Switching From AlphaTrac 2 to ReliOn Prime

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Summer and Susie, Jan 19, 2021.

  1. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Hi folks,

    I will be switching from the AlphaTrac 2 meter to the ReliOn Prime meter on Thursday, January 21st. I have received some good tips regarding the switch and want others who have made the change to add their thoughts and recommendations. Thanks! By the way, my kitty is still on the Vetsulin and I will be keeping her on that for a little longer.
     
  2. Pookie

    Pookie Member

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    Oct 10, 2020
    Hi Summer! We've chatted about this on earlier threads so I won't repeat myself here. I just wanted to mention that this language from HOW TO CREATE A SPREADSHEET was helpful for me when I made the switch:

    3. If you switch from a pet meter calibrated for feline blood (e.g. Alpha Trak) to a human meter, or vice-versa, please PM me and I will be happy to help you modify your current SS so you won't have multiple SS links (the board limits how many you can have). It also allows those helping you to view the BG history easier.
    Updated January 18, 2021 by Marje and Gracie

    I asked Marje via PM and she was kind enough to make the change to my spreadsheet so the reference numbers were correct.

    E
     
  3. Summer and Susie

    Summer and Susie Member

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    Marge, I remember the conversation and I thought I sent you a message earlier today to help me convert the SS for this Thursday. Maybe it did not go through but I thought it was sent directly to you. Thank you for updating my SS!

    Enid, sorry. I thought this was from Marge. I sent her a message and hope she received it.
     
  4. Mariette

    Mariette Member

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    Nov 15, 2020
    I switched as well. You can take a look at the remarks section in my 2020 spreadsheet. I tracked the differences in readings for a few days around Deceomber 1 as I was preparing for the switch. I also had a Contour Next and felt that there was a much better correlation between the Relion and Alphatrack than the Contour and Alphatrack. So it gave me some peace of mind with the switch.

    I also switched insulin at the same time so the blood glucose numbers in the spreadsheet aren't all due to the meters.
     
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  5. Mariette

    Mariette Member

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    Wanted to add the Relion actually gave me higher readings than the Alphatrack on occasion so that's not a typo in my spreadsheet.
    Also you do need more blood for the Relion. I did miss that aspect of the Alphatrack.
     
  6. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    I am considering switching to the Lantus but did not want to make two changes at once. I'll watch the numbers with the ReliOn for a while then speak to my Vet, and this board, about the insulin conversion. Thanks for the info and I'll look at your spreadsheet.
     
  7. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    That is my biggest concern - that I will need more blood. I might not stay with the ReliOn but heard it was a more accurate meter. Please explain what TR is and what SLGS means? I still do not understand and saw on your spreadsheet "No more TR - looking for a safe dose". Buddy is looking good compared to 2020!
     
  8. Mariette

    Mariette Member

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    TR and SLGS are the Lantus dosing protocols:
    https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

    Buddy suddenly started needing less insulin in a hurry so I felt I needed to abandon the TR (tight regulation) protocol at that point. I had to reduce him quicker than the protocol allows for. But it really helped to get us get to that point.
     
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  9. Summer and Susie

    Summer and Susie Member

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    Another scary aspect. When numbers really start to go low. Looks like he is OTJ. Congrats! Wish I could just get Susie down to around 90 and keep her there so I don't have to worry about hypoglycemia and testing late into the night.
     
  10. Mariette

    Mariette Member

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    Not officially otj. You do a trial first... watch the numbers for two weeks. I'm very hopeful though! Thank you :)

    I know what you mean... I also wanted to keep Buddy flat and green. Unfortunately they never do what we want. Ideally they should be 50-80, but I hear you. It gets really scary when it's dropping low and you know it's the insulin. Lantus is supposed to be more gentle (flatter) curves than the Vetsulin so it might be a better insulin for your nerves.
     
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  11. Summer and Susie

    Summer and Susie Member

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    One more question for you. I read your attachment about the TR and SLGS. Both cases recommend testing for ketones. Are these just test strips that you get their urine on? Should I be testing for ketones now or only worry about that when the numbers start to go low? Thanks. You have been a big help. I'm impressed that it looks like you haven't been on this site long and you know so much. I feel like I am never going to understand all of this.
     
  12. Mariette

    Mariette Member

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    Yes, it's those urine strips. You should actually test when the numbers are higher. So it's a good idea to test now if you can.

    I'm definitely not an expert at this! But as I'm sure you realize you have to do a ton of reading on here and looking at other people's spreadsheets to get a grasp on what's going on. Your cat will do their own thing but referring to other spreadsheets can help you a great deal. Insulin is a scary powerful medicine and you're the only one who can keep your kitty safe.
     
    Last edited: Jan 19, 2021
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  13. Summer and Susie

    Summer and Susie Member

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    Thanks!
     
  14. Mariette

    Mariette Member

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    i just realized the normal values I told you 50-80 is for the human meters, not the Alphatrack!
     
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  15. Summer and Susie

    Summer and Susie Member

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    I guessed that. I think I read that I needed to be concerned if her numbers dropped beneath 90 with the Alphatrac. I might be confused (as usual) because I have read that the AlphaTrac numbers tend to read higher than human meters but you said sometimes you would get higher numbers with ReliOn than Alphatrac. Can I ask one more question? I see you are in LA. What do you feed your kitty and how often? I feed Susie the Fancy Feast Classic Pate.
     
  16. Mariette

    Mariette Member

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    Yeah I did get some higher readings. It's not supposed to be the norm. But I thought to mention that, because from everything I've read Relion was supposed to consistently read lower. There is supposed to be a margin of error you should expect for both meters.. I think 20%. So that could maybe explain it.

    For what it's worth I'm really glad I switched to the Relion. I didn't realize how often I'd be testing. The lower the numbers go the more I wanted to test to make sure he stayed safe. And both meters would sometimes error out on the strips. The Alphatrack was obviously more infuriating because of the price of the strips. Relion seemed to only error out when there wasn't enough blood for the test. You'll get to recognize when it's enough.

    I went crazy with the food ordering initially. I gave away all the gravy stuff I had only to realize that I should have kept those for the 'hypo toolkit'. Ideally you want some combination of medium and high carb food for those emergencies. As well as some honey or Karo. I also ordered some feeding syringes just in case I needed them to administer the karo.

    I feed a vaiety right now. I like him having some stuff to chew as well as the pates so I have some of the Fancy Feast Purely also some of the Tiki after dark. Then I give Fancy Feast pates, Tiki pates, Koha rabbit, Sheba, also some Fussie cat. I read they're not supposed to eat fish too frequently and I had a lot of those initially so filled out with more options.

    He's supposed to lose weight and I'm trying to keep better track of that now, but I've let it slip a bit. When the numbers go low you kind of just want to get food in them to keep them safe.

    I made a spreadsheet to help me calculate the total calories a day:
    https://docs.google.com/spreadsheet...qTVlkoET9-mVyVYediwqe1H9n19ggFPZPM-6X/pubhtml

    Buddy's close to 19 pounds and he has to get back down to 14. So he probably eats way more than normal right now.
    With the Lantus you have to feed right before the shot. I think with Vetsulin it's a bit different. And then I fed him smaller amounts through the day.
     
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  17. Mariette

    Mariette Member

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  18. Summer and Susie

    Summer and Susie Member

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    Alphatrak strips are like 5 times more expensive than ReliOn so that is one of the reasons I switched. Plus, this site doesn't want members to use the AlphaTrac. I had so much cat food before Susie was diagnosed. I have kept it all including the Fancy Feast Gravy because I did hear that was good for the Toolkit. I also have the Karo syrup. Susie really misses her Purina dry food but I won't go back to dry. Buddy is a big kitty at 19 lbs. My Susie is currently 14.56 but I have been told by my vet that I need to get her down to 10 lbs which seems excessive. She will be 9 in April and I have seen too many old cats wither away from weight loss. I didn't want that to happen to her but now here I am with a diabetic cat. My mistake.

    Thanks for all the food information. I did not know that I shouldn't be giving too much seafood. She seems to like that best. She seems happy with me just feeding her and trying to stretch her dinners out 12 hours has been the hardest for her. She was used to being fed around 6:30 am and then again around 3:00 pm. Plus she had Purina dry to graze on. I am trying to supplement her diet with Whole Life treats during mid day but I sometimes wonder if she doesn't get enough carbs. Anyway, thank you again for your support and all the information. I will take all this one day at a time.
     
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  19. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    @Mariette -

    I'm so glad to hear how well Buddy's doing! You've done a terrific job of managing his diabetes. :cat:


    Mogs
    .
     
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  20. Mariette

    Mariette Member

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    I also have the dry food regret with Buddy. That may have been a big factor that brought on the diabetes for him too. He used to be feral and much preferred the wet when he was outdoors. We brought him inside last April and also left out the dry to graze on. Just so he'd have a sense of food security along with being trapped inside for the first time. But I had no idea how how carb those were. And of course he started going for it more and more. To the point of ignoring his wet food... except for lapping up the gravy. So obviously he had become a carb addict.

    One day at a time is the only way to tackle this. There's only so much you can learn a day.
     
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  21. Mariette

    Mariette Member

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    Thank you Mogs! :bighug:
    I couldn't have done it without this forum. And Buddy being such a trooper.
     
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  22. Summer and Susie

    Summer and Susie Member

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    Susie just had her lowest score, ever, this late in the day. Is all of this just the inter-day variablility? I cannot figure out her nadir. Is it +4, +6 or now +9? Does it just take a lot of time to figure this out or does the insulin actually start to help better with time?
     
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  23. Mariette

    Mariette Member

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    Nov 15, 2020
    So happy to hear that!

    I'm afraid I'm totally clueless about Vetsulin. It seems every type of insulin is their own unique monster that you have to get to know. You should call on the Vetsulin specific forum for dosing and nadir advice.
    https://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/

    With Lantus the nadir is usually at about +6. I think it's supposed to be earlier with Vetsulin. But then you have to factor in how the food can effect the numbers too. It's a lot!
    With Lantus there's also the 'depot' you have to keep in mind. It's like a little reserve tank that is proportional to your regular consistent dose. So that complicates things even more! But that's also what helps the numbers stay a bit flatter as far as I understand.
     
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  24. Summer and Susie

    Summer and Susie Member

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    Thanks, Mariette. I don't know if I am happy about this or not because I thought I was getting to a point where I could figure her nadir out and this just throws everything off track.

    I wanted to say to you that I admire you for taking in a diabetic stray. It is always commendable to take in a stray but one with major health issues makes you a Saint. Bless you for your care of Buddy. He is one lucky kitty.
     
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  25. Mariette

    Mariette Member

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    Aww thank you for your kind words.
    He wasn't diabetic when I took him in. So I inadvertently caused it :( Either with him getting neutered or the dry food or the sudden decrease in activity.

    You'll find your way through this diabetes maze. You're definitely at the right place and doing all the right things for Susie. Good luck and just keep asking folks on here questions if you're unsure. There's a lot of people with way more experience than me on here.
     
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  26. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I just want to correct this for any other new members that are reading it.

    On the FDMB, we do not tell members what meters they can and cannot use. I, myself, have an AT that I occasionally used. We have many members here who continue to use the AT. If we suggest members use a human meter, it is for two reasons:

    • it’s much cheaper
    • our dosing and methods of regulation are based on the use of human meters
    Neither one of the above prevents any member from continuing to use a pet meter. If this site did not want members to use them, we wouldn’t have spreadsheet templates for them.

    Just sayin ‘.
     
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  27. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    On your Sticky Dosing Methods: SLGS and TR it states "THE USE OF PET-SPECIFIC METERS IS DISCOURAGED BECAUSE THE DOSING METHODS USED ON THE FDMB WERE CREATED WITH METERS CALIBRATED FOR HUMANS. ALL REFERENCED NUMBERS CORRESPOND WITH METERS FOR HUMANS, NOT PET METERS." I am switching because the AlphaTrac test stips are five times more expensive than ReliOn, I have seen a few cases where it is stated that numbers are higher on the AlphaTrac and I thought this is what the board preferred I do.
     
  28. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Yes, I know. And that’s exactly what I said. Read my post again. It refers to dosing and regulation methods.

    It’s up to you whatever meter you want to use...anyone advising will adjust their info to accommodate that.
     
  29. Summer and Susie

    Summer and Susie Member

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    Big problems using the ReliOn Prime this morning. The first time I tried I got a really low number of 80, then a 99, then I didn't push the strip in enough then I didn't get enough blood and lastly I got no numbers even though the strip was pushed in all the way. Poor cat. After all that she just bolted. I tried again at 1+5 and got a reading of only 98. All these numbers are significantly lower than what I would be getting for this time of the day on my AlphaTrac 2. I did notice after getting the blood that my display had an arrow flashing to the right next to the picture of the test strip. I did not see anything about this in the manual and wondered if it was a normal reading. For all you folks who use the ReliOn Prime meter do you also get this right flashing arrow after getting a result? Thanks so much. The meter is much harder to use than the AT. Requires more blood and it harder to push the strip all the way in with one hand when you are holding your cat with the other.
     
  30. Summer and Susie

    Summer and Susie Member

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    Marje, I just got a 94 @ +6.75. I guess if we are relying on the ReliOn meter, and she gets another score in the 90's for her PMPS, would I give Susie a shot after her dinner tonight? I do not want to be up 4 or 6 hours after her evening shot to check her blood. I just don't understand this massive difference in the blood glucose meter readings.
     
  31. Pookie

    Pookie Member

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    Hi Summer. Let me preface this by reminding everyone that I'm a newbie, but ...

    I see on your SS that Susie has had readings in the low 100's using the AT2 (and that lovely 102 on 1/9!). Given that the human meter reads lower than the AT2, I guess I'm not too surprised to see high 90's with the ReliOn. If I were in your place, I'd take a reading with the AT2, too, just to see what it comes up with.

    I don't use that model, but I did find an online manual -- it seems the arrows to the right of the test strip drawing are "insert" and "remove" reminders:

    upload_2021-1-21_13-8-33.png
     
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  32. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Thank you so much, Enid. I did see that diagram but never saw the explanation of the flashing arrow. I just ordered new strips for my AT2 (expensive) because I wasn't sure about the accuracy of the ReliOn. Just seems really weird that the numbers, between the two meters, are so totally different and that I haven't had the "bouncing" like I did with the AT2. I really questioned the ReliOn today but maybe I should have been questioning the AT2. How do you know which one is more accurate? My gosh, our cats lives depend on these meters and the dosages. When I look at her numbers with ReliOn it scares me to think that I was going to up her insulin dose. If the AT2 was that inaccurate I could have killed her with upping the dosages. Thanks so much for "having my back"! By the way, if Susie's PMPS is in the 90's this afternoon do I still do a shot? Now I'm getting concerned about low numbers.
     
  33. Pookie

    Pookie Member

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    I'm not sure that one is more accurate or reliable than the other. For instance, if the hypo range on an AT2 starts at 67 and the hypo range on a human meter starts at 49, then that's a spread of 18 points. So I figure if you add 18 points to today's reading of 99 and you get a sort-of-equivalency on a pet meter of 117-ish. Susie's been in the neighborhood before with readings taken from the AT2.

    I don't have the experience or knowledge to be able to "read" your spreadsheet and will leave that to folks who can (@Marje and Gracie or @JanetNJ) and I'm sure not going to give dosing advice!

    But, I will say that while I was dosing Lola I took the guidance from the dosing guidelines (Prozinc, in Lola's case). Here's the language from
    BEGINNER'S GUIDE TO CANINSULIN/VETSULIN:

    The general guidelines for making dose changes are:
    • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
    • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
    • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
    • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
    I only did one low shoot with Lola. She was at 114 at AMPS. I debated whether or not to shoot and decided to go ahead, largely because it was a reduced dose and because it was AMPS, I had plenty of test strips and I was going to be around. (I would not have done so at PMPS.) As it turned out, Lola's BG dropped 40% in 90 minutes and we had to start feeding her medium carb food to slow her descent. We kept her out of hypo range by doing so, but it was all the excitement I needed for the day. In fact, that day's PMPS turned out to be day 1 of Lola's OTJ trial, that that low shoot turned out to be her last injection :cat:
     
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  34. Summer and Susie

    Summer and Susie Member

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    I did ask Marje, earlier in the day, about whether I should give Susie a shot this evening if her glucose was still in the 90's. Turns out her +9.5 was at 104 so she is going up. I will do her PMPS around 5:00 and if it is higher or about the same I may go back to 1 unit instead of 1.25. I just don't want to worry about her all night long. I have not heard back from Marje. What a difference a day makes. All this time I have been worried about high numbers and now I'm worried about low numbers. Congrats on Lola being OJT. Sounds like you had to weather the storm on that last day before you got there. That is my biggest fear. The low numbers. Thanks, Enid.
     
  35. Critter Mom

    Critter Mom Well-Known Member

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    Categorically no. That would be WAY too low a preshot for Vetsulin.

    If you get a preshot lower than 200 on the human meter, do not feed, stall for 20-30 minutes and test again to see whether Susie's BG has risen high enough to give the next dose. While you're waiting, it would be a good idea to post for help. Include in your thread title the current date, a note that you are stalling and need guidance on Vetsulin dosing.

    Here's the link to the FDMB Vetsulin Guide. It has more information on stalling, etc.

    I suggest you hold the current dose until you get used to the new meter. Then I'd suggest you post asking for members with Vetsulin experience to review the spreadsheet and give you some input on dosing.


    Mogs
    .
     
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  36. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Thank you, Enid, for helping Summer but I want to be sure and clarify this. There is no such thing as a “hypo range”. The reduction point for the AT is below 68 but that does not equate to below 50 on the human meter. The two meters are not equivocal at any range. Also, when we discuss “hypo”, we mean a BG low enough to cause symptomatic hypoglycemia. While ECID, I have seen many cats, and my own cat, in the low 30s on a human meter without symptoms. That doesn’t mean I didn’t quickly react to get her BG up and we all should. But we do not set any specific BG or range here as “hypoglycemic”. I hope that helps.

    I’ve been out all day. You might consider posting on the Vetsulin/Caninsulin insulin support group of this forum. There are members there that are used to using the insulin and can help more with dosing.
     
  37. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Summer sent me a PM and asked this question. I’m posting it here to answer so as to not violate board policies.

    Yes....when her BG has risen over 200 without having fed within two hours.
     
  38. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Seems so contradictory. I understand the delay in the shot but if the BG is low why would I not feed and then monitor?
     
  39. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    It’s not contradictory at all. If you have any intention of shooting, you don’t want to feed because it can cause a food spike. If you then shoot a higher BG from a food spike, there is potential the BG will then drop quickly at onset.
     
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  40. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Okay. Hard to understand this one when we are told to supplement the diet with high carbs or karo syrup if the glucose is really low. I guess it has to do with shooting or not. I will try to understand. Give me some time and thanks for getting back with me.
     
  41. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Really low is not around 200. 90s are not really low. As an example, if a member using Lantus gets a 40 at shot time, the advice is to not feed, retest in 20 mins; if the BG is not higher then feed a tsp of LC (not HC or syrup). If the BG is in the 30s, you definitely need the big guns like karo.
     
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  42. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Does LC mean low carb food? So If I am using Vetsulin and I get 90 (or is it 68) or lower at pre shot I should wait about 20 minutes then retest. If the number is not higher I would give her a tsp of low carb cat food. If the number has dropped then I should rub Karo on her gums or give her some gravy type food? Thanks for your patience.
     
  43. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    LC is low carb, yes.

    I gave you an example for Lantus, not Vetsulin, just to show you what constitutes “really low numbers” in reference to your question in post 40 above. My apologies if I did not make it clear that there was no intent for you to extrapolate that information to using Vetsulin.

    I also received another PM from you and am posting it here so all can see but have to ask, again, that all questions requesting advice be posted in your threads and not in PMs.

    Nadirs can vary but if you look at the information on Vetsulin Dosing, you are seeing nadirs that would have you continuing to hold the dose. You also don’t have any data for nighttime nadirs so I’m not comfortable advising for any dose increase.

    As I have before, I’d like to suggest you post in the Vetsulin/Caninsulin/Normalin Insulin Support Group and read the stickys there. There are members who have a better familiarity with dosing Vetsulin. Thank you so much.
     
  44. Summer and Susie

    Summer and Susie Member

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  45. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You’re welcome. :)

    Also, if I could ask, please, if you can update your signature block to take out the AT meter and add ReliOn meter, that would be really helpful. Thanks again.
     

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