Like so many before me, I find it impossible to draw blood to test for glucose

[Anabel]

Hello everyone,

I know this is a recurrent topic. Trust me, I've been reading your very useful posts before rwriting my own, but I'm desperate.

The context: my cat Merlet had a high-grade lymphoma tumor removed from his point of injection early June. Oncologists decided a 4-pill chemo treatment to prevent any possible tiny cells from spreading.

He has IBD (which was the reason the lump was found timely), so they also decided he should take steroids. He's 13 and he's objectively a bit chonky, not excessively, but steroids have risks.

Cue 2 to 3 weeks ago, more than a week after chemo pill 3. His conduct changed, he had less appetite and hid a little, less sociable, etc. He had pancreatitis, mild, probably because we acted very quickly. He also had hyperglucemia, so we started with ProZinc. I was always unable to draw blood for testing, so initially I stuck to all of us getting used to the insulin shots, since the vet came often to check him due to the pancreatitis. 2 visits ago, she found his glucose already fine, a bit low, but she had to take blood to test all the pancreatitis stuff, so he had been on less insulin but not eating for 6 hours. Last Friday, she came back normally just to test Merlet's glucose level, and he was at 68. But he showed no signs of feeling bad at all, so she adjusted the dose to 1 unit.

She (and I as well) suspect Merlet might actually not be diabetic as such or at least will enter remission pretty soon. However, now there's the risk of hypoglucemia and glucose testing is a must. I've tried everything except for the warm rice sock because I'm pretty sure he'd be spooked (he's very good, but gets scared easily).

First we tried his hind toes, but he hates being touched there and not even the vet could draw blood easily. We changed to the ear, which had better reaction from Merlet, but still no blood. Yesterday I know I pricked him, but it's like the blood stayed "inside" (see pic, from today). He lashed out, we stopped. Today he acted out even with the insulin shot, which is unusual.

I'm terrified he will die thinking I'm this terrible person who hurt him, and he'll die unhappy due to all the handling. The vet can't come until next week. I think Merlet may have low glucose, but not hypoglucemia at all. What can I do? First, for his health, second, for his happiness and well-being.

Sorry for the super long message!

 

[squeem3]

Hometesting Links and Tips

Have you tried the unheated sock on the ear? Just to get your cat used to it. If the sock is adult sized, try a baby sized sock instead. Or just cup your hand over the ear for a minute or so at random times during the day before working up to a sock. Some cats need a slow acclimation to ear testing.

There are other methods to warm up ears: warm coffee mug, pill bottle filled with hot water, rubbing, etc. Some may work for ears that have learned to bleed easily.

From the pic, it looks like you poked too far into the ear. You want to poke between the edge of the ear and the vein that runs along it.

There is a CGM blood glucose meter you can look into. It's the FreeStyle Libre. It basically sticks to the shaved skin and monitors levels, sending the readings to an app on a phone. The vet will put the first one on and you can learn to do it yourself at home afterwards. @Staci & Ivy can provide more details on it.

 

[Alisa and Tito]

Hello everyone,

I know this is a recurrent topic. Trust me, I've been reading your very useful posts before rwriting my own, but I'm desperate.

The context: my cat Merlet had a high-grade lymphoma tumor removed from his point of injection early June. Oncologists decided a 4-pill chemo treatment to prevent any possible tiny cells from spreading.

He has IBD (which was the reason the lump was found timely), so they also decided he should take steroids. He's 13 and he's objectively a bit chonky, not excessively, but steroids have risks.

Cue 2 to 3 weeks ago, more than a week after chemo pill 3. His conduct changed, he had less appetite and hid a little, less sociable, etc. He had pancreatitis, mild, probably because we acted very quickly. He also had hyperglucemia, so we started with ProZinc. I was always unable to draw blood for testing, so initially I stuck to all of us getting used to the insulin shots, since the vet came often to check him due to the pancreatitis. 2 visits ago, she found his glucose already fine, a bit low, but she had to take blood to test all the pancreatitis stuff, so he had been on less insulin but not eating for 6 hours. Last Friday, she came back normally just to test Merlet's glucose level, and he was at 68. But he showed no signs of feeling bad at all, so she adjusted the dose to 1 unit.

She (and I as well) suspect Merlet might actually not be diabetic as such or at least will enter remission pretty soon. However, now there's the risk of hypoglucemia and glucose testing is a must. I've tried everything except for the warm rice sock because I'm pretty sure he'd be spooked (he's very good, but gets scared easily).

First we tried his hind toes, but he hates being touched there and not even the vet could draw blood easily. We changed to the ear, which had better reaction from Merlet, but still no blood. Yesterday I know I pricked him, but it's like the blood stayed "inside" (see pic, from today). He lashed out, we stopped. Today he acted out even with the insulin shot, which is unusual.

I'm terrified he will die thinking I'm this terrible person who hurt him, and he'll die unhappy due to all the handling. The vet can't come until next week. I think Merlet may have low glucose, but not hypoglucemia at all. What can I do? First, for his health, second, for his happiness and well-being.

Sorry for the super long message!

He might love the sock....it feels good. Try it but don't test him, just get him used to it

 

[Anabel]

He might love the sock....it feels good. Try it but don't test him, just get him used to it

You are right, I guess I feel so bad seeing how he watches my hands all the time to see whether I'm going to do something to him that I feel overwhelmed myself by adding stuff, but this is not intrusive at all.

If I may ask, how did you overcome the fear of pricking him? I use a lancet freehand (he gets scared otherwise) and it pains me every time, so most times I hardly even touch him and, when I do, well, you can see the result

 

[Anabel]

Thanks for your reply!

I started yesterday getting him used to touching his ears at random times (he's very affectionate, but the ears seem to be ticklish and not a common petting site for him, let's say). I will try every method you mention, to see which one works better for him.

Thanks for the advice on where to poke him! The vet said more or less "anywhere is fine", but that doesn't seem to be the case, I just hope it's not painful, I feel awful when I see it.

I learned in this very forum about the FreeStyle Libre! I'll definitely consult with Merlet's vet if measuring his glucose myself turns out to be impossible. I forgot to mention that Merlet has asthma and has been on an Aerokat inhaler for like 9 years. THAT also seemed impossible, but we took it very slowly (a month just letting him smell the bit that goes on his face), and he loves that moment, he asks for it. And the vet said that's way harder than this, so I guess there's still hope, right?

 

[Sienne and Gabby (GA)]

Please keep in mind that it takes more than a few days for the capillary bed along the edge of the ear to develop. Once it does, your kitty's ear will bleed more easily. Also, what gauge lancet are you using? In the beginning, when your cat's ear is "learning" to bleed, you want to use a wider gauge lancet. Often, a meter comes with lancets that are around 30 gauge. You want to start out with a lancet that's 28 gauge or lower. It's less comfortable but it will work better.

The other thing that helps are treats! Whatever Merlet likes is good. If you are using a product from the pet food store, you want something that is protein only. Many kitties are quite fond of freeze dried treats (e.g., chicken). Since he has IBD, I would stick with treat that's a novel protein so you don't end up with an IBD flare. Also, treats don't have to be food (although we tend to think of food first).

I overcame my fear of poking my cat by understanding that getting a blood glucose test was the only way to keep Gabby safe. Quite honestly, after her initial "What the heck are you doing to me?" and then giving her a treat (she was very food motivated), she associated the treat with the poke and I could pretty much do what I needed to. At some level, she also realized that what I was doing (tests and shots) helped her to feel better.

 

[CORKY]

You are right, I guess I feel so bad seeing how he watches my hands all the time to see whether I'm going to do something to him that I feel overwhelmed myself by adding stuff, but this is not intrusive at all.

If I may ask, how did you overcome the fear of pricking him? I use a lancet freehand (he gets scared otherwise) and it pains me every time, so most times I hardly even touch him and, when I do, well, you can see the result

For Corky get him used to the testing, I would place in front of him the monitor, the sock, let him smell it, then rub his head for a bit to make hi comfortable, I lightly place the palm of my hand between the ears lightly to get a grip, you want the head steady still, if he moves his head abruptly when you are pricking, the needle can tear the tip of the ear, it happened to me at first, so cup the ear with the sock, with the strip already in the monitor, and VOALA! you, as Squeem3 said you went too far inside the ear, the veins are around the tip of the ear, also once you pinch softly press, so the blood comes out, sometimes you do not see the droplet immediately after pinching, also as the days go by the capillaries will swell and it will be very easy to test below is a link on step by step and video that could be of great help

Hometesting Links and Tips

 

[Anabel]

Please keep in mind that it takes more than a few days for the capillary bed along the edge of the ear to develop. Once it does, your kitty's ear will bleed more easily. Also, what gauge lancet are you using? In the beginning, when your cat's ear is "learning" to bleed, you want to use a wider gauge lancet. Often, a meter comes with lancets that are around 30 gauge. You want to start out with a lancet that's 28 gauge or lower. It's less comfortable but it will work better.

The other thing that helps are treats! Whatever Merlet likes is good. If you are using a product from the pet food store, you want something that is protein only. Many kitties are quite fond of freeze dried treats (e.g., chicken). Since he has IBD, I would stick with treat that's a novel protein so you don't end up with an IBD flare. Also, treats don't have to be food (although we tend to think of food first).

I overcame my fear of poking my cat by understanding that getting a blood glucose test was the only way to keep Gabby safe. Quite honestly, after her initial "What the heck are you doing to me?" and then giving her a treat (she was very food motivated), she associated the treat with the poke and I could pretty much do what I needed to. At some level, she also realized that what I was doing (tests and shots) helped her to feel better.

Thank you!

I was not aware until I researched into this forum that the bleeding may not be so easy, since the vet managed to get a drop at first try (but she's a vet, and I'm not!).

I also checked the gauge lancet yesterday thanks to this forum (it's really a life-saver!), and it's gauge 26, but very very tiny, I've used it on myself, and he barely reacted when the vet poked him, so it's not too painful (well, yesterday I probably hurt him). Do you think it would be better with a 28 gauge, less painful for him?

Our experience with the inhaler mask tells me that he can be food motivated at first, but he is not when he's anxious. What he enjoys most about those moments are that we pay attention to him, it's moments we spend together with him and just with him. I imagine the routine also helps. He purrs most times now, if you can even imagine that. So you're absolutely right about food not necessarily being the prime motivating factor!

We do have dried freeze treats and I give him those, but, since he's most likely a bit low on glucose now (and due to the pancreatitis), we also give him other more creamy treats that he loves and we know don't make him puke. (He's still on a tiny dose of steroids, and a chat with the oncologists is pending).

Merlet trusts us very much, even though he's not a cat that trusts easily (too busy being scared of everything), so at least he know we're not trying to harm him, but knowing I hurt him feels terrible. You are totally right, I need to get a grip, because now I still have some time; if he has hypoglucemia, I will not.

Thanks again!

 

[Anabel]

For Corky get him used to the testing, I would place in front of him the monitor, the sock, let him smell it, then rub his head for a bit to make hi comfortable, I lightly place the palm of my hand between the ears lightly to get a grip, you want the head steady still, if he moves his head abruptly when you are pricking, the needle can tear the tip of the ear, it happened to me at first, so cup the ear with the sock, with the strip already in the monitor, and VOALA! you, as Squeem3 said you went too far inside the ear, the veins are around the tip of the ear, also once you pinch softly press, so the blood comes out, sometimes you do not see the droplet immediately after pinching, also as the days go by the capillaries will swell and it will be very easy to test below is a link on step by step and video that could be of great help

Hometesting Links and Tips

Thank you so much, I've already check the step by step pics that I had missed before and I was doing it from the inside of the ear, and I think that's harder.

It makes me feel a tiny bit better knowing that I'm not the only one who accidentally made a mess with our poor furry baby's ear, although I wish it wasn't so!

Since he has a bit of a trauma now, I'll most likely do as you say, but I probably won't poke him today, just let him get used to everything and associate it with time together. Of course, I'm monitoring his behaviour to see that he's not feeling unwell!

 

[CORKY]

Thank you so much, I've already check the step by step pics that I had missed before and I was doing it from the inside of the ear, and I think that's harder.

It makes me feel a tiny bit better knowing that I'm not the only one who accidentally made a mess with our poor furry baby's ear, although I wish it wasn't so!

Since he has a bit of a trauma now, I'll most likely do as you say, but I probably won't poke him today, just let him get used to everything and associate it with time together. Of course, I'm monitoring his behaviour to see that he's not feeling unwell!

We all have messed up and still do at on time or another, it gets easier, and yes you pinch the ear from the outside, Corky has dark hair, so I always tell members that I have a small flashlight plan size, I place it in my mouth and when I pinch I see the droplet much better, and before you know you’ll be better than your vet, because no one knows your fur baby better than you

 

[soreto]

We all have messed up and still do at on time or another, it gets easier, and yes you pinch the ear from the outside, Corky has dark hair, so I always tell members that I have a small flashlight plan size, I place it in my mouth and when I pinch I see the droplet much better, and before you know you’ll be better than your vet, because no one knows your fur baby better than you

wait, are you saying you take blood from the furry side of the ear? doesn't the blood just absorb into the fur?

 

[CORKY]

wait, are you saying you take blood from the furry side of the ear? doesn't the blood just absorb into the fur?

YES, from the outside tip of the ear, around the outer part is where the veins are, after a couple of days the capillaries will swell and it becomes much easier to draw blood and no, it does not absorbs, it just stays there like a little dot, so you should have the strip already in the monitor, to pick it up, , you just tip the end of the strip, if you put too much it will read error, then just wipe the residue with a tissue ,if blood still comes out after wiping just hold the tissue softly on the area until it stops

 

[Tim & Pookey]

I think it's a mixed bag on folks using inside versus outside of the ear. We always do the inside. Flip it up so it's easier to access and see and "milk" it once we have a little drop.

 

[soreto]

YES, from the outside tip of the ear, around the outer part is where the veins are, after a couple of days the capillaries will swell and it becomes much easier to draw blood and no, it does not absorbs, it just stays there like a little dot, so you should have the strip already in the monitor, to pick it up, , you just tip the end of the strip, if you put too much it will read error, then just wipe the residue with a tissue ,if blood still comes out after wiping just hold the tissue softly on the area until it stops

wow i had no idea! i had a vet tech that really freaked me out cause she punctured the middle, inside of the ear, --- & she free-handed it. it almost gave me a panic attack.

 

[CORKY]

wow i had no idea! i had a vet tech that really freaked me out cause she punctured the middle, inside of the ear, --- & she free-handed it. it almost gave me a panic attack.

The outside of the ear is tougher than the inside they do not feel it as much, the inner part of the ear is very tender, I have pinching Corky’s right ear on the same place for 3 years down the ear and he’s just fine the capillaries are perfect he doesn’t even feel it, try not to pinch all the way to the other side, just tip in the needle, there has been times that I still have to pinch him 3 time before I draw blood, not often, but it happens

 

[JL and Chip]

If I may ask, how did you overcome the fear of pricking him? I use a lancet freehand (he gets scared otherwise) and it pains me every time, so most times I hardly even touch him and, when I do, well, you can see the result

Whether to freehand or use a lancing device is a personal choice. If the device scares him, you can always try to acclimate him to it by clicking near his ear without drawing blood. I’m wondering if using a device would be easier on you than freehanding and might set you both up for better success in the long term.

I admire those who can freehand. I am not needle phobic at all but absolutely prefer a lancing device. I find I have much better aim and control and even after 4 diabetics and 20 years of testing, I still have epic fails when trying to freehand.

 

[Margicats]

Hi Everyone! As you all know by now, Benny's recent visit to a new specialist, Cats-only Vet and accompanying blood tests revealed that he was NOT diabetic and likely a controlled diabetic, because I had switched his food to 3 carbs or below only. Clearly, his previous blood tests showed high glucose levels and, if you remember, Benny was having hypo episodes on even 1 unit of Vetsulin. Unfortunately, the bad news was the blood test results showed possible pancreatitis and kidney disease. So now it's on to kidney diet food only. Benny hates Weruva PHos but loves Royal Canin renal diet. Figures he would like the more expensive of the two, so he has to get a job. Ha! The reason I'm rehashing all of this is because, first, in Anabel's situation, my Vet had told me about both a liquid and a tablet for feline diabetes. Is anyone familiar with this? However, kitty has to not have pancreatitis and something else, which I forget. Needless to say, I did not have to cross that bridge with Benny, but it might be of use to Anabel to research it, if her kitty is found not to have pancreatitis. I know she said that he initially had mild pancreatitis, so maybe it might work. Here's my second reason, anyone have a suggestion for wet cat food for my controlled-diabetic, kidney disease, pancreatic Kitty (Benny, bless his heart), that will not break the bank?

 

[squeem3]

@Wendy&Neko @Sienne and Gabby (GA) see Margicats' post above with a question about a liquid and a tablet to treat diabetes.

 

[Sienne and Gabby (GA)]

The vet is likely referring to Senvelgo or Bexacat. This is our post on these newer treatments. If this is what the vet is referring to, I do not think he would qualify for treatment with either. They are not to be used with a cat that has been on insulin or in cats with kidney issues.

 

[JL and Chip]

If the tablets are glipizide, then that would be a definite “no” as well.