First time giving insulin and a bit overwhelmed

[missMeows]

Hello all!

I'm very happy to have stumbled upon this forum. I'm getting so much mixed information and am just getting so confused and overwhelmed.

My 11.5 year old kitty, Angel (aka- Miss Meows), had been diagnosed about 2 months ago. I spent the last few weeks working out what food I wanted her to be on before I started her on insulin since I read that changing food while on insulin is a no-no. I brought her in last night to the vet and she was prescribed Lantus at 1 unit twice a day. When I went to the pharmacy to get it filled, I was under the impression that this insulin (as mentioned from a previous vet visit) would be expensive but they had a 6 month size vial for $300, or the 1 month size vial for $50. I was hoping to grab the $50 but the pharmacist said there was no such thing! So I took deep breaths and said ok... I'll get the $300 bottle, at least it's a 6 month supply. Then after reading some posts this morning with people mentioning expiration dates on the insulin, I looked at mine and it says 28 days! Twenty-eight days for $300! OMG, I'm about to cry How do you all deal with the cost that goes into this??? I honestly want whats best for her but ::breath:: I'm overwhelmed...

Not only that, but giving my little kitty insulin breaks my heart. I'm ok with the whole process, but she is not. And I was hoping someone could give me some extra advice. She really doesn't like me making that "tent." I tried giving her insulin for the first time this morning while she was busy eating breakfast (her favorite thing ever) and she tried running away while the needle was in her back. I didn't get the chance to pull the syringe back to see if there was blood or air. I just injected it. I think I got it all good, but this is awful. I'm thinking of maybe trying to make breakfast and dinner the reward for the insulin, but can I give it before she eats? We are considering maybe creating a spot where we put her (like on a table) so she knows what's to come and it gives her some sense of routine. Has anyone tried that? Does it have to be while or after she eats in order to do that?

Also, she seems to be drinking a lot more today. Is that typical after they start insulin?

I guess my last question is, and I saw some mentioned in other posts but the recommendations seem a little out dated, but can I get a good recommendation on a glucose monitor? I was looking at them yesterday at the pharmacy but I don't know what to look for in a good one. And all that jargon was just so darn confusing.

Thank you so much, in advance, for your time. I'm hoping this gets easier as time progresses.

 

[Stacym20]

Welcome and yes, breathe!

The 28 day expiration is required to be noted for humans as Lantus is a human insulin. Some will say a vial lasts anywhere from 3-6 months in a cat and some have even used every last drop of a vial. I think your vet must have been talking about the pens when he mentioned the one month supply. The pens come in a box of 5 but sometimes you can find a pharmacy that will sell a single pen. Then you use the pen as a mini vial.

Giving the injection while Angel is eating and hopefully distracted is how most do it here. There is a "roll" method that you can use instead of tenting. I've switched to it recently with great success. I'll see if I can find the link in a bit.

The Walmart ReliOn micro or confirm are popular around here as far as glucometers go. You can use the Target up & up brand (rebranded on-sync) if you're a Target shopper instead.

Believe it or not, it does get easier with time!

 

[Louellen]

MissMeows, I'm in the same boat as you. In spite of having had a previous diabetic cat, it's been 10 years since I've had to inject insulin (I was also injecting other things as well as Topper required so many different things due to other health concerns as well that weren't diabetic related), I'm having to re-learn as things are changing. I didn't do home testing at that time as it wasn't recommended but, took Topper to the vets for his "curve" (meaning that they monitor his levels all day to see whether his dosage was ok or not). And, we didn't know very much back then either...especially about foods. We simply gave prescription diets (which weren't many back then) and hoped for the best. I always had a bottle of corn syrup in the fridge in case of a hypoglycaemic reaction but, never had to use it. Topper passed away with heart issues NOT the diabetes (separate health issues that the diabetes worsened but, didn't cause).

I'm learning as I go too and have decided to do what you're doing, change the food FIRST before going to the insulin with Morrigan (my nearly 10 year old cat, also newly diagnosed) so that the levels of insulin are titrated to the new food levels. It's HARD. I know. I'm going through the same angst that you are. I completely understand what you're feeling but, thankfully...there are good people here with loads of knowledge and I'm reading as much as my mind can take in at one shot (before I want to take up drinking )

If I were you, I'd take that 6 month supply back and they SHOULD give you a new bottle once they see that the expiration date is way before the 6 month mark. If they don't...raise heck! Refuse to accept that from them.

I remember with Topper, I clipped a bit of fur in 2 or 3 areas so that when I made that "tent", I could easily see the skin. Meaning that I clipped fur just below an area of longer fur where I could use it to pull up the skin into that tent. I was like you. I never got the time to pull back and check for blood etc.. I'd make sure that I got all of the air bubbles out of the syringe with a couple of finger flicks (as the needle was in the bottle) and push out the excess until the bubbles were gone then, just inject and check to make sure (with a quick feel over the fur) that I had gotten it in. Don't worry too much about getting all of this criteria down and able to be done with the first few weeks or even a month or 2. Just get that insulin in the best way that you know how. It's a learning curve for us and them. We all have to get used to it in steps. Nothing is going to be "text book perfect" and let's face it...if we didn't have the net and sites like this one to go to...we wouldn't know the difference. Thankfully, we do have this site and information available to us but...it can also be so overwhelming, can't it? I'm overwhelmed and I've done this before.

I'm sure more veteran diabetic cat moms and dads will chime in here and offer up more of their expertise as I'm relying upon the same help but, in the meantime, just get the shot in and do your best. As you get used to it, so will Angel. Trust me...they don't feel this as much as we think. Yes, it IS "heart breaking" to have to inject them twice a day but, it's eventually going to get to a point where she will not even notice it. It will become like second nature to her...eat and get a shot....done...continue eating. The hard part is on us! We have the emotion and feelings of "guilt" for sticking them but, they don't feel it much. Really! They eat, get an injection then go on to play or sleep or whatever they usually do. It's us who lay awake, trembling, crying or whatever, wondering if we're doing it all right. Want to join me in taking up drinking for a bit? (joking) Just do your best and rest with the idea that you got the insulin into her but, DO take that $300 vial back and INSIST that they give you the proper date to match the 6 month supply! 28 days doesn't cut it and I'm sure, once you point that out to them...they will have no problem giving you one that isn't out of date.

I'm sure other members will help you...it's just that it's Easter Weekend so, a lot of people are likely busy and not on the net as much as usual. Hang in there and just get her shots into her. You're likely at a low dosage right now anyway so, just do your best to remain relaxed and calm and let Angel and you get used to the entire procedure first...THEN...if you want to...you can become more proficient at doing the rest of the fancy work.

Hope this helps and that you go easy on yourself with this. Trust me...it's harder on us than it is on them!

 

[Stacym20]

Here's the link that describes the roll method: http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

 

[missMeows]

MissMeows, I'm in the same boat as you. In spite of having had a previous diabetic cat, it's been 10 years since I've had to inject insulin (I was also injecting other things as well as Topper required so many different things due to other health concerns as well that weren't diabetic related), I'm having to re-learn as things are changing. I didn't do home testing at that time as it wasn't recommended but, took Topper to the vets for his "curve" (meaning that they monitor his levels all day to see whether his dosage was ok or not). And, we didn't know very much back then either...especially about foods. We simply gave prescription diets (which weren't many back then) and hoped for the best. I always had a bottle of corn syrup in the fridge in case of a hypoglycaemic reaction but, never had to use it. Topper passed away with heart issues NOT the diabetes (separate health issues that the diabetes worsened but, didn't cause).

I'm learning as I go too and have decided to do what you're doing, change the food FIRST before going to the insulin with Morrigan (my nearly 10 year old cat, also newly diagnosed) so that the levels of insulin are titrated to the new food levels. It's HARD. I know. I'm going through the same angst that you are. I completely understand what you're feeling but, thankfully...there are good people here with loads of knowledge and I'm reading as much as my mind can take in at one shot (before I want to take up drinking )

If I were you, I'd take that 6 month supply back and they SHOULD give you a new bottle once they see that the expiration date is way before the 6 month mark. If they don't...raise heck! Refuse to accept that from them.

I remember with Topper, I clipped a bit of fur in 2 or 3 areas so that when I made that "tent", I could easily see the skin. Meaning that I clipped fur just below an area of longer fur where I could use it to pull up the skin into that tent. I was like you. I never got the time to pull back and check for blood etc.. I'd make sure that I got all of the air bubbles out of the syringe with a couple of finger flicks (as the needle was in the bottle) and push out the excess until the bubbles were gone then, just inject and check to make sure (with a quick feel over the fur) that I had gotten it in. Don't worry too much about getting all of this criteria down and able to be done with the first few weeks or even a month or 2. Just get that insulin in the best way that you know how. It's a learning curve for us and them. We all have to get used to it in steps. Nothing is going to be "text book perfect" and let's face it...if we didn't have the net and sites like this one to go to...we wouldn't know the difference. Thankfully, we do have this site and information available to us but...it can also be so overwhelming, can't it? I'm overwhelmed and I've done this before.

I'm sure more veteran diabetic cat moms and dads will chime in here and offer up more of their expertise as I'm relying upon the same help but, in the meantime, just get the shot in and do your best. As you get used to it, so will Angel. Trust me...they don't feel this as much as we think. Yes, it IS "heart breaking" to have to inject them twice a day but, it's eventually going to get to a point where she will not even notice it. It will become like second nature to her...eat and get a shot....done...continue eating. The hard part is on us! We have the emotion and feelings of "guilt" for sticking them but, they don't feel it much. Really! They eat, get an injection then go on to play or sleep or whatever they usually do. It's us who lay awake, trembling, crying or whatever, wondering if we're doing it all right. Want to join me in taking up drinking for a bit? (joking) Just do your best and rest with the idea that you got the insulin into her but, DO take that $300 vial back and INSIST that they give you the proper date to match the 6 month supply! 28 days doesn't cut it and I'm sure, once you point that out to them...they will have no problem giving you one that isn't out of date.

I'm sure other members will help you...it's just that it's Easter Weekend so, a lot of people are likely busy and not on the net as much as usual. Hang in there and just get her shots into her. You're likely at a low dosage right now anyway so, just do your best to remain relaxed and calm and let Angel and you get used to the entire procedure first...THEN...if you want to...you can become more proficient at doing the rest of the fancy work.

Hope this helps and that you go easy on yourself with this. Trust me...it's harder on us than it is on them!

Thank you Louellen for you kind words. Even though I know I'm not the only one in this mess, it really helps to here someone say it to you directly. After calming down a bit and reading Stacym20's reply, I called the vet and the pharmacy and they all agreed that the 28 days is a precaution for people, and I can keep the insulin in the fridge pretty much until it is used up. Phew! At least it doesn't seem like my kitty hates me all that much today. Just more annoyed that I dared bother her during breakfast ;-) I'm not testing her at home quiet yet, I need to get a glucose monitor and my vet wants me to come back in a week to check her levels at her 6 hour mark (meaning 6 hours after breakfast insulin) and she said she would go over glucose monitoring with me then. I think we will be ok. I spoke to my fiance today while he was at work and he calmed me down a bit too. Tonight should be easier because I'll have him help me keep her calm and happy. Thank you so much again for you kind words and I wish you the best of luck in your "relearning." I'm starting to feel like we can get through this

 

[missMeows]

Welcome and yes, breathe!

The 28 day expiration is required to be noted for humans as Lantus is a human insulin. Some will say a vial lasts anywhere from 3-6 months in a cat and some have even used every last drop of a vial. I think your vet must have been talking about the pens when he mentioned the one month supply. The pens come in a box of 5 but sometimes you can find a pharmacy that will sell a single pen. Then you use the pen as a mini vial.

Giving the injection while Angel is eating and hopefully distracted is how most do it here. There is a "roll" method that you can use instead of tenting. I've switched to it recently with great success. I'll see if I can find the link in a bit.

The Walmart ReliOn micro or confirm are popular around here as far as glucometers go. You can use the Target up & up brand (rebranded on-sync) if you're a Target shopper instead.

Believe it or not, it does get easier with time!

Thank you Stacym20, after I read your comment I called my vet and pharmacy and they both agreed with what you said. I'll talk to my vet when I see her next week to ask about the pens. That might be an easier, cheaper way.

I'll keep practicing the injections while she is eating and I'll try that roll method tonight. I saw the link you posted and it was super helpful. It broke everything down in a simple, non overwhelming way and I definitely needed to see that. I'll look into that Target brand glucometer, too! It's nice to see that there are somethings to do with FD that wont break the bank ;-) Thank you so much for your kind words, it really helped me calm the heck down ;-)

 

[Squeaky and KT (GA)]

Hi extra sweet Miss Meows and MamaBean (<-that's 'human' )! Welcome to the best place you never wanted to be!

First - insulin expiration date. ...(edited..) - says 28 days after opening...vial should not have that close of an expiration date. Most of us use the pens like a mini-vial instead - NOT with the pen needles tho so don't let the pharmacist sell you those! Those only dose in full units - we change cat's dosages by .25 units. If you look at the end after removing the cap, you'll find a small rubber seal just like the vials.

Just ask about the jargon when you find you that you don't understand - we sometimes forget to not use it when beginning initial explanations.

We even have a place for all your questions - the Main Health forum. There's lots of good information there and people just waiting to help!

The 'sugar dance' isn't hard - it's just different! Sweet girl will get used to all this very quickly and no, she's not going to hate you for it. Doc comes to me for testing when he hears his meter beep.

 

[Larry and Kitties]

irst - insulin expiration date. The vials are for humans and are dated for 28 days, you can't buy it dated months out.

I am confused by that statement. An unopened pen or vial can be used until (or really after) the expiration date on the vial/pen if kept refrigerated. That is typically one or two years after purchase.
However, once you start using the via;/pen the manufacturer says it is good for 28 days for Lantus and 40 days for Levemir. That is with it refrigerated or not. For the pen, they specifically say do not refrigerate after you start using a pen. All of us here do refrigerate our in-use pens.

 

[Squeaky and KT (GA)]

I am confused by that statement. An unopened pen or vial can be used until (or really after) the expiration date on the vial/pen if kept refrigerated. That is typically one or two years after purchase.
However, once you start using the via;/pen the manufacturer says it is good for 28 days for Lantus and 40 days for Levemir. That is with it refrigerated or not. For the pen, they specifically say do not refrigerate after you start using a pen. All of us here do refrigerate our in-use pens.

My bad Larry! You're right! It's 28 days after opening...<...insert BIG embarrassed face here...>


.

 

[Louellen]

Here's the link that describes the roll method: http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

Thank you, Stacey for that link for me as well! I'm going to try this method.

 

[Wendy&Neko]

Welcome! And here is a post on Info, Storage and Handling of Lantus.

 

[missMeows]

Hi extra sweet Miss Meows and MamaBean (<-that's 'human' )! Welcome to the best place you never wanted to be!

First - insulin expiration date. ...(edited..) - says 28 days after opening...vial should not have that close of an expiration date. Most of us use the pens like a mini-vial instead - NOT with the pen needles tho so don't let the pharmacist sell you those! Those only dose in full units - we change cat's dosages by .25 units. If you look at the end after removing the cap, you'll find a small rubber seal just like the vials.

Just ask about the jargon when you find you that you don't understand - we sometimes forget to not use it when beginning initial explanations.

We even have a place for all your questions - the Main Health forum. There's lots of good information there and people just waiting to help!

The 'sugar dance' isn't hard - it's just different! Sweet girl will get used to all this very quickly and no, she's not going to hate you for it. Doc comes to me for testing when he hears his meter beep.

Thank you for the encouragement! Today and last night went better. We put her up on a table and fed her up there while giving insulin. I think the change of scenery helped distract her. Funny thing, she seems so affectionate lately. Even head bumping me when I got home last night. She never head bumps! I wonder if she's starting to realize that what we're doing makes her feel better? I dunno, but there is definitely a change.

Just a thought, but it might be neat to start a thread where people give their tip/tricks that made their cats tolerate or even like getting their shots. Your comment about how your little guy comes to you for testing seems like a fairy tail. I'd love to know what your secrete is!

One last question, this morning after giving her the shot, she smelled a little like what I'd imagine insulin smells like. I've pretty certain I didn't do a fur shot (the smell was by her head), have you ever experienced this? Is it worrisome? I'll check that Main Health Forum in the meantime!

Thanks again so much for your advice and kind words. This forum is helping me a ton!

 

[Squeaky and KT (GA)]

I'm grinnin that today and last night went better!!! May I ask YOUR name? We know sweet baby's but not yours.

The key - TREATS! Most of us use freeze dried chicken/turkey/shrimp available in the treat sections of most pet food stores. Only meat so no carbs! Give them after test and shots. Dakota isn't a big 'treat' cat but he (and me too) LOVES extra petting and snuggling - I use that instead of something edible now.

Most insulin smells like old bandaids... We've all done 'fur shots' but DON'T ever give more, you never truly know how much might have gotten in. Just mark it as such and give next shot at the regular time. I wouldn't worry about the smell unless it stays and you know it's not insulin then I'd track down it's cause. Could be ears or mouth issues...

Don't hesitate to ask questions when you run across something that confuses you!

See you over in Health!!!

HUGS!

 

[missMeows]

I'm grinnin that today and last night went better!!! May I ask YOUR name? We know sweet baby's but not yours.

The key - TREATS! Most of us use freeze dried chicken/turkey/shrimp available in the treat sections of most pet food stores. Only meat so no carbs! Give them after test and shots. Dakota isn't a big 'treat' cat but he (and me too) LOVES extra petting and snuggling - I use that instead of something edible now.

Most insulin smells like old bandaids... We've all done 'fur shots' but DON'T ever give more, you never truly know how much might have gotten in. Just mark it as such and give next shot at the regular time. I wouldn't worry about the smell unless it stays and you know it's not insulin then I'd track down it's cause. Could be ears or mouth issues...

Don't hesitate to ask questions when you run across something that confuses you!

See you over in Health!!!

HUGS!

Thank you! And it's Gabrielle
I've been giving kitty the freeze dried treats and the LOVES them. I'm gonna try using them as a reward/incentive for the BG testings. Hopefully she will be as ok with that as she is becoming with the daily shots. I'm pretty sure this week I've done two 'fur shots', but I find that if I take my time and try not to rush, it's less likely to happen. Learning curves... yay. haha!

Thanks again for all your advice