11/03 Junga AMPS testing failure -- what should I shoot?

[jldnvjld]

Junga is newly diagnosed. Our current prescribed dosage is 1 u. glargine BID (twice a day.)

I am still having trouble with home testing. Treats were working for a bit to get him to hold still long enough, as I have a hard time getting a blood sample (and so I got some numbers and was planning to try for a curve this weekend), but now Junga's not interested in the treat while I'm trying to test. I will keep trying and try to figure something out.

I did post to the main board on my ear-pricking problems a few days ago.

In the meantime, just shoot as prescribed and watch for symptoms of hypo when I'm home? I don't know when I will be able to produce a curve, since that is dependent on my ability to consistently get samples, and I'm not there at this point. I still plan to try for a curve this weekend, but I am not very optimistic.

J.

 

[PeterDevonMocha]

Re: 11/03 Junga AMPS testing failure

I know it can be frustrating if your cat doesn't want to cooperate during test time. I do know there are some helpful links on here (but I'm not good at finding them) so hopefully someone can post them here for you to read over. When I test mocha, I set her on the counter and wrap my body somewhat over hers. My right side is butted up next to her left side, and my right arm is over her, kinda cuddling her into my rib area. I have a folded piece of toilet paper ready in my hand (but when I first started, I couldn't hold the tp and everything else so I wrapped my finger in a bandaid!) The meter has the stick in it ready to go and my pen is clicked back ready to fire. I hold the tp behind her ear (the inside area) click the pen and while still holding her ear (cause she likes to flick her ear!) I set down the pen, reach for the meter, sip up the blood, set down the meter and fold the tp over her ear where I poked and apply a bit of pressure to help any bruising. I know its a crazy explanation but I hope you found some of it helpful. Don't give up though!!

 

[jldnvjld]

Re: 11/03 Junga AMPS testing failure

When I test mocha, I set her on the counter and wrap my body somewhat over hers. My right side is butted up next to her left side, and my right arm is over her, kinda cuddling her into my rib area. I have a folded piece of toilet paper ready in my hand (but when I first started, I couldn't hold the tp and everything else so I wrapped my finger in a bandaid!) The meter has the stick in it ready to go and my pen is clicked back ready to fire. I hold the tp behind her ear (the inside area) click the pen and while still holding her ear (cause she likes to flick her ear!) I set down the pen, reach for the meter, sip up the blood, set down the meter and fold the tp over her ear where I poked and apply a bit of pressure to help any bruising.

I'm using a similar technique, although I usually end up pricking his ear about eight times, and milking the ear in between tries in an attempt to get a drop. I don't push the strip all the way into the meter until I see a drop, given how long this takes. At that point, if he's not totally *done* with the situation, he'll hold still enough for me to get the drop sipped up; otherwise he's struggling and sometimes I don't get enough blood on the strip (like this morning.)

This morning I'm pondering how to put a (white?) line on the cap of the black lancet pen to help me aim the pen. The clear cap that comes with the pen is for "alternate site testing" and only makes very shallow pokes. I am guessing that part of my problem with the ear pricking may be that I'm not hitting exactly on the sweet spot (hard to really know). My depth perception isn't good enough to free-hand it; I'm going to have to use the pen.

So I take it I should just shoot as prescribed until I can test consistently?

j.

 

[Kim 'n Shadow]

Re: 11/03 Junga AMPS testing failure

When we first started testing SHadow, it took the both of us to hold her. She doesn't wrestle anymore, she's pretty used to it. If I was here by myself, I would kneal on the ground, put her between my legs with her head facing forward, almost like I was sitting on her, she couldn't go backwards, she couldn't go forwards. Glad no one had a camera, I'm sure it wouldn't have been a pretty picture but it worked very well for us.

Dr. Lisa says in her article that sometimes it is easier to use a 25Ga lancet when you first start out - it makes a bigger hole and is easier to get a blood droplet. She has good hints and gives links to some youtubes that might give you some handy hints. http://www.catinfo.org/?link=felinediab ... Monitoring. I read this article many times trying to prepare myself for home testing. She has some pictures that show her testing Calvin, that is where I learned the "squat over the kitty" technique - not pretty but effective.

Relax and breathe the next time you try it - Junga will sense your tension and he will be more tense. Everybody struggles with it at first. Don't worry, you'll get there.

 

[jldnvjld]

Re: 11/03 Junga AMPS testing failure

Dr. Lisa says in her article that sometimes it is easier to use a 25Ga lancet when you first start out - it makes a bigger hole and is easier to get a blood droplet. She has good hints and gives links to some youtubes that might give you some handy hints. http://www.catinfo.org/?link=felinediab ... Monitoring.

I have read that article over and over and have watched bunches of youtube videos.

I am using a 26G lancet (I put that on the spreadsheet), which is the biggest one that Relion makes (took some hunting to find those.) That should be quite close to the 25 gauge lancet that Dr. Lisa suggests.

I have tried the between-the-knees-on-the-floor position too. It's just that when I'm holding the ear/head with one hand and the meter with the other, he can still wiggle his head, and is pretty wiggly if I've been repeatedly stabbing his ear. It's not so much the body at that point.

I will keep trying. So I guess I should just shoot as prescribed until I can get numbers?

 

[PeterDevonMocha]

Re: 11/03 Junga AMPS testing failure

hmmm I really don't have any advice as far as what to shoot, if you cant test her BG's. I know that is what you are really hoping to get an answer too! I will say that in the beginning, when we were first learning to test, I was here and so was peter, but then he had to go to work (we started on a holiday weekend) and when I tried testing on my own for the first few tries mocha really fought me. I had to start using a very authoritative voice, one I don't normally use with mocha. I firmly told her NO MOCHA ... and she would settle down just long enough for me to get that blood test in .. I had to do it the first few times but now she lays down like a pro!

 

[Anne&Muffin (GA)]

Re: 11/03 Junga AMPS testing failure

When I first started with Muffin, I had to use the 26g lancets and press the pen pretty hard against her ear before poking. She was always pretty good about sitting still for it, tho.

 

[Kim 'n Shadow]

Re: 11/03 Junga AMPS testing failure

J - edit your subject line to something like "still shoot?" so the dosing experts will know that you still have questions.

 

[Laurie and Mr Tinkles]

Re: 11/03 Junga AMPS testing failure

I would try using the clear cap....that's what I use. It makes it easier to see where you are poking. It should poke deep enough to get blood. Some people find it helpful to draw a line on the cap to help you line it up with the sweet spot on the ear.

Other ideas for you to try:

Make sure you are putting a little pressure on the ear with the pen before triggering the lancet, keeping counter-pressure on the other side of the ear. Keep pressing after you trigger it, count to three. You should see the blood drop bead up during that time. Some people use a flashlight on the other side of the ear to push against and it helps you see the vein and line up the sweet spot easier. Are you warming the ear with a rice sock? I just use friction...rub the ear to warm it up.

We really want you to be successful testing, shooting blind is really not something we like to see....keep trying on the testing. If you post on Health with your location (city,state) and ask for home testing help, someone in your area may be able to come and help you learn.

 

[Jenny and Sue]

I have not been successful with ear testing. I test using the two back paws. I hold Sue like a baby in my arms on his back and test the foot. I know some people don't like paw testing, but it works for us. You might give it a try. It's better than no test at all.

 

[jldnvjld]

Re: 11/03 Junga AMPS testing failure -- what to shoot?

We really want you to be successful testing, shooting blind is really not something we like to see....keep trying on the testing. If you post on Health with your location (city,state) and ask for home testing help, someone in your area may be able to come and help you learn.

So you would suggest no insulin until I can test reliably? Is that what most beginners do?

When I last posted on 'health' with ear-pricking problems, someone suggested adding my location to my profile, which I did.

This morning I added racing stripes (lines) to the black cap of my lancet pen. I will also try the clear cap. I did try warming the ear, but he quickly associated that with the pricking to follow, which meant warming got him squirming faster. And so I dropped it in favor of trying to make the process faster.

 

[jldnvjld]

I have not been successful with ear testing. I test using the two back paws. I hold Sue like a baby in my arms on his back and test the foot. I know some people don't like paw testing, but it works for us. You might give it a try. It's better than no test at all.

Junga doesn't much like having his feet messed with. But I'll add that to my list of things to try.

J.

 

[Sienne and Gabby (GA)]

Is there a way to adjust the depth for the lancet prick on your pen? You may want to see about adjusting it and using the clear cap.

Most of us are very apprehensive about shooting blind. You are seeing numbers under 100 with 0.5u. It's very important to know what Junga's numbers are especially once you are seeing numbers in this range. If you can't test today, I just can't bring myself to tell you to give insulin with the potential of numbers tanking and your not knowing what's going on.

I'm also not sure why you are considering increasing the dose to 1.0u. I would not consider increasing given the response you've been getting. You need to keep your doses consistent. At this point, I would not change Junga's dose.

 

[Perry and Sooty]

We test Sooty on the kitchen counter top and I like to get him lying on his side, that way he can't back away. I just then select whichever ear is next, bend it back with my thumb over the first finger, lance the inside edge freehand (no clicker) - at about a 45deg angle, trying not to go right through the ear and out the other side (but I often do!). If you are nce and firm with him, he's as good as gold and usually purrs through the whole procedure - but if you're at all apprehensive and/or don't hold his head and ear in a way that conveys "don't you dare move untl we get that drop into this meter!" then it can get a bit funny and he'll try and duck away, shake his ear, etc. We very rarely lose a drop these days though!

To summarize - ya gotsta be Firm - but gentle too - basically, pretend you're a Vet !!! And corny though it may be, "practice makes purrfect" - there's no shortcuts, I'm afraid!

 

[Anonymous]

Welcome to the "No Luck" club! Both my friend, Dixie, and I do paw pricks and we are using (or going to as soon as they come) 26 ga lancets. Save the treat for after and try cooked hamberger. As for dosage - I don't know - but, plenty here do and will advise you. Good luck.

 

[Marje and Gracie]

Are you warming his ear first? I tried the pens and didn't like it so we freehand. At first, I was putting a cottonball on the inside of her ear so when I pokeyed the ear, I didn't stab myself but I wasn't getting good sticks. So I found an old contact lens case..the kind with the two compartments...I took one of the lids which is about an inch in diameter and we put that on the inside of her ear and then pokey the outside. We're able to use 31g lancets now and just lightly stick the edge. It takes practice but you'll get there and then hopefully, he'll get more comfortable with it. It also seems that Gracie's ears have gotten less sensitive to the pokeys. The other thing I do is immediately put a cold, damp baby washcloth around the ear where I stuck her to stop any bleeding, prevent bruising, and hopefully take away any discomfort. I know it's tough...hang in there....you really need testing to be able to effectively monitor him.

 

[jldnvjld]

Is there a way to adjust the depth for the lancet prick on your pen? You may want to see about adjusting it and using the clear cap.

I am going to try the clear cap, which doesn't have a depth adjustment. I have the black cap set on 5, which Dr. Lisa says is the number she has the most success with. Others on 'health' have suggested I try a shallower setting.

I'm also not sure why you are considering increasing the dose to 1.0u. I would not consider increasing given the response you've been getting. You need to keep your doses consistent. At this point, I would not change Junga's dose.

I put the prescribed doses on the spreadsheet, but they're not very prominent, I know. The prescribed dose is/was 1.0 BID as of Monday evening, down from 2.0 BID on the 23rd. The 0.5 is/was a stab in the dark on my part, and maybe I shouldn't have done that, as I did make the doses inconsistent.

In despair,

J.

 

[Sienne and Gabby (GA)]

If you are getting green numbers with 0.5u, I would stay there and not go back to 1.0u. However, since you're seeing greens, if you can't test, you may need to lower the dose further for safety's sake until you can test consistently.

 

[Pat+Raja+Shadow (GA)]

I find that a folded tissue under the ear is good because it and my finger give a good backing for the ear. If you do not "feel" the lancet cap with your under finger, you will just let the ear bounce away, know what I mean? you need your finger under the ear to press the lancet cap onto the ear...you will feel it through the ear with your finger.
You know, I thought my cats would hate me for doing all this poking and pricking....
I had two diagnosed together last August.

I realized that shooting insulin when I do not know the numbers but testing is like driving down the highway at 90 mph with a paper bag over my head. I needed those numbers! It was non-negotiable for us. I HAD to learn to do this and my two cats needed to go along with it....it was that simple.

Now, my Shadow jumps up on the testing towel and lays down to get both his tests and shots....
They son realize that you are helping them and they learn that this is just part of the new routine. The beep of the meter is like the signal that we need to get serious and pay attention.

Don't laugh, but I do talk to my two very seriously and I explain exactly what is going on. Not sure why it seems as if they understand, but I always tell people that it is worth a try. It will get better as you get used to doing it. It will become like a familiar routine. But it is extremely important. Actually, it is vitally important.

I agree with Sienne that 1.0u is way too much insulin if you are not testing. And with those greens that Junga is getting on the .5u it is questionable whether that is a safe dose at this point. IF you were testing, this would be sooo perfect....but if you cannot test those lower numbers, it can be a dangerous situation.... The insulin is working beautifully but if you are not able to see his BGs then we have a problem....
Watching for symptoms is not the way to go. We watch the numbers with our meters and when they get lower numbers, we can intervene with high carb gravy to bring them up and they will not experience a true hypo. We monitor closely at the lower numbers so our kitties are not in danger...

I think you have the tools now to test and certainly you have seen enough videos and heard enough hints...now, it is just the practicing that needs to be done. Maybe practice a little more, okay? Have you tried the meter on your own finger? that might give you a good idea of what should happen. Maybe try that... I do hope you can get this...you will feel so much more in control when you are able to test...it will be sooo good!

 

[Laurie and Mr Tinkles]

I agree with what Sienne and Pat are saying...Junga is seeing greens with 0.5u, I would not raise the dose back up to 1.0u. I also agree that the 0.5u may not be a safe dose either, so you may need to reduce further if you can't test. Please know that we have Junga's safety in mind when we say this, it is much better for him to be high than too low!

I don't think it was a mistake to reduce the dose to 0.5u, I think your instincts are good on that! We need to talk about no shoot numbers though....shooting a number under 150 without any data is risky, so if you have that situation again, please post and ask for help before you shoot, ok? Please don't despair, you will get him on track!

I agree also with Pat about continuing to try to test...it does take practice and persistence, you'll get it!

 

[Dyana]

I know most people test on the back of the ear, but I've always tested on the inside of the ear where there's less hair.
Just my two cents.

 

[jldnvjld]

Re: 11/03 Junga AMPS testing failure

I would try using the clear cap....that's what I use. It makes it easier to see where you are poking.

Thanks; the clear cap works a little better. Now I'm poking him on average of three times to get a sample, rather than eight or so.

J.

 

[Miriam and Putty (GA)]

If Junga is impatient with your poking you could always wrap him in a little blanket. I had to wrap Putty like a burrito for about a month because he was very difficult to test and I had a hard time getting blood. Now he just jumps onto the blanket and lets me test. I don't have to wrap him or give him treats. I never thought it would happen.