Injection Tips

[k9diabetes]

It is so difficult to explain injections!! Makes me wish I'd done a video of how we did Chris' shots.

Some helpful images and tutorials follow.

Where to Inject



From BD Diabetes for Dogs website: http://www.bddiabetes.com/us/main.aspx?cat=1&id=384

From the site's tutorial on giving injections, here's one way of making a tent:



They suggest a 45 degree angle on the syringe:



This is a pinch on the flank:



I'd say this flank picture looks pretty much like how I injected Chris along the ribs.

[k9diabetes]

AlphaTrak's video (second part where injection is given): http://www.cat-dog-diabetes.com/vide..._the_dog_2.mpg

From: http://www.cat-dog-diabetes.com/dogs...in-therapy.asp



As he's pushing the plunger in, you get a somewhat better view of the syringe and the tent.

[k9diabetes]

From the following site for humans: http://www.diabeteshealth.com/read/1999/02/01/1409.html (no longer available)

If you've ever hit muscle with a needle, you know the pain. If you've ever injected the right dose of insulin and still found your blood sugar sky high, you might have injected too shallowly and hit skin.

Insulin injections that are too deep or too shallow can really foul up glucose levels. For most injections, the goal is to hit the layer of fat between the skin and the muscle.

Hitting this target involves knowing the thicknesses of your own body layers, whether to pinch up or not, and which needle length to use. The medical community is finding that injection techniques play a significant role in blood sugar control.

Hitting the Fat
What's beneath the surface of your skin? The areas a needle can hit are as follows (also see Figure 1):

• skin
• subdermal layer (just underneath the skin)
• fat
• epimuscular space (just underneath the fat, on top of the muscle)
• muscle

Very important note about where you're trying to get the insulin:

Among all people with diabetes, however, the goal is to hit the fat layer.

[eyelostit]

Hi Ida,

When dx Niki got her injections in her scruff anywhere from the middle to the sides of the scruff area, she usually never flinched, I picked up her scruff area, made the tent and injected at a slight downward angle at top of tent, never thru the tent, I could feel the needle as it went thru the skin with no resistance and then injected. I think Baby would flinch if you hit a muscle as they do at times when they get a rabies shot or she may have flinched if needle went into skin area, let me find some pics or if I remember tonight I will get my mum to take the picture of my injection. Ok was able to save the picture from the BD link.
Its done the same way at top of scruff area, see how the needle is going in at an angle.

Hope this helps,
Dolly

[We Hope]

Ida,

One thing for sure is you didn't hit a muscle. When insulin is injected into a muscle, it works much faster than it does when you inject it under the skin:

http://diabetesindogs.wikia.com/wiki/IM

"Intramuscular insulin injection is a technique used for both pets and people in an effort to hasten onset, compared to the usual technique of injecting subcutaneously. It's often referred to medically by the abbreviation IM.

"Because it carries with it a substantial risk of hypoglycemia, giving insulin intramuscularly should only be done with guidance from a medical professional."

http://www.bd.com/us/diabetes/page.a...t=7001&id=7395

There are other areas you can inject besides the scruff:

"Some veterinarians feel that the scruff is not the best place to inject because this area is prone to the formation of lumps under the skin, and because it is easier for the owner to mistakenly inject into muscle or skin. Any of these would interfere with proper insulin absorption. Other veterinarians feel that the scruff is acceptable as an injection site if the owner uses proper injection technique.

"Whichever injection sites you use, the key is to use proper pinch-up technique so that the needle goes into the fat layer below the skin - not into skin or muscle, and not through the pinch and out the other side, which just squirts insulin onto the pet's fur instead of into the pet.

"It is important to rotate injection sites, because constant use of the same spot will cause scarring, which will affect how well the insulin is absorbed."

Another reason some don't prefer using the scruff is because of the absorption from the area:

http://web.archive.org/web/200702081..._diabetes.html

Dr. Greco:

"Is the client rotating sites?

"Is the client injecting in the proper place? (Armpit or flank instead of in the scruff; the scruff is a poorly vascularized area with slow absorption.)"

When we went to Caninsulin/Vetsulin, I switched over to the Intervet suggested areas for shots:

http://www.vetsulin.com/vet/DosingOverview.aspx

"Using a U-40 insulin syringe, administer the injection subcutaneously, 2 to 5 cm (3/4 to 2 in) from the dorsal midline [spine], varying from behind the scapulae [shoulder blades] to the mid-lumbar [back] region and alternating sides."

In the morning, I would give Lucky's shot on one side, and in the evening on the other. I'd also vary the injection site by working my way up and down the areas above. This made sure I wasn't giving the shots in the same place all the time.

Because Lucky wouldn't let me either do a pinch or tent on his skin, my answer about whether I could see the needle would be different.

Correct way to give an injection when "tenting" the skin. This makes sure the insulin is injected into the skin flap created by "tenting" it. When the skin "tent" is released, the injected insulin is under it, or subcutaneous.

Does this picture help?

The next picture is the wrong way to give a shot:

Wrong way to give a shot: The needle has totally passed through the "tented skin". The insulin, or any other injected drug, will be injected into the air. Note that in this graphic, the injection point is much closer to the "pinch" area holding the "tent" up. In the correct graphic, the injection point is closer to the body.

HTH!

Kathy

[We Hope]

http://www.bd.com/us/diabetes/page.a...=7001&id=7433#

BD Diabetes Slide Show--How To Inject A Dog With Insulin

[Patty]

Here's a pic of where I use on Ali's side



You can really use the area from behind the shoulder to the edge of the rib cage.

Patty

[Patty]

Andy,
Here's a good picture of the layers and angle you want to use for a subcutaneous injection. Injecting into muscle can potentially cause a much faster absorption of the insulin.

Patty