Ear sampling at the vet

A little background information:

Yeager is 12 and a half and just in the past 6 months was diagnosed as diabetic. For the first few months we had many complications, from going into shock to being rushed to the vet because he wasn't able to use the bathroom. I'm very happy to say he has been incredibly stable after going from 20 pounds to about 12! After eating his ranges are from 80 to 110 and no longer needs a shot due to maybe, an hour after eating he stabilizes to around 60-70. He is incredibly relaxed and dosen't mind his blood being tested from his paw, but right before Christmas I took him for his most recent appointment (she said he is doing perfect) and they must have checked in his ear. I first noticed that it was warmer than the other ear so I checked with my flashlight and sure enough there was a nice, even blood pool under his ear(very thin and very light red). There is no large lump and no pain from what I can gather but I did notice some very small bumps from what looks like the testing site. It is slightly crusty with maybe an even smaller infected bump. I put some neosporin spray on it and was stopping here to check with other cat moms and dads. If this is something really bad I want to know if I should take him to the vet.

I am very thankful for any help!

My name is Mim

 

Keep an eye on it. I noticed with Smokey that the vets used an 18 gauge needle to poke her when they tested her one of the few times there. I about died when I saw them stab her with that giant needle. It might take more time for the prick to heal up if yor vet's office used something large to do the test and didn't pinch it off enough to stop blood from pooling inside the ear. Alternating heat and cool can possibly help flush the bad blood out of there.

 

I don't get the vet's offices. When Menace returned home after her stay at the Emergency vet after diagnosis, she had a huge blood scab on her ear. You'd think these folks either don't know what they are doing or just don't take the time to make sure the bleeding has stopped. I NEVER have any scabs or bruising on my girl's ears when I am testing and cannot for the life of me understand how this happened. I was appalled!

I agree with Melanie. Keep an eye on it and alternating heat and cold will help.

 

Mim I am so sorry that happened to your fur baby I also test using the paw as Magellan made it clear the ears where off limits! My only advise has been covered by both Melanie and Linda give your baby scritches and hugs from me ok??

 

I can understand; I saw the vet techs at our previous practice trying to test Saoirse. If Menace went through similar you'd be justifiably appalled; it was a major ordeal. I do wonder whether that's why some veterinary professionals are of the opinion that home testing would destroy the relationship between cat and caregiver and therefore counsel against it. If Saoirse had to go through a similar palaver every time I home test, I wouldn't expect her to like me very much any more.


Mogs
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I think you may be on to something! Even my vet's tech sent me home with syringe needles 5/8" long 25 gauge and told me I could reuse them several times. No doubt they are re-using needles and that alone can tear the tissue up. Sad! Miss Menace has to have some dental work done soon and I will be providing them with her lancing device and lancets and insisting they use it even if I have to instruct them on how to use it!

 

I could use a few tips. I started out with 28 g lancets (I think these were the original AT) but then thought I could go smaller and picked up some 33 g lancets at the drug store... Well those were too thin and I could never get blood. I don't use a device, just the lancet. So then I found some 30 g and those work well, but my boys ears get pretty beat up, scabby.... . Would love to hear the tips you will give them!

Wynken loves the rice sock warming his ear, as I rub it all over his head too, while warming his ear. He does not mind the poke, but when I put the sock down and milk his ear to get the drop (which appears on its own only about 25% of the time) he really dislikes me pushing on his ears with my fingers... And after I get the drop on the strip, I do try to apply a bit of pressure to the site, but by that time he is like "no! No, don't touch my ears!" I usually only get to apply pressure for 2-3 seconds... Ideas?

 

Seriously? I mean, seriously??????

In addition to the blunting, it would contaminate the insulin! I despair ...

When I saw Saoirse being tested at our old practice she was hunched up in a growling ball with one vet tech holding her in a vice-like grip while another one hunched over her poking near the base of the outer edge of her ear. My darling little one was terrified. Justifiably.

When we moved practices and our current vet was showing me how to test they showed me the correct part of the ear to poke, but then a big wad of warm but soggy cotton wool was produced and my girl found the stuffing of same into her little ear most uncomfortable. No wonder I was so filled with trepidation when it was my turn to test her at home. I was determined to find a better way to make testing more comfortable for Saoirse. I tried with the little rice sock but Saoirse really didn't like anything 'in' her ear. Thankfully the tip I got about using warm water in a plastic receptacle was the solution we needed. Initially I used little plastic test tubes but they were brittle and prone to thermal shock. Now I use a decent sized plastic pipette. It allows me to easily warm just the edge of Saoirse's ear - one-handed!

A few months ago our vet did a house call to get an accurate reading of Saoirse's blood pressure. They don't say anything to me but I know they have been a little concerned about the frequency with which I test Saoirse. I took the opportunity to demonstrate our testing technique, and I think they were genuinely surprised at just how content and chilled Saoirse was throughout the test. They also thanked me for sharing the tip. I do hope that they'll incorporate it into the home testing tutorials as an option for other patients so that other caregivers and kitties might have an easier and more pleasant time when home testing. It would be nice to think that Saoirse and myself could pay a little forward locally as well as online.


Mogs
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this is terrible!! I think some medicated salve should clear it up--but def keep an eye on it---so sorry this happened

 

Hi Cara

Aw, that's lovely.

Saoirse doesn't like it on the odd occasions when I need to 'milk' the ear - it's the only thing that bothers her - but thankfully it doesn't happen to us very often. For us, the key is to really warm the ear well enough and for long enough, and then to do the poke as quickly as possible so that the ear doesn't get a chance to cool down.

Here's the technique we use:

• First I prepare the test station. I make sure the test strip is part way into the glucometer, and that the lancet device (28 gauge lancet) and a paper strip for supporting the edge of Saoirse's ear are ready to go. (Note: I have an Alphatrack lancing device but I use it with the clear plastic cover removed and I freehand the actual poke. That way I can see clearly where I am aiming the lancet tip, and also it allows me to do the actual poke at a slight angle. I have a near permanent shake (PTSD problem) and I find that, even though I freehand the actual poke, using the lancing device gives me better control than using the lancet on its own.)

• Next I warm the water and fill the plastic pipette I use to warm Saoirse's ear. I stand the pipette in the cup of warmed water to keep it at the right temperature while I prepare Saoirse's ear for testing.

• I then apply a thin film of Vaseline to the 'sweet spot' area on the edge of Saoirse's ear to help the blood sample droplet bead up.

• I warm Saoirse's ear with one hand and push the strip into the meter with the other while her ear is warming.

• When the ear is warm enough and the meter is ready I get the paper support strip under Saoirse's ear, gripping the edge of the ear lightly - just enough to discourage any sudden head movement from Saoirse, and then I ask her to hold still while I do the actual poke as quickly as possible.

Our success rate for getting a decent droplet without any need to 'milk' the ear is very close to 100%.

Hope the above gives you some helpful ideas.


Mogs


EDITED TO ADD:

After the blood draw, I fold the strip of kitchen paper over the edge of Saoirse's ear and squeeze gently for about 8-10 seconds to stem the blood flow and help prevent bruising. (My thanks to both yourself and Linda for reminding me to include this important step.) Funnily enough, Saoirse doesn't mind the post-poke ear squeeze; it's just the 'milking' squeezes she isn't keen on. Maybe it's because she knows that what happens next is a yummy freeze-dried chicken treat! She seems to like my heaping praise on her, too.
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@Cara and Wynken To some extent, this is a trial and error proposition because all our cats react differently. I have to admit I am blessed with a very patient laid back little girl who has always loved having her ears cuddled and rubbed and they bleed beautifully (EEK! I sound like a vampire!). She often comes to get me around test/shot time. There are also those days however when she is a little less patient, in a frisky mood, or just wants her food and I get a little more fuss and what I call the "dreaded head shake". That's when I have to use my Mommy voice to calm her down a little and let her know we have to get our business done. That's an advantage you don't have with Wynken. I imagine though that Wynken would pick up vibrations so perhaps you could find something (music or humming or some other sound) to create a calming sound she associates only with testing. I think some of this comes down to your speed/efficiency as well as kitty tolerance. I spent a bit of time developing a testing process (sans cat) to ensure I was not making Menace stay still and patient for too long as I have a nosy little supervisor (Worf, her little brother) who likes to watch and redirect her attention.

I'd spend a lot of time playing with Wynken's ears in much the same manner as you use for testing including holding with a tiny bit of pressure and make sure his ear is warm. The real trick is to be able to hold the ear for long enough to quell the bleeding (I'm guessing I hold about 10 seconds), then I recheck the poke spot for any residual leakage and hold again for another few seconds no matter what I find. I then kiss her "booboo" and her head and of course tell her what a good girl she is and then give her food which is her reward!

Technique wise, I use 28 gauge lancets in the AT lancing device with the cap off. Had no luck getting blood with the cap on. I use a cosmetic pad folded against the back of her ear and poke on the inner side of the ear (black hair makes the blood drop really hard to see) with the lancing device set on 3. I hold the lancing device somewhere between a 45 and 60 degree angle.

Hope that helps at least a little.

 

Not to gross you out more but those needles were not for the insulin! They were to get that tiny drop of blood needed to get a reading! YIKES!

I can only imagine how horrified you were watching those testing shenanigans! I think I would have verbally abused them and run for the hills had I been there! So glad you got to pass your technique and knowledge on to some of the "professionals". In my case, being an R.N., nobody ever showed me how to test or inject. I had a pretty good idea of what to do and frankly at this point, I am glad I never witnessed one their show and tells!

 

Thank you @Critter Mom and @MrWorfMen's Mom . Some of those things I already do and some I have not tried.... I may go back to 28 g lancets... The drop came out on its own a lot more frequently with those... Then I won't have to "milk" and he subsequently might be more tolerant for the pressure needed to stop the bleed.

I am such a lucky cat mom. Wynk is always up for testing. If he's lying in his bed I just go over and do it and he often doesn't get up! If he's walking around I show him the hot sock and he just jumps up on the testing bench like "ok, I know what this is about!" It's amazing, but he *never* jumps down til I'm through, although if it's getting close to meal time he is a little wiggly. That starting out with the strip half in was a lifesaver for me... I never push it all the way until I actually see the blood. Wasted too many strips from having them time out..

I just feel badly that I can't always put pressure for long enough to prevent the little hematoma and scabs (we really only get those on heavy testing weekends like Christmas and New Years, so he'll get a break to heal this week.)

Thanks again for explaining your techniques! Always so much to learn here in this forum!

 

That is so cute that he comes when you show him the rice sock! I wonder if you used another identical rice sock, not warmed up, to apply pressure after poking if you could "trick" him into allowing a little longer hold on his ear!

 

I can tell you my process, which has been working very well despite Shenandoah being one of the few kitties who does not like testing. Perhaps you can experiment with pieces of it to figure out what works for you. Every cat and owner combination is a bit different.

I don't use the rice sock, but instead spend a few minutes rubbing her ears and gently breathing on them to warm them up. I always rub both, even though I'm only going to prick one. I figure I would be uncomfortable having one ear warmer than the other, so she might as well. I then take a folded piece of gauze and hold it behind her ear. I give a little prick on the very edge of her ear, between 1/2 and 3/4 up the side (she does better at closer to the 1/2 mark, but I don't want to do the same spot all the time). Then I wait a few seconds. Often that is enough to get a reading, if not I VERY gently squeeze above and below the prick. She does not like me working it too much, so it's really just a bit of a pinch. Once a little drop forms I put my (ready to go) meter up to it, grab a drop, and switch the gauze so it's folded around the ear. I hold it firmly in place until 2-3 times as long as it takes the meter to beep, all while giving her pets and telling her how good she is. Then I move the gauze slightly, give a quick squeeze, and make sure there is no blood on it in the new location (if there is, I hold a bit longer and repeat).
She has no scarring, and we get blood 100% of the time (very rarely is it too little to get a reading).

I agree with what others have seen her regarding the vet's. Shenandoah came back from the vet's with a bunch of little scabs on her ear I do have to wonder if that's why I had such a hard time getting started with testing, with her screaming whenever I tried. I still have a hard time doing her right ear, which is the one that had all the scabs. So mostly I just stick to her left, except occasionally trying the right to see how it goes.

 

Excellent suggestion.

 

I bet they'd use spears to eat cocktail sausages.

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I have no doubt you are right! These little critters pick up on those little details a lot more than most folks give them credit for! Hopefully with time and some extra ear cuddles/rubs, you'll be able to get Shenandoah to accept testing on the right ear too!

 

And they have long memories, too.

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@Mim - How is Yeager's little ear today? Healing well, I hope. Has the blood pool dissipated?

I also hope that hearing about other kitties' recoveries from their 'war wounds' offers some reassurance. My Saoirse's ears looked red raw in places following the curves run by the vets who diagnosed her, but they improved a lot within a few days. Thankfully, she gets all her tests at home now and I've got better at the testing over time.


Mogs
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Hello all and thank you so much! I did almost everything you all told me about (hot and cold ect) and it is working!

The blood under my babies ear seems to have dissipated, the only thing that remains is a small surface bump that has maybe collected a small bit of blood and whatever is leftover from the infection. There are no more crusted parts just that bump. Skin around is not inflamed, it just seems like the infection has become isolated to just that spot now. I am putting the medication on it and I believe that is what helped him the most. Should I continue with this idea or should I call the vet?

 

Thanks for the update. Glad to hear it seems to be improving. I think you can just continue what you are doing and watch it. If it stops improving or gets worse, then a vet visit might be in order. Human diabetics don't always heal up quite as fast as non-diabetics and I'm sure it's the same for our cats.

 

Hi Mim,

Thanks for the update. I'm glad to hear that Yeager's ear is healing. To be on the safe side, I'd be inclined to give the vets a call to let them know and see whether Yeager might need any other treatments.


Mogs
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this is a very timely subject for me and I hope it is okay if I ask some advice about the rice sock/plastic pipette. I am incredibly lucky as my Scamp comes when called and provides me with a blood sample with only a little cuddling of the ear (my hands are normally hot!!). But my babysitters are no where near as lucky as I am. She always comes when called but no matter what they have tried she will not provide a blood sample easily anymore!! And this is stressing my babysitters out (she seems okish cuz she sticks around and doesnt run away but there is food involved and that may be why!!! LOL). Out of the blue I remembered about the rice sock and thought that may help the sitters (I am off to warmer climes for a couple of weeks in January).

So hot is the rice supposed to be? I am assuming it should be warmed in the microwave for a small amount of time (30 seconds - too long??) Or how hot should the water be to warm the ear? Would a prescription bottle work for the water?

It is really frustrating because the baby sitter that will be living here does exactly what I do because I trained him and he can get blood on occasion but it has become a struggle for him - Scamp adores him - she will often go to him if I am not sitting when she wants to cuddle (when there is a room full of people for her to choose from) so I don't think she is too upset that I am not home (she's not too happy either but she knows the other choice is to come with me and that is a horrible thought for her - and yes I do take her with me on short trips - she doesn't like to travel!!)

Any advice would be much appreciated!!!

 

How very lucky you are to have someone to move in and keep Scamp happy and safe!

I think the amount of time in the microwave for a rice sock will depend on the oven. I'd test it as one would with baby formula. If it's not too hot on your inner wrist then it's ok for kitty's ear. I have used the vial from test strips with hot water (from a hot water dispenser tap) but it has a pretty thick liner compared to a prescription bottle and I'm not sure I'd trust a pill bottle with water in the microwave.

 

i would just use hot water from the tap not the microwave - but Scamp is my baby and I never did baby formula (LOL) thanks for putting in about the inner wrist - great advice!! I am indeed truly thankful for my babysitter - this vacation has been a year in the making and it won't happen again for a very long time!! I can't push my luck with my baby sitter - he is allergic to cats too boot!! (he just ignores the allergy and he loves my Scamp)!!
thank you!!

 

My little Radar thinks that the microwave beep means there's soon to be a treat offered to him. We started with a wet washcloth and then switched over to the sock which works way better for us. We heat the sock with rice in our microwave for 25 seconds in the winter because his ears are like little ice cubes especially first thing in the morning. We always first test on our own wrist to make sure it's not tooooo hot. Radar loves loves loves to have his ears rubbed now and purrs the whole time. We found that in the summer we didn't need to heat the sock quite that long. You will have to experiment and see how it works for you. Hope this helps.

 

Same applies for the water used to fill a plastic receptacle.
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Just hopped onto ebay (US) for an example of the pipettes:

http://www.ebay.com/itm/10pcs-5ML-D...893763?hash=item3f52ab3d83:g:Gz8AAOSwibFUXc9D

You can reuse the pipette - one lasts for ages.