Correlation between glucose concentrations

SMALL ANIMALS/
in serum, plasma, and whole blood

EXOTIC
measured by a point-of-care glucometer
and serum glucose concentration
measured by an automated biochemical analyzer
for canine and feline blood samples
Barbara S. Tauk, DVM; Kenneth J. Drobatz, DVM, MSCE; Koranda A. Wallace, DVM; Rebecka S. Hess, DVM

Objective—To investigate the correlation between glucose concentrations in serum, plas-

ma, and whole blood measured by a point-of-care glucometer (POCG) and serum glucose
concentration measured by a biochemical analyzer.
Design—Prospective clinical study.
Samples—96 blood samples from 80 dogs and 90 blood samples from 65 cats.
Procedures—Serum, plasma, and whole blood were obtained from each blood sample.
The glucose concentrations in serum, plasma, and whole blood measured by a POCG were
compared with the serum glucose concentration measured by a biochemical analyzer by
use of the Lin concordance correlation coefficient (ρc) and Bland-Altman plots.
Results—For both canine and feline samples, glucose concentrations in serum and plasma
measured by the POCG were more strongly correlated with the serum glucose concentra-
tion measured by the biochemical analyzer (ρc, 0.98 for both canine serum and plasma; ρc,
0.99 for both feline serum and plasma) than was that in whole blood (ρc, 0.62 for canine
samples; ρc, 0.90 for feline samples). The mean difference between the glucose concentra-
tions determined by the biochemical analyzer and the POCG in serum, plasma, and whole
blood was 0.4, 0.3, and 31 mg/dL, respectively, for canine samples and 7, 6, and 32 mg/dL,
respectively, for feline samples.
Conclusions and Clinical Relevance—Results indicated that use of a POCG to measure
glucose concentrations in serum or plasma may increase the accuracy and reliability of
diagnostic and treatment decisions associated with glucose homeostasis disorders in dogs
and cats. (J Am Vet Med Assoc 2015;246:1327–1333)

P oint-of-care glucometers are widely used in vet-

erinary hospitals for quick, easy, and cost-effective
measurement of blood glucose concentration in canine
and feline patients. The use of POCGs is particularly
important for serial measurement of blood glucose con-
centration in diabetic dogs and cats, in which insulin
dose adjustments are required.1–3 Point-of-care glu-
cometers are also commonly used to routinely monitor
blood glucose concentration in hospitalized dogs and
cats, especially patients with diseases associated with
glucose homeostasis disorders such as liver disease,
sepsis, neoplasia, hypoadrenocorticism, and insulin-
oma, and juvenile or neonatal animals that are weak,
depressed, or neurologically unstable.
From the Department of Clinical Studies-Philadelphia, School of Veter-
inary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
Dr. Wallace’s present address is Antech Diagnostic Laboratory at
the Veterinary Specialty and Emergency Center, 301 Veterans Hwy,
Levittow, PA 19056.
Presented in abstract form at the annual conference of the American
College of Veterinary Internal Medicine, Nashville, Tenn, June 2014.
Supported by a gift from Catherine and Frederick Adler.
The authors declare no conflicts of interest, financial or otherwise.
Address correspondence to Dr. Hess (rhess@vet.upenn.edu).
POCG
ABBREVIATION
Point-of-care glucometer
Results of some studies4,5 indicate that use of a POCG
for measurement of glucose concentration in whole blood
samples produces unreliable results for dogs. Thus, use
of a POCG to monitor blood glucose concentrations in
hospitalized patients is limited by concerns that the re-
sults provided by the POCG might lead to erroneous clini-
cal decisions.4 However, certain aspects of POCGs make
their use preferable to that of an automated biochemical
analyzer for measurement of glucose concentration. For
example, results can be obtained within 1 minute, which
is advantageous in emergency situations; only a small
amount (0.6 µL) of blood is necessary to measure glu-
cose concentration, which is helpful when monitoring
patients that are very small or markedly anemic; and it is
fairly inexpensive to use, which is beneficial when serial
monitoring of serum or plasma glucose concentration by
biochemical analysis is cost prohibitive.
In previous studies,4,5 glucose concentration was
measured in whole blood by a POCG and in serum by

JAVMA, Vol 246, No. 12, June 15, 2015 Scientific Reports 1327
 a biochemical analyzer. We hypothesized that the cor- 25 mg/dL) used to establish the reference interval for
relation between the results obtained by a POCG and
SMALL ANIMALS/

the biochemical analyzer. It was assumed that the SD

biochemical analyzer would be improved if the POCG of the glucose concentrations determined by the POCG
EXOTIC

was used to measure the glucose concentration in se-
rum or plasma. The purpose of the study reported here
was to investigate the respective correlations between
glucose concentrations in serum, plasma, and whole
blood measured by a POCG and serum glucose concen-
tration measured by a biochemical analyzer for canine
and feline blood samples.
Materials and Methods
Animals—The study was performed between April
and October 2013 during periods allocated for research
for one of the investigators (BST). Dogs and cats ex-
amined at the University of Pennsylvania Ryan Veteri-
nary Hospital for reasons unrelated to the study that
required collection of a blood sample for diagnostic
purposes were eligible for enrollment. All study proto-
cols were approved by the University of Pennsylvania
Institutional Animal Care and Use Committee, and all
blood samples were obtained from patients as part of a
diagnostic plan developed by the attending clinicians
with consent from the owners.
Sample size calculation—A 2-sided paired t test
was used to perform a power calculation to determine
the number of samples required to detect a difference
of at least 15 mg/dL between the glucose concentration
determined by the biochemical analyzer and that deter-
mined by the POCG. The calculation was made on the
basis of the mean ± SD glucose concentration (117 ±
would be similar to that of the glucose concentrations
determined by the biochemical analyzer. Other assump-
tions included a power of 0.8, type I error rate of 0.05,
correlation of 0.7, and a ratio of 1 between the POCG
and biochemical analyzer results. The calculation re-
sulted in a required sample size of 44 blood samples for
both dogs and cats; however, additional samples from
eligible animals were analyzed as they became available
until the end of the allocated research time.
Experimental protocol—Immediately after each
blood sample was obtained, a drop of whole blood was
analyzed by a POCGa that was designated specifically for
the study, and the remainder of the sample was placed in
a heparinized capillary tube,b a nonheparinized capillary
tube,c and an evacuated glass blood collection tubed or
plastic microtainer.e The capillary tubes were centrifuged
within 3 minutes after collection and used to measure
the PCV and obtain serum (nonheparinized tube) and
plasma (heparinized tube) for measurement of glucose
concentration by the POCG. Serum was harvested from
the samples stored in the evacuated glass blood collec-
tion tubes or plastic microtainers within 15 minutes after
collection, and the serum glucose concentration was de-
termined by an automated biochemical analyzer.f
POCG—The glucose concentration in all samples
was measured with the same POCG by means of an
enzymatic glucose dehydrogenase reaction and quan-
titative amperometric assay.6 Briefly, 0.6 µL of a sample

Table 1—Descriptive statistics for the glucose concentration in serum, plasma, and whole blood mea-
sured by a POCG and serum glucose concentration measured by an automated biochemical analyzer
for 96 blood samples obtained from 80 dogs and 90 blood samples obtained from 65 cats.

Glucose concentration (mg/dL)

Species Analyzer Sample type Mean ± SD Median (range)
Dog POCG Serum 113 ± 43 100 (75–308)
POCG Plasma 113 ± 41 102 (76–295)
POCG Whole blood 82 ± 31 76 (45–231)
Biochemical analyzer Serum 113 ± 38 102 (78–286)
Cat POCG Serum 150 ± 85 119 (57–498)
POCG Plasma 151 ± 85 121 (57–492)
POCG Whole blood 125 ± 73 98 (39–420)
Biochemical analyzer Serum 157 ± 87 126 (68–519)

For animals from which multiple blood samples were obtained, there was at least a 2-hour interval be-
tween sample collections.

Table 2—Results of Lin concordance correlation analyses in which the respective glucose concentra-
tions in serum, plasma, and whole blood measured by a POCG were compared with the serum glucose
concentration measured by an automated biochemical analyzer for 96 blood samples obtained from 80
dogs and 90 blood samples obtained from 65 cats.

Species Sample analyzed by POCG ρc (95% confidence interval) Bias correction factor
Dog Serum 0.981 (0.98–0.99) 0.993
Plasma 0.983 (0.98–0.99) 0.997
Whole blood 0.624 (0.54–0.71) 0.697
Cat Serum 0.990 (0.986–0.994) 0.997
Plasma 0.992 (0.989–0.995) 0.997
Whole blood 0.900 (0.88–0.93) 0.913

For all comparisons, the referent was serum glucose concentration determined by an automated bio-
chemical analyzer and P < 0.001.

1328 Scientific Reports JAVMA, Vol 246, No. 12, June 15, 2015
 Table 3—Results of Lin concordance correlation analyses in which the respective glucose concentrations
in serum, plasma, and whole blood measured by a POCG were compared with the serum glucose concen-

SMALL ANIMALS/
tration measured by an automated biochemical analyzer for a subset of 26 blood samples obtained from
dogs and 25 blood samples obtained from cats that were characterized as being hyperglycemic (glucose

EXOTIC
concentration as determined by the biochemical analyzer, > 112 mg/dL for dogs and > 168 mg/dL for cats).

Species Sample analyzed by POCG ρc (95% confidence interval) Bias correction factor
Dog Serum 0.981 (0.97–0.99) 0.990
Plasma 0.984 (0.97–0.99) 0.995
Whole blood 0.656 (0.51–0.81) 0.711
Cat Serum 0.988 (0.98–0.99) 0.996
Plasma 0.992 (0.990–0.998) 0.997
Whole blood 0.865 (0.79–0.94) 0.874

See Table 2 for key.

was applied directly to a glucose test

strip, which was then inserted into the
POCG, and results were generated in ap-
proximately 5 seconds.7 One investiga-
tor (BST) operated the POCG through-
out the study. The POCG was operated
in accordance with the manufacturer’s
recommendations7 except that glucose
concentrations were measured in se-
rum and plasma as well as whole blood
and venous rather than capillary blood
samples were analyzed. The POCG was
calibrated in accordance with the manu-
facturer’s instructions7 with manufactur-
er-provided control solution and calibra-
tion test strips at the onset of the study
and each time a new box of 50 test strips
was opened.

Biochemical analyzer—The bio-

chemical analyzer measured the glucose
concentration of each serum sample
by use of an enzymatic hexokinase oxi-
dase reaction, and results were detected
colormetrically.8 The analyzer required
10 µL of serum for analysis and generated
results in approximately 5 minutes.8 It
was operated by trained laboratory tech-
nologists. The reference range established
by the laboratory for serum glucose con-
centration was 65 to 112 mg/dL for dogs
and 67 to 168 mg/dL for cats, and serum
glucose concentrations below or above
those ranges were characterized as being
consistent with hypoglycemia or hyper-
glycemia, respectively.
Statistical analysis—For each
sample type (serum, plasma, and whole
blood) and analyzer (biochemical ana-
lyzer and POCG), the distribution of the
glucose concentration data was assessed
for normality by means of the Shapiro-
Wilks test. Descriptive data were gener- Figure 1—Box-and-whisker plots of the difference between the glucose concentra-
ated. The respective differences between tion in whole blood, serum, and plasma measured by a POCG and the serum glucose
the glucose concentrations in serum, concentration measured by an automated biochemical analyzer for 96 blood samples
plasma, and whole blood measured by obtained from 80 dogs (A) and 90 blood samples obtained from 65 cats (B). For each
plot, the solid line in the middle of each box represents the median, the top and bottom
the POCG and the serum glucose con- edges of the box delimit the interquartile range, the brackets represent the most ex-
centration measured by the biochemical treme data point within 1.5 times the nearest quartile, and the circles represent outliers.

JAVMA, Vol 246, No. 12, June 15, 2015 Scientific Reports 1329
 analyzer were evaluated with Lin concor-
dance correlation analyses9 and Bland-
SMALL ANIMALS/

Altman plots. Additionally, Lin concor-

EXOTIC

dance correlation analysis was used to

evaluate a subgroup of hyperglycemic
blood samples from both dogs and cats
to determine whether the correlation be-
tween the glucose concentration deter-
mined by the POCG and that determined
by the biochemical analyzer varied as the
glucose concentration increased. The re-
sults reported for each Lin concordance
correlation analysis included the ρc and
associated 95% confidence interval and
the bias correction factor, which indi-
cates how far the line of best fit for the
data deviates from the 45° line that passes
through the origin.
Linear regression analysis was used
to evaluate the association of the PCV
with the correlation between the whole
blood glucose concentration measured
by the POCG and the serum glucose
concentration measured by the bio-
chemical analyzer. For reporting pur-
poses, the PCV reference range was 40%
to 60% for dogs and 32% to 48% for cats,
and anemia was defined as a PCV < 40%
for dogs and < 32% for cats. All analyses
were performed with a statistical soft-
ware program,g and values of P < 0.05
were considered significant.

Results
Ninety-six blood samples obtained
from 80 client-owned dogs and 90 blood
samples obtained from 65 client-owned
cats were analyzed. For animals from
which multiple blood samples were ob-
tained, there was at least a 2-hour in-
terval between sample collections. The
glucose concentrations in serum, plas-
ma, and whole blood measured by the
POCG and the serum glucose concen-
tration measured by the automated bio-
chemical analyzer for both dogs and cats
were summarized (Table 1). The serum

Figure 2—Bland-Altman plots of the respective

differences between glucose concentration in
serum (POCG serum; A), plasma (POCG plas-
ma; B), and whole blood (POCG whole blood;
C) measured by the POCG and the serum
glucose concentration measured by the auto-
mated biochemical analyzer (ABA) for 96 blood
samples obtained from 80 dogs. For each plot,
the dashed line represents a mean difference
of 0 between the glucose concentrations being
compared, the middle solid line represents the
mean difference between the glucose concen-
trations being compared, and the upper and
lower solid lines represent the 95% limits of
agreement (mean difference ± 1.96 SD). The
closer the middle solid line is to the dashed
line, the better the agreement between the 2
glucose concentrations being compared.

1330 Scientific Reports JAVMA, Vol 246, No. 12, June 15, 2015
glucose concentration measured by the
biochemical analyzer was considered the

SMALL ANIMALS/
gold standard for all samples.

EXOTIC
For the 96 canine samples, the serum
glucose concentration determined by the
biochemical analyzer was within the refer-
ence range (65 to 112 mg/dL) for 70 (73%)
samples and was > 112 mg/dL (hyper-
glycemia) for the remaining 26 (27%)
samples. Twenty-three (24%) samples had
a whole blood glucose concentration < 65
mg/dL when measured with the POCG
(mean ± SD, 56 ± 6 mg/dL; median, 57
mg/dL; range, 45 to 64 mg/dL); however,
none of those samples were classified as
hypoglycemic (glucose concentration,
< 65 mg/dL) on the basis of the serum
glucose concentration measured by the
biochemical analyzer. For the 90 feline
samples, the serum glucose concentra-
tion determined by the biochemical ana-
lyzer was within the reference range (67
to 168 mg/dL) for 65 (72%) samples and
was > 168 mg/dL (hyperglycemia) for the
remaining 25 (28%) samples. Five (6%)
samples had a whole blood glucose con-
centration < 67 mg/dL when measured
with the POCG (mean ± SD, 55 ± 11 mg/
dL; median, 62 mg/dL; range, 39 to 65
mg/dL); however, none of those samples
were classified as hypoglycemic (glucose
concentration, < 67 mg/dL) on the basis
of the serum glucose concentration mea-
sured by the biochemical analyzer.
Results of the Lin concordance cor-
relation analyses indicated that the serum
glucose concentration measured by the
biochemical analyzer was significantly (P
< 0.001) correlated with the glucose con-
centration measured by the POCG, re-
gardless of the sample (serum, plasma, or
whole blood) analyzed (Table 2). How-
ever, the glucose concentrations in serum
and plasma determined by the POCG
were more strongly correlated with the
serum glucose concentration determined
by the biochemical analyzer than was the
whole blood glucose concentration deter-
mined by the POCG. Similar results were
obtained when the subset of 26 canine
samples and 25 feline samples that were
classified as hyperglycemic on the basis
of the serum glucose concentration mea-
sured by the biochemical analyzer were
assessed (Table 3), which suggested that
the correlation between the results of the

Figure 3—Bland-Altman plots of the respective

differences between glucose concentration
in serum (A), plasma (B), and whole blood (C)
measured by the POCG and the serum glucose
concentration measured by the automated bio-
chemical analyzer for 90 blood samples obtained
from 65 cats. See Figure 2 for remainder of key.

JAVMA, Vol 246, No. 12, June 15, 2015 Scientific Reports 1331
 POCG and biochemical analyzer did not vary as glucose
concentration increased.
SMALL ANIMALS/
The respective differences between the glucose
concentration in serum, plasma, and whole blood mea-
EXOTIC
sured by the POCG and the serum glucose concentra-
tion measured by the biochemical analyzer for both ca-
nine and feline samples were summarized (Figure 1).
The corresponding Bland-Altman plots for dogs (Figure
2) and cats (Figure 3) are provided. Similar to the Lin
concordance correlation analyses, the Bland-Altman
plots indicate that the glucose concentrations measured
by the POCG in serum and plasma more closely agreed
with the serum glucose concentration measured by the
biochemical analyzer than did the whole blood glucose
concentration measured by the POCG, as evidenced by
the narrower 95% limits of agreement for the POCG re-
sults for serum and plasma, compared with the POCG
results for whole blood.
For the 96 canine samples, the PCV was within the
reference range (40% to 60%) for 67 (70%) samples and
< 40% for the remaining 29 (30%) samples; none of the
samples had a PCV > 60%. Results of linear regression
indicated that the correlation between the whole blood
glucose concentration measured by the POCG and the
serum glucose concentration measured by the biochemi-
cal analyzer was significantly better for samples with a
PCV < 40%, compared with that for samples with a PCV
within the reference range, although the coefficient of
determination for the analysis was only 0.48.
For the 90 feline samples, the PCV was within the
reference range (32% to 48%) for 61 (68%) samples, was
< 32% for 27 (30%) samples, and was > 48% for 2 (2%)
samples. Results of the linear regression did not indicate
an association between the PCV and the correlation be-
tween the whole blood glucose concentration measured
by the POCG and the serum glucose concentration mea-
sured by the biochemical analyzer when the PCV was
within or below the reference range. The small number
of samples with a PCV above the reference range pre-
vented a similar analysis with that group of samples.
Discussion
Results of the present study indicated that there
was excellent correlation between serum glucose con-
centration measured by a biochemical analyzer (gold
standard) and glucose concentrations measured by
a POCG in serum and plasma, but not whole blood,
for canine and feline samples. Accurate measurement
of glucose concentration in hospitalized patients is of
paramount importance for the timely diagnosis and
treatment of many diseases and conditions, including
diabetes mellitus. Measurement of glucose concentra-
tion by a POCG is appealing because POCGs are widely
available, inexpensive, and easy to use and provide re-
sults rapidly. However, the use of POCGs in veterinary
practice has been hampered because of inaccurate re-
sults, especially when whole blood is analyzed.4,5 Find-
ings of the present study suggested that use of a POCG
to measure glucose concentration in serum or plasma
yielded accurate results, which could improve the accu-
racy, reliability, and speed of diagnostic and treatment
decisions for hospitalized dogs and cats with abnormal
glucose homeostasis.
1332 Scientific Reports
Inaccurate measurement of glucose concentration
can adversely affect treatment decisions.4,5 In a study4 in
which the glucose concentration was measured in 110
whole blood samples obtained from 34 dogs with vari-
ous POCGs, it was estimated that inaccurate glucose
measurements would cause erroneous treatment deci-
sions 8% to 67% of the time, depending on the POCG
used. In another study10 in which a POCG was used
to measure glucose concentration in serial whole blood
samples obtained from diabetic dogs being treated
with insulin, it was estimated that contradictory rec-
ommendations for insulin administration were often
provided for the same dog on the basis of serial glu-
cose measurements obtained on 2 consecutive days.
These 2 studies4,10 highlight the possible unfortunate
clinical outcomes associated with the use of a POCG
to measure glucose concentration in whole blood sam-
ples. The findings of the present study suggested that
use of a POCG to measure glucose concentration in
serum or plasma instead of whole blood provided ac-
curate results. Thus, the particular POCG used in this
study might be useful for serial monitoring of serum or
plasma glucose concentrations in patients with diabe-
tes mellitus and enhance the accuracy of insulin dose
adjustments for those patients; this may be particularly
important for patients in which hypoglycemia is sus-
pected. In the present study, all 23 canine and 5 feline
samples that were misclassified as hypoglycemic on the
basis of whole blood glucose concentration measured
by the POCG were correctly classified as normoglyce-
mic on the basis of the serum and plasma glucose con-
centrations measured by the POCG, when the serum
glucose concentration measured by a biochemical ana-
lyzer was used as the gold standard.
Although serum glucose concentration measured
with the biochemical analyzer was excellently corre-
lated with the glucose concentration measured by the
POCG in both serum and plasma, it was best correlated
with the plasma glucose concentration measured by the
POCG. Therefore, plasma might be the best sample for
POCG measurement of glucose concentration, which
means that heparinized capillary tubes would be pre-
ferred over nonheparinized capillary tubes for blood
sample processing.
For both canine and feline samples, the correlation
between serum glucose concentration measured by the
biochemical analyzer and the glucose concentrations
in serum and plasma measured by the POCG remained
excellent, even for the subgroup of animals with
hyperglycemia (glucose concentration, > 112 mg/dL
for dogs and > 168 mg/dL for cats). However, samples
with marked hyperglycemia (glucose concentration, >
300 mg/dL for dogs and > 500 mg/dL for cats) were not
evaluated in the present study, and none of the sam-
ples in this study had marked hypoglycemia (glucose
concentration, < 60 mg/dL for dogs and < 60 mg/dL
for cats). Further research is warranted to investigate
the correlation of glucose concentration measured by a
biochemical analyzer or some other reference method
and the glucose concentration measured by a POCG
for dogs and cats with varying degrees of hypoglycemia
and hyperglycemia.
Only the correlation between whole blood glucose
concentration measured by the POCG and the serum
JAVMA, Vol 246, No. 12, June 15, 2015
glucose concentration measured by the biochemical
analyzer was evaluated for an association with PCV
because the PCV was not expected to affect the glu-
cose concentration measured by the POCG in serum
and plasma samples. Results indicated that the corre-
lation between the whole blood glucose concentration
measured by the POCG and the serum glucose concen-
tration measured by the biochemical analyzer was sig-
nificantly better for canine samples with a PCV < 40%,
compared with that for canine samples with a PCV
within the reference range. However, the coefficient of
determination was 0.48, which suggested that the PCV
accounted for only 48% of the variation in the differ-
ence between the whole blood glucose concentration
measured by the POCG and the serum glucose concen-
tration measured by the biochemical analyzer. A similar
association between PCV and the correlation between
the whole blood glucose concentration measured by
the POCG and the serum glucose concentration mea-
sured by the biochemical analyzer was not observed in
the feline samples. Results of other studies11–14 suggest
that Hct significantly affects the measurement of whole
blood glucose concentration by a POCG in dogs, cats,
and humans. In human blood samples with a low Hct,
the whole blood glucose concentration measured by a
POCG is generally overestimated, compared with the
serum glucose concentration measured by a biochemi-
cal analyzer.14 Although the mechanism for that finding
is not fully understood, the viscosity of a blood sample
is positively associated with its Hct and some investi-
gators14 have hypothesized that the ability of plasma
to reach the reaction surface of the POCG test strip is
negatively associated with Hct such that the amount of
plasma that reaches the reaction surface of the test strip
for a sample with a low Hct is proportionately greater
than the amount of plasma that reaches the reaction
surface of the test strip for a sample with a higher Hct,
and consequently, the glucose concentration measured
by a POCG will be greater for the sample with a low Hct
than that for the sample with a higher Hct. The reason
that the glucose concentrations in serum and plasma
measured by the POCG were more strongly correlated
with the serum glucose concentration measured by the
biochemical analyzer than was the whole blood glucose
concentration measured by the POCG in the present
study might have been associated with the removal of
the RBCs from the serum and plasma. Additional stud-
ies are necessary to determine whether hemoconcentra-
tion or polycythemia affects the POCG measurement of
glucose concentration in serum and plasma.
A limitation of the present study was the fact that
only 1 POCG was evaluated. The results may have dif-
fered had other POCGs produced by the same manufac-
turer or other manufacturers been evaluated. Another
limitation was that blood samples with marked hypo-
glycemia or hyperglycemia were not analyzed. Finally,
the manufacturer of the POCG recommends that it
only be used to evaluate fresh capillary blood samples.
In the present study, fresh venous blood samples were
JAVMA, Vol 246, No. 12, June 15, 2015
analyzed, and it is unknown whether the type of blood
sample (capillary vs venous) would affect measurement
SMALL ANIMALS/
of the glucose concentration by the POCG.
EXOTIC
In the present study, there was excellent correlation
between serum glucose concentration measured by a
biochemical analyzer and glucose concentrations mea-
sured by a POCG in serum and plasma, but not whole
blood, for canine and feline blood samples. Use of the
POCG to measure glucose concentrations in serum or
plasma may increase the timeliness, accuracy, and reli-
ability of diagnostic and treatment decisions associated
with glucose homeostasis disorders in dogs and cats.
a. Accu-Check Aviva, Roche Diagnostics Corp, Indianapolis, Ind.
b. Heparinized capillary tubes, Thermo Fisher Scientific, Waltham,
Mass.
c. Nonheparinized capillary tubes, Thermo Fisher Scientific, Waltham,
Mass.
d. Monoject blood collection tubes, Covidien, Mansfield, Mass.
e. CAPIJECT micro collection tubes, Terumo Medical Corp, Elkton,
Md.
f. Vitros Chemistry System 350, Ortho-Clinical Diagnostics, Rochester,
NY.
g. Stata, version 12.0 for Mac, Stata Corp, College Station, Tex.
References
1. Hess RS, Drobatz KJ. Glargine insulin for treatment of natu-
rally occurring diabetes mellitus in dogs. J Am Vet Med Assoc
2013;243:1154–1161.
2. Sears KW, Drobatz KJ, Hess RS. Use of lispro insulin for treat-
ment of diabetic ketoacidosis in dogs. J Vet Emerg Crit Care (San
Antonio) 2012;22:211–218.
3. Claus MA, Silverstein DC, Shofer FS, et al. Comparison of regular
insulin infusion doses in critically ill diabetic cats: 29 cases (1999–
2007). J Vet Emerg Crit Care (San Antonio) 2010;20:509–517.
4. Cohn LA, McCaw DL, Tate DJ, et al. Assessment of five portable
blood glucose meters, a point-of-care analyzer, and color test
strips for measuring blood glucose concentration in dogs. J Am
Vet Med Assoc 2000;216:198–202.
5. Johnson BM, Fry MM, Flatland B, et al. Comparison of a human
portable blood glucose meter, veterinary portable blood glu-
cose meter, and automated chemistry analyzer for measurement
of blood glucose concentrations in dogs. J Am Vet Med Assoc
2009;235:1309–1313.
6. Hönes J, Müller P, Surridge N. The technology behind glucose me-
ters: test strips. Diabetes Technol Ther 2008;10(suppl 1):10S–26S.
7. ACCU-CHEK Aviva blood glucose meter user manual. Indianapo-
lis: Roche Diagnostics, 2011.
8. Vitros 350/250/250AT chemistry analyzer user manual, version
2.1. Rochester, NY: Ortho Clinical Diagnostics, 2008.
9. Lin LI. A concordance correlation coefficient to evaluate repro-
ducibility. Biometrics 1989;45:255–268.
10. Fleeman LM, Rand JS. Evaluation of day-to-day variability of
serial blood glucose concentration curves in diabetic dogs. J Am
Vet Med Assoc 2003;222:317–321.
11. Wess G, Reusch C. Assessment of five portable blood glucose
meters for use in cats. Am J Vet Res 2000;61:1587–1592.
12. Wess G, Reusch C. Assessment of five portable blood glucose
meters for use in dogs. J Am Vet Med Assoc 2000;216:203–209.
13. Paul AE, Shiel RE, Juvet F, et al. Effect of hematocrit on accuracy
of two point-of-care glucometers for use in dogs. Am J Vet Res
2011;72:1204–1208.
14. Ramljak S, Lock JP, Schipper C, et al. Hematocrit interference of
blood glucose meters for patient self-measurement. J Diabetes
Sci Technol 2013;7:179–189.
Scientific Reports 1333