Discrepancy between BG reading and urine glucose reading?

[Choo]

This afternoon, with the help of our petsitter, I managed to get a BG reading for Bangkok. It was a very good 4.5 which is normal. I had performed the BG test 5 hours after insulin.

At 11:45 AM, I had performed a keto diastix urine test. Ketones were negative. Glucose was 1%.

At 6:35 PM, I performed another keto diastix urine test. Ketones negative. Glucose maybe 1/2 %.

Bangkok is very lethargic, lying on his side often. He does get up and move around but his activity level is very low. He has also been drinking a lot today and peeing a lot.

Has anyone experienced a normal BG but a high glucose urine test?

I spoke to the assistant vet. She was happy with the BG results but puzzled about his lack of energy as his BG is normal. She suggested perhaps x-rays or ultrasound to see if something else is going on.

Has anyone experienced a similar thing - normal BG but high urine glucose and lethargic cat?

 

[Chris & China (GA)]

Remember, it takes time for urine to be formed and so the results you're getting on the urine are really showing you where his blood glucose was several hours ago.

As for the lethargy, I'd try to get a ketone test in the next time you have fresh urine....While it's usually cats with high BG numbers that we worry about most, any cat can start throwing ketones and if it's more than a trace, they need to be at the vet immediately

It'll also help us to help you if you start using our BG spreadsheet so we can get a better idea of what the BG been running lately

ETA...sorry...I just noticed that you have been checking for ketones...at 1am in the morning, I just missed it in your post

 

[Vyktors Mum]

You are doing a bit of an oranges and apples comparison there. The BG gives you a specific measurement at a specific point in time whereas the urine test gives you somewhat of an average since the last pee. So the glucose in the urine is showing you that Choo isn't staying within the normal range whereas the BG test showed you that he was in the normal range at that particular point in time.

Choo could be lethargic from big swings in BG, but that's just one possibility. As Chris suggested it would be helpful it you would set up the spreadsheet (your vet should love it too) there's no way for us to be more definitive without it.

Also, Choo is gorgeous

 

[Choo]

I'm Choo and my cat's name is Bangkok but thank you for your compliments!

I'll see if I can get the BG spreadsheet done. My vet only requires BG taken twice a week, thank goodness! Bangkok's ears are very difficult to prick for even a pin head drop of blood.

Thanks for your replies.

 

[Chris & China (GA)]

Have you ever tried getting blood from his pawpad?

It's not surprising that your vet doesn't discuss home testing...Most don't...but it really is very important to learn to home test to keep Bangkok safe as well as to know how well he's responding to treatment.

Insulin is a very powerful hormone and even a little can cause hypoglycemia which can kill quickly.

I'd strongly encourage for you to continue to try to find a way you can test him at home that he'll tolerate. I know it sounds crazy, but the vast majority of our kitties learn to accept testing pretty easily and a LOT of them will start coming when they're called or even when they hear us opening the test kit! It's all a matter of having them associate testing with something they enjoy (like food!)

Here's something I wrote up for some other members that's worth a try!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

You can also "scrape" the blood drop onto your fingernail and then test from there!

If you absolutely can't get him to tolerate ear testing, here's a video on paw testing (there are more on YouTube...but most of the videos are ear testing)

 

[BJM]

While you work on blood glucose testing, please check my signature link Secondary Monitoring Tools and track water consumption, dehydration, and urine ketones and glucose (KetoDiaStix or generic). While these are less precise indicators, they are some of the key characteristics which will show you if you are gaining any control and if you may need veterinary assistance (ketones higher than a trace may indicate diabetic ketoacidosis)

 

[Choo]

Thank you all for your replies. I'll definitely be looking into all these things. His urine glucose level was finally lower today and I feel encouraged by the results. It says there's 1/2 % glucose while in the past, it was always at least 1 -2 % glucose.

 

[Critter Mom]

@Choo - I'm very glad to read that Bangkok's urine test results are improving. I can remember the time Saoirse first gave me a negative test for glucose in her urine. It was the first major milestone we hit on her way to recovery. (Caninsulin wasn't agreeing with her so it was hard to tell how she was doing from clinical signs alone.) My heart jumped for joy.