Shaking! So nervous!

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Lesliejm

Lesliejm

Member Since 2017
Yesterday Mango was fine when I gave the shots, but now he is catching on and fights me. He is super when checking blood. I know it will get better, but I am nervous that I am not getting it in the right place. I am trying to do it quick. I can't draw back to look for blood, he will go nuts if I don't hurry. I did my spreadsheet but I don't see it here. amps 261
 
:bighug:

Here is your previous thread (post). It makes it easier for us to look back and see what has previously been discussed.

http://www.felinediabetes.com/FDMB/threads/first-shot-of-lantus.187640/#post-2083766

What I found helpful it testing in one place (location) only, every time. That is the testing place and when he is there he knows that is what we are doing. Stern voice and a strong hand. Lots and lots of praises and scritches and kisses after. I have a different location for shots but same principle.

I can't locate the instructions for the SS (to put the link in your signature).

Here is the link to your SS
https://docs.google.com/spreadsheet...uqj68Ojrbph9XrTLKwcteOkJzR19ClhLoCrI2/pubhtml

Lesliejm said:
I can't draw back to look for blood, he will go nuts if I don't hurry.
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Not sure what you mean here.

It will get easier.
 
Breathe. It's going to be all right! :)

Where are you trying to give the shot?

Can you describe what, if anything in particular, that you may be doing to provoke Mango to respond?

In the meantime, here are a couple of useful shot tips:
  • Don't worry about pulling the plunger back to look for blood. We're not injecting into a fat or muscle layer, where it's important to check for that sort of thing. For a routine subcutaneous injection like this, it is highly unlikely that you're going to hit a blood vessel. Here are a couple representative links on the topic:
http://www.felinediabetes.com/FDMB/threads/checking-if-youve-hit-a-blood-vessel.69956/
http://www.felinediabetes.com/FDMB/threads/drawing-back-the-needle-plunger.25745/
  • After you draw the insulin into the syringe, let it sit out for a couple of minutes to warm up. An injection of cold insulin can be uncomfortable, so allowing it to warm up a bit can make the shot a lot more tolerable.
  • Try giving the shot while Mango is eating. Many people find that their cat doesn't even notice that they're getting a shot because they're too busy enjoying their food.
  • Take a moment to look at the needle tip. Angle it in the light and rotate it around. Do you see the beveled edge? When you inject, make sure that edge is facing up. Doing so helps the needle enter the skin with as little resistance as possible. If it's not angled up properly, it can cause discomfort.
 
I tried while he was eating. As soon as I start pulling up the skin he gets upset because he knows its coming. I will let it warm up. I draw it then put it in the fridge. I will just let it sit out. I am not sure I get it in the subq. Today he flinched and the needle came out bent!! at least I have the weekend to work on the right technique. I am a teacher and I have so much stress at school and now this!! And I am leaving the 28 of Dec. to visit my granddaughter in Texas and now I HAVE to board him and he has never been boarded before and I am scared that he will get stressed and die!
 
A couple of things that help me:
  1. I find it hard to see whether I have bevel side up when I'm giving the injection so I put a small mark in Sharpie marker on the syringe barrel near (but not on) the needle indicating bevel side up when I'm getting it ready to draw insulin. It helps a lot - read it on an old FDMB thread a long time ago.
  2. If your kitty has loose-ish skin along his sides, try injecting there. I sit Teasel between my legs on the floor facing forward, grab a little side fur to raise his skin tautly into a tent and feel for the indentation (the tent "door) and insert the needle there. Quick and businesslike is the key.
 
When I first started, I followed the steps in this video, and it helped me. I wonder if it would help you and Mango? It's a little long with the explanations at the beginning, but it worked for me... :-)

 
Great tips from @Kris & Teasel. I give Jenks his shots in the sides as well. Here's a brief rundown of alternate injection sites to try. You can administer insulin pretty much anywhere you can grab and tent loose skin that your cat will tolerate.

injection-sites-picture-jpg.11600


Also, try to relax. If you're stressed out approaching the shot, Mango will sense it and tense up as well. Your cat will tend to mirror your level of anxiety, so calm begets calm.
 
Leslie, my heart goes out to you :bighug: It will get easier for both of you . I had the vet shave a small spot on both sides of Elmo to eliminate messing with his fur ...made it easier for he and I . Many hugs and prayers coming your way :bighug: You can do this and it will get easier :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
My kitty doesn't have a lot of loose skin, and he hated when I would try to pinch it up to make the tent in his skin. He seems to prefer when I grab some fur and pull up that way instead of pinching the skin at all. Still makes the gap between skin and muscle to shoot into, but bothers him less.

As Lizzie suggested, having one location for doing the injections has helped a lot. Sam will not hold still, but over time he's learned that the shot place is for shots and he does better. I also put down a few pieces of freeze dried chicken to keep him busy while I shoot. Bribery is a powerful tool. :cool:
 
Yes, that is a great idea. So much useful information in this thread for newbies - lots to unpack!
As tough as it is, just try to be casual and efficient. Think about when a nurse gives you an injection. Does he or she seem panicked or nervous? Nope, just another routine stick. As time passes, you'll be able to "test/feed/shoot" like a pro.
 
Two things here :

For blood testing try to use the same spot only if it's fresh (within a few hours). Otherwise do not overuse the same one, you
can have the blood vessel on the hear unusable if you have too many ''missed shot''. To keep him stable, I always set Small Kitty
on the table and set my harm around him with forearm parallel with the body. Pet him before proceeding, it will cool him down.

For shot time, go from behind. When he's eating just pull the fur on top of any legs and insert the needle. Don't be afraid, these
are so tiny that there is no pain. Once you're inside stick it there and press hard on the plunger before pulling out.

Hope this helps.
.
 
Just a cautionary note -- as with everything we'll suggest, every cat is different (ECID -- we even have an abbreviation for it). I routinely tested Gabby on one ear and it was probably very close to the same spot. I also shot in her scruff. This was for the entire time she was diabetic -- 6.5 yrs. She was a hugely food motivated kitty so in the beginning, she got a treat every time I tested even if it wasn't a successful test. She got her shot when her head was in her food. She was far more interested in what was in the bowl than with what I was doing. Most cats are a bit put off with what we're doing at first. Then, they start to realize that whatever it is we're doing is causing them to feel better. I had no success with shooting in her flank. This was probably more me than her.

There are several different recommendations as to how to shoot. Some people "roll" the skin over a finger to pull up the skin and create the space below the skin to shoot into. I just created a pocket by gently pulling either fur or skin. Some cats are more used to having their scruff pulled because this is what their momma cat did to carry them around when they were kittens.

If it's any consolation whatsoever, when Gabby was diagnosed, she was very ill and hospitalized at a kitty ICU. The vet never gave me instructions on how to administer insulin -- he assumed I knew how. (I do medical-speak very well.) I learned how to shoot and test by watching YouTube videos. I was very nervous giving those first couple of shots. I also had a vet tech tell me to check for blood in the syringe. That was just not going to happen! I tried it a couple of times -- it made no difference and Gabby gave me the stink eye.

 
So.....listening to my vet and writing down instructions, I tested Mango this morning, 122, gave 3 units after she instructed and now 3 hours later his BG is 48. NOW I call her and NOW she changed her mind and only 1 unit if it is under 150. I just had to give honey. Not shot today.
 
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Lesliejm said:
So.....listening to my vet and writing down instructions, I tested Mango this morning, 122, gave 3 units after she instructed and now 3 hours later his BG is 48. NOW I call her and NOW she changed her mind and only 1 unit if it is under 150. I just had to give honey. Not shot today.
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Can you update your title to show the 48 or start a new thread to get eyes on this? It's been 30 minutes, can you test again? The honey wears off fast and hypos can last for a bit. Please test again now and if still low, more honey or a tsp or 2 of high carb food. What meter are you using again? Human meter or AlphaTRAK?
 
3 hours after it was 48. Now it is 87. I use a human meter. I have the spreadsheet going but can't figure out how to show it.
 
Okay, that's good he's come up, I would test him again in 30 minutes, the honey can wear off. Has he eaten any regular food? What is the name brand of the meter you are using please? 48 means wildly different things depending if you're using a human meter or a cat meter.
 
The insulin usually gets lowest somewhere in the middle of the cycle, we don't know Mango's typical nadir, so best to keep a good eye because he can keep dropping as the insulin takes hold. Honey can wear off and can only raise the numbers for a short time in most cases.
 
How much of his food has he eaten today and when? Will he eat a little of it right now? You don't want to give him a full meal because you want him to be hungry if he goes low again so you can bring him back up, but a tsp or two of a higher carb food (or any cat food if you don't have that) will help sustain him when the honey wears off.
 
You'll need to keep watching and testing him. This is from the sticky at the top of this forum:

  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
 
Good advise from Stacy above, Id do just like that for my cat.:)

Leslie, do not forget to reduce his dose tonight by 0.25U - he earned it by going below 50 today. Congrats!
I do not know how many carbs is in Nutro but if it is low carbs containing food then perhaps you'll need to reduce the dose by more than quarter of a unit. Three units sounds a bit too much for a newly Dx cat, in my humble opinion.
 
I guess I just don't get it. If he is in normal range when I test his amps and pmps, do I give him a shot?
 
Stacy & Asia said:
You'll need to keep watching and testing him. This is from the sticky at the top of this forum:

  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
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I will keep an eye on him. I am not going to leave him alone today and my hubby will be home with him all week while I am at work, he is retired thank goodness! Not until I can get a hang of this and understand the numbers. It will take me some time.
 
Lesliejm said:
I guess I just don't get it. If he is in normal range when I test his amps and pmps, do I give him a shot?
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Which protocol are you following? (I know you're new at this so maybe you haven't picked one yet.)

Short answer: yes, you may.

Longer answer: until you have more data on what he is doing, some may tell you to have a "no shoot" number. Ill defer to the more seasoned members on that.

He is in good numbers now! And you did a good job handling this. I know its stressful, especially when everything is so new. We are here for you :bighug:


One piece of advice, if it wasny given yet - Lantus is best with consistency. Using a sliding scale won't give you good numbers or data. The forum can work with you to find a good dose that you can shoot no matter if he is in the 300s or 100s.
 
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Lesliejm said:
I guess I just don't get it. If he is in normal range when I test his amps and pmps, do I give him a shot?
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The general approach here for someone Dx so recently is to post for help in case of a low pre-shot test(aka normal range BG level) and, most likely but not as a rule you might have to skip the shot or to give a token dose instead. New members usually do not give injection below 150 or even 200 at the start unless they are well prepared and someone else with experience can stay with them for that cycle.

The best way to proceed I think is to post once you have the PM pre-shot reading - and ask others what would they do.

I apologize if you had already answered it but was he recently switched to the low carbs wet food?
Well if so then there is a chance that he could be one of the luckiest once whose diabetes is controlled by food alone - no shots! (fingers crossed that's the case). But only consistent/ routine testing and SS updating can help assessing such possibility.

Does it make any sense?
 
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Tanya and Ducia said:
The general approach here for someone Dx so recently is to post for help in case of a low pre-shot test(aka normal range BG level) and, most likely but not as a rule you might have to skip the shot or to give a token dose instead. New members usually do not give injection below 150 or even 200 at the start unless they are well prepared and someone else with experience can stay with them for that cycle.

The best way to proceed I think is to post once you have the PM pre-shot reading - and ask others what would they do.

I apologize if you had already answered it but was he recently switched to the low carbs wet food?
Well if so then there is a chance that he could be one of the luckiest once whose diabetes is controlled by food alone - no shots! (fingers crossed that's the case). But only consistent/ routing testing and SS updating can help assessing such possibility.

Does it make any sense?
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Yes, he was just changed 5 days ago to wet food. Nutro does not have the carbs listed, but there are no ingredients that indicate high carbs. The reason I feed that is because that is what he will eat. Although now he doesn't want to eat much. Maybe 1 oz of food for lunch. I will leave it out for a while.
 
Just talked to vet. If he is below 150 amps or pmps, no shot. I will keep checking his throughout the day. Next check is 2pm. He is sleeping now. Poor baby!
 
Dosing advice depends on if you want to follow SLGS method or TR protocol. You can read about them up top and see which one looks like it fits better for you. Regardless of whatever you choose there, in light of today's numbers, 3 units is too high a dose for Mango. If your vet is telling you to change the dose based on preshot numbers, I'm sorry to say they are misinformed on how Lantus works. That is true of other types of insulin, but for long acting Lantus, you want to shoot the same amount in am and pm and you decide when to increase or decrease based on nadir (how low the dose takes Mango) and not preshot numbers.

It's a lot to absorb and there's so much help here, ask all the questions you need to. It gets easier. :bighug:
 
Lesliejm said:
Just talked to vet. If he is below 150 amps or pmps, no shot.
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Lesliejm said:
The vet told me this....150-250 1 unit, 250 and over 2 units, below 150 none
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And in your previous post - your vet told you to only feed twice a day. All this leads me to believe your vet is not used to dosing Lantus. Twice a day feeds and dosing based on the preshot number (which he originally said you don't need to test for :banghead:), is what you do for in and out insulins like Vetsulin, not depot insulins like Lantus and Levemir. Here we dose based on how LOW the dose takes the cat. 48 is too low for any cat on insulin. And good job testing and catching that number by the way! My vet was also more familiar with in and out insulins (Vetsulin/Caninsulin), it's quite common on vets of a certain age.

In your previous post, it was suggested that you go back to to 2 units and I agree with that. Try gathering data at 2 units before deciding what to do next. You did get a 65 on 2.0 units, and regardless of which dosing method you are using, that would mean either holding the dose or decreasing. You don't want the nadirs or low points to get below 50 and 65 is pretty close. It's much easier to start lower and work your way, that have to fight low numbers cause you started too high.

It'll really help us help you to help Mango if you can put data in the spreadsheet from when he first started getting insulin. Sounds like you did have some data from when he was getting 2 units. Any info reallly helps fill in the picture.

By the way - great job today! :bighug:
 
Lesliejm said:
Yes, he was just changed 5 days ago to wet food.
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Lesliejm said:
he doesn't want to eat much. Maybe 1 oz of food for lunch.
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That's explains that scary BG 48 today. If he eats low carbs only and so very little of it the 3 units is way too much for him for now.
Lantus is great insulin for cats but it has cumulative nature - i.e it builds up inside the tissues and releases itself over period of time. So far Mango received 3 dose 3U each.ETA: at least that's what is in SS at the moment. Chances are that he established a "depot" of insulin and will affect his BG levels even if you skip the shot tonight. Continuous testing is needed.

Lesliejm said:
Maybe 1 oz of food for lunch
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Might I ask why does he eat so little? Any tummy issues?Litter box problems?
 
Tanya and Ducia said:
That's explains that scary BG 48 today. If he eats low carbs only and so very little of it the 3 units is way too much for him for now.
Lantus is great insulin for cats but it has cumulative nature - i.e it builds up inside the tissues and releases itself over period of time. So far Mango received 3 dose 3U each.ETA: at least that's what is in SS at the moment. Chances are that he established a "depot" of insulin and will affect his BG levels even if you skip the shot tonight. Continuous testing is needed.


Might I ask why does he eat so little? Any tummy issues?Litter box problems?
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He might not like the food. Still trying to find one he likes. Trying different flavors.
 
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