Tips
for Success
- Read
your glucometer manual.
- Put
all the materials on your right if you're right handed or on your left
if you're left-handed.
- Begin
by petting and stroking your cat, speaking in affectionate tones
- Do
NOT clean the stick area with alcohol. If dirty, use water and then
dry thoroughly.
- Use
the cloth or sock to warm the ear or paw pad before pricking to increase
blood flow and enlarge the capillaries and veins. Alternatively, gently
massage the area with your fingertips.
- If
you use the lancet manually (not in a pen), prick at a 45 degree angle.
- Praise
your pet and consider giving a treat.
Method
- Assemble
all your materials and wash your hands.
- Position
your cat so both of you are comfortable.
- Locate
a vein on your cat's ear by shining a flashlight behind it. The vein
will look like a red string and should be near the edge of the ear.
If you are using a paw pad, use the large pad.
Photo courtesty of Pawprints and TEN - Use
the cloth or sock to warm the ear or paw pad before pricking to increase
blood flow and enlarge the capillaries and veins. Alternatively, gently
massage the area with your fingertips.
- Position
the lancet and do the prick.
- Touch
the tip of the test strip to the top of the blood drop at a slight angle.
- If
necessary apply slight pressure to the prick site for a few seconds
to stop the bleeding.
- Wait
for the glucometer to give the final reading. Most glucometers will
warn you if there is insufficient blood on the test strip.
- Record
the date, time, and glucose reading in a notebook. Your meter will store a lot of data, but you should always back up your data manually or, if available with your meter, download the data to your computer periodically.
Links
and tips from others:
Testing
for Feline Blood Glucose -
the Movie!
Ear
sticks: 5 contributions
Footpad
sticks: 2 contributions
Ear
Sticks
I.
Contributed by Julie Paque
Supplies
needed:
Blood
glucose monitor that requires a small amount of blood. (I use the Precision
Blood Glucose Monitor made by Medisense. It needs only 5 micro liters
of blood, vs. up to 30 micro liters for other monitors. Their customer
service at their 800 number is great, too.) These are available from your
local pharmacy, and a rebate is also often available, bringing the price
down considerably. The companies make their money with the test strips,
not the meters.
Test
strips for monitor (most come with a learning supply.) These run about
$35-40 for a supply of 50 strips.
Microcapillaries,
75 mm long by 1 mm diameter. You can use heparinized or non-heparinized,
it doesn't matter, so go for what you can find or is cheaper. Your vet
may be able to help you get some, or a medical or chemistry supply store.
Use one per test.
A
bulb with a hole for the end of the microcapillary (optional, to blow
the blood out of the capillary onto the test strip.)
Tissue
or gauze pads
Outline
of procedure:
You
will use the lancet included in the blood glucose monitor kit to prick
the ear of your cat. The microcapillary will pick up the blood drop from
the ear and you will put it on the test strip.
Detailed
steps:
Learn
how to use the meter, testing on yourself.
Getting
blood from the cat:
a.
Look carefully around the edge of the ear, you'll see a vein running just
inside the edge. You may need a flashlight to see the vein, shine the
flashlight from under the ear and the vein is visible even on dark haired
cats.
b.
When learning it is best to test the cat when he's warm. Such as when
he's been sitting in the sun, or curled up in a particularly warm spot.
You'll notice a big difference in the temperature of the ears, and it
is much easier to get blood from warm ears than from cold ones! Later
on when you have the technique down you'll be able to do it even when
they're cold, but make it easy on yourself by optimizing conditions for
you and the cat.
c.
Have a folded tissue or gauze pad, the lancet, and the capillary ready.
Put the cat between your knees, facing away from you. Keep your feet together
so he can't back out. Don't wash the ear with water or alcohol before
you prick it, you'll never be able to collect the blood.
d.
You're going to use the lancet to prick the ear near the vein, if you
hit the vein you'll get plenty of blood, if you're near it you'll still
be able to get enough. Put the tissue underneath the ear so you don't
prick yourself and contaminate the blood sample. You may need to prick
more than once initially to get enough blood, gentle massage around the
site will also encourage the blood to come out. After you've done a series
of tests in the same area it becomes slightly swollen and it is easier
to get the blood on one prick.
e.
Pick up the blood with the capillary. For the Precision monitor I need
a little more than 5 mm of blood in the capillary in order to perform
the test. It just so happens that the capillaries that I am using have
a line at the 5 mm mark. Set the capillary with the blood aside and use
the tissue to apply pressure to stop any bleeding on the cat's ear. Give
him a big hug for cooperating and let him free.
f.
Put the test strip in the monitor and wait for the ready signal. Put the
blood on the strip. If you have a bulb for the end of the capillary cover
the hole and squeeze to get the blood out of the capillary. If you don't
have one you can blow through the opposite end. Record the results in
the booklet.
If
the results of any test seem unusual it is always a good idea to repeat
the test. Don't ever make radical changes in what you're doing based on
a single results. And it's always a good idea to keep your vet up to date
on the results of your testing and work with him or her to determine any
changes necessary to your cat's regimen.
II.
Contributed by Darlene
I
have a Glucometer Elite, and love it. All you need is a drop of blood
the size of an "o" in newspaper print. No separate capillary
tubes -- it's built right into the test strip. I do ear sticks when I
test, which isn't often these days because Pooter is doing so well. Before
he was regulated, I did my own curves and plotted them for the vet to
look at rather than taking the cat in for a whole day, and spot-checked
once in a while when he wasn't acting right.
The
chemical reaction in the test strip is very sensitive to humidity and
anything else that can get into that little slot, so you have to be both
careful and quick. Once you put the test strip into the machine, you only
have three minutes to get the sample, which may not be enough while you're
still learning how to keep the cat from flicking his ear and sending the
blood drop off into space.
Here's
my sequence. First I open an alcohol swab and twirl the lancet in it a
few times to clean it off, then I open the foil test strip packet and
put the strip into the meter just far enough to sit there but not far
enough to activate it. Then I use the swab to sterilize the closed end
of the packet and a patch of table for the cleaned packet to rest on.
Then
I snuggle the cat and massage his ear until its good and warm (bleeds
easier then ... some people bring a lamp down close to warm up the ear).
Then I stick him, and if he doesn't bleed right away I massage the ear
from the base up towards the pinhole and that sometimes brings up a small
drop, otherwise he gets stuck again. Now you have to be quick, because
that tiny drop congeals fast.
I
scoop the drop up onto the sterilized end of the foil packet and release
the cat -- takes both hands to slip the open end of the packet back over
the test strip to protect it from contamination while you push it the
rest of the way into the meter (without losing the drop of blood on the
other end). In a couple of seconds the meter says it's ready, and you
just touch the droplet to the end of the test strip until it's sucked
up and you hear the beep.
If
your cat is more cooperative than Pooter, you'll find that in no time
you can warm the cat's ear up first, then start the meter, do the stick,
and take the sample right off the cat's ear. More often than not, the
irritation of the poke and the blood sitting there will bring on twitches,
so I had to find a way of getting the sample onto a sterile surface before
he bled all over the kitchen.
Oh
-- I was told not to use alcohol or anything to clean the cat's ear for
this, since it just inhibits bleeding and might contaminate the sample.
The bleeding stops in seconds, and he's had no infection or irritation
despite the kazillion times I poked him in same spots. I do re-use the
lancets, and clean them with alcohol before and after each use. I tried
using the spring-loaded pen that jabs the lancet quickly, but the noise
made him jump, so now I just hold the lancet itself. It's easier to aim
right at the little vein if you can see the sharp tip and exactly where
it's going, too.
The
glucometer is a great idea, and Pooter wasn't even close to regulated
until I curved him with it several times. You'll know exactly what's going
on with his blood sugars at the exact time you need to know -- this means
you can tell when his insulin peaks, how far down it's taking the BG and
for how long, and adjust his feeding (quantity and quality) to perfectly
cover the insulin. Urine testing never gives you this precision -- it
only tells you that at some point over the last X hours, the BG did or
didn't get high enough to cause glucose dumping (and if it did, you don't
know when or for how long -- all you know is that the BG was high enough
for dumping to occur, which is the same level at which organic damage
is being done). The meter will pay for itself in reduced vet visits, too.
The main benefit for Pooter is that with close monitoring, a lot of the
damage done to his body by poorly controlled diabetes is reversing --
his legs are stronger, his kidneys are concentrating urine instead of
washing out glucose, etc. etc.
The
main benefit for me is is that I got my life back -- I can inject him,
feed him, and take off for the day without worrying whether he died in
agony while I was out. For several months I absolutely had to be there
when the insulin peaked, because he had so many reactions, or over-feed
him to make sure there wasn't one, so he got fatter and fatter and sicker
and sicker. We're both much happier now!
Darlene
III.
Contributed by Kathy
Procedure
for Home Testing of Blood Glucose using a Glucometer Elite Meter and
a Lancet Device: Ear Sticks or Paw Sticks
. The "Follow-up" section of this monograph has an excellent description
of using a spreadsheet to track your cat's progress.
IV.
Contributed by Donna B.
A
nice comprehensive write-up of this caretaker's
approach to glucose monitoring.
V.
Contributed by Eileen Swords RN, BA, BSN
I
recommend the Fast Take monitor & the Soft Touch automatic lancet.
(I am an NICU RN with 20 years of experience).
It
is a very good idea to do all glucose testing in a "procedure room"
in the house (in our case, it's our spare bedroom & we now call it
the "torture room"). The rationale for this is that the cat
will be able to truly relax in the "safe" areas of the house.
We use this technique in the hospital with our Peds patients so that they
feel more relaxed in their hospital room. Our kitty gives us a very pained
look when he is taken in "the room", but he is VERY HAPPY when
he is ANYWHERE else. We have not done this with the Insulin injections
because he really does not seem to mind them.
Footpad
Sticks
I.
Contributed by Jerry
I
just wanted to add my endorsement of the Glucometer Elite brand for home
glucose testing. I tried another (cheaper) brand but was not able to obtain
a large enough drop of blood for a reliable test. Glucometer Elite requires
about one-fifth as much blood, making sampling much less traumatic on
cat and owner.
I
don't use the lancing device supplied with the Elite. Rather, I use a
standard pen-shaped lancing device. I use the head attachment intended
in humans for thick, calloused skin - for a bit deeper puncture. Press
this FIRMLY into the big pad on kitty's rear foot. My cat had not cried
nor flinched with this method. Finally, transferring the tiny drop of
blood to the strip is easy; the strip itself wicks the sample into a little
chamber. There is no continued bleeding, by the way. ***layman's experience
only - your results may vary*** - I offer this as an alternative to using
the marginal ear vein.
Best
of luck to all, Jerry
II.
Contributed by Kathy
You
may need to stick with the lancet manually or use a lancet device that
gives deeper penetration (e.g., SoftClix with adjustable depth) and larger
lancets to get enough blood. Otherwise it shows real promise as an alternate
site to give the ears a break. Our cat doesn't even move, like she doesn't
even feel the stick.
First wipe off the large pad on one of the paws with warm water and dry
it. Press the lancet device FIRMLY against the pad and release the lancet.
Then squeeze the pad to get a blood drop. Continue as described with ear
sticks.
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