? 3/2/20 New Member - Question on Glucose Meters

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tiffyozmo

tiffyozmo

Member Since 2020
Hello,

My cat, Maverick, was just diagnosed with diabetes this past weekend. He has a host of other health problems (kidney disease, IBD or lymphoma, possible liver issue, current bladder infection). He is 14 and his health decline started about a year ago. He was a 17lb cat and is now approx. 11lbs. He was on Prednisolone for approx 5 months and has now developed diabetes. My vet has switched him to Budesonide. He's also on Cerenia, Clavacillin (for infection), Benezipril, and Lantus insulin now.

I've had a diabetic cat before (Maverick's sister). It was a pretty traumatic experience. She had severe pancreatitis, diabetes, and was diagnosed with Cushing's disease. She sadly passed away, and we were never able to get her blood sugar in check. At that time I had purchased OneTouch Ultra meter and did home monitoring.

Back to Maverick - My vet wants me to buy the Alpha Trak. As many people pointed out here, the strips are super expensive. My vet says that human glucose monitors are not accurate for cats. Has anyone tried the PetTest Advocate BGM system or any other cheaper pet-specific monitors? I'm hoping if I find a cheaper pet-specific BG monitor so my vet will be appeased.

General advice is also appreciated. :)
 
Hello and Welcome. Sounds like your previous diabetes experience was tough with Cushings too.

Why does your vet need to approve the meter? He isn’t paying for the test strips is he? My vet used the Onetouch Ultra in her office and said it was quite close to lab results. Then Abbott started really marketing their AT. My vet asked if I wanted one. Umm, no? She wasn’t using it either. :p As it turns out, our dosing methods were developed with human meters, so it is actually better to use a human meter to manage the dose.

I think of vets pushing those meters as the same way they push the “prescription” but not really anything special vet food. In a phrase “not necessary”. There are enough expenses with insulin you don’t need to add strip cost. I think vets should just be happy you are treating the cat and doing home blood testing.

Enough on that. My girl was on budesonide for either IBD or small cell lymphoma too. We could not diagnose properly because her heart could not handle anesthesia. For us, budesonide did not impact blood sugars, though it does for some. I was also dealing with kidney disease. What food are you feeding now? You want a low carb, low phosphorus wet or raw food. Does Maverick need novel proteins too? That does make food choices even trickier,. Been there, done that. :rolleyes:
 
Yes, I totally agree with your stance on meters, but I am trying to avoid conflict with the vet. I offered to bring my meter in so we could compare results, but she didn't really seem open to that. I might just bring it in or use the OneTouch Ultra anyway. Undecided there.

Maverick has the same trouble getting a diagnosis. My vet doesn't think he could handle anesthesia either. I hope that the budesonide doesn't cause him harm, like I think the pred did. During the time he was on pred, he lost almost 3 lbs and his blood sugar seems to have spiked. Right now I'm mainly feeding him Koha Limited Ingredient Turkey canned food. I went to the catinfo.org spreadsheet and found a food that Maverick likes and has less than 10% carb, less than 200 phosphorus, and limited ingredient / novel protein like my vet recommended. My vet did try to push the prescription diets, but not as hard as the meter. The problem causing symptom for Maverick is lack of appetite. It's a serious struggle to get him to eat. He acts hungry. For a while I was mixing in other low carb foods like Tiki Cat and Weruva, but I'm back to mostly Koha LI Turkey. He does have Wysong Epigen 90 sitting out for him to free feed, but he doesn't eat it.
 
tiffyozmo said:
The problem causing symptom for Maverick is lack of appetite. It's a serious struggle to get him to eat. He acts hungry. For a while I was mixing in other low carb foods like Tiki Cat and Weruva, but I'm back to mostly Koha LI Turkey. He does have Wysong Epigen 90 sitting out for him to free feed, but he doesn't eat it.
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Cat not eating well + not enough insulin + infection/inflammation (think the IBD and the bladder infection) is the classic setup for ketones and then DKA.

We already have 3 members on the message board this week, trying to save their DKA cats.

Please, please test for ketones ASAP. And every single day. It's that important.
If he acts hungry and won't eat, it could be nausea. Get some cerenia or ondansetron, may be available over the counter in Canada.

Could be pancreatitis also. Is he "meatloafing"?
 
A specialist tested him for ketones on Friday, but she didn't say anything about those test results. I've never heard of testing that. Is there a link to a page that explains ketone testing?

Maverick is currently taking 4mg of Cerenia each day. My vet said she wouldn't be surprised if he had pancreatitis. I'm not familiar with the term meatloafing.
 
Ketones/Diabetic Ketoacidosis (DKA): Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters
Basically, purchase some urine ketone test strips at your local pharmacy/drugstore/ chemist. The kind people use to test their urine if they are on the keto diet or are diabetic.
Stick the ketone in fresh urine. Read the result on the ketone test strip.

Or there are specific blood and ketone test meters. The ketones are tested using separate test strips. The meters can pick up the ketones quicker than the urine test strips. Ketones show up in the blood first, than need to be filtered out by the kidneys before they show up in the urine. Meters can be useful for the shy pee-er. Or if it's difficult to catch your cat at the litter box.

Urine catching tips and tricks.

Ketones can develop very quickly. From one day to the next.

Meatloafing - curled up, in a big lump, legs tucked under, head down, eyes closed, laying there like a big hunk of meatloaf. Or looking like a loaf of bread. Not moving much, maybe showing some signs of pain. Sitting hunched with back arched, paws gathered under the body, nose resting on the floor, and eyes closed. This is known as the “meatloaf” position.

Pancreatitis: A Primer On Pancreatitis
 
Deb & Wink said:
Get some cerenia or ondansetron, may be available over the counter in Canada.
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Ondansetron needs a prescription in Canada. Get the generic brand otherwise it's mega $$$. Cerenia only available from the vet. Many vets dose too low on the antinausea meds. If you look at the file on (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease there is a section on guidelines for anti nausea meds, page 232 table 9 that says the Cerenia dose should be 2 mg/kg every 24 hours for the pill version. At 11 lbs, Maverick is 5 kg, should be getting 10 mg per day. Maybe try bumping it up to 8 mg (easier to cut) and see if that helps the nausea. If the vet fusses, sent them the article. By the way, been there done that on underdosing the nausea meds until I learned better. :( Many vets dose the pill version the same as the injectible, but you need twice as much.
 
I've never noticed him meatloafing, but now that I know what it is I will keep an eye out. I will go out to try to find some ketone strips at the pharmacy tonight. Also, I will try giving him more cerenia when I he is struggling to eat.

He's been taking 1 unit of insulin b.i.d for two whole days now, and his appetite has improved significantly. Last night I was shocked he ate an entire 5.5oz can of Koha, which is about 200 calories, considering he had 1/2 can in the morning that put him around 300 calories for the day. This morning he wanted 3/4 of a can, so already 150 calories for today. This is excellent news! I guess the insulin is making him feel better, which is helping his appetite. I started testing his BG with the OneTouch Ultra that I have prior to feeding and giving insulin and putting the values in the spreadsheet. Would this be considered SLGS? Its been sort of a struggle to test his BG along with pilling most of his meds and shots. I realize how important it is, so I will continue to test Maverick's patience and low carb treat motivation. If his PS value is below 90, should I not give him the 1 unit dose? This morning it was 121, which kind of worried me.
 
I can see your spreadsheet. It looks like the 1 dose last night and again this morning? Any chance you can get a test again mid morning? 121 is a really low number to shoot for a cat that is brand new to insulin. We suggest people stop and ask for help if they see a number below 200 when they are new.

tiffyozmo said:
Would this be considered SLGS?
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The starting dose for cats eating wet food and if you are using SLGS is 0.5 units, not 1.0 units. That is for cats eating dry food. Given his early great response, I think I'd go back to 0.5 units tonight, presuming he is in a safe range to shoot. Low numbers can also mean they are looking for food to bring up the numbers.
 
I leave my house at 6:45AM for work and return around 5:30PM, so I'm not able to test while at work. The internal medicine veterinary specialist recommended the 1 unit of Lantus 2x daily 12 hours apart after Maverick's BG tested over 500 in her office. I told her what food I was feeding. I then ran that insulin dosing plan by my main vet and she was okay with it. When I asked the veterinary specialist about monitoring Maverick's BG at home, she scoffed and acted like that was a crazy idea. She said they do not recommend that owners do that, instead she suggested that I bring him in after a week of the treatment plan for a $121 glucose curve. I was not a fan of the specialist, so I reached out again to my regular vet.

My regular vet doesn't do in-house glucose curves. They recommend that owners monitor the BG of their cats themselves, which is consistent with what I was thinking, but she didn't give me any guidance on how to do that. It's been several years since Maverick's sister passed, and I was not successful with her regulation. I remembered that at a minimum I needed to test him prior to giving insulin. That's how I ended up here. The first couple of doses, I just gave him because I was unsure about the advice from my vet that Human BG monitors won't work. I guess I'm just struggling a little with the fact that my vet wants me to get the Alpha Trak meter. If I reach out to her about my current readings, she might just dismiss them as inaccurate because it's a human meter. The strips aren't expired, but they do expire soon. So, I'm a little wary about the reliability of the readings. Should I just buy the AT? It doesn't seem like anyone is familiar with the PetTest meter.

Now I'm kind of worried that I may have overdosed him this morning. Also, I wasn't able to find the insulin needles with the 1/2 unit marks. I really want to do right by my baby, so I'm a little stressed by all of this. I can test him when I get home again. Should I start a new post at that point?
 
Your choice if you want to start a new post on a new topic or continue on this one.

Could you put the other doses you gave into the spreadsheet? It's OK if there wasn't a preahot test. It'll still help us determine how the depot is building. If that 121 was just the second shot, it's more of a concern that if it's a few days since the first shot.

Test when you get home -paws crossed he's safe.

The specialist vet needs to go back to school - or at least read the latest guidelines on treating feline diabetics. :banghead: Your own vet seems more up to date, even if she has bought into the AT marketing on the meters. It's your money if you want to buy it. I just flat out told my vet no, the test strips were too expensive. I'd rather be able to get more tests when I need to with cheaper test strips and strips that are readily available in most pharmacies. With the AT you have to either have the vet clinic open and have them in stock, or wait for them to arrive in the post. Not a good thing if your cat decides to go low one night. Hundreds and hundreds of cats have had their diabetes successfully treated with human meters here.

After the first couple weeks of being on here, I stopped asking my vet about dose. I always needed help on her days off and sometimes it would take a day to get back to me, and after I had to give this shot. It just was easier for me to follow the dosing methods here. I printed off the dosing method for my vet, showed her some snapshots of the spreadsheet. After that, the only question she asked was the current dose.

Do you have a Walmart near you? Their Relion syringes are supposed to have 1/2 unit markings.
 
Totally agree on the specialist comment.

Okay, yes on the spreadsheet. I added the other doses to the spreadsheet. I do have a Walmart nearby. I can look for the Relion syringes and the keto strips tonight. I'm about to leave work, so I'll head straight home first to test and report the PS BG # in a new thread.
 
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