Lancet versus Lancet Device

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Alessandra Franco, Feb 11, 2020.

  1. Alessandra Franco

    Alessandra Franco Member

    Joined:
    Dec 21, 2019
    Hello All,

    I’m ready to start testing Minnie’s glucose level at home. The glucose meter came with a lancet device, but when my vet’s tech showed me how to do it she just used a lancet and said she’d never used the device and didn’t even know how to use it. I read online that the clicking sound startle some cats making it harder to puncture the ear. I was wondering what most people here do? Appreciate your thoughts on this. Thank you!!!
     
  2. Sarah&Soph

    Sarah&Soph Member

    Joined:
    Jun 18, 2019
    It’s really a personal preference. Many people here do not use the lancet device and just use the lancet freehand. I do use the device because I could never find the right pressure to poke without it and it bothered my cat. She has gotten used to the click and doesn’t react to it :cat:
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    6 of one, half a dozen of the other.
    Some lancet devices are noisier than others. If yours is, try clicking it around her ears, to get her used to the noise.
    Some people have arthritis in their hands or bigger fingers and find holding the tiny lancet difficult.

    Lancet goes in at an angle to the ear, bevel side up.
    Lancet device is placed flat against the ear, outer edge.
    Both need some sort of firm backing on the opposite side of the ear to press against. (Do not recommend only your finger). Lots of people use a small piece of tissue or a cotton ball to back up the poke site.

    Aim for the 'sweet spot'.

    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 usually start with a larger gauge lancet such as 28g or 29g until the ear learns 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 of blood. 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 beveled so the sharpest part goes in first, if used correctly.
     
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  4. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Not every lance pen is the same. I have tried many lancet pens. I like best the ones that came with my One Touch Ultra meters. I only have one left. The other ones wore out, the threads on the screw top that you remove to replace the lancet wore out and the cap would not stay on. THe ones that came with the One Touch Mini was not bad. I found a metal one on Amazon and have three of those and the one remaining One touch Ultra
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Which metal one are you talking about? Letting other people know the brand name would help.
     
  6. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Yes, the sound can be startling to some kitties. I started out using the lancet device, and once I got used to doing the pokies I continued to use the device, but freehand, so I guess I'm somewhere in between :). I was actually more worried about the testing than the insulin injections, so I poked myself a few times in my finger with the lancet, just to get a feel for it. You don't need to do that, just saying find what makes you and your kitty comfortable. One tip I can share, which I was told when I first started, was to sing while you are doing the poke, it helps keep you calmer. And after the pokie, hold the test area with a cotton pad for about 10 seconds or so, just to help avoid bruising.
     
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  7. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
  8. toomanycats

    toomanycats Member

    Joined:
    Feb 7, 2020
    My kitty doesn't startle at the sound, and I prefer the device bc it does the "thrust" for me, so that's what we use for now. A ReliOn pen I believe.
    Edit to add: I keep the cap thingy that allows you to adjust depth off of my pen. I just use it "naked" lol
     
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  9. Alessandra Franco

    Alessandra Franco Member

    Joined:
    Dec 21, 2019
    Thanks everyone!

    @Christie & Maverick Im also more worried about this since the injections are a piece of cake now and Minnie doesn’t mind them at all. I’m sure with practice this will become less of a “thing” but I’m very intimidated right now.

    what’s the setting y’all recommend for the lancet device? The tech folded her ear in half with the outer part facing out, then found an inner vein and poked it with the lancet and did a bit of a digging in circular motion then removed the lancet and squeezed the tiny role and the blood came out. Not a ton. I’m going to practice to say the least before attempting a curve day. Since she’s regulated right now and the glucose level that day at the vet was 144, I think I have some time. I think the hardest will be first thing in the morning since they’re usually both meowing on top of their lungs for breakfast...

    Unrelated question, are most cats here also on Gabapentin? I’m increasing her to 20mg twice a day now but it seems most cats are at 50mg twice a day
     
  10. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Bigger lancets, 26 to 28 gauge. Labeled "For alternate site testing" on the box.
    Depth setting is your choice.
    Practice on yourself first, to judge depth. (It stings, we have more nerves in our fingers)
    Something firm backing up the ear, so you don't poke all the way through.
    Double poke right next to each other to get a bigger blood drop. Harder to do with the lancet device, you need to recock it to get that second poke.

    Here is where you should be aiming, not for the vein.
    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 usually start with a larger gauge lancet such as 28g or 29g until the ear learns 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 of blood. 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 beveled so the sharpest part goes in first, if used correctly.

    from Marje and Gracie's Testing and Shooting Tips

    It's buried in the Hometesting Links and Tips - includes numerous links, instructions, pictures, & videos
    within
    INDEX: Health Links/FAQs

    Within
    Health Links / FAQs about Feline Diabetes

    p.s. Deb, who knows where to find stuff here to help you out. Should have been a reference librarian in one of my former lives.

    p.p.s Now you have that sweet spot diagram twice!!!
     
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  11. toomanycats

    toomanycats Member

    Joined:
    Feb 7, 2020
    Wait...is it a problem if it goes all the way through? I'm not honestly sure if mine goes all the way through - I think it might kind of a lot
     
  12. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    No not a lot of cats on gabapentin here. Seen it used for arthritis in some cats here. Good for nerve pain, so if a cat has diabetic neuropathy, discuss with your vet.

    Pain can spike BG (blood glucose) levels. Nerve pain is exhausting also.
     
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  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    When you poke, you don't want to poke your own finger and draw blood. Then you might mix up human and cat blood and get a false reading on the BG meter.:blackeye:

    You can readjust the depth setting on your lancet device if you want. Although, the depth setting is usually controlled by the cap and toomanycats said she had removed the cap.
    The ears will heal, grow more capillaries in the "sweet spot".
    You can put the tiniest dab of triple antibiotic with pain relief ointment (not the cream) on the poke spot.
    I'm pretty sure it's the ointment and not the cream that is recommended. Don't remember why. Less spreadable because of the oil content I guess.
    Takes the "sting" out.
    Wipe off any excess so it doesn't get in your cat's eyes.
     
  14. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Alessandra,

    Would you put some information in your user profile for us? The signature is very helpful to those of us assisting you.

    Upper right hand corner, click on your avatar and a drop down list appears, select "Signature" and start typing away.
    Nice to see your first name, your cats name age and sex, diagnosis date, insulin used, meter used, food fed. Any other medical conditions your cat my have that would help us to respond better to you.

    Editing your Signature, Profile, and Preferences

    Then when you have your spreadsheet (SS) setup, you would link it into your signature. We have a template available for the SS so you do not have to "reinvent the wheel." Good set of instructions on how to set the spreadsheet (SS) up are here: FDMB Spreadsheet Instructions

    What it all means is explained in this link. Understanding the Spreadsheet/Grid

    It's a handy tool for keeping track of your cat's Blood glucose tests. You can record the insulin doses. And put any sort of helpful remarks in the far right column labeled "Remarks" such as the food you feed, how the appetite is, any issues you may be seeing.

    And a good resource for those of us helping you out. We can see patterns and suggest changes.
     
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  15. toomanycats

    toomanycats Member

    Joined:
    Feb 7, 2020
    @Deb & Wink oh I use a cotton ball; I don't poke me! I don't actually even know if I've poked all the way through - I was just worried...what if I did?!
    I've been using Neosporin ointment but only after the poke. Anyways, sounds like we're good lol. I was just suddenly concerned I was doing it wrong.
     
  16. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
    I use the pen that came with my OneTouch Verio meter, and I like it. Edward doesn't seem to mind the click... maybe he's just gotten used to the "new normal." I do find that it goes through the ear from time to time... sometimes he'll bleed better on the inside fo his ear than the outside, go figure. But a tissue with a bit of pressure always stops the bleeding right away, so I'm not too worried about it. I almost always "pierced" his ear every time, when I free-handed the lancet at the beginning of my testing journey.
     
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  17. SnowKat

    SnowKat Member

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    Jan 11, 2020
    And I always use the warm rice sock to hold his ear against when I poke him. I wash it once a week, or after it gets a few spots of dried blood on it.
     
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  18. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Learning to treat feline diabetes is difficult, especially in the first 2 weeks as you learn more.

    We've seen too many people find this message board, desperately seeking help with their diabetic cat and wanting to know more than the vet office or clinic told them.

    No question is "silly" except the one you do not ask.
    After you have removed the rice first I hope! I was just picturing the sock with rice still in it, going through the hot water wash and coming out kind of soggy. New way to cook rice anyone?:joyful:
     
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  19. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
    @Deb & Wink LOL, yes I remove the rice first! :D That would be quite interesting batch of cooked rice, I must say... :eek:
     
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  20. _Bobbie

    _Bobbie Member

    Joined:
    Feb 9, 2020
    Super newbie to testing here. I first tried using a device - Accu-Chek FastClix, but had two problems - I had a really hard time being precise in location, and the lancets in the drum were too small. I switched to larger lancets (26) and found doing it freehand to be much easier. I put a cotton ball inside my kitty's ear, and haven't poked through yet. I will switch to a finer lancet once Alex is a better bleeder. The larger lancet made a huge difference, though.

    Alex takes gabapentin. He took 25mg twice a day for a long time, but my vet just bumped him up to 50mg twice a day because of his arthritis and neuropathy. He is a big guy - 17 lbs, but should be closer to 20.
     
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  21. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    I always found a more shallow setting did the trick, if memory serves, I used 2 in the beginning. Most definitely not necessary to hit a vein, they have little capillaries as the pic posed by Deb. If you hit the vein, it's not terrible, but it can bleed a lot...and if they shake their head, well think CSI crime scene :p, well okay maybe that's a wee bit of an exaggeration lol, but the first time I hit a vein in the ear, Maverick shook his head and I had blood splatter on the walls.

    Is Minnie the black kitty or the little one in your pic? One other thing to mention is I bought a small head lamp, you can find them on Amazon, and so I've been told maybe even in dollar stores. In the beginning I was super frustrated, thinking I wasn't doing it right, since I could never seem to get a blood drop on the first poke. Then I realized, because Maverick has black fur on his ears, I just wasn't seeing it :rolleyes:. The head lamp helps because I can get great focused light and still have both my hands free. Best $10 I ever spent. Not sure if this was previously mentioned, but you can put a little polysporin before you poke, it can help bead up the blood drop. Sometimes the blood seeps into the fur instead of making a nice drop.
     
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  22. Alessandra Franco

    Alessandra Franco Member

    Joined:
    Dec 21, 2019
    Christie, Minnie is the white tabby one so her pink ear should help me locate the blood easier ha! The vet tech poked the inside of the ear that has more skin and less hair. She also used her cell phone flash light to do what you’re describing and I was wondering how the hell id be able to do that and poke with one hand only so thanks for the tip!!
     
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  23. Alessandra Franco

    Alessandra Franco Member

    Joined:
    Dec 21, 2019
    Minnie developed severe neuropathy and I blame my fist vet for taking too long to adjust the insulin dosage and myself for not knowing anything about diabetes and not finding this forum sooner!! Thankfully she’s improved so much and it’s back to jumping on the living room furniture, going up and down the stairs and even started using the litter box again. She’s on a lot of things since I took her to an internal specialist vet and a nutritionist as well. All the usual like b12 methyl but also probiotics, antioxidants and now gabapentin. I’m increasing her dosage to 20 twice a day but it’s hard to tell what working when she’s on so many different meds and supplements
     
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  24. _Bobbie

    _Bobbie Member

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    Feb 9, 2020
    It's so encouraging to hear stories about cats recovering from neuropathy. Thank you. I've been giving Alex the methyl B12 for a few days, knowing it will take a while to kick in. I'm glad Minnie is getting better!
     
  25. Alessandra Franco

    Alessandra Franco Member

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    Dec 21, 2019
    will do!!!
     
  26. Alessandra Franco

    Alessandra Franco Member

    Joined:
    Dec 21, 2019
    I didn’t believe it would be possible when people told me it just took time because it was so severe, but she’s seriously 80-90% better at this point so just hang in there because it does take a few months. What dosage are you giving him? She’s up to 7 mcg a day. I’d also suggest asking about the antioxidant. It’s a supplement and not prescription so I can’t imagine it has side effects but the nutritionist put her on it to combat the oxidation around the nerves from the glucose build up. She’s taking Thorne for small animals one capsule a day. Here’s the link to the site:

    https://thornevet.com/products/small-animal-antioxidant?_pos=1&_sid=82a316fa5&_ss=r
     
    Last edited: Feb 13, 2020
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  27. Alessandra Franco

    Alessandra Franco Member

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    Dec 21, 2019
    Another unrelated lancet question, any other cats on antioxidant in addition to b12 methyl?
     
  28. _Bobbie

    _Bobbie Member

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    Feb 9, 2020
    Thank you! For the first few days, he took 5000mcg and 200 mcg folate. I ordered Zobaline, which is 3000mcg and 200 mcg folate, and have been giving him that for two days. Do you feel like the higher dose is more helpful?

    And thanks for the recommendation for the antioxidant. I will definitely look into that.
     
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  29. Alessandra Franco

    Alessandra Franco Member

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    Dec 21, 2019
    Again, she’s on so many things it’s hard for me to say if it’s one thing or the combination of the program she’s on. Controlling her pancreatitis with the right probiotics was definitely huge. I started with zobaline once a day but then switched to the vitacost version and I think other folks here use it as well. That comes in 5000 per capsule so I started giving her 1 and 1/2 since is water soluble and the excess will just her “peed out”. My vet thought it was okay. I think most people are giving them 2 zobalines a a day for a total of 6000, at least that’s what I heard from Laurie who got zobaline to start making the feline version, but feel free to correct me if I’m wrong folks!
     
  30. Alessandra Franco

    Alessandra Franco Member

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    Dec 21, 2019
    Done! :)
     
  31. Alessandra Franco

    Alessandra Franco Member

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    Dec 21, 2019
    I just did a successful test for the first time yay! I was prepared to fail at first but it was easier then with the vet tech. I used a warm cloth in the plastic bag and I think she had more of an issue with that then the actual test. I’ll get rice this week and I’ll make the sock. Anyway, used the diagram above to hit the sweet spot (thank you btw!) and I didn’t even have to poke too hard the blood came out right away. I just used a lancet. The device didn’t feel right to me. Minnie didn’t enjoy it and let out a meow, but also didn’t fight it at all and remained still. The not so great news is that I got a 249 reading, but it’s it’s late in the day and we’re only about 4 hours away from her next shot. She hasn’t been drinking more water or peeing more so I’ll try to do this once a day at the same time this week and then I’ll be ready to do the curve over the weekend. Next I’ll set up the spreadsheet.

    Thank y’all :)
     
    Last edited: Feb 17, 2020

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