April 06, 2018

Azi's Experience Learning to Administer Insulin

Azi Chegini describes her experience in learning from her veterinarian and veterinary technician how to administer insulin and the support she received as she was learning; Ruth MacPete, DVM, talks about handouts veterinarians give to owners to walk them through insulin administration; and Richard Goldstein, DVM, DACVIM, reinforces that the goal of therapy in managing diabetes in pets is to maintain quality of life.


Richard Goldstein, DVM, DACVIM: Azi, you heard it from our end. We think we’re doing a great job at this. How was your experience?

Azi Chegini: Obviously, I was lucky to have a veterinarian who did do exactly what these ladies have been saying, the experts. I’ve got a traitor here.

Richard Goldstein, DVM, DACVIM: That’s OK.

Azi Chegini: But clearly, he loves you and you two are very great at what you do.

Richard Goldstein, DVM, DACVIM: Walk us through it. How did it happen for you? When did you learn it? Who taught it with Charlie?

Azi Chegini: I learned it with Charlie, and I was almost as much an expert as you can become at that. But my veterinarian and technician were the ones who showed me. They didn’t have any stuffed animals; they used an orange.

Richard Goldstein, DVM, DACVIM: Oranges are great, by the way. An orange has a good feel to it, once you hit an orange.

Azi Chegini: Exactly. They said, “This is how you do it, make sure.” That’s exactly what it was. “Are you using the right syringe? This is how you don’t shake it.” All of that was a step-by-step process they explained to me, and I actually did give an injection in front of them.

Richard Goldstein, DVM, DACVIM: Is that the first time you’d ever given an injection?

Azi Chegini: No.

Richard Goldstein, DVM, DACVIM: You don’t have to answer that, I guess.

Azi Chegini: No, it wasn’t. I’ve actually done Biomet injections before.

Richard Goldstein, DVM, DACVIM: All right, so you weren’t quite as scared as some.

Azi Chegini: But still, I think for me not being the veterinarian or technician, it’s more of the emotional part of it.

Ruth MacPete, DVM: It is. You don’t want to hurt your pet.

Azi Chegini: Exactly.

Richard Goldstein, DVM, DACVIM: What was the toughest part of it for you? Was it just hearing the talk and thinking, “OK, can I actually do this?” What was the hardest part that you anticipated?

Azi Chegini: I think it was part of, I am going to go home with this pet who clearly needs me, I’m going to go home with the instructions, but am I going to get it right? But I think those tools that they gave me and practice made it easier. When I went home, I actually did it. I remember calling my veterinarian and technician and telling them, “It’s done, I’m good. What do I do now?” They just said, “Relax, you’re just going to do this 1 more time, and we promise you by the end of the week that you’re going to feel like this is nothing.” That’s exactly what happened.

Ruth MacPete, DVM: I was just going to add that with all the information we give people, that can be overwhelming, too. They listen to me talk, then they listen to the technician talk. Like you said, they need time to process everything. But we also give people handouts. Almost every veterinarian is going to give somebody a handout with all of these instructions, so they don’t have to memorize what we say. They’re going home with a piece of paper that usually reminds you to roll the insulin, not shake it, and talks to you about the syringes that you’re using and how to pull up the insulin. And then, we talk to them about logging it and everything else. We’re also not just explaining it verbally, we’re giving them a piece of paper. I know for me, it helps to sometimes have something written down and be able to look back at it and say, “Oh yes, that’s what Brittney said, that’s what MacPete said. Oh yes, I remember that.”

Richard Goldstein, DVM, DACVIM: How was that for you?

Azi Chegini: I absolutely agree. I think the reason I’m really excited about this and I’m glad that I’m sitting among the experts is having a piece of video, having something that in the middle of night after you’ve had to work. Again, I’m a person who has a job and has a pet; this is not what I do every day like you guys. At the end of the day with everything else that is going on in my mind, having a place to be able to just click and watch reinforces and cements everything that I just heard from my veterinarian and technician. It just helps me that I can even listen to it and say, “OK, I got it,” and then have the paperwork and the handouts to actually reference later on when I have time. I think that’s what I’m excited about, PetConnections and these videos, because that tells me, “You have hope, there is a solution, don’t worry.” That’s what I hear, in that order.

Richard Goldstein, DVM, DACVIM: Well, you’re a role model now. Azi, with Spider, how long did it take to get the right dose and get into a rhythm and a pattern?

Azi Chegini: About a month, maybe a little bit longer. He was completely off. The foster, who was a great foster, still had 6 other dogs, and he wasn’t getting everything that he needed. She had to actually take him to the veterinarian to do the curve or the study that they do for a day. So, it was really helpful for me to get the resources from my veterinarian and have the monitor at home to be able to do it on a day that I’m off work and can actually do it.

Richard Goldstein, DVM, DACVIM: And to help figure out the dose.

Azi Chegini: Absolutely. And then, I would call or text my veterinarian right away and say, “This is what I got, what do I do?” I’m not going to say that I’m an expert at it, but at least I can collect the data and let them be analyzed.

Richard Goldstein, DVM, DACVIM: Was the insulin from the veterinarian or was it from a pharmacy?

Azi Chegini: It was from the veterinarian.

Richard Goldstein, DVM, DACVIM: Good, that’s great.

Azi Chegini: Yes, and the needles. Everything.

Richard Goldstein, DVM, DACVIM: I know you texted her. You said you called her all the time. About how often did you actually have to go in with Spider initially?

Azi Chegini: Initially, we went once a month.

Richard Goldstein, DVM, DACVIM: That’s not bad. That’s great.

Azi Chegini: No, it wasn’t bad, just because of the experience that I had with Charlie, which involved a lot more going in. But now we do the bloodwork every 6 months and a wellness checkup. If I have any questions, I do use the monitoring.

Richard Goldstein, DVM, DACVIM: How often do you do that? How often do you use home monitoring?

Azi Chegini: I actually do it once a month, or almost once a month. I pick a Saturday or Sunday and I just start from 7 or 8 o’clock in the morning and record what I get every hour. Then I text all the information right to my veterinarian and ask, “Am I doing this right? Do I need to change any of the units? Do I need to change the timing? What do I do?” And she just basically gives me her interpretation.

Richard Goldstein, DVM, DACVIM: We’re going to get really deep into home monitoring in just a moment, but just before that, remember our goal, right? Our goal with pets is quality of life. We want them to be happy, healthy pets and not spend the whole day by the water bowl, not eat a ton, and not lose weight. They should just be happy and live a normal life, with a little bit of a shot here and there. So, if those were the goals, how is Spider doing?

Azi Chegini: He’s snoring.

Richard Goldstein, DVM, DACVIM: Do you think that so far, he’s been successful? Have you been successful?

Azi Chegini: I would absolutely say that, in this case, I give myself a pat on the back. Yes, absolutely.

Richard Goldstein, DVM, DACVIM: That’s great, thank you.

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