Syringe and Dosing Advice Please

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Hi everyone! This is my first post so I wanted to start off by thanking this amazing community. Tessie was diagnosed almost a month ago and because of this site and all the experienced advice, we are so much better off than if we had followed the vets instructions. So I've been reading up and learning as much as I can but I still have some questions on syringes and want to know what you all think!

Tessie is on PZI and we use the U-40, 29 gauge syringes. The vet said under no circumstances to use any other syringes, but after seeing conversion charts on here, it seems that people do. Anyway, Tessie has been a dream patient but lately is getting more and more upset over the shots. Crying when the needle goes in and trying to get away. I feel like I do a good job of making it as comfortable as possible-warming insulin vile in my hands, getting a good tent while she's eating, bevil side up on the needle, staying calm, etc. but it really just seems to hurt her.

So what syringes do you all use and where do you buy them? Is the insulin conversion easy enough that it's worth switching?

Once again, thank you all so much for making this very overwhelming process so much easier!
 
Do you give the shots in different places so that one area will not get too sore? I use U-40 syringes (with 1/2 unit markings) from ADWDiabetes.com. I have used three different brands. I really think there are some 'bad' needles from time to time regardless of brand. There are times it seems to hurt Mia a bit when I give the shot even though most of the time it is fine.
 
Do you give the shots in different places so that one area will not get too sore? I use U-40 syringes (with 1/2 unit markings) from ADWDiabetes.com. I have used three different brands. I really think there are some 'bad' needles from time to time regardless of brand. There are times it seems to hurt Mia a bit when I give the shot even though most of the time it is fine.

I've been alternating between her sides, shoulders, and middle shoulder area. The ones I have aren't 1/2 unit so I will definitely check out that site as I'd like to be more precise about measuring. Are the ones you use 29 gauge as well?
 
Are you home testing? Can you post the numbers you're getting? It could be that the dose is wrong for him and he's trying to tell you that.
I am home testing but haven't yet used the spreadsheet on here. The vet started her at 2 units and told me not to home test but of course after a little reading I was terrified to blindly give the 2. I started home testing her on 1 unit...here are some of her numbers from that:
Amps: 386. +4: 365. +8.5: 289. Pmps: 318
Amps: 393. +6.5: 217. Pmps: 370
Amps: 468. +5.5: 268. Pmps: 259
Amps: 386. +4.5: 253. Pmps: 407

I kept her at 1 unit for almost a week then her AMPS was 509 so I decided to try the vets dosage at 2 units:
Amps: 509. +2.5: 305. +5.5: 229. Pmps: 343. +3: 179
Amps: 383. +3: 290. +6.75: 202. Pmps: 413.
Amps: 480. +6.5: 314. Pmps: 292.
Amps: 316. +4: 260. +6.5: 231. Pmps: 517.
Amps: 257. +2.5: 313. Pmps: 415
Amps: 260. +3: 384. +6: 154( I was so excited!) +9: 240. Pmps: 459. +2.25: 327

Then today her amps was 394.

Sorry for the horrible format, I'm sure it's annoying to read! I will try to get the spreadsheet going next week.

Also she's around 8 pounds, eating friskies patte, no dry food.
 
I feel like I do a good job of making it as comfortable as possible-warming insulin vile in my hands, getting a good tent while she's eating, bevil side up on the needle, staying calm, etc. but it really just seems to hurt her.
Make sure you're grabbing enough loose skin to make a tent shape, pull it up tautly, feel for the depression that is the "tent door" and insert the needle near the bottom of the door but not too close to kitty. Sometimes a very slight downward angle helps. If you're using the scruff you could try loose skin along her sides. Skin tightness and clear impression of a tent door are key.

So what syringes do you all use and where do you buy them? Is the insulin conversion easy enough that it's worth switching?
Using U100 syringes with half unit marks and the conversion chart allows a bigger range of fractional doses. Here's a link to the conversion chart: http://www.felinediabetes.com/insulin-conversions.htm
Here's an example of the U100 syringes you can use: https://www.adwdiabetes.com/product/6941/bd-ultra-fine-insulin-syringes Walmart should have similar in their ReliOn store brand.

Re dose: you got a better response at 2 u but it'll be helpful to see data on a spreadsheet. Congrats on testing BG at home though! :)

Here's the new member's handout I made up a while ago:
______________________________________________________________________________________________

It would help us if you set up your signature (light grey text under a post). Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................

Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
.................................................................................................................................................................................................................................

Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
.................................................................................................................................................................................................................................

Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
 
Thank you so much for all the info. I'm hoping after some more time on the insulin she will be needing less and it sounds like the U-100 will be a lot better for measuring, not to mention smaller and way cheaper than the U40 from my vet. I will work on my signature and spreadsheet next week. All the advice on this site really is incredible, thanks!
 
Hi Megan and Tessie! And welcome! Kris has given you some great info, so I'll just add that my kitty won't let me pinch his skin into a tent. He acts like I'm hurting him and will do anything to get me to let go. I've found that taking a little of his fur and pulling up that way to raise a little tent works better. Then I can shoot without pinching him. So try the tent first, but if that doesn't work, you can try using his fur to lift up and make the space needed to inject.
 
Hi Megan and Tessie! And welcome! Kris has given you some great info, so I'll just add that my kitty won't let me pinch his skin into a tent. He acts like I'm hurting him and will do anything to get me to let go. I've found that taking a little of his fur and pulling up that way to raise a little tent works better. Then I can shoot without pinching him. So try the tent first, but if that doesn't work, you can try using his fur to lift up and make the space needed to inject.
It's so nice to see how all of the kitties here have such customized treatment plans. So many amazing owners! Tessie doesn't seem to mind being tented, I've been tenting her skin and poking with my finger while she's having snacks or while I'm petting her, etc. just to make sure she's used to it. She loves being pet so she's always happy for any attention. It's really just as the needle is going in that she cries. It feels like the needle goes in nice and smooth too..I just think it hurts her :( I'm going to order the U-100 syringes that Kris suggested and hopefully the smaller needles will be more comfortable.

This is the hardest part for sure, seeing her have any discomfort. But I know it's necessary. Surprisingly, she sits on my lap and purrs while I test her ears...literally seems to somewhat enjoy it. I'm sure the shots will become easier for her soon too. Can't thank you all enough for all the advice and tips!
 
I just use the spreadsheet because it needs to be up-to-date with the most current numbers in order for anyone here to help with dosing. I didn't want to be in a position where I needed urgent advice and had to spend time updating my numbers first. At this point I don't ask for dosing advice very often, so I do sometimes jot the info down and add it later, but that's been more recent. Most of the time since diagnosis I kept my spreadsheet current.
 
I'd advise just using the SS personally. It's just extra work if you have to write it down then update. BUT if you know you won't have time to update right away, you could write it down and then just update the SS as soon as you can. :) We do ask that you keep it update as Djamila said...if you need urgent advice, we need all the info and you don't want to be in a position where you have to update during an urgent situation!
 
Megan my vet told me the exact same thing yesterday and I am with you new to having a baby with Diabetes. I decided to ignore her and listen to everyone here and today I am glad I did when her BG dropped today. Her thing was she didn't want me stressing myself over checking her. To me it is no stress at all and Candi loves the attention.
 
You might want to buy the 31 gauge needle. That’s all I use as it’s smaller in size. They have the 100 in 31 gauge, Baby flinched with the 29 also! I get mine at Walmart.
I'm going to Walmart today for more test strips (somehow have almost used 100 already!) so I was planning on looking at their selection. I definitely want to try the 31 gauge...what brand do you use? Are they shorter as well? Are they syringes or do you use an insulin pen? Sorry for all the questions, just trying to figure out what will be best!
 
Megan my vet told me the exact same thing yesterday and I am with you new to having a baby with Diabetes. I decided to ignore her and listen to everyone here and today I am glad I did when her BG dropped today. Her thing was she didn't want me stressing myself over checking her. To me it is no stress at all and Candi loves the attention.
The more I learn about diabetes, the more surprised I am by some of the advice my vet gave me. It's much less stressful testing and actually knowing where their levels are instead of constantly guessing and worrying! I'm glad Candi is loving the attention too-it sure makes it easier on us!
 
I'm going to Walmart today for more test strips (somehow have almost used 100 already!) so I was planning on looking at their selection. I definitely want to try the 31 gauge...what brand do you use? Are they shorter as well? Are they syringes or do you use an insulin pen? Sorry for all the questions, just trying to figure out what will be best!
You can get the Walmart branded, Relion, syringes in 29 or 31 gauge. 31 gauge needles are thinner and shorter. Personally, I prefer the longer needles but I think many people prefer the shorter ones. Since your kitty is flinching you might want to try the 31 gauge to see if it's better. Both sizes come with 1/2 unit markings.
 
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I'm going to Walmart today for more test strips (somehow have almost used 100 already!) so I was planning on looking at their selection. I definitely want to try the 31 gauge...what brand do you use? Are they shorter as well? Are they syringes or do you use an insulin pen? Sorry for all the questions, just trying to figure out what will be best!


It’s the relion brand ... 31 gauge, u100, 5/16 short needles. Also orange caps!!!
Sorry just got home..& didn’t see it till now!
 
Now that I have been using the 31 gauge syringes on her for a few days, I wanted to give you an update. Tessie is still fussing and trying to get away when she knows it's time for her shot but no more crying when I actually stick her. I think she barely notices the actual shot now and that this is just her remembering the pinch from the bigger needle. I think a few more days and she will be just fine.

I'm finally using the spreadsheet and am loving it. I thought I had a good system before (on paper) but it really doesn't compare to being able to see the color-coded, columned results all on one page. It also makes it much easier to see what times I should be testing more-what a great tool! I'm endlessly grateful for all of the efforts put into this site.

Anyway, Tessie's numbers have been consistently high for her PMPS tests. I thought she might be bouncing slightly and since I went straight from 1 to 2 units before, I was curious how she'd do at 1.5. I lowered her dose yesterday which resulted in higher numbers. I know 3 cycles is recommended but I did decide to raise her back to 2 this morning after seeing her symptoms return (super hungry, thirsty, agitated, ect). I feel bad for jumping her around! Learning from my mistakes, I have decided it's probably best to aim for a healthy nadir and I'm hoping that her PMPS test numbers will eventually even out.

I'm hoping to get some more testing in this weekend (especially after her PMPS) but if anyone happens to look at her spreadsheet and has any feedback or suggestions for me, I am listening! :)
 
Hurray for your success with injections! And it's great that you see the value in the spreadsheet. :smuggrin:

I think the blues on your SS are an indication that 2 u is a decent base dose right now and you'll need to increase slowly from there. I'd encourage you to increase by no more than 0.25 u (eyeballed) at a time. You could try that tomorrow AM and make a point to get a +2 or +3 test to see what's going on.
 
Hurray for your success with injections! And it's great that you see the value in the spreadsheet. :smuggrin:

I think the blues on your SS are an indication that 2 u is a decent base dose right now and you'll need to increase slowly from there. I'd encourage you to increase by no more than 0.25 u (eyeballed) at a time. You could try that tomorrow AM and make a point to get a +2 or +3 test to see what's going on.
For some reason, maybe because she's small, I really thought she'd need less insulin. I need to constantly remind myself that she needs as much as she needs and that it's okay. I may not be able to test as much tomorrow so I may try the slight increase on Friday or Saturday. Thank you for the suggestion Kris, you seem very conservative in other posts regarding dose increases which makes me value your opinion even more.
 
I'm going to Walmart today for more test strips (somehow have almost used 100 already!) so I was planning on looking at their selection. I definitely want to try the 31 gauge...what brand do you use? Are they shorter as well? Are they syringes or do you use an insulin pen? Sorry for all the questions, just trying to figure out what will be best!
I HATE my 31g...I just ordered 29g in hopes it’ll be substantially larger. 31g is like trying to stick a hair strand in a marshmallow. That’s just me and Gretchen..somebody else here may love 31g.
This is just an issue with me (last night’s tear filled posts) right now.
 
I HATE my 31g...I just ordered 29g in hopes it’ll be substantially larger. 31g is like trying to stick a hair strand in a marshmallow. That’s just me and Gretchen..somebody else here may love 31g.
This is just an issue with me (last night’s tear filled posts) right now.
I'm sorry, it can be so hard figuring what works best for our kitties. The 29 gauge is definitely longer than the 31. Every time I take the 31g needle out of the insulin vile I'm shocked at how tiny it is. I hope the longer ones make it easier for you and Gretchen!
 
An hour before Tessie's PMPS she started acting super hungry so I expected her preshot number would be high. It ended up being 237, which has been the lowest PMPS yet. I did decide to give the full 2 units but of course afterward, I was second-guessing myself and worried she'd get too low. Tested again at +1 and it went up to 323. So I'm a little less worried but still going to test her in an hour or two after her food digests to see where she's at.
 
So she was at her lowest PMPS last night at 237 then tested today at 508 for her AMPS. Sometimes this feels like such a guessing game. Poor girl, that big jump cannot feel good.
 
So she was at her lowest PMPS last night at 237 then tested today at 508 for her AMPS. Sometimes this feels like such a guessing game. Poor girl, that big jump cannot feel good.
I'm sure bouncing must make them feel "off". It can be almost impossible to control though. And, yes, it can feel like a guessing game. o_O I think it's time to try 2.25 u with Tessie. Hold that dose for two or three days and if you don't get any good blues at least, increase to 2.5 u after that. Keep posting here for advice.
 
I'm sure bouncing must make them feel "off". It can be almost impossible to control though. And, yes, it can feel like a guessing game. o_O I think it's time to try 2.25 u with Tessie. Hold that dose for two or three days and if you don't get any good blues at least, increase to 2.5 u after that. Keep posting here for advice.
Thanks Kris! I will raise her dose on Saturday and will definitely keep posting for advice. You are all lifesavers!
 
Raised Tessie's does to 2.25 this morning and had the pleasure of giving my first fur shot :( You guys weren't kidding, what a crappy feeling.
 
This morning Tessie got a .2 dose increase and we tested a blue and her first GREEN! The green was at +8.5 which concerns me a little since it's lower than her +6. So I'm assuming that I missed her nadir and wondering how low she went. She's acting fine though :) As long as her PMPS is around 200 or higher should I still be giving 2.2 units? And probably set an alarm to check her overnight? Or maybe if its 300+ give the 2.2u and if it's 200-300 give 2u?

It's exciting to see some progress (even if it's only been a day) but it makes me a little nervous!
 
Good morning everyone! Tessie's AMPS this morning is 150. I tested her other ear right after at 170. Anyway, no shot yet at that low number but I did decide to give her breakfast since she seemed pretty hungry. My plan is to test her again in 2 hours and assuming her BG is in the 200s or higher, will give a small dose, maybe .5 units. By giving the small dosage, I'm hoping to get back on our normal schedule for this evening with a dose a little lower than normal, maybe 1 or 1.5 units, once again, depending on her PMPS.

I'm hoping for a confirmation that this seems like a good plan, but if you disagree, please let me know! I'm noticing fewer reds and more healthy numbers (and behavior), and with the fur shot a few nights ago, I hate to see her go without at least a token dose. Thank you!

P.S. I really wish I had chosen last night to wake up and test! I would have loved to know where her mid-cycle numbers were. :facepalm:
 
Good morning everyone! Tessie's AMPS this morning is 150. I tested her other ear right after at 170. Anyway, no shot yet at that low number but I did decide to give her breakfast since she seemed pretty hungry. My plan is to test her again in 2 hours and assuming her BG is in the 200s or higher, will give a small dose, maybe .5 units. By giving the small dosage, I'm hoping to get back on our normal schedule for this evening with a dose a little lower than normal, maybe 1 or 1.5 units, once again, depending on her PMPS.

I'm hoping for a confirmation that this seems like a good plan, but if you disagree, please let me know! I'm noticing fewer reds and more healthy numbers (and behavior), and with the fur shot a few nights ago, I hate to see her go without at least a token dose. Thank you!

P.S. I really wish I had chosen last night to wake up and test! I would have loved to know where her mid-cycle numbers were. :facepalm:
You don't need to wait that long. An hour should be fine. I did that feed, wait, retest thing with my guy when he was on ProZinc. If you're home to test you could try 1 u. Depending on PMPS you could try 1.75 u tonight.
 
You don't need to wait that long. An hour should be fine. I did that feed, wait, retest thing with my guy when he was on ProZinc. If you're home to test you could try 1 u. Depending on PMPS you could try 1.75 u tonight.
Thank you Kris! I will be home to monitor her today so I will go and test her now. She's been waiting around just staring at me the last 15 minutes so I think she could use some insulin.
 
She was at 241 so I gave 1 unit and now she is happily eating breakfast #2. Thanks again for the sounding board!

By the way, since I started this thread originally because the injections seemed painful to her, I wanted to update that her shots have been going great! After switching to short U-100 needles, she still fussed a little because of the ouchy memories of past shots, which lasted a couple of days. Ever since then, she just munches away on her food and doesn't even flinch for the poke. It also means that I had no excuse for the fur shot the other night. I was just rushing. Onward and upward!
 
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