new member question about home blood glucose monitoring

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angelbearmom

Member Since 2013
Hi! I have 3 cats. One, Harold has diabetes. He came into the shelter as a stray in early 2012. I wasn't able to take him right away as I had another foster cat. During the time before I got him he'd had diabetes and then didn't have it and then.........had it again. So came to me in June 2012. In February this year he all of a sudden didn't need insulin any more. But, 2 weeks ago it was decided that he needed to go back on it again. Taking him to the vet for fructosamine tests is stressful for him and expensive for me. So I want to talk to the vet about home glucose monitoring. My hands are fairly clumsy and he's not a very cuddly cat so however I do the prick it will have to be fast and once. I'd like to do the test in his paw pad. I've seen a number of articles online about that and how it's just as good. But I've also seen another article saying to never do it. Any opinions or experiences? I've started holding him and stroking his paws several times a day so if I get the goahead with him he's used to being handled. I take him for the fructosamine test tomorrow. I like the idea of finding out what his blood sugar is quickly rather than the several days it is between deciding he needs it and then actually getting to the vet. Thanks, Barb
 
angelbearmom said:
Hi! I have 3 cats. One, Harold has diabetes. He came into the shelter as a stray in early 2012. I wasn't able to take him right away as I had another foster cat. During the time before I got him he'd had diabetes and then didn't have it and then.........had it again. So came to me in June 2012. In February this year he all of a sudden didn't need insulin any more. But, 2 weeks ago it was decided that he needed to go back on it again. Taking him to the vet for fructosamine tests is stressful for him and expensive for me. So I want to talk to the vet about home glucose monitoring. My hands are fairly clumsy and he's not a very cuddly cat so however I do the prick it will have to be fast and once. I'd like to do the test in his paw pad. I've seen a number of articles online about that and how it's just as good. But I've also seen another article saying to never do it. Any opinions or experiences? I've started holding him and stroking his paws several times a day so if I get the goahead with him he's used to being handled. I take him for the fructosamine test tomorrow. I like the idea of finding out what his blood sugar is quickly rather than the several days it is between deciding he needs it and then actually getting to the vet. Thanks, Barb
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The fructosamine test is only an average of the numbers for the last few weeks, and it does little except to tell you how well the numbers have been. In order to know if it's safe to give insulin shots, it's best to test before every shot.

I have never tested on the paws because I truly don't feel it's a clean way to test. Yes, I know several people will scream that there's nothing wrong with it and that their cat has never has any infection, etc. Sorry, I prefer the poke on the tip of the ears.
Both of my cats pretty much slept through the pokes on the ears, and cats truly do get used to it because a great deal of cats come running when it's time to be tested.
If you have issues holding him still, you can start with a burrito method of wrapping a towel or something around his body and keeping him still in your lap. You are trying to get him used to his feet being touched but try the same with his head and ears.... many cats just don't like their feet touched but the head and ears are OK.

You mention that he's been on and off as a diabetic, how do you know this? Are you basing your info on fructosamine tests? I don't think that's the best way, and home testing is definite. You can save your money on that test by just getting a meter and testing him every day. Those numbers are real time and tell you his number immediately. Be sure to keep a log, noting when he ate, how much and what food, and when you test him because food influences numbers. If possible, try to test him on an empty stomach. Cats who are very carb sensitive will register quite high numbers if eating any dry foods, so feeding wet is a better diet if you want to see if maybe he can be a diet controlled diabetic.
 
Thanks for the info. The changes in his needs-insulin vs no insulin came after I noticed a change in behaviour, called the vet, took him in and waited until she called me. When he stopped needing it in the winter I took him in and they found his blood sugar was low so cut back on the insulin. He kept not appearing well and not eating so I took him back again and they kept him for several days and discovered he didn't need the insulin. He'd been a foster cat as I couldn't afford his medical bills but I agreed to adopt him when he didn't need insulin. The lady from the pound and I have a sort of a deal to help with general costs. I'm not quite sure what we'll be doing now they're going up again. I take my own blood sugars and would use my meter to start with to see if it's something that will work for him. I would feel much better if I was checking the levels daily. I think it would be better for him too.
 
angelbearmom said:
Thanks for the info. The changes in his needs-insulin vs no insulin came after I noticed a change in behaviour, called the vet, took him in and waited until she called me. When he stopped needing it in the winter I took him in and they found his blood sugar was low so cut back on the insulin. He kept not appearing well and not eating so I took him back again and they kept him for several days and discovered he didn't need the insulin. He'd been a foster cat as I couldn't afford his medical bills but I agreed to adopt him when he didn't need insulin. The lady from the pound and I have a sort of a deal to help with general costs. I'm not quite sure what we'll be doing now they're going up again. I take my own blood sugars and would use my meter to start with to see if it's something that will work for him. I would feel much better if I was checking the levels daily. I think it would be better for him too.
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You are going to be much better off by home testing because no visits to the vet and stress on him....
If you already have a meter, then that's great! Just start testing him here and there, before food and on an empty stomach, a couple hours after eating, before bed, etc. Keeping a log will help you see how he's doing. If you are feeding him a low carb wet diet, maybe he might turn out to be a diet controlled diabetic.
 
Welcome to the board.

While you work on blood glucose testing, there are some Secondary Monitoring Tools in my signature link which provide tips on testing for urine ketones. Ketones are a by-product of fat breakdown and high levels may signal diabetic ketoacidosis, a complication of unregulated diabetes. Additionally, tracking food and water consumption, plus fecal and urinary output also gives you some clues to how your cat is doing.
 
Thanks for the answers everyone. What is the normal range of blood sugar for a cat? How high is too high and how low is too low?
 
We generally think a cat is regulated if the have preshots in the mid 200s and are in double digits at midcycle, but not below 40. (40 is hypo territory)

We say a cat is in remission if they range from 40-120 for 2 weeks without insulin.
 
Sue and Oliver (GA) said:
We generally think a cat is regulated if the have preshots in the mid 200s and are in double digits at midcycle, but not below 40. (40 is hypo territory)

We say a cat is in remission if they range from 40-120 for 2 weeks without insulin.
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What is this on a human blood glucose meter? They use numbers like 4.5, 6.7, etc.
 
angelbearmom said:
Thanks for the answers everyone. What is the normal range of blood sugar for a cat? How high is too high and how low is too low?
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I would consider preshot numbers under 200 as regulated because over 200 and you are contributing to organ damage.
Aim for under 200 at all times.

To say that 40 is hypo territory is misleading. There are many a non-diabetic cat who is always in the 40s, including one of my own who's normally around 42 or so.

When giving insulin, it's generally said to "feed the 40's" meaning if your cat is getting insulin and drops below 50, then you should offer some higher carb wet food to bring up the number, plus the cat would earn a dose reduction if going below 50 a couple times.

If you are giving your cat the good dose for YOUR cat, regulated should put your cat under 200 at all times.

The US goes by a diff scale than Canadian/World...
there is a conversion method..... BG Conversion Calculator

So to convert the numbers I mentioned:
40 = 2.2
50 = 2.8
100 = 5.6
150 = 8.4
200 = 11.1
 
Another number to consider. We tell new diabetics not to shoot under 200 but to wait 20 minutes, without feeding and retest. You want to be sure they are rising and over 200. Once you have data to know how your cat will react, you can lower that threshold under 200.
 
I did it!!!! I tried to get a test done before he ate but didn't get enough blood on the strip and hadn't brought extra strips with me where I was doing it. So I tried again a little while ago and did it. His level is high 22.4 (400). It could be because it was only 3 hrs after his meal. I'll try to get it in the morning before he eats. We'll have to watch the levels for awhile to see what his normal is. As I said, he's not a cuddly cat and they always have trouble at the vet getting blood from him. So, I'm happy it looks like this will work. It will certainly be better for him to have it kept a closer eye on.

What times of day is it recommended to test? Is there a cat based data sheet for entering the numbers? Or just use a human one? Thanks again, Barb
 
Hurray! Welcome to the Vampire Club!

400 is a diabetic number. Unless you are in the midst of changing to all wet low carb, I'd start insulin. Did I miss type and dose of insulin? What food?

You want to test before each shot, to be sure the amount of insulin you are planning to give is safe. And midcycle, to see how the insulin is working.
 
Welcome to the Vampire Club!!

Testing - When and Why

1) We test before giving insulin (pre-shot) to make sure it is safe to give. Starting out, do not give below 200 mg/dL (11.1 international)

2) We may test at +2 hours after giving insulin to see how fast the glucose is dropping. If the numbers suggest the drop may be too big, we'll continue testing every 2 hours (or sooner if it looks like it'll get below 50 mg/dL[2.7 international]) to identify if we need to intervene.

3) We test around the expected low point to see how low the glucose goes. For N type insulins (Novolin, Humulin), this is around +3 to +4 hours after the shot. For Prozinc, this is about +5 to +6 hours after the shot. For Lantus, this is +5 to +7 hours after the shot. For Levemir, this is around +6 to +8 hours after the shot. These time frames may vary with insulin and cat.

4) If the glucose goes below 50 mg/dL, not at nadir, we'll start a testing/feeding/15-30 minute wait and repeat process until the numbers come up to a safe level and are rising for roughly 3 tests in a row.

5) When we have stable dose management for 6 to 10 shots, depending on the insulin, we'll do a curve - testing from pre-shot to pre-shot, every 2 hours.
 
He's on caninusin 2 units 1x/day. This is what he was put on 2 weeks ago when it was discovered that he was no longer in remission. This morning it's 19.1 (about 350). I'm taking him to the vet this morning to get the fructosamine test done. I'll try to do him just before we leave to see if it's come down any. I just don't want to do him too many times so it doesn't get harder to hold on him. Barb
 
What kind of food are you giving him. Wet? Dry? Brand/type?

Also let us know what country/ state/province etc you are in, it will help us make recommendations etc
 
We've tried him on several different wet foods. He gets diarrhea easily. He seems to do best with Friskies chicken blends. He refuses to eat the official gastro foods.

I'm in BC near Vancouver.
 
Ok cool. Can you get him just to eat the friskies pâtés? They are lower carb and better to help regulate his diabetes.

Second, has your vet spoken to you about lantus, levemir or prozinc? Caninsulin is really rough on cats and not the best insulin for them. They do much better on the ones I mentioned, and have a higher chance of remission. You can get a vial of lantus from most pharmacies (I find Costco cheapest but I hear the great Canadian superstore might be cheaper ) for around $75 and it lasts six months if you keep it in the fridge.

What meter are you using? I use the bayer contour USB I got free (I can give you the link) and order strips off eBay from the US for around $50 for 100 including free lancets and shipping.


Wendy
 
Can you get him just to eat the friskies pâtés?
We tried him on all the varieties of Friskies and the shredded/chunks of the poultry lovers collection are all he'll eat. He totally refuses the gastro and intestinal varieties of anything.


Second, has your vet spoken to you about lantus, levemir or prozinc?
No. I really haven't spoken much with the vet. Today the assistant called me with the results of the fructosamine and that he's to go back onto 2 insulin injections a day. I'm working on keeping careful records on his levels. The vet wants to do another fructosamine in 3 weeks. Hopefully then I can talk to her and show her his numbers and maybe then we can talk about changing insulin.

What meter are you using?
I'm using the bayer contour-not the usb one. It's what I use for myself so it was handy. I'm being told by others that you shouldn't use human meters but have seen lots saying it's ok. So for now that's what I'll use.
 
Re: human vs animal-specific glucometers and lab results

The FDA allows glucometers to read within 20% of what a lab test would get.
Human glucometers read 30-40% lower than pet specific glucometers(reference). Its like reading Celcius vs Fahrenheit on the thermometer.

A spreadsheet listing sample data, the +/- 20% and the estimated lab values for the sample data is here.
 
Do you have data that backs up that "Human glucometers read 30-40% lower than pet specific glucometers. "?

BJM said:
Re: human vs animal-specific glucometers and lab results

The FDA allows glucometers to read within 20% of what a lab test would get.
Human glucometers read 30-40% lower than pet specific glucometers. Its like reading Celcius vs Fahrenheit on the thermometer.

A spreadsheet listing sample data, the +/- 20% and the estimated lab values for the sample data is here.
Click to expand...
 
That's a shame on the food as those gravy friskies are too high carb at 13-15%. They probably contributed to the diabetes issue, and will continue to spike his blood sugar which will make regulating him more difficult. If there is a way you can slowly transition him to the lower carb ones (see this chart column C should be under 10% calories from carbs http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf ) that will help immensely.

The bayer meters are perfectly reliable for cats.
 
Larry

The link is on the spreadsheet, I've added it to my previous post, and here as well. From the University of Queensland Centre for Companion Animal Health.reference
 
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