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As I explained in this question, my dog is newly diagnosed with diabetes, and I'm having problems giving her the daily insulin injections without causing her pain and stress.

I initially gave the shots on her leg and shoulders on alternate days, alternating left and right in the morning and evening, to avoid building up sensitivity on any one place. In an attempt to make sure I was injecting properly, I tried the scruff of her neck, where the skin is looser, and that worked better (but not perfectly).

I had read that the scruff of the neck was not a good place for insulin injections, but I've also seen lots of people claiming that's the place they use, and I also noticed that's where my vet injects her vaccine shots.

So, how big of a deal is the location of the shots? I have a very small dog (10lbs) and it's not very much insulin (3 units 2x/day), if that matters.

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    You may not get a definitive answer. Many thing medical have differing lines of thought. The best answer will probably pull from published sources indicating different opinions and the supporting evidence for each. Often with things like this what is definitive yesterday is not today, but will be tomorrow... I encourage you to research and post an answer (with references) that will allow people to make their own decisions. – James Jenkins Dec 19 '14 at 14:24
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    @JamesJenkins I am working on one now; at the advice of my vet's technician I starting injecting into the scruff of the neck this week and it seems to have resulted in a necessary dose adjustment; I'm waiting to see how that plays out before I answer, and doing my research in the mean time. – KutuluMike Dec 19 '14 at 17:16
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Unfortunately, there does not appear to be a strong consensus among vets on this topic; however, based on my research (largely including information about humans with type 1 diabetes), it seems the answer is:

Insulin injection site has an impact on the effectiveness, but it is far more important to pick a site and be consistent

The main reason that the injection site makes a difference is because different sites have different insulin absorption rates. 1,2 The absorption rate is determined by a number of factors, including capillary density, type of tissue at the site, amount of blood flow, etc. In humans, for example, injections in the stomach are absorbed faster that injections in the buttocks.

With dogs, the three primary injection sites people use are the shoulder, the thigh, and the neck. Of these, the neck has a slower absorption rate than the other two, which are generally the same. This means that the same dose injected into the neck will take longer to have an effect, but will also last longer (a slow absorption rate has an "extended release" effect).

(NOTE: It is strongly recommend that you do not inject into your dog's abdomen unless you check with your vet! That site is generally used by people that are prescribed rapid-onset insulin, while dogs are almost alwaye prescribed NPH insulin, like Novalin-N, which would go into the arms, legs, or buttocks.3. Humans also tend to have large fatty deposits in the abdomen, which your dog may or may not have.)

The primary impact of this for pet owners is that changing injection site changes how quickly the glucose level goes up and down. In my case, my vet does a weekly glucose check at the same time every week, so changing the injection site means the same dose at the same time in the morning would result in different readings. And, in fact, when I switched from thigh to neck, my dose did increase slightly, but the glucose also seemed to stabilize better.

In humans, it is common to pick different injection sites for the morning and evening dose -- a fast-acting injection site after breakfast, where you will be awake to monitor your glucose during the day, and a slow-acting site after dinner so it works all night. For pets, you will want to be more consistent, since your pet cannot readily warn you if something "feels wrong" until the problem gets bad enough to show physical symptoms. It will depend on your specific situation, how often you can check your pets levels, how well monitored they are, etc.

Ultimately, as with everything else, you should talk to your vet if you are concerned. Just be prepared to explain your concerns, as this is apparently not the kind of detail many vets are aware of. (It helped for me to show my vet the information for human diabetics.)


There are other factors that go into picking an injection site, so you should factor all of these in when making your decision:

  • You should always rotate your injection sites, or you risk conditions like lipodystrophy (changes in the subcutaneous fat), which will make the injection less effective.4,5 Choose different sites in the same area, e.g. opposite shoulders, or opposite sides of the neck.
  • Your pet may take better to certain sites than others. For example, the neck seems to be a preferred injection site for other subcutaneous injections (it's where your vet probably puts their vaccines) because it's the least discomfort. Picking a good injection site will not help if your pet's struggles make you miss the injection.
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I give it to him in his neck,but a couple of times while injecting insulin I put the needle in,and some came out of the needle while injecting him.I guess he moved ,not sure but i don't know if i got it in.I don't know how to pinch in a triangle on his neck.I don't know if i am doing it right.It is a scarey situation. I wish I could just inject into his thigh because I can do it fast and with no problems.But they do not recommend that. Thank.
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  • It sounds to me like your needle is missing the mark and getting put into tissue that's too dense and the needle is breaking. Injecting into the thigh or neck should work the same; there's nothing wrong with injecting into the thigh as long as you get the medicine above the muscle and such. I'd definitely get your vet to demonstrate for you. – KutuluMike Aug 4 '18 at 19:27
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My dog too has just been diagnosed with diabetes and I am injecting him twice a day 12 hours apart. I find it better to inject whilst he his eating and then he is distracted . I gather up the scruff of skin on his back below his collar, push in the middle to make a pocket and inject here (our veterinary nurse taught me this) to date its working well and he is tolerating it. Talk to your vets and get some advice .

  • Welcome to Pets Stack Exchange :) - You may want to read How to Answer for some tips on improving your answer. – Henders Jan 16 '19 at 11:12
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I have a dog which has been stabilised on insulin for a year. I inject him just behind the collar and he doesn’t seem to feel it. He (and I) are creatures of habit. I just say needle and a treat and he knows what I mean. Always likes the treat.

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