Difficulty Getting Blood for Testing

So when we first started testing Victor we didn't have too much trouble getting blood, especially after we started putting Vaseline on the area beforehand, and I've seen people say on here that it gets easier to get blood as time goes on, but for us it seems to have gotten more difficult instead, even with using the Vaseline.
I sometimes have to poke multiple times before any blood will even come up. Anyone have any ideas about why we're having more trouble now and what we can do about it?

On another note, we don't seem to have found the right dose for Victor yet, but I just can't help but wonder how in the world you're supposed to get glucose levels regulated with Humulin when it lasts such a short time? It doesn't seem possible when the BG levels start rising again before it's anywhere near time for the next dose.

 

Do you heat up the ear before you poke? That really does help. You can do it with a sock filled with rice that you microwave to heat, or just get really hot water on the corner of a rag, wring out the excess and use that - that is what I do, and it works for cleaning the area before/after, too.

 

Never tried heating the ear since it didn't seem necessary at first, so I guess we'll have to try that out now with the hot water and rag. How long should you hold it on the ear?

 

I did not heat the ear in the very beginning either, but once I started, I found that it made a big difference. I just hold it on her ear a few seconds.. maybe 5 at the most, probably more like 3. As long as the rag is good and warm, it heats the ear right up. After the poke, I use it to apply light pressure to the spot then wipe away any blood that remains. (I test quite a lot, so I use a rag four times - a new corner each time.)

 

I massage the ear a good bit before I poke. Someone on here recommended two quick pokes close together to get enough blood. I've done that, too. More often than not, I've had to poke multiple times and sometimes start the process over again on the other ear to get a sample. What a sorry mama I am!! Hate it when that happens.

 

Sounds like you might want to try heating it first, too.

 

Same here! Victor gets so aggravated by it when I have to poke multiple times and it makes me feel so bad, and then because he's annoyed he doesn't always take his shot as cooperatively either.

 

I used to have to do that too. I felt like such a mean mom! Heating her ear really does help. I have a sock with rice and I rub it all around her head. On her cheeks and under her chin and then give her ears a good rub with it. She loves it and it does seem to help her bleed better.

 

When we first started I had heard about the warm rice sock, but there is NO way sweet pea would let me hold it to her ear! So I just started washing my hands in hot water and getting them warm, then I'd massage her ear with my warm hands for about 10 seconds. It seemed to work!

 

You've been given good hints about getting a good drop of blood. What size are your lancet needles? A thicker needle can work better (26 - 28 gauge) and these are usually labelled "for alternate site use" on the box at the pharmacy.

Re Victor's dose: I think the biggest barrier for you right now is the high carb dry food. Will you be able to try Friskies pates soon? They're in the 4 to 6% carb range and that should have a significant impact on his BG levels.

Re humulin: it does seem to lose its oomph early but other insulins that are longer lasting are much more expensive. Lantus tends to work very well in many cats but is extremely expensive in the US. A 10 mL vial can be over $300 USD. Many people order from a Canadian pharmacy but it would still be about $180 (CAD?). You can buy a single pen of Lantus from some folks on the "supply closet" forum. I also suggest you contact DCIN (Diabetic Cats in Need) to see if they can help. The contact person here on FDMB is @Chris & China. You might be eligible for help based on what you've told me about your situation.

 

From the start we've used 26 gauge lancets, so I will definitely start trying the methods suggested for heating his ear.

My mom will be going to the store tomorrow to pick up some cans of wet food, so I will make sure to post when we're ready to start the switch.

Thanks for the suggestion about DCIN, I will look into that; it would be a big relief if we could get some help with the cost for stuff like that

 

I second the importance of switching to a low carb food as soon as possible.

Also, re the Lantus - some pharmacies here in the States will sell you a single Lantus pen for about $85 rather than the usual box of 5 for $300 plus. Ask the pharmacists - they often know which pharmacies in the area will sell you a single pen. That's how I found out about it. And I hope you're able to get some help from DCIN.

 

Best spot to poke for blood sample Hope this helps

 

Here's another Photo sweet spot

 

I had trouble getting blood to. I took all the suggestions on here. Rice in sock nope he wanted to eat it. Best I found was warming my hands and rubbing his ears then poke it works every time plus he thinks he's getting special ear massages

 

@Kris & Teasel @JanetNJ Haven't seen anything from you guys lately about Victor's dosage, whether you think it should be increased or anything, so I was just wondering about that.

 

My apologies! You're moving in the right direction. I read your note about the small reduction last night. He would have been fine with 3.75 u again but I know you're on the learning curve still. I'd bump him up to 4 u this AM because you're able to test as needed and he's starting to show you some nice blues.

This is from the user's guide for Humulin. I'd suggerst you print it out and highlight the key points for ready reference if you don't get a response here on the forum:

Q: It’s time for my cat’s shot but the BG is a little too low. What now?
If your cat’s BG is a bit below 250 mg/dL [13.8 mmol/L] on a human meter you can consider ‘stalling’.
‘Stalling’ is waiting - without feeding your cat - for 20+ minutes, then retesting to see if the BG has risen to a suitable level.
You are looking for a number that is rising, not falling, and is up to at least 250 mg/dL [13.8 mmol/L] on a human meter.

If using a pet meter, such as Alphatrak2, you may want to raise the number above 250 mg/dL [13.8 mmol/L] to give an added margin of safety. (If in doubt seek advice from your vet.)

If you have time, you can repeat the process to see if the cat’s BG reaches a number you can shoot. But you may not want to continue more than an hour, as this may throw your schedule out (and your cat will become increasingly hungry!). If in doubt, skip the shot.

If your cat’s pre-shot level is significantly lower than usual, post on the forum for advice about how to proceed.

Note: If your cat has had ketones or DKA (Diabetic Ketoacidosis) then DO please post on the forum for further advice if you are considering skipping a shot, or raising your ‘no shoot’ threshold.


Q: How low should I let my cat’s BG drop on N/NPH?
It's advisable to not let the BG drop lower than 100 - 120 mg/dL [5.6 - 6.7 mmol], as measured on a human meter, at the peak of the cycle.
If you are using a pet meter you may want to keep the nadir higher than is suggested for human meters. (If in doubt seek advice from your vet.)
N/NPH can drop the BG very sharply indeed. Trying not to let the BG drop below these levels helps to give a buffer of safety.

If you get a BG of 100 - 120 mg/dL [5.6 - 6.7 mmol] on a human meter, and there is still some time to go until the peak of the cycle you may need to take action to ensure that the BG doesn’t drop much lower, and monitor closely until past the peak of the cycle.
Note: If you are using a pet meter you may need to keep the nadir higher than is suggested for human meters. (If in doubt seek advice from your vet.)

 

Reviving this post to ask a related question: We've been warming up Victor's ear by getting a washcloth wet and heating it for 20 seconds in the microwave, but since he tends to swat at my hands when I try to poke his ear, sometimes his ear cools off by the time I actually do manage it, so we don't get any blood and I have to reheat the washcloth and try again. So I was wondering how long rice socks stay warm for after being heated up, because it would be much easier if we could just have something that stayed warm for a couple of minutes or so.

What makes it even more difficult is the fact that we are still having issues with our furnace - it either won't come on at all when it starts getting cold in here or it comes on but only stays on for a minute or two and then goes back off, which obviously isn't going to keep it warm in here, so trying to get Victor's ear warm and keeping it warm long enough to get a blood drop - especially when he's in one of his more uncooperative moods - is not easy, to say the least

 

Do you put something behind the ear like a folded piece of tissue to support it & did you see the pic i sent for the sweet spot? It's right on the edge of the ear.

 

As @JoyBee&Ravan said, it helps to be poking on the edge of the ear. I poke on the extreme outside edge of the ear - so that I am almost but not quite poking on the underside - in the sweet spot and it makes it much much easier.

 

I use a rice sock in the winter when Teasel's ears are cold. It holds heat longer than a wet wash cloth. If you have a microwave oven it's really easy to heat it quickly. You want it very warm but still "touchable".