2. Feline Diabetes Pam Baker, D.V.M.

3. Special Thanks to Nancy Johnson

4. Dedicated to Delli, Harry(GA) & Leo(GA) Leo Gibson 1986-1999 Harry Johnson 1986 - 1/1/2000 Delli Baker

5. What are the typical clinical signs of diabetes?

6. Polydypsia

7. How much drinking is too much?

8. Polydypsia = water intake > 45 mL/kg/day A 4 kg cat should not consume more than 3/4 cup/ day

9. Polyuria

10. Polyphagia

11. Weight loss

12. Underwear fetishes?

13. “Temporary high blood sugars cause illness, low blood sugars cause death …”

14. Hypoglycemia lethargy increased appetite incoordination/staggering grumpiness nausea seizures death

15. Dandruff

16. Dandruff?

17. Hypoglycemia What clinical sign of hypoglycemia have we missed?

18. A cat with hypoglycemia may show no obvious clinical signs!

19. Daffy Baker 1982-1999

22. Testing Urine Glucose

23. Time Blood Glucose Renal threshhold - urine glucose will be increased at time A A

24. Time Blood Glucose Renal threshold - urine glucose will be increased at time B, even though the cat has become hypoglycemic! B

26. Testing Urine Ketones

27. - 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

30. Why Test At Home?

31. Less STRESS

32. Stress HYPERGLYCEMIA Altered eating patterns potentially INACCURATE RESULTS

33. Testing at home most closely duplicates the normal daily routine of the patient.

34. Instant information 24 hours a day

35. Collect all the supplies before you begin glucometer test strips lancet lancet device cotton or gauze warming cloth treats

36. Place the cat in a comfortable spot

37. Marginal Ear Vein Work in a area with good lighting Use a flashlight or a desk lamp to identify the vein if necessary

38. Warm the ear!

39. Warm the ear - heat a damp washcloth in the microwave for 15 seconds - put the warm cloth in plastic bag

40. Load the lancet device (if using)

44. Insert test strip

45. - glucometer displays strip code, date & time

46. Apply firm pressure to the back of the ear (use gauze or tissue if desired)

47. Position the point of the lancet between the ear vein & the edge of the ear

49. Prick the ear

51. You may also use the back of the ear

52. “Milk” the ear to produce adequate drop if necessary

53. Hold the ear steady

54. Touch the test strip to the blood drop

55. Let the strip “suck up” the sample

57. Ensure the strip is “full” empty inadequate sample correct sample size

58. Proper filling of Fast Take strip

59. Apply pressure to the blood collection site

60. Fast Take Touch blood drop to the pad of the stick May also use a micropipette

61. Wait for the results

62. PRAISE!

63. Judge an animal’s response to therapy by clinical signs

65. Bayer Elite & Elite XL small sample size capillary action 3 minutes to get sample range = 20-600 mg/dL may not indicate if sample is insufficient a beep does not mean there is enough blood

67. Lifescan Fast Take small sample size (2.5 uL) range = 20-600 mg/dL 2 minutes to get sample no capillary action reading takes 15 seconds may get an unusually low number if insufficient sample

68. micropipette

69. Accu-Chek Advantage 4 uL sample capillary action strips additional blood may be added within 15 seconds range = 10-600 mg/dL

70. 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 = 0-500 mg/dL

71. Abbott Precision QID 3.5 uL sample volume range= 20-600 mg/dL can add more blood to strip if the first drop is not enough touch blood to strip

73. Microlet comes with Elite 3-dot depth is best

74. Softclix adjustable depth difficult to cap lancet after use

75. Websites of Interest www.felinediabetes.com www.sugarcats.com www.petdiabetes.com http://members.atlantic.net/~bobj/earprick.html

77. When increasing the insulin dose...

78. Can different insulins be mixed? Yes, but not all. Check the compatibility with the manufacturer first.

79. How do you convert Canadian (SI) units to US units? Canadian units (mmol/L) x 18 = U.S. units (mg/dL) X 18 =

80. How do the readings differ if the sample is capillary blood or venous blood?

81. Venous blood reads 7-15% higher than capillary blood

82. 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%