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

By |2018-03-06T13:46:29+00:00Updated: January 11th, 2018|Pet Care, Pet Diabetes, Pet Newsletter|19 Comments

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.

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About the Author:

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.

19 Comments

  1. Stacey January 18, 2018 at 12:24 pm - Reply

    Hello Dr. Joi,

    My Vet just reduced my cat’s U100 insulin dosage from 1 unit to 1/2 of 1 unit, but I cannot find syringes that start at half unit, even if I change gauge. It seems they all start at 1 unit, what can I do?

    Thank you.

    Stacey

    • Dr . Joi Sutton January 18, 2018 at 8:08 pm - Reply

      Stacy, they do make a 3/10 cc syringe with half 7 it markings. On our website they are item number sy5751509436. Or, you can out “half unit” into the search box on the adw website. They are made by UltiCare

  2. Stacey January 18, 2018 at 12:26 pm - Reply

    Hello Dr. Joi:

    The Vet just reduced my cat’s U100 insulin dosage from 1 unit to 1/2 of 1 unit, but I cannot seem to find any syringes that start at 1/2 of 1 unit, even if I get a different gauge, what do I do?

    Thank you

    • Dr . Joi Sutton January 24, 2018 at 6:17 am - Reply

      They do make half unit marking insulin syringes, but the first “half unit” may not be clearly marked due to space on the syringe. Search “half unit” in the adw website search box to see the options. In this case you may be doing what we vets have been doing for decades… estimating a half unit. I used to drive the vet techs nuts at the emergency hospital where I worked in the 1990s over this. I’d say, a smidge under or a smidge over or a half unit and they would be frustrated with me. I’m so thankful that there finally are half unit marking syringes these days. I wish a company would make a 1/10 cc syringe with half unit markings. That would be awesome. I’ve asked ulicare reps to consider this in the past but I’m guessing it isn’t a very difficult size to make. Do your best. 🙂 Joi

  3. Dennis January 19, 2018 at 10:25 am - Reply

    We all hate seeing our pets in pain. These injection tips are definitely a pet owner’s lifesaver. Moving the injection site sounds like a good way to make your pet dread the injection less. Thank you for sharing.

  4. Alma Cooper May 25, 2018 at 8:55 am - Reply

    Dr Joi,
    I appreciate your comments. I’m afraid I missed when I gave my dog a shot of insulin. I will wait until the next shot is due.

    I do have a question. My dachshund/chihuahua mix has gone from 19 to 13.8 lbs. The vet said give him 5 units (from 3) and canned dog food. He is losing so much weight. I had been giving him boiled chicken with broccoli and green beans and brown rice. She said I was giving him too many carbs and to change to the canned dog food. I’ve been weaning him out of the homemade food to the canned. It is grain free chicken.

    It seems to me with this minimal diet he will lose even more weight.

    I would like your thoughts on this and how I can help him gain some of his weight back. I’m finding it harder to grab the skin to inject.

    Thank you.

    • Dr . Joi Sutton May 25, 2018 at 4:46 pm - Reply

      The weight loss I sent most likely from unretulated diabetes, although it could be concurrent disease. Step one is to run a blood glucose curve!!! Blood glucose curves tell us if we should adjust the insulin dose up or down or leave it where it is. No matter how many calories you feed, if your pet isn’t unable to utilize those calories it can’t gain weight to achieve proper weight. Do you run blood glucose curves at home? Do you own a blood glucose meter? First let’s see how well the blood glucose is regulated.

      Next, if there hasn’t been a recent CBC and chemistry profile and urinalysis, have your vet run these tests! Also, ask your vet to evaluate the calories fed and likely increase portions fed.

      Keep me posted! You may also email me directly at joi.suttondvm@adwdiabetes.com.

  5. Connie June 15, 2018 at 9:32 am - Reply

    My dog has lost a ton of weight. She is down to 21 lbs from 33 a few years ago. Her diiabetes has been difficult to control. We have always done insulin shots in her belly (she hates the scruff!), but in the past year she has startes yelping with shots. I wonder if there is less wiggle room since she used to have significantly more abdominal fat. We tent. We rub. We warm the insulin. We have tried cold packs on her belly. Nothing is working. Is it just a consequence of too little belly fat?

    • Dr . Joi Sutton June 19, 2018 at 9:12 pm - Reply

      Connie, it is common practice for humans to give injections to themselves in the tummy, but I’ve never given a dog or cat an injection in the abdomen. Why don’t you try the scruff for a bit to give her a break.
      When I first teach folks to give injections to their pet I have them start in the scruff until they feel confident. Then I have them move the injection site around. I do typically have them inject the top side of the pet for ease. We rotate sites to decrease scar tissue at any one site. Scar tissue could affect absorption of the insulin.
      I do think the weight loss could make her more sensitive to the injections.
      Do chat with your vet about her glucose curves and run a blood panel, up and urine culture to see if you can find a cause for her weight loss. Hopefully when she isn’t so lean the injection she won’t hurt so much.
      Good luck!

  6. Matthew July 7, 2018 at 4:02 am - Reply

    I have a sibirian samoyed and for the past three months I’ve been giving her shots with insulin pen only at the abdomen and switching positions. She receives one shot in the morning at the right side and the evening at the opposite. She looks fine and her blood sugar is normal. However the thing that wories me is using the abdomen. That’s by my vet recommendation. I could not found antywhere on the internet using that site to give shots. Is it ok if I continue doing so or should go for the shoulders hips instead?

    • Dr . Joi Sutton July 8, 2018 at 12:15 am - Reply

      I’ve never given insulin injections to a pet in the belly. I typically stick to the topline of s pet, often massaging the pet with my non-dominant hand. Once folks get good at giving injections I have them change injection sites—go down one side of the pet and then back up the other. If you poke the same site each time pet pet could form scar tissue which could hinder insulin absorption.
      🙂 Joi

      • Matthew July 8, 2018 at 2:26 am - Reply

        Thank Joi, I’ll probably try doing that. You know Samoyedes and their thick coat and fur, I had to shave her stomach to manage to give the shots properly. If you are familiar and if it makes any difference I’m using a Levemir Insulin and Flex Touch Pen. Giving her 4 units with each shot. Her blood sugar dropped from 27 to 6.5 (in the morning one-hour post breakfast).

        • Dr . Joi Sutton July 9, 2018 at 1:16 am - Reply

          I like levemir quite well for dogs. 🙂

  7. Penguin Lopez July 23, 2018 at 5:22 pm - Reply

    I have a Mini dachshund has gone from 16 to 12.4 lbs. The vet said give him 2 units. I just did how soon should he be feeling ready to start eating? In reality he hasn’t eaten in 2 days.He wasn’t able to walk at one point or even lift his head he was dehydrated 8%. Hes drinking today and I started insulin just curious what to expect as far as appetite.Hes sleeping alot but seems peaceful should I force feed him? Is he ok as long as hes drinking?

    • Dr . Joi Sutton July 24, 2018 at 7:59 pm - Reply

      He does not sound stable. Please take him back to the vet clinic ASAP for evaluation.

  8. About Penguin July 24, 2018 at 8:52 am - Reply

    Update 1 st shot yesterday 6 pm 2nd shot this morning drinking well but not eating at all.any suggestions?

    • Dr . Joi Sutton July 24, 2018 at 8:00 pm - Reply

      A diabetic who is not eating for days should see a veterinarian promptly.

  9. Rose August 4, 2018 at 7:00 am - Reply

    To Connie

    My dog takes insulin and she don’t care for the scruff either. We give her her shot in her butt.her left side in the morning and right side at night.

    • Dr . Joi Sutton August 6, 2018 at 6:39 pm - Reply

      Once someone gets used to giving injections to a pet (usually in the scruff as it often hurts less there) I want rotation of injection sites. Repeat injections at any one site can lead to scar tissue and affect absorption of the insulin. I usually have folks go down one side then up the other. 🙂

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