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|60 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.

60 Comments

  1. Nalana Fields July 22, 2021 at 10:33 am - Reply

    Found out my 11 yr old poodle has diabetes back in April.Been trying to give 1 shot in morning 7 am or there about and 1in evening. He’s getting harder and harder to feed that early in morning. He was never used to eating that early before. I have used everything to try to coax him to eat. This morning he just wouldn’t eat anything. But in evenings I have no problem. Today he had to miss his morning dose because of not eating. It looks like this is an every day thing now. Not sure how to handle the situation. My vet told me that as long as I could get him to eat a bite of anything I could give him insulin. Then usually I could get him to eat around one in afternoon. But then it got
    harder to get him to eat in evening. I am so frustrated that I can’t give him insulin on schedule. Do you have any advice for me. My poodle is my world and I feel like I am letting him down.

    • Dr . Joi Sutton July 25, 2021 at 3:00 pm - Reply

      It sounds like he was a once a day eater even before he had diabetes. Have yo7 tried feeding him less at meal sothatheis hungry when the next injection time (12 hours later) he is hungry? That would be my first step. And of course if he isn’t eating an you wish to give him insulin you should check his blood glucose. That can help you and your vet how much insul8n to give in such situations.

      It’s also possible that he may be nauseous. Diabetic dogs not uncommonly also have a smouldering pancreatitis which causes nausea. High blood glucose can also cause nausea. Ask your vet about a prescription of an anti-nausea medication to see if that helps his appetite. Cerenia and zofran (ondansetron) are both excellent anti-nausea medications. Zofran is now generic and quite affordable if you do a couple week trial.

      Chat again with your vet. And if you aren’t check8ng the blood glucose at home already, I suggest yo7 gets Alphatrak meter. It’s the easiest pet glucose meter to use as it’s so simple and it requires such a tiny droplet of blood for a blood glucose reading.

  2. Anonymous July 20, 2021 at 11:00 am - Reply

    I’m concerned that because I don’t pinch the skin on my dogs scruff that the insulin isn’t being absorbed correctly ?

    • Dr . Joi Sutton July 25, 2021 at 2:52 pm - Reply

      I don’t think pinching the skin affects the absorption. Certainly some things can affect absorption such as cold weather versus hot weather.
      It’s always a good idea to rub the injection site before you poke your pet as it stimulates nerve endings and decreases the pain felt by your pet. And rubbing the site after the injection for a couple seconds also helps decrease pain. (You love your pet and rubbing the injection site pre and post injection will be soothing emotionally for your pet in addition to decreasing pain sensation from the poke.

  3. Linda Madden July 18, 2021 at 12:36 pm - Reply

    My cairn has been sick and diarrhea and is off food can I give her insulin with out food

    • Dr . Joi Sutton July 18, 2021 at 10:43 pm - Reply

      When you say she’s is sick does that mean she is vomiting? I hope you have a blood glucose monitor. Without knowing her blood glucose you don’t know if she can take her insulin dosage. Contact your veterinarian immediately. And check her blood glucose so you can make educated choices. I have an article on the ADW website titled Tips and Tricks for obtaining blood for a pets blood glucose test that you might read.

  4. Debie Wendler July 15, 2021 at 1:43 pm - Reply

    We missed our 1st dose of insulin this morning. Should I give the afternoon injection like normal. We just found out Minnie (6 yr old; 15 #) was diabetic yesterday so I had to get the insulin today. The vet sent me home with 1 filled syringe . This whole process is stressing me out!

    • Dr . Joi Sutton July 18, 2021 at 10:59 pm - Reply

      In general if you miss a dose you should likely wait til the next regularly scheduled dose. As you are new to diabetes care, look for the “back to basics” articles I wrote on our ADW website a couple years ago. Plan on getting an Alphatrak blood glucose monitor (as it is the easiest to use of the pet blood glucose monitors and takes the smallest droplet of blood to get a reading). Google 2018 AAHA Diabetes Guidelines which is a wealth of information about pet diabetes. And check out veterinarypartner.com which has some great education articles for pet owners about diabetes. Education is key to a well controlled diabetic pet. I’m not sure if Minnie is a dog or a cat. Know that feline diabetics have better glucose regulation on low carbohydrate diets.

  5. Craig Peters July 5, 2021 at 8:59 pm - Reply

    Hello, Dr … Do you have any advice for giving insulin shots to a troublesome terrier? We have been giving our Cairn twice-daily shots (5 units) and at first it was relatively easy… we would give it to him while he was eating or otherwise distracted… Few problems… But over time he has grown to dread the shot; It’s less about the pain than the process. He fights like a proverbial mad dog. We have had to use a muzzle more often than not in recent weeks. It occasionally can be a 20-30 minute stressful struggle. He arches and twitches his body such that it’s impossible to keep a pinch still enough to inject. Help! Any tips welcome!

    • Dr . Joi Sutton July 11, 2021 at 8:50 am - Reply

      Do you rub the site before giving the injection? With any injection it I should best to rub and massage the pet before giving the injection and also after the injection. It stimulates the nerve endings in the skin and just as your mama said when you were little and had a boo boo, rubbing it does indeed mKe it feel better. You might pet him in such a manner at times when you aren’t following the rub with an injection as well. Pets can send your anxiety so relax and be calm.
      Have you tried other injection sites just in case it’s a tender area for him? Most often I have clients start with injections over the scruff as that area tends to hurt less for a poke. Then as folks get less she’ll shocked with the idea of poking their sweetie I have them go down one side of the pet then up another side.
      I’m glad you have a soft muzzle for him as terriers can be headstrong. If there is more than one person in the home, one can distract the pet and the other can give the injection.
      A favorite treat such a a small piece of chicken can be given at the time of the poke as well.
      Chat with your veterinarian for any ideas from the doctor who has examined him.
      Best, Joi

  6. Ann Marie July 2, 2021 at 8:03 am - Reply

    I gave my dog a shot & I’m not sure there was insulin in the needle

    • Dr . Joi Sutton July 4, 2021 at 9:42 pm - Reply

      In a situation where you think you missed or part came out or maybe you didn’t have insulin in the syringe, the safest option is to wait until the next dose and give insulin then. The reason why we don’t want you giving another dose is that on the chance your pet did get the insulin a 2nd dose could cause hypoglycemia. Make sense?

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