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-   -   Gretel is now our angel (http://k9diabetes.com/forum/showthread.php?t=5547)

CoolGram 03-06-2010 06:13 AM

Trouble brewing at injection time
 
Hello everyone!

It has been about 6 weeks since Gretel (my 8 yr. old mini schnauzer) was diagnosed. Up until a few days ago, she was taking the injections like a champ. The first week I gave them to her she came to me after eating without me even needing to call her to me. Then she gradually decided maybe she really didn't want to come, but when I called her she came without hesitation. This past week she has gotten more and more hesitant to come, she has jerked several times and yelped once when the needle went it. Of course this isn't helping me, because it makes me more nervous to give it, which I know isn't good. We seem to be doing things in just the reverse of everyone else. Most people start out rocky, but eventually things improve. We started out better than expected but now we're going downhill. I would really like to nip this in the bud before it gets worse. Oh, in case anyone is wondering, I do give her a treat following the injection, so she knows she has that to look forward to.

I have been injecting into the scruff of her neck because it seems that's where the most loose skin is on her. I had been instructed to inject anywhere from the scruff down to an area above the shoulder blades, sort of in a triangular area. But the lower I go, the less excess skin there is and it becomes harder to inject there.

I'm wondering if she's simply getting sore in the scruff area? I do move the site from left side, then middle, then right side. But every third injection I'm back at the same site again.

I've also read in this forum that the beveled edge of the needle should be down when the injection is given. Could this be the problem, that the needle isn't turned in the right direction? I really couldn't even tell which side was which until I got a magnifying glass out. Does anyone know whether the beveled edge is always on the same side of the syringe barrel or do you need to look at each one to see where it is?

As always, thank you to all who respond. I really appreciate your help.

Carolyn

Dakotapix 03-06-2010 06:42 AM

Re: Trouble brewing at injection time
 
My own schnauzer, Wolfie, had an excess of fatty growth around his scruff so my vet advised us to inject insulin below the scruff. I tried to vary the injection point from both sides of his back and along both flanks to avoid overly sensitizing any one area of his body. I also kept a bag of his favorite treats in his vision to distract him while giving the shot. I think Natalie and most forum members will suggest that you vary the injection point. Somewhere on the forum there's an illustration that diagrams good injection points on a dog.

catusgirl66 03-06-2010 06:43 AM

Re: Trouble brewing at injection time
 
Hi i'm new at this too lol. My dogs name is Boober we have been having a heck of a time with her... at least she is eating some now. I too have been having some problems with the shots, so you are not alone. But see I was told not to give in the neck area but to imagine a saddleback like whats on beagles and to do it only in that area and to switch sides each injections. Boober she is the same way, she yelps or jerks whats bad is one night she didn't even get all meds had to stick twice, because I put it in and she jerks on me urggggg. I hope like you this gets easier .

Kelly

CoolGram 03-06-2010 06:54 AM

Re: Trouble brewing at injection time
 
Yes, I did see the instructions on different sites to inject. I have just been doing what I was instructed to do by my vet, but I plan on mentioning this to her to see if she has any particular objection to me finding a different site. I do vary the site as much as I can, given the small area I have to work with, but she just doesn't have much loose skin anywhere but on her scruff. I think I will try to set the treat container in front of her while I inject her, so maybe that will help her refocus on that, rather than what I'm doing to her! Thanks for your suggestions!

ozzi 03-06-2010 07:00 AM

Re: Trouble brewing at injection time
 
Quote:

Originally Posted by CoolGram (Post 25683)
I've also read in this forum that the beveled edge of the needle should be down when the injection is given.
Carolyn

Hi Carolyn,

Actually, the bevel should be UP when giving the injection. This is for purposes of comfort for the dog. You do have to look for the bevel every time because the needles are not in the exact same position on the barrel of the syringe each and every time. If the bevel is down, it will still be effective, so that is not the worry...it's about comfort when injecting. Gretel might be having pain because the bevel is down. I'm not sure if you're warming the insulin prior to injection, but I take it out of the frig, draw it up, and put it under my armpit for 5 minutes. I think if you warm it and try injecting with the bevel up every time, Gretel will find it more comfortable.

Regarding locations, I have read that absorption is less effective in the scruff because of limited vascularization, and that the armpit and flank are more effective, however my vet did instruct me to inject in the UPPER half of the body and showed me how to do it in the neck, and I have been doing that as well.

Kevin

CarolW 03-06-2010 07:47 AM

Re: Trouble brewing at injection time
 
Hi Carolyn,

The bevel on the syringe needs to be UP, not down! I mark the bevels on my syringes. Have a look here:

http://www.coherentdog.org/vek/bevelup.php

Make sure to scroll down on that page and look at each of the pictures.

That page is part of the "painless injection" series, and you can use the NEXT, PREV, and UP buttons above the main picture on each of those pages, to look at the other pages in the series. On the main index page, scroll down to see the "Parts List" that takes you to the page of your choice.

Where the bevel is varies completely; there's no way to tell, but if you've marked the syringe (I use a Sharpie, Fine Point, permanent marker), it becomes easy enough to hold the syringe with the bevel up.

Another possibility that occurs to me is that maybe you're not getting the insulin warm enough for Gretel's comfort. When you test the contents of the syringe with your fingers, you want to have the impression that it's VERY distinctly WARM-feeling. It should feel as though it's at body-temperature, at least.

So, have a look here:

http://www.coherentdog.org/vek/vekkiewarm.php

and use the NEXT button to check the next page as well.

I'd actually suggest you read the entire series with some care, because it took Kumbi and me a long time to discover each of the excruciating details that go together to assure that injections remain truly painless.

Kumbi REALLY lets me know when an injection hurts. As one did the other day. I just must have hit something wrong. But when some 99.9% of the injections really are painless, dogs do very well, and easily forgive the very rare painful one.

About injecting anywhere but into the scruff - the scruff being definitely the easiest place to pull up a lot of skin - it feels scary to me, too, to shoot into other areas, where I can only pull up just a little bit of skin - a tiny fold between my fingers. The pictures on Coherent Dog show a fold-pinch, rather than the "tent-style" I've seen on some other sites. As long as you can get a bit of a fold up, you can place the needle just below your thumb (bevel up), holding the syringe almost tangent to the body, but aimed so the needle tip will go under the skin when you slide it in.

Dr. Greco, on the BD site, says insulin is poorly absorbed from the scruff, so she recommends using the other sites available. There's a picture of some of those sites here

http://www.coherentdog.org/vek/backscruffinj.php

and another, which shows some other alternatives, here:

http://www.k9diabetes.com/forum/show...51&postcount=5

By the way, what syringes are you using - could you describe them in detail, please? That is, what's the capacity? I'm using 3/10 cc syringes by BD. What gauge are the needles? And what length is the needle? Mine are 8 mm (5/16-inch) - these are SHORT needles. Should suit Gretel very well. And the syringe barrels - big bonus here - have half-unit markings. Mine are called BD UltraFine II 3/10 cc, 8 mm, 31-gauge, half-unit markings. I'm in Canada, which is why the "8 mm."

If you're not using the thinnest (higher gauge numbers are thinner), these very fine needles should make injections very comfortable for Gretel.

You're now at an awkward stage with Gretel, who WILL be suspicious that the injection is going to hurt. In this situation, I'd give Gretel a treat before the injection, as well as after.

Gretel sounds like all truly great dogs - she is very cooperative!
Good for her, and good for you!

Don't miss this post by Ozzi (Kevin) that he wrote yesterday; though it's about getting blood samples for a glucometer, the same principles apply when you change where you inject, and how you're holding skin:

http://www.k9diabetes.com/forum/showthread.php?t=1701

Oh, hey, Kevin seems to have replied to you here while I've been writing this long post - I'll have to wait to read it! (not for long, though).

Yell if you want more help with this!

Sat, 6 Mar 2010 06:46:53 (PST)

ozzi 03-06-2010 07:50 AM

Re: Trouble brewing at injection time
 
LOL...I just love you to pieces Carol!!
Kevin

Margaret Boyle 03-06-2010 08:02 AM

Re: Trouble brewing at injection time
 
Hi Carolyn,

I have a mini schnauzer Lucy, all the advice you have been given is spot on.

As regards the scruff area this can build up fatty tissue, so it is best to try and find other sites. I inject Lucy down both sides of her sides away from the spine area, I alternate one side in the morning the other at night.;)

You will find what is best for you. The bevel should be facing up the bevel
glistens when you hold it under a light. Put a little straight line at the top of your barrel with a red marker pen. This will keep you right.:) I open a packet of syringes and I mark them all the ones I am going to use.

Always warm your insulin in the syringe put it under your armpit for 60 to 90 seconds it will feel warm when you take it out. Cold insulin stings.:eek:

You will be fine Carolyn, we have all been there it all takes time.

I keep Lucy's treats beside me and she can see the little tub and knows she will have her treat. I use boiled turkey cut into small bite pieces.
Everyone has there own treats.;)

You are doing well.

Marg

CarolW 03-06-2010 08:08 AM

Re: Trouble brewing at injection time
 
Gosh, Kevin!

Quote:

I'm not sure if you're warming the insulin prior to injection, but I take it out of the frig, draw it up, and put it under my armpit for 5 minutes.
FIVE MINUTES? Your armpit must be even colder - lots colder - than my scrawny little one! Oh, I KNOW WHY! You expend all your warmth here on the forum!

(Hehe - my vet suggested 15 seconds, but I find 30 seconds works better - that long seems very reliable!)

I suppose, too, it depends on just HOW you tuck the filled syringe in to your armpit! I place my finger over the filled area, needle already carefully re-capped, so as not to dull the needle. I protect the plunger end from rubbing against anything by cradling it in my palm. And then, I duck the syringe tip under my clothing, and carefully place the needle-end, using my finger as a guide, against the nearest fold of my armpit - and -

CLAMP! - arm against chest-wall. Whew!

Meantime, I'm standing at my computer, looking at pretty pictures, or reading this forum, and watching the Duality Software clock count the seconds. Very handy stuff.

http://www.coherentdog.org/vek/calendarscope.php

It's better if I look at pictures instead of reading this forum, or I might be clamping on that syringe for five minutes! So absorbing!

Sat, 6 Mar 2010 07:06:56 (PST)

ozzi 03-06-2010 08:16 AM

Re: Trouble brewing at injection time
 
Wow Carol...thank you! Actually my vet never told me about warming the insulin at all and in the beginning I never did! It wasn't until I brought my cat Zakk to his vet for an annual physical exam that I found out about it. I told Zakk's vet that Ozzi seemed to be in pain when I gave him the injections...you just know when your dog is in pain vs being "a baby." LOL She suggested taking out the bottle of insulin and leaving it on the counter to warm up. I thought this seemed excessive, so developed my "own" procedure and stuck it in my armpit for 5 minutes. I am so glad that you told me I don't need to do it that long! I will make that adjustment!! Thanks again!


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