Top Tip 3 - Sweetening the Deal with your Glucometer

Not every upgrade to a clinic’s in house laboratory capability needs to be through the purchase of expensive equipment. Many clinics have long had access to the humble in-house glucometer and we often reach for simple diagnostics as a first step in even the most complicated cases. Sometimes comprehensive blood screens are not available instantaneously so information from in-house diagnostics is particularly useful.

Here’s a couple of situations where the humble glucometer may earn its keep

Abdominal effusions

If you have a patient with an abdominal effusion and you are unsure if it could be managed medically or if it needs to go to surgery, here are two tests you may find helpful:

1. Complete a glucose reading on the abdominal fluid. If it is more than 20 points lower in the abdomen (using mg/dl where mmol/l x 18 = mg/dl) compared with blood glucose e.g. BG = 176mg/dl and glucose in effusion = 98mg/dl, then septic peritonitis is more likely than a sterile peritonitis or ascites.
2. 2. Make a slide of the effusion and look for intracellular bacteria. If the glucose differential is >20mg/dl and there is intracellular bacteria, then exploratory sugery is indicated as soon as the patient is stable.

And for the feline patient…

For cats with a suspected thromboembolism (“saddle thrombus”) check the blood glucose on a foreleg (it will usually be >10mmol/l due to stress) and the blood glucose on a back leg at the same time, using the same glucometer. A significant difference may indicate the presence of a clot when taken into account with other supportive clinical signs.

Of course a glucometer is only part of a comprehensive in-house laboratory setup, but even the most unassuming of laboratory equipment can be extremely helpful in building a diagnostic picture.

Your local chemist or diabetes organisations are great places to purchase a replacement or additional glucometer. There is also plenty of discussion on online veterinary forums should you be looking for a comparison between specific glucometer makes and models.

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