? Help this bumbling rookie get some blood from my fat turkey

Discussion in 'Feline Health - (The Main Forum)' started by Butterball, Feb 2, 2018.

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  1. Butterball

    Butterball Member

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    Feb 2, 2018
    My 12 year old turkey Rocky was diagnosed with diabetes last week after we took him to the vet because of the usual symptoms- excessive thirst and hunger, some muscle mass loss, and walking on his back legs. I didn't take it well but reading more about it I understand it's a manageable condition that can even be "reversed" with the right care

    The thing is, I just can't get a good sample at home from him. This was his first 5 days on 3 units of Novolin twice a day, as directed by the vet. I had also been feeding him majority wet food since a week or so before we took him to the vet just so he was getting enough water, witch about half of a 1/4 cup scoop of dry (and whatever he pillaged from our other cat's left overs). And before that his whole life it was mainly dry food with probably half a can wet every so often. The wet I had been giving him that week before the vet were not the lowest carbs, Friskies Shreds, but it's what we had at the time and it was better than all dry. I'm now giving him a full wet low carb diet (Fancy Feast Classic and I'd like to try Wellness Complete but he doesn't have much experience with pates) that I don't intend to change ever. I've read pretty much everything on CatInfo.org, so I've been following the Novolin protocol: test, feed, shoot. Except, the test part...we've gotten one successful test from him last night (the first time we tried to home test), just before his second shoot about 12 hours after his first shoot and a couple feedings. A reading of 455 on my dad's OneTouch Ultra 2 (he has diabetes too), compared to the lab results from Thursday's vet visit of 450

    The thing is, it's not my little snuggle pillow that's really the problem, it's my "technique" (or lack of). He's very cooperative. Giving the insulin shot takes literally 5 seconds of no fuss. He lets me get 6-7 good pokes on his ear and doesn't mind some brief squeezing. But I waste all those opportunities by not getting a good drop to form except that one fluke on Thursday. He's pretty understanding (and I coerce him with deli meat through the process) but after so many failed attempts he just puts his paw up and is like "you're done" and I understand because I don't want to turn this important thing into something he hates. Tried twice today, both events failures.

    It's very frustrating because I feel that every time I try and fail to get a reading it takes him further away from being able to recover because I have no idea if his diet change and insulin are working. SOME of his symptoms SEEM better. He's not walking on his back legs anymore, it SEEMS like he's not drinking as much, and he doesn't SEEM to be as adamant about being fed as he was in the weeks leading up to the vet visit. But that 455 reading still has me bummed out, the urine strips still being the darkest color bum me out, and he doesn't move from his spot in the kitchen much still. Only if he wants to snuggle with me on the couch or I take a bowl of cereal in my bedroom and he demands his rightful little spoonful of milk.

    Maybe my pen isn't working well? I tried testing him a few hours ago before I fed him for his last shot (given at 10 pm CST tonight) but none of the pokes drew blood. It's the OneTouch pen set to 6, which got the sample from yesterday but today it just seems like a total dud. Is there a specific model of pen that cat owners have discovered to be the Excalibur of blood drop summoning? This one is making me mad. I'm afraid to freehand it because I don't want to do it too hard and make him not want to do it anymore. His patience and cooperation is such a precious currency I don't want to waste. He's such a nice and smooshable turkey

    Sorry for being long but it's just a horrible feeling knowing that his progress is stonewalled solely by my inability to make a nearly microscopic bubble of blood come out of his ear ridge like all the cats on YouTube do on the first poke. I just want to make my treat goblin better, and taking him to the vet every week for testing is stressful for him and too expensive, and my mom and I have never had to do anything like this before

    If I can just get those first two pokes to WORK, everything should be fine. HOW do you do that? What are your secrets
     
  2. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Are you warming up the ear really good before you poke?

    A small sock filled with rice and microwaved or a pill bottle filled with warm water are both good things you can use to warm the edge of the ear up before you poke. (check temperature against your wrist like a baby bottle)

    A cold ear is much harder to get blood from!

    As you poke more and more, new capillaries will grow in and it'll get easier.....it's just going to take some time.
     
  3. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    Testing
    We all know the basics:
    • Warm the ear with a rice sock or a warm washcloth wrapped in a plastic bag.
    • Either freehand or use a lancing device; new members usuallystart with a larger gauge lancet such as 28g or 29g until the earlearns to bleed; then progress to a 31g or 33g which are finer.
    • Be sure to poke in the "sweet spot" and not the major vein that runs along the length of the ear.Poking the vein will not only hurt, but will result in a lot ofblood. The sweet spot is on the edge of the ear.
    [​IMG]

    But did you also know there is a particular way for the lancet to be used? It has one side that is bevelled so the sharpest part goes in first, if used correctly. In the photo below, you can see the lancet is angled. When you poke the ear, it should be held in the position shown below so thelongest side of it is on the bottom.Lancets should only be used once to ensure they are at their sharpest.
     
  4. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    @Chris & China this is not good?
     
  5. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    I hope he's talking about the urine glucose test, not the ketone test
     
  6. Butterball

    Butterball Member

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    Feb 2, 2018
    Ya the standard glucose test strips, the color hasn’t budged, though at this point I obviously need some hard numbers

    I haven’t tried a warmed item for the ear yet, I’ll give it a shot with the morning test attempt. I dunno if he’ll like it but I guess he might not have a choice if that’s what makes it work!

    As for the lancet I can’t really tell what position the needle is because it’s enclosed in a circular handle that doesn’t have any kind of indicator. And I hadn’t thought of the sharpness. I did use the same lancet for all the attempts today, do they lose their sharpness fast?
     
  7. Butterball

    Butterball Member

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    Feb 2, 2018
    Oh and one more thing

    I’ve read that smearing a little Vaseline on the edge of the ears can help the blood bead better. Can the experienced pros confirm that?
     
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  8. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    yes...a very thin film helps the blood bead up....just like oil and water
     
  9. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    For better control on position, you can try freehanding the lancet (either without the device at all, or using the device without the plastic cone and not doing the click).

    They do indeed get dull with use, so it's best not to reuse them.

    Hope today's attempts go better! It does take time to get everything firing on all cylinders, glad Rocky is so agreeable!
     
  10. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    Sep 15, 2017
    Patience... calm .... I held the rice sack a good 2 minutes & rubbed ears intermittently before poking... in the beginning. As stated above; the capillaries grow more abundant in that area as time goes by... I used Vaseline first, neosporin after to help sooth those little ears! You’re gonna be great at this soon! Good job not giving up! I also had the test strip inserted part way into my meter so I could give it a little push on the end & not contaminate the strip with Vaseline or anything else... hope this helps! :)
     
  11. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I use the warm, damp corner of a washcloth... I hold it on Mia's ear a few seconds before the poke then use it to clean up and apply light pressure a few seconds after the poke. I hold the lancet in my hand (I cannot imagine dealing with the device) so I can see the needle clearly and where I am sticking it. A quick stick in the 'sweet spot' area does the job. There are occasions, when I have to give it a second after I poke before the blood drop comes out, but normally, that is not the case. It is extremely rare for no blood to come and me to have to stick her again. In the very beginning, I did have times like you describe when after a few pokes, I still could not get blood. The warming, even just a little, really does help. Also, as everyone says, they do start to bleed more easily the more you test. Sometimes, but not always, I apply a little Neosporin (ointment, not cream) afterwards, especially if it is a day when I am doing a lot of testing.
     
  12. Sylvie

    Sylvie Member

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    Sep 26, 2017
    i free hand without the cap on lancet pen on but, still use the click button, it is most reliable to me. the caps on the lancet pens i have used are horrible for pets to me, on one of my pet ones the lancet needle doesn't even poke up to the cap's hole at all and other it barely does and will only poke if push skin into it, best to free hand since cat's ear doesn't bubble up like our fingers into bevelled opening area to be poked with cap on.

    I don't think poking their ear hurts as much as we think, in the beginning i have literally poked through the ear on more than one occassion (when using new lancet mostly, i reuse them each for about 2-3 days) and my cat didn't seem to care. After a few tries you will learn how to hold it just close enough to ear to poke (if using click button still) without poking through or having to redo it. it really is easier to do than you may think.
     
  13. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I would not reuse a lancet. After first use, they are no longer sterile. Also, a used needle becomes more painful with each use.
     
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  14. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    I PROMISE you that this gets easier and very soon you will be giving reassurance and advice to newbies :bighug::)
     
  15. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    I freehand. And I'm a horrible lancet reuser. :(:nailbiting::oops:
    I've luckily never needed to warm ears more than check they weren't freezing with my fingers.
    I usually poke and put the lancet/needle away, then pick up my glucometer, then grab (gently!) the ear again to see if the blood is pearling. If the drop seems good enough, I push the strip all the way into the glucometer and test when it's ready. If there doesn't seem to be a drop, then I put down the glucometer again and poke once more. I kind of "blind poke" somewhere where I think the capillaries are and hope for the best. I try to minimise the constraint on the cat, even if it means I sometimes miss a poke (not that often) and have to do it again.

    With my civvie Erica (not diabetic but did have high BG this last week), well, she was much less cooperative, so I have had to resort to "grab ear, poke twice and hope one works". Not idea but better than chasing her around the office when she's growling and unhappy.

    It does get better with practice -- yours and the cat's!
     
  16. Butterball

    Butterball Member

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    Feb 2, 2018
    Mission accomplished!

    Tried again at 4:10 pm CST. Couldn't get one this morning before the first shoot unfortunately because we needed to go to the store for batteries for another meter we're going to use

    This time I held him in my lap while my mom did the poking. First poke, a little squeeze, nice drop, touch it with the strip...nothing. The blood didn't absorb into the thing, it just sat there on top of it. Like, what the hell? No idea what that was about. Some petting and a few treats later, second drop, success.

    It read 112 mg/dL. His first shoot was 3 units Novolin around 10:15 am.

    We discussed what he had eaten today and my mom said she gave him like a tablespoon of dry food (I reminded her of the new diet, won't happen again) after the shoot this morning. Then about an hour or so later I gave him a 3 oz can of Fancy Feast Classic pate before we went to the store to get more cat food. I say he ate about half of it. Yesterday he did eat a full can in one sitting, though it took him longer than usual. Most times I seen him between 10-12 he was at the water bowl, though I didn't see a lot of drinking. Then we came back around 3:30 pm and I catch him taking some nibbles out of the dog's food. We test him and I give him half a 5 0z can of Wellness Turkey pate...ate MAYBE half? Wouldn't touch the rest, even tried the Parmesan trick.

    So to sum up, about 6 hours after first shoot of 3 units with what I'd say is less food in him than usual, 112 mg/dL. We'll try another test later at 10 pm before his next shoot

    A few concerns though:

    1. This is not the same machine we got the 455 reading on Thursday with. They're two different OneTouch machines. Could there be a HUGE discrepancy between two different OneTouch machines?

    2. Him not eating the food I got is also kind of concerning. Now, my mom said she saw him eating the dry food she gave him, he did eat from the two different pates (but not all/much), he inhaled the new organic treats I got him as test rewards, I did catch him with his face in a dog bowl, and he did eat the pieces of deli beef I gave him 10 minutes ago. Then he looked at his bowl, got excited, I guess forgot what I put in it, and then was like..."oh, this...", He also plucked out the pieces of beef I put in the pate with surgical precision

    So I'm not sure if his appetite has changed or he just doesn't like pate. The wet food we've given him in the past was either chunky or shreded. One other cat we have ate all hers. The sisters Boots and Tink didn't know what it was (though Tink ate most of hers because Tink ultimately eats anything), even the stray cat outside we take care of needed to sniff it with suspicion.

    Obviously I don't want to feed him dry food, I don't want to shoot if he hasn't eaten much, and I don't want to starve a diabetic cat to get him to eat his veggies so to speak, so what should I do if he really doesn't like the pate? If he continues to turn his nose up at it would it be okay to run out real quick to get some of the higher carb Friskies Shreds he's been eating all week? Are there any good lower carb wet foods that come in chunks or shreds I can try?
     
  17. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    I can just comment on the blood drop on test strip: make sure you understand how the test strip is constructed and where to get the blood. On the AlphaTrak and FreeStyle strips, for example, there is a tiny tiny pointy thing on the side of the strip. There is a tiny canal in that pointy thing, that will aspirate the blood inside the strip by capillarity. The pointy bit is meant to poke through the membrane of the blood drop. Once I understood that and started "poking" the blood drop with the pointy bit, my success rate went up hugely.
     
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  18. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Fancy Feast has a "chunky" chicken and turkey that are low carb.

    There are a lot of foods that aren't pate's that are also low carb but it'll take some work on your part. Check out this food chart

    You want foods that are under 10% carbs and most of the brands listed are online so you can see what form they come in (pate, chunks, shreds, etc.)

    One I know for a fact isn't a pate is Tiki
     
  19. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    I know my relion will give an error, or nothing at all if there is a big glob of blood. It's like it sits on the Strip instead of going up in the strip. It's just practice, it will get easier. :) testing before giving the shots are so crucial. Be patient with yourselves it's alot to take in. Butterball (love the name) head bumps
     
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  20. Butterball

    Butterball Member

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    Feb 2, 2018
    Got him again! First try, he's so good with us now, less squirming especially on the milking part and now we use a clear cap for the pen that makes it much easier to see what's going on. He also seems calmer when I'm holding him. I'll need to practice by myself though for when I won't have any help. Hoping it's all like this from now on. I want to thank all of you for the encouragement, I was on the verge of tears that first night of trying. This place is such a god send for wrapping your head around such a scary condition.

    He also did pound his Friskie Shreds. When he was done with that I offered him his left over FF Classic pate. He gave it a few courtesy licks and literally turned his back on it. The game is on, Rocky... I have some FF Chunky in the mail, hopefully he likes that.

    The results were 467 @ 9:39 pm. Yikes! I hope the 112 wasn't a fluke. And if it wasn't, they're not kidding about the Novolin "ping-pong". Obviously more tests will tell. I really would like to use a longer lasting insulin but they're so expensive. I read BCP PZI can be around $40 or so and you can get Lantus for a more reasonable price from Canada. It might be worth it though for more consistent coverage and not having to do this three times a day. We'll call the vet on Monday to report the tests and ask him about a longer insulin because they both require prescriptions.
     
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  21. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Will he eat the "flaked" Friskies Tuna or Tuna & Egg?

    You might try finding the lowest carb Shreds too and mix the pate with it so it's got a more "shred-like" texture
     
  22. Butterball

    Butterball Member

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    Feb 2, 2018
    I did get a can of the Flaked Tuna and Egg but I gave him beef tonight. I'll try that tomorrow, I didn't know it was lower carbs than the other flavors
     
  23. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Yeah, the FOOD CHART has it at 4% for Tuna and 6% for Tuna & Egg

    Hopefully you'll find something Butterball likes soon!
     
  24. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    I've personally never "milked" as there is something about interstitial fluid that has a different BG fraction and can contaminate the reading. I just wait a bit, letting go of his ear, scratching his chin, then checking a few seconds later to see if blood is pearling.

    I can imagine! I think we've all been there. It took me 40 minutes to get a reading the first morning I did a test, and I had to get one before injecting, had said my vet (good advice by the way).
     
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