Canine insulin injection -- what am I doing wrong?

Question

My dog was recently diagnosed with diabetes, so I have been giving her twice-daily insulin injections for the past 10 days. I've watched my vet do it, I've watched dozens of YouTube videos, and I've read everything I can find about the proper technique, but somehow, I can't seem to get it right.

Every time I inject my dog, she fidgets when I insert the needle, but not overly much, but as soon as I begin to inject the insulin itself, she yelps and either jerks away, or tries to bite me. More than once I've ended up with bent syringes and insulin on her fur because of it.

I'm following the procedure as shown, for example, in this video: https://www.youtube.com/watch?v=6jOEKUTU-Ac

1. Take the insulin out of the fridge and roll it around to mix it up.
2. Draw out slightly more than the needed dose into a new fresh syringe, tap out the air bubbles, then return the excess.
3. Allow the syringe to warm up in my hand for several minutes as I prepare and put out the dogs' food.
4. After my dog is finished her meal, I pull her onto my lap and find a place where the skin is loose. I have been rotating between left and right shoulder and left and right rump so far.
5. Pull up a fold of skin ("tent" it) between my fingers.
6. Push the needle into the middle of the folder at ~45 degree angle
7. Slowly inject the contents of the syringe.

From everything I've read, this is supposed to be so painless that the dog may not even acknowledge that anything happened, but my dog is getting progressively more anxious each time I do it. I thought I would have gotten the hang of it by now, but I seem to be getting worse.

My main concern is that I'm doing something wrong and injecting the insulin incorrectly; my vet said something about making sure I was doing a subdural and not an intradermal injection, but how would I know? As far as I can tell I'm getting the needle beneath the skin correctly: it's hard to tell with my dog's long hair, but I'm not feeling any resistance to either the needle or the fluid, and the needle's not coming back out of the skin.

(I've done the practicing on the orange bit, and I think I have it right, but oranges don't yelp when you mess up :( )

Is there something else I can do to make sure I do this injection properly, or at least reassure myself that I'm not hurting my dog and that her insulin is going where it should?

Answer 1

Your question does a great job of addressing many key points about giving insulin to your dog.

Nothing in the following answer is intended to replace direction by your veterinarian. These are just considerations not addressed in your question.

• One of the first things that comes to mind, is your comfort level. Consider if you are transmitting your anxiety to your pet.

• Rotating sites is important your Vet should have given you direction Try not hit the same spot regularly, but try to hit the same area regularly. Maybe alternate shoulders morning and night, but get slightly different spots. See related question How important is the insulin injection spot on a dog?

• If you are using an 8mm needle it is about a 1/3 of inch long when you grasp the dogs skin and pinch to lift the hide, you should be able to tell that the hide is less thick than the needle is long. The reason you are lifting the skin is to create a space between the hide and the muscle, in your mind target the end of the needle entering the Subcutaneous space. You don't want the tip of the needle in the muscle or in the skin. With people they will often plunge the needle straight in to the skin in an area that has fat underneath, so the insulin is delivered in the fat between the skin and the muscle.

• Be alert for bruising, If you can see a bruise under the fur don't use that area until the bruise has healed.

• You may or may not have been taught to check for flash back, once the needle is inserted if you pull up on the plunger and blood enters the syringe you are in a blood vessel, this is called flash back. There are differing lines of thought on this, if you have questions/concerns discuss them with your vet. RE:Aspiration in injections: should we continue or abandon the practice?

Answer 2

We give our dog a bit of canned dog food while she gets her injection as a diversion. She's so busy eating her treat that she doesn't notice the injection. In fact, she gets excited when we say 'let's go get your shot", and lets us know when it's time for her shot by dancing and crying if we're not watching the clock.

Answer 3

I question the 45 degree angle for needle insertion for a subcutaneous injection. I have been trained to ensure the needle is PARALLEL to the animal body's when injecting- parallel to the surface of the skin on the back. If you angle the needle too much, you may enter a muscle, go through the skin to the opposite side, or stick your own finger. And I found that if the bevel of the needle is facing up ts helps. I know in humans, we use 45 degree angle insertions, but not with canines.

Answer 4

I don't think you are doing anything wrong, it is an injection and she just isn't liking it. My Labrador is not liking his injections I am new to this too. I am luckier than you as he does not try to bite but he does lie down and roll on his back and wriggle. Same as he has been doing for years when I clip his claws. I think you need to relax a little and stop feeling it is your fault. Just do the best you can she will pick up your anxiety or lack of and react to it. Try sitting with her and giving her a cuddle while you do it. Good Luck to you anyway, we all need a lot of that!

Answer 5

There are different-sized needles. For some reason, the larger ones seem to be the ones getting dispensed - maybe just for larger dogs - but regardless of the the size of your dog, at first try using the smallest needle available.

It does NOT need to go in that far - if it does, you are not giving the medicine properly! It goes just below the skin into the fat layer.

If your dog is not 'behaving' when you try to give injection, and/or if the dog's blood sugar levels aren't improving, it's probably because you are injecting into the muscle - where it will do no good. Try a smaller sized needle and make sure you look at the needles to compare their sizes.