Continuous Glucose Monitoring In Cats
Matthew Kornya, DVM, ABVP Residency Trained, ACVIM Resident, Ontario Veterinary College, The Cat Clinic, Ontario, Canada
Matthew Kornya, DVM, ABVP Residency Trained, ACVIM Resident, earned his DVM from Ontario Veterinary College, where he is working to complete a small animal internal medicine residency. Dr. Kornya completed an American Board of Veterinary Practitioners feline residency in private practice and has worked with the Winn Feline Foundation, AAFP, and regional and national feline organizations and conferences. His interests are in feline internal medicine, especially retrovirology and hematology.
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Monitoring Your Diabetic Pet At Home
Monitoring glucose levels is important to ensure that your pet is getting the correct amount of insulin which ensures that its body can effectively utilize the energy that is being ingested with their diet. Monitoring helps to ensure that your pet has minimal side effects from blood sugar levels that are too high or too low, which will hopefully help to prevent long-term complications from diabetes.
You will need a few pieces of equipment to monitor your pets glucose at home, including:
Glucose monitor: a device that measures the level of glucose in a blood sample. Because healthy glucose ranges are different in dogs and cats, you should use a monitor or purchase one that has specific settings for both dogs and cats. Ask your veterinarian to recommend a glucometer that will ensure the most accurate test results.
Glucose test strips: individual strips that collect the blood and work with your glucose monitor. It is best to use the test strips that are designed to go with the glucose monitor purchased, and to check expiration date of strips before each use. Remember to enter the code on the strips anytime you open a new package this correlates to the batch of strips and helps ensure accuracy.
Lancets and lancing device: A lancing device is a spring-loaded piece of equipment that holds the lancet and allows it to prick the skin in a manner allows for best and most accurate sample collection.
The Best Glucose Monitors For Dogs In 2022
Unfortunately, it isn’t just humans that get diabetes – cats and dogs are prone to this disease too. Overfeeding can cause diabetes in dogs and more and more cases are being discovered each day by veterinary professionals. Once your dog has been diagnosed with diabetes, the veterinarian may suggest that you monitor your pet’s glucose levels at home. There are lots of different glucose monitoring kits for dogs available online and we have found the best and presented them in this review.
Keep reading to find out which dog diabetes test kit is our number one favorite…
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Accuracy And Correlation With Blood Glucose Measurement
It is important to remember that the interstitial glucose concentration, also called sensor glucose , is not the same as the blood glucose concentration . The relationship between intravascular and interstitial glucose is quite complex,3 and differences between SG and BG readings are expected. Briefly, because it takes time for glucose to diffuse from the intravascular to the interstitial space, changes in SG lag behind those in BG. This lag time has been shown to be as little as 5 to 6 minutes in humans,4-6 and estimated to be 5 to 12 minutes in dogs.7 This timeframe is short enough that clinical decision regarding insulin or glucose therapy will be impacted minimally. Some human studies have demonstrated a close correlation of SG and BG, particularly when BG levels are stable.7-9 However, with large swings in BGwhich are common in veterinary patients with diabetesthe magnitude of BG peaks, troughs, and changes are more pronounced than those in interstitial glucose. In the authors experience, SG may be up to 20 mg/dL lower than BG at peak levels. Nonetheless, acceptable correlation has been found in diabetic dogs and cats, and SG readings are considered accurate estimates of BG in dogs with diabetic ketoacidosis .10-12
Continuous Glucose Monitoring For Dogs
Continuous Glucose Monitoring for Dogs: A researcher is using a continuous glucose-monitoring device commonly used in humans with diabetes to help treat dogs and other animals. Our research has found that continuous glucose monitoring devices can be used in dogs, cats, cows and horses, said University of Missouri researcher Charles Wiedmeyer. Use of this system alleviated the need for multiple blood samples. It also reduces the stress associated with obtaining those samples. This system may provide greater monitoring capabilities in animals with diabetes and promote the diagnostic and research potential of glucose monitoring in veterinary patients, he added. Dogs with diabetes are similar to children with diabetes in that they rely on caregivers to manage their disease. Diabetes Technology and Therapeutics, July 2010
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Easy At Home Glucose Monitoring For Diabetic Cats And Dogs Freestyle Libre
Life just got a little easier for owners of diabetic companion animals. The Freestyle Libre glucose monitoring is a faster, easier, and less painful way to monitor your diabetic pets glucose levels at home.
FreeStyle Libre is one of many flash glucose monitoring systems on the market. This system has been used by more veterinarians to date and has been studied and some veterinary universities.Its also the only flash system currently that has a published study in dogs.
At this time, the company , does not provide support for veterinary use (e.g. it is not approved in animals, and they do not answer questions about animal use on their support line nor do they replace the Sensor should it prematurely detach from an animal or fail to work on an animal.
That said, veterinary use with the Freestyle Libre allows you to monitor your pets glucose levels at home by simply scanning a sensor that can be placed at your veterinarians facility and usually stays on 6-10 days. This makes it easy to obtain many readings for many days in a row without additional stress for you or your pet.
Flash glucose monitoring systems measure the glucose in the fluid that is present in the tissues under the skin . There is a small difference in this measurement as compared to the amount of glucose in the blood, but for the purpose of monitoring your pets overall trends in glucose, the difference is not significant.
How it Works
How the Sensor is Implanted
How do I Get One?
Indications For Use Of A Cgm
The system can be used in clinic on newly diagnosed diabetics to look at response to insulin and duration of effect, after which the patient is discharged with the sensor in place. Cats with diabetic ketoacidosis , unstable diabetics or those feline patients approaching remission may also benefit.
CGM could be used in septic or critical patients where hypoglycaemia is a concern, or patients on insulin or glucose continuous rate infusions. However, these indications have not been studied in cats at this time and the time lag between blood and interstitial glucose must be taken into account, which is particularly evident during rapid changes in blood glucose . Validation of results with measurement of blood glucose is recommended in such patients before adjusting treatment protocols.
The author has found most useful in cats approaching remission, in patients with DKA and in animals where stress in the clinic is highly likely to influence glucose curve interpretation and decisions on insulin dose
The author has found it most useful in cats approaching remission, in patients with DKA and in animals where stress in the clinic is highly likely to influence glucose curve interpretation and decisions on insulin dose. Figure 6 shows data from a FreeStyle Libre device on a cat entering diabetic remission.
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Continuous Glucose Monitoring For Pets
Glucose monitoring is a necessary, but difficult, part of caring for a diabetic pet. Timing is important. You have to prick your pet , then you have to get the info to your vet. Glucose curves are often needed to help your vet interpret a pets response to insulin therapy. This either means a stressful day in the hospital for the pet or an owners time commitment to prick their pet at least 8- 12 times . Yuck! Well, GOOD NEWS FOR PARENTS OF DIABETIC PETS!
Continuous glucose monitoring for pets has arrived!
- No pricking your pets lip, pads, or ears!
- Get a Blood glucose curve at home, every day, for up to 14 consecutive days!
- Glucose curves are Better than at home or in the hospital: Blood glucose is measured every MINUTE, averaged and recorded every 15 minutes, for 14 days!
- Cost effective: a single sensor that can read 14 days of hourly blood glucoses costs about the same as a single 8 hour curve in the hospital with only 4-6 blood glucose samples
- Stress free no stress factor to adversely affect the glucose readings!
The Freestyle Libre for dogs and cats has been used innumerable times by Board Certified veterinary internists with terrific success!
Internists are recommending applying a sensor whenever:
- A pets blood glucose readings arent making sense
- Every 3-4 months when owners dont want to do blood glucose monitoring at home
- Whenever a pets Frucotsamine levels arent well managed
- To get control of newly diagnosed diabetics
Insulin For Diabetic Pets
Insulin is an injectable version of the hormone normally produced by your pet’s pancreas. It is used to help the body move glucose from the bloodstream and into the cells where it can be used for energy.
Every pets metabolism is different and there are multiple factors that can affect its blood sugar, so there is no set right amount of insulin for certain sized pets. As a result, there will be some trial and error required to determine the amount of insulin that your pet needs.
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How To Test Your Dog’s Blood Glucose & Ketones
There are a few different ways that you can test your dog’s glucose levels and ketones. You can use blood glucose monitors which require a small sample of blood taken from an area on your dog, or you can use urine testing strips. With both of these methods, it is absolutely essential that you speak to your veterinarian for advice as each animal is unique and their needs can differ greatly. Some veterinarians require urine samples to be taken, whereas others will need you to take small blood samples. In both cases, they will show you how to do this, what to look out for, and how best to record the data.
What The Future Holds
With the improvements in CGM technology in the past 2 decades and ongoing development, use of CGMs is likely to become much more common in veterinary patients with diabetes. Long-acting, subcutaneous sensors are already available for human patients when these sensors are paired to an insulin pump, the result is, essentially, a synthetic endocrine pancreas. This technology is being developed and tested in veterinary patients and may be available in the future.29,30
Because veterinarians do not have to manage diabetic patients for decades , the tight glucose control that is desired in human medicine may never be a goal of veterinary medicine, and some more advanced applications may not apply to veterinary patients. However, even with current technology, management of diabetic patients can improve drastically.
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Best Glucose Monitors For Dogs
Specially designed for cats & dogs
Only requires a small blood sample
Provides accurate results
This pet glucose meter has been specially designed and calibrated to be used on cats and dogs and analyzes your pets glucose levels with a tiny drop of blood. This kit is easy to use and provides a convenient way to monitor your dogs diabetes from the comfort of your home. Read our guide and FAQs to find out what the best testing site is for your pet dog.
25 x test strips included
Glucose chip & lancing device
Stores up to 500 tests
This test kit provides everything you need to monitor your dogs glucose levels. Inside this kit, youll find testing strips, a lance device, meter, control solution, and gauge lancets. We like that it comes in its own case too so you can keep everything together in one handy place. Promising a high level of accuracy, the iPet PRO Kit provides results in around 5 seconds, and as well as being fast and accurate its simple to use.
Test results in 5 seconds
25 x test trips included
400 test memory
50 x strips per tube
Can detect: protein, glucose, PH, ketone and more
Easy to use
Negative LCD screen for clearer readings
Full starter kit with testing strips, lancets, lancing device, batteries and more
Strip ejector for fast and hygienic removal of used test strips
Highly accurate results every time
User manual & logbook
Q: Can I Use A Human Glucose Meter On A Dog
This question is always found in pet forums – and to some degree, it makes sense to use human blood glucose monitors on your pets. Blood glucose levels are tested in similar ways for both humans and some animals, such as cats. But this doesn’t mean that the same monitors used will deliver the same results. The reason why human blood glucose monitors and animal monitors differ is that the balance of glucose found in human bodies and animal bodies differs greatly. Glucose monitors need to be specifically calibrated for use with a cat or dog or you will get inaccurate results.
What To Look For In A Glucose Monitor For Dogs
When looking at glucose monitors for your pet dog it might be tempting to go for the cheapest option – don’t ever do this! Look for a reputable brand that has been backed by veterinarians and other professionals in the industry. Starter kits provide a good option for beginners as they contain everything you need to start monitoring your dog’s blood sugar levels. Take a look at the kits which provide easy-to-read screens and can store a decent amount of test results too – it’s always good to be able to look and see how your pet’s blood levels have changed. Accuracy is the most important feature of blood glucose monitors. Find the most accurate testing kit on the market for the best results.
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continuous glucose monitoring system portable glucometer diabetic ketoacidosis hyperglycaemia hypoglycaemia
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Obtaining And Interpreting Data
A standard glucose curve is based on 8 to 10 readings collected over a single day. By contrast, the Dexcom G6 takes a reading every 5 minutes and the Freestyle Libre every 1 minute over the course of several days. These data can be displayed in a variety of ways to give clinicians a better understanding of glucose trends and management of the patient. Feeding, exercise, and sleep cycles can be monitored as well. CGMs may be able to detect previously unobserved persistent hyperglycemia and Somogyi events.27,28
If the SG is out of the sensors range , the monitor displays a HI or LO alert. This should prompt collection of an ear-prick sample to be read by a PBGM. The readers designed for use with the Freestyle and Dexcom systems include a PBGM in the handheld monitor however, separate test strips are required, and these have not been validated for veterinary species.
Figure 3. Examples of information displayed on a Freestyle Libre CGM reader. Daily graph.
Figure 3. Examples of information displayed on a Freestyle Libre CGM reader. Percentage of time spent in target range.
Figure 4. Examples of information displayed when the data from the Freestyle Libre monitor is downloaded to a computer or the Freestyle website. Summary of recording period outlining quartiles averaged over that period and percentage of time outside of target range.
One Measurement Isnt Enough
In veterinary medicine, the gold standard method of measuring whether a pets blood sugar is well-controlled has been to perform a serial blood glucose curve, where blood sugar is measured every two hours throughout the day. This test is often performed in the hospital, but some owners are able to do this at home using glucometers calibrated for animals. Curves require new blood samples to be taken each time, either by pricking the ear, the paw pad, inside the lip or by drawing blood from a vein with needle and syringe. For accurate monitoring and proper insulin dosage adjustment, veterinarians need to see how low or high a patients glucose gets during the day, and when these high and low points occur.
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