Alphatrak Accuracy and Inappetance (Unrelated)

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Pudding

Pudding

Member Since 2016
Hello there, probably time that Pudding moved to the main board.

I took Pudding to the vets today for his second glucose curve. As I got my new Alphatrak2 a couple of days ago I decided to take it with me to compare with the vet's. (She also has an Alphatrak 2 meter).

On arrival 1 hour after food we each did a test using the same test site. My reading was 33.2, hers was 28.1. She agreed to keep my meter with her all day and do every test twice - even using each other's test strips for some tests incase it was those. There were some significant diffferences. In one case hers said 20 and mine said 31.1! Some were closer together, but in another case hers read 19.6 and mine 25.5. In all but two cases, out of 10, my meter was higher. The nadir was at the same place, her reading was 17.7 - which was encouraging seeing how high he has been - mine was 19.5.

The vet has suggested I send my meter back and try to get a replacement and that she will write a letter if needed. Is this degree of difference a known feature in Alphatrak machines? If mine is generally higher can I just treat it as a high reading machine and perhaps get worried about hypos at a slightly higher number?

The real problem, though, has been getting Pudding to eat enough. He's clearly hungry and starts to eat with gusto but then stops after eating only about half of what he should. Saturday it was a real effort to get him to eat anything at all. He went off the prescription diabetic food very quickly and now won't even touch the dry diabetic stuff, which he used to eat before. I started him on Lily's kitchen wet food yesterday as said to be very low carb. He seems to like it to start with but again gets bored. I've found he doesn't seem to like wet food in a bowl - don't think he likes getting it on his face. Cutting it up into small cubes and putting on a plate helps. He also seems to eat more if I start hand feeding what he's left. However still not finishing it up. Vet suggested heating it up and this seemd to help a bit too. He should eat 150g twice a day and finally he finished this evenings 150g after about 2.5 hours on and off reminding and coaxing. Is this normal when changing to wet food? Any other tips for getting him to eat what he should?

Finally, I'm hoping things improve as he's no longer confined to one room. He had a pacemaker fitted just over 3 weeks ago and part of his post-op care was that stairs were forbidden. He was allowed into the rest of the house today and it seems to have really perked him up, sniffing round all his favourite spots. Only thing is that he wants to go in the garden now, which is still not allowed.

Anyway, sorry for the long post but it's nice to get it all down. Any suggestions and tips welcome.
 
In regards to the difference in readings on the two AT2 meters, my first questions would be whether both meters were set on the correct code for the strips used in them when these comparisons were done and were the comparisons done on the same drop of blood. If either meter was used with the wrong code, that could explain the differences in your comparison results. If both meters were set on the correct code for the strips used to test, then it's possible either meter could be off. It doesn't necessarily have to be your meter that is reading incorrectly. There is test solution that can be used with the AT2 meter and comes in the kit with a new meter. I'd check your meter with the control solution ensuring your meter is set to the same code number as that on your vial of strips and see if you get a reading within the range on the vial. If you do, then it may be that the vet's meter is the one not reading accurately.

If you just recently started transitioning Pudding over to wet food, it may just be that he is still not sure about the wet food and really wants his old grub so he's delaying eating hoping you'll give in. :cat: Never underestimate a cat! You could try putting some parmesan cheese on the wet food, some crushed up protein treats or add a bit of warm water or even tuna water or a bit of tuna to the food to entice him more.
 
I have read that meter readings can vary by 20%. Also, to perfectly compare two meters, you have to test the same drop of blood at the same exact moment because glucose fluctuates from one moment to the next. (This is what i have read though it does seem rather odd!)

I'm kinda glad your kitty wont eat the dry food. Dry food really isnt the best for diabetics. No tests at the vet shows why pudding's appetite isnt up to snuff? Maybe he cant eat that much all at once right now after the pacemaker? Perhaps smaller amounts more often?
 
I agree that smaller meals more frequently may be a good option to try.

The difference between pet meter and human meter readings is NOT a specific % difference. The difference in readings will be greater the higher the readings. There is no direct conversion formula and the 20% meter variance allowed by the FDA means even if there were a formula it wouldn't be exact because every reading can be 20% more or less than what is displayed on the meter. Two human meters will not necessarily read exactly the same on the same drop of blood again because of the 20% meter variance allowance and specific meter algorithms.
 
MrWorfMen's Mom said:
I agree that smaller meals more frequently may be a good option to try.

The difference between pet meter and human meter readings is NOT a specific % difference. The difference in readings will be greater the higher the readings. There is no direct conversion formula and the 20% meter variance allowed by the FDA means even if there were a formula it wouldn't be exact because every reading can be 20% more or less than what is displayed on the meter. Two human meters will not necessarily read exactly the same on the same drop of blood again because of the 20% meter variance allowance and specific meter algorithms.
Click to expand...

Hmm? No the 20% i was referencing was between two meters of the same type. Comparing one alphatrak to another, as the OP stated.

There is no conversion rate between pet and human meters, no, but thats not what the OP was talking about.

Or did i misunderstand something?
 
Thanks everyone for your comments. The meters were coded correctly for the test strips - at least for the first onse as I was present, the rest were all done while I was not there. For this first one we also used the same drop of blood. The difference was 5 units which is within 20% of even the lower unit. So perhaps I don't need to try to get a replacement. I used a control solution when I first got it and it was fine and I checked again today and again it was fine.

Reading was 19.3 this morning before feeding - much lower than he has been. I very slightly reduced his insulin just in case we overshoot.
 
I think the meters are probably OK.
Now, regarding food: I'm not a great advocate of veterinary foods and I would avoid them all together.
I'm glad you are transitioning Pudding to better quality food like Lilly's kitchen. Another one I just bought (I'm in the UK like you) is Natures Menu Country Hunter 96% chicken & goose, they also do frozen raw food, worth visiting their website
www.naturesmenu.co.uk.
I use this calculation for amount of food with my pets:
2 - 3% of body weight in grams, so if your cat weighs 6 kilograms which equals 6000 grams your daily amount of wet food would be 120 - 180 grams divided into however many portions you want to feed over 24 hour. Now, depending on your cats circumstances you need to feed less if overweight and more if needs to gain weight. Small portions spread out throughout the 24 hour period is the best way to feed diabetic cat as bigger portions in one go are too taxing for the pancreas which is already struggling due to diabetes.
Could you please put some more information in your profile and your signature about you and your cat: how old, when diagnosed with FD, any other health problems, what insulin you're using etc. I would like to welcome you and assure you that you can find a lot of information and support in dealing with FD here from very dedicated members.
Most people here use human glucometer because AlphaTrak strips are very expensive unless you have a good pet insurance or you don't have to worry too much about the cost of test strips.
Would you consider setting up a spread sheet for recording Pudding's BG? This is really a fantastic tool and would really help you to manage your cat's treatment. If you have any problems setting it up somebody here would help you.
Could you look up Rocky's SS, it will give an idea what it is.
Please ask as many questions as you need as we are here for you and your cat.
Wishing you a successful journey towards regulation and remission.
Best of luck
Marlena:cat:
 
Hello Marlena, thanks for the comment. My vet was very insistent that food should be taken away after a couple of hours. Anyway, he's been a lot better today - it took him a couple of goes but he ate 1.5 Lily trays this morning.

I have to test him at about 4.00pm to find his nadir today.

I'm a bit nervous as I have to be out at work tomorrow and Thurssay so will not be around at nadir. As his figures seem to be coming down I think I might just reduce the insulin slightly - I want him to be here when I get back, does that sound senseible or a bit over cautious?

Will set up a spreadsheet soon. Flatmate is the tech wiz and I don't understand the Google app thing but he is away in India working at the moment, back on Saturday. He's also downloaded the Royal Veterinary College diabetes app - maybe we can just upload that.
 
@Misterbeesmom
Misterbeesmom said:
No the 20% i was referencing was between two meters of the same type. Comparing one alphatrak to another, as the OP stated.
Click to expand...

Sorry perhaps I misunderstood your post. :oops: You're right that all meters, pet or human have a 20% variance allowance in the US. Not sure what that allowance is in the UK. In Canada it's 15%. I just wanted to make sure no one misinterpreted and assumed a constant 20% between pet and human meter readings when both types are being used by members and lurkers on this site.
 
Glad you are setting up a spreadsheet. We have a world version that will easily convert between metric and US. What kind of ProZinc are you using? There are two available in the UK. @Marlena will be able to help you with the particulars. And Marlena, can you give Pudding's Mom some general guidelines in metric for AlphaTrak - just a no shoot number (200 US) and a hypo number (68 US)
 
PZI (protamine zinc insulin) is the general name of some insulins like ProZinc and Hypurin. They are different insulins but they are both PZI because they have protamine zinc in their formulation. ProZinc is human recombinant so molecularly similar to human insulin and Hypurin is 100% bovine most molecularly similar to cats own insulin but it is insulin for humans. So there is only one ProZinc. I wanted long lasting and bovine insulin for my cat and, at the time of Rocky's diagnosis the only insulin for cats was Caninsulin or long lasting human one. Only recently in the UK vets got the option of ProZinc. So I think the ProZinc in the USA is the same as ProZinc here. The numbers while using AlphaTrack are 3.7 or below to treat for possible hypo and no shot for beginners is below 11.
So now back to Sue @Sue and Oliver (GA) for dosing, nadirs and etc.

Stuart, back to feeding.
I was suggesting that you feed your cat at regular intervals with small amount of food like let's say every 3 or 4 hours including night time. It seems the best regime to keep diabetic cat sugar level stable. It is not always possible. I can do it right now because I'm at home a lot and also I have an automatic cat feeder. I agree with your vet that leaving wet food for the cat to graze might not be a very good option, it depends on few things. My cat is very greedy and would eat everything in one go and possibly vomit, food left for the cat to graze might spoil in hot weather etc. You have to think how best you can manage that but generally feeding smaller portions more often is preferable. It is not very good for a cat to eat a big portion of food in one go. I think you mentioned 150 grams of food twice a day - it is too much I think unless you need to fatten up your cat. We recommend that you pour a bit of hot water and mix it with the food.
 
Thanks Marlena. Packet says "Insulin human as protamine zinc insulin".

Eating is getting better. Also, as said in another thread, I've realised that another fall back could be sardines tinned in water or cooked frozen fish that comes in blocks. We used to feed this as a change sometimes and he loves them. As they are human food they both have very detailed nutritional information. Sardines are 0.6% carbohydrate, and the fish 1% so quite low.

The 150g a day comes from the Lily's kitchen feeding guideline for an all wet-food with a cat of my size - Pudding is 6.25 kg and is about at correct weight. (Was 9kg when we first got him and we dieted him down to 6.5kg in a year). It does seem quite a lot on the plate though. Will have to leave him all day tomorrow and Thursday when I'm at work so will leave out anything he doesn't finish before I leave so he can have it later.

He was 19.3 before food this morning. I gave 1.65 units (as near as I could judge), down from 1.75 previously. He was 16.0 by mid afternoon. Planning to reduce to 1.5 units tomorrow depending on morning reading.
 
Fish occasionally is Ok but why sardines in water not in olive oil? Oil is very good for the cat and sardines are good source of protein and low carb but your cat needs fat. As an addition to normal diet only, the nutritional information shouldn't really be that important as long as it is low carb.
150 gr of food per day sounds just about right if we think about the calculation I mentioned earlier - 2 -3% of body weight in grams.
What about feeding smaller more frequent portions throughout the day? You said the vet suggested to take away food after 2 hours - what do you mean by that in the view of feeding? The reason you need to feed your cat during the day is that on ProZinc his BG should be dropping after 6-7 hours and he should have some food available around this time. I understand that you are not going to be at home all day but did you think about automatic pet feeder? It is really very good and helped me enormously, the one I use is PetPod, bought in a pet shop.
 
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