Home Monitoring of the Diabetic Cat with a Glucometer

Diabetes mellitus (sugar diabetes) is a common disease in cats. Routine monitoring of blood is easily performed with a blood glucometer.

Similar to people, many cats with diabetes need daily injections of insulin. However, difficulty often arises in determining the optimal type, dosage, and frequency of insulin administration. As with diabetic people, each cat is a little different in what they require and how they respond to treatment.

For example, inadequate dosing can lead to poorly controlled diabetes. On the other hand, excessive doses can cause weakness, coma and even death.

One of the best ways to determine the optimal insulin dose in a pet is the glucose curve. In this test, a series of blood glucose (sugar) tests is done over a 24-hour period. The results of this test facilitate proper insulin dosage and time of insulin administration.

Blood glucose can be measured at your vet or it is possible to perform this test at home. On occasion, a spot check which is a single blood glucose measurement is done but more commonly, a “glucose curve” is recommended.

Why do Home Monitoring with a Glucometer?

Cats are often stressed when they come to the veterinary hospital. Sometimes the stress will prevent cats from eating and artificially increase blood glucose levels.

Home monitoring decreases stress and also saves the pet owner the expense of the testing at the vet clinic. However the time your vet takes to interpret the results and communicate changes is worthy of some professional charge.

What is a Glucometer?

A blood glucometer is a little device that measures blood glucose levels. They are commonly used in people with diabetes and are being used with increased frequency to monitor cats at home.

What Kind of Glucometer Should You Get?

There are many different brands of glucometer marketed for humans however they appear to have varying amounts of accuracy in cats. For example, a recent test revealed an average of 180 mg/dl difference between the human and veterinary machine. In general, it appears that human glucometers read 10% to 15% lower on cat blood than they do on human blood. Every machine can be a little different.

Most glucometers come with instructions, the meter, a control solution for calibration method, lancets, and glucose sticks for the meter to read.

The machine that reads most accurately for cats and is recommended by veterinary specialist most often is the AlphaTrak, Ascensia Elite, or the One Touch Ultra. The AlphaTrak is preferred. Even these machines, which tend to be the most accurate of the machines on cats, tend have a 10 to 15% variance with blood run on a more sophisticated chemistry analyzer.

If a human machine is used, it is recommended to determine the accuracy of the machine by your vet preforming concurrent measurements on your machine and their lab machine to determine the difference. Several readings are recommended, ideally at normal, high and low ranges.

How Do You Use the Lancets?

Blood lancets are the little needle devices that pick the skin causing bleeding that allows us to obtain a blood sample. The lancet is used to make a small puncture. In people, they call this puncture a fingerstick as the lancets are shaped to be used on human fingers.

Blood lancets are generally disposable. Most pet owners will use them a couple times before disposal. Some glucometers come with a lancing device, generally shaped like a pen, which allows you to insert the lancet and with the push of a button inserts the lancet into the skin. The sudden motion and click scares some pets. Some models of lancing devices have a silent action and allows up to 6 depth settings (Softclix lancing device). The depth settings can be helpful. For example, some tissues such as the elbow callus may require slightly more depth to draw blood.

Many pet owners use the lancet manually. Just twist off the cap to expose the needle. As an alternative to a lancet, a syringe needle can be used.

Some cat owners need to use different size lancets, different needle sizes or adjust their lancing device to a deeper depth to obtain an adequate sized blood sample to obtain a glucometer reading.

Where Do You Get Blood On a Cat?

Getting blood on a cat can be challenging. The procedure for obtaining the blood, getting the blood on the test strip and using the machine is the same. What is different is where you get the blood sample. In cats – the veins on the ears work well.

The glucometers are fairly simple to use once you get the hang of it. To use, insert a dipstick in the meter, turn it on (some meters will turn on when you insert the stick), puncture your pet to obtain the blood sample, and touch the dipstick to the drop of blood that begins to form and the glucometer will analyze the sample.

Some websites suggest that you over-clip a nail to obtain a blood sample. This is not recommended unless you are in an emergency situation as it is typically more painful for your cat than the other sites.

How Do You Perform a Blood Glucose Check?

Assemble your supplies in an area with good lighting. This includes the glucometer, test strip, Vaseline, lancet, tissue and any treat you may want to give after the test.

Prepare the meter by inserting the test strip.

Identify the area you want to use. If you are using the ear , you may dab a little Vaseline on the area you plan to use. The Vaseline helps soothe the ear and encourages the blood to bead which makes it easier to obtain the sample.

Tell your kitty gently that he or she is a good cat!

Hold your cat in a manner that will allow you to get the sample, if possible you may want to have a helper for the first few glucose checks until you are more comfortable with the procedure. Stick the ear vein with the lancet or needle and allow for a small drop of blood to form.

Pick up the meter into which the test strip has already been inserted, and hold it next to the bead of blood. Allow the test strip to wick up the blood. Generally the machine will beep telling you the test is in progress.

Occasionally a nice bead of blood doesn’t form. This can be because you didn’t insert the lancet or needle deep enough in the tissue to cause bleeding. In this case you can sometimes “milk” the area – applying pressure around the lanced tissue to push blood toward the prick. This can sometimes encourage a bead of blood to form, which can then be analyzed. Sometimes you have to redo the prick.

When Do You Perform a Blood Glucose Check

A spot check should be done any time a pet looks weak or is having symptoms of diabetes such as those described above. Weakness, trouble walking can be symptoms of a low blood glucose. For more information go to Hypoglycemia in Cats. Emergency treatment starts with rubbing some Karo® syrup on your cats gums.

For information about symptoms of diabetes – go to Diabetes Mellitus in Cats.

A glucose curve should be routinely done approximately one week after any change in dosage of insulin.

What Does a Glucose Curve Reveal?

Glucose levels are constantly fluctuating, depending on diet, exercise, underlying illness, and the pet’s individual glucose requirements. A glucose curve will reveal at what time the cat’s glucose level is the highest (also referred to at the peak) and when it is lowest (also referred to as the trough) relative to diet and insulin administration. A glucose curve will also help your veterinarian determine if your pet is receiving the proper type and dose of insulin. If the glucose levels always register too high or too low throughout the curve, the insulin needs to be adjusted.

How is a Blood Glucose Curve Done at Home

A small blood sample is drawn every 2 hours and the sugar level is determined. This information is recorded for 12 hours. If the blood glucose falls below 150 mg/dl at any time, the frequency of sampling the blood glucose should increase to every hour.

You can create a simple chart to record the results such as below:

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The blood sugar levels are later reviewed relative to food intake and insulin administration. Based on these results, and your veterinarian’s interpretation, the insulin may be altered.

If the blood glucose is consistently high even though the pet is on insulin, the dosage is increased. If the blood glucose is consistently low, the dose of insulin needs to be reduced. If the duration of effect is suboptimal, a different type of insulin may be recommended.

Will My Cat Be Upset with My Testing?

In general, this is a quick and relatively painless procedure in cats. Most cats do well. The hardest part for most cats is the restraint required to obtain your sample for cats that are resistant to restraint. In this case it may be better to have this test performed at your veterinary’s office where they are trained to test and restrain pets.

For cats that are extremely fractious, they can be hospitalized for a couple days to acclimate them to the smells and sounds of the hospital before the test is performed. At the hospital, the cat should ideally be isolated and protect the cat from any upsetting sights and sounds (such as isolated away from the dogs). After the cat is somewhat acclimated, they can begin the glucose curve. Some cats won’t eat at the hospital and may not acclimate.

Another option that can work for some cats is if the pet owners lives near by – to bring the cat in to the hospital every 2 hours for testing. This approach has its own stresses including the travel and catching your cat to place in the kennel. When the cat arrives at the hospital, the test should be done as quickly, efficiently and with the minimal amount of stress to the cat and quickly given back to the owner.

How do You Reward a Cat After a Blood Glucose?

One option for a reward is a little piece of canned tuna or a very small sliver of canned cat food that your cat likes.