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View Full Version : Molly, my other diabetic


Denise
05-20-2008, 09:15 PM
I don't talk about Molly much because she's been pretty easy but she is doing a bit what Bogie is doing, not willing to eat what I need her to eat everyday and adjusting her insulin is getting to be a pain too.

I curved her not long ago and her numbers were good, I was OK with it but I am going to ahve to do another one cause fasting bg's aren't so great.

I think part of her problem is the lack of choices I have for injection sights. She is compact and tight skinned and except for the scruff area I can't get hold of any skin. Her scruff area is fatty, not thick like we see after too many injections to one spot, just fatty. I may have to resort to injecting without lifting skin. Anyone else do this? You wouldn't think after all the shots I've given that this would bother me, but it does.

Any tips or thoughts on this injection sight thing?

She isn't running high long enough to cause PU/PD and can be coaxed to play anytime but I'd still like to figure her insulin needs out better.

I may have to go back to home cooking to and feeding 4 things to 5 dogs. Argh!!!

If so I want to do something in loaf form or crck pot type foods.

Adding a note here about Bubba, the fibrosarcoma cat. He's losing weight and I can't get him to eat extra in an amount that will help. I got Fancy Feast and he might eat 1/4 of the can. He seems to feel good though but at 18 pounds this guy was a big cat but not fat. He was 15.5 last time at the vets and weighing him here a couple nights ago he was 14.7.

I guess I need to research fattening up a cat. You'd think I knew how since Shaq is 26 pounds!!!!!!!! One I can't put weight on and one I can't get it off!!!

We Hope
05-20-2008, 09:51 PM
Denise,

Never talked much about it previously but I never gave Lucky any of his shots the "standard" way. Early on, I found out that he got offended when I tried either pinching or tenting his skin. Offended enough for me to see that it would be an obstacle in his cooperation. :)

So I sat down with an empty syringe with the cap on it and tried to figure out how I would give myself a shot if I needed to do it. Worked it out in my head that if I was gonna do that to me, I would need to hold the syringe at a 90 degree angle and then pierce my skin with the needle, so that the insulin would go sub-"Q".

Transferred the process to Lucky and had no problems giving him his shots like that at all. We used the standard length needles and I was comfortable with them--partly I guess because this was the way I needed to give him his shots and partly because I was frequently injecting insulin into a moving target, because he'd get wiggly at shot time, anticipating the treat afterward. :D

He got his shots like this whether I was using the scruff of his neck when we were using U100 insulins or after transferring to Caninsulin/Vetsulin and using the Intervet method of behind shoulders to near tail area, keeping away from the spine.

Didn't talk a lot about it before because I thought it might mess up others who were new to this.

Not sure if this helps any, but hope it does!

fatdog55
05-21-2008, 06:47 AM
Denise
Sorry I have nothing to offer regarding where to give shots on a tight pet. Knowing you, Im sure youll find a way !
Weve been fortunate with Zip ( if you can call it fortunate ) to have lotsa room on each side, plus the fact that hes got plenty of tentable skin.

Kathy Im trying to picture how you administered the shots to Lucky based on your description above.
When you say 90 degrees, the way I am reading it, is that you are going straight into the side.
If that is correct, how long is a standard length needle?, and what would happen to the quality of the insulin if you went past sub-Q ?
Ive always used the short ( 5/16 ths inch ) with Zip but I have seen U100 insulin syringes that were probably inch, or perhaps a bit longer.
Id be very interested if you would go into this in a bit more depth.
Thanks Paul

Denise
05-21-2008, 06:48 AM
Yea, I can do that. Did you go WITH the fur or against? Was there a spot that was easiest to use?

I didn't even tell anything about Molly! She is a black and tan Chihuahua, about 11 pounds, 10 would be better! I think her age is "guessed" and I say she is 8 years old.

Molly's first mom (that we know about) found her as a stray in Houston Tx. This mom was an old woman that coddled the crud out of her, I guess! : )
When she died her daughter took Molly but had a housefull of BIG dogs and really didn't care for small dogs. She found Bud's Place, a senior rescue where all the dogs actually live WITH the woman that started the place. Sandy had 11 other small older dogs with health issues then and still took Molly. Molly didn't like her shots so the daughter hadd stopped giving her her insulin!!! She wasn't too messed up when Sandy got her and she got things straightened out. SHe needed a dental and lost 2 teeth though.

In the summer of 2006 I looked at the DDB page of adoptable pets. Just seeing her picture once and I couldn't stop thinking about her. I knew hubby would be a hard sell so I just kept praying about it, filled out an application for adoption and waited. In August I told hubby I really needed to fly to Tx. to get Molly and he surpirised me with and "OK".

Sept. 1 I got my hands on that little dog who's face had been burned into my mind for several months, it was like a dream!

A transport groupl helped get her to me, I flew into Dallas and a woman in Houston met us half way. I stayed the night at my step daughters and the next day hopped a plane home. Molly never made a peep on the plane, I couldn't believe how good she was. When I got home I slowly introduced her to the other animals (no one knew if she liked cats or not) and even the first night everything was fine and no one's nose was out of joint. She is my only cuddler, sleeps by my pillow and except for barking her damands has been no problem. She is a yapper but that's OK.

I had to muzzle her for shots for a few months but decided that was crazy and just winged it. She still reacts to most of her shots and maybe this new technique will help with that.

She came to me as a described "chow hound" but it's seldom the case that she pigs out. She loves car rides but won't walk on a leash because she is too busy sniffing ever inch she walks on.

Her favorite things are squeaky toys and chicken jerky. Her least favorite things are shots and anal gland exams! LOL

Denise
05-21-2008, 06:52 AM
Hi Paul, we must have been posting at the same time.

I use the short needles too and I think Kathy is referring to the 1/2 inch. Not sure about the quality of the insulin of gotten too deep but in my case I am wondering about that using the thick fatty neck skin tent anyway so....

Yes, I rarely post for help or suggestions, usually out of frustration. When one isse hits me I can deal with that and usually figure it out on my own but right now with Bogie messed up, Reba with Cushings, Bubba with cancer and my FIV guy, Sam isn't doing great....well, I feel like I can't think some days! Just getting all their meds into them at the right time each day can make me nutso! : )

Nice to see you here Paul!!!

We Hope
05-21-2008, 09:46 AM
OK--We'll start with Paul's post first.

I was using the standard 1/2 inch length needles and 29 gauge whether they were U 100 or U 40 syringes. Since we were using Lente insulin and 70% of that is Ultralente insulin (the largest insulin crystals--size is what makes them last), I never wanted to use anything less then a 29 gauge. One of my "experienced" people with diabetes (over 50 years of shots), uses beef Lente for himself as a basal and said he was not at all comfortable with a lesser gauge for it. He explained that since the Ultralente crystals were large, there was a chance they could plug the needle, thus you wouldn't be getting the proper amount of the Ultralente portion of the insulin when you injected. He's been doing it that way for more than 50 years, so I took his advice about staying with a 29 gauge needle size.

Though we don't get an abstract, this PubMed citation refers to needle plugging; Monotard was Novo Nordisk's non-North American name for their Lente insulins--when they still made any Lente here, it was called Novolin L:

http://www.ncbi.nlm.nih.gov/pubmed/78375?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum

Lancet July 15 1978

"Plugging" of needles with monotard insulin.
O'Mullane NM, Robinson PL.

If you give insulin in the muscle (IM), it will work faster than a shot given under the skin. Years ago on the other board, we had someone there with a dog who initially had to give IM insulin shots, on the advice of her vet. When they had her dog under better control, she switched to the usual sub "Q" injections. When we were having problems with getting something that would work for Lucky in the beginning, we talked about IM shots for him; finding that pork Lente worked great for him meant we didn't need to go there. IM insulin should only be done on the advice of a doctor because of the faster factor.

And here we see a case where a person was accidentally injecting herself IM instead of sub "Q" with Lantus (glargine)--normally a long-acting insulin:

http://www.ncbi.nlm.nih.gov/pubmed/16176210?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum

Diabetic Medicine October 22, 2005

Early hypoglycaemia after accidental intramuscular injection of insulin glargine.

"We studied a slim 24-year-old female with Type 1 diabetes who repeatedly experienced severe hypoglycaemia after switching from NPH insulin to insulin glargine at identical daily doses. METHODS: Clinical examination and high-resolution ultrasound. RESULTS: The patient frequently placed her injections into muscle tissue, followed by unexpected rapid insulin action. After correction of her injection technique, hypoglycaemia did not recur. CONCLUSIONS: The long-acting kinetics of insulin glargine require precipitation in the subcutaneous tissue. Therefore, each patient's injection technique should be carefully checked when treatment with insulin glargine is initiated, particularly in young and lean individuals."

OK, Denise, now we're gonna pick a spot. :)

When I worked this out with myself and the empty, capped syringe, I realized that if I wanted to inject myself with something and make certain it was only under my skin, I needed to hold the syringe and needle parallel to where I wanted to put it, then just pierce the skin carefully to get the needle under and then inject. For Lucky, there was the added part of getting past the fur, so I'd part it and look for a spot for my needle to go.

Can't say there was any spot I had problems doing this with. I went from the neck scruff to the Intervet method of from shoulders almost to tail area, and keeping well away from his spine. I'd rotate sides--one in the morning and one in the evening--and would slightly change where the shot coming 24 hours later would go. When I found a spot for the needle, I'd pierce Lucky's skin, making sure that it was in far enough so the insulin wouldn't be lost on the skin or fur--and then I'd depress the plunger.

Since we had Lucky who didn't want his skin pinched (another Chihuahua like Molly who had tight skin) and me who worried about going IM accidentally and who wanted to get all of the insulin to him and also wanted be sure the needle stayed put while he was wiggling, I had to figure out some method that worked for us both. He got his shots without objection and I had the peace of mind that they couldn't possibly be IM ones and that I'd gotten all of the insulin under his skin.

We Hope
05-21-2008, 11:16 AM
Just thought I'd add this about switching needle lengths. If the control is good and there's no huge reason to switch from the length you're using now, I'd suggest you stay with what's working.

Sometimes switching to a different needle length can affect the control:

http://www.bddiabetes.com/us/main.aspx?cat=1&id=253

"Talk to your doctor or nurse educator to see if short needles are right for you. If you give them a try, you'll need to check your blood sugar regularly to ensure that the short needle isn't affecting your blood glucose control."

Ages ago on the other board, we had someone whose well-regulated dog suddenly wasn't anymore. There was no underlying illness causing it, nor had anything with the amount of insulin, food, etc. changed either. The only change made was from the standard 1/2 inch length needles to a shorter one; going back to the longer needles solved the dog's control problem. So whether you use longer or shorter needles, if they're working well for you, I'd say stay with what works unless there's a real reason to change.

eyelostit
05-21-2008, 04:44 PM
With Niki's scruff getting the scar tissue from injections, I have been giving her shots like the vet does, i think thats the 90 angle, just goin in sideways under the skin and down a teeny bit, I think she likes this alot better than the tent thing I did for years.

We Hope
05-21-2008, 05:11 PM
Dolly, it sounds like you're giving Niki's shots the way I gave Lucky's. Maybe that's why I thought to do it that way--after all these years, I know John and his Dad have rubbed off on me well! :)

k9diabetes
05-22-2008, 02:52 PM
The needle angle you were using still isn't clear to me.

Was it like a T facing sideways, the top of the T being the body and the needle being the base of the T, pointed directly at the body straight down?

Or did you make the syringe more parallel with the body, |\ with | being the body and \ being the syringe, so that you were sliding the needle in flat underneath the skin? More like this only without the pinch?

http://www.bddiabetes.com/us/images/pets/injectdog_14.jpg

We Hope
05-22-2008, 03:02 PM
I was sliding the needle flat under the skin with it parallel to the body. :)

http://k9diabetes.com/forum/attachment.php?attachmentid=1&stc=1&d=1211491832

Should have thought to do this yesterday. :o

k9diabetes
05-23-2008, 08:25 PM
We may have injected into the muscle with Chris this morning. The plunger was difficult to push in, like it was hitting resistance. Didn't feel right at all but his fur was dry so I knew it was "in."

His BG at meal time was 121. Two hours later it was 64. Not at all like Chris to drop during the first two hours.

With frosting, a couple small crackers, and some beef, he went up just 20 points in half an hour and another 10 points in another 1.75 hours.

Then his insulin ran out early and/or the extra food overwhelmed it, I suspect a little of both... and his blood sugar went from 98 at 3:45pm to 305 at 5:45pm.

We Hope
05-23-2008, 09:05 PM
That was my worry with Lucky--going into the muscle when I didn't intend on being there. Have seen various warnings and cautions on children's diabetes websites to parents and caregivers re: smaller bodies means easier to accidentally go through to the muscle.

At 9.5 lb, Lucky surely fit the picture of a small body. But he was upset with me when I'd try to pinch his skin so that wouldn't happen--enough so that he was trying to elude me at shot times.

So I had to come up with this way to do his shots. It satisfied me that I was strictly under the skin only and it didn't bother him at all that I was parting his fur to look for a spot for the needle and then piercing his skin with it. But for heaven's sake--DON'T pinch his skin! :D

I think you owe your boy a hammie over the weekend for this! ;)

eyelostit
05-25-2008, 10:37 PM
We hope, your pix good, thats what i have been doing

k9diabetes
07-04-2008, 06:33 PM
Here's the discussion about the angle of the syringe when giving injections.

Denise
02-10-2009, 10:50 AM
Molly is still doing well, can't complain at all. Compared to Bogie with his other issues, she is so easy.

I DID switch to the 31 guage but I still end up injecting into fatty thick areas sometimes and her bg reflects it.

She is so different from Bogie. If he was higher than 300 he was lethargic but Molly is still in play mode up to the next injection time.

She needs a check up, some labs done but I have to get Reba and Char dealt with first, then Molly and Bubba (sarcoma) and then Shaq and Sam. It never ends!!!

So, not really any news but I thought I should start posting here again when I can. I will try to catch up with everyone and the new people.

Hope you are all well, hugs to your babies.

k9diabetes
02-10-2009, 11:03 AM
Hi Denise!! It's nice to see you. I'm on my way out with the Jackster, who lately has been wasting his dog park time to obsess on grungy tennis balls, completely ignoring all the dogs running around him.

How's Bubba doing?

We were worried about Gus - he was having soft stools and looked miserable again. Thought we had lost control of his IBD/lymphoma. Turns out his anal sacs, glands, whatever they are... I don't really want to know... were EXTREMELY full! Vet said he'd never seen such large ones :o

We find this out after spending a lot of money on a new ultrasound, which requires sedation. As soon as the vet "cleaned him out" he was right as rain again. He's actually kind of plump these days.

Natalie

acushdogsmom
02-10-2009, 04:59 PM
Hi Denise! So good to see your post! A belated Happy New year to you and yours. :D