Problems with regulation
In cases of poor glycemic control, make a blood glucose curve and check for other concurrent or underlying disorders.
- Discuss the daily routine with the cat owner—are injections and meals correctly timed? See Feeding schedule.
- Ask for a breakdown of exactly what the cat eats—perhaps the cat is receiving too many snacks or the incorrect diet. See Nutrition.
Factors thought to contribute to a poor response to insulin treatment:
- Incorrect storage of insulin or poor injection technique
- Insulin resistance
- Somogyi effect
- Rapid metabolism of insulin
In cases of a poor response to insulin therapy, it is important to rule out these factors first.
Ask owners to demonstrate how they inject their pet and check the following:
- Is the insulin being stored correctly?
- Is the insulin being mixed properly?
- Is the insulin being injected subcutaneously?
- Is the injection site being correctly located?
- Is the injection site being rotated?
If using a syringe:
- How long has the vial been in use?
- Is the correct dose being drawn up into the syringe?
- Is a new syringe being used for each injection?
- Have the air bubbles been removed from the syringe during dose measurement?
If using VetPen®:
- Is the insulin cartridge inserted into the VetPen properly?
- Have the air bubbles been removed from the VetPen cartridge?
- Is a new needle being used for each injection?
- Is the correct dose being chosen using the dose selector?
- Is the release button being pushed down fully so that the dose selector returns to the start line?
- Is the movement of the dose selector restricted by the way the VetPen is being held?
- Is the needle being held in the skin for at least 5 seconds after the dose selector has returned to the start line?