When you’re the pet parent of a diabetic pet, the last thing you want is to have them associate their insulin injections with something scary. Some diabetic pets will need insulin every 12 hours for the rest of their lives, and if they don’t get their injections regularly because they’re hiding or trying to bite, the results could be life-threatening. It’s also important to minimize fear, anxiety, and stress (FAS) in our pets for their emotional welfare and to honor the bond we share. Here are some Fear Free techniques to consider using for your newly diagnosed diabetic pet.
The Treat-Ment Station
When it comes to providing Fear Free husbandry and medical care, treat-ment stations are a game changer. A treat-ment station is a comfortable, non-slip surface such as a bathmat, yoga mat, or pet bed that you can start using to help make your pet’s insulin injections positive. You want your pet to associate their treat-ment station with good things like treats and praise, and to have the ability to go to the station and leave the station on their own. Providing this sense of control significantly decreases the FAS a pet can have with handling.
Ideally, training sessions for diabetic pets should happen around the time of insulin injections to avoid causing fluctuations in blood sugar levels throughout the day. Always check with your vet about which treats are appropriate. Most diets prescribed for diabetic pets come in a canned formulation, which can be easily smeared onto a textured food puzzle like a LickiMat to give you extra time to administer the injection.
When station training, try to position yourself at the same level as your pet since pets can find it scary when someone is bending over them. You can spray the station with a calming pheromone such as Adaptil or Feliway 30 minutes ahead of time, and have your vet-approved treats ready in a treat pouch. Call your pet with a happy voice and lure them over to the station with a treat, then toss a pea-sized treat every couple of seconds when your pet is on the station. Throw a treat away from the station, and reward them for coming back to the station. Always end the session on a good note. If your pet moves away from the station and loses interest, pick up the mat and end the training so you can respect that opportunity for choice. You can also end the session by tossing a treat away from the station and doing something fun like asking for a trick.
Unlike a “settle” mat, the treat-ment station should be stored when not in use because you want to be there to positively reinforce your pet for going onto their station. The beauty of treat-ment station training is that the station is portable, and with practice, can help reduce FAS for care when your pet is in a stressful place like the groomer or the vet clinic.
Training for Injections
Do you remember when you first switched to an electric toothbrush? The initial few brushes were programmed to start at lower speed, because the manufacturers knew that it was a strange feeling and wanted the brusher to gradually get used to the sensation before going up to full speed. We want to apply that same principle to training for insulin injections.
Many pets don’t like having certain areas of their body handled, and the feeling of having their skin lifted for the injection can feel uncomfortable. Some pets even develop FAS when they see a syringe because they’ve associated them with past painful or frightening experiences at the vet. Using a technique called desensitization and counterconditioning (DS-CC) can gradually accustom your pet to the injection by pairing it with something to change their emotional response. In this instance, the “something” will be treats and praise so that they feel positive about their injections.
As with treat-ment station training, try to time your injection training around the time of feeding/insulin injections to help minimize blood glucose fluctuations. Monitor your pet’s body language for signs of FAS (more in the “Resources” section). Staying below your pet’s threshold and remaining patient as you progress through the steps are key to making injections Fear Free.
First, we want to teach your pet that the sight of an insulin syringe means something good is coming. You can start by showing your pet the capped syringe at a distance and giving them a treat for approaching, then putting the syringe and treats back behind your back so they learn that when the syringe comes out, so do the treats. If your pet is fearful of syringes, back up a training step and place the syringe on a surface further away, then treat them for approaching the syringe on their own.
Once they’re comfortable with the sight of syringes, you can start DS-CC to handling for the injections. Logistically, insulin injections are usually given somewhere on the pet’s back because it’s often the most comfortable for us and for the pet. You can start with the area between the shoulders, although eventually you’ll want to start rotating the injection sites somewhat because skin can start to scar with repeat injections in the same site and potentially make the insulin less well-absorbed.
Place yourself on the same level as your pet and positioned next to or behind them, since eye contact can cause stress. Touch your pet lightly between the shoulders, then give a treat. Repeat until your pet is comfortable and associates a touch with a treat. Next, practice lifting the skin between the shoulders a couple of inches, then treat. Once your pet is comfortable with having their skin lifted, you will progress to training your pet to accept having their skin “poked” with a capped insulin syringe, then a fake needle such as the tip of a ballpoint pen. As you start to get more practice with handling the syringe and your pet’s skin, you’ll find that most insulin injections take only a few seconds to administer.
Ideally, you would break up injection training into multiple short sessions over time to minimize your pet’s FAS levels and let training progress at your pet’s own pace. Unfortunately, you may not have this luxury because most newly diagnosed diabetic pets will need to start their insulin as soon as possible. If your pet is showing significant stress during injection training, ensure that their treats are high-value, and try smearing the canned version of their prescribed food onto a textured food puzzle to act as a long-lasting distractor. Some pets are sensitive to even the tiny needles on insulin syringes, so you can decrease the pain of injections by applying a thin layer of topical anesthetic cream called EMLA (lidocaine/ prilocaine) to the site one hour prior.
Ask your vet if a calming medication to use during DS-CC for the first couple of weeks would be appropriate for your pet. Finally, if your pet is still showing FAS with insulin injections, don’t hesitate to reach out to a Fear Free trainer or other positive trainer. We don’t want your pet to have any negative associations with something as medically essential as receiving insulin, and taking these few extra steps will ensure that they’re as stress-free as possible.
“It’s important to respect growling and not punish it, especially with greetings,” she noted.
Putting It All Together
Now that your pet is comfortable with their treat-ment station and insulin injections, it’s time to start training your pet for injections on their stations. Some pets will do great with receiving their insulin immediately on their stations, but with others you may have to back up a few steps and use higher value reinforcers/ distractors if they start showing FAS. With time, your pet will show just as much excitement when they see their treat-ment mat as Dorie does because you’ve helped bring Fear Free to their medical care.
Resources
https://www.fearfreehappyhomes.com/video/cat-body-language-101/
https://www.fearfreehappyhomes.com/how-to-help-your-dog-love-vet-care/
https://www.fearfreehappyhomes.com/video/creating-a-fear-free-treat-ment-station/
https://fearfreepets.com/resources/directory/
https://karenpryoracademy.com/find-a-trainer/#!directory/map
https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes_insulin_cat_final.pdf
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Dr. Julie Liu is a Fear Free and Cat Friendly veterinarian, speaker, and freelancer based in Austin, Texas. Dr. Liu has a special for a special passion for felines and senior pets, and loves travel. Learn more about her work at www.fluxvet.com.
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