11/11 Portia-AMPS 283 +6 180 PMPS 237 -paraphernalia

Hi all
Previous condo viewtopic.php?f=9&t=107809

As I mentioned previously, Ive had some difficulty in getting blood from Portia becasue she seems stressed out by the ear prick so I havent been monitoring her as I should. At any rate, I did get her glucose reading this morning as indicated on the subject. I also bought the relion micro from walmart over the weekend and have so far compared two BG reading between the relion and alphatrak 2.

Reading 1 (two days ago): Alpha trak 284mg/dL; ReliOn 213
Reading 2 (today): Alphatrak 288mg/dL; ReliOn 283

This doesnt seem correct to me. Can anyone help with this?
Thanks
Rita

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi Rita and Portia and welcome to LL.
Generally speaking, the AlphaTrak will run about 30 points higher than the Relion, but since there can be meter variance within one meter and between the two (I believe that 20% variance is the "acceptable" percentage), your numbers are within the "acceptable" range. In the higher range of blood-glucose numbers, there is likely to be a larger span between the readings of the two meters. The advice always given on the FDMB is to choose one meter and stick with it. Otherwise you will drive yourself crazy. Given the cost of the AlphaTrack and it's strips, and given the fact that most of the beans here use "human" meters, like the Relion (because the strips are relatively inexpensive and because it is easier for many of us to correlate the readings of the human meters with the color-coding on the spreadsheet), my suggestion would be to use the Relion.

Best of luck with getting blood from Portia's ear. It will get easier. The ear has to be "trained" to bleed. Often one ear bleeds better than the other.

Ella & Rusty

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

If you take a look at the tables at the end of the Roomp & Rand Tight Regulation Protocol, you'll note that typically the Alpha Track runs about 30 points higher than a meter calibrated for human blood (e.g., your Relion). If you also factor in that there can be roughly 20% variance in any test you get, it may help to put the different numbers in perspective.

Ultimately, it's easier on you if you pick one meter and stay with that meter. Moving between meters is a great way to make your head hurt!

As a side note, some people have observed that there can sometimes be a greater difference in numbers at the higher end of the range.

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi all,
Thank you for your response. That makes sense. I was expecting there to be a uniform difference of about 30 mg/dL so I dint understand why one was off by so much and the other wasn't. I will be using the ReliOn for sure. Ive ordered some alphatrak strips just so I can do glucose curves for my vet but for my own daily testing, I will def be using the ReliOn. Should I be testing them side by side for a few more tests just to make sure the ReliOn meter is ok? The alphatrak came with calibrator strips which the reliOn did not come with . Hence the concern.

Thanks
Rita

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi again, Rita,
I don't think you need to test them side-by-side any more. It wouldn't serve any useful purpose. If you are curious or worried about the accuracy of the Relion, you can order the test solution from Walmart. Otherwise, you can test yourself with the Relion. Get a test at the same time on consecutive days and see if the numbers are acceptable (within the 20% range).

Ella & Rusty

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi Ella,
Ok. That sounds good. I will just use ReliOn. I did test my husband's BG with ReliOn and it was 90 so Im guessing that's normal?

I just spoke to my vet and she said that we need to check her BG about a week after starting lantus and if its still in the 300s (with alphatrak) then we will increase her insulin to 2 units/BID.

Portia continues to hide so taking regular readings is really tough. I will be buying neosporin today and hopefully that will help her.

Rita

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi Sienna,
I just sent the article and the protocol to my vet. No harm in trying to get her on board. I see that there is a 30 point difference roughly between the two. I will be using the relIon for routine home testing and the ALphatrak for curves for my vet. If you guys think the ReliOn readings arent way off, then thats encouraging.
Thanks
Rita

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Rita:

That would be x4 the increase that's typically recommended with Lantus based on research. Dose increases are typically in 0.25u increments and at most, 0.5u increments (if nadirs are TYPICALLY above 300). You may want to take a look at this article from a leading vet journal and share it with your vet. Once a cat has been on Lantus for 5 - 7 days, you want to consider raising the dose. After the initial period, if you're using the TR Protocol, you may want to consider raising the dose after at least 3 days. Take a look at the sticky note on the TR Protocol for more information.

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Hi Sienna,
Wow. That does seem to be a big difference. Right now, Portia is getting 1unit/2x daily. Does that sound right?
Rita

 

Re: 11/11 Portia-AMPS 288-questions about relion vs alphatra

Yes, a typical starting dose is 1u BID (two times a day). And .25U is the typical increase. Remember too, that dosing is based on the lowest numbers in the cycle (nadir) not on the preshot tests which are typically the highest. Portia has only been on Lantus for a few days and already seeing better numbers. If your vet insists on a full unit rise he hasn't been reading the standards set in the vet journals. Sometimes we just need to smile and say "yes, sure" and go home and do what seems safe. It is always better to play it safe and go slowly, especially while you are learning how Portia is reacting to the Lantus.

I'm glad to see your SS up and running. I know you might be a little nervous about messing w/ it now, but if you could just go back into your signature and change the ccc to pub. It will make it much faster for us to open it and give advice.

 

Re: 11/11 Portia-AMPS 288- where should I buy the parapherna

Hi Tess,
I just changed my signature and changed it to pub. Let me know if this is better.

I sent my vet the article so hopefully she will be able to read it. I think Porti'as numbers are looking better (based on a relatively few data points though). She actually came out of hiding today so I will take a nadir reading. Her treats havent come in yet so I havent been able to reward her and that maybe part of the problem. I have also got neosporin and will try that at the nadir reading.

I've looked at sitcky with info and I have a couple of questions;

(i) Where do you buy your half unit needles from? Mine are 1unit increments.
(ii) My insulin vial is at a concentration of 100U/ml. Is this standard for insulin? If so, then any syringe that has markings in units should be ok.
(iii) Unlike the demo video, Ive been syringing insulin back into the vial when I take out 1U (as instructed by the vet tech at my vet). I now see that that might not be a good idea due to the possible contamination of the vial by residue in the syringe. Ive been doing this since thursday. Can I continue to use the insulin or should I buy a new one?

(iv) In the video, she said she bought insulin for a little over a $100 (cant remember the exact $ amount). Mine was $180 so I was wondering if there was a pahramcy (CVS, Rite Aid,etc) that you all buy insulin from that may be cheaper than the Johns Hopkins pharmacy I used.

If I should post this in the general forum let me know.
Thanks
Rita

 

Re: 11/11 Portia-AMPS 288-where do I buy all the paraphernal

Great, your SS opens much faster now!

No, some insulins are U40 concentrations, so not all unit marked syringes work for Lantus which is U100. Most of the U40 insulins and syringes are only available from vets though, few pharmacies carry them. U40 syringes have a red cap and U100 have an orange cap, so be sure to check the cap color.

Many of us order our syringes for American Diabetes Wholesale (ADW). Usually quite a bit cheaper than retail, plus easier to find. I think Walmart has Relion syringes in half unit markings. At ADW there are several brands that have half unit markings, Terumo, Monoject and BD, maybe a couple of others. I like the Terumo but there is very little resistance in the plunger and it takes some getting used to.

As for the price of the Lantus the video is probably a few years old and prices have gone up a lot recently. Check out GoodRx, it will compare prices at most pharmacies in an area. There is also a discount coupon from Lantus that you can download, I think the link is listed in the Supply Closet forum.

As for shooting the Lantus back in the vial, no not a good idea. It may or may not have caused a problem, I would continue to use it as long as you are seeing good results. But be sure to check for cloudiness or floating particles, that means the insulin is breaking down and time to get a new vial.

Also Ask you vet for a Rx for the pens rather than the vial. They are a little more initial outlay, but you get 15ml not 10. The really good thing about them is that each pen can be used like a mini vial w/ 3ml of insulin. You still use syringes to draw the dose, don't get the needles that attach to the pen for auto dosing! So if it gets contaminated or too old you only lose the remainder of the 3ml pen, not the whole 10ml vial. And the unused pens remain sealed and have a longer shelf life that way.

Also some pharmacies will sell just one pen at a time.

 

Re: 11/11 Portia-AMPS 288-where do I buy all the paraphernal

i made the video about 2 years ago and lantus has gone up a lot in price since then. i was buying my vials at a small local pharmacy chain in Oregon. i've read that it'll be available in generic in 2014, so prices should go down then.

don't see-saw the insulin. but don't toss it out either. just use it as long as it seems good - no floaties or cloudiness, or thready filaments in it.

the pens are great choices - punkin had acromegaly, a high-dose condition, so for us the vials were a better buy. for most diabetic cats the pens are more cost-effective. and yes, don't buy the needles that go with the pen.

i'm a huge fan of the Terumo .5u marked syringes. i bought them from American Diabetes Wholesale. If you register first with MrRebates.com you'll get 4% back from every purchase. You register, then go to health/diet category and find ADW, click, and it takes you to ADW. somehow mrrebates keeps track of your purchases and you request a check after every $20 or so in rebates.

the syringes are these: they have the .5u markings, they are fairly consistent markings between one syringe to the next, and the plunger glides smoothly. the needle itself is also small, so hurts less. http://www.americandiabeteswholesale.com/product/terumo-thinpro-insulin-syringe_5891_112.htm

On ADW you can also keep a shopping list and easily re-order things. I used the Relion Confirm and was able to use these generic strips with them, which are really cheap: http://www.americandiabeteswholesal...-sensor-blood-glucose-test-strips_4050_54.htm I don't know if they will work with the Relion Micro or not, however. You can always edit the subject line of today's post and put in questions, then people who have experience with that topic will come and post.

if you don't want to register with mrrebates, you can use the link to ADW at the top of the forum page. then the % goes to the site webmaster.

 

Re: 11/11 Portia-AMPS 283 +6- 180 paraphernalia sources

Hi Julie and Tess,
Thank you so much for the information. It sounds like it might be worth just buying some of the 0.5 U syringes in case we have to decrease or increase Portia's dose. Ill look into the Terumo from the link you sent me.

Thanks for the link to the website. I might do some shopping around before I invest in the next vial of insulin.

Ill keep an eye out for any floating matter,etc in my insulin and Ill be sure not to inject stuff back into it anymore.

Portia's +6.5 reading today was great. 180 using ReliOn. Thats pretty great right?

I slathered neosporin on ear so hopefully she wont be sore anymore.

Thanks for your input

Rita

 

Re: 11/11 Portia-AMPS 288-where do I buy all the paraphernal

180 is great for just a few days on Lantus! I don't know about" slathering" on the neosporin, just a little. Many put in on wait a few minutes and wipe off the excess. You don't want her grooming it off and ingesting it. Not sure if it would hurt, but better safe than sorry.

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

Hi Tess,
Hahah.. I exaggerate a little when I say slather. I put a little on her ear. I dint wipe off the excess though. Will go do that right now!!
Do you guys wipe of a with a wet towel?
Rita

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

I'd really encourage you to get syringes that are in half-unit increments. It will make getting consistent doses much easier. Like the others, I purchase my Terumo syringes from ADW. They ship quickly. You may need a prescription for syringes from your vet. Many states require a prescription in order to sell syringes. You vet can easily call in an Rx or fax it if you are purchasing on-line. They typically keep the Rx on file so you don't have to keep calling to get the syringe Rx renewed.

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

I actually don't use neosporin. I would think a tissue would be fine. We use 33 gauge lancets and Tess doesn't get sore ears at all and we usually test 8 times a day! As it gets easier to get blood you can go w/ the finer lancets. Next time you buy the look for BD brand as well. i think they are sharper and hurt less. Be sure to put pressure on the site for about 20 seonds after the test. It stops the bleeding and bruising. Do you use the automatic device or free hand. If you free hand hold the lanct at 45º angle and barel touch the ear, twisting the lancet slightly as you do. It is actually faceted and makes a small cut not a hole. Twisting opens the cut a little to let it bleed easier and the pressure afterwards seals it up.

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

Hi Sienna,
I will be buying the terumo syringes. Even though I still have quite a few of the ones Ive already bought, if we need to increase her insulin, by anything less than a full unit, I wont be able to use mine. So Im just going to go ahead and buy the bag online. Looks like I wont need a Rx to buy it online.
Thanks
Rita

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

Apparently our shopping link to ADW is down, but you can just google them. The nice thing about the link is that FDMB gets a commission to help keep the site running and it doesn't cost you extra.

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

Hi Tess,
I use an automatic device. Ive tried to free hand it but I always chicken out right when I get to her ear and so I eventually poke her but not enough to get blood and I end up having to stick her multiple times. I just bought the ReliOn lancet which is a 30G needle. Apparently the ones that come with the alphatrak start up kit are 28G and thats what Ive been using till now. Hopefully switching her to the ReliOn lancets will cause less bruising (?)

Ive been alternating ears because i dont want to repeatedly poke her on a bruised spot. But now I can see the spots in both her ears.Poor thing. Hopefully the neosporin (which I just wiped off with a wet towel) and the smaller needles will help with bruising.

Rita

 

Re: 11/11 Portia-AMPS 283 +6 180-paraphernalia

I dint realize FDMB had a link to it. I just googled it. Thats nice that they get a commission. Will make sure to buy through FDMB from now on.
Rita

 

HI Tess,
I was wondering if you knew if Terumo had a 5/16" needle? On ADW, I only see 3/8" which Im assuming is a longer needle? Im scared that by using a longer needle I may go in too deep.
Let me know.
Thanks
Rita

 

you can just use a dry kleenex to wipe off the excess neosporin.

you shouldn't have a problem with the different length syringe needles. i used both and honestly it didn't matter to me at all. are you tenting up and area and then going in parallel to the body? we always shot in the scruff although a lot of people move the spot around. i lifted up a hunk (which separates skin away from muscle), then put the needle in parallel to the spine. if you hit muscle it will hurt and portia will let you know that you got her!

with the Tight Regulation Protocol we adjust doses all the time. dogs get a dose figured out at the vet's and then they stay at that dose forever. cats seem to need regular adjusting because their metabolisms are so fast. the .5u syringe markings really save your life when you're measuring 1.25 instead of 1.0!!

sounds like you're really getting the hang of things. well done!