I never even considered using a lancet more than once (with the exception of multiple pokes for one test). 200 of them costs me like $4 at Walmart. I've made it through, I think, 4 bottle of test strips and still have about 1/4 of the lancets left. Just thinking sterilization-wise... I use one per test. If the point touches anything I get a new one out. If I were to use one all day, I'd sterilize it between uses, just to be safe. At the super low cost of lancets, I'm not willing to risk getting his ear infected by poking with a dirty lancet.
I also wondered about using the paw... but just the fact that they use the litter box (plus just walking around) makes me think there's a far greater chance of infection. JMHO, I wouldn't want to stick my hand, with fresh poke holes in it, into their litterbox - no matter HOW frequently it's cleaned.