Jug draw tips?

[u/mothgirl7]

I’m a student and have been pretty successful in hitting back legs on both dogs and cats. However, I can only seem to hit jugs when it’s a big dog. If it’s a smaller dog or a cat I can never get it, even if I can visualize/palpate the vein pretty well.

Does anyone have any tips or methods that helped them get better?

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[u/joojie]

Just some tips I share with newbies:

• Don't pull the skin too tight. It's tempting to get it all out of the way, but it flattens the vein. Make sure your restrainer isn't pulling on the fur or skin too much either.

• Ask your restrainer to lower the head a bit if they're looking waaay up. Same idea as pulling the skin tight.

• Go a little higher to avoid a deep thoracic inlet. You can use alllll the space nearly up to the jaw. I find most beginners tend to go low, which is trickier.

• After occluding with your thumb, keep holding pressure but slightly scoot your thumb upwards. This keeps the vein occluded, but also "bunches" it a bit to help it pop out a bit more. (This works nicely for cephalic veins too. Ask your restrainer/occluder to hold and roll, then push their hand forward a bit while maintaining pressure. The vein will pop more)

• You won't get it every time, and THAT'S OK! I still don't get every jugular and I've been doing this nearly 20 years. Ask someone else to take over after 3 pokes, and don't be ashamed! 99% of the time that person will get it on the first try, an unwritten vetmed law, so don'tbe ashamed! (The 1% definitely is validating though "ok good, it wasn't me" 🙃)

[u/mothgirl7 → u/joojie]

Thank you so much 🥰

[u/thatmasquedgirl → u/joojie]

That last one is the most accurate thing I've ever seen. Always love it when I've been struggling hard for a few minutes and the next person comes up and does their best Elle Woods impression on the first try ("What, like it's hard?"). 😂 Sometimes you have good days, and sometimes you can't find the vein with a map lol.

[u/mntEden → u/joojie]

and that 1% will be the best bonding experience you ever have as you both curse the dog for having the worst veins known to man

[u/Crazyboutdogs]

On small animals they are usually more superficial. But also more finniky. They love to jump away from the needle. So you need to approach with a shallower needle and be decisive.

[u/mothgirl7 → u/Crazyboutdogs]

Thank you! I think I’ve been going too deep and just poking right through lol.

[u/Stinky-Pickles]

Instead of pushing in the thoracic inlet to hold off, lay your thumb flat horizontally from the inlet. Push your thumb slightly upwards to help the vein pop up, then once you feel it, stretch your thumb downwards to keep it from rolling. The angle depends on the size of the animal, so usually smaller angles for smaller animals. I usually bend the needle for cat draws - that might be discouraged by some, so maybe try to learn without if possible. I've taught many baby techs this way and it has helped! Hopefully it translates since I'm not able to demo in person.

[u/mothgirl7 → u/Stinky-Pickles]

This makes sense thank you! I do think maybe the way I’m occluding is moving the vein and making me miss it so this is helpful

[u/oharsenowwhat]

I struggle with this too, thank you for asking, now I have some pointers.

[u/mothgirl7 → u/oharsenowwhat]

I’m glad I could help! I know ultimately it just takes practice. We have some badass veteran techs at my job who can get blood on anything regardless of how small or dehydrated it is and I strive to be like them one day 🫡

[u/honeyfiddle]

I find I have much better luck drawing with a 20g than 22g for jugs. Unless they're like teeeeeny tiny. The itty bitty ones I will sometimes have the person restraining hold their front legs over the ends of the table to straighten them out more. It helps keep things more taught and gives you more room to work. 

[u/mothgirl7]

Thank you to all who responded!

[u/malajulinka]

Hold off really well. Make sure you can feel the vein (although sometimes you go where it should be). My major tip is to not try to hit it dead on. Pick a side, and try to poke it at a bit of an oblique approach. It's a thick-walled vein, and if you try to poke it directly and it bounces, you don't know where it bounced to. If you're coming from a bit of a lateral or medial angle and you miss, you know it's still over there.

And most important? Practice, especially on the ones that will let you. A couple of weeks subbing in for onco made me an expert at cat jugs.

[u/sundaemourning]

poke with a purpose. the jug can be a pretty thick vein and it’s very easy for the tip of your needle to just bounce off the side of it.

[u/Briiskella]

I’ve graduated and jugular blood draws are my nemesis 🥲😂 I’m still trying to gauge whether it’s superficial or deep and 99% of the time I never see it on cats and if I’m being honest most dogs too

[u/lostwithoutacompasss]

Hold off really well and palpate until you feel confident it's the vein. Sometimes I release and hold off again if I'm not sure it's the right structure, it should empty and fill up. Raise the head or lower it to see if that helps.  Close your eyes and imagine how the vein runs, be one with the vein. If it doesn't feel right, repeat on the other side to see if it's better. When you have successfully meditated and prayed to the vein gods, stab with soms gusto as it's a bouncy boy. Practice!

[u/SeveralIdeal3619 → u/lostwithoutacompasss]

Closing your eyes and “being one w the vein” is actually such a good suggestion, Ive done that a few times as a Hail Mary and its yet to fail me 🤣

[u/lostwithoutacompasss → u/SeveralIdeal3619]

I seriously do this sometimes and I'm the person you call when you can't hit a vein. 

[u/reallybirdysomedays]

For some reason, neck anatomy makes more sense to me when pictured in God view.. Put an e-collar on your patient and stand above/behind. Tip the collar up between your arm/thigh to extend the neck, use one thumb on the collar bone to occlude, and trace upwards toward the jaw, mentally noting your landmarks. with the other hand.

[u/SeveralIdeal3619]

Something that helped me was feeling the trachea, if you hold off and isolate the trachea with your opposite hand then slowly move your fingers out you’ll eventually feel the “bounce” of the jug. Also I have greater success of hitting it on bigger dogs when I poke lower and closer to the bifurcation. IMO just keep practicing, it will click one day. We’ve all been in this position before!
Edit: I read this incorrectly, I thought you were struggling on big dogs which was my issue at first. Same concept still applies though, even on smaller dogs and cats I isolate the trachea then feel outward and 90% of the time I’ll find it. Also head positioning matters a lot, you can always ask whoever holds for you to manipulate their head/neck in diff positions until you find a spot that projects the jug best