I can’t think of a disease that causes more owner anxiety than diabetes. Something about having to give a shot twice a day, every day, to an animal you love is very daunting. Then you do it a couple times and suddenly, it’s a breeze! I’ll also answer the common question of “how far apart/early/late can I give the insulin?”
Insulin is kept in the refrigerator. Some pens made for humans can be left out for periods of time, but for the most part, plan on refrigerating the insulin. If you have a decent drive to the pharmacy or vet office, bring a little cooler to bring the insulin home. It needs to be gently mixed before each dose. Vetsulin, an insulin made specifically for dogs and cats, can be shaken like a polaroid picture. Other insulins need to be gently inverted in a rocking motion, not shaken like orange juice.
Your veterinarian will show you how to give shots, and make sure you get some practice with saline solution while still at the clinic! When I have clients practice in front of me, I can watch the fear leave their body after 1-2 practice shots. Nobody every needs a third – they walk out confidently! It’s 90% mental/fear, and once you get over it, you’re home free.
Here’s some pointers on shot-giving (hoping to have a video soon!):
- Choose a super special treat or snack that your pet gets ONLY during the insulin shot. That ensures a happy pet, as well as one that is distracted (eating) and moving around less. For cats, a little tuna juice tends to work well. For dogs, a thin layer of peanut butter on a plate takes some time to clean up. We want our pets to associate the injection with something positive – many of my patients remind their owner it’s shot time!
- We generally aim for the back, between the shoulder, but insulin can be given under the skin anywhere! Try not to hit the exact same place over and over. Some owners move it in a little circle on the back, some do a 4-corners approach. Do what works for you. You basically want a spot that has skin you can easily pinch.
- Pinch the skin with your thumb and middle finger. That leaves your index finger free. If you’re right handed, do this with your left hand. Feel the “tent” of skin that forms from your pinching. That’s where the shot goes.
- After drawing up the insulin and getting the bubbles out, hold the syringe with your thumb and middle finger, leaving your index finger free to depress the plunger.
- Insert the needle completely into the skin. You can part the fur if you want, if the pet is super shaggy, but not a requirement. Once the needle is in, then depress the plunger to inject the insulin. Done!
- Remove the syringe and dispose of safely. Warning! Yes, it is a tiny, wimpy needle. And yes, the plastic cover seems rather thick. Believe me when I say that tiny needle can bend and poke through that plastic cap, poking you and making you bleed like nobody’s business. (not that I’ve done that! LOL)
- You may use an old milk jug or coffee can to keep used syringes. They are meant for one use, no more. I love the Safe Clip – it removes the (sharp!) needle and allows you to throw the syringe in the trash!
If multiple people will be giving the shots, I suggest having a pow wow on measuring the insulin. 3 units to my eyes might look like 3.5 to yours. So, get everyone on the same page.
Pick a time (two times actually, 12 hours apart) and stick with it. Most people do 7 am/7pm or something similar. I have a client who works late and gives the insulin at midnight and noon! Do what works with your schedule. I often feed the animal first, make sure they eat, then give the insulin. Some veterinarians recommend giving the shot 30 minutes before a meal. That makes the most sense biologically, but then what if the pet doesn’t eat? You have insulin in them that you can’t get out! And now we worry about their blood sugar dropping too low. If we make sure they eat before giving the shot, that’s a non-issue.
Here’s how to handle other common questions:
- You have 1 hour on either side of that time you chose to give the insulin shots. So if you chose 7 am/pm, then between 6 and 8 is acceptable. Obviously, giving it at 7:00 on the dot is ideal, but sometimes life gets in the way. Also, if you have to give insulin at 8 one time, do not make the next dose at 6. Try to get as close to 11-12 hours apart as you can.
- If you have to give a shot earlier or later than that +/- 1 hour window, it’s better to skip that dose altogether. I’d rather have your pet have high blood sugar (not a huge deal) by missing an insulin shot than risk him getting too low (very bad!) by getting insulin shots too close together.
- If you give a shot, and your pet moves, making you not so sure if it actually went in or not, don’t panic. Also, do not give another shot. Again, better to have a missed shot than to get a double dose!
- If multiple people in the house are responsible for giving the shots, have a paper or dry erase board to check off when the shot was given, to avoid any double dosing.
How can you tell if it’s working? How do you know when to worry? Check out the rest of the Diabetes series:
- Pet owners introduction to diabetes
- Monitoring a diabetic pet
- Diets for diabetic animals
- Urine problems in diabetic dogs and cats
- Who’s Somogyi and why should you care?
Check out our podcast episode about diabetes. In an hour, we couldn’t even cover every detail, but you’ll learn and laugh with us along the way!