Erratic BG --advice on doing first curve

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heidi

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Hi, everyone.
I'm having newbie blood testing issues. The first test I must have hit a vein because Frodo bled all over the place. My meter read "hi" which means greater than 600 (about an hour before shot). After at least 30 pokes in four days, I finally got enough blood for a second test on Sat. Frodo's BG was 462 at about 8.5 hours post shot. Yesterday after three pokes (I finally used the lancet free-hand and got too much blood again) I got a 52 reading at 5.5 hours after his shot. Obviously that one has me worried. . . He showed no signs of hypoglycemia, but I fed him just in case and he seemed fine the rest of the day. I could not get enough blood for another test later.

Anyway, the erratic BG readings have me worried. As does my lack of ability to draw enough blood most of the time. I am going to try to do a full curve tomorrow since it will be the only day I'm home all-day this week. Here is my blood testing protocol -- I am warming Frodo's ears with a rice sock for about 15-30 seconds post prick and am trying to do some ear massage although he hates me touching his ears. I am using a 28 guage lancet. I am trying to hit the sweet spot but most the time I don't get any blood, let alone "enough" blood. I keep the sock behind the ear and the lancet device pressed against it, so it has something to "poke against." I got desperate yesterday and did a free-hand poke without the lancet device but Frodo hated that and wouldn't let me close to him again for an hour afterward (I did get enough blood to test--too much!). I am giving him lots of pats and a treat afterwards, but he is still stressed and unhappy about the procedure. Any other ideas? Part of my problem is that he doesn't like being restrained when my 3-year-old twins are in the room since they are loud and unpredictable, but I'm a single mother and trying to find a quiet place to be alone with the cat to test is almost impossible--especially since it took almost 15 minutes for me to get enough blood to test yesterday.

Thanks,
Heidi
 
Could you try and do it while the kiddos are napping?
Where in Missouri are you at?
What dose of what insulin are you using?
 
Maybe try using the bathroom or a bedroom and explain to your children how important it is? Also, have you switched yet to the Lantus? If you are still using that N insulin, that is the reason for the ups and downs. N is fast acting and short duration and basically is not a good insulin for a cat.
 
heidi said:
I am warming Frodo's ears with a rice sock for about 15-30 seconds post prick and am trying to do some ear massage although he hates me touching his ears.
Click to expand...

Did you mean that you are warming his hear before you prick? or after?

I warm my cat's ear before I prick. I use the lancet device with a setting of "2". I use a cotton round on the other side to hold the ear steady and have something to to poke into should it go through the ear.


~Monica
 
On your lancet device, there should be an adjustment dial, something to adjust the depth that the lancet pokes. On mine, it goes up to 5 and I have it set at 3 or 3.5 for my cats. Also, I don't aim for any spot, just the general vicinity as cats' ears will 'learn' to bleed in time. By hitting bang on the vein, you can expect a gusher.
I prefer the lancet device as it's quick and cats are fine with a fast poke rather than a slow manual one by hand..... try it on yourself - poke yourself using the lancet device and then poke yourself again free hand.

If you can give your type of insulin and the dose and your shot times, people will be able to help better, as the type of insulin will determine how people reply to you. Some are longer lasting, and some have dose based on the lowest number but others are based on the numbers at shot time. If using N, it's pretty harsh, so it would be great if you could switch to one of the smoother and longer lasting insulins, and you will see much improvement.

I think I would want to include the kids, not hide the issue from them. If you can explain that the cat needs medicine and you need to test first, get them to help in some small ways and let them watch to see what you are doing.

It's best if you can go with the lancet device and knowing the BG at shot time is quite important to know.
 
Thanks for your replies, everyone.
I switched Frodo to Lantus 8 days ago. He gets 1.5 units twice a day (he's a very large cat - ideal weight around 12 pounds, probably at 13 now). The vet wanted me to give him 2.5 units but I wasn't comfortable with that dose until I got blood testing under control. He gets a low carb canned food.

I am warming the ear before the poke. I have the lancet device set at the deepest setting. I personally bleed like crazy with this setting . . . I'm using the 28 gauge lancet. Maybe I need the 26 gauge? I agree that the free-hand poke was awful. I don't want to do it again, but I'm not getting any blood or just a tiny speck with the lancet device. I'm just so frustrated and I feel like I'm traumatizing my cat. He really hates this. I have been using the rice sock as the "behind the ear" pressure since this seems easiest, but I could try cotton tonight.

I've talked to my boys about the kitty being sick and needing a shot and needing his blood tested. They are trying to be quiet so they don't disturb him, but it is hard for them. None of my cats (all former ferals) have warmed up to the boys. They are all very leery and don't want the boys too close to them unless it's on their terms. Unfortunately, this means I'm getting scratched up terribly by Frodo as he fights to get away from me, just because one of the boys fell down and started crying and running toward us. If he's just sitting calmly in my lap when a boy comes running, he jumps down and runs away--no big deal. But because I'm restraining him for the blood draw, I get the freak out response and lots of blood - my own!

Sorry. This is sounding like a bunch of excuses. I guess I'm just frustrated and really want to help my cat. Do you think a partial curve or an erratic curve (not every two hours) has value? I might be able to arrange for my mom to come entertain the boys a few times tomorrow so that I have at least a few times to test Frodo alone. I'm thinking this might be necessary while we're both trying to figure this out.

Thanks again.
Heidi and Frodo
 
Hi Heidi

My cat does not trust my kids either but is good at being tested...if my kids were around though I'd have no chance. you have to do what you CAN do and not drive yourself crazy, ok?

You don't need to curve all the time, but you should try and figure out how low he's going as that will help with dosing. The low number you got is lovely, you just don't know if he went lower or not, so why not do spot checks around +6 and then vary a bit by 30mins, etc. to see what you get?

Jen
 
Good on you doing home testing. I had a lot of problems with testing my girl in the beginning. We did use the heated sock and 28 gauge lancets and even had the device on the highest setting of 5.
This video helped me a ton. You might try it out. Yes kitty won't like it but it makes it easier to get the test, and testing will help save his life!

http://www.youtube.com/watch?v=kXyrKSJTlYA&context=C35b7d4dADOEgsToPDskLMsK6hmPqAYFj-MpeQfV7B

Either way it does get better. the first week i despaired of ever getting a bloodtest to work. She was so squirmy, and her ear didn't bleed barely at all. Now we don't even use the sock anymore and usually can get blood by the third poke. Sometimes i still need to noodle her in a towel if she is having a day she wants to be a pill. I always give freeze dried chicken treat after blood test and after shot.
 
Hi Heidi,

I'm still new at hometesting, but it's already gotten easier than it was the first few days. We've been at it for a couple of weeks now, and are still working on doing more frequent testing. I've learned that the longer I warm his ear, the better. At first I don't think I was warming his ear long enough. Sometimes I don't get blood the first time and I have to warm some more and try again. I'm using 26g lancets now, at the highest setting, and I don't get blood every time. Everyone says the cat will get more used to it as time goes on.
I would also second the suggestion of treats with every poke- successful or not.
Good luck!
 
Heidi, I am glad to hear the boys are trying to be quiet, so what about if you planned the testing.... when it's time to test, tell the boys it's test time, have everything already for testing, and ask them if they can be silent for 2min, not to make a peep, so you can test the kitty and give meds. Maybe if they know it's quiet for test time, it will be easier for them. Thank them after for being so quiet as it was so helpful to kitty.
 
Wonderful that you're testing!!! HUGS!!! It will get easier!

Suggestion - work WITH the boy's energy. Let them choose a stuffed cats (or other animals if they want instead) maybe even saying "maybe THAT one is diabetic like Frodo" or something to make a game of it. Also get a kids doctor's kit - need something to represent your lancet pen, your meter and a 'shot'. They're young so you can make lots of stuff be 'xyz' When it's test time, while YOU get ready, THEY have to wash hands, get their stuff out, get their cat/bear/dog/dino and get in their position (where you can watch them while you work). While YOU test or shoot, THEY can test and shoot - and learn about diabetes at the same time. Maybe THEY get a treat along with Frodo.

BTW - if you're not giving Frodo a treat after every 'doing', you'll find it MUCH easier on all of you to begin. Got to be something low carb, we use freeze dried chicken and liver from the dog treat section of PetSmart. No other ingredient, just freeze dried meat. Every test and every shot KT gets 3-4 small pieces.

HUGS!
 
GOOD ON YOU you are doing a great job. It took me and Akbah quite a while to work out a routine and I have no shouty boys to fill my heart with joy and scare my cat.
The comments above have as much wisdom as I can think of. Don't give up. Determination was a key ingredient when I first started those miserable poke sessions with no blood and everyone unhappy. This too will improve. Ears really do 'learn' to bleed. And you are a good catmother. Your cat will forgive you (especially as the poking gets easier and he gets the hang of poke=treat)
 
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