Sometimes pet owners feel they just can’t do something. I’ll admit, collecting blood from your pet or giving an injection the first few times can be daunting for a pet owner. I recall 30 years ago, when I was just a pup, giving injections into an orange to practice. It’s true!
Last week a woman brought in her diabetic cat who was on an oral hypoglycemic medication but no insulin. Her prior vet is a good friend of mine and was greatly frustrated by this client’s refusal to give insulin injections. She did what she could, with the owner’s refusal to give insulin, and prescribed an oral medication. Even though cats are usually type 2 diabetics to start, often due to obesity and high carb foods, it’s best to get them on insulin right away. Theoretically oral hypoglycemic medications could help a diabetic cat, but our goal with newly diagnosed diabetic cats is to get them into remission. If we dawdle and pussyfoot around instead of getting them on insulin right away we are unlikely to get them regulated nor into remission. Additionally, type 2 diabetic cats over time can become type 1 (insulin dependent) diabetics.
This lovely lady refused to give injections because she was afraid she would hurt her cat. His blood glucose was over 500. He was dehydrated and having trouble walking. He felt like crud. He needed insulin! She said her hands didn’t work as well as they used to. She gestured with her hands as she explained this to me. Her hands looked fine to me as she gestured. My staff went in and let her practice giving injections into a towel until she felt she could do it. She had believed she couldn’t give an injection until she knew she could. I didn’t really give her a choice. Clearly the only treatment she had previously allowed by her prior doctor was not working. I had her practice giving injections of saline into a towel with my staff helping her. She then believed she was capable of injecting her cat. When the kitty came back for a recheck this week he looked like a million bucks. He wasn’t regulated yet, but he looked like a different cat. She beamed with pride that she was able to give the injections. I don’t yet have her trying to check his blood glucose at home… I was just tickled that she got over this hurdle in her mind. Baby steps.
Now let’s chat about checking blood glucose at home. This may be an even bigger emotional hurdle for some folks than giving insulin injections because it involves blood. Some folks actually pass out at the sight of blood, especially if the blood is from a beloved pet! This is one of the reasons I like when pets are getting tested at with at-home meter so much – test strips these days require such a small amount of blood for glucose testing! It just takes and patience to get comfortable with the process. But, once you do, it will become easier for you, less stressful for your pet, and also save you a lot of time and money in the long-run.
Perhaps the most commonly asked question I get is how to check a blood glucose. At my clinic in South Florida we get a lot of snowbirds. I now have a family that spends part of the year up in New Jersey and the winter down here. Their dog has been diabetic for a year and they had never heard of a glucose curve. Their other vet would do spot checks. He was unregulated. They were willing to try testing at home, but had their reservations. This senior pet’s ears were extremely fuzzy. Even when I shaved some fur over the marginal ear vein, the fuzz wicked away the blood drop. The owners didn’t like the idea of getting blood from the inside of his lip. Aha! I spotted his beautiful elbow calluses that senior dogs can get, bare from fur. I did my sock trick (uncooked rice or beans in a sock and warmed in the microwave to warm the site), and he gave us a beautiful sample, way more than we needed. So at that point I dialed back the depth on the lancing device a notch for the next time they tried it. They then successfully ran a blood glucose curve at home!
I discourage running blood glucose curves in my clinic. I will run a curve in my clinic if an owner is physically unable or emotionally unwilling to do it at home, but I much prefer for curves to be run at home. There is likely an artificial elevation of the blood glucose when run in a clinic setting. It’s the white coat syndrome. When pets are in a vet clinic they can easily have stress hyperglycemia. We hate to base an insulin dosage on potentially faulty information.
Additionally, home testing saves pet owners big bucks!
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NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.
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