Not getting blood from the pricks

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Elizabeth A

Elizabeth A

Member Since 2013
I just started the tests today, and I guess I may need some technique guidance because blood doesn't always come from the pricks. Sometimes I get it first go, sometimes I am having to back off after three tries and wait half an hour. Two test results, trying for the third in a few minutes. I massage the ear first, it is warm. I am aiming for the edge of the ear, above the flappy bit. I have been doing it freehand, I have 27 weight lancets. It isn't supposed to go through the other side, right? I have a pen in the kit, maybe I should try that? No one demonstrated that at the office, so I will have to figure how the settings work. It's safe to put on the highest setting at first? Thanks, I am feeling incompetent and overwhelmed right now. I managed to get a nice drop just now, but still don't know why it's good sometimes and no blood others.
 
I would warm the ear with a rice sack or a prescription pill bottle filled with very warm water for a minute or so. Massaging the ears may not be enough at first - the capilliaries start to fill up when they are very warm. After awhile, you won't need to get the ear so warm.

Do you have something behind the ear to poke against? I liked a small makeup sponge; some people use folded kleenix. I liked the lancet device but lots of people freehand - personal preference.

And you can always do a quick second poke - just another poke with the same lancet in the same hole to widen the spot.
 
I go freehand, and I get better results when I aim at an angle to the ear. When I go straight in, I am more likely to poke through.
Then there's just practice and finding his "sweet spot". On my Chester, it's about halfway up between the flap and the tip.
 
I use a cotton ball inside her ear and a lancet pen. I had a terrible time with freehand, and the pen is easier for me. We're new to this, so I have to poke her a bunch to get blood. Right now we're still on the highest setting, but I've heard it gets easier and eventually I'll move the setting lower
 
I have been putting a cotton ball behind the ear, that does seem to work as far as keeping it steady. Last time I got too much blood, I hadn't expected that. I also pricked my thumb, that hurt! Glad to read there aren't too many nerve endings in that part of the ear, and Leia is so nice about this. It's probably good she is used to the procedure having had this at the vets many times. Thanks for all the ideas here, I will try to get a second poke in the same place if I can, I wouldn't have thought of that. Did I mention she's black, and I can't even pretend to see the vein? I can't really see it from the underside either. But I know it's there.
 
Three tips that really helped me when I first started the ear pokes with Wink.

1. I shaved a tiny patch of fur on his ear with a straight razor. He has long black fur, black ears and I was having a really hard time seeing what I was doing with all that hair in the way. Didn't need this after about 3 weeks, so let the hair grow back.

2. A tiny dab of vaseline or triple antibiotic ointment (TAO) with pain relief, the gel kind not the cream, helped to get the blood to bead up. The TAO with pain relief also helps to heal the ear and take away some of the pain. Only use a tiny dab and wipe up any excess with a tissue.

3. Bright light. I'm older, my eyes need more light these days to see what is going on. I clipped a reading lamp to my bathroom towel bar. Some people shine a small flashlight from underneath the ear to help them see better.

Remember to always give a small no-carb, high protein treat as a reward. Freeze dried chicken, bonito flakes, a tiny piece of fresh, unspiced cooked chicken. This will get Leia to look forward to the test and treat process even better.
 
Hi Elizabeth,

Jazz is black too, so like Deb, I found the torch thing really helped at first (get someone else to hold it if you can). After a while, once I got the hang of it, I found I didn't need to use a torch and 'knew' where best to poke - just make sure there's decent lighting where you test. (I do it freehand with a lancet too, and it's not meant to go right through/pierce the ear, just on one side enough to get the blood drop - I wasn't clear about that at first either and had to ask the nice people here!)

The single biggest thing that helped me with the testing was to make sure the ear is sufficiently warm (really warm) before poking. Makes it soo much easier to get enough blood on the first poke! :-D I use a little face towel and pour boiling water over (over the sink!) and then flap it a bit to make sure not too hot before sealing it in a ziplock bag and pressing it against her ear till ear is nice and warm (check temp first against your inner wrist).

If she's sleeping curled up, and you are about to test, it's also easier sometimes to just test on the ear she's been lying on, as it will be pretty warm already ;-)

Everyone else has given great advice here already. Not sure if you've already done this, but practice testing yourself (top/side of finger seems a good place) with the freehand lancet you use on Leia, and also with the pen before you use it on her, if you are going to try that. It really does help get a better idea of what it feels like, and may help you work out the right depth setting with the pen. Good luck!
 
Hi Elizabeth, from another 'Elizabeth'! :smile:

As others have said, some find using the lancet freehand easier, some prefer the penlet device. My close vision isn't great so I use the penlet. I press it against the outer edge of the ear (with a finger inside the ear to act as a 'resist'), click, and hope for the best. This rather haphazard technique has served us very well for six and a half years.

Initally though I did find it quite hard sometimes to get blood, and I found a teensy smear of vaseline on the outer edge of the ear worked wonders in helping that precious droplet of blood to 'bead up' and stopped it disappearing into the fur. Also, the blood flow runs from the tip of the ear to the base, so gently massaging below the poke site will encourage the blood to flow.

You will get the hang of this. Honestly! And the ears really do bleed more easily over time (I think they make more capillaries or something...)

Elizabeth
 
Elizabeth,
Congratulations on getting blood! Others gave you great tips. I recently had to teach someone and here is a tip I gave her that worked. After getting blood, milk it a little if needed to make sure that it is enough and then put the blood on your fingernail. You can then put the strip up to your fingernail with ease. This works if your kitty is getting fidgety. Getting blood does get easier with practice. I totally understand about the black ear. From time to time I watch someone's diabetics and one has black ears. It's not easy. Someone told me once that she does it on the inside of the ear and she can see. Good luck and welcome to the vampire club. :)
Wendy it flew past me. :)
 
Thanks for all you advice on this, tomorrow is the one week point where I do the curve. I am still apprehensive, no lie. But, I did get my own meter and am hoping fedex delivers the strips today or in the am. I have 4 left from the vets kit they loaned me, a different meter type than what I bought, and wanted to do a side by side tomorrow. That's sounds all ambitious, doesn't it, lol. Anyway, I did get a box of lancets, and am wondering if they are really okay for using on Leia. I'm such a wuss about this anyway. They are safety lancets and look like a sort of plastic box. You push the end, and I guess a needle hits the ear. Has anyone used these? I guess it wouldn't hurt, but I'm feeling chicken because it's different. My meter can with a pen and a few normal ones and I still have some needles from the vet, so I don't have to use them. Here is a link if you want to look http://www.amazon.com/gp/product/B0077A ... UTF8&psc=1. I can give them to a friend if they aren't appropriate, so just hoping someone here knows.
 
Dont get all caught up in the differences between the meters - they tend to vary by 20% but are more similar as you go lower which is most important.

Never seen these lancets before, but if you arent sure, test the lancet on yourself first! If you get blood and it doesnt go, like all the way through your finger or something, you should be fine.
 
I took a look at those lancets you ordered.
They look like a cross between a lancing pen where you put a lancet in the end and the plain lancets that many of us just use freehand.
Sort of like a one time use throw away lancing pen.

Lancing pens normally come with the glucometer you buy.

I did notice that they look expensive. I can get a box of 100 lancets at Wal-Mart for about $3.74 or a box of 210 for $5.84.
 
Hi Elizabeth,
I'm not familiar with the type of lancet that you ordered. Trying it out on yourself first is a great idea. If you like them and are more comfortable with them,use them. The lancets that you buy in a box of 100 etc. would be less expensive though. Have you ever used a lancet devise? With time this whole process will become like pouring your morning coffee. But foremost congratulations on testing your kitty.
 
Thank you guys, I appreciate the input! You are way braver than me trying them on yourselves first. Today was my second "curve" day, so I tried lancet 31 gauge freehand, lancet 31 gauge in pen, and find I really prefer the "naked" needles the vet gave me. I'm going to buy a bunch from them, they are the 28 gauge, and have caps so it's easy to toss them. I am still expecting a box of normal lancets 28 gauge, maybe I'll like those too.

I don't know if this will ever be second nature, but I did manage to get 5 readings today spaced appropriately. I only had to stop and wait a half hour the first one this morning, I do think it got easier each time but poor thing I did go back to the same ear. I also compared the two meters on two of the readings and I think the new one is close enough. It was about 13 off the highest reading and 1 off on a lower reading.I guess the vet's office gets their pricey meter back, lol! Still getting used to what the things on the meter mean, but I'll look at the booklet again before next time.

Last night I reread the hints you guys gave me and that really helped to refresh what to do, thank you so much. I did use the same place for a second poke if I could, and I was in there asking her to please lay on one ear to warm it up, haha. I did not stick myself today, big improvement! I think figuring out placement is still the thing I am not good at, probably one of the reasons I like the freehand is because that pen tip just looks so big. And the square box lancet I didn't have the nerve to try. My diabetic friend is going to get a few supplies...

From what your website says we have been on the slow and go approach, make a change, wait a week to change again, but that has worked for Leia. Until this month she was way down to 1 on her dose, then who knows why she's up again, with associated bloodwork changes. I think we still need an increase based on today, but the vet gets to tell me that. With her very checkered medical history we always think it could be some other issue going on, so I was happy to see her numbers had come down some from last week, that's hopeful. But she's still near 500 and the low I measured was 150. Not there yet. Thanks to anyone who bothered to read this, it helps me work through this to type it.
 
Before you know it testing will be something you can do in your sleep.. Or at least when you are half awake at 2am..lol. Great job on the testing!!!

Now that you are testing you might want to set up a spreadsheet. It will help, you, us and possibly your vet, track trends and look for patterns in order to evaluate dose. Here's the template we all use.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

If you get that sheet set up we can take a look and see what's going on before you make a dose change. She could easily be bouncing.. Which means below but essentially she could be dropping low and bouncing back up.. These lows can be hard to spot too as they tend to happen at night!!

Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
 
Wow, I didn't realize the liver is involved. Leia had liver cancer about 3 years ago and we test her liver enzymes every four months to look for recurrence. It was a DOG cancer and they tend to get it repeatedly. So far, so good but between that and her IBD. I know my vet increases slowly, especially with her, but she has been too high a good month now at least. I felt so much better to have my whole box of testing strips and new monitor, lol, now I can do whatever is needed and it will be a lot more than she was getting. That said, it was enough until she went wonky.
 
Yes, it's that darn liver that panics when it sees numbers lower than expected and pumps out glucogen to raise the BG's back into what it considers a safer range.
 
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