5/16" Needles

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TreeburnerCT

TreeburnerCT

Member Since 2018
I just started home BG testing today and started my 16 year old cat Amber on 1 unit of Humulin-N. I realize this is not the ideal insulin, but nothing better was available OTC and that's what the vet prescribed (after being very rude about me wanting to do this at home).

Her blood sugar at 8:15 this morning was 284 on an Alphatrak2 meter so I fed her and then at 9am I gave her 1 unit of Humulin-N for the first time.

However, giving the injection was harder than I expected because all I have is the short 5/16" needles. I felt it pop through the skin and there didn't appear to be any wetness afterwards, but it's hard to tell with such a small amount of liquid.

Are 5/16" needles long enough and I just need to get more comfortable with the technique, or do I need longer needles to get through all that hair and then skin more easily?

Thanks,
Joe
 
Welcome, from someone else with a 16-yr old Amber cat!

5'16" length is pretty standard, you actually don't want them really long because then they can poke out the other side of the "tent". That said, it depends on how you are doing the shot and where you are shooting. How did your vet demo the technique for you?

I've never used Humulin-N, so I don't know if it has any distinctive odor, but if it does, you can see if you did a "fur shot" by sniffing the shot area afterwards.
 
Ugh, unfortunately I think that's what happened as I can smell a medicine smell on her. The Vet wanted to do the regulation and curve at the office, however she's on vacation this week so her colleague was going to see Amber. However, when I explained after researching I wanted to do it myself and not put her through the stress the Vet (the colleague, not her regular Vet) gave me the prescription but was downright rude and said to take my business elsewhere despite me being very cool headed and presenting a very valid argument.

The regular Vet demonstrated how to do an injection but not with the syringe, so I'm having to learn on my own. Not going to restick her three hours late as that will throw off the schedule we're trying to get her on, but I'll have to be more careful to penetrate fully and not worry so much about going too deep.

Thanks so much for the info!

Thanks,
Joe

Amber by Joe Eckert, on Flickr
 
It's actually a benefit that insulin has such a distinct Band-Aid like smell. I always rub my fingers lightly over the injection site and smell them to see if I've missed. If in doubt I put my nose into Teasel's fur.

I'm sorry you received that treatment by the vet. It's based on ego and is inappropriate. If you like her colleague, your regular vet, it's worth having a calm, candid conversation about how you want to treat Amber's diabetes. If you demonstrate a willingness to learn all you can about testing, etc. and emphasize your need to give the best care you can within your financial constraints she shouldn't argue. It's so important to have a vet who'll work collaboratively with you. If that proves to be impossible you could try calling other practices to find out what their experience is with feline diabetes, owners testing at home, etc.

Re injections: I use half inch needles with no difficulty. Were you taught to inject in the scruff? If so, pull up firmly on her skin to make a taut "tent". Feel for the tent "door". That's exactly where you want to insert the needle in a straight ahead but very slightly downward direction. Work on perfecting that technique. Later on if necessary you can try other injection sites along her sides, especially if she has loose skin there.
 
She did demonstrated the tent technique on the back of the neck, but I used her side as I read blood flow in the scruff is poor. If it's alright to start there then move to the sides that would be easier as she didn't like me pinching her sides but has no problem with the scruff.

The BG testing, which I was more worried about, turned out to be simple once I did it right. I was touching the wrong spot on the strip to the blood, so stuck her like 10 times and went though 10 strips for a single test, which she just let me do with no problem. Once I realized the blood has to enter the side, not the front, I finally had no trouble and got her post food reading of 427.

Will be sure the insulin gets in next dose then monitor her BG overnight.

Thanks,
Joe
 
TreeburnerCT said:
She did demonstrated the tent technique on the back of the neck, but I used her side as I read blood flow in the scruff is poor. If it's alright to start there then move to the sides that would be easier as she didn't like me pinching her sides but has no problem with the scruff.

The BG testing, which I was more worried about, turned out to be simple once I did it right. I was touching the wrong spot on the strip to the blood, so stuck her like 10 times and went though 10 strips for a single test, which she just let me do with no problem. Once I realized the blood has to enter the side, not the front, I finally had no trouble and got her post food reading of 427.

Will be sure the insulin gets in next dose then monitor her BG overnight.

Thanks,
Joe
Click to expand...
Use the scruff for now until you're more confident in your technique. It's better than missing and putting insulin in her fur. :)
 
Getting extremely frustrated, just failed two more times in a row (I knew the first missed so I tried again) shooting for the scruff. The first time I thought for sure I was in, but left a wet smelly spot on the fur. So I cleaned her off and tried again, and thought for sure I had it in but she squirmed and when I withdrew the needle it was bent at a 45 degree angle and again, a wet spot.

I'm not trying again until the morning since I should have tomorrow off due to a large snowstorm, but how do you keep the tented skin from retreating from the needle when pricked? Any suggestions would be appreciated, she won't be seeing her Vet until next week at least so I really want to get her started before that and do the curve.

Thanks,
Joe
 
TreeburnerCT said:
how do you keep the tented skin from retreating from the needle when pricked?
Click to expand...
Pull the tent up as tautly as you can. The needle should slide in like it's going into butter. Are you using a new syringe for each injection? The needles get blunted quickly and can then be painful.
 
Absolutely, new needle for each injection. I'm a recovering IV drug user (12 years clean) so I know the damage reusing syringes can do. These 30g needles are just so fragile even though they're shorter than the 1/2" 29g which was my go-to for IV.

Am I trying to use my fingers behind the bunched skin as a backing to stick, or am I trying to inject into a roll so the skin is already being forced outward? I got the impression it's neither and you're just trying to create a wall of skin to stick, but that wall retreats when I try to stick it.

Thanks,
Joe
 
Are you holding the skin with one hand while you inject? I always "pinch" and create a tent with my left hand and hold it and brush away the fur so I can see a line of skin, then stick the needle with my right hand and push the plunger if that makes sense.
 
Yes I'm pinching the skin up into a tent, but I guess I'm having trouble because her fur is so thick. I'm going to try wetting it slightly tomorrow morning so I can separate the fur and see the skin rather than trying to poke through fur into skin.

Thanks,
Joe
 
Actually, you lift the skin straight up tautly. You aren’t using your fingers as a backing for the poke site. Once lifted up you should be able to feel a slight upside down V-shaped depression into the tent. That’s the tent door and that depression is where you poke the needle. You might find that 29 gauge needles are a little more robust. Also a half inch needle might work better. That’s what I use.

Some people get a vet tech to shave a small patch of skin so it’s easier to see the needle going in.
 
Congrats on the 12 year recovery.

I use 5/16" needles on Leo. I pull his skin out in a mini-tent then just plunge her on in. Works every time.

I used to use 1/2" needles. But they actually went through the tent a few times. Sorry to hear about your fur shot. When it happens you just have to wait it out until the next dose.
 
Thank you all for the compliments and all of the invaluable info.

So this morning I separated her fur with a wet paper towel, pulled a skin tent up and stuck the exposed skin. The needle seemed to slide in but I rotated slightly and pushed forward to make sure it was all the way in, then injected.

Afterwards I could smell the insulin slightly but I think that was from wetting the spot I missed last night. I don't see how I could have missed as I could see that the needle was in, so I think I was finally successful. The only way to know for sure is to do the curve and see if there is any response to the injection, but feeling a lot less frustrated at the moment. Now if 1 unit is too little I should still see some kind of response in her blood sugar, right?

Thanks,
Joe
 
Well the shot I thought for sure I got in had zero effect on her blood glucose values, so apparently I screwed it up again.

Tonight I'll try pinching so that I can shoot from her side instead of front to back, the fur seems to separate more when I do that. I feel so bad making her wait over and over to get the insulin in her successfully but I'd hate to have her spend days at the Vet to get started only to have her stressed and still have this trouble when she gets back, plus with her Vet on vacation seeing the other Dr. is not an option. At least she's been really good about letting me do everything.

-Joe
 
Don't get discouraged. One of the frustrating things about all of this is that it's not always as simple as "insulin in, BG down". There are lots of things going on physiologically. One of the most confusing is that, if BG drops, the cat's body has countermeasures to bring it back up (we call this "bouncing"). Bounces can last up to three days in particularly bouncy kitties. That's one reason we encourage people to set up a spreadsheet to record data-- a lot of the patterns are only evident over time. Instructions for the spreadsheet template we use are HERE.

In the meantime: what was Amber's BG this morning? What was it when you just tested, and how many hours was it after the shot?
 
Amber's BG at 7:30 before feeding was 374, she was then fed her regular food and at 8:20 her BG was 427. I gave the injection of 1 unit at 8:30
and at 10:00 checked again and her BG was 446.

On a positive note the "convenient" injection of antibiotics and/or the Cerenia seems to be working as she's back to eating good, and she doesn't seem stressed at all about me poking and prodding her.

Will keep checking her BG throughout the day and hopefully things go better later.

Thanks,
Joe
 
OK, that's really not bad at all!

The higher number at 8:20 is probably due to a food bump. The 446 at 10:00 an hour and a half after the shot (in our usual notation, that's +1.5-- we're all in different time zones here!) is more or less the same as 427, but that's not long after you'd expect the insulin to start to kick in. Many cats would have already started dropping by then, but every cat is different. And, again, without knowing what's been going on over the last few days, for all we know she's in a "bounce" period right now anyway.

I think Humulin-N usually sees peak activity between +3 and +6, so definitely get a test in during that period so we can see if there's going to be any action today.
 
Oh, and good news that you have an "easy" cat to poke! That always makes it less stressful all around.

Was the antibiotic called "Convenia", by any chance?
 
TreeburnerCT said:
Ugh, unfortunately I think that's what happened as I can smell a medicine smell on her. The Vet wanted to do the regulation and curve at the office, however she's on vacation this week so her colleague was going to see Amber. However, when I explained after researching I wanted to do it myself and not put her through the stress the Vet (the colleague, not her regular Vet) gave me the prescription but was downright rude and said to take my business elsewhere despite me being very cool headed and presenting a very valid argument.

The regular Vet demonstrated how to do an injection but not with the syringe, so I'm having to learn on my own. Not going to restick her three hours late as that will throw off the schedule we're trying to get her on, but I'll have to be more careful to penetrate fully and not worry so much about going too deep.

Thanks so much for the info!

Thanks,
Joe

Amber by Joe Eckert, on Flickr
Click to expand...
She’s beautiful
 
I checked her at noon and she was at 495 but she had just finished her morning food, and I will get it again once she wakes up since she will not have eaten for a while. It really seems like the needle just isn't penetrating deeply enough, I don't understand why I'm having so much trouble. I did order 1/2" 29g needles that should be here Friday but I really hope I can get this right tonight. Thanks for everyone's concern, I don't have my computer here with me but will fill my data in on the spreadsheet once I do.

Thanks,
Joe
 
She hasn't, I've been trying since yesterday morning but have not gotten an injection in successfully yet. I did however get some low carb wet food, and despite usually turning her nose up at anything pate she actually gobbled it up! Time to try again shortly, hopefully the 5th time is the charm.

Thanks,
Joe
 
This time I pulled the skin even harder to try to make it more taut so it wouldn't retreat from the needle, and I went further down the tent away from my fingers. It looked like I was in and I don't see any oily/wet spot on her fur, I do smell insulin but I couldn't get that smell off her from the earlier misses and it doesn't smell strongly so I think I finally got it.

Amber is LOVING the FF Classic Beef Feast, she usually won't eat anything without gravy but I guess we just never tried the right one.

Thanks for all the help and encouragement, hoping I got it squared away now but I am looking forward to trying the longer spikes.

Thanks,
Joe
 
I gave Amber the other half can of the FF Classic Beef Feast at 8:45p and she gobbled that up as well, I didn't want to withhold her dry yet but she hasn't eaten any of that yet and I just tested her at 9:30p and she's at 362, a good sign finally! I'm going to check her every 2 hours overnight and hopefully that will give me some idea of how she responds to the Humulin-N.

Thanks everyone for the info and compliments on my baby!

Thanks,
Joe
 
It would be helpful to you and us if you did a spreadsheet. That way we can map the patterns over time. And it will help determine safe dosing increases.

You don't have to do it permanently, but it does help in the beginning to get the patterns established.
 
Amber's current spreadsheet is up. I could see the response of the successful injection, but it didn't have enough effect. She ate another new food, Purina One Grain-Free Classic Beef, so I'm really happy to see my picky eater has gotten less picky with the new dietary requirements. I'm going to give her 1 unit tonight since I won't be here but tomorrow I'm going to up her to 1.5u and pop home a couple times from work during the day.

Thanks,
Joe
 
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