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How to do an Ear Prick on a Cat to Test Blood Glucose

Illustrated with a Bayer Glucometer Elite XL on the back of the ear.

Cat's Ear from back showing veinBayer Glucometer Elite XL

 

Harry, our reluctant star, age 13

Harry, diagnosed diabetic 5/14/99 at age 13 years...the reluctant star of our BG testing photos.

Supplies


While essentially similar, there are some differences between the newer Elite XL and the older Elite model which doesn't have the button. The Dex model has the advanced features of the Elite XL, plus more. The LifeScan FastTake is also very popular with diabetic pet owners.

 

lancet, Elite XL & strips, vaseline, warm damp washcloth in plasticStep 1.  Gather Supplies in an area with strong lighting.

We prefer to hold the lancet in our hand, and not use any sort of lancet device.  This lets us see exactly where the point is going into the ear.  Many like the Soft Touch, Microlet, BD, or Softclix spring-loaded lancet devices that allow you to set the depth of penetration.

Step 2.  Warm washcloth (~15 sec in a 1000 watt microwave or use hot water).

Step 3.  Sit comfortably with cat in your lap or next to you.

When first starting out, we set up a desk lamp on the coffee table and sat on the sofa facing the light, to clearly see the vein at the outer edge of the ear.  Having the sofa arm available to wedge Harry against, helped to control his wriggly maneuvers and calm him.  As we learned where to prick, the strong light to see the vein wasn't so important anymore.  Now we test him wherever he happens to be--sitting on the kitchen floor is easiest at meal time.  Some prefer to stand and use a counter area for testing.  With a more difficult cat, both BG tests and insulin shots are easier to do while the cat is distracted by eating.  Try different approaches, you'll soon find a routine that works for you and your cat.
 


 Step 4.    Apply the warm washcloth until the ear is really WARM, almost HOT!

Wrap washcloth around ear to warm itThe ear should be clean and dry. Check the temperature of the washcloth before applying it to the ear.  It must be very warm, but not so hot that it would be uncomfortable or burn.  Wrap a corner around the front side of the ear to warm both the front and back sides at once.  If the ear still feels cool to your touch, it isn't warm enough to bleed easily.  Don't try the prick until the ear is good and warm, it'll just be frustrating for both you and your cat.

Another approach is to use a 75 watt bulb in a lamp you can position close to the ear to warm it--less intrusive than the washcloth. Some owners put regular uncooked rice in a sock and heat it in a microwave for the heat source.

 
 

 

Cat Ear from back showing veinStep 5.    Look for the vein--orient the cat to the light so you can see it well.

You are aiming for the area between the vein and the outer edge of the ear, somewhere in the top half.  You can see slight bruising where Harry has gotten pricked a lot recently. We prick the back (fur) side, others prick the front, both work.

Step 6.    Apply a thin coat of Vaseline to area you will prick (optional).

Vaseline will help the blood drop to bead up instead of spreading into the fur. If you put very little on and rub it into the fur, that's enough. Harry considers a lick of Vaseline to be a treat and it helps prevent hairballs too. Don't use alcohol on the ear before or after the ear prick, it doesn't really sterilize the skin with the fur but it could dry the skin and make the ear prick sting.

Elite XL meter strip F codeElite XL meter last BG readingStep 7.    Insert test strip fully into the meter to turn it on.

Meter must be off before you insert the test strip. Be sure the strip is firmly seated--you can do it one-handed with practice.  The tab on the right side of the strip is hidden when the strip is fully inserted.  The Elite strip can be inserted far enough to turn on meter but then fall out when you pick the meter up to sip up the blood drop (the things we learn through experience!). The Elite meters beep when they turn on. When ready to accept a sample, the Elite meters alternately display the meter F code which should match the F code on the strip foil wrapper, and the last BG value measured.
 

 

 

Step 8.    Remove cover and position lancet between vein and outer edge.

Some people like to use a folded tissue or cotton ball as a backing (on front side of the ear) while pricking, I use my finger. The tissue or cotton ball can be folded around the edge of the ear while you apply pressure to stop bleeding and help prevent bruising. When testing more than once a day, try to alternate ears or at least move to a different spot on the ear each time.

Step 9.    Take a deep breath and exhale slowly to relax yourself, then quickly and gently prick ear.

Hand prick back of cat's ear - rear viewHand prick back of cat's ear - side view

 

Step 10.    Blood drop should well up.  Slowly stroke ear, if needed.

Stroke, wait a few seconds for the capillaries to refill, then stroke again.  If you don't get a big enough drop before it starts to coagulate, you will need to prick again.  The drop in the close-up is actually about 3 times what we need for the Elite, which requires a 3 microliter sample.  The lancet you use does make a difference.  We get no blood with a Liberty New Thin Lancet, but lots with the B-D Ultra Fine II or the Ulster Gentle-let Fine Point type.  If you are sure you are getting the ear warm enough, try a different lancet or different depth setting on your lancet device. Examples of different size drops in microliters
Blood drop close-upBlood drop - side view

Step 11.    Hold tip end of test strip to the base of blood drop and "sip" it.

Elite strip sipping blood drop, close-upElite strip sipping sample from rear

 

 

 

 

 

Don't let go of the ear!  Your cat will flick the blood drop all over everything, if you do.
If it has already been close to 3 minutes, remove and re-insert the strip to restart the countdown.  The Elite meters will shut off after 3 minutes, even in the middle of sipping up the blood drop.  Try explaining to your cat that everything was perfect except your timing.  Your manual should tell you if your particular meter has an automatic shut-off feature and how long you have. When the meter is ready to accept a sample, the Elite display will alternately flash the "F" code of the strips it is expecting and the last reading taken.

Hold the tip of the test strip to the base of the blood drop. It only takes a second or two to "sip" up the blood drop. The Elite meters beep when "sipping" is detected. You may still be able to sip a little more in, so don't remove it right away unless the strip is already full. The meter then displays the seconds as they count down from 29, beeps again, and displays the result. The beep does NOT mean that you have a sufficient sample. You must look at the strip to tell if you have enough blood on the strip for a valid result.

Step 12.    Put the meter down and apply pressure to ear for 15 sec.

Gentle pressure on the prick site for a few seconds will help prevent bruising. In the rare event that bleeding doesn't stop immediately, standard first aid techniques such as continued pressure, ice, or a styptic pencil will handle it.

Step 13.    Look at your strip and make sure it filled completely.

Use your reading glasses or a magnifier, if you need them. A strip (not pictured) looked full to me without magnification, but the square was only half-covered = insufficient sample = lower BG reading. The repeat test was 50 pts higher than the short-fill.

If blood didn't fill square sensor area completely, your reading will be falsely low and BG test should be repeated.   When the blood comes all the way to the circle with the +, you can be sure the strip filled completely.  Always retest if you have any doubts. 

The color would be more red in a fresh sample--in the time it took to get these pictures the blood turned brown in our strip.

DO NOT REMOVE THE STRIP until after you have checked it visually.  You can't delete a reading from the Elite XL meter's memory once the strip has been removed, and the low reading will be included in the 14 day average.  To delete a reading, press the button once and hold until CONT flashes, then press it again and hold until  DEL flashes.  Remove strip while DEL is flashing to delete the reading from memory.
Elite strip sufficient fill to + circleElite strip sufficient fill close-up

Step 14.    Reward cat.  Praise, brush, cuddle or feed meal or treat

Recognize that treats given with BG tests will elevate BGs, so don't be too generous with them when trying to do a curve to  evaluate the effectiveness of your treatment. However, if you give the same treats at the same times everyday, they are part of the daily diet and should be included when doing curves for regulation.

Step 15.     Record BG number, time, date, & notes about food/insulin.

Since the Elite XL meters shut off automatically 3 min. after you insert the strip, you may need to press the button to turn it on, before you can view your result. The Elite shows all display segments, then a date screen, then displays the average of the last 14 days of readings (MEM with A below it appears at bottom left of display). The 14-day average does not include any deleted readings (DEL) or control readings (CONT), unless you forgot to mark them as such.

Press the button to scroll back through previous readings, one at a time. The Elite XL stores the last 120 test results. The older model Elite (not XL) only stores 20 readings and may not include the date and time.

The large number at the top of the display is the BG reading. The date (month and day) and time the reading were taken display on the bottom row. The units that the meter is set to display (mg/dL United States, or mmol/L Canada & Europe) show just above the time. If the reading was deleted before removing the strip, a DEL will show just above the date.

The Elite XL and FastTake both have a data port which will allow you to download the readings in the meter memory to a computer, and use software to plot graphs of BG readings over time.  To use the automatic download, you will have to purchase the special cable and maybe the software (Bayer's WinGlucofacts is free on their website, LifeScan's InTouch software must be purchased ~$69).  Newer models will probably all include this feature soon.  However, there are advantages to recording each reading as you go, along with notes about any changes in feeding schedule, appetite, or  insulin (everyone "misses" sometime).  You can enter your readings manually, without buying the cable and doing the automatic memory download and still get all the fancy graphs.

Bayer Win Glucofacts Sample Data Screens

Troubleshooting
 

Elite XL Meter test result displayedGood Luck with your first BG prick.  They'll be routine very soon.

Feline Blood Glucose Curves

 More Views and Hints  Source
 Home BG Testing Experiences  Feline Diabetes site
 How to do BG tests  Pet Diabetes site
 How to do Insulin Shots  Auburn Univ. Vet School site

 

Web Sites featuring Feline Diabetes

 Feline Diabetes Home Page Great Message Board, Lots of Helpful Information
 Pets With Diabetes Home Page Covers Cats & Dogs, Beautifully Organized
 Sugarcats Home Page Humor Message Board (secret agents), PZI insulin info, Map of Diabetic Cats - register, you may find others nearby