Trouble with glucose testing - need tips fast

Discussion in 'Feline Health - (The Main Forum)' started by katmom, Jan 21, 2018.

  1. katmom

    katmom New Member

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    Jan 20, 2018
    Ozzie is an 8-year old FIV positive male diagnosed with diabetes in December. He’s down to 6-7 pounds from 12 because he went undiagnosed for so long - we and the vet thought his symptoms were the result of long-term steroid use (0.5-1 ml of prednisone twice a day to control FIV-related inflammation). I now give only 0.1 ml of prednisone twice a day.

    He’s getting 3 units of Prozinc twice a day and will eat in the morning, but becomes progressively more lethargic as the day goes on, refusing to eat or drink. Yesterday by 5 pm he vomited and eliminated outside the litter box and just was miserable. The vet gave him fluids and his BG was 419.

    In hopes that he’ll eat better if his diabetes is better controlled, I’m trying to test at home with a Relion meter and lancet tool, but after a single instance of beginners luck can not get any blood from his ears or pads. Blood will spread out beneath the ear tissues like a hematoma where I’ve pricked, but no blood comes from the puncture in spite of my rubbing toward the puncture site. I haven’t gotten any results from the pad - aiming for the side of the pad near the skin.

    I’m afraid Oz might not have much time left for us to get this right. Thanks for any help.
     
  2. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Hello, I'm pretty new here too. I can say that I have difficulty getting blood too. Usually takes 4 or 5 pricks before any blood comes out. I just started this week and Rufus' poor ears look terrible :( I'm trying to find the thread that had some advice for me. I know they say to try at an angle with the lancet device, and also to warm up his ear. Either rub on it or use a sock filled with a little rice in microwave for 15 seconds.

    Sorry to hear about Ozzie, but I'm sure he'll bounce back. Rufus was diaganosed around Thansgiving and nowhere near regulation and his numbers are higher :( Just got to be positive as it takes time!
     
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  3. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    Putting a very thin layer of Neosporin with pain relief might help the blood bead up vs spreading out in his fur.
    I used to rub Chuck's ears between my fingers to get the blood flowing and warm them up.
    Do you use the lancet device or free hand with the lancet? If using the device you can try applying more pressure then clicking.
    If free hand, and going at an angle isn't working you could try straight on. When desperate for a sample, aim for the vein.
    I use the lancet device and when switching lancets sometimes they sit a little lower than the one before so I still have to poke a couple times.
    Over time the ears "learn" to bleed... We used to poke on a 3 setting and now we use 1.
    Keep praising and giving treats. The Neosporin with pain relief will help any soreness from all the pokes.
     
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  4. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    Are you testing for Ketones at home? It's important to test when they have symptoms like this and/or high BG.
    It's possible the dose could be too much and it's causing him to go hypo and then bouncing from that to very high BG. Your home testing will help figure that out.
     
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  5. srk4cats

    srk4cats Well-Known Member

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    Jan 19, 2017
    Yes, lots of blood comes out when you hit the vein. When I prick Chloe's ear, I never know if the blood will come from the outside or the inside of the ear.
    I tried the lancet device one time and the noise startled both me and Chloe. I'm nearsighted and prefer getting up close and using a lancet only.
     
    Last edited: Jan 21, 2018
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  6. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    I haven't had a diabetic in quite awhile, but here are my testing tips. I hope they help!

    1. 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. I would 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.

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

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

    4. Put a very thin smear of vaseline or neosporin 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 - it gives a firm base to press against, and keeps you from getting poked. Some people use cotton balls, makeup sponges. I used a waded up paper towel. It was 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 praise and treats!


    It takes time to get a 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 test strip up to her ear - I think it tickled.

    Oh! I would limit testing to 4 attempts. If you haven't gotten a reading, consider giving a reduced dose or try later.
     
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  7. katmom

    katmom New Member

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    Jan 20, 2018
    I am not at this time. No one is home during the day and I have two cats, so in my admittedly limited understanding of this testing I don’t see how I could test urine for one cat without camping out by the litter box. Maybe it is easier than I think, but I’ve been focusing all energies on keeping Oz alive and trying to test BG! I’m puzzled why the vet wouldn’t have checked for ketoacidosis yesterday. Maybe I can take him in to the vet tomorrow to be tested for ketones?
     
  8. katmom

    katmom New Member

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    Jan 20, 2018
    He has one white ear through which the veins show clearly. I can try to hit the vein. The lancet device noise doesn’t seem to bother him. Thank you!
     
  9. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    I think that would be worth if for peace of mind!
     
  10. katmom

    katmom New Member

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  11. katmom

    katmom New Member

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    Jan 20, 2018
    Thank you. Is there a reason not to try more than 4 attempts?
     
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  12. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Those were great tips by Maggies Mom, but I respectfully disagree about having the strip in the meter before getting blood. My issue is it does take some time and tries to get a prick, s after I see blood I stick the strip in. On my machine if you stick the strip in it is only valid for 30 sec or a minute not sure. After that, it errors out and the strip needs to be tossed. And with strips being a dollar a piece they are like gold to me!
     
    Last edited: Jan 21, 2018
  13. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    I know in my case I tried about 15 times the other day and gave up. Rufus was like wth are you doing. I know it doesn't hurt him, he was like hurry up and get outta my face :)
     
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  14. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

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    Dec 28, 2009
    I only stuck the strip in a little - I would push it in all the way after getting blood.

    I quit after 4 attempts, and would wait a little before retrying, because Maggie would get annoyed and I didn't want her to hate the process.
     
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  15. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    What size Lancet are you using?
     
  16. MaSha

    MaSha Member

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    Apr 8, 2016
    We've been home-testing our cat since he was diagnosed almost 2 years ago.
    We use a human glucose meter and now I use a small Vetpen needle that has never been used, to gently scratch his ear - I never pierce and never use a lancet, just a very fine needle. I used to buy ordinary small needles in pharmacies.

    The scratched surface is basically a dot, NOT a line.
    If a drop of blood does not appear immediately, I wait a bit, or gently massage the area around it.

    To illustrate where I usually scratch my cat's ears I uploaded a photo - easier to show than to explain.
    I don't know if I was just lucky, or if there's really a system to this "madness", but I almost never have problems drawing blood when testing his glucose levels. I did however pierced his ear at the beginning once or twice - ouch and sometimes there would be more than a single drop I strive for.

    I assure you it gets better with practice!
    If his ears are too cold rub them a bit.

    Hope this helps.

    I just wanted to add that we too had problems before stabilizing our cat on insulin. He refused to eat and drink (I had to force feed him). He also had a liver inflammation, so when that was resolved with antibiotics, things got radically better.

    At the very beginning, a vet that had not properly examined him had given him a corticosteroid injection that almost killed him. It took at least a month for him to get back on his feet. But we didn't give up. We fed him, when he had to eat but didn't want to. We monitored his behavior (litter habits, for one) and when he couldn't climb to sleep in our bed, we placed a mattress on the floor so that he could sleep with us.

    When he wouldn't eat, I read somewhere that cats prefer eating from plates than bowls - the sides of bowls bother their whiskers :) So I started putting his food on plates. Then I put his plate on a stack of books, since it appears that they may prefer it that way.

    At some point we had to give him vitamin B complex, to prevent nerve damage.

    He went into remission (his glucose levels got back to normal) when we stopped feeding him dry food for diabetic cats and gave him chicken. He's in remission now, after a short period of having to be put again on insulin.

    My point is it's a roller-coaster and cats are tough!

    Hang in there!

    I wish you and Ozzie all the best!
     

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  17. katmom

    katmom New Member

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    Jan 20, 2018
    33 gauge
     
  18. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Try a smaller number (26 or 28 gauge)-- it will be thicker and make a larger hole. Much easier to make ears bleed in the early days!
     
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  19. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    Most people recommend using a larger size Lancet, such as 26 or 28 gauge. You may have better luck with a bigger Lancet.

    As the numbers go up the Lancet gets smaller. I started out using 30 gauge on Mogee and have never had an issue. They were out of the 30 gauge one time and I bought the 33 gauge and they worked for us but we're pretty flimsy and didn't produce nearly as much blood.
     
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  20. katmom

    katmom New Member

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    Jan 20, 2018
    Thank you! The encouragement means a lot!!
     
  21. katmom

    katmom New Member

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    Jan 20, 2018
    I’ll try this.
     
  22. katmom

    katmom New Member

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    Jan 20, 2018
    I massage the ear, hold a folded Kleenex underneath, then apply the lancet device straight on firmly, near the edge but not on the edge of the ear, about halfway up - just above the folds on the lower part of the ear. He doesn’t seem to mind although gets restless when it takes forever. The blood is spreading beneath the skin and I’m not sure what’s causing it to do that. Might try the angle and aim for a vein as another poster suggested.
     
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  23. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Yep there's your problem. The bigger the number the smaller the Lancet. 26-28 is definitly what you want
     
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  24. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    Keep an eye on that. It could cause a small hematoma. If it spreads under the skin, hold some pressure to stop the bleeding and try another spot or the other ear.
    Janet is right, try a thicker lancet. It might be the issue.
     
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  25. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Diagram of the 'sweet spot' on the ear in this post:

    Testing and injection tips

    Once you have the paper support under the ear try wrapping both the support and the ear around your index finger, holding the two in place with your thumb and middle finger so that the ear is a little taut. This little bit of tension should hopefully make it easier to break the surface of the skin. Also, if you try freehanding with the lancet make sure that the bevelled side is facing upwards and keep the lancet at about a 45 degree angle to the ear, aiming at the sweet spot, about 1mm in from the edge of the ear. Try using a motion similar to pricking a balloon.


    Mogs
    .
     
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  26. katmom

    katmom New Member

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    Jan 20, 2018
    Took him to the vet for a glucose curve and ketone check. No ketones! And his numbers were in the 160-300 range which is a big improvement from over the weekend. Vet suggested no more than 2 units twice a day so we will reduce the dose. My husband says he’ll help with the testing, which sounds great as at this point he probably has more fortitude than I do. Going to start fresh tomorrow armed with all the great advice and tips. Thanks everyone!
     
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  27. Badtux

    Badtux Member

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    Dec 9, 2017
    I had a lot of trouble getting blood out of my cat Tux's ear. I could not freehand a lancet either, I just don't have the eyesight nor the dexterity (arthritis) to do that. The final solution I arrived at for my cat:

    1) Petroleum jelly.
    2) A sock with a small amount of rice in it. A small child's sock is best. You don't want much rice, maybe 1/4th cup. Heat it in the microwave for 15-20 seconds (depending on the power of your microwave), test it against your own ear, and if it feels hot but not burning hot, it's the right temperature.
    3) A lancet that makes a *big* hole. I'm using the Relion 26 gauge ones that say "For Alternate Site Use"
    4) A lancet holder that has a clear cap so you can actually aim the thing. I'm using the Relion lancet holder that you buy separately from Walmart with the clear cap (not the one that's included with the meter, which I found doesn't aim straight).
    5) a 2x2 sterile gauze pad.

    So my procedure:

    * Take gauze pad out of its package and unfurl it. Take test strip out of packet and set it on top of tester.
    * After heating sock in microwave, hug cat to me, pushing his rear down and giving him lots of hugs and cuddles. He tolerates this because he's a placid baby. You'll need to figure best way to do your cat based on your cat's personality.
    * rub a thin coat of petroleum jelly on his ear so that blood will pool up rather than wick into his ear hairs. Wipe excess off and wipe it onto a napkin. (Which happens to be right there because I do this on my dining room table next to his food bowl, which sits on a cloth napkin... a friend notes that my cat gets the 5 star restaurant treatment, heh).
    * Insert test strip into tester
    * Use the heated sock to heat up the cat's ear a *lot*. I keep the heated sock pressed to the underside of my cat's ear until the margin vein on top of his ear engorges. I'm also giving him cuddles with my other hand while that one hand holds the sock against his ear. Once I see that margin vein pop up out of his ear, I then grab the lancing device with my spare (third?) hand, press it against the area between the vein and the outside of the ear about 2/3rds of the way up the outside edge of his ear, and press the button. *Usually* I get blood the first time. Sometimes he moves, or the sock isn't firmly pressed against the other side and the ear bounces away from the lancet, or etc., and I have to try a second or even a third time. So it goes. If I can't get it where I'm aiming right now, I move to another site further up the outside edge of the ear or further down the outside edge of the ear, wherever I think the vein looks most engorged. Note that I'm aiming *outside* the vein.
    * and once I have the blood bead, I can do the ear rub if it's not big enough (usually don't have to, a 26 gauge lancet is pretty big), sip it with my meter, then use the 2x2 gauze pad to put pressure on *both* sides of the ear. Then give my cat a treat while telling him he's a good boy and giving him a few last cuddles.
    * Give him some wet food that he likes too at that same time, just to make sure he knows you appreciate him being a good boy!

    The real secret to getting blood out of my cat's ear is getting my cat's ear really, really hot with that rice-filled sock, to the point where the margin vein engorges with blood. So hot that he starts being annoyed a bit and tries to flick his ear away (thankfully Tux is not one of those howly hissy bitey kind of cats, he's just a real laid back kitteh who lets me know he's annoyed but doesn't go wild on me). If I don't get his ear that hot, it's like trying to get blood from a turnip. It just won't happen. Do test the sock on your own ear first to make sure you're not going to scorch your poor kitty's ear though!
     
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  28. katmom

    katmom New Member

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    Jan 20, 2018
    Badtux you’re up early! Thank you for the detailed procedure and lighthearted approach. Half the battle is screwing up my confidence to try again, and again, and everyone’s sense of humor really picks me up. I did four sticks in the ear yesterday with a slightly larger lancet - but got just a trace of blood, not enough for the test strip. I’ll try getting the ear much warmer; I’ve just been massaging it.
     
  29. katmom

    katmom New Member

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    Jan 20, 2018
    I’m very sad to report that We helped Oz cross the Rainbow Bridge today. He stopped eating and drinking entirely and the vet found a massive inoperable growth on his liver. Along with his other issues, it was too much for him to overcome.

    I can’t express strongly enough how much your cheerful and experienced counsel meant to me during a desperate time. Please continue helping other owners of diabetic cats many of whom, I hope and trust, will enjoy extended time with their beloved kitties thanks in part to this forum.

    He’s at peace. Thank you all. ☯️❤️❤️
     
  30. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    I'm so sorry for your loss, Katmom. Sad news indeed. Big hugs to you.
     
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  31. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Oh, I'm so sorry. You did all you could, but he just had so many things stacked against him :(.
    Fly free, little Oz. :rb_icon:
     
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  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I'm so sorry you had to let your kitty go. :rb_icon:cat_wings>o
     
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  33. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm so sorry to hear that Oz has gone to the Bridge.

    (((Katmom)))

    :bighug:


    Mogs
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