Newly Diagnosed, What's "normal" range for Alphatrak?

TL;DR: What's the normal range for Alphatrak meters? Is it 120-300 like this one site (which is linked below) mentioned?

The long version:

Hey there!

My 8 year old cat got recently diagnosed with diabetes after I noticed she was urinating more and inappropriately. Thought it was UTI, but... whelp.

The first vet ended up accidentally guilting me into buying Alphatrak, even though I mentioned I saw human ones work. I am definitely going to buy a human one after my current troubles with it, but...

I started her on Lantus shots last Sunday. I was told to test her in a week, and if she was 120-240, that's a good range. She was 354 when they did the demonstration for me in the vet's office.

On Thursday, she ended up vomiting, which is really abnormal for her (usually only does a few times a year). It was about 7 hours after the shot, which I know hits the lowest range after 6 hours. It was only once, so I gave her the shot again since it could've just been random.

This time, 9 hours after the next shot, she got sick multiple times so I immediately decided to test her blood. Besides vomiting, there was no other symptoms of hypoglycemia, but I wanted to check it anyway. First result, 54. I knew that was bad, but she wasn't displaying any symptoms besides the vomiting (she was fighting me really hard on the blood draw, and I do know that you can be symptom-less), so I immediately tested it again after many "error" strips. 214. I e-mailed the vet, but since it was the middle of the night, I decided to not give her another shot. That ended up being the right call as she vomited again about 4 hours later, and it would have been an hour or two after the scheduled shot.

Vet told me to hold off, and monitor her before giving her insulin again. Because I coax her out to get the shot with the expensive prescription diabetic wet food, I was letting her eat her normal diet. I waited until Saturday to test her again. 306. If the info on this site is correct, that was barely above the normal range so I decided to wait. I immediately switched her back to the wet food since I was curious if that'd affect her range (no reason to let her eat the dry food, she tends to ignore the free range food when she's given the wet food)

I waited another two days (today, Monday) to test her again. 296. Despite not shot since Thursday, her litter has remained normal and she's not urinating like she was for that two weeks when we figured out there was something wrong. (week 1 discovering it, week 2 waiting for insulin to ship)

I'm going to call the vet in the morning, but I guess I want to know if the normal range is for Alphatrak? Is it 120-300?

Also definitely going to switch to a human meter. For a $1 per strip, these tests seem pretty unreliable and the "error" message just keeps making me waste strips.

Also going to keep her on the diabetic wet food for now, so no worries! I leave the dry food out in case she get's hungry after her shot and for the non-diabetic cat (who is having crystals in her urine so I'm going to need to find wet food for her too), but she has very little interest in it when she's getting the canned food twice a day. (Just wish it was easier to coax her to eat from the can so I could split one into two meals. She isn't interested in it after I refrigerate it, but will go out and eat it periodically through the day if I leave it out)

Thanks a lot for the help!

 

Lots of things going on here!

We recommend testing before every single shot. All of them! We also recommend testing more mid cycle when you can too, but as an absolute total minimum is testing before a shot. This is life saving and can help prevent accidentally causing a dangerous hypo.

Also, prescription food is usually crap and full of carbs. A wet food diet with low carbs is best, there is a great big file listing most wet foods and their carb content for more info.

I can’t help with the normal range of the meter though, I know the alpha track reads “higher” than human monitors though. Have you seen the spreadsheet that we recommend here? If you can set one up for yourself and input the data you have, that helps a lot for everyone to help you.

 

Normal range for alphatrak in a cat is 68 to 150.
68 is the take action number. You don’t want the cat to drop below that. Give some high carb food or drop of honey if below 68.

Human meter normal range of numbers
is 50 to 120.
Take action number is 50.

A human Meter is fine. Most of us use them and our protocols are based on human meter numbers.

Are you feeding a low carb diet at the moment.? As Amy said there is no need for prescription diets. They are expensive and often full of carbs.
Ask lots of questions!! We are here to help.
Bron.

 

Just reading through your post again...........how often are you giving the insulin?...
Lantus insulin should only be given every 12 hours and only after testing the blood sugar to see it is safe to give the insulin.
NEVER give the insulin during the cycle.....which it appears you did, if I am reading your post correctly..
You are risking sending your cat into a hypo episode.
54 on the Alphatrak is very low and far too low to give insulin..If you get a number that low again please give your kitty some honey and higher carb food and retest again in 20 minutes.
Please only give the insulin every 12 hours, if the numbers are high enough .......

 

As Bron said above the normal range for a non-diabetic cat would be around 68 - 150 on Alphatrak.
However with a cat on insulin the numbers that you aim for at the peak of the insulin cycle (lowest blood glucose) will depend on a number of factors including the insulin type, the diet, your ability to test blood glucose, and your experience of how your cat responds to the insulin.

Numbers below 68 on Alphatrak are in hypoglycemic range. The lower you go, the greater the risk. So, if you see numbers in this range, or your cat is headed toward these numbers then appropriate action should be taken to keep your kitty safe. Hypo can kill.
The fact that you got a number in hypo range means that dose should have been reduced immediately as it is clearly too high.

I too don't quite understand what you've said in your post regarding timing/frequency of the insulin shots, and I may have misunderstood. But with Lantus you absolutely do not want to give shots more frequently than 12 hourly....
Lantus is a 'depot' insulin. It forms a store under the skin that is released over time. It can take a few days to see the full effect of any given dose (when the depot is at its optimum level for that dose).

For more information about how Lantus works do have a read of the info stickies in the Lantus forum.
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

Sorry for the confusion, but yeah, I was giving my cat the shot every 12 hours. I'll definitely start her up again at the next meal time, since she's been near the 300 range in the times I've been testing. I just started her on the insulin, and was told to do the first small line, so one unit if I understand correctly?

I was told her blood sugar should "peak" at the lowest around 6 hours after the shot because of how it works, before slowly going back up again. That's why I was concerned she was vomiting since it was after the "peak" point where her sugar should have been going back up again. Interesting to see it can take a few days to see the full effect, not sure if that's why she was getting sick then since that would've been a few days after I started. I'll be sure to give the info sticky a read over.

I will definitely test her before every shot then. I definitely don't want to risk Hypoglycemia. I did find some lovely spreadsheets I planned on using. I just haven't had time to try to process the exact data on it. (Edit: Found the resource and it explains all the data stuff on it, so I understand it now!)

And thanks for the food recommendations! I'll make sure to track that sheet down and see what food is on there.

I guess my current question is besides the pre-shot number, how often should I test her? I just need to try some better techniques for blood draw since she gets upset when I do it. I'll try a few of the different tricks I see here, since right now I've just been rubbing the ear and hoping for the best. (She feels the prick so I might be doing it too hard or something. I also felt a scab so I am probably hurting her too. I just need to get better at it, and I imagine she will get more use to it in time though.) I also will need to do some research on human meters at some point, but I'll stick with Alpha Trak until I run out of test strips at least.

Thanks again for everything so far! It's been a bit of a learning curve for me.

Edit: After spending nearly 4 hours looking at food, I think I'll swap from the Purina prescription diet to this Fancy Feast, since I'll be feeding two cats with it. (Unless Iam's chicken is better? Not sure if the one cat will eat pate, but she's not the diabetic one.) Thanks again for the advice

 

So you need to do before every shot.

You also ideally need to do a *test* around mid cycle whenever you can, often this ends up being about +3 in the evening (before bed) for those that work during the day.

And then on days you’re at home and able to get more readings, then do. Ideally do a full curve when you can but even getting various mid cycle tests on various different days can give a picture as well.

 

@flyingduster
I think you meant to say ‘you need to do a BSL around midcycle whenever you can’ NOT ‘you need to do a shot around midcycle’

 

Oops! Yes! Will edit that to avoid confusion.

 

@flyingduster

Should I be trying to prick the same spot every time? Right now, her ears look terrible. She has scabs on both ears, and when I flash a light to try to find the vein, It looks like they're possibly bruised? Kind of like this (pretend orange is the vein)




I used a rice sock for the first time, and I only needed to poke her once this time. But testing is proving rather stressful. I definitely will keep doing it before the shots, but I really don't want to her ear if I'm doing it wrong for mid-curve or curve testing. On the plus side, she's pretty much ignoring the insulin shots now since it's nothing compared to trying to do her ears.

 

I used both ears and used both edges of the ear.
After you poke and get the blood for testing, put some pressure over the poke with a cotton ball or tissue to stop the bleeding and it should stop the bruising.
You don't want to hit the vein, but the area between the vein and the edge of the ear if you can..
It will get much easier for both of you I promise. You are doing well. It is so good you are testing.

 

I try swapping ears and moving about a bit, and always put firm pressure on as soon as I have the drop of blood. While I hold the firm pressure for a few seconds I give her snuggles and attention.