My 12 year old male was diagnosed with DM last week. Vet "gave" me Glucotest urinary glucose detection "confetti" to sprinkle in the itter box. I am a human physician and was very quickly frustrated by the lack of precision and picked up a FreeStyle Freedom Lite meter from a diabetes nurse at work. So far getting blood from the ear is not a problem although it sometimes takes several sticks-my cat doesn't seem to mind as long as I give him chicken as a treat. Then I looked at the website for the Alphatrak which is the glucometer my vet recommends (and sells) and read that results are not reliable for cats when using a human meter because the amount of glucose in the serum as opposed to intracellular is different for cats and humans. Now I am so confused. My cat was using 1 unit lantus BID and the last 4 readings (yesterday morning and evening and this morning and evening) were 241/219/343 and 335. After looking over this forum I plan on keeping the dose what is is til at least next week although I did give him 2 units tonight before I signed on. Is everyone out there using "human" meters and does anyone use an Alphatrak? Does anyone know of a scientifically based article that compares the Alphatrak to human meters and especially to the Freestyle? Both are made by Abbott and of course the Alphatrak and the test strips for it are much more expensive than the ones for the Freestyle. Thanks
Newly diagnosed-? on difference between human and cat meters
- Thread starter Horton
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MommaOfMuse
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Well the only real difference between the human meter and the AlphaTrac is that normal range for a cat on a human meter is between 40-120 and on the alphatrac normal is between 70-150 so basically a human meter reads about 30 points lower than a pet-only meter.
However, we have several folks here that had use the Freestyle Lite after they changed their strips to find that that particular meter was giving false low reading, so low in fact that at least one cat I know of went into DKA because of it and another that appeared by looking at the readings to be nearly in remission but was showing all clinical signs of still being an unregulated diabetic. When his owner switched to a Bayer Contour meter she discovered the reason why, his numbers were still in the high 300s and 400s.
Most human meters work just fine for testing a diabetic cat, but we do caution against using the Freestyles because of those false low readings.
Mel, Maxwell, Musette & The Fur Gang
Well the only real difference between the human meter and the AlphaTrac is that normal range for a cat on a human meter is between 40-120 and on the alphatrac normal is between 70-150 so basically a human meter reads about 30 points lower than a pet-only meter.
However, we have several folks here that had use the Freestyle Lite after they changed their strips to find that that particular meter was giving false low reading, so low in fact that at least one cat I know of went into DKA because of it and another that appeared by looking at the readings to be nearly in remission but was showing all clinical signs of still being an unregulated diabetic. When his owner switched to a Bayer Contour meter she discovered the reason why, his numbers were still in the high 300s and 400s.
Most human meters work just fine for testing a diabetic cat, but we do caution against using the Freestyles because of those false low readings.
Mel, Maxwell, Musette & The Fur Gang
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
I used a WalMart ReliOn Confirm, a branded version of the Arkray USA Glucocard 01. Takes a tiny drop of blood (0.3mm), reasonably consistent data, WalMart is open nearly round the clock, and best of all both meter and strips are among the least expensive out there.
Normwise, Dr Janice Rand of the Centre for Companion Animal Health, University of Queensland worked with members of the German Diabetes-katzen and worked out the human glucometer reference ranges to use with feline diabetics.
Some of the resulting articles are these:
Glargine & BG control-Roomp & Rand_2009-JFMS
Roomp & Rand 2008 dosing testing protocol
I used a WalMart ReliOn Confirm, a branded version of the Arkray USA Glucocard 01. Takes a tiny drop of blood (0.3mm), reasonably consistent data, WalMart is open nearly round the clock, and best of all both meter and strips are among the least expensive out there.
Normwise, Dr Janice Rand of the Centre for Companion Animal Health, University of Queensland worked with members of the German Diabetes-katzen and worked out the human glucometer reference ranges to use with feline diabetics.
Some of the resulting articles are these:
Glargine & BG control-Roomp & Rand_2009-JFMS
Roomp & Rand 2008 dosing testing protocol
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
To improve success with the blood testing:
For the peripheral ear vein nick, you're aiming about 1/3 up from the base of the pinna, lateral to the ear vein (they really mean 'peripheral!).
What size lancet are you using? Most find the 27 to 28 gauge lancet works best when you start. Over time, repeated pricking seems to develop more blood vessels and make it easier to obtain droplets using a finer gauge.
Also, it can help to warm the ear slightly to dilate the blood vessels- about a quarter cup of rice tied in the toe of a thin sock, microwaved about 15 seconds, tested on your wrist to make sure its not too hot, may be used to warm the ear and with a tissue on top of it, may be used to brace the ear a bit while you test.
To improve success with the blood testing:
For the peripheral ear vein nick, you're aiming about 1/3 up from the base of the pinna, lateral to the ear vein (they really mean 'peripheral!).
What size lancet are you using? Most find the 27 to 28 gauge lancet works best when you start. Over time, repeated pricking seems to develop more blood vessels and make it easier to obtain droplets using a finer gauge.
Also, it can help to warm the ear slightly to dilate the blood vessels- about a quarter cup of rice tied in the toe of a thin sock, microwaved about 15 seconds, tested on your wrist to make sure its not too hot, may be used to warm the ear and with a tissue on top of it, may be used to brace the ear a bit while you test.
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Really important: Feline Lantus doses are adjusted based on the nadir, after 5-7 days of use.
This means you'll need to get a curve when you want to evaluate the dose for adjustment. Basically, you test every 2 hours from pre-shot to pre-shot, then sharing that data with the vet (although we do have the protocol for dose adjustment in our Lantus forums). Getting the curve does not require taking the cat to the vet as vet stress may alter the responses and generate invalid data. If you do all the testing in the familiar home environment, the data are more representative of your cat's response to Lantus.
To help you keep track of the data, we have instructions for a spreadsheet which color codes the test results here. If you share it with anyone who has the link, you'll be able to get feedback from the experienced Lantus users.
The dose adjustment protocol, as well as info on using Lantus with cats is posted in the Lantus forums.
LANTUS (GLARGINE) - Tight Regulation
for those who can follow the details of the tight regulation protocol, which has established success in getting feline diabetics to a diet-controlled state.
"RELAXED" LANTUS - for those who can't follow all the requirements of Tight Regulation due to schedules, comorbid conditions in the cat which complicate dosing, erratic responses to the insulin and more.
Really important: Feline Lantus doses are adjusted based on the nadir, after 5-7 days of use.
This means you'll need to get a curve when you want to evaluate the dose for adjustment. Basically, you test every 2 hours from pre-shot to pre-shot, then sharing that data with the vet (although we do have the protocol for dose adjustment in our Lantus forums). Getting the curve does not require taking the cat to the vet as vet stress may alter the responses and generate invalid data. If you do all the testing in the familiar home environment, the data are more representative of your cat's response to Lantus.
To help you keep track of the data, we have instructions for a spreadsheet which color codes the test results here. If you share it with anyone who has the link, you'll be able to get feedback from the experienced Lantus users.
The dose adjustment protocol, as well as info on using Lantus with cats is posted in the Lantus forums.
LANTUS (GLARGINE) - Tight Regulation
for those who can follow the details of the tight regulation protocol, which has established success in getting feline diabetics to a diet-controlled state.
"RELAXED" LANTUS - for those who can't follow all the requirements of Tight Regulation due to schedules, comorbid conditions in the cat which complicate dosing, erratic responses to the insulin and more.
Re: Newly diagnosed-? on difference between human and cat me
I can't tell you how much I appreciate your replies. Even as a physician (and definitely NOT an endocrinologist or internist-I do sports medicine) this is a bit overwhelming. The 2 articles were very helpful and I plan to print them out and take them with me to my vet appointment Tuesday. I called and asked for an appointment with a small animal vet to discuss treatment and to bring my meter along and compare to their testing. I adopted my cat, now 12, 2 years ago when his former owner couldn't take care of him and because he is only indoors I really didn't take him to the vet unless I noticed a problem so he didn't exactly have a regular vet. I noticed he was drinking more and the litter box was filling up more quickly about a week before I took him in and the vet I was scheduled with was a large animal vet. I left him at the hospital for 3 nights and when I picked him up a vet tech did the diabetic teaching. I'm wondering what the experience has been like for others. Is that the norm? It has me really wondering if this is the right vet since this is all so important to Horton's health and his and my success in managing his DM. I'm thinking at this point that vets might not be all too enthusiastic about changing diet and even trying to get cats OTJ. I am not a lifelong "cat person" but fortunately my sister is a major dog person into agility, raw food diets, etc. so she has quickly enlightened me about the carbohydrate loaded junk I was feeding Horton til now (Meow Mix) and I am gradually switching to Orijen dry and Merrick canned. Sure gets complicated cause I know if I change diet too quickly while also trying to increase lantus to the right dose he could go hypo. Anyways, wondering how often one runs into a vet willing to take a holistic approach and help with diet as well as home monitoring, etc.
I bought a ReliOn meter today at Walmart after calling for a price on FreeStyle test strips (oh my!!!). So glad to hear you were using the same meter! I didn't do my glucose reading tonight using both simultaneously as I was having more trouble than usual getting the "drop" but I did get the highest reading I have so far since I started doing them 4/19. The others had been 241/219/343/335/245/159/265 and suddenly 481. So what you said about the FreeStyle really has me wondering. I plan to take both meters with me and use the vets venous sample on each to see how they compare. Do you know what kind of testing they do when you go for diabetes follow-up appointments? Is it from the jugular vein?
How long have you been caring for a diabetic cat?
Thanks again!
I can't tell you how much I appreciate your replies. Even as a physician (and definitely NOT an endocrinologist or internist-I do sports medicine) this is a bit overwhelming. The 2 articles were very helpful and I plan to print them out and take them with me to my vet appointment Tuesday. I called and asked for an appointment with a small animal vet to discuss treatment and to bring my meter along and compare to their testing. I adopted my cat, now 12, 2 years ago when his former owner couldn't take care of him and because he is only indoors I really didn't take him to the vet unless I noticed a problem so he didn't exactly have a regular vet. I noticed he was drinking more and the litter box was filling up more quickly about a week before I took him in and the vet I was scheduled with was a large animal vet. I left him at the hospital for 3 nights and when I picked him up a vet tech did the diabetic teaching. I'm wondering what the experience has been like for others. Is that the norm? It has me really wondering if this is the right vet since this is all so important to Horton's health and his and my success in managing his DM. I'm thinking at this point that vets might not be all too enthusiastic about changing diet and even trying to get cats OTJ. I am not a lifelong "cat person" but fortunately my sister is a major dog person into agility, raw food diets, etc. so she has quickly enlightened me about the carbohydrate loaded junk I was feeding Horton til now (Meow Mix) and I am gradually switching to Orijen dry and Merrick canned. Sure gets complicated cause I know if I change diet too quickly while also trying to increase lantus to the right dose he could go hypo. Anyways, wondering how often one runs into a vet willing to take a holistic approach and help with diet as well as home monitoring, etc.
I bought a ReliOn meter today at Walmart after calling for a price on FreeStyle test strips (oh my!!!). So glad to hear you were using the same meter! I didn't do my glucose reading tonight using both simultaneously as I was having more trouble than usual getting the "drop" but I did get the highest reading I have so far since I started doing them 4/19. The others had been 241/219/343/335/245/159/265 and suddenly 481. So what you said about the FreeStyle really has me wondering. I plan to take both meters with me and use the vets venous sample on each to see how they compare. Do you know what kind of testing they do when you go for diabetes follow-up appointments? Is it from the jugular vein?
How long have you been caring for a diabetic cat?
Thanks again!
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
If you get the cat off the juice, you're not paying for the prescription food, the office curves, and fructosamine testing because you have data collected at home.
Newer trained and up to date vets may support home monitoring and curves. Some vets won't suggest it because they know that some clients will choose to euthanize, rather than treat a diabetic pet.
After about 2.5 years, Spitzer threw a saddle thrombus, causing great pain and partial paralysis of both hind legs. Probable chronic pain and/or residual neuropathy and/or partial paralysis plus a 50/50 chance of throwing another clot within 10 months made the humane decision to let him go less difficult, but no less painful. He had a mild heart murmur, chronic pancreatitis and inflammatory bowel disease, complicating his care and possibly contributing to the clot formation.
That is the old school approach of we'll do it for you... and charge you accordingly. With careful home testing, the owner is able to determine the dose, as well as adjust it, without the effects of Vet stress altering the data and without the additional expense.Horton said:
If you get the cat off the juice, you're not paying for the prescription food, the office curves, and fructosamine testing because you have data collected at home.
Newer trained and up to date vets may support home monitoring and curves. Some vets won't suggest it because they know that some clients will choose to euthanize, rather than treat a diabetic pet.
Generally, they will take blood from a leg vein. They should test for glucose, ketones, and possibly fructosamine (kind of like a Hemoglobin A1C test in humans - it is more of an average over a couple of weeks), as well as routine CBC and chemistries. They may check the urine for ketones too, although that is not as precise as a blood ketone test. (Ketones indicate insufficient insulin and warn of increased risk for diabetic ketoacidosis, a potentially fatal condition.) If they check the urine, it should be done through a cystocentesis, and reviewed for any signs of infection, as that may elevate glucose levels.Horton said:
Per Dr Pierson of Cat Info, we strongly advocate eliminating all dry food as it is a water-depleted diet. Cats were not designed to eat dry foods and their thirst mechanism does not compensate sufficiently, resulting in a chronic state of mild dehydration. This puts extra stress on the renal system and may eventually result in renal failure.Horton said:
After about 2.5 years, Spitzer threw a saddle thrombus, causing great pain and partial paralysis of both hind legs. Probable chronic pain and/or residual neuropathy and/or partial paralysis plus a 50/50 chance of throwing another clot within 10 months made the humane decision to let him go less difficult, but no less painful. He had a mild heart murmur, chronic pancreatitis and inflammatory bowel disease, complicating his care and possibly contributing to the clot formation.
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Until you get a spreadsheet set up, it helps us to interpret the numbers if you will enter them
AMPS ~ test for morning preshot
+# ~ # hours after the shot
ex
+6 ~ 6 hours after the shot and the average glucose nadir for Lantus doses
PMPS ~ test value for evening preshot
Note: many cats go somewhat lower at night.
Until you get a spreadsheet set up, it helps us to interpret the numbers if you will enter them
AMPS ~ test for morning preshot
+# ~ # hours after the shot
ex
+6 ~ 6 hours after the shot and the average glucose nadir for Lantus doses
PMPS ~ test value for evening preshot
Note: many cats go somewhat lower at night.
Re: Newly diagnosed-? on difference between human and cat me
I'm so glad you found this board - its a wealth of information and helpful folks. I'm a relatively new sugarcat Mom - my 19 year old cat was diagnosed in December. My regular vet wasn't available when I noticed Sitka wasn't well so I took her to a local clinic. When the vet there said she was diabetic I asked about home testing and the reply was "that it wasn't advised". I thought that was really odd - but coming to this board found out that its a more usual response then not. However when I found a vet who specializes in treating diabetes one of their first questions was "do you hometest". When I said yes they said "Great - do you have some readings for us". It still puzzles me why some vets are so against home testing. They wouldn't give themselves insulin without testing so why should a cat be different? One other thing - the first three weeks on Lantus Sitka's readings were all over the place. I'm glad that I didn't change her dosing based on those first weeks or she would have gotten more insulin then she needed. Lantus builds a reserve or shed so you do have to be careful on dose increases - the saying here is "start low and go slow". Jan
I'm so glad you found this board - its a wealth of information and helpful folks. I'm a relatively new sugarcat Mom - my 19 year old cat was diagnosed in December. My regular vet wasn't available when I noticed Sitka wasn't well so I took her to a local clinic. When the vet there said she was diabetic I asked about home testing and the reply was "that it wasn't advised". I thought that was really odd - but coming to this board found out that its a more usual response then not. However when I found a vet who specializes in treating diabetes one of their first questions was "do you hometest". When I said yes they said "Great - do you have some readings for us". It still puzzles me why some vets are so against home testing. They wouldn't give themselves insulin without testing so why should a cat be different? One other thing - the first three weeks on Lantus Sitka's readings were all over the place. I'm glad that I didn't change her dosing based on those first weeks or she would have gotten more insulin then she needed. Lantus builds a reserve or shed so you do have to be careful on dose increases - the saying here is "start low and go slow". Jan
Re: Newly diagnosed-? on difference between human and cat me
Sounds like good advice. That helps to hear that your readings were all over the first 3 weeks and so did reading the message board's advice to go SLOW. I only brought him home 5 days ago and have increased from 1 unit bid to 1 in am and 2 at PM. This morning using my new ReliOn meter his sugar was 540! I called the vet and this is the first time I talked to a vet since leaving Horton at the clinic after his diagnosis. Looking back I now think it was not good that they never had a vet talk with me. I wish in hindsight they had scheduled the pick up with a vet and sold me an alphatrak right from the start. Surely they must know how anxious a person is when confronted with this new diagnosis. Do they think we are not willing or able to do all that we can to take care of our animals? I have our appointment Tuesday and will get the aplhatrak then. The cost of the meter isn't so much an issue as the cost of the test strips but luckily even those I can manage. It isn't worth it to me to argue with the vet saying that my readings might not be accurate. I have my ReliON and will do simultaneous tests using both and let you guys know how they are comparing. My concern is that I might be able to count on that 30 point difference at some glucose levels but not others. I think my project for today will be to try and work on the spreadsheets you guys have set up. Not too computer or spread sheet savvy so that might be a challenge.
Vet this morning mentioned Purina DM cat food. It raised my feathers as soon as I heard it as my understanding is that it is still a high carb diet. But as a physician I do know we have to be careful with protein loading in people with renal issues so it makes sense to me that we would have to be careful with cats as well. Anyways the on-call vet promised me we would discuss the nutrition counts at the next visit. Does anyone know of any good articles comparing cat foods in being able to get a cat into remission? Especially comparing Purina DM to any low card diet using other foods like Orijin or Varus? I was happy to hear the on-call vet mention that they have been able to get some of their cat patients into remission using Purina DM. Not so much to hear praise for Purina but rather just to hear a vet recognizing the goal of remission instead of just continuing insulin but getting the numbers to improve.
Surprising thing is that through this all Horton has for the most part been perfectly fine. Acting his usual self. Just was peeing and drinking so much. I asked the vet today about symptoms of DKA (ketoacidosis) since I'm not seeing low sugars but am seeing high ones and she said sitting at the water bowl but not drinking is one. Looking back I now realize he had been doing that, probably for a couple months before I took him in. I just thought he was a little obsessed and being a cat. Makes me think his sugars were up for months. I guess the frutosamine test would answer that one. I also asked the vet about ketone testing and she said they didn't really do that and that the litter box strips sorta do that (I don't think they really do???sugar spills into the urine if the glucose level is high but ketones don't until they are ketotic???). I did glance at the urine results while in the vets office first night and noticed glucose was ++++ but ketones was negative. SO very much to learn..........
Thanks again to all.
Sounds like good advice. That helps to hear that your readings were all over the first 3 weeks and so did reading the message board's advice to go SLOW. I only brought him home 5 days ago and have increased from 1 unit bid to 1 in am and 2 at PM. This morning using my new ReliOn meter his sugar was 540! I called the vet and this is the first time I talked to a vet since leaving Horton at the clinic after his diagnosis. Looking back I now think it was not good that they never had a vet talk with me. I wish in hindsight they had scheduled the pick up with a vet and sold me an alphatrak right from the start. Surely they must know how anxious a person is when confronted with this new diagnosis. Do they think we are not willing or able to do all that we can to take care of our animals? I have our appointment Tuesday and will get the aplhatrak then. The cost of the meter isn't so much an issue as the cost of the test strips but luckily even those I can manage. It isn't worth it to me to argue with the vet saying that my readings might not be accurate. I have my ReliON and will do simultaneous tests using both and let you guys know how they are comparing. My concern is that I might be able to count on that 30 point difference at some glucose levels but not others. I think my project for today will be to try and work on the spreadsheets you guys have set up. Not too computer or spread sheet savvy so that might be a challenge.
Vet this morning mentioned Purina DM cat food. It raised my feathers as soon as I heard it as my understanding is that it is still a high carb diet. But as a physician I do know we have to be careful with protein loading in people with renal issues so it makes sense to me that we would have to be careful with cats as well. Anyways the on-call vet promised me we would discuss the nutrition counts at the next visit. Does anyone know of any good articles comparing cat foods in being able to get a cat into remission? Especially comparing Purina DM to any low card diet using other foods like Orijin or Varus? I was happy to hear the on-call vet mention that they have been able to get some of their cat patients into remission using Purina DM. Not so much to hear praise for Purina but rather just to hear a vet recognizing the goal of remission instead of just continuing insulin but getting the numbers to improve.
Surprising thing is that through this all Horton has for the most part been perfectly fine. Acting his usual self. Just was peeing and drinking so much. I asked the vet today about symptoms of DKA (ketoacidosis) since I'm not seeing low sugars but am seeing high ones and she said sitting at the water bowl but not drinking is one. Looking back I now realize he had been doing that, probably for a couple months before I took him in. I just thought he was a little obsessed and being a cat. Makes me think his sugars were up for months. I guess the frutosamine test would answer that one. I also asked the vet about ketone testing and she said they didn't really do that and that the litter box strips sorta do that (I don't think they really do???sugar spills into the urine if the glucose level is high but ketones don't until they are ketotic???). I did glance at the urine results while in the vets office first night and noticed glucose was ++++ but ketones was negative. SO very much to learn..........
Thanks again to all.
Re: Newly diagnosed-? on difference between human and cat me
Horton, in your last post you were asking about food values - here is the list that most of us use to find a good low carb food for cats. Mostly everyone here stays with 10% or less carbs. If your cat does have CRF (chronic renal failure) its trickier because its better to use a low carb, low phosphorus food but there are varieties out there fitting both bills. Don't go by the phosphorus values on Janet & Binky's list as I understand they are outdated. Tanya's CRF list is more accurate for phosphorus values. The over-riding factor is finding a food that your cat will eat - 'cause you can buy the best stuff on the planet but if they won't eat it then it won't work.
Janet & Binky's page: http://binkyspage.tripod.com/canfood.html
Tanya's CRF page: http://www.felinecrf.org/food_data_tables.htm#tables
Some cats, like my old lady, have so many different issues you just have to find the best one that works for your kitty. I've found that I have to go with different foods to match her needs - she gets a low carb food in the morning and a higher carb/higher calorie food in the afternoon/evening. She is an anomaly though - she is diabetic, has moderate/severe CRF, and Inflammatory Bowel Disease as well as just being old
.
Jan
Horton, in your last post you were asking about food values - here is the list that most of us use to find a good low carb food for cats. Mostly everyone here stays with 10% or less carbs. If your cat does have CRF (chronic renal failure) its trickier because its better to use a low carb, low phosphorus food but there are varieties out there fitting both bills. Don't go by the phosphorus values on Janet & Binky's list as I understand they are outdated. Tanya's CRF list is more accurate for phosphorus values. The over-riding factor is finding a food that your cat will eat - 'cause you can buy the best stuff on the planet but if they won't eat it then it won't work.
Janet & Binky's page: http://binkyspage.tripod.com/canfood.html
Tanya's CRF page: http://www.felinecrf.org/food_data_tables.htm#tables
Some cats, like my old lady, have so many different issues you just have to find the best one that works for your kitty. I've found that I have to go with different foods to match her needs - she gets a low carb food in the morning and a higher carb/higher calorie food in the afternoon/evening. She is an anomaly though - she is diabetic, has moderate/severe CRF, and Inflammatory Bowel Disease as well as just being old
.Jan
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Heads up - Lantus is dosed with the exact same amount every 12 hours.
This is because it is a depo insulin, which forms subcutaneous crystals when injected and those are gradually dissolved and absorbed. When you vary the dose, you set up an undulating roller coaster with wider swings than optimal for the cat. Also, shooting more at night can set your cat up for a possible hypoglycemic episode, as many cats go lower at night.
As far as the protein issue goes, (if I understood her correctly) Vet Dr Pierson of Cat info believes you ought to provide reasonable amounts of high quality protein, as the feline body handles these better than large amounts of low quality proteins. Plus, the so called 'renal-sparing diets' can set a renal cat up for malnutrition if they do not consume enough of the low protein diet to maintain muscle mass and other protein structures in the body. If you search this site for her posts, she has discussed this a number of times.
Horton said:
Heads up - Lantus is dosed with the exact same amount every 12 hours.
This is because it is a depo insulin, which forms subcutaneous crystals when injected and those are gradually dissolved and absorbed. When you vary the dose, you set up an undulating roller coaster with wider swings than optimal for the cat. Also, shooting more at night can set your cat up for a possible hypoglycemic episode, as many cats go lower at night.
As far as the protein issue goes, (if I understood her correctly) Vet Dr Pierson of Cat info believes you ought to provide reasonable amounts of high quality protein, as the feline body handles these better than large amounts of low quality proteins. Plus, the so called 'renal-sparing diets' can set a renal cat up for malnutrition if they do not consume enough of the low protein diet to maintain muscle mass and other protein structures in the body. If you search this site for her posts, she has discussed this a number of times.
Re: Newly diagnosed-? on difference between human and cat me
Good point on the higher evening dose. I just increased the dose at that time becasue I had gotten such a high reading. So many little details that are important. I am doing a glucose curve today checking his level every 4 hours or less. Will check out the website with the nutrition details. As always-thanks
Good point on the higher evening dose. I just increased the dose at that time becasue I had gotten such a high reading. So many little details that are important. I am doing a glucose curve today checking his level every 4 hours or less. Will check out the website with the nutrition details. As always-thanks
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
When you increase Lantus doses, they are done in small amounts at a time - there's a whole protocol in the Lantus forums you can follow. Generally, the increase is 0.25 to 0.5 units at a time, lest you overshoot (pun intended) the optimal dose. Then you hold the dose for 3-7 days, depending on how tightly you've following the protocol.
Note - measuring 0.25 units is difficult, because syringes only have half unit markings at best, so you are eyeballing a value. Do be sure to get the U-100 syringes with half unit markings, as it improves dose measurement. Clip on magnifiers or headband magnifiers may help in measuring small doses.
When you increase Lantus doses, they are done in small amounts at a time - there's a whole protocol in the Lantus forums you can follow. Generally, the increase is 0.25 to 0.5 units at a time, lest you overshoot (pun intended) the optimal dose. Then you hold the dose for 3-7 days, depending on how tightly you've following the protocol.
Note - measuring 0.25 units is difficult, because syringes only have half unit markings at best, so you are eyeballing a value. Do be sure to get the U-100 syringes with half unit markings, as it improves dose measurement. Clip on magnifiers or headband magnifiers may help in measuring small doses.
arozeboom
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
If you're still curious about the Alpha vs. human meters, we have some non-scientific comparisons here.
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=66746&hilit=alphatrak
Also, if you look at my spreadsheet (in my signature) there are two tabs. One of Alpha readings and one for recent Relion equivalents.
Good luck!
If you're still curious about the Alpha vs. human meters, we have some non-scientific comparisons here.
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=66746&hilit=alphatrak
Also, if you look at my spreadsheet (in my signature) there are two tabs. One of Alpha readings and one for recent Relion equivalents.
Good luck!
BJM
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
I wrote them and received the following PDF files on AlphaTrak. You may find the evaluation one particularly suited to answering your questions. If it weren't so pricey and inconvenient to obtain test strips (via vet or online, which doesn't work if you're needing them immediately for a situation), I supsect more people would use them.
I wrote them and received the following PDF files on AlphaTrak. You may find the evaluation one particularly suited to answering your questions. If it weren't so pricey and inconvenient to obtain test strips (via vet or online, which doesn't work if you're needing them immediately for a situation), I supsect more people would use them.
Julia & Bandit (GA)
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
The pet meter is not necessary because the dosing protocol for Lantus is written for human meters: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. In my opinion, the pet meters are a waste of money, because for what you'll be using it for, you don't need accuracy, you just need consistency in the meter. You're looking for trends and patterns over time, NOT exact individual numbers. All you have to do is remember that the normal range on a human meter is 50-120, and that the renal threshold is around 200. You just change your point of reference, and the numbers you're obtaining with your relion are fine. Most people home testing use human meters with great success with our cats. When Bandit was diagnosed with diabetes, my vet told me we could get the Alphatrak if I really wanted, but any human meter would do just fine for the reasons I explained above. It's very important that you're able to test as frequently as the insulin requires (with Lantus, at least 3 times a day), so if the higher cost of strips is going to prevent you from testing as often as needed, the human meter would actually be better for you and your cat.
If the cost of the alphatrak is not going to keep you from testing as much as you need to, then make sure that you use the protocol written for the alphatrak. It's in the document I provided after the human meter protocol.
The pet meter is not necessary because the dosing protocol for Lantus is written for human meters: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. In my opinion, the pet meters are a waste of money, because for what you'll be using it for, you don't need accuracy, you just need consistency in the meter. You're looking for trends and patterns over time, NOT exact individual numbers. All you have to do is remember that the normal range on a human meter is 50-120, and that the renal threshold is around 200. You just change your point of reference, and the numbers you're obtaining with your relion are fine. Most people home testing use human meters with great success with our cats. When Bandit was diagnosed with diabetes, my vet told me we could get the Alphatrak if I really wanted, but any human meter would do just fine for the reasons I explained above. It's very important that you're able to test as frequently as the insulin requires (with Lantus, at least 3 times a day), so if the higher cost of strips is going to prevent you from testing as often as needed, the human meter would actually be better for you and your cat.
If the cost of the alphatrak is not going to keep you from testing as much as you need to, then make sure that you use the protocol written for the alphatrak. It's in the document I provided after the human meter protocol.
Update on Horton
Just wanted to update all of you who have helped me so much with Horton since he was diagnosed with DM. He is doing great! His last 4 readings on the alphatrak were 106, 90 and 96 and 130. He is getting 1 to 1 1/4 units lantus twice a day. Horton's coat is softer, he is more energetic and my company last week couldn't believe how nice he was compared with his usual hissing around "strangers". The litter box is so much easier to tackle with just small normal size clumps instead of the huge ones that clued me into his problem. The biggest difference was changing his food, something I doubt I would have done as quickly without your input and without having a sister who is VERY into canine nutrition and has for years told me about the junk used in most commercial foods. (I thought she was a little overly obsessive.) I truly think I might have only considered what the vet told me and felt the other diet advice was just too "out there". I still need to get him off dry but I tried initially to use Purina canned DM and found his appetite was too inconsistent and was fearful of his numbers going low and so was giving our old Meow Mix if he didn't eat the canned. His numbers were anywhere from 50-500. I found I had to re-prioritize and decided since he is a dry food junkie to switch to EVO low carb dry (8% carbs) which he likes very much and then after getting the glucose readings under control to work more on the switch to canned. Within 2 weeks I have been able to reduce the lantus from 2 1/2 twice a day to the 2-2 1/2 TOTAL daily that he is currently using AND the numbers are consistent and where they should be. I am a true believer now in catinfo.org and Dr. Pierson's nutritional advice. We had a vet check-up tonight and I brought in my graph along with Dr. Pierson's article on Feline Nutrition Basics for my vet and I do believe she is going to read it rather than just humor me. How could she not when 3 weeks before his reading at the vet was 726!? I appreciate all of you who referred me to the various websites and articles and provided your input and experience.
Now I am asking for some advice on canned foods. There is just so much info out there and I do get too busy with work and the dogs and this time of year with gardening (one of my VERY favorite things) and have to admit I have not done so well looking over the sites that list nutrition quality of canned foods. I haven't learned to translate the nutrition analysis on the packages into carb counts. (EVO low carb has the info there already-there were 2 flavors-one with 8% carbs and the other-which I haven't tried yet-with I believe 12%). Do any of you know of a couple good canned varieties with 10% carbs or less? Horton WILL eat cooked chicken meat on occassion and also will eat cooked fish but otherwise doesn't seem very interested in canned. I don't even know what his preference is. I was trying different cans such as Merrick and Purina DM and even some of the Fancy Feast varieties, mostly looking at the ingredients (which are in VERY small print almost impossible for these 49 y/o eyes to read) and going for ones with meats as the first 4 or 5 ingredients and trying to avoid rice and grains. Has it worked for any of you to add a little canned into the dry and just increase the proportion over time? I can play around with it a little on the weekends when I can check his numbers more frequently but am scared of him not eating when I am away at work and also scared of seeing those 400 and 500 readings again.
BTW-I do have the Alphatrak but I also have a Relion meter. My correlations have been good. With his higher numbers (300-500) the difference is usually about 50-60 and with the lower numbers he is now getting (100's) the difference is pretty consistently 30 points.
One more interesting story. I met another DM cat owner tonight at the vet. Cat was diagnosed in February and started on lantus. He was up to 20+ units twice a day! Still wasn't responding. The vet then changed him to humulin and he was using 10+ units twice a day before they made a switch in his food (hard to believe no diet change at that point!). They are now using Purina DM and he is doing well on only 2 units twice a day. I showed them the article from catinfo.org and they were very interested and plan to look it up at home. I feel like a crusader!
Thanks again for all your help. This message board is awesome.
Just wanted to update all of you who have helped me so much with Horton since he was diagnosed with DM. He is doing great! His last 4 readings on the alphatrak were 106, 90 and 96 and 130. He is getting 1 to 1 1/4 units lantus twice a day. Horton's coat is softer, he is more energetic and my company last week couldn't believe how nice he was compared with his usual hissing around "strangers". The litter box is so much easier to tackle with just small normal size clumps instead of the huge ones that clued me into his problem. The biggest difference was changing his food, something I doubt I would have done as quickly without your input and without having a sister who is VERY into canine nutrition and has for years told me about the junk used in most commercial foods. (I thought she was a little overly obsessive.) I truly think I might have only considered what the vet told me and felt the other diet advice was just too "out there". I still need to get him off dry but I tried initially to use Purina canned DM and found his appetite was too inconsistent and was fearful of his numbers going low and so was giving our old Meow Mix if he didn't eat the canned. His numbers were anywhere from 50-500. I found I had to re-prioritize and decided since he is a dry food junkie to switch to EVO low carb dry (8% carbs) which he likes very much and then after getting the glucose readings under control to work more on the switch to canned. Within 2 weeks I have been able to reduce the lantus from 2 1/2 twice a day to the 2-2 1/2 TOTAL daily that he is currently using AND the numbers are consistent and where they should be. I am a true believer now in catinfo.org and Dr. Pierson's nutritional advice. We had a vet check-up tonight and I brought in my graph along with Dr. Pierson's article on Feline Nutrition Basics for my vet and I do believe she is going to read it rather than just humor me. How could she not when 3 weeks before his reading at the vet was 726!? I appreciate all of you who referred me to the various websites and articles and provided your input and experience.
Now I am asking for some advice on canned foods. There is just so much info out there and I do get too busy with work and the dogs and this time of year with gardening (one of my VERY favorite things) and have to admit I have not done so well looking over the sites that list nutrition quality of canned foods. I haven't learned to translate the nutrition analysis on the packages into carb counts. (EVO low carb has the info there already-there were 2 flavors-one with 8% carbs and the other-which I haven't tried yet-with I believe 12%). Do any of you know of a couple good canned varieties with 10% carbs or less? Horton WILL eat cooked chicken meat on occassion and also will eat cooked fish but otherwise doesn't seem very interested in canned. I don't even know what his preference is. I was trying different cans such as Merrick and Purina DM and even some of the Fancy Feast varieties, mostly looking at the ingredients (which are in VERY small print almost impossible for these 49 y/o eyes to read) and going for ones with meats as the first 4 or 5 ingredients and trying to avoid rice and grains. Has it worked for any of you to add a little canned into the dry and just increase the proportion over time? I can play around with it a little on the weekends when I can check his numbers more frequently but am scared of him not eating when I am away at work and also scared of seeing those 400 and 500 readings again.
BTW-I do have the Alphatrak but I also have a Relion meter. My correlations have been good. With his higher numbers (300-500) the difference is usually about 50-60 and with the lower numbers he is now getting (100's) the difference is pretty consistently 30 points.
One more interesting story. I met another DM cat owner tonight at the vet. Cat was diagnosed in February and started on lantus. He was up to 20+ units twice a day! Still wasn't responding. The vet then changed him to humulin and he was using 10+ units twice a day before they made a switch in his food (hard to believe no diet change at that point!). They are now using Purina DM and he is doing well on only 2 units twice a day. I showed them the article from catinfo.org and they were very interested and plan to look it up at home. I feel like a crusader!
Thanks again for all your help. This message board is awesome.
Doug N Libby
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Good morning -
You were asking about canned foods. Here's a list most of us use: http://binkyspage.tripod.com/CanFoodNew.html. I switched Hershey before joining this site and was pleased to learn I had chosen one of the lower carb foods on this list. When I was thinking of making a switch, I went through this list and noted a few I wanted to consider. Since the print on the cans is SO small, I went to websites (like PetSmart) to read the ingredients.
Hershey eats Wellness (<6% carbs), but Oreo (non-diabetic) got tired of Wellness and eats Friskies Pate' (averaging 8% carbs). A lot of kitties on the forum eat Friskies, Fancy Feast or some of the Special Kitty varieties.
Hope this helps -
Libby (and Hershey, too!)
Good morning -
You were asking about canned foods. Here's a list most of us use: http://binkyspage.tripod.com/CanFoodNew.html. I switched Hershey before joining this site and was pleased to learn I had chosen one of the lower carb foods on this list. When I was thinking of making a switch, I went through this list and noted a few I wanted to consider. Since the print on the cans is SO small, I went to websites (like PetSmart) to read the ingredients.
Hershey eats Wellness (<6% carbs), but Oreo (non-diabetic) got tired of Wellness and eats Friskies Pate' (averaging 8% carbs). A lot of kitties on the forum eat Friskies, Fancy Feast or some of the Special Kitty varieties.
Hope this helps -
Libby (and Hershey, too!)
MelanieAndRacci
Very Active Member
Re: Newly diagnosed-? on difference between human and cat me
Hi,
I'm so happy that Horton is doing so well!
I wanted to say that Racci was a confirmed dry food junkie for over 15 years and is now on canned food only. It was a very difficult switch and still is difficult as she is extremely picky about what she will eat but so far her favorites have been Wellness which she got tired of, then Core, also by Wellness, and now BG ( Before Grain by Merrick). She will only eat Salmon and Beef & sometimes Duck in canned food so far.
Btw, she was on Purina DM Dry and loved it but as soon as she switched to lower carb canned foods, her bg readings went way down. Now when she is feeling well she is usually in the normal range or near it. Racci has other complications so when not feeling well she shifts into the 200's.
I've found that most vets are not supportive of good diets or safe testing methods and the best thing is to handle it myself and let the vets handle everything else. :smile: I guess they just do not have time to update their procedures on every illness.
Melanie & Racci
Hi,
I'm so happy that Horton is doing so well!
I wanted to say that Racci was a confirmed dry food junkie for over 15 years and is now on canned food only. It was a very difficult switch and still is difficult as she is extremely picky about what she will eat but so far her favorites have been Wellness which she got tired of, then Core, also by Wellness, and now BG ( Before Grain by Merrick). She will only eat Salmon and Beef & sometimes Duck in canned food so far.
Btw, she was on Purina DM Dry and loved it but as soon as she switched to lower carb canned foods, her bg readings went way down. Now when she is feeling well she is usually in the normal range or near it. Racci has other complications so when not feeling well she shifts into the 200's.
I've found that most vets are not supportive of good diets or safe testing methods and the best thing is to handle it myself and let the vets handle everything else. :smile: I guess they just do not have time to update their procedures on every illness.
Melanie & Racci
Re: Newly diagnosed-? on difference between human and cat me
I started on the alphatrak....very expensive test strips!! I had someone help me out and donate me a contour USB.
I decided to compare the two for about 5 days, the most I had with difference was 20 points!!! generally the Alphatrak read 5-20 points higher than the contour. It should not be a factor in the amount of insulin you give with these small number difference. The cost is a lot easier to deal with also!
I started on the alphatrak....very expensive test strips!! I had someone help me out and donate me a contour USB.
I decided to compare the two for about 5 days, the most I had with difference was 20 points!!! generally the Alphatrak read 5-20 points higher than the contour. It should not be a factor in the amount of insulin you give with these small number difference. The cost is a lot easier to deal with also!
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