AT2 Meter

Hi, I am an old member on here from way back. I had an IAA/diabetic male cat, Buddy that was a happy guy living with Diabetes for almost 3 yrs. (GA from lung cancer). At the time I tested using Relion meter/strips with no problems, I home tested and gave shots using Lantus then Levimar, so I know most of the basics. I haven't been on here for a long time, so have forgotten things but some things are coming back. Very interesting coming back and reading some of the posts.
Here is the story now:
I have a daughter-in-law who's cat was just dx'd with diabetes, has had Asthma for about 10 months. For reasons I won't go into right now, she wants to use the AT2 meter. I know there is a lot of discussion about the AT2 versus a human meter, I don't really want to debate that, I'm really only looking for info on when you test with that meter what protocol or what info do you go by on deductions or increases etc with number showing from meter.?? Her cat has been in hospital for a week now with having to be in oxygen tank. I'm trying to get as much info to help her when bringing her baby home. The vet has her on 2 units ( Yes I KNOW its alot) of Lantus. At this point she is more concerned about her breathing than the diabetes, so while she is still in hospital she is letting vet decide what to do. So if there is anyone who would be interested in talking that would be wonderful. I am eventually going to possibly have my daughter-law join this group. No disrespect but I do not wish to debate which meter is better or not, I just need help with the AT2.
THANK YOU for any and all input
Jan

 

Hi jan! So sweet of you to start researching for your DIL's kitty.

BTW, my cat started on 2u lantus as well. He was 14 pounds at the time. It wasnt too much. Actually turned out not to be enough.

Anyhoo i began using the AT2 the end of april. I liked it very much. I only recently switched to relion micro to keep costs down, and to avoid having to 'translate' numbers while i took on the Tight Regulation protocol.

Before i started TR i was using the AT2 and doing increases/decreases through vet, who i would share my cat's ss with. I'm not sure thats the info you're looking for, but i'll try to answer any questions you have. What helped me in my case is that my vet also uses the AT2 for inhouse checks, so we'd all be on the same page. Readings higher than 250 was hyperglycemic, and lower than 65 would be hypoglycemic.

 

At this time, the only "official" difference between the AT and a human meter is the point at which you take reductions on Tight Regulation....On the AT it's below 68....On a human meter, it's below 50

If doing SLGS, the reduction point is 90 for both

 

Hi Jan ,
That is wonderful that you are helping your daughter-in-law
I only use the Alphatrak2 meter. I have two one as a back up.
In the morning before I feed and give insulin I test. So test , feed shoot all within 5 to 10 minutes
I test at +2 +4 +6+9 some days more testing and some days less.
In the evening I test, feed shoot all within 5-to minutes.
My kitty Fritz has asthma has for about 6 years now.
I am fairly new to FD so I can't offer dosing advice.
If you'd like read the sticky's for both TR (tight Regulation) or SLGS . Lots of helpful information for managing the diabetes.
I hope this info will help?
Please come back this is a great resource for FD.

 

Oh what else i liked about the AT2 were the test strips. They have two areas on the sides for blood capture, so its really easy to get a sample even on a fidgety cat. As a comparison, on the relion micro the sample area is in the center, and its a relatively tiny area.

 

Hi Deb,
My DIL, works all day so she will probably only be testing in morning and night. Were s trying to figure things out. I have been reading a lot on the human/cat meter, and I think at this point we need to understand on the AT2, what is the low no shoot. I know that isn't a cut and dry answer, but I think her vet is basically a stick with same amount, not really using any kind of protocol. But I want to be able to at least have an idea of to low to high.

 

My vet said dont shoot below 100 on the AT2.
We never got that low so i cant say personally how effective that number is for the no-shoot threshold. I'm sure others here can expand on that.

 

I know if you do the TR with Levemir you shoot as low as 68 on the AT2 meter. But you have to be feeding only low carbs and no kibble. I need to check to see if it's the same for Lantus. Have you been able to look at the two TR or SLGS?
Lantus and Leviemer are both depot carryover insulins so it can take sometime for the insulin to build up in the system.
It's important to be able to monitor thru the day to watch for hypo if you will only be monitoring twice a day you should leave food with MC carbs out in case the GB drops.
I am hoping someone with a lot more knowledge and experience can comment on this.
I like the AT2 it just gives me more comfort knowing the meter is made for cat blood.
It's important not to just be raising the dose too much at one time you could miss the dose that's just right for kitty.
Hopefully someone will be online soon to answer some questions.

 

@Doodles & Karen I think I'm getting in over my head with trying to help Jan & Buddy

 

Hi Jan. Long time no see! If your daughter-in-law won't be testing much she'll probably be better off starting out with the Start Low Go Slow Method found here:

LANTUS & LEVEMIR - START LOW, GO SLOW METHOD (SLGS)

She should the follow the dose adjustments as written even though she's using the AT2 meter. The reduction point with SLGS is 90 mg/dL on both human and pet-specific meters. Remember, Lantus dosing adjustments are based on how low the dose takes kitty.

Later on she may want to switch to the TR Protocol. It's up to her.

Here's some links to basic information you might want to share with her:

How to treat HYPOS
jojo and bunny's HYPO TOOL BOX

Hometesting Links and Tips
FDMB SPREADSHEET INSTRUCTIONS
UNDERSTANDING THE SPREADSHEET/GRID

LANTUS & LEVEMIR - THE BASICS: NEW TO THE GROUP? START HERE!
LANTUS & LEVEMIR - SYRINGE & INSULIN INFO: HANDLING, DRAWING, & FINE DOSES
LANTUS & LEVEMIR - WHAT IS THE INSULIN DEPOT?

Stop by the Lantus & Levemir Forum. There's a lot of info there that will refresh your memory pretty quick!

Hope all is well with your family!
~ Jill & Alex (GA)

 

Hi Jill,
Yes long time. All is well.
Well I tried to get my dil to use a relion, but she thinks the petmeter is more accurate for cat blood. I know the big debate!! But for now I'm very confused on what to tell her . She catches on pretty quick, so would you recommend a specific paper she could read to understand on how to decide the shoot no shoot. Its been so long, I don't remember to much, I don't feel comfortable on giving advice on dosing. . I have been reading a lot, but I would like to give her something that will explain easily if possible. Do you have an opinion on what to give her???? Meaning the info on AT2 BG versus Human BG.
Thanks for jumping in here. Hope all is well with you!!!

 

I think a good place for her to start would be to read through LANTUS & LEVEMIR - START LOW, GO SLOW METHOD (SLGS). That will give her some of the basics. Not too many members followed SLGS back when you were here, but it works!

Unfortunately, I lost Alex to cancer awhile back, but other than that all's well here! The family has been getting bigger every year. Grandchild #9 should be arriving next week!

 

Sorry to hear that. I lost Buddy to cancer also, his was Lung Cancer. Still miss him everyday!! Ok will have her read those. She is very busy but I'm going to try and get her to join here.
Thanks!!!

 

Awesome! I hope she has time to join.
Good talking to you... take care!

 

Hi!
We use the AT2 and like the others said below 68 earns a reduction (on tight reg) .....

 

Hi Jan, I have used the AT2 meter since setting off on this sweet journey but to be honest, my vet never gave me an exact "don't shoot" number. It seems to me, after much research, that there is precious little reference material available based on use of the pet meters probably largely due to the fact that most folks (a lot of vets included) use human meters due to the high cost of the pet meter strips.

Of note is that my little girl has IAA so I never ran into any potentially "no shoot" numbers until I had compiled mounds of data about how my cat reacted to insulin.

In the very beginning, before I had much data, I set my "no shoot" limit in the 220-230 range. If mid cycle monitoring had not been possible, I probably would have raised this to 250 in the very beginning and then lowered it as I got a better feel for how my cat was reacting but then I tend to be overly cautious. With time and a lot of data, I gradually lowered that range and now shoot much lower numbers using 120-150 on the AT2 as reduction points.

 

In the true spirit of the FDMB, I'm replying to Jan's PM here so it's subject to peer review:

90 mg/dL is the suggested low (reduction point) when following the Start Low, Go Slow Method no matter what meter your DIL is using. Whatever BG number she sees on the meter is what she'll use to follow the suggested guidelines in SLGS. Does that answer your question?

Basic dosing guidelines copied from the SLGS Method:

Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
• Generally, shots are to be given 12 hours apart.

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:

Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.​

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.


Lather, Rinse, and Repeat!


Jan, as I mentioned earlier, you'll remember Lantus dosing is based on how low the dose takes kitty. That means your DIL will have to get some spot checks or mid-cycle tests in in order to know when to make dose adjustments. Some people do weekly curves. Some get those "in the door/out the door" tests. Many get a "before bed" spot check every night. Some get a +2 at least once a day. If the +2 is the similar or lower than the preshot number, she should continue testing because it's likely to be an active cycle which may require close monitoring.

Discovering how low the dose is dropping kitty is required to keep kitty safe when making dose adjustments.



Make sense?

 

That's what I pretty much thought!! Thank You so much!!!

 

You're welcome!
I hope you're able to persuade her to join the FDMB. I think she'll find the board helpful.

 

The "normal" glucose range based on a pet meter is higher than what is considered a "normal" range using a human meter, just as the low BG warning number is higher for a pet meter than a human meter, so why would one wait till they got a reading of 90mg/dl on a pet meter to make a reduction using SLGS?

I assume the 90ml/dl was arrived at to provide a comfortable margin of safety using a human meter with the SLGS method ie. making reductions earlier to avoid having BG numbers drop as low as those employed using TR. Using that 90 mg/dl. as the reduction point with a pet meter is diminishing that safety/comfort margin. Using a human meter, the 90 mg/dl reduction point is 40 points above the 50mg/dl low warning number. On a pet meter, that difference will be shrunk to 22 points using 90mg/dl for reductions. Why would the SLGS method afford those using a human meter more of a safety/comfort margin than those using a pet meter? Or does that 90mg/dl have nothing to do with safety margins? If not safety/comfort, then what is the significance of 90mg/dl? How was it arrived at?

I'd truly like to understand the rationale for using the same reduction number for meters employing totally different measurement scales. To wait for a reading of 90mg/dl with a pet meter to make a dose reduction, IMHO, takes away a significant degree of the "comfort zone" and/or safety SLGS affords the caregiver and makes the SLGS method somewhat more aggressive than it is when using a human meter. Based on my personal dual testing for the past year, a reading of 90mg/dl on a pet meter is roughly the equivalent of high 50's to low 60's on my human meter and that to me would make use of the same reduction number with a pet meter fall somewhere between SLGS and TR.

 

I was just wondering what would be considered low. Probably won't get to close to that number. DIL cat isn't doing well, so don't know where were going right now! Her original vet has been out of town, and she has been dealing with different vets, her primary vet who she loves will evaluate cat tonight. She has complete faith in him so she will I'm sure go with whatever he tells her. Time will tell.
Thanks

 

Jan, I'm so sorry to hear your DIL's cat is not doing well. We'll keep your DIL and her cat in our thoughts and prayers for a good outcome!

 

Thank You!!