Testing urine for glucose levels?

I am certainly NOT advocating glucose urine testing for people that can get blood easily or train their cat to accept the process of BG home testing. I know that blood testing is the most accurate and safest for any cat on insulin. I am simply asking the group if BG home testing is not possible, is urine testing a viable option if the cat is going to be kept on a very low dose of insulin? I am afraid the alternative is to just keep her on low carb diet and hope she does not get any worse without insulin. I do not feel comfortable putting her on insulin with zero monitoring at all.

I know urine glucose testing is far from ideal, but the more I attempt to get blood samples, the more I am only making my cat afraid of me. All I am succeeding in doing is training her to struggle and run away. She has never done that in her life. At this point if I were able to get blood samples, it would be after she is really stressed and it would not be accurate anyway.

I may try to see if I can “pretend” to get sample, ie. click lancet device (free hand won’t work for her), touch her ear like trying to get blood sample with meter, then stop before she tries to run and just pet her. I really do not think it is going to work though.

I have gotten 2 samples since I started trying to test. Today was the 3rd attempt and it is now to the point I am just scaring her. Now her favorite place where she gets brushed and petted has become a place she is afraid to go because of this.

I have not started insulin yet, have only changed diet but have seen great improvement over the last 10 days (less peeing, fur is soft not dirty looking, seems to be gaining a little weight) and the 2 tests I was able to do have been consecutively lower since diet change. Last one was around 250. I am hoping since she is now in relatively low numbers for an untreated diabetic cat, a low dose ie. .5 BID may be enough to get her into remission? If I am using urine testing would rather start her at .25 BID to be safe if that would do anything at all, maybe that is too low to do anything?

I can easily get urine samples once or twice a day, but they would be random times when she has to pee, not right before a shot obviously. There are sticks that test ranges, ie. Under 100, 100-250, over 250, etc.

See article here:
https://www.aaha.org/guidelines/diabetes_guidelines/urine_glucose_management.aspx

Thanks

 

This is where I'd start. Set up a desensitization and reward routine and practice it several times a day for many days. There are owners of semi feral kitties who have had success with that. @Djamila is one.

 

There are secondary monitoring tools such as urine testing, and they are better than nothing. They won't give you the information you need to guide the dose though.

My cat didn't tolerate human touch at all when he was diagnosed, so it was quite the journey for us. I can tell you that the single most important factor in getting us to where we are now, was what I chose to believe about home testing. I had to get myself to the point where I believed it would work, and I believed that the time and effort were worth investing to get us there.

Sam was not considered adoptable when I took him. The shelter told me it was unlikely to work and I should bring him back if it didn't and they would put him down. And I thought about bringing him back a number of times as he was super aggressive. So much so that for several months no one could come visit me because he would attack. He was not an easy cat to socialize since he was older when he was captured and fixed and had lived a fairly successful life as a wild cat, even surviving being shot at some point (still has a steel BB in his bum), so ample reason not to trust humans.

Adding to his aversion to human touch, Sam isn't a cat that doesn't feel it. You'll read a lot on here that cats don't feel the pain from the poke, and I believe that's true for most cats, but not for all cats. My non-diabetic cat can sleep right through a test - he honestly doesn't feel it. Sam does. So I had to get him used to being handled, and get him to trust me enough to endure the poke and stay still enough to get the test done. I assure you though, if I could earn this little wild cat's trust and move forward with regular testing, anyone can.

Start with desensitizing. Take Honey there six or seven times every day. Sit her down, rub her ears, give her a treat, and then let her go. Build positive association and safety. Do this for a day if that's enough. A few days if she needs more time.

As soon as you can, add in the click if you really feel you need to use the device. There is honestly no reason why you need to use it though. If it's a matter of it being difficult for you to hold just the lancet, a lot of people put the lancet in the device, and then take the cap off so they can see the needle location better, and free poke. If you're worreid about poking all the way through, don't be. We pierce our kitties ears all the time around here. You'll learn to gauge the depth better as you get used to this, but if you go all the way through it doesn't matter. However, if the click doesn't scare her, then by all means keep using the device if you're more comfortable with it.

Once she's used to the place, touching her ears, clicking the device, and getting a treat, then add in warming the ear. If the ear is warm, the blood sample is easier to get. So use a baby sock, or a little bit of fabric tied into a bag with uncooked rice in it. Warm it in the microwave before you bring her to the testing place. Bring Honey over, warm her ear with the rice sock, click the device, give a treat, let her go.

Remember you are repeating these habits many times every day. Without fail. You have to build association and trust. And you have to be consistent. Cats are creatures of habit. They become comfortable and secure in routines. They are scared when routines are broken. So build the habit so Honey knows that she can trust you.

At this point you are probably about a week in (you may be able to go faster since she already trusts you - or you may need to go slower if you are anxious - part of all of this is calming down the human since cats read our anxiety and doubts and respond to those). Now you are warming her ear and she is used to the click. It's time to do the test. Put a test strip part way into the meter. Warm her ear. Push the strip the rest of the way in to turn it on. Poke and "milk" her ear to get a little bead of blood, and have the test strip suck it up.

If it works, great! Give her a treat. If it doesn't work, don't stress. Give her a treat anyway. Let her go. Wait ten minutes and bring her back and try it again. The kitty always gets the treat, regardless of if the test works or not.

In the earlier days, there were many many failed tests at my house. Often because Sam was simply not one to hold still. So he would take off, or just wiggle too much for me to get the test before he flicked his head and the blood was gone. So I would give him a treat (always at the testing station - if he took off, he had to come back to get the treat), take a break, and then bring him back and try again.

If I got frustrated, he would read that and hide. It is so incredibly important for the human to be in a calm, confident, determined state of mind through all of this. I used to repeat calmly to myself and to Sam, "we will get this test done. it will keep you safe. we will find a way". I also found it helpful to recite poetry to keep myself from stressing about the test. Other people listen to music or sing softly. And I would put a pot of cat grass in front of Sam so he had a little distraction as well.

Everyone finds their own habits and tricks that work for them and their cats. It takes some time. and some persistence. and a lot of low carb treats (or brushing if your kitty is more motivated by that). I assure you though that you can find a way that works for you and Honey.

 

Thanks for the advice. I give you an awful lot of credit for doing this with a semi-feral kitty. My cat is a very mild mannered, calm kitty (or was for the last 7 years, before this) and the way this has been going has made her skittish. I think it is going in the wrong direction because maybe I went too fast not “training” her to get used to each step. I have been able to get blood a couple times, but she now takes off running right after I stick her ( maybe she hears the device and the click is scaring her), so the main problem now is not being able to get test strip to the blood on her ear because she is now running and hiding, which she has never done before. I am using device because tried freehand and she won’t tolerate me holding her ear for long, with device I can stick her from “mid air” not holding her ear. This morning I stuck her, she took off, I caught her and tried to get strip to the blood (which was already drying by then) she moved her head and escaped and all I got was a little blood on my shirt! I will keep trying by implementing “training” her to get tested. Not sure if I should hold off starting insulin at this point. I really was hoping I could get her under control with diet alone, but I know that is not likely. Also from research I did, urine strips will only show glucose above 180, anything lower won’t be detected, so you won’t know how low below 180 it really is. That sucks, I thought that might have worked. Thanks again!

 

This is excellent, Djamila!

 

I've never tried this myself, and maybe it has already been suggested... Some people don't try to wick up the blood on the ear but instead transfer the drop to a fingernail and use the strip on that. This might help when you can draw blood but she won't hold still for the time needed to directly collect the sample.

For what it's worth, after washing my hands I run hot water over my fingertips and that seems to work well enough for warming my guy's ear. This saves me from one more object to juggle in the process.

I feel so bad for you. It was just horrible, when we were at a bad point in learning how to test, to have my Thomas actually run away when he saw me.

 

Thanks for the support. I will hopefully figure something out that works. She is always so laid back, even at the vet, I did not anticipate her running away or fighting me on this. Figured she would just sit there and let me stick her, guess mommy is not as smart as the cat...