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.
Ensure Your Pet’s Health with Reliable Insulin Syringes
Ensure Your Pet’s Health with Reliable Insulin Syringes
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.
Good morning. I have a question I have been rotating shoulder blades but we have scar tissue so I have been moving down the side toward about 2 inches from the spin or a little lower. Athena ( 9 yr old pomchi) skin now twitches when injection the insulin not when I poke but when I inject I have tried everything and it still twitches. Is this normal? In her shoulder area it did not do this.
Good question!
I think injections typically hurt less in the shoulder/scruff area. (That’s why for many years vets used to routinely give vaccinations there before we moved to limbs..) Nonetheless, you don’t want to give insulin where she had built up scar tissue as that could hinder absorption.
The amount of insulin for a small doggie is typically a small volume, but if she reacts to the administration rather than the needle insertion perhaps it is that insulin is kept in the fridge and she’s reacting to the cold. Maybe let the syringe with the insulin sit at room temp for a few minutes before you give it? Or, perhaps she has a superficial nerve that is in the area you’ve started injecting. Of course, chat with her veterinarian. 🙂
Hi again, I want to add something as I was just reading more. The insulin did not go through the tent because it was on her back on the side where the shot went in from, not where it would go if it had gone through. It was as if it came out upon removal, in the direction like I was pressing the plunger as I was taking the syringe out.
I want there to know, but I can tell you that there isn’t much residual fluid in the “hub” of an insulin needle. Perhaps you hadn’t pushed the plunger in all the way. In regular needles the volume in the “hub” (the space between the barrel of the syringe and the fully depressed plunger) is about 1/20th of a cc. The volume in the hub of an insulin needle is minuscule.
I just gave my cat her insulin and I know the shot went in and I saw the needle come out after I pushed the plunger… then I noticed a long streak of wetness on her back and it was obviously the insulin. It smells so strongly. How on earth is it that this happened? It has happened on occasion that I can smell it on her. This time I saw it and she gets 2.5 units (lantus) and I have no idea how much actually went in her since I could visibly see it on her fur. It was on the top of her fur in a line. Is it possible for it to squirt out of her skin? I am not giving more and will wait until her next dose. It’s just really challenging to get a good tent and inject as her skin is tight and this morning took a few attempts. It went seamlessly and then I saw the wetness and have no idea how that’s possible since I literally saw the needle come out so know I had it in her skin and not just on the fur.
Also, my vet is quite fond of kibble even for diabetics so my cat, who was all wet before, does get some prescription kibble as treats with her shot. Have you found even the prescription ones, used like this (she gets maybe a teaspoon of them at a time or less usually) is still not good? She loves them and getting “treats” so this is about the happiness factor as well as calorie intake. She’s 15 and gets half prescription wet and half high quality wet for a meal because she doesn’t like the prescription taste much but we do see the beneficial effects from it.
Thanks so much.
Hello!
It may be that you went through the skin then entered through the another area of skin (past the entry point) again. In almost 40 years in the vet world I did that once (not for insulin but during an injection). 15 year old cats tend to have thin skin so it can be done.
As far as kibble, even the low carb veterinary prescription diabetic diets tends to have a higher carbohydrate content than canned food. Higher carbs can cause more glucose levels than low carb diets. I recommend avoiding kibble for diabetic cats, but I’m not your vet. If her blood glucose is well regulated despite the bit of kibble who am I to take away her joy. We all know that carbs are delicious. 🙂
There is a chart online that lists carb content of most commercial cat foods. You could Google “cat food composition chart” to find it.
You are doing a good job!
My dogs sugar dropped very low I know I need to skip the next shot because I had to give him Karo syrup but on the next shot he’s going to be very high it happened last night too & before so when you go to give the next shot after even though he’s high should you drop 2 units to be safe he doesn’t drop low again??? I thought my vet said to skip the next shot after you give him when he drops low so this morning he was soooo high I did only give him 2 units this morning but I gave him the high dose last night because he was still high well he dropped bad low again a few hours after again I know now I shouldn’t have done the 2 units this morning but should you knock it back on the 2nd one??? I tried to use the meter but I live alone so he goes CRAZY if I try to test him with it I can’t hold him to do it so I don’t know exactly how low he was thank you
I can’t answer this because I’ve not examined your pet. Clearly you understand that you should be checking his blood glucose whenever you think his blood glucose level is low. In such a situation, if you could get a neighbor to come help, perhaps hold him in a blanket or use a soft cloth muzzle, while you check the blood glucose. I need you to chat with your veterinarian who has examined him. Of course, whenever you think his glucose level is low, put food in front of him! Karo syrup is quick and appropriate if your pet is staggering or tremoring, but real food works great if your pet is willing and able to eat. Typically I advise that folks check their pet’s blood glucose with a meter such as the Alphatrak at the curve nadir (nadir is when the blood glucose curve bottoms out). It is the nadir that helps us adjust a pet’s insulin dosage. Maybe you should also ask your vet or vet tech for another lesson on checking his blood glucose. They might have handy tips.
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?
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!
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
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
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!
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