Re: Question for Dr. Kellon and Invokana dose for Riosa


Hi, Heather.
Not Dr Kellon, and I can't address any of your questions about Invokana.
I need to update my comments on glucometers based on my recent experience. Initially, I had no problems using a glucometer to check a drop of Cayuse's blood drawn by my vet. Starting last fall, I started getting error codes every single time. It works fine with my blood, so there's nothing wrong with the glucometer. I've tried new test strips, calibrated it, changed the battery. Error codes keep on coming with Cayuse's blood. 
After some reading about humans and veterinary glucometers, I found there are factors that will make your glucometer refuse to read the glucose in the blood or provide inaccurate results: 
1. Low temperature. The blood must be and remain fresh and warm! A cold day can cause problems.
2. Hematocrit outside the usual parameters for humans
3. Finicky test strips that you buy by the dozen but use a few times a year.
4. Impact of drugs or vitamins that confound the results. 
There are probably more. In short, while my glucometer worked well initially, it no longer works consistently with Cayuse's blood. 
There's another issue we need to think about. Even working perfectly, glucometer accuracy isn't fantastic. It can be working perfectly within the specifications required by the FDA, and it can still give results that are plus or minus 15mg/dl of the actual blood glucose.  Cayuse's results, when the glucometer worked for her, were about plus or minus 5 mg/dl of lab results.
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
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