Marianne's Pebbles - In Hospital TA&M 10/20

[Dollydog]

Re: pebbles vet visit for her eye

Happy Easter!
I have an AlphaTrak but have only used it a few times. Our vet in Nevada used an AlphaTrak on Lady all the time so that was the only measurement we ever had for her blood glucose. The difference between your 2 meters is interesting and I'm looking forward to Natalie's response.
Jo-Ann & Lady

[k9diabetes]

Re: pebbles vet visit for her eye

I am not sure about control solution for the AlphaTrak since it is adjusted for dogs. I don't know if they make an adjusted control solution.

Do you have the meter coded for dogs? Just want to make sure as AlphaTrak has one code for cats and one for dogs.

What I don't like about the AlphaTrak and all of the animal-adjusted meters is that they do not read the glucose level more accurately. They rely on an artificial adjustment that is based on an average of some number of tests in a group of dogs, I forget how many they used... and then they take an average of the difference in the meter's readings and the lab analyzer values from those tests and they "adjust" the meter to raise the reading to the average amount difference.

So say you have the following group of dogs tested on the meter that will become the AlphaTrak and on a lab analyzer:

Dog 1 - Meter 85 - Lab - 85 - difference = meter 0 low
Dog 2 - Meter 100 - Lab 130 - difference = meter 30 low
Dog 3 - Meter 115 - Lab 165 - difference = meter 50 low
Dog 4 - Meter 120 - Lab 190 - difference = meter 70 low

The average difference is 37.5 so they would adjust readings in that range on the meter to be 38 points higher. Not so bad for Dog 2 but not so great for Dogs 1 and 4 especially.

The adjustment has no bearing on actual blood sugar.

In addition, they tested very few diabetic dogs so most of their tests were done mostly on normal blood sugar ranges with only a few dogs giving BGs in higher ranges.

Let me see if their test data is still available... it is: http://www.abbottanimalhealth.com/do...alid_Study.pdf

Of the 239 dogs they tested, only 53 were diabetic.

Also, if you take a look at their own chart, all those red dots high above the mean line are AlphaTrak readings that were higher than lab values.




This all came from http://www.abbottanimalhealth.com/ve...ng/index.shtml. Click on Download Clinical Trial to get the study date.

That said, I've found the AlphaTrak to be pretty consistent for Chris. I ran a long comparison, which showed that AlphaTrak was pretty consistently 30-40 points higher than my OneTouch Ultra, which is the same as the numerous OneTouch Ultra to Lab Analyzer comparisons I've done.



Long story short, I still prefer, no matter what meter you use, that you have some comparisons done of the meter versus a lab analyzer as that is really the only way to know how far off your meter might be, even if it's an AlphaTrak.

I have noted, also, that it seems like Freestyle works better with small dogs. I'm not sure why that is but I've seen it be very close to right on with some small dogs. It did not work as well for us. Was off by more like 60 points as I recall.

As far as cost, if your vet will sell you the strips at cost, that's probably the cheapest. There are other sites where they can be purchased.

Medi-Vet... I think this is where I bought them.
http://www.medi-vet.com/SearchResult...ords=alphatrak

The price was better than the one offered by my vet... wasn't impressed with her wanting to take a huge cut on that cost.

Hope that helps!

Natalie

[rhodesian46]

Re: pebbles vet visit for her eye

Natalie,
I know that they have a control solution I checked and I am coded for dogs(7)
I just don't understand the large point difference even when she was 117 Bg on freestyle she was 196 dog meter, Could the strips be bad? Maybe the meter got thrown around by UPS in route? If Pebbles was in fact 446 an hour after she ate on dog meter than I would of noticed a big increase in water intake. Do you advise me not using this meter until I get some control solution? I hate to waste the strips I was thinking if Texas A & M can get me her dogfood cheaper they probably can get me the strips and solution cheaper as well Will call tomorrow for sure.Her Bgs are higher than normal today even using the freestyle. I took her off the Cephalexin as it is not helping her bacteria skin infection ( on Fri eve)I wonder if stopping the Cephalexin that that could of made her Bgs go up? She has been on that for 5 weeks or more.I guess I am having a hard time (if the dog meter is correct) accepting that her Bgs are really that high if correct.I wish we knew of someone who has a freestyle freedom and a dog meter Her third eyelid has not retracted back yet She has only been on med for 2 days Does it take time?

[k9diabetes]

Re: pebbles vet visit for her eye

I really can't say what may be causing the difference - Yes, the test strips and/or the meter could be bad. It could also be that the AlphaTrak adjustment is not appropriate for Pebbles.

If your Freestyle is reading her BG pretty accurately, then the adjustment made in the AlphaTrak could be artificially raising the readings.

If you have urine test strips, you could test the urine and see which reading it confirms. That works best when the blood sugar is down in lower numbers, so if the AlphaTrak said 250 and the Freestyle said 160, the urine test could confirm which was correct based on whether there was glucose in the urine. Positive for glucose would confirm the AlphaTrak and negative would confirm the Freestyle.

I don't know what Pebbles is like. Chris' drinking doesn't increase noticeably until his blood sugar is well over 400, closer to 500. That's why we could never use pure observation to monitor his regulation. Pebbles may be the same but I can't recall if this has been sorted out since you need to be doing testing and noting the BG when the increased drinking occurs.

See what you can confirm with urine strips and then the best thing to do is to take both meters to the local vet and have him/her run a blood sample and test both of them against the lab analyzer. If you're lucky, they have an in-house analyzer and could test just her glucose right there on the premises rather than having to send it out.

Last time I did this I tested Chris with my meter myself just before the blood draw and just after. Then they ran the sample they drew in-house. My two tests both came within 35 points of their test.

If the eye isn't better by Monday or Tuesday, I do think the ophthalmologist is indicated. I've just seen too many conditions that have gone undiagnosed by general vets. There are other possibilities for the eyelid being up besides infection and the ophth. can test her eye pressures and see if they are low, suggesting the possibility of noninfectious inflammation.

It does seem like antibiotics can affect blood glucose. I can't give you any objective information on that; it's just something I've observed in Chris.

Refresh my memory on the skin infection - what symptoms does she have?

Natalie

I just don't understand the large point difference even when she was 117 Bg on freestyle she was 196 dog meter, Could the strips be bad? Maybe the meter got thrown around by UPS in route? If Pebbles was in fact 446 an hour after she ate on dog meter than I would of noticed a big increase in water intake. Do you advise me not using this meter until I get some control solution? I hate to waste the strips I was thinking if Texas A & M can get me her dogfood cheaper they probably can get me the strips and solution cheaper as well Will call tomorrow for sure.Her Bgs are higher than normal today even using the freestyle. I took her off the Cephalexin as it is not helping her bacteria skin infection ( on Fri eve)I wonder if stopping the Cephalexin that that could of made her Bgs go up? She has been on that for 5 weeks or more.I guess I am having a hard time (if the dog meter is correct) accepting that her Bgs are really that high if correct.I wish we knew of someone who has a freestyle freedom and a dog meter Her third eyelid has not retracted back yet She has only been on med for 2 days Does it take time?

[rhodesian46]

Re: pebbles vet visit for her eye

here is her curve for today Not as good as last week.
5:30 AM-fasting 234 Freestyle 350 Alphatrak-fed,gave meds-new bottle of insulin
6:30 Am- 330 freestyle 446 alphatrak then walked 15 mns gave 2 baby milk bones
8:30 AM-239 Freestyle new bottle of strips
10:30 AM- 272 freestyle
12:30 PM- 266 freestyle
2:30 PM-201 freestyle
4:30 PM- 199 freestyle 280 alphatrak 100mg/dl(diastix)
So here is a prime example of the urine strips reading really low but Alphatrac said 280.
Pebbles skin infection is that I can pull her hair off her like skinning an animal The baldness has a yellow crust around the diameter Dr Stone looked at it in Dec and said it was a bacterial skin infection She doesn't have a lot of bald patches but what she has they haven't gotten any better Her eye is not bothering her a bit. I am hoping it can wait till I go to the appointment on 4/16 If the eye pressure is low what could it be? I mean what could a noninfectious inflammation be?

[k9diabetes]

Re: pebbles vet visit for her eye

I don't know what all might cause eye inflammation.

Mature cataracts is one source. Pretty much any time a diabetic has fully developed cataracts they will have inflammation - the lens breaking down generates it. Chris is given daily eye drops (diclofenac or Voltaren) to control that, which has worked well for him. He must use them for the rest of his life.

From Veterinary Partner.com (http://www.veterinarypartner.com/Content.plx?P=A&C=&A=1945&SourceID=)

When a cataract is ?hypermature,? it is starting to actually liquefy and dissolve. While this can actually lead to the restoration of vision which sounds like a positive turn of events but the dissolution process is quite inflammatory.

Uveitis is inflammation of the uveal tract of the eye, which consists of the vascular tissues of the eye. In simpler terms, uveitis is the inflammation that results when the hypermature cataract begins to liquefy.

Did the vet do a tear test where they put a little strip of filter paper between the eyeball and the lid to check the amount of tears she can produce?

Dry eye is pretty common in diabetics and usually easy enough to manage with a lubricating ointment.

As for the skin infection, did they scrape and culture it to see what kind of bacteria it is and whether it is susceptible to cephalexin?

I would think, if it is in limited patches, that they would perhaps have you apply an ointment directly to the patches.

How big are the bald areas?

[Kiska'smom]

Re: pebbles vet visit for her eye

Hi Marianne,

I'm so glad that Pebbles is doing better! With everything else that you do, eye-drops should be a snap!

Jeanne and Kiska

[eyelostit]

Re: pebbles vet visit for her eye

Always good to hear good news!!!, I know you are happy!!

[ladysmom06]

Re: pebbles vet visit for her eye

Hi Marianne,

Just checking to see how Pebbles eye is doing. Hoping everything is going well. Hugs to you and the gang.

[rhodesian46]

Re: pebbles vet visit for her eye

Hi everybody,
Couldn't get on this site last night! Pebbles eye has not gotten any better. She does care that it looks the way it does. I think the other eye is starting to do the same but not as bad. Her IMS Dr Stone e mailed me today and said that he would check her eye out in April So I think he doesn't feel that it is a dire emergency But I have been a lttle ditsy Remember when I told ya'll thatthe Alphatrak was way off WELL I called the tech at Alphatrak today We used the control solution meter and strips were fine. BUT I WAS GETTING THE BLOOD INCORRECTLY!!! WITH A HUMAN METER I HOLD IT TO THE SIDE With the dog meter you are supposed to let the blood go on the side of the strip. yes it did give me incorrect results. Tonight at fasting she was 137 freestyle 187 Alphatrak Will compare this Sun for her curve. Meanwhile I sent the curve to Dr stone He replied that they may do a curve in April since the differences in meter were so great. I e mailed him just now an said I feel real stupid. I was doing it wrong! NatALIE THE VET LAST WEEK DIDN'T DO A TEAR TEST ON PEBBLES! Just a yellow dye in her eye.The bacteria skin infection is about quarter sizes. Dr Stone said today thatI should take her off the Cephalexin he will do a skin culture in April. he doesn't want me to increase insulin as he says that we may see a reduction. So she is at 49 u BID now.
Marianne and Pebbles

[k9diabetes]

Re: pebbles vet visit for her eye

One thing I dislike about the AlphaTrak is the channel that takes up the blood not being visible.

And one thing I always liked about the OneTouch Ultra is the entire channel you fill with blood is visible and the meter errors out rather than gives a bad reading if it's not filled properly. If there's even a tiny bit too little blood, it gives an error reading.

...

I just realized... 137 and 187!!! Those are great readings!!!!!!!

Natalie

[Ricksma]

Re: pebbles vet visit for her eye

Yay Marianne....don't feel bad about not doing it right...that is my one complaint about the Alpha Trak....the strips don't have the capillary action, and won't "sip" the blood onto the strip. It is a little difficult to get the blood in just the right spot, so you aren't the only one who has ever had this trouble. Just glad you got it worked out....
TERRIFIC NUMBERS!!!!!

Love and hugs, Teresa and Ricky

[We Hope]

Re: pebbles vet visit for her eye

Marianne,

Not sure if this is helpful or not, but here's a link to AlphaTrak's quick users' guide. They have illustrations of how the sample should be applied to the strip.

http://www.abbottanimalhealth.com/do...39;s_Guide.pdf

Can tell you that when first using an Accu-Chek Advantage for my mother, I promptly "killed off" all of the 10 strips included with the meter on the first test. That also--if you don't get enough blood on it, you get an error reading and you get one also if there's too much.

BTW--Abbott does sell control solution for this meter--here's their Animal Health Product Catalog--

http://www.aahcatalog.com/catalog_fi...er_Catalog.pdf

Meters and supplies are on Sec 1:3 (5 of 26)

[rhodesian46]

Re: pebbles vet visit for her eye

Actually there is a site that Alphatrak does a video on how to use their producthttp://www.alphatrakmeter.com/images/products/AlphaTRAK_Video_Imagemap.gif The tech had me go online Thanks for the info though. Any place where I could get the strips less than $59?
Marianne and pebbles

[k9diabetes]

Re: pebbles vet visit for her eye

http://www.alphatrakmeter.com/vetpro...AK/index.shtml