of our members use the Keto Mojo or the Nova Max. There are other brands out there also, I'm sure. The ketone strips are spendy, but you would have the peace of mind knowing the ketone values.

The ReliOn Confirm and Micro meters from Walmart have been discontinued (groan) and it's dicey to try to find the correct strips for them. The Arkray Glucocard 01 is the same meter/strips but they are discontinued also. Some members have found strips here and there, but the supply is getting thin. You may want to consider getting another meter that you can readily get strips for locally.

I’ve spent about $1,000 just in the last few days for her care so I’m pretty tapped out. Don’t think I can get a ketone meter & strips right now. Chemo is expensive and she just had an x-ray done too. I’ll think about it

I’m sad they’re discontinued! I bought a 200 pack of the Arkray glucocard01 strips and they should be here by this evening. Is there another meter you recommend that’s affordable and can be bought in stores?

 

[Idjit's mom]

I would grab as many of the Arkray Glucocard 01 strips as you can, and please tell me where you got them!!!!!! My husband uses the Confirm too and I only have one reserve bottle of 50 left.

I am thinking we will get the ReliOn Prime from Walmart to use next. It takes a slightly larger blood sample, but the strips are available and I don't have to order online and wait for delivery. The Prime is about $9, and 50 strips are about the same price, so it's definitely affordable.

 

[Priya&Missy]

I would grab as many of the Arkray Glucocard 01 strips as you can, and please tell me where you got them!!!!!! My husband uses the Confirm too and I only have one reserve bottle of 50 left.

I am thinking we will get the ReliOn Prime from Walmart to use next. It takes a slightly larger blood sample, but the strips are available and I don't have to order online and wait for delivery. The Prime is about $9, and 50 strips are about the same price, so it's definitely affordable.

I bought them directly from the ADW diabetes website!

 

[Idjit's mom]

Thank you very much! Will try to snag some more. I really like the Confirm and would like to continue to use it as long as possible.

One additional thought, to save you some $$. Many of our members that use Lantus, Levemir and Basaglar get them from Marks Marine Pharmacy in Canada. Cost is 1/3 to 1/2 of prices here in the states.
https://rxcanada4less.com/
If you get the 5 pens, that's your yearly supply and you could cross off another worry/concern from your list.
Vet can fax the Rx, or you can get a written Rx and mail it. This sugar dance can be a bit spendy, plus you have the added chemo etc. Bless that fur baby's heart.

 

[Priya&Missy]

Thank you very much! Will try to snag some more. I really like the Confirm and would like to continue to use it as long as possible.

One additional thought, to save you some $$. Many of our members that use Lantus, Levemir and Basaglar get them from Marks Marine Pharmacy in Canada. Cost is 1/3 to 1/2 of prices here in the states.
https://rxcanada4less.com/
If you get the 5 pens, that's your yearly supply and you could cross off another worry/concern from your list.
Vet can fax the Rx, or you can get a written Rx and mail it. This sugar dance can be a bit spendy, plus you have the added chemo etc. Bless that fur baby's heart.

Thank you, I appreciate it. She’s been through so much - several hospitalizations and close calls and I have her on fluids everyday as well as multiple medications and supplements to manage all her issues (anemia, arthritis, pancreatitis, hypertension, ckd, diabetes, cancer) AND she’s old! She’s a fighter for sure.

I was able to get a pen from Costco with a goodrx coupon for only $65!

 

[Idjit's mom]

Thank you, I appreciate it. She’s been through so much - several hospitalizations and close calls and I have her on fluids everyday as well as multiple medications and supplements to manage all her issues (anemia, arthritis, pancreatitis, hypertension, ckd, diabetes, cancer) AND she’s old! She’s a fighter for sure.

I was able to get a pen from Costco with a goodrx coupon for only $65!

Oh my, she has been through a lot! And so have you taking such good care of her. I know about being old, it's no picnic! LOL

Good on you for getting such a good deal on the Lantus pen. It sounds like you are doing everything possible under the sun to get her through and ease every day. I'm so glad you are here and will let us share in the journey, and let us love her too.

 

[Priya&Missy]

Oh my, she has been through a lot! And so have you taking such good care of her. I know about being old, it's no picnic! LOL

Good on you for getting such a good deal on the Lantus pen. It sounds like you are doing everything possible under the sun to get her through and ease every day. I'm so glad you are here and will let us share in the journey, and let us love her too.

It’s been stressful but it’s worth it. I love her so much. She got me through some really dark times and saved me, the least I can do is return the favor

 

[Idjit's mom]

Beautiful elegant cat lady! Give her some lovies for me, please.

 

[Sue and Luci]

She's a beautiful girl! You're such a good mama too! Sounds like you're doing everything possible for your girl

 

[Jill & Scooter]

She’s gorgeous! Give her some cuddles for me!

 

[JoyBee&Ravan]

Missy is a beautiful Kitty! How old is she? What type of Cancer does she have & what type of chemo does she get?

My Kitty Peggy Sue has Oral cancer & she's getting Chemo shots once a week. The chemo is Carboplatin & it's mixed with purified Sesame oil & injected into the tumor.
She's doing good. She's very thin but eats several times a day & is still enjoying life! She gets CBD OIL (Paws by Charlotte's Web) which is for pain & inflammation. It also gives her a good appetite!

Missy's glucose is not bad for such a small dose. It could be the steroids are still affecting here #'s.

I've been here for 18 months My other cat Ravan has diabetes. I don't feel I have enough experience to give dosing advice. Be careful ,everyone wants to help but I would only take advice for the people here that have more experience,like a few years.

Missy is getting such a small dose I wouldn't buy 5 pens. You can use the insulin in the pen to the last drop. My pen last's me over 3 months. (And you never know if she just might go into remission. )

When shooting the insulin you don't need to tent or pinch the skin. I don't shoot into the scruff, I use his side. I part his fur till I see the skin & insert the needle at an angle,just under the skin. Lots of area so you can shoot in a different spot each time.

I've been using the Relion Prime Meter & strips. Like Idjit's mom said, They're inexpensive & I've never had a problem in 18 months. The relion syringes , 3/10 mL 31 gauge 8mm short needle have 1/2 unit marks on them.

The site of insulin injection is important. In cats, the scruff has commonly been used as an injection site.This location is not ideal because of low blood flow & increased fibrosis caused by repeated injections. A better option is to administer the insulin along the lateral abdomen. The area should be rotated daily to prevent fibrosis at an injection site


Best of luck with Missy! Ask Lots of questions & try to read the yellow sticky notes. Lots of good info. (you forgot to put the Date you joined And when you post always include the date. Most of us post every day to keep in touch & ask questions)

You'er doing Great.

 

[Sienne and Gabby (GA)]

Welcome to the group!

I suspect your meter is just fine! You may want to replace the batteries, though.

If Missy has not. had a history of developing ketones or DKA, I would not be hugely concerned with buying a ketone meter. If you can test for urinary ketones, that should be fine. Given all that she's dealing with, I would test for ketones on a daily basis, especially if she develops an infection, a pancreatitis flair, or isn't eating.

Hopefully, since this was steroid induced, you'll be able to get Missy back into remission.

 

[Priya&Missy]

Missy is a beautiful Kitty! How old is she? What type of Cancer does she have & what type of chemo does she get?

My Kitty Peggy Sue has Oral cancer & she's getting Chemo shots once a week. The chemo is Carboplatin & it's mixed with purified Sesame oil & injected into the tumor.
She's doing good. She's very thin but eats several times a day & is still enjoying life! She gets CBD OIL (Paws by Charlotte's Web) which is for pain & inflammation. It also gives her a good appetite!

Missy's glucose is not bad for such a small dose. It could be the steroids are still affecting here #'s.

I've been here for 18 months My other cat Ravan has diabetes. I don't feel I have enough experience to give dosing advice. Be careful ,everyone wants to help but I would only take advice for the people here that have more experience,like a few years.

Missy is getting such a small dose I wouldn't buy 5 pens. You can use the insulin in the pen to the last drop. My pen last's me over 3 months. (And you never know if she just might go into remission. )

When shooting the insulin you don't need to tent or pinch the skin. I don't shoot into the scruff, I use his side. I part his fur till I see the skin & insert the needle at an angle,just under the skin. Lots of area so you can shoot in a different spot each time.

I've been using the Relion Prime Meter & strips. Like Idjit's mom said, They're inexpensive & I've never had a problem in 18 months. The relion syringes , 3/10 mL 31 gauge 8mm short needle have 1/2 unit marks on them.

View attachment 47679
The site of insulin injection is important. In cats, the scruff has commonly been used as an injection site.This location is not ideal because of low blood flow & increased fibrosis caused by repeated injections. A better option is to administer the insulin along the lateral abdomen. The area should be rotated daily to prevent fibrosis at an injection site


Best of luck with Missy! Ask Lots of questions & try to read the yellow sticky notes. Lots of good info. (you forgot to put the Date you joined And when you post always include the date. Most of us post every day to keep in touch & ask questions)

You'er doing Great.
View attachment 47680

Hi, I’m not sure on her age but I’m guessing between 15 and 17. She has a primary lung tumor and is on palladia, a chemo pill, every other day. Her tumor has stayed stable and cancer hasn’t spread. I’ve been using gabapentin for pain and cbd oil but she hates the taste. I’m glad your baby is doing well; mine is doing well too aside from the high blood sugar making her lethargic and the constant peeing and drinking water. She’s still eating well and snuggling up with me.

I agree, 5 pens is too much and I’m hoping she’ll go into remission soon so 1 pen should last quite a while on a small dose. I don’t use the scruff either, also because she gets subq fluids in that area and the skin is definitely getting tougher and scarred from daily pokes. I use the underside of her belly or the side.

Thank you, I’m trying my best to read all the links and keep up but it’s a lot of information and I’m also active in several Facebook groups so I’m more experienced with the kidney disease but less with the diabetes.

 

[Priya&Missy]

Welcome to the group!

I suspect your meter is just fine! You may want to replace the batteries, though.

If Missy has not. had a history of developing ketones or DKA, I would not be hugely concerned with buying a ketone meter. If you can test for urinary ketones, that should be fine. Given all that she's dealing with, I would test for ketones on a daily basis, especially if she develops an infection, a pancreatitis flair, or isn't eating.

Hopefully, since this was steroid induced, you'll be able to get Missy back into remission.

I’ll buy some batteries soon. The meter seems to be working just fine so far. I honestly don’t remember if Missy has a history of ketones because the initial diagnosis was 2.5 years ago and I don’t have any of the paperwork anymore. She was also seeing a vet that wasn’t knowledgeable and had just told me to go home and give insulin twice a day without testing... I switched vets after Missy almost died from that advice.

I hope she goes back into remission soon. It’s a lot to deal with this on top of the other issues. I feel like I’m starting over from square one and it feels hopeless.

 

[Idjit's mom]

I’ve been using gabapentin for pain and cbd oil but she hates the taste.

Idjit is experiencing discomfort and limping due to what we think is arthritis. I have gaba on hand, but it makes him goofy & wobbly, and so I bought CannaCompanion capsules. The capsules were not a success, as I either have to cut them and the powder spills out where he can smell and taste, or even when I tried to hide a whole cap in a piece of raw chicken he bit into it and left it on the floor. We did not attempt to try to get him to swallow the caps alone. I value my life.

We went to a CBD place here in town to look at transdermal pet CDB and the lady there told us about CBD isolate. It's a white powder, no THC, odorless, tasteless and the amount he gets is so minuscule I wasn't sure it would be effective. It was explained to me that CBD doesn't know if it's going into a human or animal and I guess that's true enough. Anyway, he's been on the exceptionally small dose 2 X a day in food for a week now and he's definitely in less pain/discomfort. Moving with much more ease and comfort. Might be an option for Missy.

 

[Sienne and Gabby (GA)]

I suspect you would remember if Missy had ketones/DKA. DKA is life threatening and usually involves several days in critical care. It's very expensive to treat since 24 hour monitoring is needed.

 

[Priya&Missy]

I suspect you would remember if Missy had ketones/DKA. DKA is life threatening and usually involves several days in critical care. It's very expensive to treat since 24 hour monitoring is needed.

I just double checked her files and she does not have a history of DKA. You’re right, I would definitely remember something big like that.

 

[JoyBee&Ravan]

The CBD that Idjit's mom uses sounds good. Just a pinch in her food & no taste.
I know the Paws CBD Oil that I use is definitely helping. I put it in a half teaspoon of Organic Chicken baby food & into a feeding syringe. It's such a small amount he just swallows it. I don't think he even tastes it.
I sure hope Missy does well. My Ravan is 17 yrs old & I don't consider that "Old" My last kitty lived to be 24 & I had several over the years that were in their 20's. Our animals are living longer just like people!

 

[Wendy&Neko]

Hello and welcome to you and your elegant girl. Depending which dosing method you decide to use, we hold the initial dose 5-7 days, to build the depot. Often cats out of remission need a higher dose than the first time on insulin, so don't be surprised if you end up at a dose that took her too low first time. Paws crossed this is a short stay on insulin.

 

[Priya&Missy]

Hello and welcome to you and your elegant girl. Depending which dosing method you decide to use, we hold the initial dose 5-7 days, to build the depot. Often cats out of remission need a higher dose than the first time on insulin, so don't be surprised if you end up at a dose that took her too low first time. Paws crossed this is a short stay on insulin.

Hi! We’re on day 4. I’m looking forward to seeing the spreadsheet after 7 days and reassessing. Today’s PMPS was lower than the last few days so it seems like it’s hopefully heading in a good direction. Thank you!

 

[Gill & George]

Hello and welcome
Your little girl has been through quite a lot and is lucky to have you batting for her side. It's hard with an a senior kitty.

I took her off the steroids August 7 because a blood test revealed a glucose of 256 and the oncologist agreed it wasn’t a good idea for Missy to be on them.

My George was given one shot of a long acting steroid and that knocked him out of remission, The Steroid stayed in his system for about 10 days and up until that point it felt like I was shooting water. You can see how that progressed with George in his SS he was a sea of red. It took a while but we got him back into good numbers quite quickly, and took our time going down the dosing scale into remission, I did dose him fairly aggressively right from when I first saw his BG levels rise 48 hrs after the steroid shot.
From what I read at the time Prednisolone is not long acting, so it would be well out of her system now as she stopped the steroids over a month ago, but she will need the insulin support to get her BG back into the normal range, just stopping the steroids is unlikely to see her go back into remission on her own.

It doesn't sound like you are doing anything wrong and it looks like you are getting insulin into her, but it's likely that you will need to go up in dose, just follow the guidelines and you will get there.
Regarding her feeling the shots, I'm wondering if with the angle you are going in at whether you might be catching muscle, I know that at times George would react to a shot and for the most it would be when he wriggled and I always figured I caught a bit of muscle and it hurt, if I got a clear shot under the skin he never felt it.
Another thing that might make it hurt is if you don't have the bevel on the needle facing the right way.
the image below shows the bevel, that needs to be facing away from the skin. I would tent the skin and insert the needle into the tent, keeping the needle parallel to the body with the bevel facing up.
(does that make sense?)
Back when we first started I didn't know about this and I would often get a complaint of George when I shot him, once someone pointed this out and I adjusted my technique we didn't get the ouchie shots.

 

[Priya&Missy]

Hello and welcome
Your little girl has been through quite a lot and is lucky to have you batting for her side. It's hard with an a senior kitty.

My George was given one shot of a long acting steroid and that knocked him out of remission, The Steroid stayed in his system for about 10 days and up until that point it felt like I was shooting water. You can see how that progressed with George in his SS he was a sea of red. It took a while but we got him back into good numbers quite quickly, and took our time going down the dosing scale into remission, I did dose him fairly aggressively right from when I first saw his BG levels rise 48 hrs after the steroid shot.
From what I read at the time Prednisolone is not long acting, so it would be well out of her system now as she stopped the steroids over a month ago, but she will need the insulin support to get her BG back into the normal range, just stopping the steroids is unlikely to see her go back into remission on her own.

It doesn't sound like you are doing anything wrong and it looks like you are getting insulin into her, but it's likely that you will need to go up in dose, just follow the guidelines and you will get there.
Regarding her feeling the shots, I'm wondering if with the angle you are going in at whether you might be catching muscle, I know that at times George would react to a shot and for the most it would be when he wriggled and I always figured I caught a bit of muscle and it hurt, if I got a clear shot under the skin he never felt it.
Another thing that might make it hurt is if you don't have the bevel on the needle facing the right way.
the image below shows the bevel, that needs to be facing away from the skin. I would tent the skin and insert the needle into the tent, keeping the needle parallel to the body with the bevel facing up.
(does that make sense?)
Back when we first started I didn't know about this and I would often get a complaint of George when I shot him, once someone pointed this out and I adjusted my technique we didn't get the ouchie shots.

I wish that I would’ve started insulin right away a month ago but the oncologist didn’t seem to think the diabetes was back and that it was just a temporary blood sugar spike from the steroids. I thought it would go back to normal after the steroids were out of her system so now I think she’s been unregulated for weeks which makes me feel awful. But I’m fairly confident I can get her back on track and I do agree that a dose increase is required soon.

I don’t think she’s feeling the shots so much as she’s getting irritated when I lay her on her side and start parting the fur and fumbling around for skin. She’s anticipating what I’m doing next and doesn’t like being touched in the tummy area.

That’s a good suggestion about the bevel. I know that’s important because I do subq fluids and always making sure it’s facing up but I totally didn’t think of that for insulin. I’ll make sure I do that if I’m not already.

 

[Gill & George]

I thought it would go back to normal after the steroids were out of her system so now I think she’s been unregulated for weeks which makes me feel awful. But I’m fairly confident I can get her back on track and I do agree that a dose increase is required soon.

I'm sure you will get her back on track.
The advice you got is nor uncommon, I'd been around on the forum enough to know that he would need insulin support, so I restarted insulin off my own back, vet wasn't involved.