Am I doing blood test the right way? Help!

I just noticed the link at the top for the device that shows where the vein is. I've been getting blood from edge of ear and I'm sure I didn't hit the vein. Will this make her values wrong! confused_cat

Leaving for dental appointment and will check back... :smile:

 

As far as I've always known, it's fine. The major vein is easier to get a blood draw from, but the surrounding capillaries are carrying the same blood.

 

I always use the edge of the ear, no probs getting the right BG as far as I know

 

No worries, you're doing it right!

You want to try and avoid the vein, the capillaries are in that 'sweet spot' between the vein and the edge, and that's exactly where you want to test from. I can't remember why exactly, but hitting the vein every time causes problems down the road--something about more bruising and damaging the vein from repeated testing. Im sure someone here knows exactly why. Occasionally, I accidentally hit the vein, and the bgs are always well within the same range we see with my fd. It doesn't hurt them, but should be avoided most of the time.

The bg values are the same from the vein and the capillaries, and it sounds like you are doing it right.

btw, it must be dental week--I'm going on wed ;-)

 

Thanks so much everyone...you're the absolute best! :mrgreen: I'm apparently determined to make myself crazy! :roll:

Unfortunately for my pocketbook, it's dental month for me :shock:

I'm going to do a spreadsheet as soon as I can concentrate on the instructions, but so far since I've been able to test, Buffy's numbers so far:

May 9 - withholding food - before meal - 447
30 minutes after feeding/PS - 474
1 hr after shoot - 451
2 hr after shoot - 312
3 hr after shoot - 295 - midnight at this point

May 10 - free-feeding - PS - 385
4 hr after shoot - 200

 

You don't want to hit the vein. You want to aim for the sweet spot between the vein and the edge of the ear. I would not worry about the BG values being affected appreciably if you accidentally hit the vein. You will know when you hit the vein because it will most likely be a comparative gusher :smile: . Everyone every now and then accidentally hits the vein - it's not the end of the world. It should just be minimized so that the vein does not become damaged from abuse. Also after you get the reading, do apply pressure to the area for about 20-30 seconds. I use two cotton balls. This will help prevent callusing and bruising over time.

You are doing good. :smile:

 

Gator and H, lol 'gusher'!!! I did exactly that this morning, big time!!!! And to Buff-Puff, yes sounds like you are doing just fine!

 

looks like you have some prettier #'s to look at today :mrgreen:
as far as the bloodletting, back in the early days you were initiated in 'the vampire club' just for getting blood! get your blood where you can...and be proud

 

Oh my, was it hard to control? Hope it wasn't too painful for kitty.

Gator & H told me the same. The numbers actually looked good to me yesterday, and not as good today. I'm sure there are bound to be slight variables, but it threw me for a humongous loop. I've been trying to think whether I did something different. The only thing I came up with is she had some FF Tender Beef and may have eaten a bit much, probably hungry for something besides fish or chicken. And later she had some 9-Lives Turkey and Giblets, but didn't eat as much of that.

:lol:

 

No, not hard to control really. It's a comparative gusher, like oops and grab the cotton balls quick. But not like blood squirting on the ceiling or anything.

 

That's good to know just in case!

Buffy's number PS just now was 571 - any thoughts on this? Is it unusual while on insulin?

 

That's high. What was the "ERR" about - do you have any better description of what happened there? Do you think you could measure out a .25u increment to 2.25u? Do your U40 syringes have a half unit markings?

BTW you are doing a good job on the testing! Your dedication to is helping you more forward faster with Buffy's treatment.

 

The ERR was an error on the meter. Not sure what happened, but when I went back to try again, she took one look at me and ran under the bed. I figured she was stressed and left her alone for an hour.

I just gave her 2 units. No the U40's are in increments of units only. Should I give a slight amount more? What should I be watching for? She has seemed unusually sedate for the past few hours. Hoping she will perk up soon.

I went ahead and tested again -- 1/2 hour post shoot 422. Whew.

 

No, you should not give more (edit: until tomorrow morning). I was thinking about you potentially upping the dose to 2.25u tomorrow morning [sorry I was not more clear about that]. No half unit markings, huh? Darn. Maybe you can practice with some water measuring different amounts 2.25, 2.5 and 2.75. The important thing is to try to keep them consistent from one dose to another so a dose of 2.25u now would be the same as 2.25u you gave at another time. Dose this make sense? This is where the U100 syringes would come in handy

 

Yes, that makes sense, I just misunderstood. I'll get some U100s for such a time as I don't trust myself.

I'm looking for the thermometer, as she feels warm to touch. Illness would drive up her BG.

 

If she's hiding under the bed for testing I can only imagine what's she's going to do when you take her temp!

If you did get the U100's you would just use them all the time instead. Some folks get them locally at their local pharmacy or even Wal-mart. It's just important to get the U100 syringes with 1/2 unit markings. The next most important this is to the the 1/3cc sized ones. The 5/16 inch "short" needles are preferred too. The gauge is not that important but the smaller the gauge [and the higher the gauge number] the better. 30g are common but if you can get 31g than that's even better.

Then when you do get them, make sure to use them with the conversion chart linked in the sticky at the top of this forum - very important!! If you have any questions before dosing with them please ask if you are not 100% sure about what dose you are actually giving.

 

:lol: She lucked out because I can't find the thermometer. So I decided to check for ketones in her urine. Should have seen the way she turned around a looked at me when I stuck the little cup under her. :mrgreen: But no ketones.

I got her to play for 5 minutes, chasing a cord, so she's feeling better. Then she wanted to go downstairs. She loves to sit down there in the den and gaze into the backyard where the floods light up the yard all the way back to the woods and she can watch any critters that are out and about - mostly neighborhood cats and deer.

So I need U100 with 1/2 unit markings, 1/3 mL size, 5/16 inch, 30 or 31 gauge.

I'll definitely be asking questions. Thanks!

 

I have to dissagree with the gator and with those high #'s i would not let another cycle go buy with #'s verging on 500 without a breakthru dose. go up a whole half unit. live a little. not to make light of it but gator she has to bring those #'s down.

 

lori is right, the numbers do need to come down. Either way you are hearing from both of us that you probably want to up the dose. Upping by .5u when you are already at 2u is not a super big jump. You are testing a good amount so I don't think you are going to miss anything important. My only thought was to potentially minimize any chance of rebound especially with that sharp early drop you have gotten. But again you are testing enough [and you have shown that Buffy is capable of normal looking curves] that you should be able to spot any rebound.

So yea, either way, tomorrow morning my suggestion would be to up the dose by at least .25u and up to .5u. .5u is probably easier to eyeball so... If you were using the U100's that range would be .2 to .4u.

Thank you lori for chiming in. I'm glad we have another set of eyeballs watching. :smile:

 

Okay. So if numbers are 500 +/-, go up a half unit -- or go up on this mornings dose regardless of PS number in order to accomplish...what? I've marked a syringe just in case.

Sharp early drop meaning tonight's numbers on the half-hour post shoot? I'm not sure what rebound is with respect to diabetes. What does it cause, a drop, higher numbers cycle?

 

No. The recommendation is to go up .25u to .5u as your new dose for a few cycles and see how that dose settles. If you were using U100's the amount would be .2 to .4u. You would keep that dose unless the PS drops below 200.

"Sharp early drop meaning tonight's numbers on the half-hour post shoot?" I'm not sure what that questions means - can you re-phrase that.

You can read a little about rebound here:
http://petdiabetes.wikia.com/wiki/Rebound

It is not the end of the world, and it can be caused by just dropping to fast or by dropping to much so that the liver might "panic" and release glycogen. One generally fixes rebound usually by backing off a little on the dose for a few cycles. Of course there is the whole "panicky" liver scenario but we are not there yet. If you want to know more about panicky liver you can search the PZI forum for it.

You'll probably want to start a new topic in the format of "month/day catname"

 

if your certain your using the syringe correctly, a u100 syringe your next reading of over 400 IMHO should be on the 5 + 1 little line which translates to 2 1/2 units. (corrections on that math?) becuase little buff puff is not coming down sufficently at mid cycle and those +12 are much too high to sustain his health.

 

2.4u of U40 insulin would read "6.0u" on a U100 syringe. On a U100 syringe with half unit markings this would be 2 ticks above the 5u line as each tick or line is a half unit. 2.2u would be 1 tick above the 5u line on a U100 syringe and would measure "5.5u."

Here is a more visual explanation:
http://felinediabetes.com/FDMB/viewtopi ... 13#p112013

 

I don't have U100 yet, so I've drawn a line on the U40 at halfway point of 2u and 3u. I'm thinking I may want to do .25 for a few cycles though. Is that how you would do it, or would you go ahead and do .5?

Sorry I'm not clear. Last night, 05/11/10, I checked at the half-hour point after giving 2u and she had dropped from 571 pre shoot to 422 post shoot within a half-hour. I thought that's what you meant by sharp early drop. But I think I should take into consideration that the 571 number was 30 minutes after a full meal. But your opinion would be anything over 400 tonight and should I still go up .25u to .5u for a few cycles?

 

I would raise the dose at the next opportunity you have and hold it at that dose unless Buffy drops below 200 on the PS. My personal preference is raising the doses in small increments. HOWEVER, I ALSO think that dose changes should happen more frequently if the changes are smaller. Smaller more frequent changes are my thing. But I'm far from an expert and I tend to do things a little different than most around here. So if you did up by only .25u then I wouldn't wait more than three cycles to up the dose again if you were not getting results [PSs coming down - even slowly] with that dose. Lori is right too and upping by .5u at this point is 100% fine too. As I said too, it might be easier for you to eyeball .5u and have that dose be a more consistent dose. Upping the dose is warranted at this point and you can make your own decision as to how much you want to up it - I would not up it more than .5u at this point though.

Yes, that is kind of what I mean by sharp early drop but I did not mean that one in particular. Buffy has a trend of seeing drops before +2 which would be considered early. Besides this 'early' drop [which is not a problem at this point], Buffy seems to be having a nice looking curve going on today.

Again, you are doing a great job with all the testing. You don't need to be staying up all night at this point - it is important you take care of yourself too. The caregiver can't give good care unless she is feeling good. :smile:

 

From the article:

So how do you know for sure which is causing rebound? From the article:

Isn't this saying it's possible the vet upped the dose too much last week, from 1u to 2u? What would happen if I went from 2u to 1.5 u? Or does it stop the rebound effect by upping dose for a few cycles?

Sorry I'm not totally understanding rebound and what needs to be done. I've been running on about 3 hours sleep/night since last week and I'm having trouble comprehending all the info overload I've experienced, but I appreciate your help with this. Maybe someone could write a simple "rebound for dummies" article. :lol:

 

I think I see what you mean. She's going from RED to YELLOW and should be going from RED to PINK -- then YELLOW. Then she should slowly climb the same way, with no drastic highs - lows - highs.

I know. Very good advice, wish it were that simple :smile: I feel I'll miss a harmful time for her, so I make myself watch for it. So far though, she's like her old self at night, rolling on the floor, pestering me to follow her around, etc. Maybe I can relax when her numbers aren't so weird -- looking forward to that!

 

It's on a case by case basis and you are not expected to know what rebound it as this point. After seeing it in a number of spread sheets you might get a feel for it. But is is just something you kind of have to see to spot - or at least it was that way for me.

It is not saying your vet upped the dose too much last week. I think it will eventually be shown that that raise in dose was just fine. If you went from 2 to 1.5u then you would probably get a shallower curve and a smaller "delta" or change from high point to nadir. Your PSs could even go up. Reducing you dose is not what I would do at this point. You are getting fairly nice curves, they are not high to quick low to quick high which is a sign of rebound. And the curves are not flat. Ideally, you would like to raise the dose until you could get the PSs to come down slowly.

AFAIK that is the rebound for dummies article. :lol: Rebound is not some bogey monster you need to fear. It is just something that can happen and there are ways to fix it. Besides perhaps slowing down the regulation process, it is not something that is considered particularly "bad" for the cat or something to be avoided like the plague or something.

Kind of, yes. The drastic/fast high, low, high thing [which is not going on right now] can potentially be a sign of rebound. I wouldn't say she would have to pass though a pink in order to have the 'perfect' curve. I look a numbers more than colors but the colors do give an slight indication I guess. Usually, they will not even start dropping until AFTER +2. But "usually" is actually rarely usually because we are dealing with cats here after all - their job is to keep us on our toes. So drop before +2 is what I mean by early - this initial drop is called "onset." What I mean by fast is the about 32% drop in 2 hours on the morning of 5/11. But honestly that is not that fast a drop over two hours assuming she started dropping right after the shot [which she probably didn't]. Worrying about too much right now might just cloud the path forward even more. :smile:

I commend your willingness to get into the detail and want to learn as much as you can right now. But please make sure to take care of yourself and get some sleep.

 

Just remember you can use food to manipulate the numbers, too. If you see she has dropped a lot in the first hour or two after shot time, you can feed a small portion of LC to try to lessen the drop.

 

Feeling a bit of relief.

Okay. With all that said, you would still go up by .5 on this evening's dose, but I should continue that dose for several cycles - how many, until numbers become more curvy?

:lol: I was afraid of that!!! It was pretty simple, but slightly confusing... @-) ... or is it just me? Don't answer that :mrgreen: Anyway - as long as I can take time to learn it all, feeling okay about it.

That's good to know! I was getting the impression it was a bogey goblin or some such...:razz: ...so thanks for setting me straight. If anyone asks, I can attest to sleep deprivation causing strange things to happen to the mind - paranoia for one. Serious here!!! nailbite_smile

 

Good point. I've done a little of that, especially when I've noticed she hasn't nibbled in a while. I have several opened cans in the fridge for the times I've done that as I don't seem to remember to thaw in time :roll: and she doesn't like it cold, of course.

I've also been trying to find a low-carb treat to reward her with, what with all the puncture wounds she's been tolerating so well. Her vet said give a few morsels of Whiskas dry as a treat, which I have been doing, and may be doing harm with that. It's probably too high carb even just a little amount. I did pick up some Whiskas milk as she's been sitting by the fridge every night begging for milk, and I think me giving in to her might have played a part in the big PS spike.

 

With all that said, I would up the dose by either .25u or .5u. Your choice. If you choose .25u and you are not seeing any improvement on the PSs then I would not sit around and wait; I would absolutely up the dose another .25u after no more than three cycles. If you up by .5u then I would wait at least three cycles to see how things are going. Other than that I'll let Lori speak to anything potentially after that - I think it would be a wait an see thing.

No not more "curvy" you are looking for the PS numbers to drop [even slowly] from one PS to another. Even if they do not drop every time, if there is a lowering trend that is fine too. When the PSs drop you will probably observe the nadirs drop too. And of course if you are below 200 on a PS then skip that dose and let us know.

On the treat thing, the Halo Liv-a-Littles are popular but are a little expensive.

 

As Gator mentioned, Liv-A-Littles are indeed popular and are often called Kitty Crack. ;-)

I buy frozen chicken breasts and cook one at a time in a pan with a little bit of oil. I cut it up and keep the pieces in a Tupperware in the fridge. They absolutely LOVE it (Buzz and 2 civies) and it is way cheaper than buying pre-made treats.

 

What kind of PS numbers am I aiming for - below 400?

Too late to talk about expense :razz:

 

That's what Pounce was for her - she can't have them any longer and doesn't understand what's up. Every time I walk near "that cupboard" she starts doing her figure-of-eight dance around my legs.

I could do that. Do you cook through or leave partially uncooked?

 

I cook all the way through. :smile: