Help with Meters

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Meowsmum

Meowsmum

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SO, I ran out of my Alphatrak strips (I had 1 left). I had read that I could use the Freedom strips. I confirmed that with our pharmacy tech. She also gave me a new meter. The new Freedom meter.

So, I ran a test on my Alphatrak using my last strip. It read 25.1

I then used the freedom test strip. It read 25.2

I then used the freedom METER and strip and got 18.5

Now this is a no code meter.

I have seen many posters using human meters. I am a bit afriad to use this Freedom meter bc of the difference in readings.

I plan on asking the vet to calibrate both meters this weekend. But I want some input on which one is more accurate? IF you use a human meter, do you use the actual reading or do you have an equation that you use translate the human meter into feline readings?

I am also weaning Meow of that Hilld M/D food. How long should I wean him onto regualr (low carb) wet food?

I also bought 50 test strips for $24.00 on Amazon.
 
I can't answer the meter questions as I've never used either of those meters.

BUT, as for the wean, for my cats I didn't wean from one food to the other. I took away the dry and replaced it with canned in one feeding. Neither of my cats had an issue, they both loved the canned food, and I don't think they had any litterbox issues either. I know this is not true of all cats though. I would think you could do the full food switch gradually over a week if your cat is eating the new food without complaint.
 
Many of us old timers were using human meters for years before Abbott caught on and designed the AT. I have never done an equation with my meter and I also have tested AT against many meters. IMHO, not worth the money, marketing ploy, and I do not use the AT. I have one but do not use it. My vet got me one as soon as it became available for me to do comparison testing. Just not worth the cost. Running out of AT test strips on a weekend, holiday, etc. means buying another meter to get you through also.
 
When using a human meter, all you have to remember is that it runs about 30 points lower than one calibrated for cats. You don't have to do any fancy conversions, you just change your point of reference. For example, with your alphatrak, you would start treating a hypo if blood glucose dropped below 80, where on a human meter you would start treating a hypo if blood glucose dropped below 50.

I think you mentioned in your other post that you were switching insulins soon? If you switch to Lantus or Levemir (which are your best bets for remission), the dosing protocol actually has guidelines for both human meters and the alphatrak.
 
Julia & Bandit said:
When using a human meter, all you have to remember is that it runs about 30 points lower than one calibrated for cats. You don't have to do any fancy conversions, you just change your point of reference. For example, with your alphatrak, you would start treating a hypo if blood glucose dropped below 80, where on a human meter you would start treating a hypo if blood glucose dropped below 50.

I think you mentioned in your other post that you were switching insulins soon? If you switch to Lantus or Levemir (which are your best bets for remission), the dosing protocol actually has guidelines for both human meters and the alphatrak.
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Really? You guys are awesome. Thank you. Yes, we are changing insulins this weekend while he is inpatient at the vets.

I just looked up the rating on our freedom meter and it basically sucks. I think I may try the one Mens Health rated #1 if there is a human protocal for it with this new insulin. Right now I am so happy I got tests strips for 1/3 of the Alpha Trak cost.
 
You're in Canada, right? I use the Aviva Accuchek, which you can get at Walmart or pretty much any other pharmacy. It's highly rated and a great meter. The strips are expensive in the store, but you can get them online on ebay and amazon pretty cheap!

http://www.walmart.ca/canada-estore...ch=yes&fromSearchBox=true&addFacet=SRCH:aviva

Here's a link to the Lantus/Levemir dosing protocol for cats, for your reference: http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf

(And here's the more palatable version from the Lantus forum: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581)
 
Julia, if you tell people to start treating for a hypo at a reading of 80 on the AT because it runs 30 points higher than a human meter which you said would read about 50, your are wrong. Even 50 is not a hypo in most cats, so you either continue to test and watch or if you feel safer, feed some food.

I did many tests and a few are: OTU 65....AT 83....AccuCheckAdvantage 69.....Contour 60.

OTU 64.....AT 87........ACA.........64............Contour 56.

OTU 71....AT 86.......ACA 68.......Contour 53.

If you use a meter, go by that meter and don't be adding or subtracting 30 points. BTW, the above numbers were all gathered immediately on one blood test each time I tested. At no time with the above tests would I have started to treat for a hypo but I did test and keep an eye out to see if they were still going down or in a holding pattern. Majority of people that have the AT may not have another meter but if they do, I hope they go by the human meter and not wait till the AT reads 50.

FWIW, because Hope and Mishka bleed well, I was able to line up 9 meters at a time using either Hope or Mishka, test strips in and blinking, and poked and sipped up into 9 meters. Looking at all the comparisons in different ranges the AT was off too many times for me to even trust it. I used the ACAdvantage by Roche because it is another excellent meter but it takes more blood than majority of meters out there do. Why even use the AT if you have to start adding/subtracting 30 points?
 
You said:
"I have seen many posters using human meters."
There is no real way to calibrate the meter. You can test your meter against the same blood that the vets uses for his tests but there are some problems with that.
- The hand meters are calibrated for capillary blood and the vet uses blood from the vein. This is a small difference.
- The vet uses blood serum for the lab test but the hand-held meters use whole blood. You have to use whole blood. The had meters are calibrated to reflect the serum/plasma reading.
- As Hope said, adding the same number of "points" for all readings is not the right thing to do.
 
Ack. I am so confused :shock:

I guess I will stick with using my Alphatrak. I will, however, ask the vet to do some calibrations to see which meter runs as close to his as possible.
 
Hope + (((Baby)))GA said:
Julia, if you tell people to start treating for a hypo at a reading of 80 on the AT because it runs 30 points higher than a human meter which you said would read about 50, your are wrong. Even 50 is not a hypo in most cats, so you either continue to test and watch or if you feel safer, feed some food.

I did many tests and a few are: OTU 65....AT 83....AccuCheckAdvantage 69.....Contour 60.

OTU 64.....AT 87........ACA.........64............Contour 56.

OTU 71....AT 86.......ACA 68.......Contour 53.

If you use a meter, go by that meter and don't be adding or subtracting 30 points. BTW, the above numbers were all gathered immediately on one blood test each time I tested. At no time with the above tests would I have started to treat for a hypo but I did test and keep an eye out to see if they were still going down or in a holding pattern. Majority of people that have the AT may not have another meter but if they do, I hope they go by the human meter and not wait till the AT reads 50.

FWIW, because Hope and Mishka bleed well, I was able to line up 9 meters at a time using either Hope or Mishka, test strips in and blinking, and poked and sipped up into 9 meters. Looking at all the comparisons in different ranges the AT was off too many times for me to even trust it. I used the ACAdvantage by Roche because it is another excellent meter but it takes more blood than majority of meters out there do. Why even use the AT if you have to start adding/subtracting 30 points?
Click to expand...

Every cat is different, but I said that you generally start treating BELOW those numbers, not at them. I think there's a misunderstanding with what I mean by "treating." In some cases, treating could mean just retesting again if you're just under 50 (or 80 on the AT) and seeing if the number continues to drop, or feeding some low carb food for a boost. But if your cat drops below 80 on the AT, or 50 on a human meter, you do definitely need to watch out for hypos.

The two meters aren't going to test exactly 30 points apart every time you test. It depends on the human meter you have--some run higher, some run lower. My point was that the only difference between the meters is that the AlphaTrak runs about 30 points higher, so you have to adjust your perspective. I don't see what is wrong with that statement.

A human meter is more than adequate for what you'll be using it for--making sure it's safe to shoot insulin, and seeing how the insulin is working to lower your cat's blood sugar.

And I agree that you do need to stick with whatever meter you decide to use, and not try to convert the numbers between the two. That's why I provided the protocol that has both the AlphaTrack guidelines and the human meter guidelines. Please don't be discouraged from using a human meter--you can really use either the AT or a human meter just as well, you just need to make sure that you're using the correct dosing guidelines depending on which one you choose, and sticking to the same meter for all your testing.
 
I just tried to two meters againn and the AT said his insulin was 12!! (YAy, thank you for the info about the Hills food. As soon as I changed his diet his numbers came down!) and 9.2

So they read beween 3 and 7 off.

I dont do insulin until 10:30 tonight. SO I will feed at 7;30 regular low carb food then test again at 10:30 and scale the amount of insulin back based on those results.
 
This particular veterinarian informed me that they have done comparison studies with human glucometers and have found that in lower numbers the human glucometers are calibrated to read lower than the actual reading to spur humans into doing something about hypoglycemia.
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That has been proved to be false as the meters, by law, have to read what the bg glucose is at the time. It still goes around now and then though. Also, those charts Janet did were based on meters I had tested and gave her the numbers.
 
I found a wonderful site the outlines the differences in human vs feline glucose meters. I hope I can share these. What is your opinion on these articles?


http://www.ncbi.nlm.nih.gov/pubmed/20852246


Assessing portable blood glucose meters for clinical use in cats in the United Kingdom.

Dobromylskyj MJ, Sparkes AH.


Source

Faculty of Veterinary Medicine, University of Glasgow, Garscube Estate, Glasgow G61 1QH. melaniejovet@live.co.uk


Abstract

The aims of this study were to evaluate six portable blood glucose meters for use in cats in a clinical setting and to identify potential sources of inaccuracy such as the effect of glucose concentration and haematocrit. Excess fluorinated whole-blood samples were obtained and were tested using the six meters and a reference laboratory method. Bland-Altman plots were constructed and an error grid analysis was performed, using a grid adapted in this study for diabetic cats. Error grids are a clinically oriented non-parametric approach to blood glucose data, and are designed to determine whether differences between glucometer and laboratory readings are clinically significant. All the meters studied had the potential to under- or overestimate blood glucose levels to varying degrees throughout the glycaemic range. This variation was not consistent enough to be predictable and correctable. The study failed to demonstrate any link between haematocrit and difference between laboratory and glucometer readings.

Schweiz Arch Tierheilkd. 2009 Sep;151(9):448-51.


******************************************************
http://www.ncbi.nlm.nih.gov/pubmed/19722134

Evaluation of a new portable glucose meter designed for the use in cats.

Zini E, Moretti S, Tschuor F, Reusch CE.


Source

Clinic for small animal internal medicine, University of Zürich.


Abstract

Portable blood glucose meters (PBGMs) are useful in the management of diabetes mellitus in cats. In the present study we compared the performance of two PBGMs: the AlphaTRAK (Abbott Animal Health, Maidenhead, England) specifically developed for dogs and cats, and the Ascensia ELITE (Bayer HealthCare, Zurich, Switzerland) developed for humans. Quality parameters, including precision and accuracy, were better for the AlphaTRAK meter compared to Ascensia ELITE. While the AlphaTRAK meter results did not differ from the reference method, results from the Ascensia ELITE were significantly (P<0.001) lower. The superior performance of the AlphaTRAK meter supports its use to monitor blood glucose levels in cats.

PMID: 19722134 [PubMed - indexed for MEDLINE]


Publication Types, MeSH Terms, Substances
 
For the purposes that you'll be using the meter for, you don't need pinpoint accuracy. A human meter is not super accurate (they are allowed to have a variance of +/- 20%), but that's why it's only used for home monitoring, and not as a diagnostic tool. Precision is more important than accuracy with testing, meaning you need consistent readings (using the same meter for all your testing), not accurate ones. Dosing decisions are not made based off of one specific value, but rather ranges or patterns of values. The "corrections" for the inaccuracy of human meters are already written into the dosing protocols.

There is no problem using the alphatrak if you want to keep using it. But there is also no problem using a human meter if you want to switch due to the cost/availability of the alphatrak strips. What's important is that you stick with one single meter, and use the correct dosing protocol for that meter (human or animal).
 
THAT makes sense. Thank you. Whew. I feel better now. \

I should probably stop researching the heck out of everything.
 
results from the Ascensia ELITE were significantly (P<0.001) lower
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Used to be called Bayer Elite and I always knew that ran lower, especially at low numbers, than many meters. Found that out when I switched to it years back, ran fructosamine on both, and then went back to my OTU.
 
If you plan to continue with the AlphaTrak, I would add that to your signature in capital letters so people will realize it when they respond to posts about dosing and numbers. It just helps us figure out "what's what" in terms of numbers.
 
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