Diabities and Animia

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I haven't manage to test his ur in, becouse I have hard time separating litters. I live in 1 bedroom apartment and got 2 kitties. I have 2 jobs and basicly rarely home. My husband trying to help but he works 12-13 hour shifts too.
In this case, I'd suggest also getting a blood ketone meter (works the same way as a glucometer). The test strips for ketone meters are not cheap but you don't need to test for ketones as often as you need to test blood glucose levels. I really think they're a very worthwhile investment for ketone-prone kitties, especially in circumstances like yours and your hubbie's. :)

I belibe he does have nausia...he got the simptoms:(
I suggest giving your vet a phone call to let him know. I hope he will prescribe something for Wenz. The right anti-nausea treatment can make an absolute world of difference to a kitty who's having trouble eating.


Mogs
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Yes, he was very dehydrated! I am keeping an eye now how much he drinks
I see....
We were giving Ducia subcutaneous fluids (SQF) daily for a few weeks at home - Lactated Ringer's solution to improve her potassium and other electrolytes. Additional benefits are - better hydration, flashing ketones out and appetite improvement. Ask your vet if he thinks it'll help. Administering at home is easier done than it said.
is Denamarin prescription medication?
It's veterinarian - so yes, you get it from your vet. Really helps.
I belibe he does have nausia...he got the simptoms
The right anti-nausea treatment can make an absolute world of difference to a kitty who's having trouble eating.
I completely agree with Mogs and couldn't have said it better - anti nausea med is a number one tool to deal with inappetence which in its turn can lead to either DKA or to a Hypo - in case the insulin kicks in when there is no food on-board. Visious cycle - I'd address the nausea issue right away and aggressively - diabetic's well-being is so dependent on their foods!
Speaking Russian helps too!
:DAt last I can put it to some good use, lol
 
I completely agree with Mogs and couldn't have said it better - anti nausea med is a number one tool to deal with inappetence which in its turn can lead to either DKA or to a Hypo - in case the insulin kicks in when there is no food on-board. Visious cycle - I'd address the nausea issue right away and aggressively - diabetic's well-being is so dependent on their foods!

:DAt last I can put it to some good use, lol
I defenetly will. I just hope I am not missing anything. I didn't even had a chance to check his sugar, had to run to work. Tanya, did Дуся had a problem with bleeding after home testing? Coz of his law RBC i am afraid to poke his paw for blood. Even though it is a small poke.
 
I suggest giving your vet a phone call to let him know. I hope he will prescribe something for Wenz. The right anti-nausea treatment can make an absolute world of difference to a kitty who's having trouble eating.


Mogs
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I defenetly will give him a call. He was always a great eater, seeing him like this killing me
 
How’s Wenz? Have you spoken to the vet?
Hey, i am still at work...i hope he is good there. I finish at 11.30 pm:(good thing my vet gave us medication for nausea. My father in law was nice enough to pick it up. It needs to be given 30 mins before the meal,so hopefully my husband be able to give it to him so when I come home i can feed him and give a shot. I hope it helps his appetite and his condition.
 
Hey guys, just want to thank you all again. We started antinousa medication last night. I can see improvements in him every day. He is coming out more, actually comes out to eat I don't have to bring food to him. As of yesterday he won't eat stand up, now he does. Appetite is still not that great. He won't even finish a can( small cans), but better than was.i mad him some boil eggs too and add it to liver, he enjoyed that. So after all, i belive we are doing not too bad. Haven't had a chance to use a matter, luck of time. But I be off on the weekend, so hope to try than with no rush. Hope you all and your fluffers having a great day.
 
Hi Olga,

We started antinousa medication last night. I can see improvements in him every day.
I am so pleased to hear that the anti-nausea meds are helping Wenz. Which medication did your vet prescribe?

He is coming out more, actually comes out to eat I don't have to bring food to him. As of yesterday he won't eat stand up, now he does. Appetite is still not that great. He won't even finish a can( small cans), but better than was.

If you're not doing so already, try raising Wenz's food and water bowls up a few inches from the floor (e.g. stick a few paperback books or similar underneath the bowls). It makes it more comfortable to eat and drink when the kitty doesn't have to dip its head down.

With the insulin you're using try to encourage get Wenz to eat a fair bit before his insulin is due and wait a little while before giving the injection. Thereafter if he eats little and often throughout the rest of the cycle that'll be OK. If his appetite is still sluggish after a few days on the anti-nausea med then addition of an appetite stimulant alongside the anti-nausea treatment might enable Wenz to eat more.


Mogs
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Hi Olga,


I am so pleased to hear that the anti-nausea meds are helping Wenz. Which medication did your vet prescribe?



If you're not doing so already, try raising Wenz's food and water bowls up a few inches from the floor (e.g. stick a few paperback books or similar underneath the bowls). It makes it more comfortable to eat and drink when the kitty doesn't have to dip its head down.

With the insulin you're using try to encourage get Wenz to eat a fair bit before his insulin is due and wait a little while before giving the injection. Thereafter if he eats little and often throughout the rest of the cycle that'll be OK. If his appetite is still sluggish after a few days on the anti-nausea med then addition of an appetite stimulant alongside the anti-nausea treatment might enable Wenz to eat more.


Mogs
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I will try raising food balls, never thought about it. I am so scared when I give him an insulin that he didn't eat enough. When he walks away from the food,I wait around 10 mins and fallow him to put it again at his face and he eats again.lol and after i shoot, i still leave food out for a bitt even though doctor told me not too, i don't want him to starve.
 
Hi Olga,


I am so pleased to hear that the anti-nausea meds are helping Wenz. Which medication did your vet prescribe?



If you're not doing so already, try raising Wenz's food and water bowls up a few inches from the floor (e.g. stick a few paperback books or similar underneath the bowls). It makes it more comfortable to eat and drink when the kitty doesn't have to dip its head down.


Mogs
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I am not sure what was the name of it, i know it is a liquid. I will check when I get home from work:)
 
Drat. :banghead: Your vet has given you something that doesn't work very well for nausea in cats. Reglan, aka metoclopramide, increases speed of gastric emptying and can help with gut motility problems but cats have very few of the receptors it targets for nausea control. (Note: Reglan can be of help if the cat is nauseated due to constipation but only because it helps to resolve the constipation; the nausea subsides because the cat's no longer backed up.)

I had the very same problem as this when Saoirse had her first pancreatitis flare. I had to request specific medication from our vet.

The medications you need are either generic ondansetron (the branded version, Zofran, is much more expensive) or Cerenia (aka maropitant). I suggest you contact your vet ASAP, say that the Reglan is doing little or nothing to help with Wenz's nausea and that he is still not eating anywhere near enough food. You could then request a prescription for ondansetron or Cerenia. While response to the different meds varies from cat to cat, ondansetron may be the better one to try first. (It worked better for Saoirse and, from my reading of other cases here, it often works better than Cerenia for a lot of cats recovering from DKA or going through a pancreatitis flare.)

If your vet is not familiar with veterinary use of ondansetron, here is a reliable reference to cite (and perhaps email a copy of the document to your vet if needed?):

IDEXX Feline Pancreatitis Guidelines

The above document from the highly respected IDEXX Laboratories discusses all effective treatments for feline nausea. From the document:

There are several antiemetics available. Metoclopramide (Reglan®) is a popular antiemetic in cats and is still used by many practitioners. However, metoclopramide is a dopamine antagonist and inhibits vomiting by blocking the central nervous system (CNS) dopamine receptors in the chemoreceptor trigger zone (CRTZ). It is probably not a very good antiemetic in cats because they are reported to have few CNS dopamine receptors in the CRTZ. Dolasetron (Anzemet®) and ondansetron (Zofran®) act on the serotonin 5-HT3 receptors in the CRTZ and are very effective in cats. Lastly, although maropitant citrate (Cerenia®) is only labeled for use in dogs, it has become a popular and effective antiemetic for use in cats and acts on the neurokinin (NK) receptors in the vomiting center and can be used at 1/2 of the dog dose.

[Emphasis mine]

Generic ondansetron is a human medication (frequently used to treat nausea in chemotherapy patients). If your vet doesn't carry ondansetron it should be possible to get a written veterinary prescription and fill it at a regular pharmacy (ring round to check which local pharmacies stock it, or how quickly they can order it in for you). The dose my vet prescribed for Saoirse (4.5kg/10lb cat) is: 1-2mg ondansetron every 8-12 hours to a maximum of 4mg per day.

It's vital to get a post-DKA kitty eating properly as fast as possible both because it needs the calories and because it needs enough insulin in order to ensure a solid recovery and prevent relapses. Obviously if a kitty can't get enough food down it doesn't get enough calories and also it greatly complicates insulin treatment.

I hope your vet will be able to help. (I had to be a bit persistent in order to get an ondansetron Rx for Saoirse, and other members have reported similar experiences, but it's so worth it to get a treatment which really helps the kitty to eat again!)

Be sure to keep us updated with developments.


Mogs
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Drat. :banghead: Your vet has given you something that doesn't work very well for nausea in cats. Reglan, aka metoclopramide, increases speed of gastric emptying and can help with gut motility problems but cats have very few of the receptors it targets for nausea control. (Note: Reglan can be of help if the cat is nauseated due to constipation but only because it helps to resolve the constipation; the nausea subsides because the cat's no longer backed up.)

I had the very same problem as this when Saoirse had her first pancreatitis flare. I had to request specific medication from our vet.

The medications you need are either generic ondansetron (the branded version, Zofran, is much more expensive) or Cerenia (aka maropitant). I suggest you contact your vet ASAP, say that the Reglan is doing little or nothing to help with Wenz's nausea and that he is still not eating anywhere near enough food. You could then request a prescription for ondansetron or Cerenia. While response to the different meds varies from cat to cat, ondansetron may be the better one to try first. (It worked better for Saoirse and, from my reading of other cases here, it often works better than Cerenia for a lot of cats recovering from DKA or going through a pancreatitis flare.)

If your vet is not familiar with veterinary use of ondansetron, here is a reliable reference to cite (and perhaps email a copy of the document to your vet if needed?):

IDEXX Feline Pancreatitis Guidelines

The above document from the highly respected IDEXX Laboratories discusses all effective treatments for feline nausea. From the document:



[Emphasis mine]

Generic ondansetron is a human medication (frequently used to treat nausea in chemotherapy patients). If your vet doesn't carry ondansetron it should be possible to get a written veterinary prescription and fill it at a regular pharmacy (ring round to check which local pharmacies stock it, or how quickly they can order it in for you). The dose my vet prescribed for Saoirse (4.5kg/10lb cat) is: 1-2mg ondansetron every 8-12 hours to a maximum of 4mg per day.

It's vital to get a post-DKA kitty eating properly as fast as possible both because it needs the calories and because it needs enough insulin in order to ensure a solid recovery and prevent relapses. Obviously if a kitty can't get enough food down it doesn't get enough calories and also it greatly complicates insulin treatment.

I hope your vet will be able to help. (I had to be a bit persistent in order to get an ondansetron Rx for Saoirse, and other members have reported similar experiences, but it's so worth it to get a treatment which really helps the kitty to eat again!)

Be sure to keep us updated with developments.


Mogs
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Oh Geez, i thought at least this wont be a problem. By the way, he was never vomiting thought. I am bringing him In on Monday for glusoce check. I am gonna try tonight before second feeding and shot to do it with meter. I called them up, and yeah, he wants to stick with Reglar. Maybe when they see him monday I can convince them ather wise.
 
he wants to stick with Reglan
I'd be very interested to hear what justification the vet offered you for this treatment decision.

By the way, he was never vomiting though
I do wonder whether there's a terminology problem going on: ondansetron and Cerenia may be classed as 'anti-emetics' drugs but it doesn't automatically follow that they are only of benefit to a cat who is vomiting. They are highly effective - often life-saving - treatments for nausea in cats. I also wonder why it is that some vets seem to fail to acknowledge that a cat can be extremely nauseated but not vomit at all. Feline inappetence is always a very serious problem which can quickly become a medical emergency. It needs to be addressed urgently and aggressively, as Tanya quite rightly advocates above.

Here is another vet-authored article which discusses issues associated with use of Reglan in and other anti-emetics in cats and dogs (from professional veterinary site, DVM360). From the article:
Metoclopramide (Reglan) is a reasonably good central antiemetic drug for dogs but not for cats. Maropitant (Cerenia) is a superior broad spectrum antiemetic drug and is now recognized as an excellent first choice for control of vomiting in dogs. Studies and clinical experience have now also shown maropitant to be an effective and safe antiemetic drug for cats. While it is labeled only for dogs, clinical experience has shown it is safe to use the drug in cats as well. Maropitant is also the first choice for prevention of motion sickness vomiting in both dogs and cats.

[...]
Metoclopramide (Reglan) is a gastric prokinetic drug that also has central antiemetic effect. Metoclopramide increases gastric and proximal small intestinal motility and emptying without causing acid secretion, decreases enterogastric reflux, and provides inhibition of the chemoreceptor trigger zone. The central antiemetic effect is mediated through antagonism of dopaminergic D2 receptors in the chemoreceptor trigger zone of the medulla to inhibit vomiting induced by drugs, toxins, metabolic disease, and acid-base imbalances. Metoclopramide is a less effective central antiemetic drug in cats than in dogs because serotonin receptors, rather than dopaminergic receptors, predominate in the CTZ of cats. For vomiting in cats, I generally usually use metoclopramide only if a promotility effect is desired. Chlorpromazine, dolasetron, ondansetron, or maropitant should be used as a first or second choice to control acute frequent vomiting in cats. Parvovirus can cause gastric hypomotility and therefore the promotility effects of metoclopramide may prove beneficial. However, maropitant, dolasetron, or ondansetron are likely to be more effective than metoclopramide.


From page 3 of same article:
Ondansetron (Zofran, Glaxo Pharmaceuticals) is a potent antiemetic drug that has proven to be very effective in both humans and animals for control of severe vomiting. It has been used in human cancer patients undergoing cisplatin therapy, a drug that frequently causes nausea and severe vomiting, with dramatic results. Ondansetron acts as a selective antagonist of serotonin S3 receptors (a principal mediator of the emetic reflex). S3 receptors are found primarily in the CTZ, on vagal nerve terminals, and in the gut in enteric neurons. The principal site of action of ondansetron is in the area postrema, but it also has some peripheral gastric prokinetic activity.

In my experience, ondansetron has produced dramatic results in either controlling or at least significantly decreasing the frequency of vomiting in dogs and cats with frequent or severe vomiting, including in dogs with severe parvovirus enteritis, in pancreatitis patients, and cats with hepatic lipidosis. The recommended dose is 0.25 to 0.5 mg/lb IV given as a slow push every 6 to 12 hours (based on patient response). Frequently dogs that appear quite distressed due to nausea and vomiting look much more relaxed and comfortable within 15 minutes of receiving ondansetron. There are no reports of any significant side effects such as diarrhea, sedation, or extrapyramidal signs in human and animal trials. Its use should be considered in any patient with intractable vomiting (maropitant and dolasetron are the other top choices for this situation). Animals with significant liver disease are best managed with ondansetron or dolasetron, as maropitant must be used with caution in animals with significant hepatic dysfunction.

It is best to treat animals with frequent severe vomiting aggressively in order to significantly decrease the frequency of vomiting and to enhance patient comfort. Oftentimes early use of more aggressive therapy in controlling severe vomiting, in conjunction with other therapy, will hasten an earlier positive response and a shorter hospital stay, with a lower hospital bill than if the patient is allowed to linger too long while it receives less than effective therapy.

[Emphasis mine]

Experience shows that there is frequently no correlation between the degree of nausea a cat is experiencing and whether or not they vomit. Bearing in mind that severely nauseated cats will refuse to eat even though they are hungry, if there's nothing in the cat's stomach it is far less likely to vomit/dry heave but it still needs effective anti-nausea support to help it start eating regularly and protect it from developing serious complications like hepatic lipidosis and, in the case of feline diabetics, ketosis or DKA.

NB: As I highlighted in the article extracts above, the vet who authored the article flagged up that ondansetron would be the preferred treatment in patients with liver issues.

Hope the above article is helpful to you, Olga. Sending fusses for Wenz.


Mogs
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More reading! A very helpful article on spotting the clinical signs of nausea (including really helpful pictures of how to spot when a kitty is in an uncomfortable 'meatloaf' posture).

http://catcentric.org/care-and-health/the-problems-with-pepcid-using-diet-to-manage-nausea-in-your-cat/


Mogs
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Thank you a lot for info, i will defenetly address it to him on Monday. He actually said becouse he is not vomiting he would prefer Regan. But they closed now so hopefully I can manage it all on Monday. Also, i went to the pet store and got high calorie nutrition gel Tomlyn, do you know anything about it?it says stimulate appetite and lots of vitamins
 
Tanya, did Дуся had a problem with bleeding after home testing? Coz of his law RBC i am afraid to poke his paw for blood. Even though it is a small poke.
This is great question - the IM specialists we had seen suggested that I could partially contribute to Ducia'a anemia buy poking too often... It rang true because at the time I was using Relion Prime meter - requires larger amount of blood and also gauge 26, very wide needle, lancets - so even more blood was shed and I used to test - very frequently.

I switched to gauge 33 One Touch Delica lancets, Relion Micro meter - much, much smaller sample is required and sped up her weight gain - at this moment anemia is resolved.
I do not know how helpful my switching supplies was but it is possible... so - I'd avoid bleeding.... Pressing a cotton ball against the poke site for 10 sec - firmly but too hard to avoid bruising - will stop the bleeding.

Why do test in a paw, may I ask?

The outer edge of an ear - between the edge and the vein that goes along - is the best and the least painful testing site, IMHO..
I'd also worried about poked paw and Litter Box visits - sounds like risking infection.

I see that your vet gave you wrong nausea medication...sigh...sorry about that.

The human anti nausea or anti vomit med is ondansetron. There are many illnesses (too common nowadays, unfortunately) that call for its use - like after chemo therapy, or vertigo, head trauma, pancreatitis, etc - do you know anyone suffering from any of those? Or their parents/ grandparents?..Chances are that they were given ondansetron and might have kept it in their med chest and might be willing to give a pill to try for Wenz? You'll need a fraction of pill for a dose, if I am not mistaken. If you can get a pill of ondansetron this way it might help you thru the weekend until the vet opens. Just my thoughts. It is arch important that he eats.
got high calorie nutrition gel Tomlyn, do you know anything about it?
No I never heard of it. Check the ingredient list for carbs - especially the tiniest font they use for the most important info ;)
 
He actually said becouse he is not vomiting he would prefer Regan.

:banghead:

If you do go back to the vet and s/he insists that Reglan works for other feline patients, it is important to be firm in getting across the message that it is not working for your cat.

i went to the pet store and got high calorie nutrition gel Tomlyn, do you know anything about it?it says stimulate appetite and lots of vitamins
Word of caution: It's important to be aware that introducing something not tried before can potentially make an already queasy kitty more nauseated.

Try warming Wenz's food or maybe assist feeding by hand (hold the food at a height where Wenz doesn't have to stoop down to eat).


Mogs
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:banghead:

If you do go back to the vet and s/he insists that Reglan works for other feline patients, it is important to be firm in getting across the message that it is not working for your cat.


Word of caution: It's important to be aware that introducing something not tried before can make an already queasy kitty more nauseated.

Try warming Wenz's food or maybe assist feeding by hand (hold the food at a height where Wenz doesn't have to stoop down to eat).


Mogs
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I am holding on on that supplement for now. Just scared about what you just said. Plus, he is gluten and grain allergic. Last thing I need for him to break out now. That's what happens when I would not pay attention on what's inside the food cans. Although on chewy.com that Tomlyn had great reviews and some people used it for animic cats.
 

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Some cats can't stand having their ears messed with but tolerate paw testing fairly well. A case of better a paw pad test than no test at all. :)


Mogs
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I have to say paw also didn't work to well...he freaked out on me. Maybe he felt me nurviose. Also them lancests I got make a noise when you relise the needle. Wich I thought be better and easier, in the end he almost killed me.
 

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What are you feeding him? Maybe try a different food.
I am making menus here for him trying to trick him into eating. My fear is that he also not eating the iron supplement i put in food, he eats little with the food but not all. Tryed to forced him but no luck. Tonight I am making him some chicken breast. Lol
 
I am holding on on that supplement for now. [...] he is gluten and grain allergic.
I just had a look at the Tomlyn website; there's very little detail about the ingredients for the high calorie supplement (which I'm assuming is the one you've got as it claims to be good for enhancing a kitty's appetite). Time to break out the magnifying glass to check the label, methinks.

It might be that the ingredients are all OK for Wenz. When you have his nausea under control, he has caught up a bit on his food intake and he's more stable it might be something you could try then, perhaps? It's a good idea to also check with the vet before introducing new supplements so that s/he has a full picture of Wenz's diet.


Mogs
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I just had a look at the Tomlyn website; there's very little detail about the ingredients for the high calorie supplement (which I'm assuming is the one you've got as it claims to be good for enhancing a kitty's appetite). Time to break out the magnifying glass to check the label, methinks.

It might be that the ingredients are all OK for Wenz. When you have his nausea under control, he has caught up a bit on his food intake and he's more stable it might be something you could try then, perhaps? It's a good idea to also check with the vet before introducing new supplements so that s/he has a full picture of Wenz's diet.


Mogs
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I totally agree. I am taking that tube with me on Monday. I was reading back of it at a pet store. Really didn't find nothing suspicious that's why I thought it might be good but just like you said me and my husband decided we going to ask if at first.and I am making notes of all the info you gave me so I be prepared to prove my point.
 

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Maybe he felt me nurviose.
You're right; they do pick up on it when we're nervous. Saoirse became more relaxed about testing after I decided to put on my Big Girl Pants and get very businesslike about the whole thing. (OK, I had to pretend a lot, but it worked!)

Also them lancests I got make a noise when you relise the needle.
Not sure what the lancets for that device are like. If they look anything like this ...
iu


... you could try to just use the lancet itself and 'freehand' the poke (many people do).


Mogs
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You're right; they do pick up on it when we're nervous. Saoirse became more relaxed about testing after I decided to put on my Big Girl Pants and get very businesslike about the whole thing. (OK, I had to pretend a lot, but it worked!)


Not sure what the lancets for that device are like. If they look anything like this ...
iu


... you could try to just use the lancet itself and 'freehand' the poke (many people do).


Mogs
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It got this relise button for a needle ones you push it needle kinda stays inside. Good thing they wasnt expensive, I am.gonna try latter on...just so he calms down. But I might just look for different one tomorrow at a store. He been giving hard time with insulin today...i think he is annoyed as hell of me.lol
 

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It got this relise button for a needle ones you push it needle kinda stays inside.
Ta for photos. You could try taking the clear plastic cap off and just poking with the lancet in the device, i.e. move your hand to do the poke; don't press the button that pushes the lancet forward and makes it go 'click'. Be careful, if you do press the button with the clear cap off, it could fire the lancet across the room! :eek:

BTW, your manicure is superb! :cool:


Mogs
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Ta for photos. You could try taking the clear plastic cap off and just poking with the lancet in the device, i.e. move your hand to do the poke; don't press the button that pushes the lancet forward and makes it go 'click'. Be careful, if you do press the button with the clear cap off, it could fire the lancet across the room! :eek:

BTW, your manicure is superb! :cool:


Mogs
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Yeah...that sounds super dangerous and with my luck...i will relise it right into my eye.lol see if .maybe walmart has different ones.
Thank you, Wenzy loves my cloth(I think I spelled this one wrong) too, specialy when I scratch his back.lol
 
Ta for photos. You could try taking the clear plastic cap off and just poking with the lancet in the device, i.e. move your hand to do the poke; don't press the button that pushes the lancet forward and makes it go 'click'. Be careful, if you do press the button with the clear cap off, it could fire the lancet across the room! :eek:

BTW, your manicure is superb! :cool:


Mogs
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I have done this also, after I realized I could not aim the needle where I wanted using the trigger, and it was hard to find a balance on the depth setting. Because I test Vader in the ear, I go in at a bit of an angle, but if you are testing the paw you may want to take more of a straight shot. I only tried the paw a couple of times; he REALLY hates this more than having his ear messed with, especially if I move quick!

7293C5E1-9A0E-4235-ABA4-A288D1F0A00C.jpeg 52B4348F-E5BD-4757-9DED-CD18575056A3.jpeg
 
I have done this also, after I realized I could not aim the needle where I wanted using the trigger, and it was hard to find a balance on the depth setting. Because I test Vader in the ear, I go in at a bit of an angle, but if you are testing the paw you may want to take more of a straight shot. I only tried the paw a couple of times; he REALLY hates this more than having his ear messed with, especially if I move quick!

View attachment 33610 View attachment 33611
I am gonna try to take plastic off this ones...carefully...oh boy...i be the next one at a doctor's. I tryed again get him, he was fine untill he saw me getting that thing and he preaty much took of. This gonna be a chalange.
 
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