? Help with pricking the ear for BG testing

[Justyn]

Hi everyone, my sweet bub Socks' is home from a 4 day hospitalization at an ER vet for DKA and Pancreatitis (not a good combo) - but now that he's home, I've been testing him much, MUCH more than I used to (old vet said only necessary to test once/week - HAH). I've learned a lot since then, but am testing him at every chance I get. I haven't updated my spreadsheet but have gotten each AMPS and PMPS since he was discharged on Saturday.

That being said, I normally use the 'sweet spot' on one of his ears that has been trained to bleed - but my god, I HAVE to switch it up as his poor ear is SO bruised (i know i need to apply pressure after the poke but he jumps out of my hands as soon as ive got the blood) . I poke between the vein and the edge of the ear as I've read online..

I've tried several times poking his other ear in that same area... but NO luck. And with his bruised ear, I can hardly get any blood out of it either.. A warm sock doesn't work for him, because he just knows whats coming, so i just warm it up with my hand/breath for a while.. But as for getting the other ear, I don't know what to do! I tried pricking almost 10 times and not even a speck of blood would come out... I AM using ultra thin lancets, just to make it less painful for bub, BUT i'm thinking that could be the issue too.. Any tips are welcome!! I do not think he'd handle his paws being poked...

 

[Kris & Teasel]

One thing I've read on here is that you should try a lancet that's not too thin if you're having trouble. Slightly thicker lancets might help your problem. Apparently, the human lancets come in size ranges for different locations. Maybe ask the pharmacist about this?

 

[Justyn]

Gotcha, yes I had actually picked up the 'ultrathin' ones to hope to hurt him less but it surely has taken more jabs - so I will definitely pick up some of the bigger guage!

 

[Chris & China (GA)]

Yeah, look for some for "Alternate site testing" that are 25-28 gauge....they're still very sharp so don't really hurt any more, but they make a slightly bigger "hole"

It's also not at all unusual for one ear to bleed better than the other...China's good ear is her left....poking her right ear is like trying to get blood out of a rock.

You might try getting some of these kind of cosmetic pads.....it gives you something to "poke against" (so you don't get your finger) and then you could quickly fold it over to apply at least a few seconds of pressure

 

[Justyn]

Yeah, look for some for "Alternate site testing" that are 25-28 gauge....they're still very sharp so don't really hurt any more, but they make a slightly bigger "hole"

It's also not at all unusual for one ear to bleed better than the other...China's good ear is her left....poking her right ear is like trying to get blood out of a rock.

You might try getting some of these kind of cosmetic pads.....it gives you something to "poke against" (so you don't get your finger) and then you could quickly fold it over to apply at least a few seconds of pressure

Thank you so much for the advice! Just jabbed his opposite ear a few times after rubbing a small rice sock (worked pretty good). But so odd.. His BG was 460 or so just now.. BUT his stools werent as loose today so i think they may be affecting it.. OR he may have gotten very low today and may be bouncing but i watched him all day like a hawk and he napped only for 30 minute periods or so, and groomed himself lots, but seemed good, not low... But i cant risk him getting ketones, so i put it back to 2u to get him down at least... Will check him a bit later tonight

 

[yukon25]

but he jumps out of my hands as soon as ive got the blood) .

Try wrapping him up in a towel like a purrito. Mine will tolerate that, but of course he gets lots of behind the ear scratching from me first. He'll sit still with no towel for the insulin shot though, go figure.

 

[Woody/Cheryl (mom)]

I am a newbie but starting to get the hang of this ear pricking. Woody's ears are a brown color and may be easier than most to see where the vein is...so that could be why I am successful at this already. I am using the Relion Micro glucometer and the micro-thin lancets. I am using the sock to warm the ear. I have a small flashlight handy to help locate the vein more precisely if necessary. I manually prick the ear. I have recently discovered if you enter the vein at a slight angle it helps and minimizes poking through. I do put a thickly folded-up paper towel or cotton ball on the underside to keep from pricking myself. Also, I am entering the vein from the top of the ear in the sweet spot on the side of the vein that is not next to the edge as you read about. If I prick and don't get blood, I milk it slightly by pulling from below up toward the sweet spot where prick is. When using the micro-thin lancets, there sometimes is a short delay before the blood appears and the spot is so tiny that you may need to use a flashlight to even see it. The tiny spec of blood is enough to fill the micro bq strip. I also saw a tip on a video suggesting to make two tiny pricks next to each other. So I do that if it appears that the single prick is not working. Hope this helps out.
Also wanted to mention, Woody likes me to prick his left ear more than his right ear. Now that I can get enough blood from a tiny prick I am okay with using his left ear most of the time.

 

[Justyn]

but he jumps out of my hands as soon as ive got the blood) .

Try wrapping him up in a towel like a purrito. Mine will tolerate that, but of course he gets lots of behind the ear scratching from me first. He'll sit still with no towel for the insulin shot though, go figure.

I tried the burrito wrap this morning! No luck but thank you of course for the suggestion! haha i assumed he wouldn't like it but i figured I'd try.. would be nice to not have to wake up a cousin to help hold him still but oh well :/

 

[Justyn]

I am a newbie but starting to get the hang of this ear pricking. Woody's ears are a brown color and may be easier than most to see where the vein is...so that could be why I am successful at this already. I am using the Relion Micro glucometer and the micro-thin lancets. I am using the sock to warm the ear. I have a small flashlight handy to help locate the vein more precisely if necessary. I manually prick the ear. I have recently discovered if you enter the vein at a slight angle it helps and minimizes poking through. I do put a thickly folded-up paper towel or cotton ball on the underside to keep from pricking myself. Also, I am entering the vein from the top of the ear in the sweet spot on the side of the vein that is not next to the edge as you read about. If I prick and don't get blood, I milk it slightly by pulling from below up toward the sweet spot where prick is. When using the micro-thin lancets, there sometimes is a short delay before the blood appears and the spot is so tiny that you may need to use a flashlight to even see it. The tiny spec of blood is enough to fill the micro bq strip. I also saw a tip on a video suggesting to make two tiny pricks next to each other. So I do that if it appears that the single prick is not working. Hope this helps out.
Also wanted to mention, Woody likes me to prick his left ear more than his right ear. Now that I can get enough blood from a tiny prick I am okay with using his left ear most of the time.

Just wanted to say thank you for the tips!! I actually was able to have much more luck by entering on an angel, and I learned that having the bevel tip facing up - it really helps too. I manually prick also, but thinking about trying one of the poking-pens to take the guessing work out! Too funny with Woody having the ear preference, as my Socks does also! On the one ear it's like totally normal as he's relaxed and just getting a big hug from us, but on the other - he's freaking out/squirmish. it's always a learning experience with these guys.

 

[yukon25]

I tried the burrito wrap this morning! No luck but thank you of course for the suggestion! haha i assumed he wouldn't like it but i figured I'd try.. would be nice to not have to wake up a cousin to help hold him still but oh well :/

Oh, mine didn't like it at first either but I didn't give him any choice. I'm probably a bad cat mom but I figure I weigh more and he can learn to deal with it. After a couple of days he calmed down and didn't give me any fight in the towel. Now I can skip the towel totally. I would wrap tight around the neck, looser to the back. He didn't seem to mind as much if his back legs weren't as bound as the front. But every cat is different and my orange guy is pretty laid back for the most part.

 

[Kris & Teasel]

"he can learn to deal with it." This!

 

[Sootyca]

I'm developing a phobia of doing it now as I have struggled. I think my best way will be putting her in her carrier and doing it there as she won't be able to escape if (when) I hurt her! It's a top opening carrier and she doesn't like it at the best of times so this can be her test area I'm psyching myself up to try her this week!

 

[Kris & Teasel]

Have you tried desensitizing her to the ear routine by making the testing spot a "happy place" - ie., taking her there for snuggles and treats but no testing? Repeat +++ and then try to do a test. Don't rush the process and try to stay as calm as you can so your anxiety doesn't get transmitted to Sky. Much easier said than done I know ...

 

[Sootyca]

She is fine having her ears pressed, fondled, rubbed ... everything. Perfectly calm. I click the lancet near her and doesn't flinch. Turn ear inside out, happy as a lamb in spring. Absolutely not a bother on her. I can even press the lancet on her and she doesn't mind. It's as soon as it pricks her she doesn't like it - and it doesn 't help that I haven't had blood from her so have had to try a few times before giving up. The vets managed this week but it has made her a little more nervy. Sadly, or happily for her weight, she doesn't like treats so I do struggle for a food-reward.

I'm going to try this week after she has been in front of the fire so her ear will be really warm!

 

[Chris & China (GA)]

It's a top opening carrier and she doesn't like it at the best of times so this can be her test area I'm psyching myself up to try her this week!

If she doesn't like the carrier, I think you're just asking for more trouble by trying to force her into it each time. You want the experience to be as stress-free and calm as possible so she won't associate it with anything "scary" or painful

Here's something I wrote up for others that needed help with testing...maybe it'll help you too! (substitute "her" for "him"...LOL)

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

 

[Kris & Teasel]

She is fine having her ears pressed, fondled, rubbed ... everything. Perfectly calm. I click the lancet near her and doesn't flinch. Turn ear inside out, happy as a lamb in spring. Absolutely not a bother on her. I can even press the lancet on her and she doesn't mind. It's as soon as it pricks her she doesn't like it - and it doesn 't help that I haven't had blood from her so have had to try a few times before giving up. The vets managed this week but it has made her a little more nervy. Sadly, or happily for her weight, she doesn't like treats so I do struggle for a food-reward.

I'm going to try this week after she has been in front of the fire so her ear will be really warm!

Are you using the spring mechanism of the lancet device or have you tried freehanding the lancet? Many people find freehanding works better because there's no sound and you can control the piercing pressure much better.

 

[Woody/Cheryl (mom)]

I learned that having the bevel tip facing up - it really helps too. I manually prick also, but thinking about trying one of the poking-pens to take the guessing work out!

Is the bevel tip facing up mean you have the flat part facing up? I may not have good enough eyesight to see what a bevel tip is...LOL! Also, please update post if you have luck with the poking-pen...one came with the Woody's glucometer, but I have not tried it yet. Wish I could always get blood the first prick.

 

[Chris & China (GA)]

Is the bevel tip facing up mean you have the flat part facing up?

I have trouble seeing it too...but using a pair of reading glasses really helps!

There are some pictures included in THIS LINK that help explain the "bevel side" of both lancets and syringes

 

[Sootyca]

Finally got blood. I don't like the number it gave me at all but I still got blood - especially not after she had some good numbers last week. Took about 20 minutes in different parts of the ear but I don't think she was stressed by it all. May do her again in a couple of hours to see where we get to - she wasn't very impressed after I had taken the blood. I don't think she likes the beeping the machine makes so going to have to get that turned off!

 

[Woody/Cheryl (mom)]

Finally got blood. I don't like the number it gave me at all but I still got blood

The Alphatrak monitor strips are impressive. I took my Woody to the vet today and vet wanted to compare numbers between the human (Relion) meter I use on Woody and his Alphatrak. I pricked ear and told vet that we may have to prick again after I draw because the prick is very tiny. So I drew up on the Relion strip and vet's alphtrak was able to draw enough from the same prick!! Wow! Alphatrak strips are very impressive! I don't remember exactly, but I think the difference between the two glucometers was about 30...with Relion having the lower reading....about what I expected from what little I know (LOL). I did not have rice sock so did not get to warm the ear at the vet, but was able to get the tiny sample. (I am pricking on the top-side of ear manually at an angle from inner-side edge of vein pointing toward the outside edge of ear...in the sweet spot using smallest micro-thin lancet.) Patting myself on back for looking like a pro with vet watching.

 

[Justyn]

Are you using the spring mechanism of the lancet device or have you tried freehanding the lancet? Many people find freehanding works better because there's no sound and you can control the piercing pressure much better.

No no just pricking it by hand! I've noticed how much it helps to make sure the bevel is angeled UP!

And I also use Alphatrak so definitely doesn't need a lot of blood but sometimes ill poke and poke and poke and nothing comes out! Going in between the edge of the ear and the vein. Anytime my bub is parked infront of the fireplace is always the best time to poke, as it definitely seems the warmer it is, the easier it bleeds - but he really hates sitting there while i warm it up more than any part of the process... I do it always in the kitchen and my Fiance always has to help me, so theres a normal routine, its just getting the blood to come out!

 

[Kris & Teasel]

No no just pricking it by hand! I've noticed how much it helps to make sure the bevel is angeled UP!

And I also use Alphatrak so definitely doesn't need a lot of blood but sometimes ill poke and poke and poke and nothing comes out! Going in between the edge of the ear and the vein. Anytime my bub is parked infront of the fireplace is always the best time to poke, as it definitely seems the warmer it is, the easier it bleeds - but he really hates sitting there while i warm it up more than any part of the process... I do it always in the kitchen and my Fiance always has to help me, so theres a normal routine, its just getting the blood to come out!

Yes, bevel up helps and warm ear helps. Will Socks tolerate rubbing his ear? Friction will warm it up.

BTW - how is Socks doing since his crisis? Still on feeding tube?

 

[Justyn]

Yes, bevel up helps and warm ear helps. Will Socks tolerate rubbing his ear? Friction will warm it up.

BTW - how is Socks doing since his crisis? Still on feeding tube?

Yes he tolerates alright but gosh sometimes they are so cold and my hands are cold so it takes a while which annoys him... Ive tried running my hands under warm water to warm them up but sometimes no luck with that!

And Socks is doing pretty good! He's been eating/drinking all on his own, BGs haven't been too crazy (except after the vet yesterday - stress). Tested negative for ketones for past 3 days! Woohoo! So mainly waiting on his bloodwork to see if everythings looking better! Hoping to get the tube out soon, but haven't been in a rush as it has been so much easier to give him his meds..

 

[Woody/Cheryl (mom)]

I poke between the vein and the edge of the ear as I've read online..

I have changed my technique a little to poke between vein and edge of ear as you said. I am going up higher on the ear than before...I must have been missing the sweet spot because now I am getting a bigger droplet of blood with minimal effort. Main thing I have to watch for is to gently pull the sweet spot tight so it does not move when going in with the lancet. I don't even think Woody knows or at least doesn't seem to care I am doing it. Forgot to add that I no longer need to heat up area with rice sock.

 

[Suzanne Kostenko]

I use a cosmetic pad for support behind the ear. When his ear feels cold I put a few drops of water on the pad and microwave it for 6 seconds.
It feels hot to my fingers but by the time I get to the cat it is just right temp. and warms the ear in a min or less.