Newly diagnosed diabetic. injecting started well but going downhill

[jojo]

I'm hoping for some advice about managing my newly diagnosed dog, Juicy - she's eight years old, a labxkelpie, 27kg. Any advice would be wonderful, as this is all super new to us, but in particular we're starting to have trouble at injection time - especially just towards the end of the shot. The actual needlestick itself doesn't seem to bother her.

She was diagnosed with diabetes just over a week ago and started on 7 units of insulin AM/PM. At first she stood there calmly while I injected her, had a treat, gentle massage of the area afterwards. Everything seemed to be going pretty smoothly. As her dose was increased over the week, though, she started whimpering and pulling away at the end of the injection. She's now at 14 units AM/PM and consistently pulling away towards the end of the injection, whimpering, very distressed. Last night we had the worst attempt ever, and this morning she tried to hide from the syringe. She's getting very stressed about injection time, and I'm really upset to see her like that.

We started off so well, and I know it's only been a week, but it feels like we're going rapidly backwards. I assume her insulin will be increased again after she goes back for another curve next week, and I really want to find a way to make this better for her. I've tried to take a very practical, no-nonsense approach to injection time, because she is an anxious dog, but last night, for example, I was feeling pretty confident (as we'd had a good morning injection), but she just seems to be in pain towards the end of the shot.

I'm injecting around her scruff, in a slightly different area each time (say left, right, upper, lower areas of the scruff), squeezing a fold of skin/fat and trying to inject quickly and smoothly. She doesn't like being stroked around her hips, so I haven't tried that area. I'm using a 0.3mL 0.25mm (31G) x 8mm syringe with a short needle. She gets a treat she really likes before and after, lots of hugs and praise.

If anyone has an advice or suggestions about what might be triggering this reaction at the end of the injection, or any advice at all that stands out to you, I'd really appreciate it! Thanks!

Jo & Juicy

[Grayson]

Re: Newly diagnosed diabetic. injecting started well but going downhill

Just wondering if you're warming up the dose before injecting her? If not, the larger amount might now be enough for her to feel it going in, and cold insulin can sting! I put the loaded syringe between my lips for a few minutes while I'm putting my boys food together. The warmth from my breath takes the chill off so it won't hurt him... I also use his enthusiasm for his meals as the ideal time to inject. When he goes back for the second chomp of food, I give the shot (as his face is in the bowl and he's too busy to notice). Most times, it's done before he knows it. This would maybe be an option for you to try, if she isn't fussy on eating. Those with picky eaters prefer to get the food down before giving their shot, as you've got overdose worries if they had trouble eating their meal. The rest of the folks here may come up with some ideas for you, but cold insulin was my first thought...

[Eddie]

Re: Newly diagnosed diabetic. injecting started well but going downhill

Hello and welcome
We also inject while our dog eats. Usually he doesn't seem to notice that we have done it. You do need to be confident that the dog will eat all the food if you do this though.
We also hold the syringe in our hand for a few minutes while preparing the food to warm up the insulin.
A few owners are told by their vets to pull back on the plunger just before pushing it in to check you are not in a vein. Hardly anyone on here does that and it does not seem to be necessary. Just thought I'd mention that in case you've been told to do that..
Also you can try varying the site of the injection. People on here inject in all different places. We tend to use the side/flank/shoulder - anywhere we can get a good pinch of skin without too much fat/muscle. Our vet said it didn't matter too much where it went in so long as it went in and that seems to be the case for us. I think a few people have found that their dogs seem to react differently depending where they inject but it might be worth a try of a different site for you.
Finally, make sure you are as relaxed as possible so you don't transmit anxiety to her - easier said than done but worth trying to act relaxed even if you aren't really!
Hope it gets easier
Antonia

[CraigM]

Re: Newly diagnosed diabetic. injecting started well but going downhill

Finally, make sure you are as relaxed as possible so you don't transmit anxiety to her - easier said than done but worth trying to act relaxed even if you aren't really!
Hope it gets easier

I talk, hum, sing during the injection. This seems to keep us both calm.

Good luck

Craig

[Charlie's mom]

Re: Newly diagnosed diabetic. injecting started well but going downhill

We definitely have to warm it up before injecting and can now only inject on his left side as he'll stop eating as soon as we start touching the right. We inject on the scruff in the morning (when I'm not awake) and on his side in the evening. He will definitely flinch and try to pull away if it's not warm enough. Since he scarfs his food in under 2 minutes we make him wait to eat until it doesn't feel cool when holding the syringe next to inner wrist (like the old baby bottle tricks).

Good luck, you CAN do this!

Laura

[Judi]

Re: Newly diagnosed diabetic. injecting started well but going downhill

some dogs hurt in different places. Are you injecting fast or slow? We went through a phase where the actual insulin is what seemed to hurt Jenny too. I never did figure it out.

I also don't think many people massage afterward. I think I read somewhere that you shouldn't but I can't remember why.

We found the Sure Comfort syringes help http://www.totaldiabetessupply.com/i...ch-100-bx.html

And I would try different parts of the body. maybe the scruff hurts. At this point I find anyplace I can tent some skin and do it as quickly as possible. She got over the wincing from the insulin.

[amydunn19]

Re: Newly diagnosed diabetic. injecting started well but going downhill

She was diagnosed with diabetes just over a week ago and started on 7 units of insulin AM/PM. At first she stood there calmly while I injected her, had a treat, gentle massage of the area afterwards. Everything seemed to be going pretty smoothly. As her dose was increased over the week, though, she started whimpering and pulling away at the end of the injection. She's now at 14 units AM/PM.

I am very concerned with this much of an increase in one week. Granted, she was started very low. In fact, I find 7 units to be too low to start on a dog her size. Do you have any blood glucose readings from her diagnosis? Most vets probably would have started a little higher like 10 or 11, but now at 14 units, the raises should be much slower and I would be resistant to go any faster than a unit at a time, with a time period of 5-7 days in between. Does your vet do one glucose test or keep your dog for several hours?

I know injections are giving you issues, but that will get better with time. It would be great if you could home test if you felt like you would be able to do it.

Oh, and the scruff makes my dog cry every time. Try on her back - the sides not the spinal cord. Just pull up the skin and inject at the bottom. Tenting can be difficult and it really isn't necessary.

[k9diabetes]

Re: Newly diagnosed diabetic. injecting started well but going downhill

There are lots of different ways to inject and each dog has her own likes and dislikes.

For example, you can do everything from essentially no tenting to the skin - just sliding the needle in sideways - to a full very formal tenting. Some dogs really hate havig a serious tent made. We never did with our dog. I just gently took the skin between two fingers and pulled it away from his body and then a quick poke and very quick injection.

Also our dog didn't like injections on the right side - I think related to my being righthanded and left side injections were smoother for me. So we only did them on the right side.

Whatever gets the insulin where it needs to be is okay.

Also lots of other places you can inject:



There are lots more injection tips saved in the Answers forum section on syringes and injections - try various things and see if they make a difference.

http://www.k9diabetes.com/forum/forumdisplay.php?f=14

Sometimes it's an anxiety and not the shot itself. You can try some practice injections with a capped syringe and see if you get the same response. If you do, the response may not be related to pain or discomfort but to a building anxiety.

Natalie

I'm hoping for some advice about managing my newly diagnosed dog, Juicy - she's eight years old, a labxkelpie, 27kg. Any advice would be wonderful, as this is all super new to us, but in particular we're starting to have trouble at injection time - especially just towards the end of the shot. The actual needlestick itself doesn't seem to bother her.

She was diagnosed with diabetes just over a week ago and started on 7 units of insulin AM/PM. At first she stood there calmly while I injected her, had a treat, gentle massage of the area afterwards. Everything seemed to be going pretty smoothly. As her dose was increased over the week, though, she started whimpering and pulling away at the end of the injection. She's now at 14 units AM/PM and consistently pulling away towards the end of the injection, whimpering, very distressed. Last night we had the worst attempt ever, and this morning she tried to hide from the syringe. She's getting very stressed about injection time, and I'm really upset to see her like that.

We started off so well, and I know it's only been a week, but it feels like we're going rapidly backwards. I assume her insulin will be increased again after she goes back for another curve next week, and I really want to find a way to make this better for her. I've tried to take a very practical, no-nonsense approach to injection time, because she is an anxious dog, but last night, for example, I was feeling pretty confident (as we'd had a good morning injection), but she just seems to be in pain towards the end of the shot.

I'm injecting around her scruff, in a slightly different area each time (say left, right, upper, lower areas of the scruff), squeezing a fold of skin/fat and trying to inject quickly and smoothly. She doesn't like being stroked around her hips, so I haven't tried that area. I'm using a 0.3mL 0.25mm (31G) x 8mm syringe with a short needle. She gets a treat she really likes before and after, lots of hugs and praise.

If anyone has an advice or suggestions about what might be triggering this reaction at the end of the injection, or any advice at all that stands out to you, I'd really appreciate it! Thanks!

Jo & Juicy

[SidneyDog]

Re: Newly diagnosed diabetic. injecting started well but going downhill

Hello!
I would make sure you are keeping the needle almost parallel to her body with only a slight angle inward. If you stab directly in it will hurt.
I just grab his fatty area on his side around his shoulder area and pinch the skin and push it right parallel while he eats. I do warm it before by placing cap back on and letting it warm in my armpit area.
Good Luck! It will all come together, I promise. It's just very emotional and nerve racking at first.

[Geoff]

Re: Newly diagnosed diabetic. injecting started well but going downhill

Hello, very stressful for you! I never tented either, just squeezed between my thumb and forefinger (gently) and at 45 deg insert needle, squeeze for 1-2 seconds or so, depending on the dosage. 14 units may take 2-3 seconds. In any case my pooch didn't really like it at first and I did the same you're doing, praise, treats he loved etc. He got used to it.

I always used to make him sit but in the end I did it standing up at the nape of his neck. Not sure what else to try, distractions, towel over head? People try all sorts of things. Maybe a silly noise in a silly voice?! Anything do distract from what you're "actually" doing. I also used to warm the insulin between my hands for a 30 secs or so but I have also pre-filled the syringe and left it out for 1/2 hour prior to injection. My diabetic friend says the cold insulin stings a little going in. You're doing great, never easy but come back often, someone is bound to provide an idea or tip which may help! Good luck,

Geoff

[jojo]

Re: Newly diagnosed diabetic. injecting started well but going downhill

First of all, I just want to say thank you so much to all of you for taking time out of your days to help us with this issue! Your kindness and encouragement has been so appreciated, and your combined advice has turned around the last day of injection times for us. I wanted to wait a day to report back how things went, and so far, so much better!

Last night was our first real success since things started going downhill. We had a combination of warmed insulin, a better position to give the shot, and my sister (who's a doctor) dropping round to give the injection to break the anxiety cycle. It took some time to get Juicy settled beforehand, but she had her shot with no whimpering, no pulling away, no signs of distress at all. Today Juicy and I repeated the routine with just the two of us, and again, no whimpering, no pulling away, no signs of distress. I am so thrilled! I know this doesn't guarantee stress-free injections from here on, but the difference in Juicy so far after following the lovely advice here is just wonderful to see!

Just on her insulin increases, Amy, my apologies, I should have given more information about her progression. The vet did say that 7 units was a very low dose, but he wanted to start off cautiously, so she went from 7 to 10, then had a full day at the vet for her curve. Her glucose stayed above 18 all day, so he increased her to 14 units, and she's due to go back at the end of this week for another curve. Thank you so much for making me aware of this, I'll certainly ask him about slower increments for her next increase.

Thank you again to all of you for your advice and encouragement, it really has made such a difference to our last 24 hours, and thank you as well for the warm welcome. I'm really glad to have found this community, and I'm keeping my fingers crossed that our next few days days go as smoothly as today.

Jo & Juicy

[Eddie]

Re: Newly diagnosed diabetic. injecting started well but going downhill

I'm glad that things have got easier for you both - it generally seems to, as you all get used to the new normal.
When I was first injecting (and feeling very anxious about it all) I used to remind both Eddie and me that what I was doing was actually saving his life, one injection at a time - and that made me feel a lot better about it all!
Antonia