Reptile & Amphibian Forums

Hi everybody!

I'm new to these forums and I have a somewhat unusual question ... not sure if anyone here can help with this.

Anyway, here it goes:
I live in India with two cats and two dogs. Two weeks ago we had bloodwork done for all of them and the reports came back with a very high glucose level of 324 for one of my cats, Tommy. We are now monitoring his urine with diabetic testing sticks, and will have another blood test and urine test done shortly.

But my question is regarding this:
The lab here in India measures biochemical values in what they call "mgm %" units. Now, my vet is comparing those values to Feline Normal Ranges she takes from an American book; they are Traditional units and are given in "gm/dl". I and an online friend of mine, who is a veterinary technician, are doubtful whether these two units can actually simply be compared. Although I asked my vet about mgm % units I don't really understand what they mean. gm/dl is easy, it is gram per decilitre, but I don't understand mgm %, and she seems to be unable to explain it to me, leaving me and my friend unsure about whether to trust my vet's diagnosis. Especially with diabetes, it could be fatal if a wrong diagnosis would be made and we would inject him with too much or too little insulin! So, I'm very hesitant and don't know how to proceed.

Has anyone here experience with mgm % units, or heard of them or knows someone (maybe an Indian born doctor or vet) who can shed some light on this? I need to know whether Indian mgm % units are the same or at least very similar to the American Traditional units of gm/dl.

On a side note: although the glucose level was so high, all the diabetic sticks have so far shown a negative - no sugar at all in his urine. Also, he doesn't show any other symptoms of diabetes, no excessive drinking or urinating, no weight loss, no loss of energy. Is it likely that he has diabetes at all?

Hi There,

Welcome to the Boards!

Your question about comparing the two different types of biochemical units is a tough one. I will talk to my vet (also my boss) and see if she has any idea if they can be compared at all.

Diabetes in cats, though, is something I do know about. A blood glucose of 324 is high, but often newly diagnosed diabetic cats are much higher, at least 500. A very easy way to monitor blood glucose in a cat is by using a regular human glucometer. All you have to do is get a drop of blood from an ear to run the test. Please check out this site for more info:
http://feline diabetes.com/bg-test.htm
It would be much more accurate than trying to monitor Tommy's diabetes (if he is truly diabetic) by testing his urine.

It is puzzling that Tommy does not have any of the clinical signs of diabetes. It could be that he is in the early stages of the disease.

If Tommy has been on steroids for any reason, he would be at higher risk for developing diabetes. Being overweight can also contribute to the disease, as well as diet. The carbs in dry food can cause the disease.

There is also the possibility of controlling diabetes with oral meds, such as Glipizide, if such a drug is available where you are.

Hope this info is helpful to you. I'll be checking back to see if you post any questions.

Regards,
AshleyElla
Link

Hi AshleyElla, and thank you so much for replying!

It would be great if you could ask your vet/boss and shed some light on this mystery. I'm very hesitant to give him insuline (if that's what he would need), because if those units are just slightly off it would make it difficult to determine the right dosis.

I'm not sure if a human glucometer is available here in India, but I will ask my vet about it. We have managed to monitor his urine three times so far with the diabetic sticks, and it has been negative (no change of colour whatsoever) each time. My vet said he might have ketones in his urine which would prevent the glucose from showing up in the test. She suggested to test for ketones, and have another blood test done soon, as well as a urine test at the lab.

Tommy has not been on steroids and he is not overweight either. He does however have almost a fetish for white bread which we had fed to him once or twice a day for years. As soon as my vet told me about the high glucose we stopped that. We have also switched his food to a low fat premium brand. (Diets especially for diabetic cats are not easily available here, but if he turns out to be diabetic, we will have to order one from the US.)

Again, thank you for your concern and the info! I will check back here on Monday!

Tilda

Hi Tilda,

I did talk to my boss, and unfortunately she didn't have any answers to the biochemical unit mystery either. I'll check around on my own and will let you know if I come up with anything.

If you are interested, I'd be happy to price some glucometers here for you. I believe that some are very inexpensive, around $25.00 per unit.

Please let us know the results of the labwork when you take Tommy in.

Take care,
AshleyElla

Hello again AshleyElla,

thank you again for asking your boss and offering to ask around. I'm glad to be able to tell you though that I was able to get an explanation from a pediatrician whom I knew a long time ago and whom I emailed on Monday out of a hunch. He replied and said that the two units are in fact the same thing. Out of some reason, Indians write '%' to indicate dl (decilitre), and 'mgm' stands for mg (milligram).

So this means that Tommy had indeed a glucose level of 324 mg/dl when we tested him two weeks ago. He also had a lower than normal WBC count and a lower than normal platelet count. Direct Bilirubin is a bit too high, as is the BUN of 56 mg/dl. Albumin is also a little too high. Any thoughts?

My vet now suggested a urine test in the lab since we get only negative readings with the Diastix. She also said that glucometers are available here and we could use that as well later on, when (and if) we establish that he has diabetes and need to monitor him frequently. I'm not sure what you mean by 'pricing some glucometers for me'. Were you thinking of shipping me one? That is so nice of you! My vet seemed to think though that doing a full blood test again after the urine test is better for now so we can compare all the biochemical and other blood values once more. I will let you know the results once we get them.

Btw, there are no animal hospitals here only daytime clinics with limited opening hours, we usually have the vet come to our home and all that can be done here, is done here at home. Also, right now we are not able to get any sterile urine jars and have to wait again for a couple of days. Yes, this is how it is in India. Things move slowly!

Nevertheless, I will post any updates and developments in this thread and am grateful for any comments from you!

Till then,
Tilda

Hello again!

An update: we tested 7 times with Diastix, it was negative each time. We tested for ketones as well, there are no ketones in the urine.

Yesterday we collected urine and had it tested in the lab, again there was no glucose nor ketones found in the urine.

Is this good news?

We will do another blood test. The problem is that my vet is too advanced in her pregnancy to travel anymore, so she can't come to our apartment. What should I do:

1) wait for her assistent to come back from a trip on the 23rd this month and come to take the blood?
2) take Tommy to her office (she still works there in the mornings)? The problem with that is that Tommy freaks out VERY much when he has to go into the basket, and since blood sugar levels are affected by stress it might not be a good idea.
3) try and find another vet only to come and take blood (maybe they won't want that if it's not their case)?
4) buy a glucometer - but they are expensive and if Tommy turns out not to be diabetic we wasted the money.

Is it essential that the second blood test should be done soon? Or can I wait 10 days for her assistent?

Thank you for any insight!

Tilda

Hi Tilda!

Yes, it is very good news that no glucose or ketones have been found in Tommy's urine recently.

Does your vet think it's ok to wait for her assistant to return before retesting Tommy's blood? It's what I believe I would do in your situation, but please remember that I am not a doctor.

In the meantime, it would be good to keep Tommy on a canned-food diet if that is possible, or at least a diet high in protein. Some diabetic cats have been able to get off insulin after being placed on a high protein diet, or at least they have required a smaller dose. Makes sense if you think about it, as carbs raise blood sugar.

I am always willing to price glucometers here and look into shipping if that will help.

Take care, and please keep us updated.

AshleyElla

Hi AshleyElla!

I have researched the net and found an interesting article where it says that a very high glucose level has been found in non-diabetic cats if they were very upset over blood being drawn - which Tommy was. Here is the link if you're interested to read it: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2004&PID=8654&Category=1259&O=Generic.
At the end is a paragraph headed "Stress hyperglycaemia". The high value given there (SI value) corresponds to Tommy's value of over 300mg/dl. He might not be diabetic at all!

So, with the urine being clear (no sugar, no ketones), and him having no symptoms of diabetes at all, we have now decided to just keep watching him. We will look for signs of increased thirst and urination, and monitor his weight and urine on a regular basis.

Because he gets so stressed out when blood is taken, future blood tests will likely again show a high blood sugar, so I feel I can't be really SURE it's diabetes, and I certainly will not start any meds or injections before I'm 100% sure he is infact diabetic.

Does that sound reasonable to you?

Another thing is that his BUN had been elevated too in the last blood test - 56mg/dl, so we cannot feed him a high protein diet. He will stay on his low fat diet for now and we have cut out his favourite treats, like eggs, fish and meat .

Your comments will as always be appreciated.

Thanks a lot for the glucometer offer! Let's hope I don't need it at all!

Tilda