Tony's Jessie earned her wings

[k9diabetes]

Re: Problem with shots

I just have a minute but wanted to add a few things...

When you get a chance, check in which Margaret about possibly getting syringes with smaller needles. The 28 gauge Vetsulin syringes are on the large side and even going down to a 29 gauge needle can make a big difference in terms of comfort.

You can angle the syringe different ways, tent the skin different ways, and even inject in a different area since it sounds like she might have some scar tissue or something where you are currently trying to inject.

Here's a diagram of the different areas you can try:



Some people point the syringe down, some lay it almost flat against the body... whatever works is okay.

BD has a slide show on injecting and you might find some tips there:
http://www.bd.com/us/diabetes/page.a...t=7001&id=7394

Are you warming up the insulin in the syringe? Cold insulin stings.

And the where you put the bevel can make a difference.

Plus some places a dog just doesn't like. Chris didn't mind his left side but didn't like when I injected on the right side so we just didn't do it there. We used the side of the chest per the diagram above.

Look here if you haven't already: http://www.k9diabetes.com/forum/forumdisplay.php?f=14

I do think finer needles will help.

With her skin issues, she may be very sensitive in places too! Poor girl. You may find that you have to look around for a place where there isn't any bumps or inflammation. Try to identify some of those in advance.

Also, is the new vet working on the skin issue?

Does she have open sores, scar tissue... ?

Natalie

[ajtony]

Re: Problem with shots

Thanks Nathalie, Will take all the advice on board and try again in a couple of hours. I will also try and get hold of the finer needles (thanks for the info Margaret). Jessie doesn't have any open sores or scar tissue (yet). I have just picked up on the tip about having the bevel facing up so that may help and I will try and 'dart' the needle as advised. as well. Thanks again, Tony

[ajtony]

Re: Problem with shots

Hi Margaret, I have just received 2 boxes of syringes from Pet Drugs online but they are the 1 ml 28G x 1/2" U40 needle. I have just visited their web site to see if I can get 29G needles but cannot find them there. Do I need to order the 0.5 ml U40's or am I missing something on their website. Thanks again, Tony

[jestersmom]

Re: Problem with shots

I would try approaching the shot in a whole new way....

Go to the book store and look for Cesar Milan's books. One of them will have great advice on how to give shots, pills, etc in a loving easy way. If you approach shot giving like a battle, so will your dog.

Here are some ideas:
before giving the shot, relax with your dog on the ground, pet the neck area, give a massage, and while doing this, have the needle nearby. RIght now your dog associates the shots with tension, drama, fear, You need to make the association one of comfort, getting a massage, relaxing, etc.

With jester, when we first started, I rubbed his neck, gave him a belly rub, and he was so relaxed and not tense, the shot went right in. You also need to be confident with the needle. Maybe take the used needles and practice on a plum or orange or something to get good at the actual injection. It could be that changing locations won't do much good until your approach changes and your dog is not in panic zone when he sees that needle.

It may help to pretty much simultanesously tent and inject, and by practicing, that will come easier. I use one hand to tent, the other to inject. After the injection, i pat the spot, and say good boy. It takes about three seconds.

Good luck and relax, if you go at the procedure calmly, I think you will be amazed at the ease.

[janspack]

Re: Problem with shots

Hi Tony:

I can tell you what we did....my dog is very hyper and had to be muzzled for a while until he got used to the shots.

I'm lucky in that Pip loves to eat. I break up two diabetic cookies and put them on a plate. I make up the needle and when Pip is done eating I pick him up and put him on our counter. I put the plate of broken diabetic cookies in front of him and while he's eating I give him his injection.

As soon as he feels me tent his skin he stops eating to look at me but as soon as I'm done he goes back to eating.

I have tried shooting him fast, slow and every which way in between. I found the way that works for me from trial and error over the past two years. It has been key for us to remain calm and matter of fact while in the process of giving him insulin.

Good Luck!!!!

Pam

I always inject Dazzle when she's eating as well. She's so greedy she doesn't even flinch. She's OK to have her injection at other times as well which I've had to do occasionally though so don't know if that will work for Jesse.

As someone else said, the problem gets worse as you get more and more worked up about giving the injection - not an easy situation I know. Could one of you titbit her while the other one gives the shot? What actually does she do? I wonder as she's had a lot of skin problems if her skin is a bit tougher than usual. Maybe you could find a spot somewhere that hasn't had any changes to the skin from her previous problems.

It does get easier - I was really nervous to start with but now it's just something we do twice a day.

[Margaret Boyle]

Re: Problem with shots

Hi Margaret, I have just received 2 boxes of syringes from Pet Drugs online but they are the 1 ml 28G x 1/2" U40 needle. I have just visited their web site to see if I can get 29G needles but cannot find them there. Do I need to order the 0.5 ml U40's or am I missing something on their website. Thanks again, Tony

Sorry Tony my mistake, the syringe you are looking for is---

U40 0.5ml Caninsulin syringe
29G x 1/2" needle

Box of 30


I used to use 1ml sorry about that, you will get them no bother.


Margaret

[CarolW]

Re: Problem with shots

Tony - quite a few people have told me they've found these pages really helpful.

http://www.coherentdog.org/vek/painlessinj.php

There's also a section on engaging your dog's cooperation.

I'd also have a look at this page:

http://www.coherentdog.org/vek/groomintable.php

Let us know how things go!

Do try to get those 29-gauge needles; it really does make a difference.

If worst comes to worst, you can use even thinner (31-gauge), shorter (5/16-inch) needles, but to use THOSE, you have to make a conversion! They are the WRONG SYRINGES for Vetsulin/Caninsulin, so you cannot use the markings on the barrel in the way the numbers indicate. You have to multiply by 2.5 to get the correct Vetsulin dose.

It is SO dangerous to get the wrong dose that I don't recommend doing that without your vet's approval and double-and-triple-checking that you're doing it right.

But I have some friends who do just that - use "the wrong" syringes, make the conversion, and so, can use the very thn, very short needles.

But I think you'll be okay with the RIGHT syringes, if you can get the 29-gauge ones, and follow the tips forum members are giving you.

Mon, 21 Dec 2009 11:32:19 (PST)

[jestersmom]

Re: Problem with shots

My concern is with the approach to giving the injection. I look at dealing with my dog as if I was dealing with a toddler. Get as much prepared ahead of time as possible. Needle ready, check. Treats ready, check. Calmness, check. Dog relaxed, bladder empty, check.

I understand there may be skin issues, etc. So practicing on fruit with water so that the motion of injecting is easy. I can do it with one hand now, while creating tent with the other.

Its a good idea maybe look at other needles etc., but at this point, it seems the whole injection routine is stressful for all, and while a new needle may help, if the same method is used and the doggy is scared, nervous etc., the same issues may keep recurring.

I am always looking at this from the dogs perspective, and how they might feel, and trying to find ways to create the least amount of drama and trauma.

If the injection will be problematic due to skin issues, I would try to find a way to make the injection as comforting, routine and calm as possible for everyone. Also, the person giving the injection needs to be totally confident in piercing the skin and just quickly push right in, with no trepidation. Once the right needle is found, practice so you can just give the shot as quickly as possible. Speed and calm are paramount to getting the job done. THe petting etc, doesn't have to be a long drawn out ritual, just something to create serenity for all.

Good luck, and I know its tough. I once got stuck somewhere and had to give my daughter instructions over the phone for the injections. I told her to just be calm and stick the needle in and not to prolong the injection part, but after to give jester a big hug, belly rub and a good boy.

[ajtony]

Re: Problem with shots

Hi guys, Just got Jessie back from the vets. To say I am disgusted would be an understatement. It was a different vet. All he could say was if it was his dog he would let her go because of her skin problems. He didn't even bother mentioning any possible Cushing Disease but I am happy with that for now as the diabetes can come first. So we have stopped the vetoryl and I will try and sort a Vet Hospital appointment asap. The vet couldn't even look me in the eye. I thought he was the shop assistant. He's there if I need a prescription but I would sooner trust this forum than him. He said I may want to increase the caninsulin to 7 or 8 twice a day and when I asked for a printout of the 'curve' he said I would have to come in for it tomorrow. Anyway, I'm off to work (on nights). Just got to try Jessie's shot before I go, Cheers, Tony

[k9diabetes]

Re: New Member Jessie - Problem with shots

Dang, Tony! That's really sad... I have worked with a few people with similarly limited veterinary choices and it's just not fair.

I have come, since Chris' diagnosis with diabetes and severe heart disease, to appreciate where I live because there are probably 100 different vets within an hour's drive and often more than one doctor specializing in things like cardiology and dermatology. I treasure having a choice.

One advantage here in the U.S. is that the older insulins like NPH can be gotten without a prescription so we don't have to be held hostage in order to get a life-saving substance.

If you can find a very sympathetic and caring hospital specialist, that person might be willing to then work with you, after examining Jessie, via email and telephone as much as possible.

I have seen specialists do this in the U.S. - Kay's Bo was a mini Schnauzer with extremely severe diarrhea. She took Bo to the specialist for a thorough exam and then worked with her by telephone after that.

I used to email Chris' cardiologist with questions and even sent her videos of Chris if I wanted her to take a look at something like his breathing. It saved Chris the stress of traveling for things we could handle another way.

I'm really glad you're stopping the Vetoryl as from all I've seen here and at the Cushings forum I think Cushing's is not very likely.

Could you tell us some more about her skin condition (and maybe copy it to the Cushings forum too)?

I have some experience with skin conditions with Chris and have seen a few other dogs along the way. We were able to have a teaching hospital dermatologist who has a worldwide reputation look at Chris' case and make some recommendations. It is possible that he would do that for Jessie.

You never know - someone here may have had a dog with the same problem and can offer some advice. Pictures would be good if you can.

Hang in there... I know it doesn't seem like it but this is progress if it's a bit skewed from what you expected. You've got your insulin prescription, you've got a plan to stop the Vetoryl, and hopefully you will be able to see a more serious hospital about the skin. You've accomplished a LOT in a week's time.

I'm anxious to see the curve numbers too.

Natalie

[k9diabetes]

Re: New Member Jessie - Problem with shots

Let's talk about how much to increase the insulin.

A 2 unit increase generally is not advisable in a dog who is only on 5 units now. If you can get the vet to give you the curve, it would be easier to figure out an increase. I could see circumstances where a 2 unit increase MIGHT be warranted, like if her blood sugar is all in the 600s! Yikes, I hope that's not the case! More likely the increase in the insulin dose should be small - 1/2 to 1 unit. You can eyeball a half unit on the syringe.

Stopping the vetoryl is also likely to influence Jessie's blood sugar. There is a direct correlation between cortisol and other hormone levels and blood sugar so her insulin needs definitely could change when that medication is eliminated.

I think you may be urine testing... I'll have to look. Even that would give us some indication if it was done often for a day.

My heart hurts for all you and Jessie have been through. We have had more than one rural vet who handles mostly livestock just suggest euthanasia in response to a dog being diagnosed with diabetes. It's scary what can happen in the wrong hands.

We can get this sorted out though Tony so don't despair.

Natalie

[BestBuddy]

Re: New Member Jessie - Problem with shots

Hi Tony,

Just wondering about the skin issues. Can you describe what is happening. Pictures would be great if you can.

Jenny

[ajtony]

Re: New Member Jessie - Problem with shots

Thanks to everyone. As soon as get the curve results from the vet we will post it here. In the meantime, unless you tell us different, we will give Jessie her 5 units in the morning and then wait for the curve results. We gave her the last vetoryl on monday morning. We have been testing the urine for glucose but not for ketones (I have only just found out about this and am still tyring to get my head around it). The instruction leaflet was missing from the diastix box so we don't really know what we are doing. All I know is that initially, 3 weeks ago, after the 30 seconds, the colour was dark brown (the furthest shade of colour to the left). It is now on the third shade up which is browny/green and we thought that was a good sign. I will try and get some photos and post them tomorrow. She is very sore around her rear end/vulva and it is black/swollen and occasionally bleeding. She is scratching a lot tonight and very unsettled although she can still jump and off the settee. We don't know what to do for the best with her. She's so much part of the family and I don't want her to suffer. I'd prefer to ease her painful skin problems so that she has a relatively pain free time with us - even if she only has a short time left. My wife Pat has put some calomine lotion on her sore bits tonight, and we have a mild skin shampoo that we use. The only thing that seemed to work on her skin problems was something called 'Atopica' (quite pricey) which we used a couple of months ago, BUT it states in the information sheet not to use on diabetic dogs. Also don't know whether to ask the vet to refer Jessie to the Vet University Hospital in Glasgow, now, or wait until the new year. So many things to think about. And I know there are dogs worse off than Jessie so we must try and remain positive. cheers, Tony

[acushdogsmom]

Re: New Member Jessie - Problem with shots

Hi Tony,

Just wanted to let you know that I just wrote a long reply post to you over at the Cushing's message board.

http://www.k9cushings.com/forum/show...?t=1537&page=2

Also, in addition to the Vet University teaching Hospital in Glasgow (a great choice), Glynda may have found another option for an Internal Medicine Specialist for you, who may be closer to where you are, depending on where you live exactly.

http://www.medicinereferrals.co.uk/

[robertpri]

Re: Problem with shots

Tony - quite a few people have told me they've found these pages really helpful.

http://www.coherentdog.org/vek/painlessinj.php

Wow, Carol, your pages are really great. I follow a lot of threads here, just to learn more, and clicked to your injection pages. I had completely forgotten about injecting with the bevel side up. I knew that at one time, but it must have slipped back into my memory abyss.

I had just opened a pack of 10 tonight and used one on Mik. After seeing your site, I pulled the red cap off the remaining 9 needles and there is no pattern from one to the next. The bevel can be anywhere. I will mark barrel with black felt pen from now on.

[Actually, with good light, I went ahead and marked all 9 in advance]

I prep Mik's injection then put it carefully in a nearby dish. It's 3-4 IU Vetsulin and sits there at room temps for 20-40 minutes, while I prep meals and depending on Mik's mood to eat.

I figured that was enough "warm-up" and have never tried the arm pit. Might try that tomorrow.

thanks for great information!

bob