Human verse Pet Meter

[TiffB]

Good Afternoon,
I took Boogey to the vet yesterday and my vet insists that the human meters are not reliable and not calibrated correctly for pets. I am using the Relion Prime for at home testing. I am wondering what is the difference in numbers are between the Alphatracker and the Relion Prime? I also don't want to tick off my vet, but $40 a every 5-7 days for a BG test seems crazy!! when I can do it at home. I'm going along for now more so because I don't want to switch vets and he is insisting. Any suggestions?

We are on week three of insulin. Boogey is 13 pounds and slightly over weight. We started at 2 units and last night the vet wanted him to go to 3 units (BG at the vet was 430). I gave him the 3 units last night and this morning before his shot he was still at BG 440. This morning I only gave him 2.5 units, because I'm at work and no one is at home to monitor him. I'm still so worried about him getting too low, BUT he hasn't been under 300 yet. He is eating Hills DM dry and FF wet. Scheduled eating is going good. We are moving away from dry. I don't have a good understanding of the time frame it takes for these numbers to go down. He is still drinking and peeing alot. I'm still wondering, am I doing this correctly?? Could I be doing more?

Thanks in advance for input and thoughts,
Boogey's Mom

 

[Julia & Bandit (GA)]

A human meter is fine to use, and most are reliable. Your vet is correct that the human meter is not as quite as accurate as the Alphatrak, and there are a couple meters that read feline blood very inaccurately (fortunately, the Relion Prime is not one of these), but that is fine for the purposes that you're using it for. When we home test, we aren't looking so much for specific values, but rather trends and patterns over time, and consistency. As long as you're using the correct reference range for cats on the human meter (normal BG is 50-120, vs. 70-150 on the Alphatrak), and you're sticking to using one meter for your tests, then you're fine using the Relion meter. It is far more important that you use a meter that you can afford to test frequently enough to get good control over Boogey's BG (minimally 2x a day, but ideally 3x or more) than it is that you use the Alphatrak.

What insulin are you using with Boogey? The Lantus dosing protocol uses a human meter reference range, as do other dosing guidelines you'll find here on FDMB.

One fantastic tool I would highly recommend you set up, is a spreadsheet to record your home testing numbers. You'll need it if you need to ask for dosing advice here on FDMB (which trust me, you will at some point, since most vets don't tend to give good dosing advice). Plus, it's a very handy way for you to keep track of Boogey's numbers and share them with your vet. You can find instructions on how to do that here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/.

2u is a high starting dose for a 13 lb overweight cat. With Lantus or Levemir, the starting dose is .25u per kg of ideal weight. So for a cat whose ideal weight is 11 or 12 lbs, that would be around 1u, not 2u. Also, insulin should be raised in .25u -.5u increments, not whole units. Cats typically need very small doses of insulin (Bandit has varied from needing .25u-to 1.5u at most over the years). When you increase the dose too quickly, you can actually cause higher BG because chronic overdosing will keep BG just as high as underdosing. The goal is to find the right dose of insulin by going up in small increments so you don't overshoot your ideal dose.

Hills DM dry is very high in carbs and likely what is keeping your cat's numbers high, so phasing it out is a good thing. However, please make sure you're testing and lowering the dose as needed as you phase it out because cats usually see a 100-300 pt drop in BG once the dry is removed, meaning that his insulin need will be much lower. Most cats on a low carb canned diet do not need much more than 1-2u, and some lucky cats will go into remission from the diet change alone and no longer need insulin. If you're not testing daily and catching those drops, you could face a dangerous hypoglycemic incident.

It takes time and patience to see numbers go down. Once the dry is removed, it can take weeks or even months to get a cat regulated--typically a cat that starts on the correct treatment asap (the correct insulin, a low carb canned diet, and gradual dose adjustments via daily home testing), will see better results more quickly than a cat that was untreated for some time, or treated unsuccessfully for months/years with the wrong insulin, dosing and/or the wrong diet.

EDIT: I just went back and saw that you're using, Lantus, correct? That's great, because it's one of the best insulins for cats. If you can get your spreadsheet set up, I would head over the the Lantus forum for dosing advice, since your vet doesn't seem to be advising you on the dose correctly (this is more common than not, unfortunately). There's a ton of experienced folks there that have a wealth of experience with the insulin you're using!

 

[MrWorfMen's Mom]

The pet meter is very expensive to use in comparison to the Relion Prime which is a perfectly good alternative to the pet meter. If your vet is that pro testing, then he should be fine with you using a human meter rather than a pet one. Just tell him the cost factor has to be taken into consideration. I echo Julie's comments that it's patterns/trends rather than individual numbers we are looking at and the patterns/trends will be very similar no matter what type of meter you use. Provide the vet with the human meter reference numbers and do a comparison test at the office if need be.

 

[TiffB]

Thanks everyone. Yes he is on Lantus. I have been writing everything down just haven't put it in spreadsheet form yet. I will be doing that soon & move over to Lantus forum (I feel like I just graduated lol). I did talk to the vet about the cost of the alpha verse Relion. He just isn't comfortable with it, which ok I guess. Lantus isn't on the market for pets either, but ranting aside. Next vet visit I plan on bringing my meter to compare.

I keep testing him and I've stayed with 2.5 units all yesterday & this morning. Shots & feedings are done at 7 & 7. BG test at 10pm was 85 (he can be a stinker when I first get home about testing him. I realize before the shot is ideal), so I gave him a little regular carb cat treat before bed last night. He hasn't been that low yet. This morning he was back at 440 BG before his shot but it had been about 45 mins after eating.

 

[Tuxedo Mom]

Shots & feedings are done at 7 & 7. BG test at 10pm was 85

That test would have been what is called a +3 (3 hours after shot) With Lantus the numbers can drop up to about +5-+7 hours after shot, so there is a good chance your kitty is going even lower during the cycle (time between shots) The high number this morning could very well have been from "bouncing" which happens when the numbers drop too quickly or lower than what the body is used to. In these cases the body releases stored glucose (glucogen) which causes the glucose numbers to "bounce" back up into higher numbers. The effects of this release of stored glucose can last up to 3 days.

That is why testing before each shot is very important as well as trying to get a mid cycle test...around +4 or +5 to see how low the insulin is bringing Boogey. This is not always possible depending on your life schedule but even a +2 hour test will give some extra data. Lantus dosing changes are base on how low a dose takes your kitty. Periodic tests do not give a clear picture on how the insulin is working through the cycle. Do a test before each shot...without having fed Boogey for at least 2 hours before hand, so that the food is not influencing the numbers. Then try to get at least one test during the cycle and a night time test before bed. All this data will give a much clearer picture on how Boogey is responding to the Lantus .

 

[scoobydoox]

Good Afternoon,
I took Boogey to the vet yesterday and my vet insists that the human meters are not reliable and not calibrated correctly for pets. I am using the Relion Prime for at home testing. I am wondering what is the difference in numbers are between the Alphatracker and the Relion Prime? I also don't want to tick off my vet, but $40 a every 5-7 days for a BG test seems crazy!! when I can do it at home. I'm going along for now more so because I don't want to switch vets and he is insisting. Any suggestions?

We are on week three of insulin. Boogey is 13 pounds and slightly over weight. We started at 2 units and last night the vet wanted him to go to 3 units (BG at the vet was 430). I gave him the 3 units last night and this morning before his shot he was still at BG 440. This morning I only gave him 2.5 units, because I'm at work and no one is at home to monitor him. I'm still so worried about him getting too low, BUT he hasn't been under 300 yet. He is eating Hills DM dry and FF wet. Scheduled eating is going good. We are moving away from dry. I don't have a good understanding of the time frame it takes for these numbers to go down. He is still drinking and peeing alot. I'm still wondering, am I doing this correctly?? Could I be doing more?

Thanks in advance for input and thoughts,
Boogey's Mom

It is under 20.00 for that test at my vet. Wonder why they are charging so much more? My vet at first said no home testing. I went and bought the relion prime meter and supplies and took it with me to the next visit and made them show me how to use it and compared it to there test. The vet said it was only ten points off from his test and it was safe to use at home. Your vet should be working with you. Are there any other vets in your area you can look into to?

 

[BJM]

See my signature link on glucometers and reference values.
If you so desire to collect 100 paired tests of an AlphaTrak vs your choice of human meter, taken at the same time, I can run a quick regression for you that will show approximately how those 2 specific meters compare for you and your cat, and the + error variance.

 

[Melanie and Smokey]

If you so desire to collect 100 paired tests of an AlphaTrak vs your choice of human meter, taken at the same time, I can run a quick regression for you that will show approximately how those 2 specific meters compare for you and your cat, and the + error variance

There is no linear variance between meters and no one should use one number to estimate what the difference would be at another number. Doesn't matter if you collect 10,000 numbers. The difference is not linear so you cannot come up with a % variance. The meters will be closer at low numbers and closer at high numbers, with their widest variance in the middle so an attempt to use a % calculated at any point along that line on a different point will result in a vastly incorrect number.

I also don't want to tick off my vet, but $40 a every 5-7 days for a BG test seems crazy!!

That is an INSANE price for doing a BG number. Just shy of twice what I've paid at two different emergency hospitals where prices are always inflated. More than twice what. Just tell your vet that the number on the meter is really close and you can't afford the testing a the vet or a pet meter, it will have to be good enough. There is probably some documentation around the site that supports human meter use that you can print and take to the vet.

 

[BJM]

There is no linear variance between meters and no one should use one number to estimate what the difference would be at another number. Doesn't matter if you collect 10,000 numbers. The difference is not linear so you cannot come up with a % variance. The meters will be closer at low numbers and closer at high numbers, with their widest variance in the middle so an attempt to use a % calculated at any point along that line on a different point will result in a vastly incorrect number.

Y = f(x) + e
where the function may be a straight line or curvilinear, + error variance
And, read what I said "approximately", which is what any regression equation will give you because NO measurement is perfect, not even lap equipment. Their error variance is present, though smaller. This is a basic foundation of measurement.