Problems Giving Injections

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Junior's Mom

Junior's Mom

Member Since 2017
Hello. I am new to this forum and to feline diabetes. Junior was diagnosed over a little over a week ago. He has always been an extremely difficult cat to medicate--something even my vet noted when trying to pill him in the office once, with only partial success. For the first few days, to my shock, it was a breeze giving him the insulin shots (2 units of PZI, twice a day). I think this was in part because he felt so poorly he didn't care. As he began feeling better he began to be more difficult. I also find it more difficult to tent the skin now that he has gained back the weight he'd lost and is hydrated again (a kibble lover, his diet has been changed to low carb, high protein wet food). Now the situation has deteriorated to my having to physically restrain him, once I can pull him out of his hiding place. Needless to say this results in a very stressful situation for Junior, and for me.

I use the tenting technique shown to me at the vet's office to give the shots. I try to get the needle in quickly, at a 90 degree angle to the skin. I check to make sure the needle is oriented so that the beveled point enters first to lessen pulling or dragging. Are there any other techniques that can be used?

Have any of you had a difficult cat and how have you succeeded in giving him the shots? I have tried playing with Junior, rewarding him with treats, etc., but it's not really helping.

Thank you!
 
Welcome Junior and his Mum!
Sorry the injections aren't going as well but may be a good sign he is feeling better :). How did the Vet decide on his starting dose? We usually recommend starting at 1.0U twice a day.

Are you home testing yet? It's the best tool in our FD (feline diabetes) tool belt. Most of us use Google Sheets to track and share BG (blood glucose) numbers: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Will be helpful if you setup your Signature with some information about Junior as well: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Last link I like to give so you can read ahead of time and be prepared, but I hope you never need it:
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Only thing in your technique that sticks out at me is the 90° angle, you actually want to try 45° and insert on the lower part of the tent. The 90° angle may be hitting a muscle that he is associating with unpleasant-ness. Don't feel bad, we all had to start and find our own tricks :bighug:. Since you are using PZI, you could try giving injection while he's eating, if he's food motivated. Sounds like you are doing this alone, many of us are ;), you could maybe try holding part of his scruff with ring finger and pinky (possibly middle finger too, unless you need thumb, index, and middle for tenting) then tent with thumb and index finger. Just make sure you do not rub the injection site after. Hopefully others will chime in soon too :cat:
 
Hello again.

Never having had a diabetic cat before, I didn't ask the vet about the dosing amount. I assumed it was based on his BG being close to 500 when he was diagnosed. I also gave you the wrong information about the insulin he is taking. I thought that PZI was an acronym for ProZinc Insulin but now I know it's a different insulin entirely. Junior is on ProZinc. Thank you for the recommendation of the 45 degree angle. I'll try that; unfortunately Junior has a long memory. Also, I have rubbed the injection site afterward, which was what the veterinary technician did -- has this been causing him pain?

I have read up on hypoglycemia (it's how I found this website) and have honey in the house. One question is what form the "twitching" takes. Last night and this morning Junior experienced what I'd describe as similar to twitching skin around his hind quarters and neck but a little more pronounced. He hasn't had anything that I'd describe as muscle spasms.

Yes, I am doing this alone and my irregular work schedule has made scheduling Junior's feeding and injections more difficult. I also have to travel occasionally for work. I cancelled a two day work trip in July because I'm very concerned about what to do with Junior when I'm away. At this point I feel like I'm a poor caregiver and am letting him down.
 
Maury is my first sugar kitty too :). You can still give shot while eating with Prozinc. Rubbing the injection site shouldn't cause him pain but it effects how the insulin is absorbed.

In addition to honey, pick up some higher carb foods with gravy. Here's the link for the Hypo Tool kit for things to have: http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

The twitching skin, especially around hind quarters, could be nerve related. Uncontrolled diabetes can do nerve damage. Some kitties develop diabetic neuropathy. My boy is one who also had it in his front paws. He is doing much better with that; can barely tell his front paws were effected. Still working on getting his hind legs fully back on toes.

How irregular? Prozinc is one of the better insulins for flexibility. You have up to an hour to vary shot times. If you have to travel for work, how's your relationship with your Vet? Sometimes techs can pet sit for you; check BG, feed, administer insulin.

Don't feel that you are a poor caregiver :bighug::bighug::bighug:. You are here, you've started insulin, you've done some reading, you love him, and you are trying :bighug:. We'll help YOU and Junior as best we can with our experiences
rub.gif
 
Hi Junior's Mom!

I'm still very new to this but happy to share a few tips;)

With regards to your work schedule and travel, you could try asking your vet or even another local vet if any of their vet techs do "pet sitting". I found a pet sitter this way that is more than capable of testing and giving injections. I would be lost without her. You'd be surprised once you start asking around. Come to find out one of my neighbors had a diabetic cat and she even offered to help out in a pinch.

As far as feeding, do you have an automatic feeder? I retired my automatic feeder years ago when I switched to all wet food (unrelated to Diabetes). That was until I was given the best tip on using it with wet food. Freeze the wet food into portions and load accordingly. Works great. This way I can spread out my kitties meals into smaller meals throughout the day AND night :cat:

My bottom shelf in my freezer is filled with these:D. Its half a can of FF classics, every Sunday I pack the freezer with a boat load!
FF frozen.JPG
 
I had a difficult cat with shots. I learned quickly that I had to give her her favorite food/treat and had to get my technique down so I could be quick with the syringe.
In our case, the trick was to give her 2 or 3 raw shrimp ( chopped up small since she had no teeth)
and while her head was in the bowl, I gave that shot.
There were still some difficult days on occasion but that was what worked. I always placed them on top of her food. She usually grazed for the first few hours after her shot time.
 
My thanks to all of you for your input.

My work schedule alternates between 8am to 5-6pm and 12 noon to 9:00 pm. In general I've been trying to dose Junior between 7:00-7:30 am and 8:00-9:30 pm. Thank you, Yong, for the info that with ProZinc I have some leeway in varying the shot time. I am not home testing at this point. He is having such a negative attitude toward getting the shots that I'm reluctant to introduce another element that I know he'll be resistant to. I'm reluctant to give him the injection while he's eating because I'm afraid he'll just stop eating and hide. As it is, he stops eating and hides if he happens to catch a glimpse of me nearby (I try to discreetly check to make sure he's eating and that one of the other cats haven't taken over his bowl--he's a slow eater and the others always finish before him, which is why he's fed in a separate room). After his shot, I reward him with PureBites.

After 2 weeks with the insulin and new diet the vet has cut his insulin dose in half to 1 unit twice a day. Does anyone know what the optimum window is between feeding and giving the shot? I have been trying to get ahold of Junior for his shot within a half an hour of his eating, although I don't always succeed within this time frame (he goes into hiding after eating and it can be time consuming to get him out).

Like my vet says, Junior just hates this whole thing.
 
Has he given you any insight to what it is about the injections he does not like? Some kitty's do better with one poking thing over another (BG testing might go better than insulin injections). Good to hear dose has been reduced with new diet but it's still scary dosing blindly :oops:.

As for time passed between feeding and giving the shot, you're aiming more to keep shot time as consistent as possible. Quite a few Prozinc users, test/feed/shoot within like 5 minutes. I've had to do it on occasion too but typically my boy gets his shot about 15 minutes after he's done eating.

Would you be able to describe your step by step routine / motions with Junior? Is he a skiddish kitty to begin with?
 
All I can do is encourage you to keep at it. Some kitties are hard to get with the program but with time they'll come around. There are people here with semi-feral kitties who have learned to tolerate testing and injecting. Junior was diagnosed only a couple of weeks ago so it's very early in the game for you.

I like Yong's idea of you describing step-by-step what happens. There might be things we can suggest.
 
Junior's mom, my most untrusting cat was diagnosed with diabetes this past weekend, and I'm afraid I'm going to have the same issues as you are. He will not come near me if I am standing or walking, and if I try to give him a bowl of food, he bails. I have been trying to set up a routine morning and night where I feed them (3 cats) dinner and then have them come in for brushes or treats. However, getting him to participate is not easy. Of course, the other 2 think this is awesome! We are not doing injections yet - I have to bring him back in for the glucose scans on Friday, but I'm trying to get the feeding routine down now. I'll be interested to see how this progresses with Junior.
 
I'm sorry, Jana! I've been trying to find a routine that makes Junior comfortable--sometimes I think a routine is working , then Junior will start resisting it. I think what he hates as much as, or perhaps more than, the shot is being restrained in order to be given the injection. If I don't restrain him, he'll just take off.

Junior was one of a feral litter. It took a year before I could really handle him. He's remained skittish and fearful of others (normally hides from everyone but me). For 12 years his daily routine has always been whatever he wanted it to be, not what anyone has imposed upon him.

My shot-giving routine is as follows: Each morning and evening Junior is given a set amount of canned food (the other cats are following the same routine). After eating he hides. Sometimes he'll come out on his own within a short period of time, sometimes I have to coax him out. Either way, once I have him in my hands I take him to the bathroom where I can close the door and keep him from escaping. I get on the floor with him, pet him and talk to him, hold him with his head facing away from me and give him the injection. After I've finished he springs away from me for the door. When I let him out of the bathroom he either hides for a time or goes directly to the bedroom for treats. When he's being particularly difficult--hiding and not willingly coming out after eating--I'll take the syringe with me and inject him in the room he's hiding in if I can reach him. All of this has made giving him his insulin within a consistent daily time schedule almost impossible.
 
Junior's mom, you definitely have your hands full - you have my sympathy! Lazarus only needs his shot once a day for now. I gave him his first one last night. Once he comes to me, giving him the shot is a piece of cake - he didn't even feel it. It's just getting him to me (getting him to come to me on my schedule isn't happening right now though!). If I had to chase him down like you're having to do, I'm not sure I'd have any success at all. Best of luck to you on a smoother routine over the next few days/weeks.
 
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