Another question about home BG testing

Hello,

I have an 8 y.o. cat who was diagnosed 1 week ago. We are scheduled to begin insuline treatment tomorrow. However, there is a major problem. I am successful in drawing blood only about once in 3- 4 tries. It is honestly like on some days my cat just doesn't bleed, and on others it works the first time I poke. I don't understand what is different, because I'm doing everything exactly the same on the "good days" and the "bad days." Today is a bad day- I poked him 3 times in one ear, 2 times in the other, and even in desperation 1 time in the paw, and NOTHING came out!!! Not a trace of blood. It seems like nothing works on a "no blood" day.

My question is- can I start insuline, when I have no confidence that I will be able to test him regularly? I worry about not being able to get the blood out and sending him into a hypo. Is it better to wait with beginning insuline until I have a better success rate with testing?

This is very frustrating and disapointing.

Eva

 

Re: Another question about home BC testing

I wish I could help you, but I'm new to this too. We just started BG testing last night. I know how frustrating it can be, just remember to "breathe".
I'm sure someone will be along later--the board seems quiet tonight. Just didn't want you to linger without any responses; just wanted to give some support to a fellow 'newbie'.
I read in some of your other posts that you were considering lantus. If that is what you went with, you might want to try posting on the lantus board--it seems there are always a bunch of peeps over there at all times of the day.
Hang in there and good luck, I'm sure we will see each other around soon.

 

Re: Another question about home BC testing

Hi Eva

one of the key things to do when learning to home test is staying calm, focused and relaxed. Kitties sense your tension and they will put up a fuss.
It doesn't happen overnite, it takes practice and patience.

Often times it really helps to offer a little treat like freeze dried chicken treats.

I've added this link which will take to you to the FDMB Health Links page on home testing, there are videos and other tips in here, see if anything there helps.

viewtopic.php?f=3&t=5335

Also keep in mind - you are not hurting them, kitty ears heal - many of us here use neosporin to help that.
A little dab each ear, you can also alternate ears as well, giving each time to heal.

And one last thing - you are doing home testing to keep your cat safe when they are on insulin. Never forget that. And don't give up! It does get easier!

Might be a little quiet right now - but check back often to more replies ok?
Good luck to you! cat_pet_icon

 

Re: Another question about home BC testing

Hi,

I am pretty calm when doing the testing, and suprisingly, my cat is too. The issue is that on some days no matter how many times I poke him, there is no blood, and on other days 1 poke gives me a drop right away. I don't know what to do on the days he is not bleeding. I pricked him as many as 7 times. I know I got through his skin, becaue at least 1 time he reacted like it hurt. But still, there was no blood, despite massaging, milking, etc. I guess I could just keep poking him, but I suspect that the number of poke would not increase my success.

Please give me some advice regarding starting insulin when testing is inconsistent. Is it better to wait, or is there too much harm in delaying and better to start even though i may have to shut him at times without knowing his pre-shot number? is there a "safe" dose of insulin (we're going with Lantus), where a possibility of a hypo is greatly diminished?

E

 

Re: Another question about home BC testing

I haven't been here long enough to be confident about answering your question about starting insulin when you aren't always able to get a pre-shot number. I personally was doing it for a little over a week but that doesn't necessarily mean it's the "right" thing to do. I suspect it will depend on the kinds of numbers you're seeing when you do get a successful bg. What's the lowest number you've seen so far?

Here's a link explaining how to set up a spreadsheet and add it to your signature if you haven't done that yet viewtopic.php?f=6&t=16.

We just started testing a few days ago and I've had the same experience. Sometimes it works, other times you know you're sticking him but there's no blood. The difference for us seems to be making sure Joe's ear is very warm (we use a sock filled with rice and microwave for about 30 seconds), and just a dab of vasoline on his ear so when it does bleed it beads up and I can actually see it.

Sorry I can't be more helpful about your main question I'm sure one of the more knowledgeable members will be along soon. Wanted to make sure you know people are reading your message and give you a bump back to the top of the page.

 

Re: Another question about home BC testing

I understand what you are asking. When I was testing Maui regularly, I had issues about not getting enough blood for a test. Not only was it hard to see (black ears), but I'd poke and nothing would happen.

I did several things to help her ears bleed.

I used a warming sock -
take one sock
put 1/4 cup of rice (not instant) or oatmeal in the sock
knot the top
microwave for 30 seconds
place the sock behind the ear and hold until warm.
Then keep the sock back there while poking

I also used to massage her ears before the sock to get her blood flowing

Sometimes, I would have to poke a few times in the general area of the original poke, in order to collect the a drop with several pokes

I found that cold ears, don't bleed. I found that one ear bled better than the other. I did my best to stick with the upper edge of the ear, poking front to back.

Also, I found that holding the lancet (I freehanded) at an upward 45 degree angle helped. If I poked straight on, it never bled. But something about poking upwards caused the ear to bleed. Here's a pic of what I mean.



Finally, I used a flashlight, held it my mouth to keep hands free and shined on those black ears, so I could see where I poked and see the blood (or lack of blood).

Hope these ideas help.

And don't get discouraged and don't give up. This is one of the most important things you need to learn to help your cat.

 

Re: Another question about home BC testing

Thank you for your response, Mel.

Over the last week, here are the numbers from successful tries:

269, 376, 252, 305

He was NOT taking insulin yet last week.

The 300s he got when I tested him soon after eating. The 376 happened when my hubby mistakenly gave him the W/D wet food that day. He seems to be in the mid 200s when he eats the low-carb diet. At the vet he was a little over 400- he is a stress-kitty, he can work himself up pretty good.

Also- over the last week his clinical symptoms SIGNIFICANTLY improved- there is no excessive thirst and urination anymore. His hunger is also normalized. Thus- I feel skittish about giving him shots, especially if my testing attempt fails and I don't know where he is at pre-shot.

We are also using the rice sock and massaging the ear. One day it works marvelously, the other not at all. Don't know why that happens.

Thanks again,
Eva

 

Re: Another question about home BC testing

[quote="Hillary & Maui Finally, I used a flashlight, held it my mouth to keep hands free and shined on those black ears, so I could see where I poked and see the blood (or lack of blood).[/quote]

Hi Hillary,

I also use the rice sock. I am using a lancet device now, because free-handing was harder for me. I will definetly try using the flashlight, which i have not done before. My cat's ears are black as well and I agree that it is hard to see the places I poked.

I am trying not to feel discouraged and defeated, but on the days when I try so hard and have no results it is hard not to feel bad about it.

Thank you for your suggestions,

E

 

Re: Another question about home BC testing

Arnold's ears are usually pretty warm, but if not, I just rub his ear for a minute to get it warmer. Poking at the very edge of the ear gets the best results, too far in and I don't get anything. It's still hit and miss sometimes, a huge drop one time and nothing another. I also have my lancet device up the 2nd highest position. It was on highest but I realized I could still get a good drop w/ the next lowest. We'll try and dial it back more when we get good at this level. I hold a cotton ball behind his ear and press firmly w/ the lancer and then trigger it. It usually either gives me a big enough drop or I can milk a big enough drop out w/out having to redo it. Arnold is great about this so that helps a lot.

 

Re: Another question about home BC testing

What type of insulin will you be getting?

If it's a gentle insulin like Lantus or Levemir, I might consider a token dose BID until you get the hang of testing. If it's a stronger insulin like Prozinc, although I'm not familiar with Prozinc, I've used PZI Idexx and PZI BCP in the past and believe Prozinc is similar, I'd want to be testing.

Misty was hard to get blood from, I tried all kinds of things, even poking the inside of her ear where I saw veins.

In the end for Sadie, Misty and Tucker I found for us it was easiest to get blood at the base of the ear, right above that little triangle flap. Misty took a few weeks before her ear was trained to give blood, Sadie and Tucker's was immediate.

Can you use sticks to check for ketones and/or sugar in the urine until you get used to testing?

Hometesting is really the safest and best way to get your cat feeling better, but the numbers you have shown are high.

I'm sorry I'm not familiar with things, did you change your cats diet?

 

Re: Another question about home BC testing

My Testing Tips

1. Pet your kitty and massage the ear while you are petting him or use a rice sock to warm his ears.

2. Find a place with good light to do the testing. I used a section of my kitchen counter because it's a good height and has under cabinet lights. Put a towel down on the counter. Some people get the cat in between their legs while kneeling on the floor. Others use a couch or chair and put the cat between them and the arm. Others test in their lap. I sometimes tested Maggie in her bed.

3. Set out everything you need before getting your cat. I put the tesing strip part way into the meter, cock the pen.

4. Put a very thin smear of vaseline on the ear to help the blood bead up and not flow into the hair. I would talk to her and tell her she's being a very good girl.

5. Put something firm behind the ear - I used a waded up paper towel. It gives a firm base to work on, and keeps you from getting poked. It's handy to put light pressure on the spot after it bleeds. A little pressure will stop the bleeding and reduced bruising.

6. Most lancet pens have adjustment for depth. I started with it almost at the deepest. I worked down to the next to the smallest. Some people don't use the pen, they use the lancet free-hand.

7. Hold the ear firmly or you'll get the dreaded "ear flick" that send little spots of blood all over!

8. Some people use their fingernail to "scoop" up the blood drop, and test from the nail.

9. Don't forget the treats!


It takes time to get the technique down that will work the best for you. And If you're tense, your cat will be tense. So breathe and try to relax. Don't give up. After a while it will become second nature. And Maggie would actually purr during her test, so I know it didn't hurt her. The thing she disliked the most seemed to be holding the glucometer up to her ear - I think it tickled.

 

Re: Another question about home BC testing

We will be getting Lantus. What is considered to be a token dose?
I changed my cat's diet to wet only, low carb since last Saturday (a day after he was dxed). There was 1 day of a mishap though- my husband fed him the high-card W/D on Thursday.

 

Re: Another question about home BC testing

It's great that he's feeling better already even without insulin. Watching the whole cat is very important.

Have you seen the Lantus Insulin Support Group?

viewforum.php?f=9

They would be able to help you with dosing information, but if it were my cat, I would not go over 1/2U WITHOUT succesful hometesting. Keep practicing, you're doing great. And check out the Lantus ISG, say hi to everyone and read some of their stickies. There's great people and great information there.

 

Re: Another question about home BC testing

I would be hesitant to give insulin without having some idea of the BG level. I would start on 1/2 unit bid if urine testing showed plenty of glucose in the urine. However, if ketones show in the urine then more aggressive treatment and probably a vet visit would be necessary. Note that the people on this forum are very caring and that there are many cats out there that are successfully treated with insulin and do not home test. They just periodically go to the vet for a about six hour posy shot glucose measurement.

 

Re: Another question about home BC testing

Hi Larry, thank you for your answer. I definetly DO WANT to do home testing, but I think it will take me (and my husband) some time to master it. We are trying hard, but on some days it just does not work. Would it be OK then to give 1/2 unit of Lantus BID, do as much testing as I can, and then have Big Kitty monitored at the vet periodically, until I know I can be successful every time I poke? Or would it be better to keep practicing home testing for another week or two, and then starting him on insulin when we know we can test before every shot?

I am really not sure how urgent starting with insulin is...I have to weigh the benefits and potential risks, with the worst case scenario being me not getting blood, giving him a shot and Kitty hypoing when we are both at work. So we are trying to find a balance between treating Big Kitty and not causing him harm.

Eva

 

Re: Another question about home BC testing

I wasn't successful every time with Maui. Sometimes her ears were warm other times freezing.

The flashlight was essential on black ears. The only way to see anything. And holding it with my teeth the only way to maneuver.

I forgot to add that I also did the milking technique after poking and not wanting to keep poking. Sometimes it worked and sometimes I just had to poke again.

Keep trying, you will eventually get the hang of it and teach those darn ears to bleed.

Where are you located? There may be someone local who could help you in person.

 

Re: Another question about home BC testing

If I BG tested a new cat in a stable condition with respect to diet and environment and the BG was high (like in the 300's or above I would feel safe in starting at 1/2 unit bid. However, I would watch closely for signs of hypo and would monitor urine for glucose (and ketones). If get positive for ketones I would consult vet. If negative for glucose I would stop insulin.

 

Re: Another question about home BC testing

Larry,

Can urine be negative for glucose, but BG still high? What would that mean?

Eva

 

I am supposed to do a glucose curve today, my first attempt at testing, and I can't get blood out of Max's ear. He's also not willing to sit there until I figure it out. I don't know what to do.

 

Hi,

I'm in the same boat. My cat is pretty calm though and lets me try several times, but on some days the blood just won't flow. I know how frustrating this must be for you, because it is for me. Successful treatment really hinges on being able to home test and not being able to get it done is awful. I'm starting to think that maybe a have a "non-bleeder" type of a cat... :smile:

Please read through the responses to this post- people shared many ideas about how to make home testing easier. There are also videos of how to home test available on line- you can just put "cat diabetes home testing video" in the search.

Good Luck, I know it ain't easy.

Eva

 

The vet showed me how to do it. She had to poke his ear a couple of times in the same spot, and it still wasn't enough blood for the meter I have. Max growled and bit me when I tried this morning, so I gave up. The thing is, I cannot afford to take him in for a glucose curve. The vet wants me to do this once a month.

 

What meter do you have? From what I read here Reli On (availbale in WalMart) takes the smallest blood drop. I have Precision X and I'm not happy with it- seems like the blood drop has to be rediculously big. Also- it gives only 5 seconds to add another drop, and then shuts off. So I'm thinking about changing, but that is another expense...

 

I have the Bayer Contour that I got from this forum. I can't get a drop of blood, so I assume I'm not poking in the correct spot. I shined a flashlight and saw where the vessel is, but I must have missed it.

 

I don't think there is "a correct spot," although some spots will bleed better than others, here is what I've heard:

1. try close to the edge of the ear
2. try closer to the head- just above the triangular flap on the side of cat's ear
3. try the other ear, if you are unlucky with the first one

Also, make sure that the ear is very warm (are u using rice sock?).

With that being said, I've tried all of the above and still have major issues with getting him to bleed. As I said, i think some cats are non-bleeders. :YMSIGH:

 

Hi Joy and Eva? Everyone has a little different technique and you have to find what's right for you. I've only been at this a month and the first week was awful,but you'll get the hang of it. It really is worth it. I barely have to think about it now and Tess even purrs while I'm testing her. Even my hubby who hates the sight of blood is an old hand at it.

Here's what works for us:

• *Warming the ear does help a lot. Make sure the rice sock isn't too hot, hold it against your wrist. I start out on top of the ear since Tess is sensitive to anything in the ear.
  *After warming a touch of vaseline or Neosporin etc. will keep the blood beaded up not dispersed by the fur, so you need less blood and can see it better.
  *I was really frustrated at first too and found I did much better with Hillary's technique of not using the device just hand hold the lancet. I could see where I was aiming much better, angling in is important too.
  *Don't aim for the vein, but just between it and the ear edge.
  *A couple light pricks one right after the other is surprisingly effective. Then massage the ear to get a good drop, squeeze and stroke toward the prick from both sides.
  *Don't start to test, and then try to get another drop of blood. You won't get a good reading.
  *I also found that the lancet size (not the pen device) makes a difference. Go for a finer gauge, that's a higher number. I use a 30, I started out w/ 26 and it was awful.I also found that even at the same gauge some brands art sharper and work better. I like the BD brand or One touch ultra, but be sure to get at least a 30 gauge.
  *Treats help a lot, get them settled in and comfy before you start.
  *Finally don't get frustrated, you'll get it, and then wonder what the problem was. Keep trying, knowing the BG is really important.

 

Hi Ann,

Thank you for your suggestions. Last night was another unsuccessful try- got the blood out of my cat twice but both times not enough to fill up the strip. Will go by a ReliOn meter today after work. It is supposed to take 1/2 of the drop that Precision X (my current device) needs. I hope you are right and we will look back and wonder what the problem was. For now, I am really at awe that other newbies don't have significant issues with home testing. My husband and I consider ourselves pretty skillful people, so it is extra frustrating that we can't get this done. Will keep trying though.

Thanks again,
Eva

 

If you get a drop of blood, you could place it on your fingernail and test it from there. Sometimes I will get a drop, go to get the machine and the blood seems to have gone away so I have to milk the ear again.

So if you don't mind just putting that droplet on your fingernail for a moment, you won't have a moving a target to try to hold the strip next to. Until you get the hang of things.

 

I test along the thicker edge of the ear, not the thin one shown in many diagrams.

And I'll disagree with people who say don't give insulin if you aren't able to test with regular success; there are so many of us who started out and weren't testing, there are people who cannot test, etc. etc. that I think it would be a shame to hold off. Yes, of course there is a risk, but if you do give a small dose like 0.5 units twice a day of an insulin like lantus, you may be just fine. It is a balancing of risks; which is worse, the small chance of a hypo or continued damage and possible side effects of not giving insulin?

This is a decision only you can make, but do try not to put too much pressure on yourself

Jen

 

Just an FYI, I haven't used the relion meter but have used True Track, One Touch Ultra, Freestyle and a Bayer old style thing. Currently I'm using the Accu Check Aviva and the reason is that it sips the blood faster and better than any of the other meters I've ever used. One Touch and True Track were both great, and Freestyle sips well but having the sip area on the side of the strip was hard for my husband.

Just some extra information you probably didn't need

 

Eva, I use the Precision Xtra (assume that's what you have?) for ketone monitoring and have used it for BG monitoring to compare to my OneTouch Ultra. It does seem to take more blood for the strips - and Stash has ears that bleed quite nicely. I had to really work to fill the strip the first time I used it. Actually opened a second strip while $$$ flashed before my eyes!

Anxious to hear what you think about the ReliOn.

 

You WILL get it down pat, my friend. At first, giving Chloe her shot was my big issue. I'd have to psych myself up for it (my vet didn't tell me about the tenting technique, I learned that here, so at first I was just finding a spot of skin and getting up the nerve to poke her), and my BF had to leave the room 5 times all red faced before he could do it. Then the folks on this board told me how important BG testing was and how scary shooting blind can be. But if I couldn't shoot her, how I was going to test her blood? So I got up the guts and tried to do it. Failed. I would literally worry myself NAUSEOUS trying to get this testing done. My BF still can't do it. I did my first successful test 2 weeks ago and now I look back and wonder how I ever thought I couldn't do it. It's just routine now and you will get to that point, I promise.

Sometimes Chloe doesn't bleed either. I make sure the ear is really warm, I massage it to keep it warm, and poke in the same area a few times until I get a drop. I use the OneTouch Ultra Mini and seem to do well with the blood drop size they require.

I am so grateful that the folks here pushed me to test. When I did my first successful one, she was only in the 90s!! And that started her OTJ status and she hasn't had a drop of insulin since. I would have kept shooting and shooting and probably did God knows what to her.

Just keep at it. You'll get it.

 

I understand the frustration because sometimes I have had to poke Harley as many as four times! I felt so bad. I have found that the best way is to put him up on the cabinet which is waist high to me. In your case maybe the cabinet, washer or dryer. I also put a towel under him so he feels more sure footed. Once I get him there I scratch him around the head and ears and try to wait until he lays down. If he is lying it is much easier than having him sitting up.
I know his ears are generally cooler and sometimes just cold so if they are I rub the edges of his ears between my finger and thumb but I think the real trick is to catch the ear just inside the outer edge. Not to far in but just inside the outer edge. I also always get the blood from inside, not the hairy outside. Even with best plans and confidence I sometimes come up dry or with so little blood I know it won't work with my meter. Or he moves and smears the blood onto my fingers! Phooey!
The thing to remember is that it has to be done and practice may not make us perfect but you will get a better routine if you note what works best and work from there.
I also always treat Harley with something he loves after the test is complete and I swear I think he is beginning to look forward to it and my other cats may be jealous.

 

Keep trying, there is absolutely a learning curve here. After one attempt where we poked 5x and the drops were too small, we got a walgreens brand lancet pen, stuck it on the deepest setting, and used larger (smaller #) lancets. That worked. As we got better, we went back to smaller lancets and a shallower setting on the pen.

I always get a bigger drop than my husband does, and the vet today suggested it was the angle at which I poke that's the reason. I put the cat on the bed and sit with my legs extended around his sides, so his nose is near my toes. I use a rice sock for more than a minute and massage the ear in an upward direction while warming. When I poke, I keep the rice sock on the inside of the ear, lean over the cat, hold the ear firm (firm!) against the sock, and poke with my left hand, which means the lancet is going in toward the outer edge of the ear.

We've also found that one ear bleeds better than the other, and it's okay to try paw pads, too. Just be patient and calm and keep your hand steady

 

You might want to try the Accu-Chex Multiclix lancet-like device. I tried using the freehand lancets that came with my Relion micro, but ended up buying the Multiclix. It holds a cartridge of 6 lancets, and can be set for different depths.

Also, I've found that the inner ear is a little easier--sometimes I can get blood out of the outer ear, but then it smears on the fur before I can use it. For the inner ear, I set the Multiclix on 0.5.