It can be very intimidating or scary for owners to think about giving injections to their pets. With some encouragement and a good demonstration, the majority of pet owners will quickly become comfortable administering injections.
It is important that the owner receives handouts on diabetes, insulin, and administration. The information can be overwhelming, especially if they are apprehensive; they may forget some of what you tell them.
The doctor should go over diabetes with the owner, but technicians often give the insulin injection demonstration. Therefore, technicians should be familiar with insulin handling, and knowledgeable enough to answer basic questions about insulin and administration.
Key Points to Discuss with Owners of Diabetic Pets during Insulin Demonstration:
1) Never shake the insulin. Gently roll it prior to drawing it up in the syringe.
2) Keep the insulin refrigerated. If insulin must be taken out of the house, keep it on ice packs or in a cooler.
3) Always check, and double check, the amount of insulin drawn up prior to injecting. In the event the owner thinks too much insulin has given or if the pet got the insulin injection twice, medical attention should be sought immediately. (There are many scenarios where one family member gives the insulin, and then another family member didn't know it was already given and the pet gets double dosed) Have the owner keep a calendar and check off that the insulin was given and at what time to prevent any confusion, or in case they forget if they gave it or not.
4) NEVER RE-DOSE INSULIN. If you can't remember if you gave it or not, or you are not sure if it went in (i.e. a wet spot on the fur), just give the next scheduled dose.
5) For pets that are on insulin every 12 hours (most pets get insulin twice daily), the injections should be given as close to 12 hours apart as possible. It is generally recommended that pets are fed twice a day and that insulin is given at mealtime. If the pet is not eating or only eats a little, typically it is best to give half of the regular dose and call the veterinarian for further guidance.
6) Monitor for signs of hypoglycemia (i.e. shaking, lethargy or weakness, stumbling, seizures, etc.). If signs occur, advise owners to give some Karo syrup orally if the pet is alert enough to swallow and call the hospital or have the pet seen immediately.
7) Explain the importance of follow-up visits to check a blood glucose curve or fructosamine level. This way the pet can have regulation monitored and the doctor can adjust the insulin if needed. The owner should NEVER adjust the insulin on their own.
DEMONSTRATION:
Use a small vial of sterile saline to pretend it is the insulin vial. Gently roll the vial to show owner how to mix. Show the owner on the insulin syringe exactly where the units are and to which line or units to draw up their pet's insulin. Have them look at the syringe after you draw it up.
Show them how to hold the pet (if applicable) and how to gently lift up on the skin and subcutaneous tissue to insert the needle (usually the scruff of the neck is easiest). The needle should be inserted to the hub and the insulin is injected. After injecting, the needle should be pulled straight out. The owner should purchase a sharps container for which to place used syringes, and insulin syringes should never be re-used. The site where the injection was given should also not be rubbed.
After you give the practice saline injection and show the owner how, have them practice with the saline a couple of times so that they will feel confident in giving the insulin at home.