Self-monitoring is the standard of care for diabetic humans and HMBG ought to be best practice for diabetic pets. Most cats and dogs readily permit capillary blood sampling and by using a portable veterinary BG meter, rapid and accurate BG measurements can easily be obtained at home.
Home monitoring – best practice?
The most important development in the management of human diabetes over the last 40 years has been the ability for people to measure their own blood glucose (BG) concentrations. Self monitoring, at home, at work and on the move, has massively improved diabetic control and prevention of complications. It is now considered best practice in the vast majority of diabetic people.
As we try to attain similar standards of care in our diabetic veterinary patients, should we not be measuring BG concentrations at home? Although commonly recommended, it is my experience that most diabetic cats and dogs in the UK do not currently have home monitoring of BG concentrations (HMBG) as part of their routine.
The two pre-requisites for HMBG are a blood sample and a reliable handheld portable BG meter (PBGM) to measure BG concentrations.
Collecting a blood sample
Capillary blood sampling can be done in most diabetic pets by a single operator (the owner) who both restrains the pet and collects the sample. A skin prick on the pinna, paw pad or lip is tolerated extremely well by the majority of pets. When nurses train owners, they must be confident and comfortable with the techniques. Internet sites, such as YouTube, can be helpful to demonstrate capillary sampling.
Preparation is the key – ensure all supplies are available and that a quiet location with good lighting has been selected. Gently restrain the pet. Warm the site of collection (with a heated face-doth, for example) to improve blood circulation. Apply a thin layer of Vaseline to encourage the formation of a blood drop.
Set up the PBGM and then prick the skin with a lancing device or small needle. Bring the test strip in the PBGM into contact with the blood drop to suck up a sample. Apply pressure to the prick site, record the BG concentration and reward the pet for compliant behaviour!
Measuring blood glucose concentrations at home
BG concentrations in human diabetics are typically measured with handheld PBGMs, calibrated for people. However, the distribution of glucose in red cells and plasma is different in cats, dogs and people; human PBGMs generally read lower than the actual BG concentration when used in cats and dogs. A veterinary PBGM, such as the AlphaTRAK (Abbott Animal Health) which is specifically and separately calibrated for cats and dogs, is recommended. It easy to use, accurate and can measure a wide range of BG concentrations (1.1-41.7 mmol/1). With any handheld PBGM, it is important to frequently calibrate the device.
Author
Grant Petrie MA VetMB CertSAC CertSAM MRCVS
To cite this and other BVNA content use either
DOI: 10.1111/j.2045-0648.2011.00103.x or Veterinary Nursing Journal Vol 26 pp 364
• VOL 26 • October 2011 • Veterinary Nursing Journal