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Insulin Administration in Dogs

By Wendy C. Brooks, DVM, DipABVP 
Educational Director, VeterinaryPartner.com

Insulin is the injectable medication you use to control your diabetic dog’s blood sugar. When insulin therapy is started, the optimal dose for your pet is unknown and will have to be determined by trial and error. Most dogs will need insulin injections twice a day, though occasionally a patient is found where a single dose is long acting and once-a-day insulin works out. A dose will be selected based on what research has shown to be a good starting point, and after a couple of weeks your dog will return for a glucose curve where blood sugar levels will be mapped out over the course of a 10 to 24 hour period. The curve will show if the insulin is lasting long enough and if the dose should be raised, lowered, or kept the same. Alternatively, you can learn how to monitor your dog’s blood glucose levels yourself but if you are a beginner you may want to master giving the injections before moving on to taking blood samples.

BE SURE YOU UNDERSTAND HOW MUCH INSULIN YOU ARE SUPPOSED TO GIVE YOUR PET.  DO NOT ADJUST YOUR PET’S INSULIN DOSE WITHOUT VETERINARY GUIDANCE.

Storing Insulin

The bottle of insulin should be refrigerated.

  • Do not use insulin that is past its expiration date. In fact, it is a good idea to change to a fresh bottle every 6 to 8 weeks.
  • Do not use insulin that has been frozen. Insulin is not normally frozen but accidents happen, especially in smaller refrigerators.
  • Do not expose insulin to direct light or heat.

Syringes
 
There are two types of insulin syringes: U-40 (for insulin of the 40 units per cc concentration) and U-100 syringes (for insulin of the 100 units per cc concentration). The type of syringes used must match the insulin used.

Photo by Dr. Wendy Brooks

Insulin syringes may be available through your veterinarian’s office or through your regular drugstore but do not be surprised if a prescription is needed from your drugstore. Insulin purchased at the drugstore may or may not require prescription. Insulin is considered an over-the-counter medication for humans but when it is used in pets, it is technically off-label so prescription may be needed.

Insulin syringes are made extra fine so that human diabetics will not feel them. Veterinary syringes are similarly fine and your pet should not object to injections.

When drawing up the insulin, always hold the bottle vertically to avoid unnecessary bubbles in the syringe. Since insulin is being given under the skin, bubbles are not an enormous problem (as it would be with an intravenous injection) but we still want to minimize bubbles. If you get bubbles in the syringe, flick the syringe with your fingers until the bubble rises to the top and then simply push the air out of the syringe with the plunger.

Before injecting your pet, practice drawing up the correct amount of insulin
and feel comfortable handling the bottle and the syringes.

How to Give the Injections

First, feed your dog. The blood sugar of a dog that has not eaten a normal meal but receives insulin may drop to a dangerously low level. If your dog is not eating, this could indicate a need for a checkup with your veterinarian. After your dog has eaten, you are ready to give the injection.

Before drawing up the insulin in a syringe, roll the bottle back and forth in your palms so that the white material in the bottom is mixed in to the rest of the solution. Do not shake the bottle as the insulin molecule can be damaged.

Insulin is drawn into the syringe after holding the bottle upside down. Photo by Teri Ann Oursler, DVM
Tent the pet's skin before injecting the insulin. Photo by Teri Ann Oursler, DVM

When drawing up the insulin, always hold the bottle vertically to avoid unnecessary bubbles in the syringe. Since insulin is being given under the skin, bubbles are not an enormous problem as it would be with an intravenous injection but we still want to minimize bubbles. If you get bubbles in the syringe, flick the syringe with your fingers until the bubbles rise to the top and then simply push the air out of the syringe with the plunger.

After you have the insulin dose ready in the syringe, it is time to get your dog. Be sure you can trust your dog to hold reasonably still for the shot. Most dogs do not require a second person to hold them still but some dogs are rambunctious and a helper is necessary. If you have such a pet but no helper, consider tying a short leash around a piece of furniture. (Use a slip knot in case of a choking emergency.) Some dogs are uncooperative and require a muzzle.

Lift up a fold of skin, ideally along the side of the body. This will create a small space for the needle. Insert the needle into this space and inject the insulin. Withdraw the syringe and needle when you are finished.

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