Help with Intramuscular Adequan shots needed

Does anyone have information on giving IM shots of Adequan?
I am having troubles, and don't feel very confident shooting it IM.
My vet did the first dose, I did the second no problem. The third, J.D. growled, so I ended up giving that one SQ. The fourth, fifth, sixth and seventh went okay. And then the eighth, he growled, but I gave it IM anyway. I decided to try switching to his left hind leg instead, and just gave him his ninth bi-weekly shot, and he growled again, but I got it in. Then he fell off the couch and the leg that I shot it in seemed to shake. Now, he seems okay, but I am not feeling very comfortable with this. I tried searching the internet for some information on how to shoot intramuscular injections to cats and found nothing.
My vet showed me how, and said to run my thumb and first finger around the perimeter of his knee and feel for the muscle just inside of the knee joint (on the outside of the leg) and shoot there.
Can anyone help me?

Also, should I be aspirating (pulling back on the plunger) first to make sure there is no blood and have hit a vein?

 

There have been previous treads on this forum that said the SubQ is as good ad\s IM Adequan injections.

 

Dyana,
First off, what Larry said, I'm fairly sure that he's right, that it would work sub-q. Pretty sure the absorption rate would be different, but not sure if that matters with adequan. I think the IM would absorb a little more quickly.

I've done over 100 IM shots into what I believe is the same area you are shooting into. It would be between his "knee" and "hip" joint, into the biggest muscle in his leg, right? What we would refer to as our hamstring?

First off, is the syringe needle the same size as an insulin one? And how big is the dose per shot?

This is how I did it: I sat on the floor with Bob in front on me on his side, petted him a minute. Then I would grab his right leg (the one facing up) with my left hand, and held it so that it was straight out. My palm kept the leg from bending, and my thumb and forefinger grabbed the muscle between them. It gave me a fat and large area to shoot. I would stick the needle in about half way, and used my right thumb to pull back the plunger to make sure I wasn't in a vein/artery (I only remember once where I drew back any thing pink or red and had to find another spot), then pushed the plunger in. Bob very rarely reacted to it. A couple times he let a tiny cry out, but most times, it happened so fast that he didn't react at all. After the shot, I'd massage the muscle for 5 seconds or so, and then I let go and he got up and walked away.

He seemed to resent more that I grabbed and held his leg in place for a few seconds than the shot itself. Each shot, I would alternate legs also, although shooting the left leg was trickier because he was facing me instead of away. I could have switched hands I guess, but I'm right handed, and didn't feel as in control of the syringe with my left hand. He never growled or tried to claw or bite me, but I thought more about it when his claws and face were facing me than when they were facing away.

The vet tech who showed me how to do the shots trimmed/shaved a dime sized patch on the back/outside of Bob's legs so I'd have a "bullseye" to shoot at. That helped.

 

Thanks. I am using an insulin syringe, and giving 15 units of Adequan with a 1/2 inch needle.
I thought my vet told me to bend the knee, so that it fit in the space where my first finger and thumb came together.
I'll try it like you said with the leg straight out.
Boy, that dime sized shaved patch sounds like it was a good idea. I wish I (J.D.) had one.

I couldn't even tell you how I did it in the opposite leg this morning. I guess I kind of sort of bent his leg with my left hand and shot with my right.

So half way in with a 1/2 inch needle sounds okay? I wasn't sure how far to go in either.

I'm going to start checking for blood first, too, in the future.

J.D. just raced up the stairs, so I guess he's feeling alright :razz: .

Thanks for the info. It gives me a little more hope.

 

I was using a 1/2 inch long needle too, and half way in on the needle was about half way into the muscle, so I never had to worry about poking all the way through, and didn't have to worry about the "fur shot" either. The vet's advice to keep his leg bent was probably based on in that case, the muscle would be "relaxed", which is probably more comfortable for kitty, and would make the muscle "fatter" for you to shoot into? I just found it was easier to hold the leg immobile when it was straight out, and made the chance of Bob moving less likely. If it works easier bent, stay with that!

 

I shoot Adequan IM into Ennis. I did try SubQ but it didn't seem to help as much as the IM.

My vet showed me to shoot IM on Ennis's back. Behind his should blades about an inch, and an inch off the spine. Ennis gets 30U in an insulin syringe (1/2" inch needle because I use .5cc), and he doesn't flinch with the shot.

 

I am concerned about the doses of Adequan mentioned in this thread.

Dosing of Adequan is extremely small. Gandalf weighed 14 pounds when he received it and got .26cc. That is no where near 30 UNITS in an insulin syringe!

Dyana, if your dose is .15cc that is about right for say a 10 pound cat.

Please check with your vets that dose amounts are correct.

 

Isn't .26cc the same as 26 units in an insulin syringe?

My vet told me that 12 Units in an insulin syringe was the dose. I think (I'm at work, so I'm not certain), that he prescribed 0.12ml. Is that the same as 0.12cc? He prescribed the dose as that, and I did call him to question the dose because other people said that they were giving 30 units. Am I wrong about all this?
My vet said he had never prescribed Adequan for a cat, and wanted to go going strictly "by the book". After I called him, we compromised, and he told me to go ahead and give 15 units.
J.D. is 14 pounds or just under. Am I giving too much or too little?

 

FWIW, we just got back from the vet, who prescribed .2 ml. He gave us a larger syringe to use. Kitty weighs just over 16 lbs.

He also said sub-cutaneous would be fine. He'd prefer it lower down than the scruff, but he said scruff was acceptable if that's what we were comfortable doing.

p.s. We were told not to refrigerate the Adequan.

 

I didn't see this thread till Kathy and Kitty pointed it out today.

My vet is very thorough and has prescribed adequan a fair amount for cats. Starting Mario on it was her suggestion; I had never heard of it before. I know she used a formula to determine his dose, which is .3ml and he weighs 13lbs. She told us to shoot sub-q, and that's what we've been doing with great success.

SInce you're having a hard time with the IM shots, I really would give sub-Q a try and see how it goes for J.D. - it certainly can't hurt to give it a whirl. I think you may also find it easier to do the shot with a larger needle. We use a 25 gauge needle that is 5/8" long, and the it's a 1cc/ml syringe. The larger needle really helps get all that juice in there much more quickly.

As for the difference between equine and canine adequan, according to my vet, they are one and the same, that it's just a labeling difference. Whether or not that is true, I don't know, but that's what she said.

Amy

 

Also, what is the protocol you're following? Our vet gave us the following:

Twice a week for 4 weeks
Once a week for 4 weeks
Every other week for 4 weeks
Once a month indefinitely

 

Thank you for that. He suggested twice/week for four weeks, then 1/wk for four weeks, and then I think to one per month, but I will discuss with him.

Dyana, sorry to crash your condo.

Here is the link to the discussion Larry mentioned:

http://www.felinediabetes.com/FDMB/viewtopic.php?p=378418

They talk about shooting sub-cutaneously, and also dosing.

 

Wait, in response to Vickie's post, when my vet showed me how much Adequan to shoot she showed me on an insulin syringe. Newkitty is just under 13lbs and she gets .25ml, which was shown to me as almost the entire insulin syringe. That is the same amount of B12 that she gets. Now I am worried and confused.

 

This is close to what my Mario gets, too - .3ml and he's about 13lbs. I know my vet used a formula to arrive at this dosage....

 

Yikes,
Way too many units of measure going on!

OK, 1cc = 1ml, so yes, they're the same thing.

A standard u40 syringe I used was a 1/2 cc syringe. It held (or the highest marking on it's scale was) 20 units.
So, that would mean 1cc or 1ml equals 40 units (of insulin). I'm guessing 1 unit = 1 unit whether it's insulin or whatever kind of liquid?
If 1ml = 40 units then a dose of .25ml would be 10 units in a u40 syringe.

Can somebody check my math?
Carl

 

12 units in a U100 insulin syringe = .12 cc = .12 ml.

I have no experience with using U40 syringes, so I can't comment on how I would measure an Adequan dose using one.

 

It doesn't matter what type of syringe. You must know, however the totalcapacity of the syringe in order to know how many units to draw up. The only thing that matters is how much in ml the syringe is volume-wise. Is the u100 syringe a half ml ?
Carl

 

I am using U-100 syringes, 0.3 ml volume. Her dose is .25 ml. I have been injecting 25 units per my old vet's demonstration but after reading this I am worried I misunderstood. She is supposed to get her shot tonight.

 

OK, so the syringe is a u100. Is the total capacity of the syringe .3cc or .3ml? Does it say on the package like .3cc u100 x 1/2"?

And the highest marking on the scale is what?

Carl

 

Hi Carl. Thanks for posting. It holds 30 units. 0.3ml volume, it does not mention CCs but should that be the same as mls? It does not say the barrel size, just the gauge of the needle and the length of it.

 

Allie,

IF you are using a syringe that is a 3/10ml (might be stated as .3ml) total capacity,
AND the highest number on the scale is 30 units,
THEN yes, in order to shoot a .25ml dose, then you would draw up to the 25 unit line.

Carl

 

Hey Carl, thank you. Whew, we both appreciate your speedy replies. Going to go shoot it. Thanks again.

 

and yes, 1ml is equal to 1cc

What I didn't say clearly when I posted earlier in the thread is this.....

It doesn't make any difference what kind of syringe you use. The only important distinction between u40 and u100 syringes is not the syringe itself, but rather the concentration of the insulin that they are designed for. That's why you need to use a conversion chart when you use an insulin in a syringe that was not designed for that concentration of insulin.

When you are using the syringe to inject something other than insulin, in order to get the right dose you only need to know two things
1 - the total capacity of the syringe in ml's or cc's
2 - the highest number of units on the scale

With those two things, it's just a matter of doing the math.
If 3/10ths is 30 units, then 10/10ths is 100 units. So 1ml = 100 units, so .30ml = 30 units.

You could theoretically use a turkey baster if you knew how much it held, and how high the scale went.

Carl