Convert A Vet

Discussion in 'Feline Health - (The Main Forum)' started by Robert and Echo, Jan 13, 2010.

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  1. Robert and Echo

    Robert and Echo Administrator Staff Member Moderator

    Joined:
    Dec 18, 2008
    Reposted from the old FDMB:

    CONVERT A VET - Abstracts etc. on Home Testing
    Posted by: Cheri and Louis
    Date: July 1, 2008 06:22AM

    For folks who want to convince their vets of the value of home testing (as I did myself), here is a collection of sources I have put together. It is natural that your vet would be more convinced by information from PROFESSIONAL VETERINARY sources than by just hearing you say "Some cat owners on the Internet told me..." . These studies and comments on home testing blood glucose and on the use of portable blood glucose meters fit that qualification. The majority are from peer reviewed literature, conference presentations, etc. At the end are some comments of my own about home testing.

    Here is a document I have made with a collection of info on home testing with portable blood glucose meters. The majority is from professional veterinary sources. The formatting did not all carry over but I'm gradually working on a better looking version of this in Adobe InDesign.

    LINK : Home Testing Diabetic Pets: Professional Sources

    Here is part of that document:
    PUB-MED ABSTRACTS
    USE OF PORTABLE BLOOD GLUCOSE METERS
    & HOME BLOOD GLUCOSE MONITORING OF CATS AND DOGS WITH DM

    ABSTRACTS - PBGMs

    J Am Vet Med Assoc. 2002 Aug 1;221(3):389-92.
    Comparison of glucose concentrations in blood samples obtained with a marginal ear vein nick technique versus from a peripheral vein in healthy cats and cats with diabetes mellitus.
    Thompson MD, Taylor SM, Adams VJ, Waldner CL, Feldman EC.
    Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
    OBJECTIVE: To compare blood glucose (BG) concentrations measured with a portable blood glucose meter in blood samples obtained with a marginal ear vein (MEV) nick technique, from a peripheral venous catheter, and by direct venipuncture in healthy cats and cats with diabetes mellitus. ANIMALS: 1 0 healthy cats and 11 cats with diabetes mellitus. Procedure-On day 1, blood samples were collected every hour for 10 hours by the MEV nick technique and from a peripheral venous catheter. On day 2, blood samples were collected every hour for 10 hours by the MEV nick technique and by direct venipuncture of the medial saphenous vein. RESULTS: For all cats, mean BG concentration for samples collected by the MEV nick technique was not significantly different from mean concentration for samples obtained from the peripheral venous catheter. For healthy cats, mean BG concentration for samples collected by the MEV nick technique was not significantly different from mean concentration for samples obtained by direct venipuncture. For cats with diabetes mellitus, mean BG concentration for samples collected by the MEV nick technique was significantly different from mean concentration for samples obtained by direct venipuncture; however, for the range of concentrations examined, this difference was not clinically important. Conclusions and Clinical Relevance: Results suggest that for the range of concentrations examined, the MEV nick technique is a reasonable alternative to venous blood collection for serial measurement of BG concentrations in cats.
    PMID: 12164536 [PubMed - indexed for MEDLINE]

    J Small Anim Pract. 2000 Feb;41(2):60-6.
    Capillary blood sampling from the ear of dogs and cats and use of portable meters to measure glucose concentration.
    Wess G, Reusch C., Clinic for Small Animal Internal Medicine, University of Zurich, Switzerland.
    Two new methods for collection of capillary blood from the ear of dogs and cats for the measurement of blood glucose concentration using portable blood glucose meters (PBGMs) are described. The first method uses a lancing device after pre-warming the ear, while the second employs a vacuum lancing device. Both methods generated blood drops of adequate size, although the latter method was faster and easier to perform. Accuracy of the two PBGMs was evaluated clinically and statistically. Although assessment of statistical accuracy revealed differences between the PBGMs and the reference method, all of the PBGM readings were within clinically acceptable ranges. Measurement of capillary blood glucose concentration is easy to perform, inexpensive and fast. It may be used by owners to determine blood glucose concentrations at home, and could serve as a new tool
    for monitoring diabetic dogs and cats. PMID: 10701188 [PubMed - indexed for MEDLINE]

    Am J Vet Res. 2000 Dec;61(12):1587-92.
    Assessment of five portable blood glucose meters for use in cats.
    Wess G, Reusch C., Clinic for Small Animal Internal Medicine, University CH-8057 Zurich, Switzerland.
    OBJECTIVE: To evaluate the clinical and analytic accuracy of 5 portable blood glucose meters (PBGM) in cats, with emphasis on the detection of potential sources of error. ANIMALS: 200 cats. PROCEDURE: Venous blood glucose readings from 5 PBGM were compared with the results of a hexokinase reference method. Agreement among methods was determined by error grid analysis and statistical methods. RESULTS: A total of 2,975 PBGM readings and 513 reference values were analyzed. The accuracy of the PBGM varied in different glycemic ranges. The largest differences between PBGM readings and reference values were in the high glycemic range; 4 PBGM underestimated and 1 PBGM overestimated the reference values in most instances. In the low and reference glycemic ranges, the absolute differences between PBGM readings and reference values were small. Despite the analytic differences in accuracy, 4 PBGM had 100% and 1 PBGM had 98.7% of readings in the clinically acceptable values of the error grid analysis. Within- and between-day precisions were good for all PBGM. Significant differences were not detected between readings of EDTA and lithium-heparinized blood and fresh blood without anticoagulant. Compared with these blood types, 1 PBGM had significantly different readings with fluoride anticoagulated blood. In blood samples with a low Hct, all PBGM overestimated glucose concentrations. Sample volumes < 3 microl resulted in inaccurate measurements in 3 PBGM. CONCLUSIONS AND CLINICAL RELEVANCE: Performance varied among the 5 PBGM analyzed; however, all PBGM were deemed acceptable for clinical use in cats.
    PMID: 11131603 [PubMed - indexed for MEDLINE]

    Clin Tech Small Anim Pract. 2002 May;17(2):70-2.
    Portable blood glucose meters as a means of monitoring blood glucose concentrations in dogs and cats with diabetes mellitus.
    Stein JE, Greco DS.Veterinary Teaching Hospital, Colorado State University, 300 West Drake Road,Fort Collins, CO 80523, USA.
    The use of portable blood glucose meters (PBGM) has become common in veterinary medicine as a rapid means of monitoring animals' blood glucose in a variety of medical conditions. These hand-held monitors allow for diagnostic and therapeutic decisions to be made quickly and relatively inexpensively using only a small amount of blood. Both in conditions resulting in hyperglycemia, such as diabetes mellitus, and in those resulting in hypoglycemia, such as sepsis or the presence of an insulinoma, veterinarians have come to rely on PBGM to provide critical information on the status of their animal patients. In particular, PBGM are frequently used to measure individual blood glucose values in an animal over a period to create a blood glucose curve when evaluating the effectiveness of insulin therapy in diabetic dogs and cats. PMID: 12219719 [PubMed - indexed for MEDLINE]
    -----------------------------------------------------------------------
    ABSTRACTS - HOME MONITORING OF BLOOD GLUCOSE

    J Feline Med Surg. 2006 Apr;8(2):119-27. Epub 2005 Dec 1.
    Home monitoring of the diabetic cat.
    Reusch CE, Kley S, Casella M., Clinic for Small Animal Internal Medicine, Vetsuisse-Faculty University of Zurich, Switzerland. creusch@vetclinics.unizh.ch
    Many owners are able and willing to perform home monitoring of blood glucose concentrations in diabetic cats. Once owners are familiar with the technique, they appreciate its advantages and show long-term compliance. The success of home monitoring hinges greatly on careful preparation and instruction of the owner. Owners must have ready access to veterinary support if needed. Initially, most owners call for advice, and several of them need repeated explanation or demonstration of the procedure. The frequency of re-evaluations of the diabetic cats by veterinarians is not affected by home monitoring. One of its major advantages is that it enables frequent generation of blood glucose curves. In complicated cases, more than one curve can, therefore, be performed at home before a treatment decision is made. According to preliminary data cats managed with home monitoring may have better glycaemic control than those managed without. However, those results need to be confirmed in a large group of cats.
    PMID: 16325445 [PubMed - indexed for MEDLINE]

    Can Vet J. 2005 Aug;46(8):718-23.
    Retrospective study of owners' perception on home monitoring of blood glucose in diabetic dogs and cats.
    Van de Maele I, Rogier N, Daminet S.
    Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, B-9820 Merelbeke, Belgium. Isabelvandemaele@hotmail.com
    Home monitoring of blood glucose (HMBG) concentrations has been recommended in the monitoring of human diabetics for 3 decades. During the last number of years, it also gained popularity in long-term follow-up of diabetic cats and dogs. The aim of this retrospective study was to evaluate the practical feasibility of and identify the major problems encountered with HMBG in diabetic pets. A standard questionnaire was filled in by owners of 9 diabetic pets monitored with HMBG. The need for more than 1 puncture to obtain a blood drop, the creation of a sufficient blood drop, the need for assistance in restraining the pet, and the resistance of the pet were the most frequently encountered problems during HMBG. The major obstacles for the owners to start with HMBG were also identified. In conclusion, HMBG is a practical and simple technique for most owners and, overall, owners were satisfied.
    PMID: 16187716 [PubMed - indexed for MEDLINE]
    Article online: [www.pubmedcentral.nih.gov]

    J Feline Med Surg. 2005 Jun;7(3):163-71. Epub 2005 Jan 7.
    Home-monitoring of blood glucose in cats with diabetes mellitus: evaluation over a 4-month period.
    Casella M, Hassig M, Reusch CE., Clinic for Small Animal Internal Medicine, Vetsuisse-Faculty, University of Zurich
    Home-monitoring of blood glucose concentrations has recently been introduced to owners. The objectives of this study were to investigate the feasibility of home-monitoring of blood glucose in diabetic cats by owners, the problems encountered and to compare glucose concentrations at home with those measured in the hospital. Twelve of 15 cat owners were able to generate glucose curves over the study period of 4 months. Most problems were related to restraining the cat, generating negative pressure with the lancing device and producing a blood drop. In the majority of cases, these problems could be resolved during the study. Blood glucose concentrations in the clinic tended to be lower than at home; some of the differences were significant. No association between tolerance of the procedure and blood glucose concentrations measured at home was found. We, therefore, assume that the lower glucose levels in the hospital were caused by lack of food intake. In 38% of cases, treatment based on hospital curves would have been different from that based on home curves. Home-monitoring appears to be a valuable tool in the management of cats with diabetes mellitus. One of its major advantages is that it enables frequent generation of blood glucose curves, which is of particular importance in cats that are difficult to regulate. PMID: 15922223 [PubMed - indexed for MEDLINE]

    J Am Vet Med Assoc. 2004 Jul 15;225(2):261-6.
    Evaluation of long-term home monitoring of blood glucose concentrations in cats with diabetes mellitus: 26 cases (1999-2002).
    Kley S, Casella M, Reusch CE., Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zurich
    OBJECTIVE: To evaluate owner compliance with longterm home monitoring of blood glucose concentrations in diabetic cats and assess the influence of home monitoring on the frequency of reevaluation of those cats at a veterinary hospital. DESIGN: Retrospective study. ANIMALS: 26 cats with diabetes mellitus. PROCEDURE: Medical records of diabetic cats for which home monitoring was undertaken were reviewed, and owners were contacted by telephone. Signalment, laboratory test results, insulin treatment regimen, details of home monitoring, clinical signs during treatment, frequency of follow-up examinations, and survival times were evaluated. RESULTS: Monitoring of cats commenced within 12 weeks (median, 3 weeks) after initial evaluation; 8 owners were unable to perform home monitoring, and 1 cat was euthanatized after 1 week. In 17 cats, duration of home monitoring was 4.8 to 46.0 months (median, 22.0 months); 6 cats died after 7.0 to 18.0 months (median, 13.0 months). In 11 cats, home monitoring was ongoing at completion of the study (12.0 to 46.0 months' duration). Fourteen owners completed blood glucose curves every 2 to 4 weeks. Cats managed with home monitoring received higher dosages of insulin, compared with cats that were not monitored. Four of 17 cats managed by home monitoring had transient resolution of diabetes mellitus for as long as 1 year. Home monitoring did not affect the frequency of reevaluation at the veterinary hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Owner compliance with long-term home monitoring appeared to be satisfactory, and home monitoring did not affect the frequency of reevaluation of patients by veterinarians.PMID: 15323384 [PubMed - indexed for MEDLINE]

    Clin Tech Small Anim Pract. 2002 May;17(2):86-95.
    Home monitoring of the diabetic pet.
    Mathes MA., Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA. dogged@colostate.edu
    Home monitoring of the diabetic pet is a challenging proposition for many pet owners. Diabetes, unlike many other diseases, requires that the client, not the veterinarian, treat the disease. It is crucial that veterinarians reinforce and educate clients that successful treatment of diabetes mellitus will depend solely on the client's actions throughout the course of the treatment. This article provides guidelines on educating clients in the home monitoring process.This commonsense approach covers elements of in-home monitoring, including general appearance, clinical signs, behavior changes, feeding schedules, and medication administration. Additionally, thorough explanation is provided for clients who wish to take a more active role in obtaining and monitoring blood and urine chemistry values. This information is provided to assist the veterinary technician and veterinarian in educating clients of their responsibility in treating this disease.
    PMID: 12219722 [PubMed - indexed for MEDLINE]

    Cheri and Louis

    Cheri has a more extensive document on this in Google Docs at http://docs.google.com/Doc?docid=dfcfh8mj_0d79r3gc9&hl=en
     
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