Validation of a portable hand-held whole-blood ketone meter for use in cats

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Abstract

Background

Urinary dipsticks are the most frequent method used for screening of ketones in animals, but this method has many drawbacks. In human medicine, portable meters that measure ketones in whole blood have largely replaced urinary dipsticks.

Objective

The aim of this prospective study was to validate a portable whole-blood ketone meter for use in cats.

Methods

Sixty-two cats (11 clinically healthy, 51 with diabetes mellitus) were included in the study. The concentration of β-hydroxybuyrate (β-HB) was measured in venous and capillary blood with a hand-held ketone meter (Precision Xceed; assay range 0–8 mmol/L) and compared with a spectrophotometric method. Precision, accuracy, and the effects of hematocrit and anticoagulants were evaluated.

Results

Between-run precision using low- and high-concentration control solutions was 8.1% and 2.6%, respectively; within-run coefficient of variation determined using 12 feline blood samples was 2.8%. In the 62 cats, β-HB concentrations measured with the portable ketone meter ranged from 0–7.4 mmol/L (median 0.9 mmol/L). When β-HB concentrations measured by the portable meter were < 4.0 mmol/L there was good agreement with the reference method, but concentrations > 4.0 mmol/L were lower than those obtained by the reference method in 20 of 24 cats (83%). There was good correlation between capillary and venous measurements. Results were not affected by hematocrits from 0.17 to 0.50 L/L, but EDTA was not a suitable anticoagulant.

Conclusion

Measurement of β-HB concentration in peripheral or capillary blood by an easy-to-use portable ketone meter was suitable for detecting ketonemia in cats. Underestimation of β-HB concentration was observed at higher values, but results were sufficiently high to aid in diagnosing diabetic ketoacidosis.

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