New at injections

[jupiter_waltz]

Hi guys, gals

Just starting this insulin injection with my cat and came home with 30 syringes and a vile bottle. Is there an easier way, like a pen like humans can have. She's on a very small dose I think U40 syringe 1s't incerement. I go back to my Vet in a week for a blood/sugar curve. She was in hospital for nearly a week so I want to get this right and don't want Beeny having to go back to pet hospital. I'm using the tent method which I read about on here, it's just that sometimes it doesn't feel like it's all going in....I hope it is. No wander why cats have nine lives, there skin feels kinda tuff once you get through all the fur.

Thanks for your help anyone can give me.

Brad

 

[Elizabeth and Bertie]

Hello Brad, and welcome to FDMB!

OK, let's backtrack just a little.... You say your cat was hospitalized; did she have DKA?

What insulin is she having and what dose?

It can feel strange giving shots at first, but you will pick it up really quickly. Honestly!

When you say you don't think all of the insulin (in the syringe) is going in, what do you mean exactly? Is there still insulin left in the syringe? Or are you finding that therre is a moist patch on your cats fur..?

 

[squeem3]

Hi guys, gals

Just starting this insulin injection with my cat and came home with 30 syringes and a vile bottle. Is there an easier way, like a pen like humans can have. She's on a very small dose I think U40 syringe 1s't incerement.

Welcome :smile:

What insulin did the vet prescribe? You say you have U40 insulin syringes so you most likely have ProZinc insulin. Please double check and let us know.

ProZinc is only available in the botle.

1 unit is a really small dose to measure but it can be done :smile: I think there's a close up picture of the markings on a U40 insulin syringe somewhere.

I go back to my Vet in a week for a blood/sugar curve.

You really don't need to bring your cat to the vet for a curve. Many cats get so tressed out that their blood glucose level just stays really really high which leads to an inaccurate curve. You can do a more accurate curve at home using a Human blood glucose meter. Plus, you'll save $$$. You don't need the vet's permission to test at home.

She was in hospital for nearly a week so I want to get this right and don't want Beeny having to go back to pet hospital.

Did your cat have diabetic ketoacidosis or some other serious health condition that required hospitalization?

I'm using the tent method which I read about on here, it's just that sometimes it doesn't feel like it's all going in....I hope it is.

I think U40 insulin syringes are available with only 1/2 inch long needles. There are ProZinc users here who use U100 insulin syringes with 5/16 inch long needles instead (and using the dose conversion chart to ensure that the cat is getting the right amount of insulin. Big difference between U40 and U100). The entire short needle can be inserted right into the tent.

 

[jupiter_waltz]

Hi fellow cat lovers, thanks for your replies.

I'm really new at this so excuse my ignorance, youve given me a few more questions than I bargained for, but I guess you need all the facts to give the right solution ;-)

I think the vet said she was suffering from DKA is that diabetic ketoacidosis because she mentioned about ketoacidosis and trying to flush her system out while she was on a drip the whole time for dehydration. At first she thought Pancreritis but the tests showed all good.

Everything happened so quickly. I just noticed she wasn't eating her usual mince which she loves for about a week and was drinking lots of water. Then in the day before I took her to the vet she was very lathargic and was lying in our shower cubicle which was wet which she doesn't like. She also had the wobbly back legs. She is a Oriental Siamese 14 years old this month and was in perfect condition for her 10 year check up.

Sabrina is on Caninsulin 40iu/ml 2.5 ml and only taking 1 unit. Apparently her blood levels were 19 in the morning then came down to 6 I think after her insulin regime.

Only lately Elizabeth I think I'm getting the hang of the needles. the first couple of times I didn't feel the difference when the needle actualy punctures through there skin. Is that right you feel that, likie you just went through a barrier. Once or twice she has flinched a little ;-(

I don't feel to confident with my self at first so think going to the vet for the one day and getting a check to see if things are going all right is kind of like a peice of mind thing, but think your def right about me getting my own test equipment because nothing a vet does is ever cheap.

I am inserting the full 1/2 inch needle into the tent which seems required to get thru her thich skin. Is this incorrect, please tell me because I don't want to be causing my cat any extra pain than that is required. Lately she seems fine. I read somewhere 31 grade are better than the 30 grade I have because they are finner so I'll def consider those.

So are there no pens or are they not recommended. I just want what ever is best for my cat.

Thanks guys

Brad.

 

[squeem3]

I'm not familiar with Caninsulin (aka Vetsulin inthe US) but 1 unit is a good dose. Here's the Cainsulin guide: http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=302

No, Caninsulin is not available in pen form. Human insulins that cats use, namely Lantus and Levemir, are available in pen form.

I think the vet said she was suffering from DKA is that diabetic ketoacidosis because she mentioned about ketoacidosis and trying to flush her system out while she was on a drip the whole time for dehydration. At first she thought Pancreritis but the tests showed all good.

Keep testing for ketones at home just to be on the safe side. You can use urine test strips, either KetoStix or KetoDiastix. You can buy it at the pharmacy.

Sabrina is on Caninsulin 40iu/ml 2.5 ml and only taking 1 unit. Apparently her blood levels were 19 in the morning then came down to 6 I think after her insulin regime.

Are you testing blood glucose levels at home or do you rely on the vet to do that? Daily testing of the blood glucose levels is the only way you know if the insulin and dose is working for your cat and if it's even safe to give any insulin at all, really no different from how a Human diabetic manages his or her own disease.

Many people here test at home with a Human blod glucose meter. There are pet meters out there but they're not necessary and no more accurate than a Human meter. Plus, pet meters and supplies are much more expensive and only available online or through the vet at a huge mark up cost.

Only lately Elizabeth I think I'm getting the hang of the needles. the first couple of times I didn't feel the difference when the needle actualy punctures through there skin. Is that right you feel that, likie you just went through a barrier. Once or twice she has flinched a little ;-(

You do feel the needle going through the skin. Inserting the needle bevel side up helps a lot, IMO, and minimizes discomfort.

I am inserting the full 1/2 inch needle into the tent which seems required to get thru her thich skin. Is this incorrect, please tell me because I don't want to be causing my cat any extra pain than that is required. Lately she seems fine. I read somewhere 31 grade are better than the 30 grade I have because they are finner so I'll def consider those.

Some people shave the fur a bit so they can see the skin better and ensure that the needle is going in.

If you tent the skin, there isn't any problem with inserting the entire 1/2 inch needle right into it.

U40 insulin syringes are not available with the thinner gauge needles. If you wish to use thinner needles, then you will have to use U100 insulin syringes WITH the dose conversion chart. 1 unit of U40 insulin is actually measured to the 2.5 unit line on a U100 insulin syringe. Measuring to just the 1 unit line means that your cat is actually getting just 0.4 units of insulin.

If you decide to use U100 insulin syringes, ideally use the 3/10 cc (30 unit) ones with half unit markings. You can get 30 or 31 gauge needles that are 1/2 inch (not in 31 gauge, though) or 5/16 inch.

 

[jupiter_waltz]

Thanks squeem for your very thorough answers.

My Vet didn't even mention anything about testing for blood glucose levels or keytones. They were just concerned about me getting insulin in and being able to feed Beeny, I suppose they don't want to bombard a newbie at first who is still coping with sticking a needle into there very sick cat.

I must say she has recovered remarkably well, big bright eyes, no wonky back legs and eating on her own accord and fossicking in the garden. She's even being vocal again ;-)

She is booked in this Monday for the day long curve test so I'm sure I'll get an update from the vet about how she is really progressing. I just hope the Vet is ready for my new armourey of questions I will be asking now that you guys have given me an insight and how I should be taking matters more into my own hands on a daily basis like BG levels and not relying on their prognosis a week later.

I have been doing the injections in the scruff of the neck where my vet told me but now I see I should be doing it in other places. Is it all right to just work my way down the back where there is still lots of loose skin?

I think I will discuss it with my Vet about using the U100 syringes, but it makes sense for price and practicality. 1 unit in a U40 is pretty hard to judge. Are the U100 syringes thinner in the body to make the insulin easier to read or is it cause the diluted U40 insulin will take up more of the U100 syringe ie: 2.5 units?

I would like to use the 31 guage needles and probably better if it is a bit shorter to make sure there is no chance of a breakage. Has this ever happened that you know of. I would really freak then, okay maybe I should stick with the 30 guage.

Thanks guys

 

[Elizabeth and Bertie]

...I have been doing the injections in the scruff of the neck where my vet told me but now I see I should be doing it in other places. Is it all right to just work my way down the back where there is still lots of loose skin?

Hi, there are mixed views about where is best to give the shots. In theory I think you can give a shot pretty much anywhere there is loose skin. Some inject into the skin around the abdomen. However, whenever I've tried to give my cat a shot anywhere other than the scruff he's protested - loudly! But some cats don't have a problem with that. As they often say here, 'ECID' or 'every cat is different'.

I've injected Bertie into the scruff for over five and a half years with no problems. I vary the shot site a little, ie, towards one shoulder blade or the other, but no more variation than that.

 

[squeem3]

My Vet didn't even mention anything about testing for blood glucose levels or keytones. They were just concerned about me getting insulin in and being able to feed Beeny, I suppose they don't want to bombard a newbie at first who is still coping with sticking a needle into there very sick cat.

Some vets don't mention home testing right away, others don't mention it at all. Do discuss home blood glucose and ketone testing with the vet.

I have been doing the injections in the scruff of the neck where my vet told me but now I see I should be doing it in other places. Is it all right to just work my way down the back where there is still lots of loose skin?

Some people inject on the cat's flank instead of using the neck scruff. I'm not exactly sure where, though.

I think I will discuss it with my Vet about using the U100 syringes, but it makes sense for price and practicality. 1 unit in a U40 is pretty hard to judge. Are the U100 syringes thinner in the body to make the insulin easier to read or is it cause the diluted U40 insulin will take up more of the U100 syringe ie: 2.5 units?

U-100 will have 100 units per mL, and U-40 has 40 units per mL. This means that U-100 has 2.5 times the amount of active insulin per mL, therefore 2.5 times as strong.

There are some close up pictures of how to measure U40 insulin with a U100 insulin syringe. Here are two:

http://images2.wikia.nocookie.net/_...indogs/images/a/a1/U100syringe_U40insulin.jpg
http://farm3.static.flickr.com/2655/3992453213_a2fb0c50c0.jpg

I would like to use the 31 guage needles and probably better if it is a bit shorter to make sure there is no chance of a breakage. Has this ever happened that you know of. I would really freak then, okay maybe I should stick with the 30 guage.

Nope, no breakage with the 31 guage needle :smile:

What is your cat eating? Diet is a very important part of managing the diabetes. Prescription food (dry or canned) are not necessary at all despite what your vet may say. Many people here feed commerical brands of food like Fancy Feast and Friskies. Some feed raw food.

Here is the most up to date food chart you can use: http://www.catinfo.org/docs/Food Chart Public 9-22-12.pdf Foods that have a number 10 or less in the carbs % calorie column are good for diabetics.

 

[jupiter_waltz]

Thanks guys for clearing up a few grey areas I had. I'm definitely going to have a few questions for the vet on Monday, especially about the home testing of glucose and ketones.

Prior to the the diagnosis of Sabrina having diabetes she predominitly ate a product by VIP called Fussy Cat which is a blend of raw chicken and steak mince and had the odd bite of dry food. Since comming home from the vet she has been even fussier but I have been able to get her to eat wet food made by Snappy Tom which comes in satchels kind of like the Fancy Feast which she wont eat. Of course she still likes cooked King prawns, rather expensive and time consuming peeling them.

Thanks Brad

 

[squeem3]

Thanks guys for clearing up a few grey areas I had. I'm definitely going to have a few questions for the vet on Monday, especially about the home testing of glucose and ketones.

Here's a list of questions you can ask the vet as well: http://gorbzilla.com/questions_for_your_vet_.htm

Prior to the the diagnosis of Sabrina having diabetes she predominitly ate a product by VIP called Fussy Cat which is a blend of raw chicken and steak mince and had the odd bite of dry food.

Hmm.. the US web site for Fussie Cat is under construction :-| http://fussiecat.com/

The food looks decent ingredient-wise: http://www.arcatapet.com/item.cfm?cat=17125

Since comming home from the vet she has been even fussier but I have been able to get her to eat wet food made by Snappy Tom which comes in satchels kind of like the Fancy Feast which she wont eat.

The puches of Snappy Tom are mostly ok, just don't feed the one that has rice in it and limit the fish based ones to once in awhile meals. Rice is a grain and means that the carb content is likely over the ideal 10% for diabetics. Too much fish can lead to a cat who is addicted to eating it and who refuses to eat anything else.
http://www.snappytom.com.au/content/juicy-pilchard-chunks-with-deep-sea-bream/gjmkvd?linkid=389 Have you tried the canned Snappy Tom? There's a chicken and turkey one and more fish based variteies.

If you can, stop feeding the dry food. It can keep blood glucose levels too high.

Is the Wellness brand available where you are? That has many low carb varieties that you can feed your cat.

I wish the old board was still available. There are several threads there with fodo suggsetions for Australia members. Have you considered raw food? Some people here make their own, others feed a commercial brand.

Of course she still likes cooked King prawns, rather expensive and time consuming peeling them.

Spoiled kitty :lol: The occasional treat of cooked prawns is fine. So is plain cooked chicken.

 

[jupiter_waltz]

Thanks squeem,

Sabrina just had her sugar/blood curve stay at the vet today, another $250 and booked in for another one next week, but they changed her insulin so I think she needs the profesional monitoring. She's now on Lantus @ 2 units which is u100 so that must be a substantial increase over her previous 1 unit of u40 Canuinsulin. The vet said her levels were too high for them to meter untill 1:30pm it came down to 19.4 and then 12.5 finally when I picked her up. This really surprises me because she has been becoming her normal self lately, maybe a little lethargic yesterday.

Im using the the new U100 syringes, just want to make sure I have this right, she needs .02 ml which according to the vet is 2 units, this is on a 100 ml syringe so that is only the first marker. I think I def have to get smaller syringes with half measures.

I asked the vet about home testing and she said that was fine but said maybe only weekly, maybe thats after we have things stabilised, I mentioned ketone testing and she kind of disregarded it.

Also I can I buy Lantus myself online without a script. Her price is $61 for a 3 ml vial, I 'm sure Ican find it cheaper like the syringes.

Thanks Brad

 

[squeem3]

. She's now on Lantus @ 2 units which is u100 so that must be a substantial increase over her previous 1 unit of u40 Canuinsulin.

Generally we recommend newbies to start at no more than 1 unit twice a day, even if switching from one insulin to another.

Im using the the new U100 syringes, just want to make sure I have this right, she needs .02 ml which according to the vet is 2 units, this is on a 100 ml syringe so that is only the first marker. I think I def have to get smaller syringes with half measures.

You are using 1 ml insulin syringes?

Yes, each line represents 2 units. So the first line, not including the zero line, is 2 units.

Ideally you should use 3/10 cc (0.3 ml) insulin syringes with half unit markings. That way you can measure every single unit and even every half init.

I asked the vet about home testing and she said that was fine but said maybe only weekly, maybe thats after we have things stabilised, I mentioned ketone testing and she kind of disregarded it.

Some vets just aren't supportive of home testing :roll: There are many published studies that promote home testing. You really don't need the vet's permission at all to home test. Or even to test for ketones at home.

Would a Human doctor send a newly diagnosed patient home with no instructions at all other to give X amount of insulin twice a day? No. Diabetic cats are no different, IMO :smile:

Also I can I buy Lantus myself online without a script. Her price is $61 for a 3 ml vial, I 'm sure Ican find it cheaper like the syringes.

No, you need a script to buy Lantus. I don't know of any good Australian pharmacy web site where you can buy Lantus. You can start a new thread and ask. There are several Australian members here on FDMB.

Lantus is only available as a 10 ml bottle (vial) as as a 3 ml SoloStar insulin pen. If your vet is selling a 3 ml bottle of insulin, then I would not buy it at all. You have no way of knowing how the vet transferred the insulin from the original sterile bottle or pen to the smaller bottle or it the smaller bottle is sterile. You don't want to risk using potentially contaminated insulin.

 

[jupiter_waltz]

Hi Squeem, I'm pretty sure that 3ml vial the vet sold me was one that goes into one of those pens from looking at some pics lately. So there should be no concern about containation or dilution just worried about repeatedly putting a new syringe in the small rubber top, I guess this is all right. Have you herd of anyone else using these smaller vials as it does make economical sense because I would never use 10mls in a month. Heres a pic, hopefully, this was a learning curve on its own just to get a pic onto a BB ;-)

 

[squeem3]

That's a Lantus OptiClick insulin cartridge which is fine to use :smile: It's no longer avaiable in the US but other countries still sell them.

Both the OptiClick cartridges and the SoloStar pens are more economical than the 10 ml bottle. Ifyou buy the catridge or pen from the pharmacy, it comes in a box of five which will be at least a 5 month supply you will have on hand. The 10 ml bottle might last a month, maybe two, and you end up throwing away a barely used bottle and paying more $$ to buy a new one.

Here's info on how to handle and use Lantus: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

 

[jupiter_waltz]

Thanks Squeem for posting that video, that cleared up a few things I think I was doing wrong with needle in the vial.

Just wandering why have they stopped selling the 3ml containers in the US, basically you guys are at the froefront of everything and were like little brothers to you guys and follow your footsteps? Was it a health concern or maybe just a marketing thing where the manufacturer can ripp you off selling you quantities that you would never use.

Should I be asking my vet about PZI insulin ( is this the best for cats), I saw a post here somewhere saying the best insulin for cats and I can't find it again.

Thanks

 

[squeem3]

The US web site for the OptiClick just says that it is no longer being manufactured: http://www.opticlik.com/ It was probably a marketing decision.

Lantus is a good insulin choice, IMO. Many cats who use it end up in remission. I think the remission rate is around 80%.

BCP PZI is still made. I'm not familiar with that insulin.

 

[squeem3]

The owner of FDMB got the old board up and running again :smile: Here are some old theads with suggestions on low carb foods available in Australia:

http://www.felinediabetes.com/phorum5/read.php?8,886701,886705
http://www.felinediabetes.com/phorum5/read.php?8,1863468
http://www.felinediabetes.com/phorum5/read.php?8,893499,893612

 

[jupiter_waltz]

Thanks for the links Sqeem, there is just so much useful information on this board. I'm hoping some vets out there are reading this and practicing these principles and passing it on to fellow colleagues because you will never get such a collect group of individuals with so much personal, dedication and experience who have a wealth of knowledge to pass onto anyone who needs some assitance.

I just ordered some new 31 guage injections for my cat becuase the new syringes she gave me are 27 guage which I think is a little barbaric. Like you said though, I had to get 5/16 inch not 1/2 inch so hoping the shorter needles aren't an issue.

I must say looking at the prices of meds and syringes is usually about 4 times the price here in Australia to the ones available in the US. If I had a kitten diagnosed as diabetic, it might be cheaper to relocate ;-)

Brad.

 

[jupiter_waltz]

Hi Squeem,

Have you or anyone you know of used the 5/16" 31 guage needles. They are def a bit shorter. The first one felt fine and I felt it penetrationg the skin, the second didn't quite feel it went all the way in and the third felt like a correct insertion. The aim is just to get the insulin under the skin so surely the 5/16" needles are long enough for this purpose. Sabrina is an Oriential Siamese so only has short hair.

Anyway tomorrow is another sugar curve day at the vet.

Thanks Brad.

 

[Ry & Scooter]

I use 5/16" (8mm) length needles and far prefer them to half inch. Most people use the short needles but some do prefer the longer ones (not me though). I stick the short needle all the way into the tent, parallel with Scooter's body, and have never had a fur shot this way!

With the money you are spending on curves at the vet why don't you buy a home testing kit? Curves at the vet are pretty much useless because the stress can make your cat's BG skyrocket, so you aren't getting accurate results anyways!

 

[squeem3]

Lots of people here use the 5/16 inch needles. Others use the 1/2 inch needles. I've used both.

Inserting the needle bevel side up helps the needle penetrate the skin easier, I think. Give it a try. Also be sure to check the needle to see if it is completely smooth. I once had brand new insulin syringe with a needle that was completely bumpy :shock:

You don't need to take your cat to the vet for curves. It's a huge waste of $$$ for results that are not accurate at all. Many cats get so stressed out at the vet's office that their blood glucose levels just skyrocket up really really high. You don't need the vet's permission to test. Some vets are against it for one reason or another. There are many published veterinary studies in well known veterinary journals and magazines that promote home blood glucose testing.

Everyone here on FDMB tests their cat's blood glucose levels at home every single day. It's the only way you know if your cat is at a safe enough level for any insulin to be given and if the insulin and dose are working well. All you need is a Human diabetic blood glucose meter (glucometer). There are pet meters out there but they are really expensive and no more accurate than a Human meter. Blindly giving insulin is no different from driving a car with a paper bag over your head. It's just dangerous. Your cat could become hypoglycemic, which is not treated immediately, can be fatal.