Meter differences?

[LDB]

I took Maui in today to have the vet test with my Arkray Glucocard meter and his Alpha Trak meter using the same drop of blood. The difference was about 30% (273 on his meter, and 196 on mine). Does that sound about right to you all? He's still concerned, and I am taking the cat back tonight at 6:30 pm to test him again side-by-side when his numbers are at the low point. I have a feeling this vet will still want me to buy that animal meter for $130...

 

[Carl & Polly & Bob (GA)]

Both his meter and your meter are allowed to be "off" by 20%.
So his could be high by 20% and yours could be low by 20%...

Do the math there, assuming those two things and the actual BG could be 230, and both of your meters would be "right".

But the real point is this....
Whether a 273 or a 196, both readings are above normal and would indicate that insulin is needed. And you would give the same dose regardless.

The only time the difference would really matter is on numbers that are in the low-normal range. Like 50 or less.

If you got a 50, and he got 30% higher and got a 65... Both numbers would say "low normal BG".

If you just look at numbers, and the vet is assuming that there is always going to be a 75 point difference between his meter and yours based on that one test, then he isn't looking at it correctly. If you consider "percentage" instead of just raw numbers, then the higher the numbers, the farther apart they will appear to be on the two meters. The lower they are, the closer they will appear to be.

But they would still indicate the same thing... They will both tell you whether to give insulin or not give insulin.

If I had to pick one meter over the other, I'd pick the one with the lower numbers. Because it would allow me to more safely treat the condition. It will stop me from giving shots when the numbers are at lower levels.

 

[Deb & Wink]

The difference was about 30% (273 on his meter, and 196 on mine). Does that sound about right to you all?

Yes, 30% is about the difference between a human glucometer and a pet specific glucometer.

I have a feeling this vet will still want me to buy that animal meter for $130...

Sure, if you can afford the test strips or the vet will give you them for free or a reduced cost, the same cost as the Arkray strips, than go ahead and make that purchase.

Don't let your vet pressure you into switching or tell you human glucometers are not accurate enough. Over 90% of people here use the human glucometers. Those that start out using the Alphatrak 2, soon find out they can not afford to test enough to keep their cat safe and use 200 test strips a month. If $200-400 is in your budget for test strips, then go ahead and buy the Alphatrak.

Before Abbott Laboratories saw a lucrative market and came out with the Alphatrak, everybody used human glucometers to test their pets. Abbott marketing folks have convinced so many vets that only their glucometer is accurate enough for pets, that many vets now try give the hard sell, to push them on their clients.

IMHO, the extra cost is not worth it. I'd rather use a human glucometer and spend the extra money on cat food and cat toys.

From another member:
Reference ranges for decision making

Conceptually, it is somewhat like reading a thermometer in Celsiums vs Fahrenheit. Freezing, for example, is 0 degrees Celsiums and 32 degrees Fahrenheit.

That said, here are some glucose reference ranges for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO
- At nadir in long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, especially if for most of the cycle between shots
- Uncontrolled diabetes and in danger of DKA and hepatic lipidosis
- Test for ketones; more than a trace, go to vet ASAP.

 

[LDB]

I'm going back this evening so we can test again and we'll see if he tries to push me towards the pet meter. I'm starting to feel a bit uncomfortable with him though, and think I may need to look for another vet. In an email a couple weeks ago where we were discussing human vs pet meter, he said this -- "I don't think the price of the test strips will be that big of an issue. One of the worst things we can do to our diabetic cats, is to be so arrogant that we think we can micromanage them with test results, and forget to look at the cat. Bottom line to that statement is, I don't have people testing them all that often."

 

[Deb & Wink]

Your cat is more that a set of numbers. We don't look at only the test numbers. We also have the WCR or Whole Cat Report. The 5 P's (peeing, pooping, purring, playing, preening) plus appetite give us a good idea of how the cat is doing.

Perhaps your vet considers testing BG's 4 times a day to be micro managing. We consider it keeping our kitties safe, just like a human diabetic would. Testing at nadirs let us know when to adjust the dose up or down. Testing if the cat "doesn't look right" alerts us to low numbers and lets us give the cat some food to raise the numbers. We also have a good success rate with remission with our protocols.

Ask your vet what his goals are for your cat. Ask him how many cats he has gotten into remission. Ask how many newly diagnosed diabetic cats he treats in a year. In a week, in a month. (We probably see 4-5 newly diagnosed members a week) Ask him what recent continuing education he has done to keep current with diabetes treatments. Ask him what vet journal articles he has read on feline diabetes. Ask him if he follows the AAHA Diabetes Management Guidelines for Dogs and Cats. Ask him if he supports home testing. Ask him if he insists on curves done in his office. Ask him how often he suggests you test at home.

Our goals are to keep your cat safe, to get you and your cat feeling their best. We support you emotionally, physically, give you the knowledge and sense of control you need to manage your cat with diabetes, and if possible, get your cat into remission. Diet controlled remission.

We have 4 cats right now over in Lantus TR on OTJ trials and one (Kitty and Missy) just successfully passed her trial this weekend and is off the insulin. Does it happen for every cat? No, but a large percentage do achieve remission and I think it's a goal worth reaching for.

 

[Carl & Polly & Bob (GA)]

"I don't think the price of the test strips will be that big of an issue. One of the worst things we can do to our diabetic cats, is to be so arrogant that we think we can micromanage them with test results, and forget to look at the cat. Bottom line to that statement is, I don't have people testing them all that often."

Easy to say when he's the source of the test strips he wants you to use, and I am sure there's a margin of profit between Abbot's hands and your hands. It's your hard earned money he is willing to spend, not his own.

Ask him what his rate of remission is with diabetic cats. And of any that did go into remission, how many of those were home-tested? Maybe then he'll rethink the use of the word "arrogant". It isn't "arrogance" that motivates those who home test. It is safety. The worst thing we can do to our diabetic cats is to blindly follow the advice of people who recommended one curve a month at a vet clinic, prescription dry food diets, and shouting insulin twice a day without testing and then using one 12 hour cycle of clinic tests to evaluate dosage.

So he's trying to sell you an overpriced meter, and then what? Don't use it much because doing so would be "micromanaging"???

Looking at the cat is extremely important. He's right there. We look at our cats 24 hours a day. But you can't see hypoglycemia just by looking. Cats can drop to 35 or climb to 500 and "look" the same way. By the time you "see" symptoms of hypoglycemia or DKA, it can be too late to save a cat's life.

Sorry, we aren't supposed to bash vets. Be he's an arrogant idiot, in my humble opinion.

 

[BJM]

The Whole Cat Report includes many of the Secondary Monitoring Tools in my signature link. Many of those are questions your vet will ask - how is the hunger? The thirst? Elimination? Urination? Weight? Play? Grooming? Purring/contentment?

And most importantly, testing for ketones. These are a by-product of fat breakdown for calories. Too many ketones may result in diabetic ketoacidosis, a potentially fatal, very expensive to treat, complication of diabetes.