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- Author or Editor: Saskia Kley x
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Abstract
Objective—To evaluate owner compliance with longterm home monitoring of blood glucose concentrations in diabetic cats and assess the influence of home monitoring on the frequency of reevaluation of those cats at a veterinary hospital.
Design—Retrospective study.
Animals—26 cats with diabetes mellitus.
Procedure—Medical records of diabetic cats for which home monitoring was undertaken were reviewed, and owners were contacted by telephone. Signalment, laboratory test results, insulin treatment regimen, details of home monitoring, clinical signs during treatment, frequency of follow-up examinations, and survival times were evaluated.
Results—Monitoring of cats commenced within 12 weeks (median, 3 weeks) after initial evaluation; 8 owners were unable to perform home monitoring, and 1 cat was euthanatized after 1 week. In 17 cats, duration of home monitoring was 4.8 to 46.0 months (median, 22.0 months); 6 cats died after 7.0 to 18.0 months (median, 13.0 months). In 11 cats, home monitoring was ongoing at completion of the study (12.0 to 46.0 months' duration). Fourteen owners completed blood glucose curves every 2 to 4 weeks. Cats managed with home monitoring received higher dosages of insulin, compared with cats that were not monitored. Four of 17 cats managed by home monitoring had transient resolution of diabetes mellitus for as long as 1 year. Home monitoring did not affect the frequency of reevaluation at the veterinary hospital.
Conclusions and Clinical Relevance—Owner compliance with long-term home monitoring appeared to be satisfactory, and home monitoring did not affect the frequency of reevaluation of patients by veterinarians. (J Am Vet Med Assoc 2004;225:261–266)
Abstract
Objective—To evaluate day-to-day variability in blood glucose curves (BGCs) generated at home and at the clinic for cats with diabetes mellitus.
Design—Prospective study.
Animals—7 cats with diabetes mellitus.
Procedures—BGCs generated at home on 2 consecutive days and within 1 week at the clinic were obtained twice. On each occasion, insulin dose, amount of food, and type of food were consistent for all 3 BGCs. Results of curves generated at home were compared with each other and with the corresponding clinic curve.
Results—Differences between blood glucose concentration determined after food was withheld (fasting), nadir concentration, time to nadir concentration, maximum concentration, and mean concentration during 12 hours had high coefficients of variation, as did the difference between fasting blood glucose and nadir concentrations and area under the curve of home curves. Differences between home curve variables were not smaller than those between home and clinic curves, indicating large day-to-day variability in both home and clinic curves. Evaluation of the paired home curves led to the same theoretical recommendation for adjustment of insulin dose on 6 of 14 occasions, and evaluation of home and clinic curves resulted in the same recommendation on 14 of 28 occasions. Four of the 6 paired home curves in cats with good glycemic control and 2 of the 8 paired home curves in cats with poor glycemic control led to the same recommendation.
Conclusions and Clinical Relevance—Considerable day-to-day variability was detected in BGCs generated at home. Cats with good glycemic control may have more reproducible curves generated during blood collection at home than cats with poorer control.
