Perioperative Validation of Two Handheld Glucometers in Dogs Under General Anesthesia: Analytical Robustness and...

Area of Science:

• Veterinary Anesthesiology
• Clinical Pathology
• Medical Device Validation

Background:

• Accurate perioperative glucose monitoring is crucial for dogs under general anesthesia.
• Existing validation studies for handheld glucometers primarily focus on stable outpatient conditions, not anesthesia.
• Evaluating device performance in anesthetized animals is essential for clinical decision-making.

Purpose of the Study:

• To assess the analytical agreement and diagnostic performance of human and veterinary handheld glucometers in anesthetized dogs.
• To determine compliance with ISO 15197 standards for both devices.
• To compare a human-calibrated (Accu-Chek) and a veterinary-specific (Centrivet GK) glucometer against a laboratory reference method.

Main Methods:

• Prospective clinical validation study involving 34 anesthetized dogs.
• Collected 99 paired glucose measurements per device using Accu-Chek, Centrivet GK, and a spectrophotometric reference method.
• Statistical analyses included linear mixed-effects modeling, Bland-Altman analysis, and Passing-Bablok regression.

Main Results:

• The veterinary-specific device significantly overestimated glucose concentrations (β = 20.79 mg/dL) with substantial mean bias (22.72 mg/dL) and proportional bias.
• The human-calibrated device showed no significant difference from the reference method (β = 7.18 mg/dL) with minimal mean bias (4.44 mg/dL).
• ISO 15197 compliance was higher for the human-calibrated device (69.7%) compared to the veterinary-specific device (39.4%).

Conclusions:

• The human-calibrated glucometer demonstrated superior analytical robustness and accuracy in anesthetized dogs.
• The veterinary-specific glucometer exhibited greater bias and variability, potentially impacting clinical decisions during anesthesia.
• Human-calibrated devices may offer more reliable perioperative glucose monitoring in veterinary anesthesia settings.