Meters and lancets and strips, oh my. (Canadian help needed)

[SidneysMom]

So, as a newbie to all of this, I'm really apprehensive about using a human meter. How will I know accurate values? But the test strips for the alphaTrak 2 are insane. I'm not even sure there's a place to buy the testing strips besides Amazon.ca, and I won't be able to get them until the 18th. That makes me uncomfortable. My vet doesn't have any testing strips in stock.

Is a human meter advisable for a newbie like me to use? Can anyone give me some guidance here? I don't even know where to look, or where to start. I'm so sorry for all the questions. Is the ear prick thing separate from the monitor? I'm looking for inexpensive but as accurate as possible.

 

[FurBabiesMama]

A human meter is fine. Most people here use them. The 'ear prick thing' is a lancet. Some people, like me, just hold the lancet in their fingers to prick the cat's ear, others choose to use a lancing device that you put the lancet in and push a button for it to prick the cat's ear.

Someone in Canada will probably be along to give you specific advice on what to get there.

 

[Wendy&Neko]

If it helps, our dosing methodologies were written using human meter numbers. The research on the Tight Regulation protocol was done with human meters. It is what everyone here used to do until several years ago when the makers of pet meters ramped up their marketing to vets. My vet used a human meter.

You want lancets, start with 26 or 28 gauge to start. That is for the ear pricks. For meters, I just asked my pharmacist which one used the smallest blood drop. That will make it easier for you. I started with the Freestyle, but that was a few years ago. Cost of test strips is a major deciding factor too.

 

[Noah & me (GA)]

It's not for everyone but I did lancing free hand. Because of finger, hand and wrist injuries I used the fat BD lancets, kind of like those fat pens that are easier to grasp.

 

[Marje and Gracie]

Hi again, Jen! <3

Most of us here (both Canadian and US) use human meters because those alphatrak strips are outrageously expensive! Most Canadians use the FreeStyle Lite metre, though if you're close to the border head over and buy the ReliOn brand from Walmart.

Yes, the ear prick (lancing) device is separate from the meter. Some meters come with their own lancing device (like alphatrak has their own) but you can mix and match. You can have type X meter with type X strips, and type Y lancet device with type Y lancets. Or if you want to freehand-poke Sidney (a lot of people do this, I don't because I stink at it), you don't even need the lancing device.

The spoiler below is a breakdown of blood glucose testing readings and what they mean. You can reference it as-needed.

[SPOILER="Understanding BG Reading”

What is this source of this, please? I would suggest you remove it because it is inconsistent with information we use here.

For example, there is no basis for the statement that 50-70 on a human glucometer is equivalent to 68-80 on a pet glucometer. In fact, there is no documentation or equivalents set between human and pet glucometer. In addition, 50 on a human glucometer does not “equal” 68 on a pet glucometer. Rooms and Rand just established 68 on a pet glucometer as the lower end of normal but did not state it is the equivalent of 50 on a human meter.

 

[Panic]

What is this source of this, please?

Info I compiled from the forums here actually, but I'll remove it anyway. :/
Could you please specify what the take action range is for pet meters then if it's not 68? I've seen it on the boards several times without complaint.

 

[Marje and Gracie]

Info I compiled from the forums here actually, but I'll remove it anyway. :/

Yes because there is some incorrect info and overlap with other posts we already have. Documents like this have to be approved by the moderators and webmaster. If you’d like to submit it to us for approval, please feel free to do so. You can send it in a PM to Sienne, Wendy, and me. We will review it and pass it along to the webmaster with our comments.

Thank you.

 

[Christie & Maverick]

I am in Canada and have used the Freestyle lite meter, it has a small blood drop requirement. I have tried the One Touch, but struggled with readings, if I remember correctly it needs double the blood drop.

Just a few points of clarification, since I see that there was a post regarding understanding BG readings, and since this is posted on main health. Please be mindful that each insulin has its own nuances. We also have a saying here...every cat is different (ECID). The level of intervention when dealing with lower numbers depends on a lot of factors. As caregivers, we are encouraged to learn how the particular insulin we use works for our cat, which means understanding concepts of onset (length of time the insulin reaches bloodstream and begins to lower blood glucose), nadir (lowest point in the cycle) and duration (how long does the dose continue to lower BG). We also need to understand how carb sensitive our own cat is which is key in determining the level of intervention required. Depending on the insulin you will use, I encourage you to review the guidelines in the applicable subforum.

There is no correlation between human meters and the pet meter readings. 50 on a human meter does not equal 68 on a pet meter. As Wendy mentioned, dosing methods were written based on human meters. From my experience here, there is nothing that establishes what a normal range is for a pet meter. As well, for clarification, the number 68 on a pet meter was only established by Roomp and Rand for the Tight Regulation Protocol for Lantus and Levemir as a number which offers pet meter users some safety margin.

Renal threshold (when sugars start to spill into urine) can also vary by cat, it is usually between 200-250 on a pet meter.

One last comment. The recipe for DKA is an insufficient supply of insulin + inappetance + infection OR other systemic stress

I have seen kitties here with lower BG levels go into DKA, it is not always associated with BG numbers over a certain threshold.

 

[Panic]

Yes because there is some incorrect info and overlap with other posts we already have.

Could you direct me to BG number info for human and pet meters? I am aware there's no correlation between the two but they both still have their own take action numbers, etc. I think I found most of this on L&L forum so if the info I gathered is incorrect I'd like to learn actual number ranges FDMB has approved and goes by.

EDIT: Found the thread that I originally referenced: Thread Is this info out of date?

 

[Red & Rover (GA)]

I used the FreeStyle Lite. https://www.freestyle.abbott/ca/en/products/lite.html
I compared it to another meter I had and the FreeStyle Lite read lower. Better a meter that reads lower than higher to be on the safe side. You want a meter that requires a 0.3 drop of blood. All meters are cheap. Ask the pharmacy how much the strips cost.

Also, a tube of Polysporin ointment (not cream) with pain relief.

If you have a PC Optimum card, you can use your points. Also, if you are a senior or happen to have one handy, you can take advantage of Seniors Day at Shoppers.

 

[Marje and Gracie]

Could you direct me to BG number info for human and pet meters? I am aware there's no correlation between the two but they both still have their own take action numbers, etc. I think I found most of this on L&L forum so if the info I gathered is incorrect I'd like to learn actual number ranges FDMB has approved and goes by.

EDIT: Found the thread that I originally referenced: Thread Is this info out of date?

Yes there are issues with the info in post #8. That member basically wrote her interpretation of ranges. It is not the info we give.

The TR protocol and SLGS were written for use with a human meter. Therefore, the only reference for pet meter numbers is in the TR protocol and it’s in reference to below 68 on a pet meter being the reduction BG.

The term “take action number” is relatively new and was not used when we joined. There is no definition or reference of BGs for that term in SLGS or TR. Members have just started using that term and I’m sure different members have different ideas as to what that is.

 

[Panic]

Yes there are issues with the info in post #8. That member basically wrote her interpretation of ranges. It is not the info we give.

The TR protocol and SLGS were written for use with a human meter. Therefore, the only reference for pet meter numbers is in the TR protocol and it’s in reference to below 68 on a pet meter being the reduction BG.

The term “take action number” is relatively new and was not used when we joined. There is no definition or reference of BGs for that term in SLGS or TR. Members have just started using that term and I’m sure different members have different ideas as to equate that is.

Thank you for clarifying! So there's only official BG interpretation info here concerning TR and SLGS protocols for L&L and none officially stated for the shorter-acting insulins at this time?
Sorry if I'm straying Jen's topic a bit, just curious since she asked and I'm apparently not up to date.

 

[Marje and Gracie]

Thank you for clarifying! So there's only official BG interpretation info here concerning TR and SLGS protocols for L&L and none officially stated for the shorter-acting insulins at this time?
Sorry if I'm straying Jen's topic a bit, just curious since she asked and I'm apparently not up to date.

SLGS is for all insulins. The German forum, where the TR protocol was first developed, has some PZ users who follow the TR protocol as written by Roomp and Rand.

 

[Panic]

SLGS is for all insulins. The German forum, where the TR protocol was first developed, has some PZ users who follow the TR protocol as written by Roomp and Rand.

Thank you Marje!

 

[Marje and Gracie]

Thank you Marje!

You’re very welcome. I know you had to put slit of work into that document and we appreciate that you cared enough to do it.

Again, please feel free to submit it to us for review and comment.

Just so you are aware, even any info or sticky posts moderators write go through the same process.

 

[FurBabiesMama]

From my experience here, there is nothing that establishes what a normal range is for a pet meter

Normal is usually considered between about 75 and 150 (IDEXX has the range as 72 to 175). AlphaTrak documentation states that below 65 is consider hypoglycaemia and above 250 is considered hyperglycaemia.

 

[Noah & me (GA)]

Human meters are free in Ontario. I can't say for sure whether that's mandated by the government or the manufacturers way of getting you to buy more strips. I used an Aviva AccuChek, good memory functions, needs a very small sample. The strips are expensive and Aviva has a reputation for not publicizing recalled strips very well.

 

[MrWorfMen's Mom]

Jen, if it makes you feel any better, human meters have been used for our pets a lot longer than pet meters which are a relatively new tool in the veterinary world. Nothing wrong with either meter. Some vets still use human meters but many have now switched and will recommend pet meters to their clients BUT they also I think, do so usually assuming you will only be testing periodically rather than on a daily basis. Younger vets are more likely to be unfamiliar with human meter readings and will tell you all sorts of reasons why you can't use a human meter and/or provide totally ridiculous non-existent "conversions" often based on one in clinic BG comparison.

I started out with a pet meter. Found FDMB and was surprised to see I could use a human meter. I did dual testing with both meters and I presented my vet with the human and pet meter readings for the same period. She kept the SS copies but still seemed to think I was a bit crazy. I'm wondering if she actually studied the sheets because fast forward a few months and I got an email from my vet asking me for reference numbers for the human meter because she had a client who insisted on using the human meter. My vet is now fine with either meter but it took a bit of convincing.

The AT2 meter strips are expensive no matter where you get them, but I picked up my strips from the Pet Pharmacist in Concord (Dufferin/Steeles area). They were the most reasonable pricing I could find at the time. Not sure how they compare now.
https://thepetpharmacist.ca/product-search?f=any&type=0&search=AlphaTrak
If you decide to use the pet pharmacy, do call ahead as they sometimes were waiting for a shipment.

 

[whiskysmom]

I'm in Canada and am using the FreeStyle Lite. I can get 100 test strips for $75 at London Drugs, and 100 lancets are about $10. Right now we're using 28 gauge lancets and I'm using the lancet device that came with my meter.

You can sign up online to receive a free meter with the purchase of 100 test strips. You just download the coupon and take it to your pharmacy: https://www.freestyle.abbott/ca/en/order/lite.html

I compared my meter with my vet's AT2 one day using the same blood sample. I think they are made by the same company so are virtually identical, but the AT2 is calibrated specifically for cats and dogs and the strips are more $. Mine read a bit lower than his, but it's still super valuable for me to be able to see trends and have a consistent point of reference at home.

Best of luck!

 

[Christie & Maverick]

Normal is usually considered between about 75 and 150 (IDEXX has the range as 72 to 175). AlphaTrak documentation states that below 65 is consider hypoglycaemia and above 250 is considered hyperglycaemia.

I am familiar with the IDEXX lab normal range. My original comment was in regard to what had been stated as the normal range for pet meters, which incidentally was different than the range you have noted. The use of pet meters is still fairly new, and I don't disagree that at some point, likely before I joined, some people decided to make a suggestion of what the normal range should be. I don't take issue with that, other than to try and politely suggest, as I did in this post, that there is no established normal range for pet meters. I used the word "established" for a reason. There are no studies which have been done, again to my knowledge, which establishes this to be the case. Maybe I am being pedantic but I thought people should be aware that widely accepted isn't the same thing as established.

Don't you find it interesting that the manufacturer themselves haven't made a clear statement on what the normal should be? Sure, they've given us some wide goal posts to shoot through (65-250), but I rather suspect they remain silent for a reason.

I may be wrong, I often am , but here's some more food for thought. If each of us who has taken the time to respond in this thread went to our own vets and asked them what the normal range is on a pet meter, I might be tempted to place a bet that each of our vets would have a different reply.

I have to go and poke my cat now

 

[MrWorfMen's Mom]

they've given us some wide goal posts to shoot through (65-250), but I rather suspect they remain silent for a reason.

This is a good point because the info given in the package inserts for different pet meters don't all indicate the same reading for what they label as hypoglycemic or hyperclycemic (and they don't provide a guide of "normal" range) possibly because different labs have slightly different reference ranges so anyway you slice it BG is not an exact science and there is never going to be a totally perfect meter human or pet.

I think the best advice is to pick a meter you like and stick with it for consistent readings because even 2 human or 2 pet meters compared using the same drop of blood will not necessarily elicit the same result.

 

[SidneysMom]

I bought my supplies for a really great price. Walmart Canada gave me the Freestyle Lite meter free if I bought the test strip pack for 75 dollars. Also got the lancets and needle box. Vaseline and cotton pads.

 

[Wendy&Neko]

Well done on the bargain hunting. Good luck with the first poke.

 

[whiskysmom]

Glad you've got your supplies, and hope the vet appointment today goes well. It won't take long and you and kitty will both be comfortable with the routine!

 

[SidneysMom]

So, I got a call today from the vet's office early. Yesterday, I talked to a new receptionist, today I got the experienced one on the line, and she said that she didn't even need to have the doctor call, that I can purchase the Lantus and bring that, and even told me what kind of needles to get. So obviously I'm not the only one that has asked for a different insulin.
Today I purchased a vial of it. That was what I had to go with, but in the future I will look for the pen pack things. Here, insulin isn't too expensive so I wasn't concerned about that yet. I also got the necessary syringes. They sold me the wrong kind first and I had to return them a moment later. The other pharmacist was annoyed because she said, "I heard you say exactly what you needed, I'm not sure how you ended up with the wrong thing. Sorry about that."
So we are ready for tomorrow's appointment at 11 am. I have to be honest, I'm so nervous I'm actually sick about it. I keep bawling my face off, partially from anxiety, partially because I feel bad making Sidney wait another day for treatment. I'm one of these people that isn't very good at needles myself, so I just hope I can do this and not hurt him. I was considering asking the vet to shave a tiny portion of him so I can see how to do this at first. He's all black and I feel like it's going to be hard for me.
Also, he's starting to back off from the Fancy Feast. His appetite was really good at first, with him MOSTLY enthused and cleaning his plate. He's eating but is starting to leave a bit behind. Today he had me open three cans in a short span and took a few bits of each. I was worried he wasn't feeling good, but he kept getting distracted chasing a tiny bug on the kitchen floor. <sigh> He woke me an hour and a half later, and I had to give him the higher carb fancy feast /(1/2 can only) because I was worried he wouldn't eat and I didn't want to waste another can. I mixed it with a lot of water.
One way I've gotten him to eat in the past is by crushing up one or two freeze dried chicken pure bites onto his wet food, but I don't want to do that if I don't have to because he gets addicted to them.
You guys can probably hear my anxiety in this post. I'm so sorry. I am trying really hard to be a good mama and get everything set up properly and ready for this, but I'm just...not ready. It's all I can think of. I haven't been sleeping much at all, and I'm a total stress ball.
I've gotten really close to Sidney since my female cat, Miss, passed away last year. It's coming up on that anniversary and the fact he has this problem now just makes it doubly impactful, I guess.
I know I have to get the spreadsheet set up, but I need to wait a day because I am just utterly exhausted. I'm almost envious of my husband. He gets to go off to work, and I am at home working, so I feel like I don't have an escape from this. It's a blessing, totally, but also a curse, if that makes sense.
Anyway, thanks so much for listening to my anxiety-fuelled yapping. I've had almost two years of being free from having an intensely ill cat. She was ill for years and it was just overwhelming. And I feel like we're hopping back on that train. I hope it's not anywhere near as bad as that, but the dread I feel of the unknown is crushing me at the moment.
Everyone keeps saying it's no big deal. I'm sure I'll get to that point. It's just now, I'm not there.

 

[MrWorfMen's Mom]

You need these. And don't ever apologize for a rant. We provide moral support as well as kitty advice.

Deep breathes. You are being so proactive for Sidney that you will be just fine. Sidney is lucky to have such a good kitty Mom.

What you are experiencing is normal but we can guarantee in a short time, you'll be wondering why you thought this would be difficult. I'm a retired R.N. and believe me, I was absolutely terrified to give my cat a shot. I was surprised to find my girl was totally oblivious to it unlike a lot of humans.

If you are feeling nervous, sing to yourself or to Sidney. Our kitties pick up on our emotions so if you can approach this with a can do attitude then Sidney will soon come to learn that he gets extra attention from Mom, this is just part of his daily routine and he feels better because of it.

So until your appt. tomorrow, start desensitizing Sidney a bit with lots of playing with his ears and checking his scruff area which is likely where they will suggest you give the shots. It's not the testing or the shots that bother kitty......it's the odd fussing and manipulating of their ears or skin that gets their attention so just start getting him used to you fussing with those areas.

While black kitties can make it a wee bit more challenging to do BG testing, testing the inside edge of the ear rather than the outside makes it easier. A little smear of Vaseline to help the sample bead up and you're good to go. I think giving shots to black cats might actually be easier than lighter furred cats whose skin tone can be very similar to the fur.

One step at a time.

 

[SidneysMom]

Thank you so much for your kind words, Linda! I really needed to hear that.
I have been fussing with his ears for the past week, because I had a feeling that would be necessary. Also playing around the scruff.
Just now, I prepared a special bag with all the items for BG testing. I have NO idea how to BG test yet, but I opened the monitor, figured out how to turn it on, read the instructions, and piled the vaseline and cotton pads and testing strips, the meter and lancets in there.
I also opened one of the syringes (what teeny tiny needle! That makes me feel a bit better) and learned how to read one, though where the heck is .5? lol. It's like the line before the first line, I'm guessing.
I also practiced giving shots to a stuffed hippo and some oven mitts by pinching some "Rolls" and using a shallow angle. I know, I'm nuts, but I want to have a technique going and not having only handled the syringe the first time at the office.
I think I have to put this aside for now and get some work done. But here's hoping some prepared-ness helps ease my mind a little. I just want to get him started.
But I appreciate all of the tips and kind words so much. He honestly is the sweetest boy, and I want him to feel better asap. I'm really going to beg the vet to start at .5 or whatever the lowest Lantus dose is, because he has a UTI, and I know that can raise sugar values. He got a shot for it, but I don't want him on 1 in case it's too much.
Here's crossing fingers.

 

[MrWorfMen's Mom]

You are going to be a wonderful sugar kitty Mom! You are so organized and practising on a stuffed animal is a great idea. Never heard of using oven mitts before but hey, whatever works!

On the syringes, the half unit markings are on the left side and the full unit marking are on the right as you peer at the syringe with the needle pointed upward. The very top line on the syringe barrel is the zero line.

As you can see, you'll be giving a very tiny dose of insulin to Sidney so it will be a very quick process he probably won't even notice.

One other thing in case you decide to practice testing yourself with the glucometer......... Sidney has very few nerve endings in his ears so he will NOT feel anything close to what you feel poking a finger which is loaded with nerve endings. Testing doesn't hurt them.

 

[Wendy&Neko]

I hadn’t heard of practising on a stuffed hippo, but well done! The usual suggestion is an orange. Maybe shoot it up with some tasty liquor to relax kitty momma later.

All you ever wanted to know and more about testing http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

You got this. From someone not a nurse who used to faint at the sight of blood, not fond of needles myself. Now a cat poker. Done it for friends cats too.

 

[whiskysmom]

You are doing SO great @SidneysMom - your kitty is lucky to have a mom who is putting so much effort into research and preparations.

We were diagnosed in September and I was so nervous before my vet training session that I was almost making myself sick. I'm SUPER squeamish when it comes to needles for myself and I was scared of the responsibility! But within a few days kitty and I started getting comfortable with the routine, and now he knows the steps so well he even jumps up onto the bed at shot time and sits in the perfect position. Testing has gotten much easier too. You'll be set in no time!

Hope everything goes great today with the vet appointment and first days of shots. You've got this!!