Q. We recently moved to Richmond, Va., from New York, where I had the same vet for 25 years. My 13-year-old cat recently developed diabetes and is on three units of PVC, twice daily. One vet said to give the shot after tenting the scruff area. Another said to give it anywhere. After tenting the scruff area consistently, she recently began to growl, yell out and swipe at us. We tried distracting her with a toy, which seems to help. This morning I gave her the injection in her side and she reacted with a small whimper. What do you suggest? We are both getting anxious with the shots. 

A. I generally recommend the administration of insulin at different sites along the lateral abdomen and thorax for several reasons. First and foremost, the absorption of insulin is dependent on the local blood supply under the skin. These areas seem to allow better absorption. By alternating the location of the injection, you limit the chance of building up scar tissue in any one particular area, such as the scruff of the neck, which also acts as a barrier to absorption of the drug.

Repeated injections in the same site will eventually cause enough inflammation to become painful and may even lead to lesions in the skin.

I also recommend that the patient be distracted with a toy or a small morsel of food (in diabetic cats, protein is essential, so a small bit of chicken is perfect) so that they do not focus on the injection. I have two clients who put a dab of catnip in front of their cats before injecting them. One of these cats actually stands in front of the drawer where the catnip is kept in the morning until her owner gives her the shot. Diabetes can be a challenge, but a challenge well worth pursuing for our feline friends.