? Help interpreting urine test strip

Discussion in 'Feline Health - (The Main Forum)' started by Armish & Roo, Jun 12, 2019 at 11:04 PM.

  1. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Hi there! As I mentioned in my last post, Roo just had his dental with a couple of extractions a week ago today. The vet asked me to check his urine for glucose and ketones, so I ended up buying some of the hydrophobic litter sand and some pet urine test strips (since I think the Ketostix or ReliOn brand strips only test ketones).

    Based on trying three strips, I'm pretty confident that there's no ketones in the urine, as I'm not seeing a color change, but I'm not so sure about the glucose - its getting brown in some areas but staying blue/greenish in other areas - can I get a second opinion? Is it possible the brown spots are where the sand is being scooped up in the pipette??

    Pictures attached, taken right at the 60 second mark indicated for both glucose and ketone tests, I've circled where I dripped the pee as I only tested those two. Help!
     

    Attached Files:

  2. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Armish, I can't help you interpret the glucose reading and a BG test is going to be a much better indicator of blood sugar. The sticks are testing urine that may have been in the bladder for quite some time and isn't as accurate. We use those sticks primarily for the ketones, which you have done.
    Back in the day, and I'm dating myself terribly, all we had was these special paper strips to try to tell us the blood sugar by testing the urine. Thank goodness for the development of the glucose meters and blood testing! You will always get a much more accurate test with blood and the meter.
     
  3. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks for the input. Vet wanted me to pause on BG testing with meter and only do the strips but I've still been doing BG tests with the meter at least twice a day in preparation for starting insulin soon. Wanted to give her what she was looking for so we could have a productive convo next time I take Roo in since she wasn't convinced with just the spreadsheet and BG numbers. I sent her the images and she agrees that we should talk about insulin dosing when I take him for his dental recheck in a couple weeks. Don't worry, I'm not abandoning the BG testing daily!
     
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  4. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Very glad to hear that you are going to continue testing, that is so much more accurate and I am amazed that the vet would rely on the glucose urine test strips and discount the blood sugar tests you are getting. I do understand you wanting to be able to work with the vet however. Just remember, you are Roo's advocate and will be the one that is doing the 24/7 care.

    Looking at the spreadsheet, and seeing those numbers I believe he really does need some insulin therapy, sooner rather later. I am not an expert, but I do know from reading that a 200 BG is the renal threshold, that is the point at which glucose gets into the urine. More weeks of those "pinks" is not good for him. A non diabetic cat normal range on a human meter is 50-120. You have already provided a low carb diet and this has not lowered the BG enough.
    I am going to tag some of the more experienced members for input on this issue because I'm concerned for Roo.
    @Bron and Sheba @Olive & Paula @Bobbie And Bubba @Wendy&Neko
     
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  5. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    You already switched diet, had dental. Definitely need to get insulin started sooner rather than later. Lantus/levemir take a week to get her the depot set, so that adds more time in pinks. Vetsulin and Prozinc would act right away. I don't like to think of the dose they will suggest since they seem to be dragging their feet on this. I would not wait a few more weeks though. It's already been to long.
     
  6. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks! His next appointment is on the 24th, but I might try to reschedule to this weekend to get him started sooner rather than later. My biggest concern is that I'm going to visit family (about a three hour drive away) from 6/19-6/23 and am taking him with me. Not sure if starting insulin before this would be a good idea because while I am with family my schedule isn't going to be very consistent, and he will probably be pretty stressed with the new location and people. Hence going in to the vet the day I get back. Any advice on that?
     
  7. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    No ketones and glucose IS spilling into urine meaning his glucose is ABOVE 'renal threshold'. That's normally 230-250 which causes the kidneys to have to 'spill' extra glucose into the urine to get rid of it.
     
  8. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    If Roo is going to be under additional stress while visiting, his BG is just going to be higher, with no assistance to lower it. If it was me, and I'm no expert, I would get him on at least a starting dose, and work very hard to keep him on the 12 hour dosing schedule. The longer these high numbers persist, the lousier he feels and the harder on his body.
     
  9. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks, sounds good. The earliest appointment they had was for 8am on the 17th (upcoming Monday), and I am leaving on Wednesday morning so hopefully will have a few days to figure out a good dose before I leave. Based on what I've read, I should be requesting Lantus or ProZinc since they are longer lasting, correct?
     
  10. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Again, I can't make a solid recommendation about the insulin. We used Lantus because that's what the vet prescribed. It's a great insulin for our sugar babies, and many members use Prozinc also. There is a price difference between the two, and with Lantus you can choose to either use a vial or the pen. The pen is more cost effective, as even with refrigeration the chances of you using the full contents of a vial are very slim. If you choose Lantus, going forward you can order from Marks Marine (with a prescription) in Canada and save quite a bit.
    Take a look at the stickies at the top of the Lantus and the Prozinc forums, so that you can make an informed decision before the vet visit.
    http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/
    http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

    Be aware that these two insulins use different syringes. Throw this question out on the Main forum in a new thread, Prozinc or Lantus?, get as many informed opinions as you can.
     
  11. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
  12. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    I'm going to throw a monkey wrench in this toolbox... :) I much prefer Levemir over Lantus if you go with a depot insulin. Levemir gives a much flatter curve and works much more gently when it onsets. Even when a cat is bouncing, the numbers are still nice and even. That feels much better 'in' their body than a quick dive that I always had with Lantus. The difference in the method of delivery is also a plus. Lantus works by precipitation of small crystals in the fatty layer and is based on the ph balance of the body. If a cat has an issue with a swinging electrolyte or is not feeling well, that ph balance isn't always at neutral. Levemir works totally differently by binding to the albumin and isn't based on ph balance.

    Just more info for your toolbox! :)
     
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  13. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Thank you Lyresa, I don't know much about Lev, and it's time for me to educate myself about this insulin also. The more info, the better I think. I just checked Marks Marine and it is also available there, but I don't know the difference between US cost and there. I just know that US insulin prices are awful.
     
  14. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Wow, thank you! I didn't know this. Adding to my giant list of mental notes :bookworm:
     
  15. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    Price is about the same as Lantus.
     
  16. CandyH and Catcat

    CandyH and Catcat Member

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    Apr 23, 2019
    at Mark's Marine, looks like u$ 170 plus shipping for 5 pens
    using a discount card at several US chains, looks like $80-90 for one pen, $480-495 for 5

    of course that doesn't make mathematical sense, but discount card may not apply to multiple pens
     
  17. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    I can verify that the cost to me here in Oklahoma last fall for a box of 5 Lev pens was $425. My last pen I had that had been given to me was bad - I was suddenly completely without. Luckily I explained the situation to the head pharmacist at a small, locally owned pharmacy - she ended up just giving me a single pen from the 'Homeless Med Program' they have.
     
  18. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    I say the non-uniform color of the glucose pad is due to you not getting the pad fully covered with urine. Your first image really shows that by the brown portion stil being covered with the liquid urine.
     
  19. Bron and Sheba

    Bron and Sheba Well-Known Member

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    Feb 21, 2015
    I think you definitely need to start insulin. I would not wait until you come back. You might have bigger problems then. If a cat needs insulin it is always a good idea to start it. Start on a small dose of 1 unit and if you can test the blood sugars that will keep your kitty safe. Test before every shot and again during the cycle to see how low the insulin is taking kitty. Around +4 to + 6 is a good place to start.
    I prefer Lantus or levemir over Prozinc but that is probably because I understand them more. Your vet may not know levemir as it is newer than the others.
     
  20. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks all. Have an appointment for first thing Monday and will be requesting Levemir or Lantus. My main concern is that my boss is only allowing me to work from home for Monday so I won’t be able to monitor much after that aside from the usual AM and PM and +2/+3 in the evening. I’ll try to sneak away for a midday test around lunch on Tuesday. Hopefully all goes well.
     
  21. Bron and Sheba

    Bron and Sheba Well-Known Member

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    Feb 21, 2015
    Have you had a look at the 2 dosing methods? Have a look at the link below and choose the one you think would best suit you. You can always swap. If you are gone a lot of the time the Start Low Go Slow method might be better in the beginning at least. If you choose that one and Roo is on a low carb wet diet you should start on 0.5 units of insulin and hold that dose for a week unless he drops too low.
    Here is the link
    http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
     
  22. Bron and Sheba

    Bron and Sheba Well-Known Member

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    Feb 21, 2015
    Make sure the insulin syringes you get are the U-100 0.3ml syringes and they have the 1/2 unit markings IF you are going to be using the Lantus or levemir insulins. You can buy at Walmart.
    The Prozinc insulin uses a different syringe.
     
  23. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks Bron! Yea, I read some about the dosing methods and it looks like SLGS is probably what works best for now, at least until I get back from traveling. Then maybe transition into TR after I am more available.
     
  24. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    I’m at the vet right now and they are NOT okay with using the human meter, and went so far as to say that they won’t even look at the numbers unless it’s the AT2. Additionally they won’t start insulin today because no frutosamine results yet. I wanted to start him before travel on Wednesday because he’s so high but I don’t know what to do??? @Bron and Sheba @Idjit's mom any ideas?? Should I try to find a new vet?? I am shocked at how much of a hardass they are being.
     
  25. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    A human meter is not ideal but the lower numbers are reasonably accurate compared to an AT2. I used a human meter for two cats over many years and never got grief from my vet. I don't particularly like badmouthing other member's vets but his numbers are high, you're about to travel and they're treating you this way? That is not okay.
    @JeffJ lives in Austin, maybe he could steer you towards a more understanding vet.
     
  26. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Thanks I would love the input. They also told me that I shouldn’t be testing before shooting “because he’s not a human” and that it would make it worse. And she also basically said that everything on here is uninformed and not based on science. I’m FUMING. only saving grace is that they do want to prescribe Lantus vs other insulin’s, just not yet.
     
    Noah & me (GA) likes this.
  27. CandyH and Catcat

    CandyH and Catcat Member

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    Apr 23, 2019
    grrrr -- can you hear Catcat growling at that vet !!! :mad::cat: :mad::cat: :mad::cat:
     
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  28. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    Oh brother, did everyone hear that? What we're doing here is not based on science. Maybe this is the Dr. Phil show for cats.
    Did this guy graduate at the back of the class? You need to have your files transferred to another vet, that is a steaming pile of doo-doo!
     
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  29. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    Sorry for the double post. Some members have been here for over ten years and everything we do is based on practical experience, something you don't get from a textbook. Personally I've changed syringes, food, feeding schedules and recommended doses all with the approval of my vet who is totally open to new ideas.
    Many doctors (the ones who say "It's doctor actually) are more than inflexible to new ideas and cannot accept that a mere mortal may have a better idea. It's your cat and your money, you're free to do whatever you want.
     
  30. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Agreed. Though they are currently running the frutosamine and want to get him on Lantus starting when I get back from my trip (MUST HAVE THE FREAKING AT2 THOUGH *eyeroll*) - so maybe get the prescription and then ghost them and find a new vet. I'm at a loss and am just mindblown.
     
  31. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    I totally agree. I've been reading about this constantly and feel that I am well equipped to deal with this, and the vet is the one getting in the way. I think once I get the insulin I should be fine, but I'm having to jump through hoops. Because his frutosamine was not crazy high and he doesn't have bad clinical signs (overdrinking and overpeeing), they are saying that he might not actually be diabetic and are continuing to delay despite BG being high. I feel like I just need some support form them and I'm drowning :(
     
  32. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    Another thing I just remembered she said - when I said I wasn't loving the idea of using the AT2 because of how pricey the strips are she was like "it's not like you're using them everyday, and no one has complained about the price of them before" - well yea if you haven't given them another option of course they can't complain!!! FUMING STILL.
     
  33. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Most cat owners here have gone with human meters because of the cheaper test strips. Many go with Freestyle. I still use Alphatrak, and I purchase test strips at ~$0.35/apiece off ebay by using Freestyle Lite test strips in the Alphatrak.

    If you provide insulin to your cat, and you do NOT test before the dose, then your cat is in danger. What if you had a human child and dosed the child without testing? Then the child could die from hypoglycemia. This is not hypothetical.
     
  34. Armish & Roo

    Armish & Roo Member

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    Apr 28, 2019
    I bought the AT2, and will probably just use it for the vet curve since they are being very stubborn about it. Will continue to use my human meter to test on the daily now and after starting insulin.
     
  35. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Remember that Roo is your kitteh, and ultimately all decisions about Roo belong to you.
     
  36. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Armish, thank goodness you have the good sense to decide to keep testing. Most of us do use the human meter because of cost issues, and it's still going to tell you the blood sugar levels. You absolutely should test before injections, and in between the best you can to keep Roo safe. I have been online all day or night supporting other members with kitties with very low blood sugar (hypos) resulting from NOT TESTING. I am in agony thinking about all the other diabetic cats that this vet is treating!

    You do what you need to do for Roo. I think I would be looking for a new vet that I could trust had some experience with feline diabetes, but for now you are very wise to get what you need for Roo. I know I can rely on the information and advice from this board, Idjit is proof. Get the insulin and get Roo to a better level of health and well being. If I had a cotton picking pen of Lantus, it would be on it's way to you.

    Keep posting, reading, learning, asking questions. Let the members with years of experience guide you and let the rest of us support you in taking good care of that little guy. :bighug:
     

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