Giving a Pet Insulin Injection and Missing | Ask Dr. Joi

By Dr . Joi Sutton|2018-03-06T13:46:29-05:00Updated: January 11th, 2018|Pet Care, Pet Diabetes, Pet Newsletter|119 Comments
  • Dog about to get an insulin injection

I get some great questions from clients. They inspire me with article ideas and keep me in tune with diabetic pet owners. I enjoy interacting with our readers, and sometimes the questions are worthy of a newsletter. I bet if one person has this question and takes the time to write me, there are likely lots of folks with a similar question. Todays question is about grabbing too much skin during an pet insulin injection.

Dr. Joi, tonight I believe I grabbed too much skin when giving my dog his insulin injection and POSSIBLY gave an intramuscular injection instead of subcutaneous. It hurt him. He cried and snapped at me. I was having a difficult time pulling up skin in a different area is what I believe happened. Is this harmful to him? Will he still get the effects of the effects of the insulin or is it just lost?

When I teach folks to give insulin injections, I have them practice over the shoulder blades for the first month or so until they feel comfortable. Over the shoulder blades it is usually easy to pick up the “scruff” of a pet, and for some reason it doesn’t seem to bother pets much there. As you do it more and more you become an old pro. Once you have the hang of it you can start rotating injection sites. It is best to move injection sites around so you don’t cause scar tissue by poking the same area over and over again. Scarring could hinder insulin absorption.

Every now and then a poke may come near a nerve in the skin and hurt a bit. Or, as you experienced, a pet may wiggle and you might give it intramuscularly (IM). An IM injection could certainly affect that dose. It might be absorbed more quickly or not last as long as a subcutaneous injection (particularly if the insulin is one that is pH dependent), but don’t fret… It was just the one injection. You will be back on track the next injection.

Now, you know to rub the area before the injection, yes? Your mom probably told you when you were a kid to rub a boo-boo to make it feel better. That’s hard science! Really, when you massage the skin before an injection it stimulates nerve endings in the skin and it really does help the injection hurt less. When I give a pet an injection of any sort (insulin, medication, vaccine, whatever) I rub the skin for a couple seconds before the injection, during the injection and a couple seconds after the injection. It really helps decrease discomfort of the injection. Besides, this is your sweetie and you want to pet and hug your darling after the injection regardless for being a good pet. You want the injection to be perceived by the pet as an episode of love and cuddles rather than a poke, but in reality it is both!

Every now and then you will “miss”. Everyone does! Maybe you feel wet fur after the injection and wonder. Maybe you know right away that the needle came out. Rarely will you know that the pet got all or got none of the injection. If you are not certain, don’t give another injection. Really, a short period (well, 12 hours) of hyperglycemia for a missed shot is safer than a short period of hypoglycemia from being dosed twice. Just wait until the next injection time in 12 hours and start fresh rather than risk an episode of hypoglycemia.

Chin up. Soon you will be very proficient with insulin syringes and injections. Again, once you get the hang of it start moving the injection site around. Maybe go down one side of your pet one week then back up the next side the following week.

Have a question or comment? Then post below! I always enjoy hearing from my readers!

NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

About the Author: Dr . Joi Sutton

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida. Connect with Dr. Joi on LinkedIn


  1. Tracy E. February 7, 2024 at 9:43 pm - Reply

    We are going to be out of town for two days. Our cat will miss a Saturday morning insulin dose, will get a dose Saturday night, then will miss a Sunday morning dose, but will get their dose Sunday night. Will that be okay?

    • Dr . Joi Sutton February 11, 2024 at 7:11 pm - Reply

      It’s not ideal, but life isn’t always perfect. If your diabetic cat is well controlled, then it should be okay but your cat will have a higher blood glucose level than normal for that time while you are gone on Sunday. This is why it’s good to have a village who can help give injections for your diabetic pet so you can leave town! If your pet is not well controlled (ie a fragile diabetic), you might ask one of your vet techs if they could come do a house call for the Sunday morning dosage or treat a neighbor how to inject insulin for the Sunday dosage.

      A quick note on feeding a diabetic cat: Do know that canned food is much lower in carbs than dry food. This is why we recommend canned food for diabetic cats and skipping the kibble for diabetic cats. I prefer diabetic cats get no dry food as dry food increased the dosage needed of insulin compared to canned food. If your cat is getting dry food, be sure to chat with your veterinarian. Canned food can lower the spikes of blood glucose after a meal.

      Have a good trip!

  2. Marilyn January 15, 2024 at 10:43 am - Reply

    My dog is vicious when it is shot time. Does not let me near her. Where all can you give a dog an insulin shot. She weighs 28 lbs Shitzu bison dog

    • Dr . Joi Sutton January 16, 2024 at 1:23 pm - Reply

      First of all, be safe! Have a chat with your vet who has examined your pet for guidance. A Shi Tzu / Bichon mix is likely small enough that if you have a family member wrap her in a big blanket and distract her with a treat, you might be able to get an injection into a hind leg. Normally when we start with injections, we have owners gain confidence by giving in into the withers (over the shoulders). Once the pet owner feels comfortable with giving injections we start rotating injection sites. Over long periods of time if we don’t rotate injection sites the body can form scar tissue that can affect the absorption of insulin. So, if possible rotate which leg or hip you give the injection. Be sure to rub the skin of the injection site before you insert the needle as that stimulates nerve receptors in the skin so the pet doesn’t feel the injection as much as if you didn’t rub the skin. (If you watch your vet or a vet tech give an injection you will likely see him or her rubbing the injection site before and after the injection.) Do chat with your vet and ask for assistance. Best, Joi

  3. Ron Alexander November 20, 2023 at 6:57 pm - Reply

    I searched for info on a missed injection, or at least part of and this site came up first. I’m happy it did. This is one of the hardest things I have ever dealt with with dogs. Our 8 year old OmChi was diagnosed about 8 weeks ago. We are still struggling to get him in range. The last couple weeks, he has been giving me problems so I have to chase him down a little. I wish they could come up with a pill form like they have for cats. I will visit this site often for tips and tricks. I am really sad and struggling with this diagnosis. Thanks for letting me vent a little!

  4. carok October 2, 2023 at 4:33 pm - Reply

    I ran out of insulin and my Lhasa Apsos missed a day of insulin. Went to vet to purchase more. Rockybnwas peeing alot anfb Threw up. When home would not eat. I gave him his Full dose (15mg) as this is what vet told me to do when Rocky was first diagnosed. he is lethargic, wouldn’t eat. what should I do if he doesn’t eat 2nd meal? I have no way of cking blood level and Vet is cloised

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