VETTECH U 2024 / HOUSTON, TX
“SWEET” AND LOW: TECH TIPS FOR CLIENT EDUCATION ON DIABETES (CONT.)
Sponsored by
SATURDAY PM • SEPTEMBER 21
ALEXIA VILCHIS, LVT INTERNAL MEDICINE, GULF COAST VETERINARY SPECIALISTS
stabilizing the syringe with the other hand. I have my clients pull back on the plunger and draw up more medication than they need since this is typically easier than drawing up an exact amount on the first try. After their medication is drawn up, I show my clients how to push the excess amount of insulin back into the bottle and stop at their desired amount of insulin before pulling the syringe out. When teaching clients these techniques, I often find it easier to have them practice on small vials of saline before moving on to real insulin vials/pens. The steps to drawing up medication are typically the same for each type of insulin pen. Some insulin pens, such as VetPen®, have their own needles and can be used to administer insulin rather than being pulled up with a separate syringe. As clients become more comfortable with handling and techniques regarding insulin administration, it’s time for them to practice! I start this portion of my demo by asking my clients if they will have help at home. Establishing help at home dictates which restraint techniques I will show them. If clients have help at home, I show them a few ways their partner can safely restrain their pet before moving on to practicing administration. I have found it very helpful to email our clients demo videos that go over each step in case they need a refresher or feel nervous before their first solo time medicating their pet. This can be rather stressful for a client who has never done something like this, especially if they are giving an injection alone. I express that no matter how silly you may look while medicating your pet, your safety comes first. I often teach my clients how to burrito small animals. Another great tool is distraction. Associating being poked with something good, such as your pet's favorite toy or a treat, is also a good way of making your pet more comfortable with receiving injections. If we have a patient who may not be as tolerant of being wrapped in a towel, I will send my clients home with an e-collar, so they have an extra barrier in place to keep them safe.
Now that my demo is complete, I finish by answering any questions my client may have. The most common questions I receive are "What if I missed a dose/double dosed?" or “How can I check my pet's values?". Usually, the rule of thumb at my hospital is to assume you gave the insulin and wait to redose until the next time it is due. I also teach my clients the signs of hypoglycemia if a patient has accidentally been double-dosed. Some of these signs can include vomiting, disorientation, weakness, or seizures. If a patient starts to exhibit any of these signs, I always recommend that they call us so we can give them more specific instructions on what to do. When these cases are milder, with the doctor's recommendation, we usually advise giving the patient a small meal and checking if they get back to “normal” after a few minutes. If this is more serious or the patient does not become “normal” after their meal, we ask our clients to visit the clinic or their referring veterinarian to assess their pet more carefully. Based on the client’s comfort level, I have them check glucose values at home using a glucometer or a continuous glucose monitor. Glucometers check glucose levels by applying a small blood sample onto a test strip inserted into the glucometer. Small blood samples for glucometers can be obtained from a foot pad, lip, or ear pinna. Sample collection can be started by warming up the area first, applying pressure (a pinching motion), and then pricking with a lancet/needle. After the prick is complete, you can squeeze the poked location so blood rises to the surface. Once you see blood, it can be drawn up with the test strip from the glucometer. Continuous glucose monitors check glucose levels by placing a small catheter-like sensor into the subcutaneous interstitial space. To minimize errors when placing these sensors, we ask the clients to come into our clinic so we can place them and secure them on the patient's skin with skin glue or protective covers. When placing sensors, I shave a small patch of fur below the shoulder blades, clean it with alcohol, and let the area fully dry. As the skin
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