Fructosamine test for Diabetes in cats??

Anyone ever hear of this type test?...Took Cooper to a new Vet for his diabetes and he ran a test to measure the Fructosamine concentration as a marker of mean blood glucose..says it shows the BG during the preceding 2-3 weeks.. The test result was 432u which was 'poor' and he recommended the dose be increased 1/2u to 3.0u of insulin. I started the 3.0u dose last night.

He also said I did not have to do the home BG test before shots... This morning Cooper's BG was 119u and I skipped the Shot just to be safe..Cooper's BG readings have always been "Bouncy" so I am not sure whether to just go with Vets advice or skipped shots when my home test shows BG below 200u.

 

The fructosamine test shows an 'average' of BG values over the preceding few weeks. ...But the 'average' tells us nothing at all about the 'highs' and 'lows'. This is why home testing is SO important.... Your home testing data gives you hugely important 'in real time' information.....
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While the fructosamine test can give an overall idea of the average BG over a range of 2-3 weeks, it cannot tell you what the cat's levels are doing throughout the day. For that reason, it is not ideal to base dosing changes on a fructosamine test. Your cat can be on too much insulin and having extreme bounces and come out looking high on a fructosamine test, then the vet ups the dose and make it worse, even dangerous. Periodic blood glucose curves (test every two hours for 12 to 24 hours) are the best way to get a picture of what the current dose is doing.

You DO want to test before giving a shot. If the BG is too low, you do not want to give the shot and cause him to go way too low into the hypo range. The recommendation here is that, if it is too low, stall for about 20 minutes without feeding, then test again. If the number has risen enough, feed and give the shot. If it it has not, you can repeat the stall and test once more. If it is still too low, skip the shot. If it is rising to safer levels, proceed with the shot. When you have pre-shot BGs that are too low to shoot, this usually indicates that the dose is too high and should be reduced by .25 unit. The longer you do this and the more data you gather (you really need more mid-cycle tests to be able to tell what the doses are doing to him) the more comfortable you will become with knowing what your no-shoot number should be, but I would say you made a good call not shooting that 119!

I have a VERY bouncy girl, and what I have learned is that I have to make very slight dosing changes and give each dose several days before making another change. I have to be very gradual and let her numbers run a little higher than I want but keep a good consistent curve to them without triggering a bounce and let her body adjust. Then, I can up a tiny bit more and give that several days, and so on. Once you start making them bounce it's like you let loose a crazy rubber ball!

 

Fructosamine tests are useful when originally diagnosing FD since vet stress doesn't affect the number, as it is an average over 1-2 weeks. However once a kitty is on insulin the best way to keep a kitty safe is by regular daily testing...before each shot and once during the cycle...more if possible...the more data the better! This gives the "real-time" picture of what is happening with your kitty. There have been other members who were told their kitty was in remission because of a vet doing a fructosamine test, mean while the kitty was not even close to being regulated. This was due to a lot of highs and lows happening, which only showed up with the "average" which was in the normal range (according to the fructosamine test)

As you get more data on how Cooper responds to different doses you can ask about varying the dose depending on where the preshot number is AND how low it is taking him. Because Prozinc is an "in and out" type of insulin, adjustments can be made more often, with the help of experienced prozinc users.

You can also try posting on the Prozinc forum to see what sort of suggestions experienced users may have:

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

 

Yes, very good point, Mary Ann!
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I can only say that the fructosamine test was given by my previous not very astute vet using Antech (I think that's the name of the company, not sure). It came back that he did not have diabetes. But he sure did. He had serious diabetic neuropathy if she had bothered to look at what was in front of her. Took him to a new vet who simply looked at him, re-tested his glucose which was over 400, got him started on Lantus and a wet food diet and not only did he go into remission for a year (unfortunately he is back on insulin now) but the neuropathy cleared up in a couple of months. So I do not trust that test at all. The vet had claimed the lab said there equipment was off that day and not working properly. Just saying.

 

Wow!
I guess then that it's vital in that instance to take clinical signs into account also.... So glad you got the right diagnosis...
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