Does anyone have experience using a CGM for their cat?

[kccarney]

My Theo has just been diagnosed with acromegaly, which explains his insulin resistance, and his Internal Medicine doctor suggested that we use one among a few other treatment recommendations. Theo is a pretty calm and laid back 10 year old that I took in last December as a diabetic. He was on Bexacat at the time but had a pancreatitis issue so I had to transition him to Lantus. He is currently all the way up to 7 units BID which is why his regular vet referred me to the IM doctor. I don't know anyone personally that uses a CGM on their cat, so I wanted to post it here to see what y'all have to say. Thank you.

 

[Connie & Parker & Moonie]

Hi I don't use a Libre but I know @Elaine and Ember and @Staci & Ivy use Libres very successfully for their kitties. And you might find the below links helpful.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats – Felinediabetes.com

You'll want to manually test sometimes as a back up in case the CGM falls off or malfunctions. CGMs are expensive and you'll need to have extras on hand to replace as needed.

 

[Elaine and Ember]

Ember has been using them since April. It was definitely a learning curve with learning how to interpret the information and figuring out where and how to apply them, but it’s been a very useful tool. Staci & Ivy has given wonderful advice along the way and helped and encouraged us through it all! Ember doesn’t have acromegaly but she does have IAA, so it has been so helpful to have a way to keep track of her levels since they’re so unpredictable. It takes some patience and a willingness to accept that it’s definitely not the perfect solution, but I am so incredibly grateful to have this tool in our toolbox.
Ember wears 2 patches (a Type One Style and an tegaderm over that) over her Libre and a tank top as well. She has still managed to rip off a couple of them, but for the most part, that works pretty well for us.
I still do manual testing for her AMPS and PMPS just to keep an eye on things, and when she goes low and I’m home, I’ll verify manually as well. But I love knowing what’s going on with her glucose when I can’t be home to monitor her. Dealing with FD when you’re a control freak is so hard and this makes me feel a little better about it since I at least I don’t have to worry about her crashing and me being completely unaware of it.

 

[Staci & Ivy]

Hello and welcome to you and Theo.
I’ll just chime in but you’ve been given excellent information from Connie and Elaine.

Ivy wears a Libre since she is very feisty and doesn’t like me to manually poke her ears too often. I have found the Libre is a good way for me to manage her numbers. But it’s important to be able to still poke when you want to double check what’s going on if something seems off. Or of course, if their BG goes low and you need to know how low they actually are (since there can be a difference between the Libre and a handheld device).
Having said that, other people have found Libre readings to be very close to a handheld glucometer. So it takes some time and experience to know how your cat will read.

As Elaine mentioned, the Libre’s can be somewhat glitchy, and they are definitely not perfect.
We are using them off label as they are intended for humans. But, they are an incredibly helpful tool in trying to manage a cat with challenges and diabetes.
I’ve been using them for about three years now with Ivy.
As Elaine mentioned, we keep the Libre covered so our cats cannot mess with them or try to pull them off. Both of our cats have had successful pulling a Libre off now and then, but generally, they leave them alone.
I use a Tegaderm to cover Ivy‘s Libre and she wears a tube top on top to cover the Libre. Some cats can wear a little T-shirt or tank top but my cat didn’t like that so I had to figure out something that didn’t have anything on her shoulders.
These fussy cats

As Connie mentioned, if you’re going to be using Libre, you always want to have several extras on hand because inevitably it will fail at the worst times. Like in the middle of the night or on a weekend or when you can’t get to the pharmacy, etc..

If you have any follow up questions, feel free to ask, and we are happy to try to help

 

[kccarney]

Hi I don't use a Libre but I know @Elaine and Ember and @Staci & Ivy use Libres very successfully for their kitties. And you might find the below links helpful.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats – Felinediabetes.com

You'll want to manually test sometimes as a back up in case the CGM falls off or malfunctions. CGMs are expensive and you'll need to have extras on hand to replace as needed.

Thank you for the reply and the link.

• Is there anything in the guide that you think is particularly important for someone just starting out?
• Are there any particular supplies you'd recommend having on hand beyond the sensor itself?

 

[kccarney]

Ember has been using them since April. It was definitely a learning curve with learning how to interpret the information and figuring out where and how to apply them, but it’s been a very useful tool. Staci & Ivy has given wonderful advice along the way and helped and encouraged us through it all! Ember doesn’t have acromegaly but she does have IAA, so it has been so helpful to have a way to keep track of her levels since they’re so unpredictable. It takes some patience and a willingness to accept that it’s definitely not the perfect solution, but I am so incredibly grateful to have this tool in our toolbox.
Ember wears 2 patches (a Type One Style and an tegaderm over that) over her Libre and a tank top as well. She has still managed to rip off a couple of them, but for the most part, that works pretty well for us.
I still do manual testing for her AMPS and PMPS just to keep an eye on things, and when she goes low and I’m home, I’ll verify manually as well. But I love knowing what’s going on with her glucose when I can’t be home to monitor her. Dealing with FD when you’re a control freak is so hard and this makes me feel a little better about it since I at least I don’t have to worry about her crashing and me being completely unaware of it.

Thank you for your response. I am an old home tester from way back in 2006 with my Louie (GA) and I learned about it here when I was lucky enough to find FDMB. The CGM thing and the acro is entirely new for me so I appreciate any help I can get.

• Where does Ember wear the sensor, and how difficult is application?
• How long does a sensor typically stay attached?
• Does Ember tolerate the application and the additional coverings fairly well?
• Do you find the Libre readings generally correlate with your handheld meter, or are there significant differences?

 

[kccarney]

Hello and welcome to you and Theo.
I’ll just chime in but you’ve been given excellent information from Connie and Elaine.

Ivy wears a Libre since she is very feisty and doesn’t like me to manually poke her ears too often. I have found the Libre is a good way for me to manage her numbers. But it’s important to be able to still poke when you want to double check what’s going on if something seems off. Or of course, if their BG goes low and you need to know how low they actually are (since there can be a difference between the Libre and a handheld device).
Having said that, other people have found Libre readings to be very close to a handheld glucometer. So it takes some time and experience to know how your cat will read.

As Elaine mentioned, the Libre’s can be somewhat glitchy, and they are definitely not perfect.
We are using them off label as they are intended for humans. But, they are an incredibly helpful tool in trying to manage a cat with challenges and diabetes.
I’ve been using them for about three years now with Ivy.
As Elaine mentioned, we keep the Libre covered so our cats cannot mess with them or try to pull them off. Both of our cats have had successful pulling a Libre off now and then, but generally, they leave them alone.
I use a Tegaderm to cover Ivy‘s Libre and she wears a tube top on top to cover the Libre. Some cats can wear a little T-shirt or tank top but my cat didn’t like that so I had to figure out something that didn’t have anything on her shoulders.
These fussy cats

As Connie mentioned, if you’re going to be using Libre, you always want to have several extras on hand because inevitably it will fail at the worst times. Like in the middle of the night or on a weekend or when you can’t get to the pharmacy, etc..

If you have any follow up questions, feel free to ask, and we are happy to try to help

I appreciate the help and hope that this will be easier than I think it will be. Theo is a pretty laid back boy so I'm hoping he pays no attention to the CGM. I pre-shot test him at least twice a day and once a day for blood ketones. We have our routine down and he is pretty good about it.

• Where do you place Ivy's sensor?
• Does she tolerate the application and the tube top without too much fuss?
• Have you found any particular adhesive or covering that works better than others?
• How do you handle differences between the Libre readings and your handheld meter?
  
  

 

[Connie & Parker & Moonie]

Thank you for the reply and the link.

• Is there anything in the guide that you think is particularly important for someone just starting out?
• Are there any particular supplies you'd recommend having on hand beyond the sensor itself?

Those are probably better questions for Elaine and Staci since they’re experienced Libre users

 

[Elaine and Ember]

Thank you for your response. I am an old home tester from way back in 2006 with my Louie (GA) and I learned about it here when I was lucky enough to find FDMB. The CGM thing and the acro is entirely new for me so I appreciate any help I can get.

• Where does Ember wear the sensor, and how difficult is application?
• How long does a sensor typically stay attached?
• Does Ember tolerate the application and the additional coverings fairly well?
• Do you find the Libre readings generally correlate with your handheld meter, or are there significant differences?

• Ember wears her sensor on her side, behind her shoulder. When the vet first applied it, he did it on her shoulder and it failed immediately. I learned how to install them myself and kept doing it on the shoulder for a while since that's what he did, but I found that the numbers have been more accurate on her side.
• I've had them stay on the full 15 days, but I've had them fail earlier, Ember has ripped off a couple, and twice I've had them give me super high, inaccurate numbers so I removed them and replace them early. Once I got the hang of installation (I wasn't shaving closely enough at first) they've lasted the whole time for the most part.
• She tolerates the application beautifully! She doesn't mind being shaved and she doesn't even flinch when I do the actual application. She gets her favorite freeze dried treats the whole time to keep her from being squirmy.
• There are significant differences in both the low range and high range. I find it's most accurate in the 100s, usually, and less so in the 300s and under 100. But not always. It's hard since you can't trust it completely but it shows trends and it gives you a general idea of when you need to worry. I was super frustrated with it at first (and actually took a break from using it for a while) since I wanted exactly accurate numbers, but that's not the type of tool it is. Since I work outside the home, it gives the the safety net I need to keep her safe. I watch the trend arrows, and I monitor closely when she's dropping steeply. I have an app-controlled feeder with emergency high-carb dry food in it, so if I'm gone and can't get home and she's heading toward the danger zone, I can pull her back to safety, which is priceless.

 

[Elaine and Ember]

I just saw your other questions directed at Connie but I can answer those as well!

• Supplies on hand- I'd get alcohol wipes, Skin- Tac wipes, Brava spray, qtips, a wooden toothpick or skewer, electric clippers, the patches you're planning to use, the shirt you're planning to use (if you're going to use a shirt.)
• I think read the guide multiple times so you become familiar with it. The first few applications were super stressful for me but I eventually got the hang of it just like everything else. Staci gave me a great tip to use a toothpick (I actually use a wooden skewer) to hold down the Libre when you're pulling the applicator off. That's been an amazing tip that has saved multiple Libres from immediate failure.

 

[Staci & Ivy]

I appreciate the help and hope that this will be easier than I think it will be. Theo is a pretty laid back boy so I'm hoping he pays no attention to the CGM. I pre-shot test him at least twice a day and once a day for blood ketones. We have our routine down and he is pretty good about it.

• Where do you place Ivy's sensor?
• Does she tolerate the application and the tube top without too much fuss?
• Have you found any particular adhesive or covering that works better than others?
• How do you handle differences between the Libre readings and your handheld meter?
  

I think Elaine gave you excellent information, I would agree with everything she said.
Ivy tolerated the process of installation very well which is surprising, since she’s a pretty high stress cat (it’s why I use a Libre, she doesn’t tolerate too much poking).

She hated wearing a tee shirt with arms and her chest covered, then I had an epiphany and came up with a tube top idea and that was a game changer for us.
(A wide headband works great. Many cats don’t mind a tee shirt or tank top though).

I use a reader clear Tegaderm bandage over the Libre (or you can use a Libre patch if you like, then cover with a top.

The best tips are to have everything laid out and close at hand so you are ready to go and don’t have to get up during the process. And take a deep breath and try to be calm.

The installation takes me less time than the removal of a sensor. For removal I use coconut oil on a qtip and go around the sensor very gently and slowly. You don’t want to harm their fragile skin. Take your time. And Brava spray works very well too. I have both.
(Olive oil is also recommended, too).

I install parallel to the spine, now on the spine, lower than behind the shoulders, maybe 1/2 way down the back. And not on the side where they will lay (since that can cause a compression low).

As Elaine mentioned, you’ll get to have an idea of how the Libre reads against a handheld meter over time. And it’s best for a general range so you can know if they are too high or too low.
I don’t usually bother testing the highs. I save my pokes for when she’s very low on the sensor. And many times she’s in a safe range on a handheld, but only manual testing tells you the accuracy.

Make sure you have several Libres on hand as it can fail at the worst times and you don’t want to have to wait to get a refill at the pharmacy (yes I’ve had to replace them at midnight or on a weekend, etc. when the pharmacy wasn’t open).
I keep at least six Libre‘s on hand at all times, but I’ve been doing this for several years. So (I’m a little obsessive and just don’t want to be caught unprepared).
I’d rather have more supplies and not feeling desperate and stressed. I’m sure I’m a little over the top, but you’ll do what is comfortable for you.

Here is an idea of placement. I hope all this helps!