5/24 Lucky --- Back after a long time away

Status
Not open for further replies.
Luckyducky

Luckyducky

Member Since 2012
Hi everyone. I've been off the forums for a very long time, and I apologize for that. Part of it was moving to a new apartment, part of it was getting a new (and tiring) job. But I also hate to admit, back when Lucky's (my cat) numbers were all over the place all the time, I had lost faith in the vets (who kept charging me an arm and a leg for each visit) and in trying to keep up with these forums, partially because I'm terrible keeping up with forums, but also because none of the advice seemed to be working. So I wound up trying all sorts of different adjustments on my own to test and see if I couldn't figure out what was wrong with his glucose levels, and eventually I sort of resigned myself to just trying to stay with a more relaxed shot schedule for Lucky (right now it's 1.75u lantus every 12 hours with only slow/minor adjustments, like I'll move from 2 to 2f units if he didn't go below 50 every 5-7 or so days, and only dropping the dose if he gets below 50).

Well, I sort of feel as though recently Lucky's readings have been doing a bit ways better, which you can see in this pic here: http://i1333.photobucket.com/albums/w62 ... 95302f.png

Or on his spreadsheet, here: https://docs.google.com/spreadsheet/ccc ... web#gid=14

With Lucky's numbers seeming to spend a bit more times in the blues and greens, I figured he might finally be doing better --- but after a vet appointment today I'm not so sure, and was hoping I could turn to you all once again for some guidance.

To make a long story short, it looked like Lucky was having some problems peeing in the litterbox a few weeks ago. The vet did a urinalysis and diagnosed UTI, and put him on Zenequin. I went back today for a follow-up urinalysis and Lucky still seemed to have a UTI (not as bad, but still there according to the vet), but the vet also found a lot of glucose in his urine (according to the paperwork I received, the level was 1000 mg/dl). It was my first time talking to this new vet, and when I showed him Lucky's glucose spreadsheet, his opinion was that the numbers on my glucometer were wrong because it's a human glucometer (Arkray Glucocard Vital), and that Lucky's numbers were actually much much higher than the readings I was getting. He explained that Lucky would only get glucose in his urine if he had an excessive amount in his blood, and explained that I should be using a cat-specific glucose monitor instead.

Soon after the vet appointment this morning I went home and took Lucky's reading again to check. I decided to open a brand new glucometer to take his reading, along with the regular glucometer I had been using. The reading for my regular glucometer was 89, and my new glucometer read 72. I also tested with a new control solution: regular was reading 97, new was reading 101, which is in the range for the test strips I use (91-114). I guess I'm scratching my head since I expected Lucky to have a high glucose reading based on the urinalysis. It also seems as though my glucometers are reading properly, though now I'm calling into question their effectiveness to judge Lucky's glucose levels.

My biggest concern, though, is that the vet recommended I increase Lucky's insulin dose (though strangely enough, he didn't recommend a specific value to increase to). I think it's worrisome not just because of the unspecified amount, but also because Lucky's numbers dropped below 50 when he was at a higher dose the past several days. That aside, I was also wondering if the vet's assessment might not have taken other factors into consideration --- I'm not sure about it, but I was wondering if it might have been the stress of being at the vet that could have caused the high glucose in Lucky's urine, since Lucky seemed really alarmed and agitated the entire time I was there. I should also mention, the urinalysis showed that Lucky was negative for ketones.

Any thoughts? Are there any inexpensive vet glucometers I can look into getting? (at least, to test and compare with my current glucometers). And what do you all think about my doctor's assessment and the urinalysis results? It was honestly a pretty awful morning for me (the first vet I talked to actually had a pretty condescending attitude that really drained me a lot). Any second opinions or insight would be wonderful and appreciated.

I should also mention, apparently Lucky's teeth are pretty bad again too. It's a long story, but basically I didn't really realize the severity of Lucky's teeth problems (and hadn't been doing at all an effective job trying to brush his teeth, which I was doing every day but apparently not very good) until a few months ago when I decided to take a look at his teeth myself and saw massive buildup of tartar on the teeth. Checking his teeth was something I'd never done until that point because it was hard to hold him down (until I discovered how useful towels were for doing that). I've been brushing his teeth three times a day after meals for the past few months now, and very specifically going for his back teeth, but that said it's still very bad looking, so I have a dental cleaning scheduled for him again this coming Wednesday. I guess I didn't think very much of his dental problems previously because the last time Lucky had a cleaning (over a year ago) it didn't improve his readings, and I figured maybe it wasn't as bad of a problem as it really is, but it really does look to be a problem.
 
I don't think you need to increase the dose, you just got a 33 the other day, and I would have reduced a whole 0.25 units, but I guess you know you cat.

My vet did the condensending human glucometers aren't acurate speech to me too, recently. I didn't like that either.
You can bring your glucometer in the next vet visit and have the vet get out his glucometer and you get yours ready and you both test on the same drop of blood, to see the difference. When I have done this, my OneTouch meter would be within 10 points (I tried that one on two different occasions) and my Arkray Vital was off by more. Also, if you are getting bloodwork done before the dental, bring your glucometer and try to do a test with your Arkray right before the blood is drawn and compare your test to the bloodwork results. The glucose in the urine is from hours ago, not right then from vet stress.

Sending perfect dental vines to Lucky. I think you need a :YMHUG:
 
Hi Joe and welcome to you and Lucky. It's a long weekend so a bit quiet here today.

I do not think Lucky needs to have a dose increase at all! The 33 and the 40 you got in the last few nights say decrease, not increase. I'm glad you reduced down to 1.75. Glucose in the urine is delayed from when it is in the blood. Lucky could have had a short bounce resulting in higher numbers, then flushed that glucose into the bladder then lowered his blood glucose. So your blood sugar readings when you got back from the vet still could have been accurate.

I would stick with your human glucometer. Most people here do because of the cost and ease of purchase. The pet meter strips are way more expensive and if you suddenly need more on a long weekend, it's much easier to get human meter strips from a Walmart than a closed veterinary office. The protocol we use is based on people using a human glucometer so takes those differences into consideration. If you look a the Tight Regulation Sticky, 5 paragraphs down, there is a link to the latest paper called Management of Diabetic Cats. In it, they say at the low end of the scale (under 100), the difference between a human meter and the cat specific one is about 18. Not that big a deal. The difference does get higher as the blood sugar numbers get higher. You might want to print off a copy of that article for your vet.

A couple of comments on Lucky's spreadsheet. First, thank you for keeping it up to date. Second, you could try to vary around a bit when you get the middle of the cycle tests. Cat's don't always nadir at +6 and even those that do can change it a bit from day to day. I've noticed a number will nadir earlier if starting lower. So, mix up the tests when you are home to test, some where from around +4 to +7. That might give you a better picture. The second comment is that when you see a low, like that 33 the other night, I would keep testing until you know he is safe.

It is hard having a vet that questions everything you do. I don't see eye to eye with my vet on all things related to diabetes, but she's learned to trust what I'm doing. I was the first client to do home blood testing. Good luck with the dental.
 
Thank you both for taking the time to read through and look at Lucky's chart. I decided against increasing his dose for the moment, though I am still a bit worried about so much glucose showing up in his urine. From what I've been reading, it sounds like glucose normally shouldn't be turning up in the urine at all, though the explanation regarding a possible rebound this morning does sound like a possibility (looking at his chart, it seemed like he had a fairly quick rise up to 236 this morning, maybe because he had dropped so low last night). I also thought I should mention, the 1st urinalysis showed his urine glucose was only 100+, compared to the 1000+ for today's 2nd urinalysis, so maybe that presents a stronger case that a rebound happened. Do any of you know if these sorts of jumpy urine glucose readings in diabetic cats are normal?

I think what I'll do is purchase a vet glucometer, if only for the sake of comparing to the current glucometers I'm using. If the vet glucometer is showing much higher numbers than what my current glucometers show, I can increase the dose per the vet's recommendation, though in line with the regulation protocol. If it shows fairly comparable numbers though, I can show the vet and maybe face less resistance in using the human glucometers.

I also wanted to mention that I haven't been reducing Lucky's dose by .25u like the protocol recommends, mainly because there seems to be a cyclical nature to his numbers when I reduce it by that much. What seems to happen is, I'll get a reading below 50, reduce his dose by 0.25, a day or so later his reading will drop below 50 again, so I reduce it by another 0.25 again, and then for some reason he'll just have numbers in the 200-350 range for like a week, and I wind up increasing it again back up to where it was before, and it starts all over again. I've kind of had the impression that if I reduce in smaller increments (the skinny and fat I've seen in the past on the forum) that those sorts of cycles don't seem to happen as frequently.

I absolutely hate dealing with veterinarians. In the rare cases where I get along with the vets, I feel as though they're not giving me their honest opinion, and are just agreeing with me because 'the customer is always right'. And in the more often cases where I don't get along with the vets, it feels as though they have so much pride and over-confidence in their experience that they're completely close-minded and unwilling to consider for a moment that a patient might know something about a pet disease that they don't. I remember an experience with one of Lucky's first vets, I was trying to get a prescription for lantus pen packs (and not the vials), and the vet (apparently completely unaware that such alternative forms of glargine existed and angry that I had requested something different than her recommendation) actually had me brought into an operating room in the middle of a dental surgery on a dog, to not only chide me for asking for something different than what she prescribed while she performed the surgery in front of me, but also to emphasize her experience and why her recommendation was correct. I kept trying to explain that the lantus pens were the same thing as glargine, but she was so angry that she kept going for almost 10 minutes. When I finally got a word in and she realized I was only asking for a prescription for a different packaging of the medicine she had prescribed, she finally calmed down and tried to wave it off as being okay for me to get them. Later when I brought the pens in to their office to show them, the other vets embarrassedly admitted that they had never heard of the alternative packaged form before. I've just met way too many vets with that kind of haughty and condescending attitude, and it absolutely drains my soul having to deal with them. It's not like I don't realize that I'm not anywhere near an expert on cat care, I know they have infinitely more experience and training than I could ever hope to have. But that also doesn't mean I don't know anything at all, or that there aren't things I might know that they don't. I just wish the vets I've interacted with would treat me like a partner working together to help my pet, instead of a kid that needs to be talked down to by an authority figure.
 
HI Joe,

It's very good that you're going to get Lucky's teeth and mouth taken care of right away. A lot of people here have mentioned how any type of teeth problem can lead to higher numbers. Because our cats cannot talk to us it's hard to know if they're in any pain from bad teeth.

The other thing is, UTI's in male cats are very common when there is a stressful situation going on. Something that is new to you may not be that big of a deal but to a cat it's a huge deal. Have you changed your routine with Lucky at all?

Hope you see an improvement in his BG numbers once the dental is done.
 
(((((Joe))))) You are such a great bean and Lucky is lucky in many ways. :-D In spite of our best efforts, Zener's numbers are all over the place and have been for 3 years. Some cats are just like that. His urine usually does show glucose and only occasionally does not have glucose in it and we think he has a fairly high glucose threshold, like around 240. We are getting more philosophical about that, so as to deal with the stress better.

We used an AlphaTrak for about 6 months and finally switched to a human meter. We have never regretted it as the AT and its strips are expensive and I don't think it gave us any better data than the human meter.

Your last line described our vet perfectly: part of a team to give the best care to Zener and recognizes that LL is an important part of that. There are vets out there who will work with you. Where do you live? Maybe we know someone in your area to make a recommendation.
Liz
 
Thank you all for the encouraging words. I hope the dental helps, though the last time he had a dental it didn't seem to affect his numbers any (though, I guess I was so focused on his diabetes, that when the dental didn't help I thought it was a problem that had mostly been taken care of, I guess I didn't realize it could still be such a bad problem later on).

As for stress in Lucky's life, it didn't occur to me but that could be the case. I actually moved to a new apartment a few months ago, and though it was a bit stressful at first, it's much more peaceful than where I used to live, so Lucky has been seeming very content here. That said, I've been trying to bring Lucky back to where I used to live almost every other week, since he seems to miss it... maybe he feels homesick? Then again, he also really hates car rides, maybe that's part of it (come to think of it, he started having the strange problems at the litter box the same afternoon when we came back from where I used to live). The vet did mention that the glucose in his urinary tract could also be a reason for the infections, which sounds to make sense and is kind of what I was leaning a bit towards atm.

I also appreciate the personal account regarding Zener, it helps to put Lucky's situation into a better perspective. I can also sort of identify with the philosophy about dealing with Lucky's diabetes, I'm feeling more at peace with the struggle (well, except for when I have to talk with vets). I live in San Antonio TX in the 78249 area, so if you know of any vets familiar with practices like home testing, lantus or tight regulation around here, that might be very helpful for me and Lucky, at least for making it a lot less draining for me to have to discuss with vets about Lucky's treatment.
 
Joe

Thank you for updating us and I'm sorry you had such a crazy time at the vet.

A couple things which might help you:

1) renal threshold (that point at which sugar spills Into the urine because the BG is too high) varies from cat to cat but is typically when the BG 200-250. So if he's bouncing in that range or higher, he will spill glucose into the urine and it does take a bit of time to clear. That's why we don't use urine testing to see where the BG might be. You can get diastix that test for ketones and glucose in the urine. It takes some patience but you can get a general idea of approx what BG causes Lucky to spill glucose.

2) shaving a dose when a reduction is earned is discussed as a strategy in the TR protocol. However, it's always a good idea to take a full reduction of 0.25u when the BG goes below 40. I would have definitely taken a full reduction for that 33. The reason he might have been at 40 last night was because his depot was pretty large and hadn't drained enough. I'm glad you reduced today.

I think you've been doing pretty well with him but, as others have said, different spot checks when you are home to do them will help.
 
Just my two cents-- I do think that the car rides are stressing Lucky out and are at least a part of his UTI... If he is going to visit a person at the place where you used to live, can that person(s) instead come visit Lucky at your new apartment? :roll:

If the new place is peaceful for you and him, and the other place was not so much so, it might be that in addition to the car rides, Lucky doesn't feel so lucky being back at the old place for visits. :YMPEACE:
 
Thanks so much for the explanation regarding the renal threshold. Lucky has been very bouncy, so it seems to make sense how he would have different glucose values for each of the urinalysis tests. I will also keep in mind about the reductions, as well as the different spot checks (I've already started getting some since yesterday).

As for the car rides, I think I'll hold off on bringing him back for a few months and see how that works for him. I do think he misses the last place we lived (busy as it was) since he seems very happy when we get there, and seems sad when it's time to go. I guess we'll see if stopping the car rides helps out any though.
 
Hi Joe! Nice to see you and Lucky!

wow - what a story about the vet. There's gotta be a better vet option available. I have had 2 vets treat punkin while he was alive and neither one was anything like you mentioned. that's horrible care. Sometimes when people want to find a new vet they post on the Main Health page with their location in the subject line to see if anyone has a good vet to recommend.

One thing jumped out at me from your story about reductions when you were following the protocol before - about having him go below 50, reducing, having him go below 50 again and reducing again, then having his numbers go back up. That was my experience when we started too. Eventually Laurie and Mr. Tinkles suggested to me that I not take all the reductions. *lightbulbmoment* One factor we now look at when deciding whether or not a cat should take a reduction is how long it has been since the last reduction. A current larger dose can influence from 4-6 cycles AFTER the dose has been reduced. So if the second low number occurred within the 4-6 cycles after a previous reduction, we now often really look to see if the cat should have the reduction, or if it's still the previous dose at work. I didn't understand that in the beginning either. And if the low number is barely under 50, sometimes just holding the dose is a good option.

Marje wrote a good post on Reductions that might be a helpful reference to you. When you are reducing, the idea is that if the numbers don't continue in green numbers, go right back up to the previous dose without waiting. You do want to wait until any bounce is cleared, but once it's cleared if the numbers are overall higher, don't wait to go back up. That helps to keep the good momentum of lower numbers going. I think at least some of the times i'm looking at on Lucky's ss when you reduced, he lost the good numbers very quickly but you kept the dose reduced for a while. This change alone might help his numbers. Also, i think reducing without him going below 50 might not be helping him. I'm looking at 4/18-19 when he had a green amps on 4/18 on 2.0u, and a green amps on 4/19 but you reduced his dose to 1.75. Shooting the same dose when you're faced with a green preshot can help reduce the bouncing and flatten out his numbers.

Saying that, though - i don't know your schedule. if you can't monitor, then reducing the dose can be a good option to keep him safe - your first priority - but i'd go back to the previous dose with the very next shot (ie, give the 1.75 if you're not able to monitor and the preshot is low, but go back to 2.0 that night).

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Please ask for advice.

If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.

Keeping YOUR cat safe is the #1 priority of the FDMB.
Let's keep all our kitties in the Lantus Tight Regulation ISG safe by suggesting and taking appropriate reductions.

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...

A couple of things i'd suggest - i agree about varying the times of your testing. It's amazing how well the picture of what Lucky's blood sugar is doing will fill out as the test times are varied. I also agree that i'd have continued testing after any number in the 30's or 40's to make sure Lucky was rising ok. Regarding the testing - because vet stress can cause some cats to go up hundreds of points (open Jill/Alex's spreadsheet to see where she has noted a vet visit and how high Alex's blood sugar can go) - i wouldn't worry too much about vet testing.

There is a new document on the Tight Regulation Protocol yellow starred sticky - go about 5 paragraphs down and look for the PDF called "Management of Diabetic Cats Using Long-Lasting Insulins." It talks about using the Alphatrak, which is what vets use to test. It's clear from that document and tests FDMB members have run using AT and human meters side by side, that the meters can vary from as little as 18 points (AT always higher) to 30-40% (AT always higher.) So . . . it's not a case of human meters being wrong, they read the blood differently. Lucky's numbers overall look pretty good. He looks bouncy, but so many cats are.

The Protocol is a good place to start treating a diabetic cat, but once you've got the basics learned, it is completely appropriate to tweak things to work for your cat. Nothing wrong with that - and everything right with it!

Teeth can make a huge difference. Punkin was prone to dental ickies too - it's common with diabetic cats. Hopefully getting his teeth cleaned again and making a few tweaks on what you're doing will help Lucky get regulated.

It's great to see you! I hope the dental goes well. Let us know! julie
 
Thank you so much for the response Julie, and for all of the information regarding dose reductions. I didn't realize there were specific approaches for circumstances where back-to-back dose reductions didn't work, and it also didn't occur to me that the protocol recommendations might change if Lucky became a long-term diabetic > 1yr. So if I'm understanding correct, would it be an okay approach for me to only shave his dose whenever he drops below 50 then? And if so, is it still recommended to give a full reduction if he drops below 40? (I guess right now I'm a bit more comfortable with the idea of just doing the shave, since going slower with the reductions seems to have been working better for him, though if experience says it's better to go with the full .25 reduction when < 40, I can go with that and see how it works out). I'm also in a much, much better position for modifying Lucky's reading schedule, since I'm finally settled into my new apartment, plus my current work is thankfully telecommuting, so I'm able to stay home throughout the day to monitor Lucky.

I also didn't realize that human vs. pet glucometers were like comparing Fahrenheit and Celsius readings, and it sounds like most of the protocol recommendations are based on human glucometer readings (is that right?). I may still get a vet glucometer just to check for consistency, though I guess now I'm having second doubts about it. I should probably mention, the vets I went to yesterday were very hostile about using human glucometers. The first doctor I talked to yesterday flat-out told me that all of my home-testing information was completely useless and a waste of time because I wasn't using a veterinary glucometer, and that I needed to do a fructosamine test --- when I expressed my discomfort at her extremely negative attitude towards the home-testing with human glucometers, and if she had up-to-date experience with treating diabetic cats, she became so angry that she just stormed out of the room (this is part of what made yesterday morning so awful for me). When the second vet came, he tried to excuse the first vet blowing up as "having been pulled away to another client" (which obviously wasn't true, but I could see he was trying to be more level-headed about it and so I wanted to give him a chance). But later when he saw the urinalysis results with the high glucose in the urine, he also went on to flat-out reject the human glucometer, saying that the readings were clearly incorrect/untrustworhty and that Lucky needed a large dose increase (though perhaps tellingly, he didn't say at all how much I should increase to). It all really made me feel awful, and put all of the home-testing I did into question, though now I'm feeling more and more that maybe their inexperience dealing with diabetic cats might have been driving them to reach the wrong conclusions about Lucky's condition (that second vet even said that Lucky was surprisingly healthy considering his diabetes wasn't regulated). I will definitely go post in the Main Health area to try and see if anyone has vet recommendations in the area, since the current vet I'm seeing just doesn't seem to be working out.
 
hehe - next time you go to the vet, take this document with you. http://www.ncbi.nlm.nih.gov/pubmed/19592286 It never hurts to have the professional journal publication that validates home testing to back you up. I don't know what to say about the difference between the urinalysis glucose and the blood sugar, except that if the test was done during a bounce, say after Boomer had been high for 12 hrs, then it might be true that the urine would show high glucose then. But if you measured at the vet's, your home meter would measure the current blood glucose. I'm not sure that makes sense, but my point is that the urine test shows glucose from hours before and the blood test measures glucose in the blood right now.

J Feline Med Surg. 2009 Aug;11(8):668-82. doi: 10.1016/j.jfms.2009.04.010. Epub 2009 Jul 9.
Intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment with glargine.
Roomp K1, Rand J.
Author information
Abstract
Human diabetic patients routinely self-adjust their insulin dose using a protocol and home monitoring, and perform equally well or outperform physician directed adjustments. The objective of this study was to report the outcome of home monitoring of diabetic cats by owners using a protocol aimed at achieving euglycaemia, using ultra-low carbohydrate diets (< or =10% metabolisable energy) and the insulin analogue glargine for >10 weeks and/or until remission was achieved. Fifty-five cats diagnosed with diabetes mellitus, whose owners joined the online German Diabetes-Katzen Forum, were included. An overall remission rate of 64% was achieved in the cohort. Significantly higher remission rates were observed if good glycaemic control was achieved soon after diagnosis: 84% for cats started on the protocol within 6 months of diagnosis went into remission, and only 35% for cats that began more than 6 months after diagnosis (P<0.001). Only one mild clinical hypoglycaemic episode occurred observed despite tight blood glucose control. In conclusion, intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment with glargine.
PMID: 19592286 [PubMed - indexed for MEDLINE]
Click to expand...

Here is the full document: http://www.felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf

The most recent publication is on the Tight Reg Protocol page - that PDF I mentioned above - but i can't link to it.

As far as I know, this is the only protocol that has been published in a professional veterinary journal on how to treat a diabetic cat - and it DEPENDS on hometesting. You might ask your vet what protocol they follow in dosing their diabetic cats. ;-)

I wouldn't spend my money on the AlphaTrak. The strips cost $1 each and i can't see that they are necessary.

The thing about reductions is that you don't want to mix and match strategies. You can either shave doses or do the 3 times under 50, but don't let him go 3 times under 50 and then shave. At that point you need to take the full 0.25u. And Jill's wording on the Low Numbers sticky is pretty strong that if a cat goes into the 30's they should get the full 0.25u reduction.

Cats that have been diabetic have the stricter guidelines in order to get a reduction because in the experience of people here, that works better. That's why the guidelines list newly diagnosed cats as getting reductions when they go under 50 and cats more than one year to go under 40. I'm not certain, honestly, how that all combines with the "give a full reduction if they go under 40" suggestion. You could pm Jill and ask her to look at Lucky's spreadsheet and see if she has suggestions for you.
 
More on human glucometers. My vet uses the Onetouch human glucometer in her practice. She's compared it a lot with results she gets from the lab analysis and is very happy with the results. At one time she asked me if I wanted to get an AlphaTrak, but I gave her "the look" as it was after she'd already told me she was using the Onetouch - no sale! :lol:
 
Status
Not open for further replies.
Back
Top