Zoot!'s new vet wants us to switch to AlphaTrak - advice

[Cinnie Cole]

We finally found a vet who is well versed in diabetes and willing to work with us toward remission! He has asked us to switch from the ReLion Micro to the AlphaTrak pet meter, which is okay by us.

Is any literature on FDMB related specifically to using a pet meter instead of a human meter? Is there anyone here that can help us understand the difference in numbers as we do the switch?

Thanks from Cinnie and Zoot!

 

[Sienne and Gabby (GA)]

There is no compelling issue about using an AlphaTrack meter but there are some practical considerations.

First, vets tend to like pet-specific meters since the numbers are a bit more consistent with a serum chemistry analyzer which is the equipment that does the lab values when they send bloodwork out. The pet meter read a little higher than a human meter. The fact that an AT meter reads higher is a mixed blessing. That a human meter reads a little lower means you have a greater margin of safety (i.e., you would intervene sooner if you saw low readings on a human meter).

There is a huge difference in cost for strips between the 2 meters. The strips for the AT meter cost about $1.00 per strip. If you have a day when you need to closely monitor Zoot's numbers because he's running low, you can burn through a lot of strips. (Somehow, I suspect that vets may not be cognizant of what the difference in cost is. You may want to educate your vet what the cost per strip is for the Relion vs the AT.)

Finally, if you take a look on the Lantus board here, you'll note there at two options we use for dosing, the Tight Regulation (TR) Protocol and the Start Low Go Slow (SLGS) method. Both of these approaches are based on readings from a human meter. the TR Protocol was developed and research by a veterinarian and was published several years ago in a leading veterinary journal. The instructions for TR are very clearly based on a human meter.

 

[Cinnie Cole]

There is no compelling issue about using an AlphaTrack meter but there are some practical considerations.

First, vets tend to like pet-specific meters since the numbers are a bit more consistent with a serum chemistry analyzer which is the equipment that does the lab values when they send bloodwork out. The pet meter read a little higher than a human meter. The fact that an AT meter reads higher is a mixed blessing. That a human meter reads a little lower means you have a greater margin of safety (i.e., you would intervene sooner if you saw low readings on a human meter).

There is a huge difference in cost for strips between the 2 meters. The strips for the AT meter cost about $1.00 per strip. If you have a day when you need to closely monitor Zoot's numbers because he's running low, you can burn through a lot of strips. (Somehow, I suspect that vets may not be cognizant of what the difference in cost is. You may want to educate your vet what the cost per strip is for the Relion vs the AT.)

Finally, if you take a look on the Lantus board here, you'll note there at two options we use for dosing, the Tight Regulation (TR) Protocol and the Start Low Go Slow (SLGS) method. Both of these approaches are based on readings from a human meter. the TR Protocol was developed and research by a veterinarian and was published several years ago in a leading veterinary journal. The instructions for TR are very clearly based on a human meter.

Thanks for your advice. We are trying to have a balance between working with a Vet and managing toward remission. Because the FDMB group often seems at odds with typical veterinary practice; it makes it hard to weigh pros and cons when making our decisions. It is why we have not done either of the protocols yet. Maybe I will repost in the Lantus group to see who, if anyone is dealing with using the AlphaTrak there.

 

[Lisa and Witn (GA)]

Most people start with the Start Low Go Slow method. This is easier to follow when starting out. Once you learn how your cat typically respond to the dose and you are comfortable making dose changes, then you may want to switch methods.

 

[Kate & Toby]

Hey, im following TR with Levemir and also use an AT meter. I agree its expensive. But I'm kinda stuck now and I'm making it work. It's also the meter my vet and my specialists use, so I have no idea whether they would agree or disagree. I appreciate I'm not adding much to help you, but it works well for us.

 

[Cinnie Cole]

Hey, im following TR with Levemir and also use an AT meter. I agree its expensive. But I'm kinda stuck now and I'm making it work. It's also the meter my vet and my specialists use, so I have no idea whether they would agree or disagree. I appreciate I'm not adding much to help you, but it works well for us.

We asked our new Vet if we could use the human, but he is more comfortable with us switching to AT and using the same that they use. We can handle the cost, but want to be certain that we understand what the numbers mean - I did set up a new SS for the AT once it arrives. Thanks for your help - I will take a peek at Toby's SS.

 

[Cinnie Cole]

Most people start with the Start Low Go Slow method. This is easier to follow when starting out. Once you learn how your cat typically respond to the dose and you are comfortable making dose changes, then you may want to switch methods.

Thanks - we need to really look at what each means - meaning we need to do our research (again).

 

[Kate & Toby]

We asked our new Vet if we could use the human, but he is more comfortable with us switching to AT and using the same that they use. We can handle the cost, but want to be certain that we understand what the numbers mean - I did set up a new SS for the AT once it arrives. Thanks for your help - I will take a peek at Toby's SS.

I honestly think that as long as you are consistently using the same meter and same brand of strips (dont be tempted to try cheap strips in the AT) then you will be fine. Just get comfortable with what a hypo take action number looks like (4 ish on AT) and you should be fine. I use the spreadsheet from FDMD and this cleverly converts for others to see my readings and so we can all talk the same language. On the Lantus / Levermir forum you will notice that the way we do our daily posts is a bit different from the other groups, so for me, I have to input my numbers, and then see what the US equivalent is before I start my daily thread, but it really only takes a second.
Happy to help if I can xx

 

[Cinnie Cole]

I honestly think that as long as you are consistently using the same meter and same brand of strips (dont be tempted to try cheap strips in the AT) then you will be fine. Just get comfortable with what a hypo take action number looks like (4 ish on AT) and you should be fine. I use the spreadsheet from FDMD and this cleverly converts for others to see my readings and so we can all talk the same language. On the Lantus / Levermir forum you will notice that the way we do our daily posts is a bit different from the other groups, so for me, I have to input my numbers, and then see what the US equivalent is before I start my daily thread, but it really only takes a second.
Happy to help if I can xx

Oh great! thanks for the advice and hint on posting!

 

[FurBabiesMama]

Hi. I'm an AlphaTrak2 user and have been since I started testing in July 2017. AlphaTrak strips are batch tested to determine the code that needs to be used for the most accurate reading for a cat (there's a dog code, too). I like using it because I want my numbers to be as accurate as possible. (There is still a variance; no meter is perfect.) As far as the difference between AT results and human meter results, human meters will read lower. There is no direct conversion you can do. From what I have 'heard' here, I think the difference between the two is usually greater in higher numbers than lower numbers. Below 65 is considered hypoglycemia on an AT meter (per the meter documentation), so obviously, you would take action if your cat was dropping too close to that whereas with a human meter, 50 is what is used here as the take action number. That's probably the most important thing to be clear on if/when you switch.

As has been mentioned, AT strips are expensive. It is a considerable expense over time. So, if that is at all a concern for you, I would suggest that you consider continuing to use your human meter for daily monitoring and use the AT for curves that are intended for your vet. That is a good compromise that honors your vet's request to have AT numbers but allows you to have a more cost effective option for most of the time.

 

[Cinnie Cole]

Hi. I'm an AlphaTrak2 user and have been since I started testing in July 2017. AlphaTrak strips are batch tested to determine the code that needs to be used for the most accurate reading for a cat (there's a dog code, too). I like using it because I want my numbers to be as accurate as possible. (There is still a variance; no meter is perfect.) As far as the difference between AT results and human meter results, human meters will read lower. There is no direct conversion you can do. From what I have 'heard' here, I think the difference between the two is usually greater in higher numbers than lower numbers. Below 65 is considered hypoglycemia on an AT meter (per the meter documentation), so obviously, you would take action if your cat was dropping too close to that whereas with a human meter, 50 is what is used here as the take action number. That's probably the most important thing to be clear on if/when you switch.

As has been mentioned, AT strips are expensive. It is a considerable expense over time. So, if that is at all a concern for you, I would suggest that you consider continuing to use your human meter for daily monitoring and use the AT for curves that are intended for your vet. That is a good compromise that honors your vet's request to have AT numbers but allows you to have a more cost effective option for most of the time.

Thanks for the information - I was concerned as we switched that Marty and I both understood the numbers - since we have used the ReLion for 6 months, we don't want to make any mistakes when we change over. Thanks also for mentioning the code - my Vet mentioned that too so we will be sure to get it coded for cat!