Vet compared my Reli-on Micro to his Alpha Trak

Status
Not open for further replies.
doombuggy

doombuggy

Very Active Member
I am not happy with the results:
Alpha Trak: 189
Reli-on Micro: 111

We both agreed that cedric's numbers were up because he was at his most unfavorite place and hadn't eaten since the night before. I am going to ask them when they took the reading - yesterday was a bit of a hassle with me taking him in early for his dental, going to work for awhile, then going to the radiologist for my annual mammo and sonogram (sat there for the better part of 2 hours and 10 minutes....).

Doc recommended the One Touch; he would probably push harder on me if Cedric was still on insulin.

for those of you that have taken your meters in to compare with the vet's, what was your result? What meter do you use?
for those of you who use One Touch, how cost effective is it? Granted I am testing Cedric about once per month at this point, so I won't be going thru as many strips as I was when he was first dx'd (not that I have ver been great about getting blood from his ear...)

He has bright shiny teeth (they gave me a before and after photo) and his colon has been cleaned out. That is probably the worst after effect, though he doesn't handle anesthesia very well. I put the litter box downstairs last night just in case he needed it (I think he peed himself in the car or when we got home).

Thanks for your thoughts!

Edit to add: Spoke with Lindsay (vet tech & soon to be my pet sitter) who took the reading while Cedric was out yesterday. She used the same blood for both meters.
 
I have always used the OTU and when I compared I tested right before vet took blood and then again right after and it was 8 points off the reading from the lab, either IDEXX or Antech.....can't remember which one. I also went by 14 day and 30 day averages given on the meters and then I ran a fructosamine on both Hope and Mishka. They both came back as Excellent. I do not like the OT mini......I do love the regular OTU though.
 
Jess one thing to keep in mind is that the Alphatrak is always going to read 30 points higher than a human meter. So that makes that reading 159, Now factor in the +/- 20% that all meters have, that takes the vet meter reading to on the low end 127, and the Relion Meter's reading on the high end 133 so actually if you factor those all in both meters are within the variances for all meters.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
So, Mel, I guess I was confused. I thought the 20% difference was between the animal meter and the human meter? But your math illustrates that this is not the case?
My co-worker who has 2 diabetic cats (one has been off insulin for about 3 days now; they are Lantus users) has become diabetic herself and has an extra One Touch she would give me (her endocrinologist gave it to her - I was thinking about asking mine for one when I go in on Tuesday! I go for my thiroid problems).
 
Originally the OTU was called FastTake and back then majority of meters didn't sip the blood....we had to roll it onto the test strip.....not fun when dealing with cats.
 
Nope the Alphatrak is calibrated for cat blood, while a human meter is calibrated for human blood...that is why normal for a cat on a pet only meter is between 70-150, and on a human meter normal range is between 40-120. All meters have a +/-variance of 20% allowed by law which is why you can take two readings off the same drop of blood and get two different numbers.

My vet actually uses a human meter (bayer contour) for their diabetic patients. We actually had a pretty good laugh about it when I asked to compare meters and he pulled out the same meter as I use for Musette..lol Figured we really didn't need to compare them after that...

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
Actually, while human meters are required by the FDA to have no more than a +/- 20% variation, there is no such requirement for pet meters. http://www.fda.gov/AnimalVeterinary/ResourcesforYou/ucm047117.htm. I know a lot of studies have been done on the alphatrak so I'm sure it has an acceptable variance (just I can't say what it is because I haven't read the research nor have I owned one), but it's something to keep in mind when considering other pet meters.

For the purpose of home monitoring a cat, you need a consistent meter, not an accurate one. And since human meters are required to be consistent within a 20% variance, they work perfectly fine for home monitoring, and it doesn't matter too much what one you get (which is why the cost of strips usually ends up being the deciding factor for meters). You want to avoid ones with bad ratings like the Freestyle, but the Relion is well rated and I wouldn't waste my money on new meter if I liked the feel and cost of the Relion.
 
When we compared my Accuchek Aviva to the vet's meter, mine was 54, their's was 61.

Keep in mind that we are just looking for patterns and ranges. Even with the variance between your meters, threatment would be likely exactly the same. On a human meter you 111 falls just towards the top of the normal range of 40-120. For a pet meter their reading falls just above normal range, but it's doubful a vet would start or increase insulin based on that much above the normal range.
 
This is upsetting to me to read this thread and wonder if my meter is accurate for testing Gus. The vet had suggested I bring it in and test it against theirs. Of course this is going to cost me because I have to set up an appointment with the tech and will be billed for it.

I'm currently using the TrueTrak Results.

Can I purchase a meter that is calibrated for cats?
 
You CAN purchase a vet meter, but the strips cost a fortune and they really haven't proven to be more accurate. Alpha Trak strips are a little over a dollar apiece; I found 100 for $105 online. I pay $45 for 250 strips for my meter!

As long as you're aware of the difference, there is no need to buy the more expensive meter. You just have to be aware of the difference in the normal range on a human vs. pet meter.

Consider the variance allowed for the meter in the first example. A 111 reading with meter variance can be anywhere between 88.8 and 133.2 Add the 30 difference, and you're at 163.2, and the consider meter variance for the Alpha Trak as well...and suddenly the numbers look a lot more accurate.

It's a personal preference...personally I can't afford a pet meter and don't think I'd spend the money on one even if I could; others swear by them because they want to match the vet.
 
Rachel & Gus said:
I'm currently using the TrueTrak Results.
Click to expand...

Heads up - We have reports that meters with "True" in the name, aren't true at all.

You're better off getting one of the ones mentioned here already, or the Walmart ReliOn (aka Arkray Glucocard 01 - obtainable from our shopping partner American Diabetes Wholesale)

You do not need a pet specific glucometer You can do just fine with a regular glucometer. The objective is NOT a lab equivelant value, but rather an indicater to adjust course as needed.
 
Are you happy with your Relion meter? If you are, then stick with it.

I have used the OTU and while it's a good meter, it does require a larger blood sample than Relion and several others. So, that's something you would need to adjust to. Of course the strips are more $$.

If you are thinking about changing meters, look at the Bayer Contour - I like how easy that one is - no coding required and only needs a small blood sample.

Rachel - I HATE the Tru Track meters! If you look at Maui's ss, you can see where I used that and compared it with the OTU and the Tru numbers were so far off it was ridiculous. I returned that meter and never looked back. So, in your case, I recommend changing meters - if you want inexpensive go with Relion. If you want a name brand type - go with the Bayer Contour. It's a great, handy easy to use meter.
 
Hillary-

I use and love my Relion Micro. I got it after my True Read burned me.

Rachel-
Anything True- take with a grain of salt. I bought it because it had the cheapest strips that the Diabetic Warehouse offered. I went to Walmart and got a relion micro (or confirm- they use the same strips) for $10. Strips for 100 are $36.
 
Thank you! I just read on Dr. Lisa's site that people don't like the TrueTrack :( She also suggests Relion. Fortunately the meter cost me nothing because I got it with a rebate. I will get a new meter this week.
 
Thanks for the opinions gang. I just got off the phone with my friend who's cat Sebastian was just dx'd this week. he also has CRF. I have told my friend to come over here as soon as we got off the phone! Her vet (different from mine) put him on ProZinc but didn't tell her to test before shooting. Sold her a bag of DM dry (she has not opened yet). I told her that she needs to come over here and get help from the great folks on this board.

Will get her a Reli-on and get her on board!
 
I tested my Relion against the vet's AlphaTrak twice (two separate times--about a month apart).

First time, Relion was about 20 points *higher* than the AlphaTrak. Second time, Relion was 17 points *lower* than the AlphaTrak.
 
We have this conversation about Alpha Trak vs human glucometers all the time.

First, don't worry - it is normal for them to be different.

Second, the FDA allows glucometers to be within 20% of the "true" value. This means if the low value + 20% is higher than the high value - 20%, the values are essentially the same.

Third, you are not trying for an exact lab value, you are trying for clues to guide dosing. Both human and animal specific meters provide this. You need to compare the test results against the guidelines for the type of meter you have. The Lantus forum provides those.

Fourth, there is no advantage in spending more money and not being able to get test strips in an emergency, which is what using a pet specific meter commits you to doing.
 
I went out and bought a Relion and went in and compared it with my vet's. The vet's meter read in the 90s and mine in the 40s. This is more than a 20% difference. But then I found an article that said the Alpha Trak reads higher than it should after being tested against a lab machine.

The tech who did the testing said I cannot extrapolate a range from that - in other words if I get a reading of of 250 I can't just add 45- 50 points and expect that to be accurate. She said that the range of inaccuracy may vary depending on high and low. I already know low numbers aren't as accurate.

I feel very frustrated. Gus has had fructosamine testing done at two different doses of Lantus and they weren't good. The problem is that on the higher dose of Lantus - 3 units, he didn't feel good - just laid around like he was in pain. The vet said his numbers aren't good now, but he looks great. This is why I keep questioning if he is on the right insulin.

Ug....this is so frustrating. I can't find a meter or insulin that works!! Sometimes this disease is so overwhelming. As my vet said, just diabetes alone isn't a problem - it's the pancreatitis and IBD mixed in that makes it hard to manage.

I'm waiting for my vet to get back to me as she was out of town. I just needed to vent because I get so frustrated.
 
I understand about the multiple conditions. Spitzer would have days when he could eat and his glucose would spike; then he'd have days when he'd vomit and get near hypo territory.

Our rule of thumb here is to manage the other conditions with whatever is needed, including steroids, and treat the diabetes as best you can.
 
2 units of Lantus sounds high to me. At 250, I shoot only 1 unit - at the MOST. My personal experience is that Lantus is a strong insulin and when it works, it is long-lasting and potent. Personally, I err on the lower side when dosing with Lantus. That is my experience.

I would shoot 1 unit and stay with it about a month GENERALLY speaking. But at any rate, if your cat isn't doing well at 3 units, perhaps consider lowering the dose rather than raising?

Just a thought from my experience.
 
Thank you both for the replies.

We did lower the dose. The vet said to lower it to 1.5, but I ended up decreasing it even more after talking to her again - not realizing my True meter was 70 points lower. He was on .75 Units when he had his second fructosamine test and it was worse than it was on 3 Units. This is why I'm frustrated. I don't know where to keep him because according to my new meter - Relion - he is in the 300s. Who knows how close that is to the truth.

He is a big cat - 16.5 pounds. The vet thinks he has some British shorthair in him which is the "bulldog" of cats. He and his sister both are just giant kitties with giant heads and disproportionately small paws.

I'm still waiting to hear back from my vet. I've debated going out and getting a Bayer meter to see if it is any better. The vet's office is checking on the price for the vet meter to see if they can get me a better deal.
 
Even if you get the Alphatrak meter free, the strips are still $1 or more each, and you can't get them just anywhere.
The Bayer Contour meters are excellent, and the Relion's are perfectly acceptable.

You can compare all the meters till you are blue in the face, and will end up more frustrated.
The vet meter is more expensive, the FreeStyle & 'True' meters are to be avoided, the Relion are the most economical, and most of the others are just fine.

The 20% variance refers to a single meter, not for comparing one meter to the other. The BG you get on a meter could possibly be 20% higher or lower than what registers. You are concerned with the changes that register for your cat, on a single meter, so that you know how well or poorly an insulin is working, and/or how your cat's BG are changing.

Rachel,
For the pancreatitis, if your cat is more prone to flares, can easily be handled with fluids when needed, pain meds - often buprenex, and pepcide AC given BID. You can also talk to your vet about your getting a vial of B12 to give your cat weekly shots... B12 shots virtually eliminated my Shadoe's pancreatitis issues.

The size of a cat really has no bearing on the amount of insulin needed. Only by regularly testing BG before all shots, and doing curves when able, will you be able to tell how a dose is working and what needs to be done to adjust it.
By your saying the insulin is not working, I am not sure what to say. Many people have found that Levemir works much better for some cats who did not do as well on Lantus, or who found that PZI did not last the full 12hrs.

My Shadoe did not have very settled numbers while on Lantus, but she did much better on Levemir. The curves you do will tell you what you need to know on the dose. Looking at Gus' ss, you have no tests in the middle of cycles, so you can't know how the insulin is working.... dosing is based on the lowest BG numbers in the cycles. Sure you have all the blue ps numbers, but what's happening in the middle?
 
Out of the 4 meters I have here, and I've used them all with 3 diabetic cats (1 meter for each cat + a backup) So far my 3 faves are the two different styles of Bayer contours (plain and USB) and my Relion Micro. Right now I have a Relion Micro, A Bayer Contour, A Bayer Contour USB, and a One Touch Mini. Love the One Touch as well but the strips can be pretty pricey around here...The Relion belongs to my guy who is OTJ and I love it because I can buy vials of very few strips (10) so I don't have to worry about the strips expiring before I use them up and they are dirt cheap. And really of the two Bayer Contours I think I actually like the basic one without out all the bells and whistles to the USB one, but both are good meters.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
I'm going to look into the Bayer meter. I just worry that this insulin isn't working for Gus. He is fantastic right now - playful and jumping on the counters, but according to the Relion - his numbers are crap and his fructosamine is crap. But the Relion is wrong so I need another meter :(

I'm very unhappy right now. My vet's office said they would get back to me on Monday about the price on a meter and they haven't. My vet also didn't return my email. I get very upset when this happens because I already feel so alone in trying to deal with all of this.
 
I did just call the vet's office and they are still reviewing his chart and will get back to me. I just don't want anything bad to happen to him since if appears his numbers are high - but who knows. I just need a meter that works.

Sorry if I'm so exasperating. Both Gus and Carma have had feline herpes for the past two weeks. Gus is over his now, but Carma is still in the process of getting over it. They have both gotten antibiotic ointment and lysine, it just takes time to work. It's just one more log on the fire that never seems to stop burning. I would like to just be able to enjoy them without this constant worry.
 
Rachel & Gus said:
I'm going to look into the Bayer meter. I just worry that this insulin isn't working for Gus. He is fantastic right now - playful and jumping on the counters, but according to the Relion - his numbers are crap and his fructosamine is crap. But the Relion is wrong so I need another meter :(
Click to expand...

You need to get some mid cycle tests because the ps numbers do not tell you how Gus is doing on this insulin.
The insulin is most likely working just fine, but you need to test at a few points in between the shots to know what is happening.
I doubt that the Relion meter is wrong. I liked the Relion but being in Canada, it's not available for purchase.
Bayer Contour has always been my favorite meter and strips.
 
Am I missing something here?

Because I just looked at Gus's spreadsheet and the last numbers on it were back in March and yet when you were at the Vet's on May 1st to compare meters both numbers where in the 100s....Unless you are seeing something now that is radically different then his numbers are far from being crap. There are a lot of us that would love to see a long string of 100s with a few low 200s sprinkled in.

Is Gus in remission ...no, But from what numbers we have to look at I would say his numbers are far from Crap and actually with what data is there looks to be very well regulated so I would say unless you are seeing much higher numbers than you have shared with us, not only is his insulin working for him it is working very well for him.

Yes, we would all love to see our babies go into remission but we aren't the ones that get to decide that, some of them will, some of them won't ever go into remission and there is absolutely nothing wrong with just getting and keeping them well regulated.. I for one am tickled pink that my newly adopted diabetic girl Autumn just had an entire day in the 100s and a low 200 amps this morning.

Perhaps if you could update Gus's spreadsheet and get some mid-cycle tests we could help you figure out if its the insulin, the dose or something else that is happening..but if you are still seeing the kind of numbers you have posted on his spreadsheet...I wouldn't be terribly worried about it being a problem with either the meter or the insulin not working well. Those are by far not bad numbers.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
Also no handheld meter is going to give you an exact reading, you can test the same drop of blood 4 times and still get 4 different numbers with any meter. It is for watching for trends more than giving you an exact reading.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
I hope Musette is doing well. I know you have your hands full at the moment. I haven't had time to read through the board much.

Regarding Gus: Those numbers posted are done with the TrueTrack which was 70 points lower than the vet's meter. Everyone here said they have problems with TrueTrack so I got the Relion which tested about 45 points lower than my vet's meter. I read an article that said the Alpha Track tests higher than it should when tested against lab results. Who knows.

I have done curves on Gus and I have done spot checks. I don't have time to post all of those things because my hands are completely full at the moment and neither of the meters I have work so it's pointless. He tested fine with TrueTrack and not good with Relion.

His fructosamine is a better indicator of how well his diabetes is controlled because all meters are unreliable to a certain degree. Also - fructosamine gives you a global view of your pets diabetes. I've read enough and studied enough material to know that they are useful - especially with a cat that has pancreatitis - which is always running in the background and effecting the ups and downs. A cat with pancreatitis isn't the same as a cat with just diabetes. Gus's fructosamine came back poorly on 3 units and worse on .75 units. That's what made me take my meter in to have it tested. He is on 1.5 units now. I was going to increase it to 2 units, but I'm waiting for my vet to call me and tell me what she thinks.

My vet also doesn't like that Gus has a flat curve - he never drops more than 50 points from his preshot - even though my meters are wrong I suspect they are correct on showing the ups and downs. I said I thought that was the whole point of Lantas and Levemir - a flat curve to prevent hypo. She said he should still move more than he does.

This is why I'm frustrated.

As for remission - those people who have cats that go into remission are very fortunate. Gus will never go into remission because he has triad disease. There isn't any cure and the treatments are very poor for pancreatitis.

The one bright side is that he definitely improved in energy and playfulness after 3 acupuncture treatments - so at least there was a little silver lining.
 
Maybe check out some of the secondary monitoring tools in my signature link and see if some of those will help you monitor his diabetes better, in addition to the glucometer.

The urine ketone testing is recommended for everyone, regardless, as ketones can happen even with decent glucose levels (take a look at Momma of Muse's posts this week!), and can send a kitty to the vet for expensive hospitalization.
 
I just went ahead and bought an AlphaTrak on eBay. I just can't take the mental stress anymore. I know the AlphaTrak isn't perfect either, but after a million hours of research, I've found that it comes very close to matching the lab results. I know meters get wonky with high and low numbers, but I need to know what I'm doing and if Lantus is or isn't the right insulin for Gus. He is a hard cat to regulate because he has triad disease. My mom says that he is testing my love! Poor Gus. I don't think he wants to be difficult. He just wants to play and cuddle.

I got a kit with 25 strips for $78. The seller got good reviews on the other kits he/she sold. I'm just hoping it works properly. The best price my vet could get for me was $212. Gus is going to need dental surgery soon so every bit I save helps.

Ok...thanks everyone for listening to me blather on and on!!! I'm fraught with anxiety.
 
Well I got the AlphaTrak yesterday. Gus's numbers aren't good on the 1.5 Units of Lantus - if this meter is correct. Even though it is the one my vet uses, I'm still going to take it in and compare it to their to make sure everything is correct.

According to this meter Gus was 282 at preshot and 291 at +7 last night. Its so frustrating. He didn't even seem to budge. I'm sure my vet will want me to do a full curve over the weekend.

My vet is out of the office today so I have to wait to talk to her tomorrow. The problem is that when Gus was on 3 units of Lantus he just laid around and didn't feel well and also gained a lot of weight (an unfortunate side effect of most insulin). I had him on 2 units of Lantus last summer and he seemed to be doing pretty good - but now I know my numbers weren't right because of the meter I was using and I didn't have a fructosamine test done like I've been doing with this new vet.

I will talk to my vet about increasing him to 2 units. I still worry after doing a ton of research that Lantus isn't the insulin for him. It took me two years to find a thyroid medication that I could tolerate without horrible side effects - and I'm a human that can talk! It's terrible for kitties because they can't tell us that something is making them feel bad and additionally - cats hide their pain which makes it even worse.

I don't know that anyone here can do anything for me - I just need to get my frustrations out. Diabetes and pancreatitis combined makes it even more challenging. Sometimes it is just overwhelming when I don't feel I'm doing things right for Gus.
 
Status
Not open for further replies.
Back
Top