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  • Question about moving feeding and insulin dosing

    Hello everyone!

    First let me say what a tremendous help you all have been since Molly's diagnosis a few weeks ago. I've read a lot of tips that you have shared and mostly I feel really encouraged that I'm not the only one struggling here.

    I rescued Molly a years ago, she is now 8 years old. Her last check up we got a surprise - yup, you guessed it, Diabetes!

    Her stats:

    • Corgi mix (I think the other half is border collie from the copious amount of fur)
    • 47 lbs
    • Very mellow but has some issues with fireworks, storms, squeaks, alarms as they make her pretty jumpy and anxious. But in general she lays around all day. Does not play with toys or anything, just chills out in my office (I work from home)
    • I have been able to train her to bark on command and go outside even when it's storming but it took along time
    • We are not regulated yet, two blood curves, 2 increases - currently at 12 Units Vetsulin in the U-40 syringes
    • We were show to inject her in her scruff and to rotate that general area.

    She was fine for the first few weeks. I'd feed her and then half an hour later take her to her blanket area and give her some Old Dog Diabetic crackers and give her the shot while she was crunching. NO PROBLEM! I thought hey this isn't so bad sure she moves when eating but I can get it in the tent and then it's done (We stared at 8 Units).

    After 2 weeks she started standing up and trying to take the treats to a different area. Hum. That's odd. So we tried something different, using a bowl with a small portion of oatmeal that she would take longer on. Ok, that worked fine for a week then she started fighting me again, getting up wiggling around, kept pulling the needle out before the full dose. Sometimes I'd have to poke her 3-4 times! Ugh. By this time I'm trying to get 10 Units in her.

    After the last blood curve, we are up to the 12 Units. So then I enlisted help from the roommate because she started nipping at the needle. Fabulous right!

    I had my roomie hold a spoon with some peanut butter just smeared on it so it would take her some time to lick it off. Hey, that was great, she didn't even flinch! Cool, we got it, easy again. Um. No. We had no problems exactly 4 times and then she started moving her neck back, turning around, and generally avoiding the shot. I'd just get the needle into the tent, start pushing the insulin in, and she'd move and the needle would come out.

    So now this morning we tried with a muzzle and having the peanut butter on the spoon as an "after the shot reward" (trying to discourage the nipping), she sat and my roommate held her top area while I straddled the bottom half while she was sitting. I'm trying not to go at this too forcefully because I really want to find something long term that is not combative but we wanted to see if she would eventually comply. NOPE. Wiggled and wiggled and wiggled. I stuck her 3 times again and only could get 3 units in.

    I don't want to go down the restrain too much method because I want to be able to have anyone in our family be able to know how to give Molly her shots and I don't want to increase her fear and anxiety as I know she is carry issues.

    And I also know she is STUBBORN! So I think we do have a power struggle/training issue here but I'm stuck for how to proceed.

    I've made sure the insulin is room temp (I set it out an hour before and then roll it in my palms like the vet showed).

    I inject bevel side up.

    I make a pretty tent and just go under the skin with just enough stick to get it. When I start this she starts wiggling up a storm and bending her neck back to get at it.

    Finally, whew, I know right, here are some questions:

    • Would moving to the BD U-100's 31 gauge even make a difference or does this sound purely like a power struggle? I ask because we are so far along with the Vetsulin and the Vet is willing to switch me but we have to start over on dosing and curves. Don't even get me started on how much fun her blood testing has been.
    • Is her scruff area getting sore? I have looked around at her skin in that area and I don't see any bruising or anything like that.
    • If I switch insulins, should I go ahead and switch locations? Her hip and flank are not as skin foldy as her scruff, her scruff is really foldy but maybe she is getting sensitive? Do I just move lower? I don't want to hit her muscles around her front legs...
    • How fast can I push in the insulin? She seems to react when I push it in even though I feel it's room temperature. Is this still the same power struggle?
    • How many times can I stick her with the same needle trying to get the insulin in? She gets pissier and more nippy the more I keep trying and I move the area I'm trying to get it in but lately I've just had to abort the whole blasted thing.
    • How far in do I go with the needle? I'm not going in very far, I just poke it a bit at the bottom of the tent. I go about 45 degrees in the bottom of the tent. Do I need to adjust anything here?

    Again, thanks for sharing your tips with me through these forums, I've been coming on here in the middle of the day, the middle of the night, you name it, just to try and find ways to get this insulin process to work for my Molly girl. She is such a lovable sweet girl and I just want to do everything I can to make her healthy.

  • #2
    Re: Molly and some shot time questions

    Hi and welcome

    it could be a simple as shot location . The scruff does not appear to be the best place especially for the long haul . Its is prone to scar tissue and sometimes absorption problems and possible a more noticeable feel to shots . Its closer to the head and it maybe a personal space problem

    With my jesse i give her shot towards the backend area maybe 6 to 8 inches up from the tail ( she is a beagle ) on either side of the spine ( you don't want to inject in the spinal area ) There is no major muscle group there . plenty of space to inject and maybe reduce the effect of scar tissue . I also give her shot while she eats her dinner so her backend faces me and her face is in the bowl . I slowly tent her skin she pauses from eating and give her the shot and she continues eating

    Yes its best not to associate a negative experience to other things like eating so if you decide to use this method take your time . Another thing is you want to be fairly sure your dog will eat giving a dose while they are eating . JUst doing a bit of practice can be helpful with just tenting the skin

    It is important for you to be calm and collected dogs can sense apprehension in us

    the good thing is probably a 100 percent figure this out and find what works for them
    Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
    Jesse earned her wings on 6/21/2021

    Comment


    • #3
      First of all, you are doing great. It is very hard to get started. The scruff is generally not a great absorption area, and can be painful. My dog cried every time I used it. Plus, you get scar tissue injecting in the same area. I would go with the sides up to but not over the spine.

      Tenting is unnecessary and awkward. I would pull up some loose skin and inject at the bottom. Easier and safer for fingers. Hope this helps.
      Maggie - 15 1/2 y/o JRT diagnosed 9/2007, Angel status on 6/20/16. Her mantra was never give up but her body couldn't keep up with her spirit. Someday, baby.......

      Comment


      • #4
        Re: Molly and some shot time questions

        Have you considered using a Vetpen.
        It is purposely made to inject Vetsulin which comes in cartridges that give a total of 108 units, so in your case 9 injections per cartridge.
        It does make giving injections easier and the insulin costs work out the same as using vials.
        You can also use different length pen needles ie 4,6,8,10mm that are available for human insulin pen users which are much cheaper than buying
        purpose made Vetsulin pen needles which are 12mm and 29 guage.

        As for the injection sites I use all along the spine, starting from just aft of the neck going back to just above the back legs.
        If you can squeeze up some loose skin between your thumb and forefinger then you know there is no firm tissue like muscle and you can inject there knowing you will not cause pain.
        If you worked from neck backwards you could have 4 areas approx 1-1.5 in either side of spine thus giving 8 injection sites.
        You give left side morning and right side at night.
        To keep tabs on which area you are doing next, well I find it easy just to place the pen on a piece of card numbered 1 to 4 and spin it clockwise after evening injection so you know without trying to remember where to go next.

        You could try teaching your dog just to stand still for say 15 sec while you perform just the action of holding the skin as I mentioned and then reward with treat.
        You dont have to pull up the skin in a tent, all that is needed is a raised area of flesh produced by gently squeezing the skin between thumb and forefinger.
        Forgot to mention, you could leave your Vetpen in the kitchen say, and with a cartridge loaded, just keep out of sunlight or hot areas above 25 deg c.
        Last edited by tonyr; 11-06-2016, 12:19 PM. Reason: more info

        Comment


        • #5
          Re: Molly and some shot time questions

          I realize your main question is how to get Molly to "enjoy" her injection My Annie loved to chase a ball, so after the injection we would play ball for several minutes. If fact, after her meal she would run off to find her ball and bring it to me. I had to have her syringe ready and inject right away or she would try to play before the injection.

          Concerning the switch to Novolin-N and U-100 syringes. I found the U-100 short 8mm needle (30 or 31 gauge) to be easier than the long 28 gauge U-40 syringe. How much are you spending for your Vetsulin vial that contains 400 units of insulin? The 1000 unit vial of Novolin-N from Walmart is $25.

          Most have discovered the dosage is about the same between Vetsulin and Novolin-N (I did). Reduce the dosage just a little, like down 1 unit, for a day and run a curve on Novolin-N. Just be sure to use the correct syringe for the insulin.

          Craig
          Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

          Comment


          • #6
            Re: Molly and some shot time questions

            Hello and welcome!
            To answer some of your questions, at least as to what we do -

            We inject while our dog is eating his meals.
            He is a very reliable eater so we just make sure he seems to be his usual hungry self, then do the injection as quickly as it will go in. He usually doesn't raise his head from the bowl or stop chewing.
            This works only if you are pretty sure that your dog will eat all the food. you don't want to inject a full dose of insulin then find that only half the food is eaten, but it is a good method if your dog is at least moderately greedy!

            Our needles are quite short (half an inch) and we push them most of the way in then push the plunger quickly and it's all done. (Some vets suggest first pulling back the plunger to make sure you aren't in a vein. I don't think anyone on here does that, but occasionally people are told to do that and it makes it much more complicated and seems to be unnecessary).

            We go all along his flanks, alternating sides, morning and evening. We don't use his scruff at all. There are a few lumpy bits there and other people on here seem to have found it not to be a very good site. We do tent the skin a bit, and aim for the bottom of the tent so we are just going through skin.

            It does get very much easier as you get used to it and nearly everyone finds a method that works for them and their dog, including the VetPen that Tony mentions.

            Antonia
            Eddie - Lab x golden retriever. Weighed 63lbs. Ate Canagan. Diagnosed October 2012. 13units of Caninsulin twice a day. Had EPI as well as diabetes. Died 20 June 2017. Loved forever.

            Comment


            • #7
              Re: Molly and some shot time questions

              Hello, and welcome to you and Molly.
              • We used the Walmart ReliOn 31 gauge, 5/16" syringes ($12.58 / 100), as well as their ReliOn Novolin N insulin ($24.88 / 10ml vial). Initially used a long 29 gauge. I don't think they can even feel the 31 gauge, short needle. The 29 gauge is like a railroad spike compared to the 31.
              • Started off injecting in the scruff, and moved to along the side a few inches below the spine. Had some lumpy areas develop in the scruff area, and learned it wasn't the best area to use for insulin absorption.
              • Gave the insulin a few minutes after the meal, using a small bowl of treats to divert attention from me and the injection process.
              • Gave the injection very quickly, in just a second or two.




              Good luck with whatever you decide to do.
              Last edited by farrwf; 11-07-2016, 09:25 AM.
              Otis Farrell dx'd 12/10, best friend to his dad, Bill, for over 14 years. Left this world while in his dad’s loving arms 10/04/13. Sonny Farrell dx'd 1/14, adopted 5/15/14. Left this world while in his dad's loving arms 9/06/16. Run pain free, you Pug guys, til we're together again.

              Comment


              • #8
                Re: Molly and some shot time questions

                Thanks and hugs to everyone who replied, you are a treasure trove of experience and I have been encouraged with the responses. Sorry for my delay in posting, I had to have lumpectomy surgery! Boy, when it rains, it pours!

                I have switched to the Novolin N (ok'd by the Vet) and the 31 gauge 100-U syringes and we will give this a go. The Vet started us back down at 6 Units and we will do the curve in 7-10 days to see where we sit.

                I have read a bunch of your excellent posts about switching so I am watching her carefully during the transition.

                Wish us luck!

                Comment


                • #9
                  Molly update - we found something that works

                  Hi everyone! I wanted to post an update to Molly and to all those who shared your wisdom a shout out that we found something that is working!

                  About 10 days ago, I switched to U-100 short 8mm needle with Novolin N from Walmart. We got the ok from the vet who called in a script for us.

                  We started her over again at 6 units with the Novolin N. Just did her curve yesterday and wow, what an improvement, we are already seeing 300's. The vet has adjusted us to 7 units now and we will curve again in 7-10 days.

                  As for the actual shot process, we also found that the U-100's are a life saver! A big difference in the response from Molly. All throughout the day for the past week I have been training her to lay over and stay and she gets a reward (green beans). I use one of my "test/fake" needles, take some green beans, and have her lay down and roll over. I go thru the motions of giving the shot, pinch the skin, poke with my finger, etc and give her the treat and praise. I do this 6-8 times a day!

                  It's really funny now because she will lay over and I point to the green beans that are in her sight and say "time for shot" and she is just mesmerized watching those green beans!

                  We are having no problems or big fight anymore! She doesn't even lift her head when I administer the shot with the U-100 short 8mm needle.

                  I never thought I would be able to do this so I wanted to share my story so others behind me would be encouraged too. I had to just keep trying different things and work with Molly's response to find that sweet middle ground.

                  I want to add too that I was surprised we are getting a lot better response to the Novolin N - anyone else see this?

                  Here are the stats:

                  Corgi/Border Collie mix
                  47lbs
                  6:30 AM/PM - Hills w/d
                  7:00 AM/PM - Insulin

                  DATE TIME Insulin BLOOD SUGAR (mg/dL)
                  10/16/2016 10:30:00 AM 8 Vetsulin 464
                  10/17/2016 2:30:00 PM 505
                  10/20/2016 6:45:00 AM 576
                  10/20/2016 8:45:00 AM 513
                  10/20/2016 10:45:00 AM 410
                  10/20/2016 12:45:00 PM 471
                  10/20/2016 2:45:00 PM 490
                  10/20/2016 4:45:00 PM 524
                  10/29/2016 6:30:00 AM 10 Vetsulin 491
                  10/29/2016 8:30:00 AM 508
                  10/29/2016 10:30:00 AM 544
                  11/1/2016 10:45:00 AM 12 Vetsulin 310
                  11/22/2016 6:30:00 AM 6 Novolin N 317

                  11/22/2016 8:30:00 AM 358
                  11/22/2016 10:30:00 AM 404
                  Last edited by trek4of9; 11-23-2016, 06:05 AM. Reason: fix chart

                  Comment


                  • #10
                    Re: Molly update - we found something that works

                    That's great news.
                    Otis Farrell dx'd 12/10, best friend to his dad, Bill, for over 14 years. Left this world while in his dad’s loving arms 10/04/13. Sonny Farrell dx'd 1/14, adopted 5/15/14. Left this world while in his dad's loving arms 9/06/16. Run pain free, you Pug guys, til we're together again.

                    Comment


                    • #11
                      Re: Molly update - we found something that works

                      fantastic news!
                      Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.

                      Comment


                      • #12
                        Re: Molly update - we found something that works

                        That is awesome that you have been able to get Molly to respond. To answer your question about Vetsulin switch - Vetsulin just didn't work for my dog, and instead of my first vet wanting to try Novolin, he just wanted me to go have a bunch of expensive tests done at a specialist. Thank goodness I didn't go along with him and I seeked out another opinion with a new vet. The U100 syringes are just so much easier to work with and easier on the dog too, which you've now seen.

                        Great job on being persistent and finding ways to make the whole diabetes/insulin thing a more pleasant experience for both of you!
                        Gus - **Angel as of March 7, 2018"
                        10.5 yr mini-schnauzer, diagnosed Sept. 2015, currently 17.5 units Novolin N 2x day; diet W/D, tblsp pumpkin, Advocate PetTester tester/strips & Alpha-Trak2 for alternative (when I question weird BG readings); blind as of March 1, 2016

                        Comment


                        • #13
                          Re: Molly update - we found something that works

                          Good work! Hope you get her into a good range soon.

                          About the Novolin-N, are you getting it at Walmart / Sam's Club? Only $25/vial there and generally don't need a prescription.

                          When I switched from Vetsulin to Novolin-N the numbers were about the same between the two insulins. Each pup probably differs slightly.

                          Craig
                          Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

                          Comment


                          • #14
                            Re: Molly update - we found something that works

                            Yes, I am so thankful for Walmart prices! I'll check on needing a script or not, I'm not sure if Florida requires it. My vet is wonderful, I sent my BG numbers in via email and they bumped it up to 7 Units and then we'll curve again in 7-10 days. We are hopefully getting close.

                            In other news, oh my gosh does Molly feel better! She was very playful yesterday, running around the yard, jumping over our landscaping border, running under the tables and around all my garden gnomes. I got a little puddly, I must confess. My spunky girl is back!





                            Originally posted by CraigM View Post
                            Good work! Hope you get her into a good range soon.

                            About the Novolin-N, are you getting it at Walmart / Sam's Club? Only $25/vial there and generally don't need a prescription.

                            When I switched from Vetsulin to Novolin-N the numbers were about the same between the two insulins. Each pup probably differs slightly.

                            Craig

                            Comment


                            • #15
                              Re: Molly update - we found something that works

                              What a great looking pup!

                              Craig
                              Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

                              Comment

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