2/22 Stu AMPS 330; question about vet visit

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Ella & Rusty & Stu(GA)

Ella & Rusty & Stu(GA)

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yesterday: viewtopic.php?p=69789#p69789

Good Morning Everyone,

We started the new dose (3 units) yesterday evening. Let's see how it goes. Stu had lots of energy this morning and we played with "Big Bug" for a vigorous 15 minutes. ("Big Bug" is my name for a cat exerciser that consists of 4 small rolls of cardboard on the end of a bent wire. I can make it scuttle around the floor, or jump high in the air and Stu chases it. I forget what the real name of this cat exerciser is, but he used to really like to play this game and had hardly played it at all in the last couple of years. I think that his renewed interest in it is a good sign.) Appetite good. Ketones negative. litterbox activity good. Water consumption and peeing are high, as usual.
On Friday we will make our first visit to the vet since I started home testing in response to the very high and then very low numbers Stu got at the vet's (after being jumped up to 7 units of Lantus bid). The vet doesn't know yet that I took Stu down to 1.5 units and have been gradually working up so as to find his ideal dose. I hope all will go well. I will take a copy of Stu's SS and my blood-glucose meter so that I can compare Stu's bg reading on my meter to his reading on the vet's meter. The vet takes the blood out of a vein on Stu's leg, and from what I have read, this leg vein will produce a different reading than an ear poke (but I don't know if it is a generally higher reading or a generally lower reading). Can anyone provide me with more information on what the variables might be? (I am aware that a vet's cat-specific meter will give somewhat higher readings in general than a home-use meter.) Our visit to the vet will be at +5.5 hours, so it will be at about the time in mid-cycle that I usually test.
Thanks for any input you can provide on this matter. If I have more questions as Friday gets nearer, I'll ask.
Everyone have a good Monday.
Ella & Stu
 
Take a look at the Rand protocol from University of Queensland. It gives some information about differences between a human meter and an AlphaTrack, which is used for cats.

If you want more info on meters, send a PM to Monique and Spooky. She's familiar with the technical details about different types of meters.
 
Ear sticks are little veins, leg stick, I believe is an artery, according to vets. N More accurate according to them..
Just go armed with your data, be nice, as you know vets think their own way, but tell them you would like to stick to this protocol & hope that vet agrees--Your cat is YOUR decision--I have had 3 vets ueing Moonie's course of treatment! Finally this one acknowledges us & the protocol!
 
Actually ear sticks are capillary blood, and from the leg is from a vein (just the same as when blood is taken from the inside of your elbow bend). When the vet takes several vials of blood from the vein (usually about a Tblsp total) he running several different test on a large laboritory maschine. These maschines need the blood samples collected in different vials each which contain certain chemicals or preservatives needed for specific tests (some have anticouagulants to prevent the blood from clotting or separating, some have chemicals which help sparate the solids from the plasma etc.) with this maschine many tests can be done on a blood sample (kidney, liver, electrolytes, glucose...) For the glucose test the maschine uses plasma (the watery liquid part of the blood that contains most of the glucose and other "chemicals" transported through the body). A home meter (either human or animal) uses capillary whole blood and uses a simular method of measuring BG (glucose oxidase or hexokinase) there is a slight difference in the calibration of both a laboritory analyzer and an animal specific meter (eg. AlphaTrak). The maschines are the same in form and function rather for human or animal use (a vet could and often does buy his laboritory chemistry maschine used from a human lab) he only needs to change the computer software to have it work for cats, dogs, zebras...).

There are differences in meters for home use altho9ugh they ALL use capillary whole blood the most meters today give the result as "plasma-equivelant" this was introduced some years ago to make it easier for patients to directly compare thier results from home testing with results measured in the doctors office or lab. Basically the home meter measures the whole blood glucose conc. then built into the little computer chip inside the meter is a calculator the simply multiplies the whole blood result by 1.12 and gives that number as the plasma-equivelant. Almost all meters sold today are plasma-equivelant and compare directly with values measured in the laboritory. However home meters (animal or human) are not always extremely accurate (they don't need to be) they are not for diagnostic use but rather for "home monitoring". The US specifies that home glucose meters are allowed a varience of maximum 20% from the true value.

If you want to compare your home meter with the a laboritory value from a leg vein sample at the vets you are satisfying nothing other than your curiosity, you have an experiment set up with many different variables so the results are almost impossible to compare. You have different sample locations and type, time difference (the longer the blood sits in a tube before being put into the mashine the more the result is changed). The values shouldn't be 50% different but determining an amount of difference is not possible. If you repeated both tests 100 times you would probably get 200 different measurements.

What I can give you is some very basic conversions and reference ranges.

Whole blood glucose (ALL mammals) 60-110 mg/dl -this assumes the measurement is done on a mashine calibrated for the specific species
Plasma blood glucose (All mammals) 70-120 mg/dl -same as above

because meters designed for human tend to underestimate the BG in a sample of blood from another species (feline) we adjust our reference ranges in the protocol for using Lantus insulin. We simply say that 50 mg/dl is the bottom of the range instead of 60 mg/dl, we don't nee to adjust our readings we just need to know that below 50 is getting to low and all other numbers are just a range (more important than AMPS was 330 is the fact that it was "pink") I say the numbers we measure are zip codes not house numbers.

When using an animal calibrated meter (eg. AlphaTrak) then the plasma BG reference range applies (70-120 mg/dl) and the protocol will simply be changed by those persons using such meters to reflect below 70 being a "too low" BG.

Simple conversions:

mg/dl to mmol/l (US to international units)- blood glucose in mg/dL / 18 =BG in mmol/L) ex.108 mg/dL / 18 = 6 mmol/L in reverse (6mmol/L*18=108 mg/dl)

Plasma to whole blood glucose measurement - plasma BG/1.12= whole blood glucose (e.g. 156 mg/dL plasma / 1.12= 139.3 mg/dL whole blood) Reverse (139.3 mg/dl whole blood*1.12=156 mg/dl plasma glucose)

A plasma BG measurement on a home meter of 150 mg/dl has a 20% clinical accuracy range of 120 to 180 mg/dL.


My advice is to not bother yourself with comparing, your meter is adequate for purposes of treating your cat at home and comparisons are just going to confuse you and I garuentee most vets will not be able to follow what I just wrote or understand the differences (they are not laboritory specialists or "science geeks" or pathologists ((which I am!)))

My simple explaination.I have a meter stick in my home tool box, it got broken one day and is missing about 12 cm. I didn't throw it out beacuse I can still use it. I measured the length of my livingroom to buy new flooring. The meter stick was orginally 2 meters in length. When I measured the room It was 3 times my stick length) I did the math 3* 2 meters=6 meters - (12 cm*3)=5 meters and 64 cm

I can still use that stick, as long as I remember to add my missing 12 cm! Can you eat eat ice cream with a fork?

Of course if it's all you have, it works good enough!

or my car shows speed in km/hr does that mean I can't drive it in the United States? I can I just need to be aware of the conversion mph*1.6=km/hr

so If the speed limit is 65 MPH I can drive 104 Km/hr on my speedometer.
 
Thanks so very much, Monique. This is valuable information and answers all my questions/concerns. I'm glad that Sienne referred me to a professional. (I will be happy to reciprocate if you ever have a question about classical music!).

Ella
 
Well I do like some classical music (my telephone plays Spring from Vivaldi as a ring tone :-D ) I used to play concert flute (still have it but it sits in the closet mostly) My daughter(10) is a fan of Beethoven and watches the cartoon little Amadeus, we are not far from Salzburg so.... Don't have any burning questions right now :lol:

Good luck with your vet visit!

Songs I can play

Für Elise
Eine kleine nacht Musik
Wagenlied
Zäuberflöte
Greensleeves
L' Inno di Mameli (Italian national anthem)
Bridal Chorus from Lohengrin-Wagner
Row,Row, row your boat :razz:
 
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