Abstract
IMPORTANCE: Flash Glucose Monitoring System (FGMS; FreeStyle Libre) enables non-invasive, continuous glucose monitoring. However, its perioperative utility in canine surgeries has not been evaluated. This study highlights the feasibility of FGMS in perioperative glucose management for veterinary patients. OBJECTIVE: This study aimed to evaluate the clinical applicability and accuracy of FGMS in perioperative glucose monitoring in dogs. METHODS: Thirty-two dogs that underwent surgery were monitored during the preoperative, intraoperative, and postoperative phases using FGMS and portable blood glucose meter (PBGM). RESULTS: A total of 224 paired glucose measurements were analyzed for correlation and accuracy using ISO 15197:2013 standards. Spearman's correlation analysis revealed positive correlation between FGMS and PBGM (ρ = 0.894, ρ = 0.823, and ρ = 0.795, respectively) during the preoperative, intraoperative, and postoperative phases, respectively (p < 0.001). The Bland-Altman plot of the difference between FGMS and PBGM showed a positive bias during the intraoperative phase (23.3 mg/dL), despite a negative bias in the preoperative (-16.0 mg/dL) and postoperative (-4.58 mg/dL) phases. Parkes consensus error grid analysis demonstrated that 100% of the data pairs fell within clinically acceptable zones (zones A and B) throughout the operation. CONCLUSIONS AND RELEVANCE: FGMS provides continuous and noninvasive glucose monitoring in dogs with clinical feasibility throughout the perioperative period, although its accuracy decreases during the intraoperative phase. For patients with relatively stable blood glucose levels, the Libre device is clinically effective for perioperative glucose monitoring and provides a simpler and more accessible alternative to traditional methods.