Feline Diabetes Pam Baker, D.V.M.
Special Thanks to Nancy Johnson
Dedicated to Delli, Harry(GA) & Leo(GA) Leo Gibson Harry Johnson /1/2000 Delli Baker
What are the typical clinical signs of diabetes?
Polydypsia
How much drinking is too much?
Polydypsia = water intake > 45 mL/kg/day A 4 kg cat should not consume more than 3/4 cup/ day
Polyuria
Polyphagia
Weight loss
Underwear fetishes?
“Temporary high blood sugars cause illness, low blood sugars cause death …”
Hypoglycemia lethargy increased appetite incoordination/staggering grumpiness nausea seizures death
Dandruff
Dandruff?
Hypoglycemia What clinical sign of hypoglycemia have we missed?
A cat with hypoglycemia may show no obvious clinical signs!
Daffy Baker
Testing Urine Glucose
Time Blood Glucose Renal threshhold - urine glucose will be increased at time A A
Time Blood Glucose Renal threshold - urine glucose will be increased at time B, even though the cat has become hypoglycemic! B
Testing Urine Ketones
- urine test strips check only for acetoacetone - strips DO NOT detect beta-hydroxybutyrate - add several drops of HYDROGEN PEROXIDE to the urine in a cup, then test
Why Test At Home?
Less STRESS
Stress HYPERGLYCEMIA Altered eating patterns potentially INACCURATE RESULTS
Testing at home most closely duplicates the normal daily routine of the patient.
Instant information 24 hours a day
Collect all the supplies before you begin glucometer test strips lancet lancet device cotton or gauze warming cloth treats
Place the cat in a comfortable spot
Marginal Ear Vein Work in a area with good lighting Use a flashlight or a desk lamp to identify the vein if necessary
Warm the ear!
Warm the ear - heat a damp washcloth in the microwave for 15 seconds - put the warm cloth in plastic bag
Load the lancet device (if using)
Insert test strip
- glucometer displays strip code, date & time
Apply firm pressure to the back of the ear (use gauze or tissue if desired)
Position the point of the lancet between the ear vein & the edge of the ear
Prick the ear
You may also use the back of the ear
“Milk” the ear to produce adequate drop if necessary
Hold the ear steady
Touch the test strip to the blood drop
Let the strip “suck up” the sample
Ensure the strip is “full” empty inadequate sample correct sample size
Proper filling of Fast Take strip
Apply pressure to the blood collection site
Fast Take Touch blood drop to the pad of the stick May also use a micropipette
Wait for the results
PRAISE!
Judge an animal’s response to therapy by clinical signs
Bayer Elite & Elite XL small sample size capillary action 3 minutes to get sample range = mg/dL may not indicate if sample is insufficient a beep does not mean there is enough blood
Lifescan Fast Take small sample size (2.5 uL) range = mg/dL 2 minutes to get sample no capillary action reading takes 15 seconds may get an unusually low number if insufficient sample
micropipette
Accu-Chek Advantage 4 uL sample capillary action strips additional blood may be added within 15 seconds range = mg/dL
Surestep blood is put on the strip & then inserted in the machine you can see whether the sample is adequate you can visually check the results by the colour change, if desired larger sample size required (10-30 uL) range = mg/dL
Abbott Precision QID 3.5 uL sample volume range= mg/dL can add more blood to strip if the first drop is not enough touch blood to strip
Microlet comes with Elite 3-dot depth is best
Softclix adjustable depth difficult to cap lancet after use
Websites of Interest
When increasing the insulin dose...
Can different insulins be mixed? Yes, but not all. Check the compatibility with the manufacturer first.
How do you convert Canadian (SI) units to US units? Canadian units (mmol/L) x 18 = U.S. units (mg/dL) X 18 =
How do the readings differ if the sample is capillary blood or venous blood?
Venous blood reads 7-15% higher than capillary blood
Accuracy of Glucometers amount of error increases with blood glucose level For the Elite: BGError 600 mg/dL-38% 400 mg/dL-20% 200 mg/dL-7% 100 mg/dL-2%