Norton back on insulin

[sbnadell]

After managing Norton's diabetes with diet alone for more than a year, he is back on insulin. We noticed in late July that he was drinking a lot. We tested his BG (we had been testing every 2-3 weeks because he had been stable for a long time) and it was 276. After discussion with his vet, we continued to test him daily for 4 days and he was consistently in the high 200's. We bundled him in his thunder shirt and took him to the vet for a urine sample and fructosamine. He had sugar and blood in his urine; the vet gave him an antibiotic for a UTI. The fructosamine came back 438. So back on insulin he went.

The vet (two vets, really, take care of him) are going slow. We started him on Lantus, 1 unit once a day, on August 9th. We tested him a few times that weekend, trying to get a mini-curve at home to minimize his trips to the vet. The thunder shirt works wonders, but it is still a stressful event for him. The first day he tested 237 before the shot, then 214 at ~6.5 hours later. We were not able to get a BG the second morning before the shot, but we got one at ~6 hours later that was 218. We gave him a break from testing for a few days; it takes both of us to test him, and our work schedules don't support us doing it before every shot. Also, Norton got quite irritated at all of the poking and starts to fight us.

The first week seemed to go pretty well from the standpoint that I was able to give him the shot by myself, which is easier from a daily routine standpoint, and I seemed to be able to do it smoothly so he did not really notice most of the time. His BG one week after starting the Lantus was not really coming down much. We had one reading of 191, but everything else was still in the 200's, albeit the lower 200's. The vet had us add a second shot, so now we are giving him 1 unit twice a day.

We had a really hard time getting good blood samples for testing from him last Sunday, and ended up poking him 4 times throughout the day to get one good sample. We have not tried to test him again (the vet recommended we give him a break) since Monday, when we got a BG of 276 before giving him his shot in the evening. Norton is now fighting me when I try to give him his shot. He literally jumps as soon as the needle touches him, which means I'm needing to poke him more than once to give him the shot. I give him treats, kibble, try to be non-threatening, etc. I think I'm still doing the shot correctly so it should not hurt, but it does not seem to matter. Tonight I spent 1/2 hour trying to give him his shot with no luck. I called the vet because it had been an hour since he ate. She said to keep trying up to two hours. I left him alone for a while and finally just got him his shot. I have completely lost my confidence with this, which is not good. I would have thought I would keep getting better, and Norton would be getting used to it. But it seems we are going in the opposite direction. It is very upsetting.

I am open to any tips to get this to go easier on all of us.

Thanks-
Shari and Norton
grumpy_cat

 

[BJM]

Some cats react to the acidity of Lantus (the pH is around 4). Are you letting it warm up a touch before you shoot? sometimes, that can help.

Lantus works more optimally when dosed twice a day, as its main impact lasts roughly 12 hours. Shooting only 1 time per day leaves 12 hours of uncontrolled glucose. Shooting 0.5 units twice a day results in more level control.

Giving a low carb treat, such as freeze-dried meat or poultry with no additives, can help with the testing process. Several times a day, go to the spot where you will test and give him a treat. He will associate the spot with a reward which may reduce some of his resistance.

 

[sbnadell]

Thanks for the suggestions. I'll try warming the insulin in the syringe between my fingers. Yesterday's shots went well, no drama and got them on the first try. This morning I think I got a fur shot.

Norton's favorite treat is freeze dried salmon. He like freeze dried chicken too. He had a couple of treat spots; one is on a flattened box. Go figure.

Thanks-
Shari and Norton

 

[Anitafrnhamer]

Have you considered using a pheromone collar? When Squeak was first diagnosed he would claw, growl, and writhe every time I tried to dose him. The vet suggested a pheromone collar and Rescue Remedy ( an herbal calming blend available at health food stores) between these two he settled right in. We got him into remission within 2 months and he was diet controlled for the next 8 months when he had a relapse. When he went back on the insulin I expected a lot of resistance but he would roll onto his side and purr throughout the process. Made it much easier on both of us.

Anita and Squeaker

 

[sbnadell]

I have not heard of a pheromone collar. We use Feliway in the room of our other cat (FIV+). I do have Rescue Remedy, so we can try that if needed. Did you put it on a treat, or in his water?

Things have been going better, though we are tag-teaming more with one of us holding Norton gently while the other gives him the shot. I was able to give it to him myself this morning with no fuss. We just got a new box of syringes that have a smaller, thinner needle, so maybe that will also help.

Norton is still drinking more than normal. We tested him Friday evening before giving him his shot; his BG was 274. We're going to test him today at the 6-hour mark and see how low it is getting. Then we'll report in to the vet. I'm thinking we may need to give him more than 1 unit.

Thanks-
Shari and Norton

 

[Larry and Kitties]

If you are shooting a low does like 1 unit it is not necessary to warm the insulin unless you store the syringes in the fridge too. A room temperature syringe will warm the insulin.