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Best Glucose Meter... for my cat...

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#1
Concerned

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Hi all, I hope you don't mind me visiting your forums as a non-diabetic caregiver to a freshly diagnosed diabetic cat. My wife and I just learned that our beloved cat most likely has diabetes and I have been searching all over the net for the past few days learning everything I never thought I'd be learning about diabetes and monitoring.

Our current problem is that the diabetic cat is *extremely* skittish - he's basically feral. He's not cuddly, barely tolerates being handled - even by us... and now we're going to have to start poking his ears with lancets to figure out what sort of insulin dosage and injection schedule is required.

I found a great video on home testing of blood glucose levels in your cat, for those of you with diabetic cats - there seem to be a lot of them lately, here's the link:

http://www.veterinar...A&S=0&C=0&A=605

The site itself recommends the Accu-Check Advantage glucose meter with Comfort Curve test strips and a BD Extra fine lancet, or perhaps a Bayer Elite glucose meter. I have no idea if this information is current or out of date. Perhaps better units now exist that you could recommend.

My preferences in choosing a blood glucose monitor for our cat is that it would be:

*easy to operate - even one handed
*would use the smallest amount of blood possible - cats get pricked in the veins in the ears and he doesn't really enjoy having his ears touched in the first place.
*would give a reliable reading - as re-testing would probably raise glucose levels significantly due to the stress of the testing - is it the same with humans? Cats under stress can hit 210-400... We are hoping we can get at least the odd test done without him stressing out.

The website with the video recommends the above features in a glucose meter and also recommeneds units that use touchable test strips. There might be some handling while trying to get the strip to the freshly poked ear of a less than happy feline =(

Do any meters jump to mind when you think of touchable test strips, small drops of blood needed, ease of use even one handed? I don't really need data storage capability as most likely I'd be tracking the results in excel manually myself.

Thanks in advance for your help, and thanks for sharing such great information! You have helped my wife and I (and Charlie, the spoiled diabetic cat) immensely already! I hope my request is not too horribly out of place here!

#2
Funnygrl

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I would look into the Ascensia Contour. It's similar to the Elite, but is newer, so it uses less blood. You barely have to touch the strip for it to suck in the blood, and it does almost everything automatically (coding, memory, etc.).

#3
zookeeper671

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Hiya, Concerned~

So sorry to hear about your cat! I have some pretty wild images floating through my head of you attempting to take a blood sample. :eek:

Another meter you could look into (the one I personally use) is the Freestyle Flash. It requires the smallest blood sample (0.3 microliters) of any meter, which might be a big help to you. It's small, easy to handle, shows the reading in less than 7 seconds, and "lights up" the display and test strip (which might be handy when trying to pinpoint the poked area of the ear).

Best wishes to you and your kitty!

P.S. Here's a link to several sites that sell the Freestyle Flash. Also, the smallest lancet that's on the market (I'm pretty sure) is the BD 33g.
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#4
Concerned

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Thanks for the two recommendations, Funnygrl and zookeeper671 - I'll check the websites out for both of those.

I was hoping that technology had advanced a little since the veterinary website recommended those glucose meters I mentioned. Sounds like they just keep getting better.

Most likely I'll be experimenting on myself to make sure I can use it accurately - and let the cat watch as I poke myself. Am hoping I'll be able to acclimatize him to whichever unit I go with and be able to pull this off. I seriously doubt I'll be able to use even a quiet lancet mechanism around him so will have to get used to doing it by hand.

The lighting up function is something I had not even considered - that might be very handy as he's a dark grey and I am slightly red/green colour blind myself lol. I never thought about it. I might be playing 'find the blood drop'.

Anyway, I'll check into these two units and see if they look good. I guess I am also limited to what I can find avaiable locally too, as I'd probably be kicking myself if I had to keep mail ordering test strips into Canada. Thanks for getting me started!

#5
Harold

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Have never used the Flash, but it would get my vote. From what others have said the meter does not start to count down until you get enough blood into the strip for a test reading. I think most of the others start countdown as soon as blood is applied to the strip. Besides the small sample size the countdown feature will save you a bundle with far fewer wasted strips.

#6
Funnygrl

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I personally use the flash. I recommended the Contour over it because it uses just slight more blood, but the strip tends to suck it in better than the flash. Either one I'm sure would work well. Good luck with this mission :)

#7
lgvincent

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I have often worried about this problem in case my cat should develope diabetes, since she drinks a lot of water. Although I really like Accu-Chek products, I sort of feel like if I had to check her blood sugar, I'd probably use the Freestyle Flash because it doesn't require as much blood as the Accu-Chek Comfort Curve strip. Of course, the strips and meter are small and may be hard to handle for some (like me). I'm not sure how easy it would be to get blood from a cat and hope you don't have to do it too often (if it's possible).

I've talked to a few vets about how to treat this problem and they've all told me to test the urine for sugar in cats. I have seen a brand of cat litter that has some type of crystals (I think) in it that change color according to the presence of sugar, similar to the way the old urine test strips I used for so long do.
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#8
camjen1

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I personally would like to say good for you. I am sure alot of people in your situation would simply turn their heads and ignore the problem or they would perhaps even put the animal to sleep. Pets are family too and I am glad to see you are treating them that way.:thumbsup:
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#9
Concerned

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Thanks for all the replies and kind thoughts. Seems like a general consensus is forming about the Freestyle Flash - but I understand what you mean, Funnygrl. If the Contour actually sucks up the blood faster, it might be the better way to go. It's just so hard to choose not ever having used the technology before, as I am sure you all understand when it came time to pick your first glucose meter!

I also have doubts about just how long I'll be able to get the poor cat to sit still while we poke him with sharp objects. He learns what to be scared of EXTREMELY fast and never seems to forget. Sort of like Pavlov's dog, but in a bad way - he becomes almost instantly conditioned to flee at the slightest hint of something that has scared him in the past. The box he goes to the vet in is probably the single scariest sight in the world to him. I hope the glucose meter doesn't become a rival to the box!

We're having our consultation with the vet tomorrow (without the cat, as he gets **severely** stressed by trips out of the apartment - so much so I worry he'll die of heart failure or a stroke one of these times when we take him to the vet)... and as you can imagine we'll have a million questions for her. She'll be teaching us to give him injections and telling us more about treating Charlie.

This forum has been a great source of information, and I am just barely scratching the surface. I figured first thing I need is a good glucose meter so we can take measurements to help the vet figure out if and how much insulin he will need. It's pretty much impossible for us to do it the standard way most owners take - by leaving their pet there for a few days to be tested by the veterinary staff. He'd be so stressed out he'd be dumping glucose into his blood non-stop =( I seriously doubt, as does the vet, that they'd get accurate blood glucose readings.

I'll try and take a look at both the Flash Freestyle and the Contour tomorrow. They are popular enough brands I am sure I can find both of them to peek at locally - and I have checked their websites - they both look like great products. Thanks again for the help and support!

P.S. Switched him to Low carb, high protein wet and dry food as the vet recommended - and he *loves* it - well either that or he's still ravenous as an untreated diabetes sufferer! We shall see if he continues to enjoy it - but that's one worry less if he loves his new diet.

#10
Funnygrl

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I read in a forum somewhere that cats don't mind having their bs checked. Not sure how much truth there is in that though, since I always minded! I never had to choose my first meter, and doctor gave it to me. I got my second that way too. Before you do anything, make sure you read the thread and why you sould never pay for a meter.

#11
Concerned

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Good call, Funnygrl - I rechecked the Ascensia.ca website for the Countour and actually found they have a link there to register to be snail mailed a coupon for a FREE Contour meter with the purchase of 100 test strips.

http://www.ascensia....ntour/index.asp

The offer is good to only Canadian residents - go figure... first time I have ever seen that, but luckily we're in Canada.

So it looks like we might end up trying both meters - the Freestyle Flash and the Ascensia Contour. It appears that the Flash should come with some sort of in-box rebate coupon to refund some of the purchase price. If we can get both on the cheap we'll give them both a shot to see which freaks him out less/is easier to use. The fast blood draw on the contour might be crucial if he's going to be as fussy as we fear, even with two people holding him.

We'll know more when we have our sitdown with the vet this afternoon... I am just eager to start testing Charlie's glucose levels as we have changed his diet now. We still have minor hopes that a full diet change will get things under control, but we'll need to get him used to be tested to keep an eye on things.

I am not sure if the vet will suggest insulin right away starting today or not. I am afraid that changing his diet *and* giving him insulin might drop him too far... so testing appears to be the key to his future well-being.

Thanks again for the recommendations - and the suggestion to go looking for freebies.

We have to see our family doctor for another matter this week so I might see if our doc has any freebies lying around his office as well for the newly diagnosed...

#12
HeatherP

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Welcome Concerned. I admire and appreciate your commitment to your dear Charlie! :thumbsup: I am fortunate that so far I haven't had a diabetic cat, although I've been through other serious and chronic health problems with mine. I know how it is to have kitty basically live under the bed, cringe whenever I come near, and flat out avoid me and run away when I attept to approach. Even when it's just for a chin scratch or a hug. When dealing with a cat that has a feral history that can make medication/treatments all that much more difficult. Currently, my vet and I are trying to treat my former-feral cat, Gwynn for a nasty case of the runs. I basically have to stalk, chase and trick her in order to catch her for medicine time. :( (of course, the three things she HATES MOST are being chased, caught, and restrained)

Sometimes we have to find a balance in life between quality and quantity. I don't know that you will be easily able to ck Charlie's b/s with blood and a monitor. He may get used to it, but it might also cause an awful lot of trauma and never become an "okay" kinda thing. I'm not sure I'd be able to do it myself. I realize it's not anywhere near as accurate, but urine strips may be the way to go. Holding a strip of paper under kitty while he does his thing might very well be much less upsetting. Sometimes they never adjust to something. (I had a cat for 18 years, since he was a sickly, feral, 5 week old kitten, and he was never comfortable being picked up and cuddled, but he was my baby and we loved each other dearly.)

For what it's worth, I also love my Flash meter. I have a hard enough time managing my Diabetes on a day to day basis so I cannot imagine having to do it for somebody else. You're very brave and very devoted. I'm so happy to hear that Charlie has such a loving home, and I hope that he adjusts, and lives for many happy, healthy years. The key to good b/s control is knowledge, so I hope you'll keep us posted on how Charlie is doing and continue to visit and learn and share with us.

Thank you for being there for Charlie,
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#13
Concerned

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HeatherP - thanks for mentioning urine testing again. I'll be asking the Vet again today about it. I asked her initially when she called with the diagnosis and she seemed to think that was a bad idea for some reason.

He's also very shy about his visits to the box and I am afraid if we hovered over him or tried to stick a hand in the box while he's peeing we'd only teach him that he better find a new place to pee - like in the closet or under the bed. That or we'd draw back a stump. He actually bit my wife in the leg once when she was changing his box. I guess he was feeling extra possessive that day - and it was a bad day to be wearing shorts.

I saw that you can get special cat boxes with a urine reservior, non-absorbent litter and a collection system. That might be how we have to approach things if the blood testing freaks him out too much. Even just using nonabsorbent litter I have seen photos showing that you can just tilt the box and use a syringe to collect a sample.

I am very glad you understand about a feral kitty yourself. Charlie was the third generation of some feral cats that my mother-in-law was feeding in her neighborhood, and the only survivor of his litter. He was taken in by my mother-in-law at about 5 weeks and we took him home at 6 weeks and he's been with us nine years now.

Friends and neighbours can't understand how we put up with a wild beastie living with us who endures cuddling for maybe 2 minutes a day tops, and flees at the slightest noise or sudden movement. He may not be a lap cat, but he follows me around all day, and sleeps just out of arm's reach. If I move to another room, so does he. If I am gone for more than 4 hours at a time I really hear about it. Now they are going to think we are really insane for putting up with a diabetic feral cat. They just won't understand, and I don't expect them to. I feel sorrier for them in that I figure they must be somewhat dysfunctional themselves if they are incapable of understanding how much Charlie means to my wife and I. It's like my neighbour who treats his cats like garbage. When I told him Charlie was diagnosed diabetic the first thing out of his mouth was "Wow, how much expense are you looking at?" Obviously his cats better never develop any serious health problems or they are out of luck. He goes away lots and we feed his cats for him, and truth be told, they seem happier and healthier when he's out of town, hehe.

But yes, Charlie hiding under the bed from glucose meters and insulin needles is my biggest fear at the moment. Luckily there are several sites I have found with lots of tips for testing your cat and trying to get him used to it. He's also a major chicken junkie and we always keep a boiled breast of chicken in the fridge as a treat and to tempt him with in the event of a bad scare.

So we'll give the blood testing a good try, and try not to freak him out. I'll also try and get some urine testing strips and some non-absorbent litter, as we'll likely need keytone test strips to check his urine anyway for that occasionally.

So much to learn, but luckily he's hyperglycemic and not hypoglycemic and there doesn't appear to be any internal organ damage yet, so hopefully we can get up to speed and get his glucose levels under control before any irreovocable damage is done.

#14
HeatherP

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:topic:

I am very glad you understand about a feral kitty yourself. Charlie was the third generation of some feral cats that my mother-in-law was feeding in her neighborhood, and the only survivor of his litter. He was taken in by my mother-in-law at about 5 weeks and we took him home at 6 weeks and he's been with us nine years now.

Friends and neighbours can't understand how we put up with a wild beastie living with us who endures cuddling for maybe 2 minutes a day tops, and flees at the slightest noise or sudden movement. He may not be a lap cat, but he follows me around all day, and sleeps just out of arm's reach. If I move to another room, so does he. If I am gone for more than 4 hours at a time I really hear about it. Now they are going to think we are really insane for putting up with a diabetic feral cat. They just won't understand, and I don't expect them to. I feel sorrier for them in that I figure they must be somewhat dysfunctional themselves if they are incapable of understanding how much Charlie means to my wife and I. It's like my neighbour who treats his cats like garbage. When I told him Charlie was diagnosed diabetic the first thing out of his mouth was "Wow, how much expense are you looking at?" Obviously his cats better never develop any serious health problems or they are out of luck. He goes away lots and we feed his cats for him, and truth be told, they seem happier and healthier when he's out of town, hehe.



All cats are special, but somehow that bond with one that has been "wild" is so much dearer somehow. I think it's because of the complete trust (medicine/treatment times not withstanding) they have in us. I read once that ferals tend to bond very strongly with just one person, and being moved from one "owner" (hah!) to another can be extremely traumatic. Obviously his devotion to you is a result of your devotion to him.

(seems I'm the board's crazy cat lady) :P

p.s. If I were to admit how much $$ I've spent on medical treatments and care for my cats over the years, I'd surely be considered insane by some.
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#15
Concerned

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Met with the vet today and she agreed that if we can monitor his glucose with a meter and/or urine test strips - we can keep him off insulin for now and see if the special diabetic diet food he's been switched to can drop him back to normal glucose levels. We did indeed catch it early and his kidney and liver etc all appear to be undamaged - which is very good news.

Couldn't find anyone who carried the Freestyle Flash, though most carried the Freestyle Mini. Nobody had it for free though. The good news is they had the Ascensia Contour for free with the purchase of 100 test strips, which also happened to be on sale for $69.99 Canadian =) Plus a $25 off coupon in the box for the next test strips, plus the drug chain's gift card every box of 100 test strips you buy... and it's going to be a lot less costly than we feared.

Picked up some Bayer brad Keto-Diastix Reagent Strips for Urinalysis, and tomorrow I'll go shopping for non-absorbent pet litter so we can start testing his urine.

I'd probably pick up a Flash as well if I could find a shop that actually carries them and has them for free with a box of test strips, but at least we have the Contour now to try out, and it seems like a pretty spiffy itself. Takes twice as much blood (0.6 uL) and can waste strips due to incomplete samples - but as Funnygrl said, it really does suck up the drop of blood fast - well, the test sample fluid drop, anyway! It might be just what we need. If it doesn't work out I'll start hunting for Flash for sure, as it does look like a great unit too.

I'll sit down with the manual and give myself a poke with the lancet and try the unit out tonight once I post this reply. I'll also spend the next day or two rubbing the cat with the meter so he doesn't see it as threatening. A cheap thing to do but the end justifies the means.

BTW the vet said she recommends the Bayer line to people as well - but still says she likes the older Elite line herself. I am figuring that the Contour is basically the same technology updated? This would be good as I read somewhere that the Bayer line has +/-5% accuracy while the Freestyle has up to +/- 20%? Forgive me if this is wrong and Bayer marketing hype, I have no idea where I spotted that particular tidbit.

Hehe after my first incomplete fill I managed to test myself, then my wife. 176 mg/dL for me and 119 for my wife. Too scared to try it on the cat yet!

#16
Funnygrl

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Wow, congrats on everything!

The flash is called the Mini in Canada, so it is the same thing. Lol, never thought of that.

I know .6 is twice as much as .3 for the Mini, but either sample is quite small.

That's brave of you to try it on yourself first! I know it took me awhile to work up the courage my first time.

The Contour is pretty much just an updated Elite. You got the +/- 20% because that is the accuracy any meter is allowed to get FDA approval. MOST modern meters are much less that that as far as error is concerned. Like I said, I use the Flash/Mini meter myself. I get very good accuracy when I compare it to the lab.

Now, not to scare you or anything. But 176 is a pretty high blood sugar. Had you eaten recently?

#17
Concerned

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As I typed that I thought to myself - uh oh - either I screwed up or I might be diabetic myself! I retested after eating and it's 110, so I am guessing I screwed up one test or another - hopefully the first. That or maybe I was stressed - understandable when you are doing your first glucose meter reading ever, I hope!

I'll be sure to continue testing myself just in case - who knows, maybe the cat will end up saving my life, hehe.

Blast, I am really not a bleeder - I just wasted my third test strip today with insufficient blood drop. Better I am learning to eyeball the size of a good drop on myself and not the poor cat, but I am running out of fingers to poke.

Okay this test was 105 just 3 minutes after the 110 and we finished eating about 20 minutes ago - so that's normal for us non-regulated types I think?

I found a seemingly good chart for "Goals for Blood Glucose Control" at http://www.joslin.ha...y/wbggoal.shtml that looks good, but I am really new at this.

The numbers on the left are for a non-diabetic person, and those on the right are for a regulated diabetic:

Before Breakfast (fasting)
< 110 / 90 - 130

Before lunch, supper and snack
< 110 / 90 - 130

Two hours after meals
< 140 / < 160

Bedtime
< 120 / 110 - 150

A1C (also called Glycosylated hemoglobin A1c, HbA1c or glycohemoglobin A1c)
< 6% / < 7%

Do these numbers seem realistic/correct? My wife keeps saying - "but those numbers are for people" - but everything I have read so far seems to indicate that cats, dogs and humans all seem to have the same levels of glucose in the blood.

As it was, the blood test on Charlie came back at 27.4 of the other measurement. I wish she had given me the measurement I half understand, as I don't know how to translate between the two measures yet. On cats (and most likely people) they also test the Fructosamine level, and his was 693, while the vet said the average is between 210-418. This, the prescence of glucose in his urine (when he peed on the vet and the table), and the fact that we noticed that he was drinking and peeing a bit more than normal lately (why we brought him in - we were lucky to notice so fast) is the basis for their diagnosis of Charlie being diabetic.

Any hint as to what 27.4 (she said normal is 2.7-7.9) would be in the other blood glucose measurement? I haven't tested the cat himself yet so I don't know what kind of level to expect based on what the vet found. The Contour does 10-600 so I hope it's in that range, but I figure it must be or he'd probaly spontaneously burst into flames if he was over 600. Ideally I know I want him in the ranges indicated on the chart above. Most importantly, under 100 is *BAD* isn't it? As in Charlie could go comatose from a hypoglycemic episode? I figure I'll never get him there just by changing his diet, but if we have to start with the insulin it becomes a possibilty. If he gets a bad hairball and loses dinner I fear for his safety in the middle of the night on insulin. This happened to someone in the pet diabetes forums, and the recovery of their pet is still unsure.

#18
Funnygrl

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If you didn't wash your hands before you tested, they could have had sugar on them.

The 27.4 was probably the blood sugar. In Canada you usually use mmol/L. The other numbers were in mg/dL. To go from mmol/L to mg/dL you multiply by 18. Thus, your cat's bs was 493.

I don't know what the normal numbers for a cat are. Sorry. For me, under 100 isn't bad. I treat lows starting at 75 usually.

#19
camjen1

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http://www.diabetesf...onversion chart

I don't know if this is what your looking for.
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#20
Concerned

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Hmm, according the the pet diabetes sites, pet levels are the same as human, for glucose in the blood - with the same consequences.

Granted, cats under stress have been known to boost their levels by up to 150, but poor Charlie is still really high then, isn't he?

If he was a human walking around with a blood glucose reading of 493 would they immediately start with the insulin injections?

I know the diabetic diet by Purina and Hills (low carb high protein) is really good, but I wonder if it will be enough if his levels are this high? I guess testing will show us pretty quickly. I heard it can take up to two weeks for the full effect of a diet change to kick in for cats, so hopefully the numbers will continue to drop into a normal range.

I just want to make sure we're doing the right thing in not jumping to the insulin right away. The vet was more than happy to let us change his diet and monitor the progress, but I worry about damage to his poor little body over time if his levels stay high.

Thank for the chart, camjen1, I found one at the pet site as well: http://www.petdiabet...luc_convert.htm - nice to know I can just multiply or divide by 18 to move between the two, that's easier than using a chart for me with a calculator handy.

I *highly* recommend the www.petdiabetes.org site if you ever find yourself with a diabetic pet. Then again as experienced diabetics you would probably spot all the misinformation and flaws/gaps in the site.

Oops - that one's a good site but the one I *really* love is: http://www.felinedia....com/index.html - loads of information, articles, and even an active message board.

Again, thanks for the quick and helpful responses Funnygrl and camjen1 and everyone else who has posted such helpful information so far. You're making this a lot easier for all three of us here on the other end of the keyboard!




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