At-Home Glucose Monitoring

April 29, 2018

Gary Edelson, DVM, highlights the importance of at-home monitoring, the ease of setting up the AlphaTRAK 2 monitor, and observing glucose ranges. Dr. Edelson also demonstrates on a stuffed animal where to take the blood samples as well as how to read the AlphaTRAK 2 monitor.

Gary Edelson, DVM: In-home monitoring and checking your pet's glucose is really, really important because they don't have that stress that they do in a veterinary setting. And we know that stress actually increases their glucose, so it can make readings a little bit artificially elevated. So, when we're testing our pet's glucose at home, it's in a low-stress environment, we're going to get an actual reading, and then we can communicate those readings to our veterinarian and keep a nice log.

At-home testing requires a meter and strips, and I recommend the AlphaTRAK 2 starter kit by Zoetis. Inside this box, you're going to find strips. The strips are labeled with a reference code, one for dogs as well as one for cats. And it's really important that we set our meter accurately. When we do set the meter, we're going to take a strip out of the vial, and it's an instant-on technology, so when you put the strip into the meter it's going to come on and program to the correct number. And you can go up or down by the tests of the button. Within a couple of seconds, it's going to display to insert your blood sample, at which point you would insert your little sample into either side of the test strips, another key feature of the AlphaTRAK 2 meter.

Obtaining a blood sample may be a little intimidating for some, but it's actually a very easy, safe, and gentle process to obtain with your pet at home. First, you're going to grab a lancet. The lancet has a little cover on it that gets twisted off to expose the tiny, little needle. And on dogs and cats, there are 3 main sites that I like to use. One would be the ear, the other would be the lip, and the third would be the paw. And we'll go over on a stuffed animal where to do that so we're better apt to practice on our pet when we need to get the blood sample.

So, the first site would be the ear. I use the inner margin of the ear and I always pinch the skin where I'm going to do it, and this helps sensitize the nerves so it's not as painful when you get your sample. We take the lancet, hold it by the base, and we carefully go between our pinched fingers to get the sample. And then shortly after you squeeze, you'll get a drop of blood, in which case you would then take your strip and apply it to the blood sample, wait for the beep and then get a result. The next site would be the lip. You would take the lip and fold it up. And again, same thing: You take your fingers, you would squeeze between the lip, you would take your lancing device and go right between your fingers, squeeze for a second to get your blood sample, and same process with your meter. The last site would be the paw. We gently bend the paws back, take the paw pad, again squeeze, take your lancing device and go between, push down, up, and squeeze until you get your blood sample. Good boy.

Glucose ranges are from about 120 to 250 mmol/L in a stabilized diabetic animal. The most dangerous situation is where that blood sugar falls too low, so below 100 mmol/L. And this is where your pet can be very tired-called lethargy-weak and doesn't want to stand up. This is an emergency situation. You want to make sure you have Karo syrup or a high-sugar-concentration syrup to put on your pet's lips and call your veterinarian immediately. High ranges would be over 250 mmol/L, where we're really not fully regulated. And, again, you want to talk to your veterinarian about possibly getting into a normal reference range, between 120 and 250 mmol/L, and this is to ensure that your pet is not drinking a lot of water, not peeing a lot, and being very comfortable at home.

At-home monitoring, when we first start out, I do like to get daily samples. I try to pick out different times throughout the day, whether it's before our first insulin injection, several hours after, a different time in the afternoon, or before our last insulin injection. And make sure you're creating a chart where you are writing these numbers down so you can always discuss this with your veterinarian before making any changes.

A blood glucose curve is a series of measurements starting right before we take our insulin injection and every hour to 2 hours after, for about a full 12 hours. And the key of this glucose curve is to find the highest level and the lowest level, called the nadir, to better regulate your pet at home.