Adjusting Insulin Dosages Using Urine Strip Results

Pet Health: BG Monitoring

Adjusting Insulin Dosages Using Urine Strip Results

Some people prefer to check glucose levels in their cats by testing the urine. When blood glucose levels get too high, the kidneys cannot filter all of this and glucose "spills" into the urine. Guidelines indicate that glucose will spill into the urine when blood glucose levels are above 220 mg/dl. Individual cats will have different levels based on age, kidney damage, and other factors. When the blood glucose is within the normal range, no glucose will show up in the urine.

Although this method of monitoring means you can do it at home without sticking your cat for a blood sample, there are some problems.

1. There is a "lag" before the glucose shows up in the urine. This means that if you see glucose in the urine, they may reflect a high blood glucose several hours before, not necessarily currently. However, if you have glucose show up in the urine every time you test, you can be pretty sure that your cat needs an insulin dose adjustment.

2. Also, please be aware that urine strips cannot tell you if your animal is becoming HYPOglycemic (blood sugar too low) and needs a lower insulin dose. Hypoglycemia can be fatal or induce neurological damage.

Once your pet is well regulated, you may want to consider switching to home blood glucose testing. As always, please consult with your veterinarian.

In the initial stages of therapy the usual recommendation is to test three times per day. After regulation has been achieved, routine tests before the morning meal two to three times weekly will be enough to let you know if your pet is staying regulated.

Suggested times for doing urine glucose tests are

1. Directly before the morning meal (e.g. 7-8 a.m.)

2. Around the time of the 2nd meal (e.g. 3-4 p.m.)

3. In the evening when the insulin action declines (familiarize yourself with the insulin curves for your particular type of insulin so you will know when to expect this decline, usually 9-10 p.m. if you give an insulin shot in the morning)

From the results of urine strips, the insulin dose can be adjusted. PLEASE DO NOT MAKE RADICAL CHANGES IN YOUR CAT'S INSULIN DOSE WITHOUT CONSULTING YOUR VETERINARIAN. Also, once a dose change is made, give your cat 3 to 4 days to adjust to the new dose before considering another change.

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Urine Glucose Test Strips
Results
Time 1	Time 2	Time 3	Assessment & Adjustment of dose
trace	-	-	none: correct dose
trace	-	+	none: correct dose
+	-	-	none: correct dose
+	+	+	+10%: dose too low
-	-	-	-10%: dose too high
+	-	+	-20%: Somogyi effect

Tips:

I've seen 2 non-invasive, non-technically challenging ways to easily collect a feline urine sample.

1) Place the kitty litter pan (kitty litter and all) into a plastic garbage bag and tie the bag shut. Place the bagged box back to its normal location and wait. Most cats can still feel the litter through the plastic and accept it as the place to do their business. This results in a nice tidy pool of urine on to of the plastic (unless kitty claws through the bag, double-bagging or a few tries might be needed).

2) Replacing the kitty litter with clean aquarium gravel on testing days.

We've recently started using the first method for owners to collect urine from their cats at home to bring in for urinalysis (mainly to recheck infections and crystals), and fractious cats that would sooner perform blood samples on the staff than allow us to obtain a urine sample without sedation. It works quite well for stick and spindown urinalysis where environmental contaminants are not a major concern. We use human urine sticks for animal tests, which include glucose, so human sticks should be sufficient.