? Relion glucometer differs from Alphatrak2 at vet

What do I do about the difference in readings from my relion glucometer and the Alphatrak2 the vet uses? I am about to do Phoebe's first test then give her one unit of Prozink insulin at 9:30pn PDT.

I was at the vet today to learn how to get the blood from the ear - which was MUCH different from anything I've read here. But more importantly, the vet's aplphatrak2 glucometer tested the clinic kitty at 74 and my relionConfirm tested the clinic kitty at 45. I didn't take Phoebe in for my lesson because she gets SO upset and I don't want to start ear sticks on a sour note.

I looked at the page that talks about refernce ranges but it makes absolutely no sense to me. All those numbers, parethesis, and greater than/lesser than signs. What does it all mean and how do I apply it!? I don't get it. I'm not good with math, and even if I was I don't understand anything on that page. I feel hopeless right now. :-( I thought reference range was going to be a chart - easy to read and line my BG reading up with something the vet uses. I have to learn how to do this correctly becasue I simply cannot afford expensive test strips.
Can anyone please help me understand how to use and interpret my relion confirm BG readings?

It's been a hard day for me becasue I also took two of my kitties to be cremated this evening. Being upset is not helping me help myself and Phoebe.

 

So sorry to hear about your other two kitties and the difficult day you've had.

Let me see if I can put the ReliOn numbers into terms you can understand easily

50-120 is about the normal range for a kitty who isn't diabetic. So that's the range a lot of us here aim for with our diabetic cats because it's healthy for them. The more time they can spend in normal numbers, the better the chance of their pancreas healing and them being able to become diet controlled.

Under 50 - some non-diabetic cats do run under 50 at least some of the time. When we get a number under 50 in a cat that's on insulin, we try to bring it up above 50 - when the insulin is pushing their numbers down, we don't want them going too low because it can then be difficult to bring them back up and they can then be at risk of a hypo incident.

120-200 aren't really bad numbers. They are above the range for a non-diabetic cat, but aren't so high that they'll be doing kitty damage. A lot of vets seem to tell people to aim for 180 as a good number for regulating a cat. Many of us here think that's too high as a target number because keeping a cat at that range doesn't give much chance of them becoming diet controlled.

The higher you go up the scale after that, the less we generally like to see the numbers. After a certain point (which of course is going to vary depending on the cat - they couldn't possibly be straightforward enough for there to be one number for all of them ), you can pretty much say it's down to degrees of being too high for the cat to be feeling really good.

When you're having a better day, there are plenty of people here who can help you set up a spreadsheet to track Phoebe's numbers - the sheets are color coded so you can see at a glance what sort of range she's in a lot of the time. It makes it easier for you, and us, to help you when you have questions. But today isn't going to be the day for doing that when you're finding things difficult already.

 

So very sorry about your awful day.

I use the AT2 meter as well.

I posted this a few days ago:
http://www.felinediabetes.com/FDMB/...uman-meter-my-comparison.135441/#post-1396294

It is my comparison of the AT2 meter to the FS lite meter and some discussions and information on the difference between a pet specific meter and a human meter. As a rule of thumb I am using a formula that the human meter reads about 35% lower than the AT meter. So if you take the numbers you mentioned there is approximately a 35% difference between your vet's AT meter and your Relion meter. Because my Tuxie is finally hitting some blues and even a couple of greens I take this into consideration when deciding when to adjust shots.

Hope this helps a bit..it is difficult for me when the majority of people her use a human meter and information is usually about the readings from a human meter. But you are using a human meter so the advise given here us applicable to your meter. It is just that the vet's meter will be reading about 35% higher than yours, so something you should let them know about.

 

so Phoebe's human meter (relion confirm) just gave a BG of 127. So I have to add 35% to this number? How do I do that? How does one add 35% to a number?

 

You only need to add the 35% if the vet wants the readings related back to his Alphatrak. In real terms, 127 on a ReliOn is just a tiny bit over what we'd call normal range of 50-120. I use the Confirm as well and I don't do any calculating with the numbers - I just work with them as they are.

 

If you really, really want to work out the +35%, take your 127, divide it by 100 and multiply it by 135 (to give 171.45 as an Alphatrak equivalent reading). Or use a calculator and input 127 x 135%

 

I just gave Phoebe 1 u of prozinc. If she's just barely over normal should I expect hypoglycemia now!? She ate a full meal ( 1/4 can of Friskies pate). The vet's glucometer said she was 240 (plus a few - I can't find the lab sheet w/ numbers) on Monday. They didn't retest today.

 

Personally, I'd try and concentrate on just one set of numbers - it's easier than trying to relate them back the whole time. I think more of us here use the human glucometers than the Alphatrak so those are the numbers we're more used to looking at. I'm not familiar with Prozinc unfortunately - Rosa is a Lantus kitty so I'm not sure how 1 unit will work for Phoebe with that pre-shot reading. I would suggest that you get another test at shot time +2 hours at the latest (you may want to get a +1 as well) to see where the dose is taking her.

Just in case you need it, do you have either syrup or honey and/or some high carb cat food (the gravy type)? Chances are she'll be just fine, but just in case she needs bringing back up a bit later it's as well to make sure you have everything you need.

I'm going to cross-post a link to this thread in the Prozinc forum as I'm not familiar with the action of Prozinc at close to normal numbers so you can get some experienced eyes here in case she does drop a little low later on.

 

The first thing I did was setup the hypoglycemic toolkit as described on one of the pages here. So, yes, I have all those things together one one place. I even have a french catheter if she requires glucose rectally. There are so many treatments and procedures I CAN do for my kitties, but diabetes is new.

Okay, I will retest at +1 and at +2. Is that how you write it? +1 means an hr after insulin, and +2 means two hrs after insulin?

Thank you, thank you all who are helping. I will get over this anxiety and become a confident diabetic kitty mom, but it will take me some time. I am so glad to have found this msg board! Thank you all.

 

That's good - when she does have a day when she goes low...and sooner or later she will, you have enough to think about without wondering where you put the syrup...trust me, I've been there a few times with Rosa! You're one step ahead of me if you have the french catheter though - I've just always hoped I don't need it and tested enough to make sure it doesn't get that far...though we do have needle-less syringes if it really came down to it.

Yes, that's right, we give the + numbers as the number of hours after you gave a shot. So +1 is 1 hour after insulin etc. It makes it easier for all of us - there are people here from all over the world, so using that system rather than the time on the clock when you tested means we can all understand the significance of the number instantly.

You will get over the worst of the anxiety - I promise. It never goes away completely (and I'm not sure that it should when there's always the slight possibility of a low number showing up) but it does get to be fairly easily manageable - and quite quickly too. You're doing really well already compared to how I was at the same point in this whole thing.

 

Hi Maria,
Any update on Pheobe? Is she still OK?
And how are you doing?
(My condolences to you on the loss of your other kitties. That must be so hard for you.... )

Eliz

 

Hello! I saw the cross post on the PZI board and wanted to see how you and Phoebe are doing. How are things today? How are YOU today?

Just to let you know, the spreadsheet someone mentioned does not require any math. I can tell you this from experience, because if it did require math, I would never have gotten one set up! I'm about the biggest dunce you can imagine when it comes to math.

 

Have you seen the ProZinc protocol? It may help you figure out how to use the insulin.

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

We generally tell new diabetics not to shoot under 200 until they have enough data to know how their cat will react. What number did you get this morning?

 

Something I found really helpful (found on this site somewhere) in understanding the differences between the human and pet meters: it's like Fahrenheit vs Celsius. Both sets of numbers are correct, they're just different reference points. All of this will get easier, I promise!

 

Okay, wow! I really had a full blown panic attack last night. But I really want to thank you manxcat419, tuxedomom, Sue and Oliver, Mitzelplik'sMom, Rachel, Elizabeth and Bertie for holding me up! You guys rock and your support means SO VERY much to me. If you all weren't so kindly there for me last night I may very well have exploded, what a mess, lol. So I am over the first hump: giving her insulin, and testing for the first time. The numbers are all relative, right. So I need to become familiar with Phoebe's numbers as relative to our glucometer, right!? The more numbers I collect the clearer the picture will become - is my thinking headed in the right direction? And the clearer the picture, the more I will be able to behave rationally and educated. Worry about matching our readings with the vets's readings when neccessary, not in our daily regimen, correct?

So my head is clear today, and Phoebe did fine with her first dose of ProZinc, 1U. Her first pre insulin reading last night was 127, +2 81. This morning, 12 hrs later, pre insulin 148, +2 135. At this point the numbers don't say much to me other than the insulin is lowering the BG some, and 81 is not hypoglycemic for Phoebe right now. I know obtaining the blood sample for the BG testing will get easier the more I do it because Phoebe will learn it's a good thing and she gets a tiny food reward (petting and lovins aren't so much of a reward to Phoebe)! It actually went very well this morning and super good at +2, relatively speaking- much growling and trying to escape. I did have to scruff her lightly but she didn't run when I released her which gave me time to provide positive reinforcement, yay! I think I will need to seek her out and pet her and her ears lots of times throughout the day so she won't associate my approach with testing and therefore won't hide all the time I don't think I mentioned that Phoebe is somewhat feral and very difficult to handle - Grumpy Cat's got nothing on Phoebe! I posted a picture of her grumpy face in my intro. But she's an incredibly smart cat and has surprised me by accepting pills with a pill popper. I fully expect her to accept blood testing as a normal part of her day too.

I would love to learn how to do a spreadsheet in the future! But yes, for now I'm just happy with giving the injections and writing down BG results.

 

Hi Maria,

So sorry you had a difficult night... Big hugs to you

Did you give a unit of insulin at a preshot of 148? (and then got a +2 or 135?)
You're seeing some really lovely numbers there, but that was quite a low preshot number. See this from the FDMB Prozinc info:
"Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given."

There's no need to panic. But are you going to be able to monitor Phoebe's blood glucose over the next few hours? (Just in case she drops low)
Edited to add: Maria, if you at all concerned, DO post on the forum for advice, and start a new thread if you need to.

Eliz

 

Hi again, Maria,

You may find this info from the FDMB FAQ's helpful for giving a context to the numbers you're seeing:

"6. REGULATION

Q6.1. What is regulation?

A6.1. There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":

• Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
• Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
• Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
• Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
• Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
• Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]

There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure."

That info comes from this document:
http://binkyspage.tripod.com/faq.html#regulation

Eliz

 

I have been doing the "sugar dance" for 4 months and it is only in the last 3-4 weeks that I am starting to get my sanity back. It is quite a shock to have your little furkid diagnosed as diabetic and then try to learn all the ins and outs of it. This site has been wonderful..it has given me so much information and helped me keep those last little strings of sanity.

You are doing great!! You are home testing and asking questions, the two most important things that have helped me. When I first started testing my Tuxie it was all out war fare between us. Then as I learned to relax, so did he and now he actually will ask if it is time to be tested...since he gets a little meat treat after testing. We started a regular spot and a routine for the testing and the insulin. The other morning I got distracted after I tested and fed him. I had drawn the insulin and put it on the table by our test spot. Tuxie actually walked over, sat on his mat and stared at me as if to say "hey..there's the other pokey thing still Mom" If someone had told me it would be so routine 4 months ago I would have had them committed. I have learned to test, feed and shoot all with only one eye open in the mornings and Tuxie just lays on his mat and purrs. It ALL gets better in time. You will do just fine!!!

 

When you have time to do it, the spreadsheet is very helpful to have. And the more data you collect, the more the numbers will start to make sense. It all does get easier. It took me about 3 weeks before I stopped feeling shaky every time I did a BG test.

 

Very cute, and I totally understand!

 

Yes, today I gave insulin at a preshot BG 148. BG was 135 two hours post shot. I am using a human glucometer and these are my human glucometer readings. And yes, absolutely, I am here to monitor. I made sure I would be home to start Phoebe's insulin. I figured there would be lots of testing in the beginning - to make sure she's alright, and to ease my mind about what her BG is doing on unsulin. I can't even leave a kitty at the vet for an anesthetic procedure w/out being in the waiting room during the prodedure and until kitty is awake again! I was upset at even having to drop off my kitties for cremation yesterday. I've never been apart from them before. I used to get a private appointment for this, but the price increased 300% and is beyond my means.

When you guys mention BG 200 are you refering to a human meter or a cat meter? I thought I was catching on but now I think I am even more confused. Sigh. If RelionConfirm (human range meter) BG = 45 and Aplphtrak2 (feline range meter) BG = 74 (these are the comparison numbers I got yesterday on a healthy cat ) then the % difference is 48%. Is that right? I'm terrible at math so I could easily have it ALL wrong and be running off in some fanciful mathematic direction of my own creation; easily! So, I would I take that % difference and add it to my human meter reading to get the feline range!? Right, wrong? BG of human meter is 148 + 48% = 219. Then the feline range reading would be BG 219 and sage to give insulin. So BG 45 = BG74 (being the baseline comparison. albeit only one test) and thereby BG148 = BG219. My brain hurts! I don't know if I've even explained this understandably or not.

 

I know exactly what you mean. Sooner or later everything settles into a new routine and all of a sudden you're coping with something you never thought you could deal with. It's still exhausting and frustrating at times, but not terrifying any more after the first few months.

 

You really don't have to worry about the differences between your vet's AT meter and the Relion you are using. Almost everyone on here (except a few people like myself) use a human meter so the conversations and information listed is generally based on figures from a human meter. The only thing you need to do is tell your vet that human meters read approximately 35% (as a general range) lower than pet specific monitors like the AT they use. As long as your vet is aware of this difference she can still use your spreadsheet, once you have it set up or your handwritten notes and they can do the conversion themself.

Here is a link to an article on the difference between pet and human meters. You can always send them the information and then they can do their own calculations on your numbers. You have enough on your mind without trying to do conversions, which are not necessary when asking for advise on this forum.

https://docs.google.com/document/d/1oI_34_EgqeKdpyttFW0oLoG1mbw16IkATAWHhoQD2JU/pub

 

Oh, you've got one of those too! My two were both feral as kittens and Rosa especially is a nightmare at the vet or anywhere similar. She will tolerate me testing her (I've had them since they were 4 months old so I belong to them)! But we tried having Michael test her while I was at work and while she tolerated it for a week or so, her behavior got worse and worse until he couldn't get near her to get a test anymore. Treats, treats and more treats seems to be the only answer - I find if I give Rosa a big piece of one of the Pure Bites varieties while I'm doing the test, she'll tolerate it a bit better. I quite often test her paw pad and she'll hold the treat in her front paws and eat it while I get a test from a back paw!

Oh, and the 200 reading shot limit would be on your human meter.

 

Just wanted to say hello! I'm a few months in..and it gets so much easier! Overwhelming and scary but it all becomes natural over time..you're doing great!

 

My first time was such a nightmare, I cried until I felt sick. Goof was so scared. But it's kind of old hat now.

When I changed to the ReliOn micro from the AT2, I took it to my vet and tested it against an AT2 they had in the office ( I was out of strips for mine) and the ReliOn read 11 points lower than the AT2. Today was Goof's 4 th day with no juice, I tested him tonites after his dinner, we was 75. I'm hopeful!

 

All meters may read + or - 20% from what a lab would get. They aren't exact perfect measures.
If you really need to give a vet something, these are the 2 formulas you need
Human meter estimate = 0.65 * pet meter value
Human meter value / 0.65 = pet meter estimate

To read the Glucometer Notes in my signature, it may help to print a copy and black out what you don't need (mmol/L, for example, which is just another measurement system) or cut it into pieces and only focus on 1 piece at a time.