Injection Timing and Attitude

[hummerbee]

Ok, so we recently had asked for some advice about our little man. He had become pretty aggressive with us when it came to giving him his insulin. We're three weeks into injections. Last week we had been told to go to twice daily, 1.5u and 1u in the midst of this struggle. He's gotten better...he's not too happy when it's time to sit down for our routine. Just by grabbing the scruff behind the shoulder blades to tent the skin he gets restless and growls at us...scared me to death when the needle was halfway in and he jumped. He's a long haired boy and doesn't take good care of his fur and it mats pretty terribly, plus he hates being brushed which may be our problem when it comes to tenting the skin. We need to start testing him again, we were told to hold off on it to see if it helped with the aggression factor. It only seemed to work him up pre-shot.

A different complication has to do with when we're giving him his injections. Every Tuesday my husband and I go into work at 4 am and don't get back home until at 1pm and the earliest. This was a strange week and we had to go into work like this on three different days. Typically he gets his shots at about 7:30 before a normal work day and then again 12 hours later. For that odd day every week are there any suggestions as to when or how we need to vary things for him? We know it's not very good to miss a dose, we've just been doing his usual evening shot amount and time. We didn't want to give him his normal dose too close together before leaving on Tuesdays.

Any help would be much appreciated!

 

[KPassa]

Last week we had been told to go to twice daily, 1.5u and 1u in the midst of this struggle.

Lantus doesn't work very well on disparate doses. You want to be able to give the same dose twice a day. In this case (2.5u per day), it would be 1.25u both AM and PM (you have to eyeball it on the syringe).

Just by grabbing the scruff behind the shoulder blades to tent the skin he gets restless and growls at us...scared me to death when the needle was halfway in and he jumped. He's a long haired boy and doesn't take good care of his fur and it mats pretty terribly, plus he hates being brushed which may be our problem when it comes to tenting the skin. We need to start testing him again, we were told to hold off on it to see if it helped with the aggression factor. It only seemed to work him up pre-shot.

What size needle are you guys using? There are either "short" (5/16") or "long" (1/2"). You might want to get a different needle length to try out. I started out with the short needles and had a devil of a time with shots. Then I accidentally bought long needles one time and all of a sudden, shots got SO MUCH better for us! On the other hand, my brother (who sometimes gives Mikey his shots) seems to do better using the short needles. I think it simply comes down to shooting technique. If one size isn't working for you guys, try the other size and see if it's any better.

A couple of other things for you to try would be a different shot location (i.e. on the flank instead) and to NOT tent the skin. There are a couple of ways to give a shot without "tenting." First way is to gently pull back on the skin/fur and blow on the spot you want to give the shot to part the fur (you don't have to always blow, but it helps the first few times you do it so you can see the skin). Stick the needle in at about a 20-30 degree angle. Next way is to "roll" instead of tent. Instead of pinching with your fingers, curve them downward as you pull back with the top of your thumb (if that makes sense?).

Finally, get yourself an apple and a used syringe. Cut the apple in half and practice giving shots to the apple by aiming the needle so it's visible through the translucent skin of the cut part of the apple. Try to get the syringe deep enough so it's not poking out the opposite side, yet shallow enough that you won't hit muscle if you were doing it to a cat. This will give you a visual aid for what is going on once the needle disappears beneath the skin of the cat.

A different complication has to do with when we're giving him his injections. Every Tuesday my husband and I go into work at 4 am and don't get back home until at 1pm and the earliest. This was a strange week and we had to go into work like this on three different days. Typically he gets his shots at about 7:30 before a normal work day and then again 12 hours later. For that odd day every week are there any suggestions as to when or how we need to vary things for him? We know it's not very good to miss a dose, we've just been doing his usual evening shot amount and time. We didn't want to give him his normal dose too close together before leaving on Tuesdays.

Not sure how to help you with this one. Maybe someone else will come up with some suggestions.

 

[hummerbee]

I believe we have 1/2" syringes (for length), 100u...supposedly the smallest ones from what our vet has said. We can try changing it to the 1.25u each time, they don't have tick marks on the syringes for half units or anything.

As for the different location, as I said he doesn't take care of his fur. He has several mats we're going to shave off tonight actually so they aren't getting so tight that it hurts him. He won't really let me even touch them to check on him, which probably isn't a good sign. His previous owners used to shave him all the time so we're not sure if he's never really taken good care of his fur or if he just got out of the habit over time.

We may trying rolling the skin, I'll probably do some searching around for videos/pictures before I attempt it.

 

[KPassa]

You might also want to try warming the syringe between your fingers for a while to take off the chill of the refrigerated insulin (no, it won't ruin the insulin). Oftentimes, it's the cold that bothers them.

This page on how to give injections to cats might give you some more ideas. There is also this comment on rolling vs. tenting:

We had a terrible time with Scooter when we tried to inject using the 'tent' method, which was taught to us by the animal health technician at the local vets office. On a subsequent visit with the Vet, himself an owner of a diabetic cat, he displayed a different technique which works VERY WELL with Scooter, and she displays much less reaction and definitely less pain.

The technique is to pinch some of the skin (for me using my left hand) between your thumb and forefinger (trying to avoid grabbing muscle underneath) and ROLL your hand sideways (for me, rolling my hand over to the left)pulling the skin over your finger...this makes the cats skin MUCH TIGHTER than pinching it up into a tent, and the tighter the skin, the easier the needle penetrates without pulling.

The technique literally meant the difference between night and day, success and failure in our commitment to do what needed to be done to keep Scoots going. Just thought it worth sharing, some people might find it makes the difference for them.
(Pat and Shelley and Scooter)

 

[BJM]

...He's a long haired boy and doesn't take good care of his fur and it mats pretty terribly, plus he hates being brushed which may be our problem when it comes to tenting the skin. ...

Rather than brushing him and stressing all of you, make an appointment with the vet to have him sedated and shaved down. Mats can trap moisture next to the skin and result in ulcerations and/or infections which will make glucose control that much harder.

After that, use a mat cutter to thin the fur in weekly sessions. Begin with short sessions - maybe a minute or two at first - and use a low carb treat or an activity he enjoys after each session. A mat cutter is like a comb where one edge is sharp. You hold your fingers between the skin and the fur and work through the outer edges first. Target the fast matting areas first - between all the joints and belly, plus underneath the tail and back of the legs.

 

[BJM]

If I understand you correctly, you're switching between these 2 schedules:
4 am - 1pm
vs
7:30am -7:30 pm

Typically, you don't want to change times more than 30 minutes per day.

Your best bet is to hire someone to cover for some of these - perhaps a vet tech, or train a pet sitter to keep the 7:30 schedule working.

 

[hummerbee]

The schedule that we did this week with those three odd days as apposed to the usual one day we ended up just skipping the morning dose. The evening dose we did as usual at 7:30. I was more nervous about doing doses too close together and I didn't want to mess around with the amount we would be giving him if we were to give him an injection at 3:30 am. We may try and recruit his previous owners to take over his Tuesday morning dose...they live just down the street.

We could definitely make an appointment to get him shaved down, we've done it once before and he wasn't too pleased with either of us.

The rolling we really want to try. I think the only thing I'm worried about is if the 1/2" needle is too long if we roll the skin over the finger instead of trying to tent the skin by grabbing the scruff behind the shoulders. Should we just try it as is or get a shorter syringe?

 

[Chris & China (GA)]

The other big advantage to having him shaved down is that it will make it much easier for you to shoot because you're not dealing with what's hair, what's skin, what's matted, etc.

China is a short haired cat, but when we first started I had the vet shave a place on her scruff. That gave me the time to really get my shooting technique down because I was really able to see what I was doing. It can make a big difference.

I also think it's possible if he's badly matted, ANY touching can be painful, so it's not so much the shot, but the fact you're pulling somewhere that it's already very tender. I have another cat with long hair who mats badly too, and not long ago I had to give her some medication for awhile, and when I went to hold her by the scruff, she fought with everything she had because as I was pulling/holding the scruff, I was making the area she was matted even tighter too. After she was shaved down, things got much better.

It's great if his old owners could do the AM shots for you on those days your schedules are so different! The only other option I can think of is to move your shot times to something like 3:30am/3:30pm but I know on the days you don't have to go until 7:30am, it's no fun to get up in the wee hours of the morning when you don't have to

I hope you find something that works for your sugardude!