abbot alpha track 2 readings???

I am wondering if anyone has had issues with alpha track reading? I just checked my boy and for kicks thought I would just double check as I have not done a double for a while… it was crazy!
I got 235-281-266-303-301 (in that order) The last one was a drop of blood on the wood floor. I
took out my other alpha track meter and got 276 and 278 which is much closer than the first meter.
But what the??????
With the first meter I did just get new strips but I did all the things I am supposed to --the test strip read within the range.
I changed the code--I did a test strip-it has new batteries…..
This is concerning as I could give too much insulin --I dosed for 250-275 (even at 235 he would be ok) I didn't want to give too much but this is frustrating!! I recently bought yet another alpha track as a "spare" but I don't understand how the readings could be so different. Has this happened to anyone else? I think the first meter is going in the trash! Maybe I should call abbot?

 

All meters are allowed by the FDA to have a 20% variance in their numbers....this means that even if you use the same drop of blood on two different meters, you can be up to 20% off....Heck , even using the same drop on the same meter can read up to 20% different

To stop yourself from going crazy, pick one meter and use it....put the others somewhere safe in case you need it later

 

Yeah, there's enough stuff about feline diabetes to make ya nuts, don't let the small difference in numbers do it too. I know you just want to be safe with your baby, but the meters really are only intended to give us a pretty close approximation of the BG. But if you get a really wonky number, do re-test..

 

Thank you--I have officially gone nuts …. But I am leaning it is all a process and he is happy peeing pooping purring playful and eating !!!
I am trying not to sweat the small stuff and go with my gut--If I feel unsure I will just shoot low. Thanks again )

 

I can relate, oh, so well, lol! Been down that road a few times, myself; it'll get better, trust me!

 

I only have one meter. But sometimes I question the readings. Once I did both ears. Numbers were way off. But other times they are exact. Go figure.

But even human meter will be off. I go with the reading at the time.

 

Thank you for the reply--it is crazy-with todays technology I thought these would be more precise or at east closer with a multiple reading-20% is a lot when dosing insulin. I guess we do the best we can with the numbers we get.

 

Check this visual display of the +/- 20%.

 

Wow, that really highlights the difference in readings! Thanks for sharing that!

 

wow--I wish the margin of error was smaller-20% could be very different in dosing a 10-20 pound cat….

 

Notice that the width around a number is smaller at lower numbers. This is good, as we want to be careful at low numbers due to the increased risk of hypoglycemia.
And of course, once the glucose is up over 280 mg/dL or so, the actual number isn't really important. The glucose is too high, and you'll want to work on bringing it down.

 

I think it might come down to economics. I know pet meters, and some human meters are costly, but then there are meters that you can get for less than $20. In general, they are mass produced cheap devices. If the FDA only requires +/- 20%, from a loss/profit point of view, a manufacture isn't in the business to make anybody happier than they are required to. They'll spend as little as possible, per unit, as humanly possible to get the product on the shelves in order to maintain or increase their profit margin. One would think that the more a meter costs, the more accurate it would be. That's probably more about # of units sold (the fewer you sell, the bigger you need your margin to be) than to "quality of product".

I am not diabetic, don't even know anyone that takes insulin, but does a 20% difference matter when treating human diabetes? Is it a shoot or don't shoot thing, or do you pretty much shoot a standard dose on a regular schedule?

 

Why the "line" at 280?

Also, I'd point out that to anyone using a sliding scale, there are still decisions that are made, across the entire range of numbers. For me anyway, a 300 got a different dose than a 350 or 400 did. Of course, different doses were given on numbers well below 280 too.

I never took meter variance into account. The number on the meter was the trigger for the dose I shot. All tests were taken at face value. Personally, I think that's the only way to not drive yourself insane.

 

Per the Merck Veterinary Manual, 280 mg/dL is the approximate renal threshold where glucose spills into the urine. Some estimates say 180 mg/dl, 240 mg/dL, etc, and it may depend on the cat's renal function, too.

 

Ok, but why is that significant?

 

a) Its the level many long time members state it is good to be under - per this brief search

b) this vet clinic describes the importance as
"...Since glucose attracts water (called the osmotic effect) it pulls fluid out of the pet and causes polyuria. To compensate for this excess urination the pet drinks more water, and now has polydypsia. It now has the symptoms we abbreviate as PU/PD. Eventually it causes dehydration when the pet can’t drink enough water to keep up with the increased urination. In addition, the excess urination pulls important electrolytes out of the bloodstream like sodium and potassium, which leads to lethargy and weakness. The loss of glucose also depletes the body of its primary energy source, so additional weight loss occurs. To further add to a diabetic pet’s woes, the excess glucose that builds up in the bladder feeds bacteria that can cause a urinary tract infection."
so increased risks of electrolyte imbalances, dehydration, and bladder infection may be consequences of exceeding the renal threshold.

c) from Canine and Feline Endocrinology by Edward C. Feldman, Richard W. Nelson, Claudia Reusch, J. Catharine scott-Moncrieffc)

"Cats that have blood glucose concentrations below the renal threshold usually do not have clinical signs of diabetes, and therefore, glucose concentrations between approximately 120 and 270 mg/dL (6.7 to 15 mmol/L) may be considered to represent mild hyperglycemia."

 

Just a thought.......perhaps the rising numbers you saw were a combination of meter variance with the addition of some kitty stress. My girl is a very co-operative patient but if I were to try to do 4 tests in a row, I know she'd get miffed with me and start getting antsy which would no doubt cause a rise in her numbers. I wouldn't bother doing more than one reading unless you get a really odd number and need to double check it because the chances of getting the exact same number are very remote. Our meters give us an estimate of glucose not an exact number. Glucose in the system is constantly changing. Each reading is a snapshot of a single moment in time. Once you have lots of data over time, you get a movie which tells you how your cat reacts to what dose of insulin.

I agree with Chris....pick one meter and stick with it.

 

I thought about the stress factor but he is pretty cool about it-not a flinch and on the 2nd meter the numbers were lower than the highs on the first- either way I am using the 2nd meter and unless I suspect it is totally off (which is impossible because he is pretty happy all the time chasing the laser- jumping on counters from the flood opening cabinets meowing for me to come to him)…. still can't believe he is 15! Love that boy

 

Carl my dad has been Type II diabetic for over 20 years and when my cat was diagnosed we talked a lot about meters, btw he's also a physician.

He told me that human diabetics have long railed about the inconsistencies between meters (and individual variances in readings on a single meter) in terms of using this tool to manage their diabetes. Lots of human diabetics use their BG readings to manage the dose (this is especially important in babies, which are really more like cats since they can't really tell us how they feel) but even in adults dosing is typically dependent on what kind of insulin they are using, much like cats. Human adults, though, have the advantage of knowing how they actually feel, irrespective of whatever number the meter returns.

@jayla The technology is definitely improving but, cat or human, I agree all you can do is go with the meter you have and take the reading at face value or you will, indeed, drive yourself nuts. As Tammy has said, if you get a very strange reading, double check to be sure. As Linda pointed out, you need lots of data and once you have it, you will be able to have a better "feel' for what works with your cat.

Jayla, you have it exactly!

 

OK. But even though they might not show clinical signs, numbers in the 120-270 range are still a problem, right? I mean, cats can still suffer from glucose toxicity, and any healing can be inhibited unless the numbers are better controlled than spending most of the day in the mid-200s? Getting below the renal threshold is a great first step. But then the 2nd step should be to get the cat into normal or near-normal BG numbers for as many hours per cycle as possible, right? So that the "real healing" might start to take place?

One last question - the "280" level. Since the manual is intended for vets to use, is it safe to assume that number would be from the result of labwork, like a blood draw? (I read the page you linked, but it doesn't say) Rather than from a pet meter or human meter? I saw where it listed "normal BG range" for a cat as 75-120, but that's a range I've never seen mentioned before. Does it translate to "our language"?

 

Thank you for that feedback! The only time I've run across human diabetics has been at work when I have been called because someone is having a "diabetic episode" on the beach. Once it was someone who was hyperglycemic, but the other times were due to hypoglycemia. And yes, I agree, the advantage humans have is that they "know" they are high or low, and can take measures to correct the problem quickly.

Thanks again!
Carl

 

Based on the reports on the board lately of the AT doing this. I personally would never use an AT. I have never experienced this with my meter. (I've used 4 different meters in the brand on 5 different cats). I don't believe that the 20% variance allowance is meant to allow that a meter should vary from itself within the same instance by that much. I believe it means that it can vary from "the right" number by that much, but that a meter should be consistent unto itself. A meter should function the same way every time it processes the blood, the AT seems to just be rolling the roulette wheel. Thankfully all of the numbers seem to be at higher numbers where the decision would still be the same, but its still disturbing to see in a meter touted as being the best to use on pets.

I know that time of blood exposed to the air has caused me to get wonky numbers. If you sucked up a drop off of the floor and it had been there a while, that could probably make that number differ from a number that was taken right when the blood was fresh.

Personally, I find this pattern in the AT disturbing.

 

Melanie,
The only thing I would point out is that in this specific case, where the CG is using a sliding scale with PZI, the variance may not result in the same dose decision. Depending on where the "breaks" are on her scale. Which makes the lack of meter repeatability more significant.
I agree, it's one thing for a meter to be 20% off of "reality", but it shouldn't be off against "itself" like this.

 

I would consider elevated numbers under the renal threshold to be a problem, but I think that may explain why vets tend not to treat until the fructosamine is also elevated or the glucose is clearly above that renal threshold level.

In the AlphaTraker software manual (p 17), the default range for the AT was given as 80-180, 60 was labeled as very low, and 250 was labeled as very high. It indicates one is supposed to enter numbers the vet gives you in those dialog boxes. I believe the AlphaTrak numbers are supposed to match up with general veterinary lab equipment, though I didn't see anything specific in the documentation. Found something to support that the AT is intended to match up with a vet lab in the attached PDF.

 

The reason I got the alpha track (now have 3 ) was because I initially bought a cheaper one from target like 20$--it was fine I thought but then my boyfriend brought me his dads (who is diabetic) and cost like 200$ so I thought it would be better--in the meantime we saw our special kitty Dr who said the alpha track was better suited for us --
SOOO I tested all 3 with the same blood and quickly took the samples- the difference was huge between the 2 human meters -the expensive one was more than 50+ over the cheaper target one, then the alpha track was in the middle and the least expensive one was always lower… I stopped making myself insane and gave back the 200$ one-I put the cheap one in a drawer and stuck with AT- I have done a double randomly and usually is maybe 10-15 difference --this time was not the norm. All in all I am happy with the AT.
In my head I always ask myself if it was 10+ or 10- would I dose the same? I am pretty intuitive with him and so far so good.

 

I and several others on here use Freestyle Lite strips in our AT 2 meters. The cost is half and the numbers are very close. They're made by the same company. We've done many comparisons between us and all agree that the strips are one in the same. But, you should do your own comparisons and form your own opinion.