Procedure for Home Testing of Blood Glucose using
a Glucometer Elite Meter and a Lancet Device for Ear Sticks or Paw Sticks
As a supplement to the section
Home Blood Glucose Testing of the Diabetic Cat
This procedure is long because it's very detailed, but
it's really simple. It just takes practice and patience. You can practice
on your own finger tip (that first stick is the most difficult); I think
you'll be pleasantly surprised at how little pain there is -- just a tiny
sting -- from the small lancet and fast lancet device.
*** IMPORTANT *** Before you begin, you should read
and fully understand the instruction manual for your blood glucose meter,
test strips, lancet device, and lancets. If this procedure differs from
the instruction manual, always follow the instruction manual.
EQUIPMENT AND SUPPLIES:
- Glucometer Elite meter and test strips
- Penlet II lancet device or equivalent
- B-D ultra-fine lancets or equivalent
- cotton ball
- small flashlight
I chose the Penlet II lancet device because it is relatively
quiet and causes very little startle reaction in our cat Ginger. Several
other lancet devices may work equally well. Ginger prefers the use of
a lancet device to me holding the lancet manually and sticking the vein.
Some pets disagree, so try manual sticks too.
I. EAR STICKS:
I first wash my hands and warm them in hot water or
with a small blue gel heat pack. I position the Glucometer Elite test
strip in the meter but do not push it in far enough to activate the meter.
I hold Ginger on my lap facing forward or a bit to the side, so I am looking
at the back of her head. I massage her ear from the base upward to warm
it for increased blood flow (she likes it). I find a vein by holding the
flashlight behind her ear, shining through the ear toward me. Note: Do
not use alcohol to clean the ear immediately before testing. If the ear
is dirty, it may be cleaned with water and dried thoroughly. In the beginning,
the procedure is easier to manage with two people. If you don't have a
partner, go to the section "One Person" below.
I hold Ginger's ear steady over a cotton ball while my partner positions
the Penlet over the vein (or a little toward the edge of the ear) using
the notch on its cap as a guide. He pushes it down firmly so the ear is
securely pinned between the Penlet and cotton ball held behind the ear,
and pushes the button to release the lancet. Ginger may jump a little
but not much. Then, unless we hit the large vein directly and get plenty
of blood, I massage the ear to get a blood drop a little larger than an
"O" and hold her ear steady so she can't flick the drop off.
If there is not enough blood (soon you will be able to tell in advance),
we reposition the Penlet and try again. If we think there is enough blood,
my partner pushes the test strip into the meter to activate it and removes
the foil (save it). When the meter is ready, he touches the test strip
to the blood drop, and the blood is drawn into the test strip collection
area automatically. We continue holding the test strip in the blood a
few seconds after the meter beeps (see NOTE 1 below). Then I use the cotton
ball to dry Ginger's ear and release her (yeah!) while the Glucometer
Elite counts down and displays the blood glucose (BG) value. We record
the BG number manually along with the date & time, and use the foil
to remove the test strip from the meter & discard it. If we misjudged
and there is not enough blood for a valid reading, we discard the test
strip and start over. Some people have reported inaccurate results (too
low) if they try to re-stick and add more blood from a second drop before
the meter beeps.
When I do the test by myself, I have the meter sitting beside me, withthe
test strip inserted but the meter not activated. I hold Ginger's ear steady
over a cotton ball with one hand and position the Penlet with the other,
then push down firmly and release the lancet. Then I massage the ear to
get a blood drop. Here's the only tricky part: I hold her ear steady with
the thumb and index finger of my left hand, bring the meter to it with
my right hand, move the meter to my left hand (I hold it between my index
and middle fingers), and use my right hand to push the test strip into
the meter and remove the foil. Then I switch the meter back to my right
hand. When the meter is ready, I hold the test strip to the blood drop
and continue as described above. Later when you are confident of getting
an adequate blood drop before the meter times out (i.e. in three minutes),
you can push the test strip into the meter to activate it before beginning
the lancing process. If the time limit expires and the meter turns itself
off before you're ready, use the foil to pull the test strip out of the
meter, push it back in to reactivate the meter, and continue.
NOTE 1: We have found that with the Glucometer Elite,
the blood must completely fill the round collection area in the test strip
AND two tiny "legs" that reach toward the bottom of the "C".
If the blood sample has legs, the blood sample size should be adequate.
Like some other people have reported on the Net, we have had the meter
beep to tell us it got enough blood, but the reading was incorrect (too
low, verified by retesting immediately).
NOTE 2: When you're a beginner, it can take 10+ tries
before you get a blood drop of adequate size, so don't get discouraged.
Now it takes us only one or two tries.
To greatly reduce the number of sticks, use the lancet device head
designed for deeper penetration. It does not seem to bother Ginger any
more, and IF it goes completely through the ear, you can get a blood
drop on both sides. This seems to be easier on her than multiple sticks.
Use a lancet larger than ultra-fine
II. PAW STICKS:
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.
III. FOLLOW-UP (both types of sticks):
After the test, I discard the lancet and clean the lancet device cap
with a generous amount of alcohol on a cotton ball and let it air dry.
It is recommended that you soak the lancet cap in alcohol for 10 minutes
once a week to disinfect.
At the end of the day's testing period, I enter the BG results into
a spreadsheet (e.g., Microsoft ExcelTM) and print a graph
showing the Glucose Curve (BG vs. time). The graph is much easier to
interpret than a list of numbers -- a picture's worth a thousand words.
If desired, you can label the insulin onset, peak, and duration, low
BG, and any notes (insulin dosages and injection times, feeding amounts
and times, symptoms like excessive thirst or urination or hunger, etc.)
in text boxes on the graph. It's awesome! I give copies of the BG curves
to our veterinarian for evaluation.
Watch your pet's ears or paws for a few days afterward for signs of
swelling, infection or excessive bruising. Most bruises are small and
heal within a couple of days. If problems develop, see your veterinarian.
Rotate the site of ear and paw sticks, just as you do with insulin
injections. You can use both edges of each ear, or any foot pad (the
largest pads may work best).
Good luck to you and your diabetic pet!