7/2 - Boots litterbox update, and question about Relion/AT2 reading inconsistencies

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Megan and Boots (GA)

Member Since 2015
Yesterday's condo

So a (very) good update on yesterday's worries about Boots' sudden change to peeing outside the box: the last couple pees have been IN the box again! After a day of several pees outside the box, last night just before we went to bed, we followed him into the laundry room where he did a couple laps, stopping to sniff at previous out-of-the-box pee spots and looking suspiciously like he was about to go. Each time, we spoke gently to him, encouraged him to use his box, and gave him soft pets and scritches. Soon enough, he walked to the box, sniffed it, stepped in, and peed! Success!

Then overnight, it was clear he peed in the box again at some point (his big clumps right by the side of the box are easy to tell apart from the civvies' tiny mid-box clumps).

And now since this morning, he's peed twice more, both times in the box (the most recent time with zero coaxing - he just went right in. Each time he succeeds, we've been giving him his favorite freeze-dried chicken treat and praising him like crazy.

A hypothesis that came to me this morning: not sure if it might be arthritis related (hard to squat) or just a preference change, but I have to wonder if part of the recent avoidance is because he wants to pee standing up and/or pee against a vertical surface, and that's hard in the box. Each pee out of the box was against a wall/door, never in the middle of a room, and always standing up and peeing pretty much a stream straight back against the surface, not squatting like he has to in a box. Each litterbox we have is a standard, low-sided box. When he does go in the box, he squats right against the side of it and pees on the side wall of the box, never in the middle of the litter. Is that possible - that he just wants to stand or pee against something? We have an old storage tote that we made into a litterbox and used a while ago, but no one particularly took to it, so we retired it to the basement. I think we might bring that up and see if he would be interested in using it, as it has high walls that he could stand to pee and pee up against.

That could be wishful thinking though. It could well be some medical reason, and I'd like to figure that out. We'll still try to get a free catch sample tomorrow to bring to the vet if they are open, but since we'll be dropping him on 7/10 for an ultrasound, I'm also going to ask them to do a cysto UA while he's there all day, for a cleaner sample and analysis.

Onto another matter: yesterday and this morning, we decided to do a double-BG test on him, and use a Relion strip as normal, and also do a test with an AT2 strip. Both last night and this morning, the readings do not seem in agreement. Last night, he got 69 on Relion, but 127 on AT2. This morning, it was 66 on Relion, but 147 on AT2! Those discrepancies don't even seem like they are within the (already large) margin of error for these strips. We did re-checks with two Relions (in agreement basically) and two AT2s (also in agreement with each other). So that has me wondering which is accurate? Those AT2 readings are all at the very high end of normal or even higher than normal range (blue), but the Relion readings are squarely in the middle of the normal range of 50-100. Anyone have any thoughts on why they might be so different?

Hope everyone's having a good day today over this holiday weekend!
 
Did you use the same drop of blood for each of the tests or different drops? When doing comparisons, it's important to use the same drop of blood. BG is forever adjusting itself albeit by small amounts but if you are doing multiple tests with different drops of blood, it's been my experience that the AT2 will pick up on a rising BG faster than a human meter and multiple testing could cause some BG elevation.

Happy Fourth of July! :)
 
Good point, but yeah, we used the same drop each time, which is why it's particularly odd that they are SO different. We haven't done any side by side tests with AT2 in a while. Makes me nervous if we have been thinking he's been nice and low but maybe really hasn't been all that low?...
 
The AT2 and Relion are calibrated a bit differently. The AT2 typically runs higher than a human meter which is why we discourage people from going between the 2 meters -- you'll drive yourself crazy because the difference between the meters isn't linear. In addition, aside from the AT running higher, once you start figuring in the normal variation due to meter variation, you'll really drive yourself crazy!!

A couple of thoughts re. the boxes....
If you think Boots has arthritis, you could try sprinkling Cosequin on his food. It's not a prescription and it may help. Adequan is a prescription and I think it's a shot. That may also help to relieve the achy joints. One of the members who rarely posts these days came across a box that is higher on one side. If you can track that down, it may also be an alternative box.
 
Thanks, @Sienne and Gabby (GA) - I agree, it is enough to drive a person nuts. I just don't want to be thinking he's doing better than he is, because in the past when we've done spot checks, the Relion/AT2 readings made more sense (with the understanding that it's not a linear relationship, but knowing the baseline of "68-130" for good AT2 readings, and 50-100 for Relion for the same healthy/normal range). So to now be seeing AT2 readings above the normal range, while Relion readings are squarely in the lower half of the normal range seems really odd to me. We did do control solution tests on both too, and double-checked the each was calibrated properly. But I think in general, while I'm questioning it, I agree with you, and will probably stop doing the AT2 tests now today.

Re: boxes - we've been giving him Cosequin for close to 2 years now, and unfortunately, it doesn't seem to be doing much to slow down the progression (although without a Boots clone on no cosequin as a control, I guess I can't say that for sure!). He's stiffer getting up and down and has trouble with the stairs (still up and down them all day, but he has to do an awkward hop instead of smooth, easy steps). I think we'll be talking to our vet about either an anti-inflamatory or a pain meds to see if that might help. I'll have to look up that box you mentioned. So far today, miraculously, he's used his box every time he's peed (and one poop just now). Couple of those times, he's sniffed around and looked hesitant, but ultimately went in to do his business, and seemed OK squatting down to pee against the low side of the box. We pulled out the old storage tote box and set it near another low box (his generally preferred one) but so far, no interest shown in that. But we'll leave it out. I cut a nice low step-in opening all the way open up to the top so he can walk right in, and as long as he moves his backside a smidge in either direction (so as to not pee right back out the entrance!), I think it's a decent size for him to stand up and pee without needing to squat if that's becoming uncomfortable.
 
If he has arthritis, it could be the squatting is problematic for him. Also, can you adjust the entrance to be low so that he can easily get into the box without any jumping but still have high walls to pee against? Just a thought.
 
Yeah, that's what I did with the homemade storage tote litterbox. I cut from the top down to only about 3 inches from the bottom - so it's a nice big low opening that he can just walk right into (rather than needing to squeeze through a hole in the side). He's still showing no interest in that box though, but maybe in time he'll realize he can use it to do his business too.

Today has blown us away though. After the past 2 days of so many outside the box incidents, I was not expecting today to be like this, with him going in his box every time - no accidents! I'm also realizing though, since we've been paying extra close attention (the super hot day today kept us inside anyway, so we could keep watch) - he pees a LOT. Our civvies pee maybe 2-3 times per day, from what we can tell. Since we woke up this morning, Boots has peed pretty much like clockwork every 3 hours or so, coinciding with right after he eats, pretty much. I'll definitely mention that to our vet. I'm not sure if even controlled/regulated diabetics still have a tendency to pee more? And it's a pretty hefty volume each time too.
 
It's worth a conversation with the vet about pee volume. When Neko got into mostly regulation, she was peeing about as much as the civie. But when her kidneys started to go, the volume and frequency increased, but still not more than three times a day until close to the end.

Arthritis can definitely impact LB habits. When Neko was aching she didn't want to crouch much so I ended up with pee pads around the box for the "sail overs". Other things for inflammation are fish oil and Duralactin. Duralactin worked really well for Neko - but I would discuss with your vet first, as it shouldn't be given if there is high calcium. Besides Cosequin and Adequan, hyaluronic acid (Hyaflex is one brand) can help the joints. For pain control, acupuncture worked quite well for Neko, and she ended up with buprenorphine twice daily, which made a huge QOL difference for her.
 
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