11/15/19 Stasiu AMPS 431

JoannaDV1

JoannaDV1

Member Since 2019
Hello! I recently joined the forum since it’s been 6 weeks treating my cat without any improvement. We are way up on our Lantus dose and am wondering if I should cut back thinking we may have missed the appropriate dose. I also just changed to all moist Fancy Feast Classics pate food at the beginning of the week. I still feed him twice daily and am considering more frequent meals. I def need advice since we are not making progress.
Thank you!
 
Hi there and welcome to the forum!

It is good that you have switched to lower carb wet food. That in itself can help bring the numbers done.

It didn’t appear that you’ve missed the dose with data you have so far but anymore testing you can do will help to fill in the SS and give more information.

Apparently, you are using calipers. We take the dose up and down in increments of 0 .25 unit.

Would you be able to set up a signature with pertinent information like kitty’s name , date of DX , human or pet meter, food , and any other medical conditions. That will help us help you better.

If you could do a curve this weekend , that could help to know where to go with the dose.

Keep posting and asking questions. That is how we all learned. There is a lot of knowledge and information here willing to assist you.
 
Bobbie And Bubba said:
Hi there and welcome to the forum!

It is good that you have switched to lower carb wet food. That in itself can help bring the numbers done.

It didn’t appear that you’ve missed the dose with data you have so far but anymore testing you can do will help to fill in the SS and give more information.

Apparently, you are using calipers. We take the dose up and down in increments of 0 .25 unit.

Would you be able to set up a signature with pertinent information like kitty’s name , date of DX , human or pet meter, food , and any other medical conditions. That will help us help you better.

If you could do a curve this weekend , that could help to know where to go with the dose.

Keep posting and asking questions. That is how we all learned. There is a lot of knowledge and information here willing to assist you.
Click to expand...

I have no idea how to set up a signature with the information you are asking for, but the info is at the top of the spreadsheet I created. Stasiu does not have other medical conditions either. If you can point me in the direction how to create this signature, that would be helpful. And I will have to look into what it means to do a curve to try to do it this weekend. Thank you!
 
To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
  • Your first name (if you want)
  • Kitty's name, age, & sex
  • Date of diagnosis
  • Name of the insulin being used
  • The name of the blood glucose meter you are using
  • Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
  • Is kitty currently taking any other medications or supplements?
  • Does kitty have any health issues (current or in the past)?
  • Food: What are you currently feeding kitty?
  • Any information about your cat which is important, but hasn't been covered above
  • Your country / timezone - this helps for timezone specific advice
  • If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.

hope that helps :)
7A8B9564-BD36-4C09-BBAC-2068BDB017D3.jpeg
 
Oh also: WELCOME!! Sorry I was all business this morning since I was getting ready for work :)

happy to have you posting on the forum and hope to get to know you and Stasiu better as you post more :joyful:
 
Hi an Welcome to the forum:)

JoannaDV1 said:
We are way up on our Lantus dose and am wondering if I should cut back thinking we may have missed the appropriate dose
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It's hard to say what the current dose is doing with the data that you have at the moment.

Better than cutting back (which in a lot of cases is counter productive), I would aim to over the next few days, to fill in the blanks.

Running a curve over the weekend (testing every 3 hrs for 18 hrs) or every 2 hrs for 12 hrs, but additionally I would recommend getting at least one midcycle test on every cycle. We base Lantus dosing on how low the dose is taking our kitty and with the missing midcycle data we cannot figure this out.
Would you be able to get one or two tests each cycle? Would your work Schedule allow that?
If you work long hours then getting a test just before you go to bed even if that is a +1 or +2, it helps. Equally in the morning if you are up and about early before going to work a +10 or a +11 can help. When we ask about midcycle data it's anytime between shots, not just +5/+6/+7

JoannaDV1 said:
I still feed him twice daily and am considering more frequent meals.
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I think this is a good idea, as with lantus this seems to work better.
You want to make sure that he has no food in the two hours just prior to his insulin shot, it's important to know that the number you get just before you shoot is not influenced by food. Many of us also find that it can help not to feed after +6+7 in the cycle (unless you have to because BG was too low), feeding late in the cycle, when the insulin's effect is waning can have a tendency to push numbers up.
 
AmandaE said:
To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
  • Your first name (if you want)
  • Kitty's name, age, & sex
  • Date of diagnosis
  • Name of the insulin being used
  • The name of the blood glucose meter you are using
  • Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
  • Is kitty currently taking any other medications or supplements?
  • Does kitty have any health issues (current or in the past)?
  • Food: What are you currently feeding kitty?
  • Any information about your cat which is important, but hasn't been covered above
  • Your country / timezone - this helps for timezone specific advice
  • If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.

hope that helps :)
View attachment 49139
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Thank you! Will try later tonight!
 
Gill & George said:
Hi an Welcome to the forum:)


It's hard to say what the current dose is doing with the data that you have at the moment.

Better than cutting back (which in a lot of cases is counter productive), I would aim to over the next few days, to fill in the blanks.

Running a curve over the weekend (testing every 3 hrs for 18 hrs) or every 2 hrs for 12 hrs, but additionally I would recommend getting at least one midcycle test on every cycle. We base Lantus dosing on how low the dose is taking our kitty and with the missing midcycle data we cannot figure this out.
Would you be able to get one or two tests each cycle? Would your work Schedule allow that?
If you work long hours then getting a test just before you go to bed even if that is a +1 or +2, it helps. Equally in the morning if you are up and about early before going to work a +10 or a +11 can help. When we ask about midcycle data it's anytime between shots, not just +5/+6/+7


I think this is a good idea, as with lantus this seems to work better.
You want to make sure that he has no food in the two hours just prior to his insulin shot, it's important to know that the number you get just before you shoot is not influenced by food. Many of us also find that it can help not to feed after +6+7 in the cycle (unless you have to because BG was too low), feeding late in the cycle, when the insulin's effect is waning can have a tendency to push numbers up.
Click to expand...
I can definitely try to do this over the weekend. When I work 12 hour shifts, it’s difficult to get any values other than premeals. I leave 6am and don’t get home until 8pm or later, and then it’s difficult for me to stay up to do more testing. On my days off though, I will try to get more values. I have just been doing what my vet suggested and, clearly, it’s not providing enough info.
Thank you!
 
Welcome to the forum Joanna! Sounds like you have a plan in place for the weekend. It is more challenging for those who work outside the home...but it's doable...just gotta grab those tests anytime you're home...

Stasiu is gorgeous btw! What a cutie!
 
AmandaE said:
To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
  • Your first name (if you want)
  • Kitty's name, age, & sex
  • Date of diagnosis
  • Name of the insulin being used
  • The name of the blood glucose meter you are using
  • Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
  • Is kitty currently taking any other medications or supplements?
  • Does kitty have any health issues (current or in the past)?
  • Food: What are you currently feeding kitty?
  • Any information about your cat which is important, but hasn't been covered above
  • Your country / timezone - this helps for timezone specific advice
  • If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.

hope that helps :)
View attachment 49139
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Thanks for the info, but I have tried this multiple times and it says I am entering too much info and it won’t save. I entered this info under my personal info for now since it won’t take under signature. Other suggestions?
 
JoannaDV1 said:
Thanks for the info, but I have tried this multiple times and it says I am entering too much info and it won’t save. I entered this info under my personal info for now since it won’t take under signature. Other suggestions?
Click to expand...
Ahh yes! It looks like you would just have to shorten the information in the signature... that happened to me when I joined too. If you look, my signature is much shorter than some of the others. Maybe you could copy mine to have an idea of characters allowed?
 
JoannaDV1 said:
I also just changed to all moist Fancy Feast Classics pate food at the beginning of the week.
Click to expand...
What food was he on before you made the switch to the fancy feast? I see that's just four days ago.

Changing the diet can impact numbers greatly and reduce the insulin needs, especially if he was on a high carb diet.

ETA just read through the intro post, I see you made the switch from the Purina dry, that would be classed as HC, you may see numbers reflect the change as it works it's way out of his system. You need to be vigilant with those midcycle tests.
We have seen cats go into remission very quickly when dry is removed, it doesn't always happen, but it's important to know that it is a possibility, because a dose that was not enough can quickly become a dose that is too much.
 
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Joanna --

Part of the issue with. your kitty's numbers is that you are not shooting every 12 hours -- or close to. Because Lantus is a depot insulin, you really need to shoot as close to every 12 hours as possible. An early shot acts as a dose increase and a late shot acts like a dose reductions so every time you alter the shot times to accommodate your schedule, you are destabilizing the depot.

With your schedule, can you give us a bit more details (what days do you work). You may need to migrate the shot times -- you can move the shot time by 30 min daily and depending on how your work days are scheduled, shifting the times may be feasible. Alternatively, is there anyone else who can help with shots? I'd hate to suggest the expense of a petsitter.

I'm less familiar with some of the other insulins and how strictly you need to conform to a 12-hour interval but that may need to be an alternative if we can't figure something out with your schedule.
 
AmandaE said:
To create your own signature, click on your profile name at the upper right hand corner of the page. Select ‘Signature’ on the left side of the profile menu and write a signature containing the following information:
  • Your first name (if you want)
  • Kitty's name, age, & sex
  • Date of diagnosis
  • Name of the insulin being used
  • The name of the blood glucose meter you are using
  • Has kitty experienced any complications from diabetes? Ex. DKA, Neuropathy
  • Is kitty currently taking any other medications or supplements?
  • Does kitty have any health issues (current or in the past)?
  • Food: What are you currently feeding kitty?
  • Any information about your cat which is important, but hasn't been covered above
  • Your country / timezone - this helps for timezone specific advice
  • If you’re home testing, a link to your kitty’s spreadsheet
Select Save Changes.

hope that helps :)
View attachment 49139
Click to expand...
Just a clarification. Location should be filled in on the Profile under user name. The information that is needed in the signature line, approved by the moderators, is included in this very helpful post.

Sorry for the inconvenience but signature lines are getting too long.;)
 
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Sienne and Gabby (GA) said:
Joanna --

Part of the issue with. your kitty's numbers is that you are not shooting every 12 hours -- or close to. Because Lantus is a depot insulin, you really need to shoot as close to every 12 hours as possible. An early shot acts as a dose increase and a late shot acts like a dose reductions so every time you alter the shot times to accommodate your schedule, you are destabilizing the depot.

With your schedule, can you give us a bit more details (what days do you work). You may need to migrate the shot times -- you can move the shot time by 30 min daily and depending on how your work days are scheduled, shifting the times may be feasible. Alternatively, is there anyone else who can help with shots? I'd hate to suggest the expense of a petsitter.

I'm less familiar with some of the other insulins and how strictly you need to conform to a 12-hour interval but that may need to be an alternative if we can't figure something out with your schedule.
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I do not work the same days every week (worked Monday, Wednesday, Thursday last week and am working Monday, Tuesday and then the weekend this coming week), and work every third weekend. My husband is not interested in administering the insulin as he passes out when he gets his own needles. And he sometimes gets home later than I do. So I am not sure what I can do on the 3 days I work.
 
Well, my semi-sarcastic answer is that your husband's vasovagal response to blood/neediles can be treated. It might take a bit longer than you'd like, though.

Is there anyone who could give an injection on the days you work? Is there a vet tech from your vet's office that would be willing to do this and would it be within your budget to pay someone?

The option I hate to suggest is a different insulin. Prozinc, which is a good insulin, may have a bit more flexibility with regard to shot time but let me check with someone to see if that's the case.
 
ProZinc usually last between 10 and 12 hours for most cats and some get as long as 14 hours duration out of a shot. Being an In/Out type of insulin, it does provide a little more flexibility as far as shot times are concerned and while we usually recommend keeping shot times within 1 hour +/- normal shot time, I've seen folks shoot as early as 1.5 hours with no ill effects so I doubt the 2 hours would be a problem as long as appropriate testing is done to ensure it is safe to give insulin early. Some of this will depend on the duration Stasiu gets from ProZinc. The other possibility for consideration in the future once there is sufficient data is that the ProZinc dose can be done on a scale, adjusted from shot to shot if the different cycle lengths/duration is an issue. I think in this situation, ProZinc would be your best option.

With your Monday,Tuesday and weekend work schedule, your shot schedule would look roughly like this. If you get home earlier at night, the night shot could be given anytime from 6pm to 8pm, keeping as close to 12 hour cycles as possible.

Monday shot times 6am/8pm
Tuesday shot times 6am/8pm
Wednesday shot times 8am/8pm
Thursday shot time 8am/8pm
Friday shot times 8am/8pm
Saturday shot times 6am/8pm
Sunday shot times 6am/8pm

Would that be workable?
 
With ProZinc, you will be regarding the pre shot number rather than the nadir. Keeping that in mind, with your floating schedule, it might be your best option as ProZinc does have much more flexibility and as mentioned , you can shot a sliding scale whereas Lantus likes consistency because of it being a depot insulin.
 
@Bobbie And Bubba Not quite true. With ProZinc or any insulin you still need to know how low dose is dropping BG. While it's possible to do scale dosing based on pre-shots, it's still necessary to know how much a dose drops BG to create such a plan so it takes some data collecting before even considering a dosing scale. Dosing scales tend to work better for a kitty who is somewhat regulated.

@Sienne and Gabby (GA) Yes I originally had "as an example" but a little furry critter whose name fits her well, decided she wanted to help and I forgot to add it back in. :woot:
 
MrWorfMen's Mom said:
@Bobbie And Bubba Not quite true. With ProZinc or any insulin you still need to know how low dose is dropping BG. While it's possible to do scale dosing based on pre-shots, it's still necessary to know how much a dose drops BG to create such a plan so it takes some data collecting before even considering a dosing scale. Dosing scales tend to work better for a kitty who is somewhat regulated.

@Sienne and Gabby (GA) Yes I originally had "as an example" but a little furry critter whose name fits her well, decided she wanted to help and I forgot to add it back in. :woot:
Click to expand...
I stand corrected. What I should have said that dosing is based on pres shot numbers with consideration to the nadir.

Thanks for catching that @MrWorfMen's Mom.
 
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Sienne and Gabby (GA) said:
Well, my semi-sarcastic answer is that your husband's vasovagal response to blood/neediles can be treated. It might take a bit longer than you'd like, though.

Is there anyone who could give an injection on the days you work? Is there a vet tech from your vet's office that would be willing to do this and would it be within your budget to pay someone?

The option I hate to suggest is a different insulin. Prozinc, which is a good insulin, may have a bit more flexibility with regard to shot time but let me check with someone to see if that's the case.
Click to expand...
So big question gere that may help my husband give the Lantus....can I draw the dose up and have it sit it the refrigerator until he can give it? Or dose it have to sit in the glass bottle before it can be given?
 
It is not ideal to have the insulin sit in a syringe. I think it would depend on how long the dose would be pre-drawn for. The concern with pre-drawing the dose is that there is a lubricant in the syringe. The manufacturers advise against pre-drawing insulin but if it's not for an overly long time, it shouldn't be a problem.
 
I have pre loaded syringes before less than 12 hours with no ill effects. The lubricant does start to contaminate the insulin after a few days. To be safe I wouldn’t preload any longer than one cycle. (12 hours)

And from what I read, if you preload the syringe, stand it up in a glass in the refrigerator with the needle facing upwards.

It would be wonderful if you could get your hubby on board with testing and shooting Lantus does have a much higher remission rate than ProZinc. I used ProZinc prior to Lantus and I got a much better result when I switched to Lantus.
 
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All this is great info and, unfortunately, all different from what I had been told by the vet when I started this journey. I asked everything about food, feeding frequency, timing of Insulin doses, monitoring...and feel like it’s been wrong and I’ve been doing everything wrong for over 6 weeks. I’d like to stick to Lantus since it seems to be the best product for a diabetic cat’s chance to go into remission. Although at this stage of our treatment, it seems less likely to happen.
What are your recommendations for feeding and food amounts with the use of Lantus? I’ve changed to Fancy Feast Classics pate and want to feed more frequently than twice daily, but am not sure about timing and amounts. I also have 2 other cats, so feeding has been a challenge. This whole situation has been an unbelievable challenge- not what I expected at all.
 
JoannaDV1 said:
all different from what I had been told by the vet when I started this journey.
Click to expand...

You've gotten some great advice above - but I want to respond to your comment about the information you got from your vet - unfortunately many vets have had very little training in feline diabetes. Their limited knowledge has mis-directed more than a few cat parents to do more harm than good with their diabetic kitties.

The people on this forum have collectively far more education and experience with diabetic cats than the majority of vets combined. Vets may mean well, however often (not all, but most) give poor or limited information on treatment for diabetic cats. September isn't very long ago for a diagnosis...all is certainly not lost and there is still time to help Stasiu achieve a very healthy and long life once you help him get control of his blood glucose.

As for your comment about feeding only twice a day - I feed my Luci as often as she is hungry - and that's many times a day. If your other cats will eat the FF pate - feed them the same - you may go thru a lot of cans, but if they'll eat it, put it out there for everyone to enjoy. It's a healthy option for all cats, diabetic or not.

Please keep posting and asking questions - the people here will help you overcome all the challenges. :bighug:
 
Joanna --

Most of us were completely overwhelmed when we got here. We likewise found out that even a good vet isn't always well informed about FD. The vet I used when Gabby was diagnosed was a wonderful vet and there were some things we agreed to disagree about. Both my original vet and the vet I use now (I moved from Chicago to Columbus, OH) pretty much left me alone when it came to managing Gabby's diabetes once they realized I knew what I was doing. Not all vets are like that. What also made a difference is they are both "cat only" vets. I can't imagine how hard it would be to have to know as much as possible about every disease for every species of animal some vets treat in their practice.

When it comes to food, Stasiu is likely to be hungry all the time until numbers are better regulated. Insulin is what helps move glucose (the end product of metabolism) into the cells. If your cat isn't producing or getting enough insulin, BG numbers are high because the glucose is floating around in the blood stream. When this happens, your cat may be eating but the cells aren't getting fed as much as they need. It's also why it's hard to say how much you should feed. your cat.

Dr. Lisa's site on feline nutrition has a formula to approximate the number of calories your cat needs on a daily basis: Required calories per day = [13.6 X optimal lean body weight in pounds] + 70. This will get you into the ballpark regarding the amounts. The calories should be on the cans or are listed in Dr. Lisa's food chart. As for timing, Stasiu's numbers seem to be high and flat. Until we have a better sense of when nadir falls, I'd suggest spreading the food out mostly before +6. For many cats, if you feed after nadir, there's less insulin available to offset the influence of food. However, is Stasiu is threatening to gnaw your arm off, a low carb snack later in the cycle, as long as it's not after +10, is fine. You don't want to feed 2 hours prior to shot time to insure the pre-shot number isn't affected by food. (The exception being if numbers are low.)

I'm guessing you're not feeding your two other cats the same food as Stasiu. I did the same thing -- Gabby and Gizmo were being fed different foods and, of course, Gabby wanted Gizmo's food and vice versa. Someone here pointed out that there was no reason to give Gizmo different food. Gabby was eating a low carb, canned food diet and it was fine to give Gizmo the same food. Duh! (I felt like an idiot.) Would feeding the same food to all of your kitties be possible?

I know I probably sound like a broken record but can you please get a test every single night before you go to bed? Many cats experience lower numbers at night so you need to know that it's safe to go to sleep. In addition, without any PM tests, you're missing half of your data.

How else can we help?
 
I feel like this has become a full time job, but want all the info to make this work. I can definitely feed my cats the same food as Stasiu, but just wanted to finish up what they’ve been eating in the past. Also, my vet had just recommended premeal testing and only 1 test 4 to 6 hours after a meal. So I’m still trying to figure out when exactly I should be doing testing. I’m flying through the test strips that, as we all know, are very expensive. So, when I am home- when should the testing be done ideally?
 
JoannaDV1 said:
I’m flying through the test strips that, as we all know, are very expensive.
Click to expand...

Might I suggest that you purchase an inexpensive human meter and matching test strips? Many of us use them and the protocols are all written with human meters as reference. Save your $$ for more important things.

As mentioned above you need to at least get a test or two before going to bed in the evening...if you can get up a little earlier in the mornings before work; test/feed/shoot earlier and then you'll have a chance to grab a test just before leaving for work. Many others work outside of the home and it can be done - I know you have a difficult schedule - and there have been suggestions offered for working around that - even if it's just a few days a week that are better than others...it can be done...

What is the food they've been eating in the past?
 
Right now, it probably does feel like a full time job. It gets easier, I promise. There's so much to learn at the beginning that it's overwhelming. It will become routine.

I never used an AlphaTrak or any pet meter. I used a Bayer Contour for 6.5 years and it was just fine. The cost for AT strips is ridiculous. The human meters numbers run a bit lower than the AT but I look at that as a safety margin. I'd rather have a meter that ran a little low than one that ran high. Especially with my kitty who was prone to being a bit of a diva when it came to dropping early, fast and low, it was just fine to intervene sooner rather than later. This is my roundabout way of suggesting you save your money and get a human meter. You can buy strips online for a fraction of what the AT strips cost AND, should you run out, you can get strips for a human meter at a brick and mortar store. You can't do that with a pet specific meter. There's also the practical issue that the dosing protocols we use were all developed for a human meter. Even TR, which was published in a leading vet journal is predicated on using a human meter.

When you have a minute, take a look at Gabby's spreadsheet (SS). Like I said, she was a diva and I like data. I don't expect anyone to emulate my testaholic nature. However, until you know when Stasiu's onset and nadir are, your vet's instructions are premature. Your vet is assuming that nadir will fall in the neighborhood of +6. While that may be true on average, again, look at Gabby's SS. Her nadir was routinely early -- at around +3 -- except when it wasn't. Nadirs can and do move around. Some cats have early nadirs and some have late nadirs. If you test at +5 and nadir isn't until +8, you'll never know just how low your kitty goes. Frankly, vets give this kind of instruction a lot. My vet and I had a "discussion" about how much I tested. I pointed out how unpredictable Gabby could be and I also asked her, point blank, would she test an infant only 4 times per day. That ended the discussion. Sometimes, the practicalities evade even really good medical professionals. I also asked her if she was going to be willing to be available 24/7 if Gabby's numbers were tanking because I had FDMB backing me up when it came to managing Gabby's numbers. Again, it was a discussion ender.

We push home testing because we want to keep all of the kitties here safe. Having those BG numbers helps you to understand how your cat utilizes insulin and what your cat's patterns are (at least in general, because they like being unpredictable). I don't want to tell you to ignore your vet. On the other hand, you also don't have to tell your vet that you're testing more than he or she recommends.

With respect to your question about when to test, I'm going to speak in generalities. Lantus onset typically is at around +2. That's when the insulin starts to kick in. Nadir is at around +6, give or take. Lantus' duration is at least 12 hours and the depot gives you some overlap with the next cycle. This is why it's a good insulin for cats and why the ideal Lantus curve is flat. I had some flex with my work schedule. I tried to get a test at or before +2 so I had some sense where numbers were heading. This allowed me to figure out whether there was going to be low, medium, or high carb food in the timed feeder. I shot a 5:00 and was out the door no later than 7:45. I always got a pre-shot test. I tested more during the PM cycle because I was home. I always got a test before I went to bed. You can see though, when Gabby was being a drama queen, I went into testaholic mode.
 
Sue and Luci said:
Might I suggest that you purchase an inexpensive human meter and matching test strips? Many of us use them and the protocols are all written with human meters as reference. Save your $$ for more important things.

As mentioned above you need to at least get a test or two before going to bed in the evening...if you can get up a little earlier in the mornings before work; test/feed/shoot earlier and then you'll have a chance to grab a test just before leaving for work. Many others work outside of the home and it can be done - I know you have a difficult schedule - and there have been suggestions offered for working around that - even if it's just a few days a week that are better than others...it can be done...

What is the food they've been eating in the past?
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Any suggestion which human meter to purchase? I am definitely open to that since since the AlphaTrax strips are costly.

Testing and shooting earlier in the morning when I work would mean my husband would have to be home earlier in the evening to do the same thing- not sure that would work. I am trying to make sure he is home by 6pm to do what needs to be done as is. If I do give the insulin earlier and he is not home in 12 hours, then it causes the same problem I have now with my work schedule.
 
You can pick up just about any meter at Walmart - Relion has several reasonably priced meters/strips there - just make sure to get the matching strips.

I personally use the OneDrop - it requires a very small drop of blood, is very accurate and the strips are delivered to my home. I work full time too and it's just one less thing I have to do, constantly chasing after test strips. We go thru a ton of them in a big hurry at my house!

https://onedrop.today/?gclid=EAIaIQobChMIoc7BkL7y5QIV4R6tBh0R8AXYEAAYASAAEgJs3PD_BwE

OneDrop is a subscription based service - just an FYI if you're interested.
 
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