Bailey got his wings... June 26, 2014

[Geoff]

Hello, I have a problem whereby neither my vets blood glucose metre or my blood glucose metre can read my dogs blood. My dog was diagnosed with diabetes in December last year. The vet said they tried the machine (handheld accu-chek) and it did not work. They went and bought another tester with the same results. They have to use the lab machine to obtain results. I thought this was weird so I bought a accu-chek perfoma last Friday and tested it on myself and my wife with results as expected. I tried my dog, with a drop of blood from his upper lip and it returned a E1, E5 and E6 error (we tried this 4 times!) it appears the vets hand-held and my hand-held meter do not work on my dogs blood. The vet advises me that it DOES work on other dogs!

Now, my dog has had epilepsy (he is 9.5 years old now) since he was around 2. To treat this he is on phenobarbitone and Potassium Bromide tablets twice a day. My vet seems to think this could be interfering with his reading via the hand-held meter. But, it does work on other dogs. So, I am left without really knowing how my dogs curve is going in the evening or away from the vet. His last reading was: (in mmol/l)

37.6 8:30am
15.59 at 10:30am
10.64 at 12:30pm
8.3 at 14:30
13.5 at 16:30

I am now feeding him every 12 hours, prior to that it was approx 8am then approx 6:30pm (food then insulin) I am now feeding approx 8am and approx 8pm (+- 10mins or so) He has also recently been diagnosed with cushings disease but he is only borderline. He is also on pred forte for his cataracts and there is a chance he will lose his eyes. He also has pancreatitis! My little dog has it all!

My question is WHY is the hand held device not reading my dogs blood? Is it the accu-chek so human calibrated it will simply not register? I am going to borrow another brand to try that but I am at a loss since it SHOULD be reading blood glucose in the blood!!

Any advice or help would be appreciated if anyone know why this could be happening, it is weird.

Thanks,

Geoff

[BestBuddy]

Re: Geoff: A question about meter problem

Hi Geoff,

Welcome from another Aussie. It is really strange that you are not able to get results with a meter. I have never heard or come across this but there is always a first time.

I used a very basic human meter and always got results with it. It was a Medisense Optium. Have you any diabetic friends that have different meters that you could test on your dog?

Jenny

[Geoff]

Re: Geoff: A question about meter problem

Hello Jenny, yes it is very weird, he must be from Krypton or something! I do indeed have a friend who sits opposite me who is diabetic and he will bring in an older meter for me to try. Hopefully this gives results. I would like to progress the curve beyond the vets 4:30 reading, this whole experience is very frustrating and sad, that said he is doing very well and is perky.
Geoff

[k9diabetes]

Re: Geoff: A question about meter problem

I know seizure meds can affect blood sugar levels... a little searching found the following:

http://www.medscape.com/viewarticle/412368

This brief response suggests contacting the meter manufacturer for information on whether a medication might interfere.

http://ajcp.ascpjournals.org/content/113/1/75.full.pdf

This is a very interesting article. May not answer the question on your particular issue but it describes the chemical nature of the various meters, which I have always assumed determines why some meters work better generally on canine blood than others.

There certainly could be a connection between the particular chemical process used by a meter and a particular drug.

Does a recent blood panel show that overall his blood panel is pretty normal - not anemic or other problems with the blood itself?

Natalie

[Patty]

Re: Geoff: A question about meter problem

Hi Geoff and welcome to you.
It is interesting that your dog's blood seems to error on the AccuChek meters. I'm not aware of any ingredients in the meds you listed interfering.

This is reaching a bit, but I can tell you test strips use different technology. The AccuChek uses the GDH-PQQ technology which can't distinguish between glucose and other sugars that can be present in some meds. But you would still get a reading, just perhaps higher than actual. There was a discussion about it in this thread a while back http://www.k9diabetes.com/forum/showthread.php?t=1832

You could certainly try one that works off the Glucose Oxidase (GOD) technology, like a OneTouch Ultra or NovaMax meter, to see if you can get a reading off of one of them.

When he's had his blood drawn, is the blood lipemic (where there's more fatty substances in the blood)? That might possibly contribute.

37.6 8:30am (677 mg/dL)
15.59 at 10:30am (281)
10.64 at 12:30pm (192)
8.3 at 14:30 (149)
13.5 at 16:30 (243)

Geoff, what is your dog currently eating?

The range of high to low readings is quite wide. It looks like he needs something added to prevent the steep drop from occurring. Either that or there may be some rebound happening if his dose is too high.

Is he on Caninsulin or NPH?
What time does he receive his pred drops? The pred forte can raise blood sugar, just something to be aware of in using it.

Again, good to have you here.
Patty

[Patty]

Re: Geoff: A question about meter problem

I got pulled away from the computer while posting and just saw Natalie's response. That's a good idea to call the manufacturer to see if his meds might interfere with their particular meter.

[CarolW]

Re: Geoff: A question about meter problem

Geoff - I'm watching with great interest. I hope you can find a meter that does give you readings for your dog.

Hope you can answer the questions asked!

I'll be here, cheering you on!
Mon, 26 Mar 2012 00:31:29 (PDT)

A Big, Fat, Welcome to you and your dog to this finest of forums on canine diabetes!

[Shellie]

Re: Geoff: A question about meter problem

Hi and welcome to the forum! Thought I'd be able to give you an answer...I DO work in a lab after all but I'm stumped on this. Although....there is one possible if it's not a meter error/processing error...just thought of it...how are his lipids? Cholesterol? Triglycerides? If they are high, it's possible that your dog's blood would be too lipemic or too thick to test. We have patients that it's just so thick we have to dilute and dilute and then do calculations to get any kind of reading on. It might be just thick enough from that to not read on meters but read on a lab machine. There is also the possibility of the blood being too thick due to too many red blood cells. That would also show up on a regular blood panel like a CBC. Do you have any lab results other than just the glucose? Sometimes we also have patients that we have NO clue why but their blood won't clot properly (and shows no bleeding problems) so we can't use it for chemistries like glucose until it's been diluted.

Hrm...had more ideas than I thought! LOL Doesn't help a whole lot but it's someplace else to take a look at. You would need a full chemistry panel and a complete blood count to look at the first two ideas.

Welcome again and I hope we can give you a hand here!

[Geoff]

Re: Geoff: A question about meter problem

Hello, I will try to answer all questions at once! Thanks for the great replies!

Bailey (my dog's name) is on protaphane insulin.

http://petdiabetes.wikia.com/wiki/Protaphane

10 units each meal. My vet says that the pred forte drops causes excess cortisone in his blood stream thereby increasing insulin resistance. This, coupled with his pending cushings disease (no meds YET) makes his insulin uptake hard to manage.
I agree with the reading being quite varied (between high and low) He is fed Supercoat dry kibble

http://www.purina.com.au/supercoat/D...te_Mature.aspx

1/2 cup (metric) along with 4-5 bits of Hills Science Diet T/D dental small bites. He also has 1/4 can of Hills lite & mature chicken entree each meal and has done so since Dec 8 2011. I apply the pred drops around 7:30am, 4:30pm (when I get home from work) and 10:30-11pm when I go to bed
His blood work was done back in December, he has pancreatitis, fatty liver but the vet says all OK overall.

He had an ultrasound to determine what type of cushings has, thankfully not the bad one (adrenal gland was clear)
I am going to try another meter, I agree with the fact that some meters would give different results due to the different chemical processes (I have not read those links yet but will!)

Thanks Carol, Patty, all, it is a weird one but I am determined to get a home result!! I am hoping that feeding him at 12 hourly intervals will enable better control, back top vet this Thursday for blood curve, if no good, will have to put him on cushins meds then around we go again!!

Cheers,
Geoff (time to go feed!)

[Geoff]

Re: Geoff: A question about meter problem

Hello Shellie, I am not sure about his Cholesterol/ Triglycerides. The vet did not say anything about that! I will try another meter first and see how we go. Something is afoot, probably the accu-chek meter but who knows. Thanks!

Geoff

[CarolW]

Re: Geoff: A question about meter problem

Thanks for the wikia link, Geoff. That's clearly the insulin my Kumbi was on - here in Canada, called Novolin-NPH insulin. It suited Kumbi very well, though it took us some time to get Kumbi regulated.

I'm REALLY glad Bailey is on that insulin instead of Caninsulin, which can be extremely tricky!

I'll be here watching for your reports! Hope you can begin to get meter readings, in time!

Mon, 26 Mar 2012 15:57:39 (PDT)

[Geoff]

Re: Geoff: A question about meter problem

Hello all, does anyone know where I can get a OneTouch Ultra or NovaMax meter in Australia or perhaps ebay? Or a meter here in Australia which does testing by Glucose Oxidase (GOD) technology?

My diabetic friend only has the acuu-chek and chemists seem to mainly stock that brand.

Thanks,

Geoff

[Shellie]

Re: Geoff: A question about meter problem

Have you tried Amazon? That's where I get the strips for my OneTouchUltra 2.

[CraigM]

Re: Geoff: A question about meter problem

If the One Touch Ultra isn't common in Australia, I'd ask a vet or your chemist / pharmacist for recommendations. Take a few minutes and research what the test strips cost. Here in the States test strips can cost anywhere from about 36 cents to over a dollar each. A big difference if you average 80 a month, like I do.

The required blood droplet size is also important. Some meter / strips require much larger droplets than others. The package would give that information.

[BestBuddy]

Re: Geoff: A question about meter problem

Hi,

Couldn't find much in Aust. mentioning GOD technology but the following does mention not reacting to maltrose or galactose??????? Maybe you could call but don't mention it's for a dog because they often don't take you seriously.

http://www.onetouch.com.au/onetouch-verio

It seems to be available at lots of chemists and I noticed was cheaper at Pharmacydirect.com.au

Jenny