Blood in insulin syringe after injecting

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Shauny and MaoMao

Member Since 2012
Hi guys,

My cat Mao has recently been diagnosed with diabetes (1 month ago) and today after giving her a shot of insulin (2 international units of lantus) I saw a small drop of blood inside the tip of the syringe after injecting.

I immediately gave her more food and I have been really worried for the past two hours. I've been constantly bugging her to see if she is ok and she seems ok except for being a little sleepy as she always is after dinner.

After the incident I went searching for more information on what I should do and haven't been able to find any information anywhere and was wondering if anyone could give me some advice on what I should do now or in the event it happens again.

I am not sure what happened as a normally tent and shoot into it. Also I didn't feel like I hit her muscle but as I said I saw a small drop of blood at the end of the needle after the injection.

Any information would be appreciated...

Shauny
 
I think you went a bit too deep. Insulin is supposed to be injected just under the skin, into the fat layer under it... under the fat are capillaries and blood vessels. Here is an image from BD showing a needle hitting a capillary, notice how there is no tent and they are shooting straight down.

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I don't think it's a big deal and it might just happen occasionally, but you may want to perfect your injection technique.

Where are you injecting also? What syringes are you using? 5/16 inch or 1 inch? If 1 inch, you may want to get shorter 5/16" needles. How do you hold the syringe when you shoot into the tent? Parallel to the body or straight down? You should be shooting parallel to the cat's body into the tent.
 
Thanks for the quick reply Ry,

I normally tent and shoot in 2 alternating spots: in the morning I tent and shoot in the middle of her back below her scruff and in the evening i tent and shoot on her right side behind her shoulder by her rib.

Regarding the needle - I am using Becton Dickenson 1/2cc Lo-Dose U-100 Insulin Syringe 28G 1/2 (0.36mm x 13mm). I'm not sure if that is 5/16 or 1inch.

Regarding how I hold the syringe - I try to shoot parrelel but on ocassion I may come in on a slight angle because she gets a little twitchy when I pinch and tent. (Perhaps she gets twitchy while anticipating the shot)

She seems ok now but if it happens again what protocol should I follow? I understand getting insulin into the bloodstream could be dangerous.


Thanks,
Shauny and MaoMao
 
Hello,
I agree that it's not a big deal. You probably just nicked a tiny capillary & pulled back a bit on the plunger thus drawing the blood in (without realizing it). The process is called aspiration & used to be advised as the proper technique when giving shots. Here's what I found re this issue:

"What does aspiration mean?
Aspiration involves pulling the plunger of the syringe back once it is injected to see if blood enters the barrel of the syringe. Blood means a need to shift to another site. However, aspiration is no longer needed when injecting insulin, according to medical experts."

So, just change to a slightly different spot to give this spot a chance to heal as possibly a tiny bruise got created. If this happens again (& it can happen to all of us) apply some pressure so the spot does not bruise, but don't rub it. If you are still worried about your kitty: call an ER & talk to a vet so you can get some restful sleep. Or, alternatively, test your kitty's BG in 2 - 4 hours to reassure yourself.
Best wishes,
Sophie
 
Hi,
sorry, I didn't see your second message. Yes, it could be dangerous because the insulin will have a faster & stronger effect. From your description of the site where you injected the insulin, I think that you merely nicked a tiny capillary & did not introduce it into the blood stream. But I do see you are worried, so in your shoes I'd call an ER & just talk to a vet. You can always test the kitty now & see her BG level. Do you have enough data to compare how she normally responds to insulin this many minutes / hours after the shot?
Sophie
 
Shauny and MaoMao said:
Regarding the needle - I am using Becton Dickenson 1/2cc Lo-Dose U-100 Insulin Syringe 28G 1/2 (0.36mm x 13mm). I'm not sure if that is 5/16 or 1inch.
Click to expand...

Those sound like oldschool syringes. Here we recommend 3/10cc, 30 or 31 gauge, 5/16" needle length with half unit markings (for measuring doses like .5 or .25u easier) Yours are larger capacity wise, have a significantly larger needle width (smaller number = bigger needle), and are longer (13mm is 1 inch, 5/16 is 8mm). I would buy new syringes ASAP if I were you.
 
Sorry for that delayed response... I was just keeping an eye and playing with Mao to make sure she was still doing ok. (I plan to stay up with her until breakfast.)

Sophie: Unfortunately I haven't started home testing yet as I am still bringing her in to the vet for her bi-weekly blood curves and fructosamine tests. Also is there a recommended brand or type of glucometer that you guys all use here because I plan to start testing her ASAP.

Ry: Your syringe comment makes a lot of sense and I will definitely look into it tomorrow (smaller gauge/shorter needle/better markers). Also will any type work with Lantus or does it have to be U-100?

Thanks,

Shauny and MaoMao
 
You need u100 syringes for Lantus, they have an orange cap (u40's have a red cap)

Walmart's ReliOn series are good, you want the Confirm or Micro. They use small samples and the strips are cheap, $20 for 50 or $36 for 100. The Ultima would work too but it takes a bigger blood sample. They also have the Prime which has incredibly cheap strips ($9 for 50) but I do not know how accurate it is on cats.

Some more pricy but good meters are the Bayer Contour, Accuchek Aviva, and the OneTouch Ultra. Avoid anything with "Tru" or "True" in the name, such as the TruTrak or TRUEread and also avoid the Freestyle Lite with the butterfly on the strips as they read lower than they should on cats.
 
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