Cat struggles against injections

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Dana

Dana

Member Since 2012
So my cat Max gets 2 units morning and night of Lantus. For the first few weeks he was really good about it, and he seemed to not even notice I was doing it. After a while he still let me do it, but a little swish of his tail each time let me know he was not terribly pleased. Then one day he bolted when the needle was in him and got insulin on his fur instead of in his scruff. Now it's gotten to the point where he jerks around when I try to inject and I have to sit lightly on his body while my boyfriend holds down his head and front paws. It's nerve wracking for all of us. I can tell Max is angry, but I'm not sure if it's pain or annoyance. I always move around the injection site on the scruff, but maybe he is getting sore?
I'm curious if any of you have had this problem and how you've dealt with it. I've tried poking him when he was eating and distracted but this didn't help.
Thanks for your input!
 
How is your injecting technique? Are you easily able to just pinch a tent and inject, or are you a little nervous about doing it? It could be that Max is picking up on your nervousness. If you need any help with technique, we could point you in the direction of some very helpful documents and videos.

Have you been rewarding Max with a treat after each shot? This will help him to associate the shots with the treats.

If you are rotating sites, and not just injecting in the same place each time, the likelihood is that it's annoyance as opposed to pain. I used to work from Cleo's front left flank to her right, then back to the left but further back, then the right, and just continue working down her flanks and sides, alternating from left to right, moving down towards her tail, and then starting at the front again.

My Cleo just hates having her movement restricted. When I first started doing her insulin shots I used to try to restrict her, and keep her still, stop her from moving. This caused more problems that it cured. I soon learnt to just approach Cleo wherever she was, get down to her level, stroke the back of her head, her neck, and then quickly pinch a bit of skin and inject her. Restricting her from moving just caused untold howling and yowling and growling. Not to mention swipes of the claws. It's this highly strung, fiercly independent oriental attitude that's to blame for Cleo being like this; she just has to have things her way, has to be the one in charge, and cannot stand being told what to do! However, within a few weeks I was injecting her whilst she was dosing, and she would barely even open one sleepy eyelid before drifting back off to sleep. It doesn't take long to make it become routine.

Do you test Max's blood glucose? How is he dealing with that?

I'm sure in a matter of weeks this will become second nature to both you and Max; in the meantime however, this is the right place to be to get support and advice. Please do post again with a bit more info, and let us know how things are going.

Best of luck,

H
 
Are you tenting the skin - lifting it away from the muscle - and injecting in the "tent"? If the goes into muscle or hits bone, it hurts a LOT. You only need to inject under the skin.

Also - are you testing his blood sugar levels? Have you made a diet change?

If your cat is feeling a lot better, he may not need insulin any more -- and struggling to let you know that. He may be getting too much insulin, and he knows that the shot makes him feel worse.

2u is quite a lot of insulin. My cat is well regulated on a much smaller dose of 0.5u BID.
 
Phoebe_Tiggy_NortonGA said:
2u is quite a lot of insulin. My cat is well regulated on a much smaller dose of 0.5u BID.
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Without knowing the kitty's BG numbers one can't really speculate upon such things. Every cat is different, and many cats take 2 units BID to become regulated. Of course, home BG testing is of utmost importance in order to ensure dosage is correct. But what it takes to regulate one cat may be massively different from what is needed to regulate another.

HOWEVER: Having said that, I completely agree; 2 units BID is a very high starting dose - has this dosage been worked up to gradually, or was this the starting dose prescribed by the vet? Was this based on a glucose curve taken at the vet's office or at home? What were the high and low points of that first glucose curve?

Again, 2 units BID is a very high dose to be starting out with. Please ensure you are BG testing, as the risk of a hypo in such a situation is high if you are not regularly monitoring glucose levels.

H
 
There's a few things you could try.

If you're using a larger needle like 29 gauge, try using a 31 gauge. The bigger the number, the smaller the needle. 31 is the smallest you can get.

Try using short 8mm needles instead of longer half inch ones.

When you pull the skin up to tent, make sure you're injecting PARALLEL to the cat's body, not straight down into the tent.

If he's a good eater, shoot him while he's eating. It will keep him still and distract him from the annoyance of the needle.

Good luck!
 
I don't think the snide was necessary... I know what Helene is trying to say...

2u is a big starting dose. No argument there. We don't recommend starting at more than 1u.

But 2u is not a big dose *IF* you know your cat needs that much insulin. Some cats need more insulin, some less. But since Dana is NOT testing and started at this dose, we DON'T know her cat needs that much.

But her cat also weighs 16 pounds and is eating canned m/d at 14% carbs so that may be preventing him from crashing at 2u.
 
Phoebe_Tiggy_NortonGA said:
Thank you very much, Helene, for disagreeing, then agreeing with me. This is very confusing for newbies.

Have a lovely day -
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To avoid any confusion that could apparently be surmised from my above post, I will reiterate:

I disagree with sweeping generalisations such as "x amount is too high, as my cat only needed y amount", especially when BG figures and Hx/ Dx/ Rx info are not available. However, I do agree that if it is the case that 2 units BID has been prescribed from the outset, with no apparent reasoning behind such a decision, it may be very likely that this is too high a dose.

Hence the request for further information and BG tests, if they are available. And if BG testing has yet to be commenced, hence the strong persuasion to begin BG testing as soon as possible.

Once these further details are available, one might be better placed to determine if a dose is appropriate or not. In the meantime, home BG testing is the most important thing anybody in this situation could do, and it should be started immediately.

As Ry stated, the details of this cat's weight and diet will of course contribute to that fuller picture, that which at present we are still slightly lacking.

I hope this has clarified any perceived ambiguity.

H
 
Hi all! Thanks everyone for the feedback.

This was particularly helpful:
Ry & Scooter said:
There's a few things you could try.

If you're using a larger needle like 29 gauge, try using a 31 gauge. The bigger the number, the smaller the needle. 31 is the smallest you can get.

Try using short 8mm needles instead of longer half inch ones.

When you pull the skin up to tent, make sure you're injecting PARALLEL to the cat's body, not straight down into the tent.

If he's a good eater, shoot him while he's eating. It will keep him still and distract him from the annoyance of the needle.

Good luck!
Click to expand...

I will pay extra attention to being parallel (maybe my technique has gotten sloppy!), and try right when I give him food. As far as needles, the ones I'm using are 31 and pretty short. Had to check that though :-D Part of the problem might be that he's started grazing more rather than eating the whole can at once, like he did when he first started canned. Back then I would shoot him up about half way through the meal to make sure that he was going to eat and not get hypo, but now I try to do that and he stops eating like a quarter of the way through the can. He eats one can twice a day, btw.


Please allow me to clarify all that has happened since my original post.
Yes, Max is a bit over 16 lbs. He started on 2 units and then I took him into the vet for the glucose curve. The vet decided to up the dose to 3 units, which I was nervous about, but I upped it anyway. A few days later he was vomiting and had diarrhea. I took him back to the vet and they ran hundreds of dollars of blood tests, which I was visibly frustrated about and the vet seemed to realize this, because after about 45 minutes sitting and waiting for the results, this other vet came in. He was awesome, he was very reassuring and he actually suggested I buy a blood monitor so that I could manage him at home with him on the phone! I was so relieved, and I got the monitor. We changed the food to i/d which is for cats with sensitive tummies and I got him on some probiotics and backed off on the insulin and the diarrhea and vomiting stopped. We had to work back up to 2 units per meal. His blood sugar is usually about 200-220 in the morning and around 180-220 in the evening with the 2 units, so I'm not really worried about him crashing, but I always check.

I do feel like Max and I are in much more capable hands now. The other vet totally blew me off when I asked her about home testing. This one suggested it all by himself, and for a few weeks called me every morning to ask about Max's numbers. Obviously he can't do this forever because he's not charging me for it and he has a lot of other patients, but I thought that was really cool.

Anyway, my question about the struggling. He is really good about the ear pricking. He's obviously not a fan but he tolerates it. As for the injections, I was doing it fine, and for weeks he was tolerating it, and I never restrained him, cause he hates that and I didn't have to. I always take the Lantus out of the fridge a bit before and warm it up in my hands and stuff. And I was never nervous about it until she started the twitching, so I don't think that was what caused it. So I dunno. Maybe I should try it in other places. I know those are supposed to be better injection sites anyway but I also hear they hurt more.
 
Hello Dana,

Here are some good pics about how to inject your cat. :smile:
http://www.sugarpet.net/injecting.html

I think, if your cat is resisting then maybe either you're hurting him (injecting into muscle maybe instead of just under the skin), or he doesn't like being restrained (or both!)

Injecting into the scruff itself should not hurt your cat. There are very few nerve endings there.

The pics in the link I posted above show the 'tenting' method. You yank the skin up away from the muscle and shoot directly into that 'tent' of skin that you've made.

My own method differs slightly because I shoot my cat while he's eating and I'm standing over him. I give my cat a little of his favourite food and then give him the shot immediately he starts to eat. I get hold of some skin on his scruff between my fingers and thumb, pull it up firmly, and shoot directly downwards into the skin between my fingers and thumb.

Whichever way you do it the important thing is to lift the loose skin away from the muscle below. Don't be afraid to yank it way up. And while you're doing it, don't think about anything else. Give the insulin shot your full attention.

You will get the hang of it. And so will your cat. ;-)
 
I'm doing all these things right according to the instructions, and how my vet said. :? Like I said, he used to not even notice and now he tries to run away. I guess I'll give other injection sites a shot. No pun intended :lol:
 
Another thing you could do is change insulin from Lantus to Levemir.

please read the comparison sticky about Lantus and Levemir and print it for your vet.

In brief - Lantus is acidic and some human diabetics have mentioned that it stings when injected.

Levemir is an excellent insulin that is similar in action to the Lantus - and best news - it is NOT acidic and it does not sting when injected. A bonus is that after opening a cartridge or vial - it is good longer than Lantus, so the cost in the long run is better.
 
Our kitty mocha HATED her shots. Literally hated them. Spotchecks, no problem at all .. but mocha knew exactly when it was shot time or spotcheck time .. and if it was shot time, she'd run from us, dodge us, hide from us, terrorize us, you name it, she did it. It was a battle every single day .. but we did it .. I had to hold her tight to my chest, kinda like, her side to my chest, with her face looking behind me, and then peter would give her the shot in her side facing him .. It was the ONLY way we could get her shots done .. and we tried everything .. the burrito method, the trying it in a different room so she wouldn't know it was coming, the putting food directly in front of her, giving her treats, praising her, anything and everything you could think of, we did .. and it failed. BUT, with me holding her, we got the job done, and that was what was most important, you know? It wasn't conventional, but it got done!
 
Something changed. If a cat is fine with the dose, the method, and the food for weeks, then suddenly avoids shots, something's changed. Is the food the same, the shot times are the same-every 12hrs, the syringes the same?

Cats are smart and if you give them something that will make them feel badly, hypo, chances are that they will avoid it.

I agree with the dose of 2u being high, unless the cat started at a lower dose like 1u or .5u, then increased based on some BG numbers indicating the dose was still not bringing the BG down low enough.
A test at the vet is unreliable, as are the majority of curves at the vet office because of just the stress alone. One of my cats ALWAYS tested higher at the vet office, and another sometimes tested lower at the office. When they got home, after about 30min, their BG went back to a normal and true number for them.

I would ask if home testing is being done, and if yes, can you please provide the BG numbers you have. If not home testing, it would be a good idea to start because you may find that your cat is going very low, then bouncing and feeling like crap.

One of my cats was very jumpy on Lantus but she was much better, more relaxed, when I switched her onto Levemir. Switching to Levemir at some point may be a consideration if you can find no problems with your method.

Without knowing the cat's BG numbers, no one can say what is the problem.
 
I do want to add in that mocha was like that from shot number one, she wasn't ever fine with shots :lol: And that attitude from her lasted two entire years!! Right up till her last shot of insulin!
 
Inserting the needle bevel side up will hlep the needle slide in effortlessly and cause minimal pain, if any. Also be sure to check that the needle is completely smooth before you even draw up the insulin. I once had an insulin syringe that had a completely bumpy needle :shock:
 
You're using a new needle for each shot, correct?

I see that you're testing per-shot ... are you also getting mid-cycle tests? If so, what are you seeing for a nadir (low point in the cycle)?

Are you using the same box/package of syringes that you started with or are you using new/different ones? Are they U-100 syringes?
 
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