Bubba has Moderate Ketones :(

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Bobbie And Bubba

Bobbie And Bubba

Member Since 2015
After the one urine test came back from the vet's with a +3 Ketone, she asked me to get a ketone test in yesterday and I got one after he ate dinner and it came back Moderate. Yikes. I am to call her today with his BG and the ketone results. I raised him from 2.6 to-2.8. The test before last I got on him was apparently not good as I did not know how long the urine was on the saran wrap. This time I emptied the box and use noabsorb beads. (apparently the ketones can evaporate)

He is eating great (always hungry!) Peeing like a race horse, drinking lots of water (and I add water to his food) and otherwise seems normal except his numbers won't come down. This makes me very nervous and now I know why he's continuing to lose weight. Is there anything else I can do?

Posted in ProZinc also.
 
Bobbie And Bubba said:
After the one urine test came back from the vet's with a +3 Ketone, she asked me to get a ketone test in yesterday and I got one after he ate dinner and it came back Moderate. Yikes. I am to call her today with his BG and the ketone results. I raised him from 2.6 to-2.8. The test before last I got on him was apparently not good as I did not know how long the urine was on the saran wrap. This time I emptied the box and use noabsorb beads. (apparently the ketones can evaporate)

He is eating great (always hungry!) Peeing like a race horse, drinking lots of water (and I add water to his food) and otherwise seems normal except his numbers won't come down. This makes me very nervous and now I know why he's continuing to lose weight. Is there anything else I can do?

Posted in ProZinc also.
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Poor guy hope he starts improving soon.those strips first two colors are hard to read.sometimes I can't tell if it is tan or a tad pink.
 
SpecklesandMe said:
Oh no! Just saw this! How's Bubba doing today? Hope all's well!
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I love your new pic!! He's doing okay as far as eating well (he's actually starving) doing all the P's. Just weighed him and he's down to 14 lbs! I am getting scared. He will get some more blood work on Friday if the urine culture doesn't show anything. He is stumping the vet too to have him in the 200's stuck and have ketones.........Thanks for asking.
 
granadilla said:
Oh Bobbie, I'm sorry. I know how worried you must be. Hugs to you, and paws crossed for a quick resolution.
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I was wondering how he had ketones too when he is doing good with his bg.very strange.miss kitty is still losing weight too and I'm trying to get more in her and it is hard since she is such a small eater.little tad here little tad there all day.takes 12 hrs to get 1/2 can of wet food down her.:banghead: I really hope they figure out what is causing bubba's ketones.how do they get rid of the ketones besides getting the bg regulated?
 
Cat girl said:
I was wondering how he had ketones too when he is doing good with his bg.very strange.miss kitty is still losing weight too and I'm trying to get more in her and it is hard since she is such a small eater.little tad here little tad there all day.takes 12 hrs to get 1/2 can of wet food down her.:banghead: I really hope they figure out what is causing bubba's ketones.how do they get rid of the ketones besides getting the bg regulated?
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Hey Beth, I am sorry that Miss Kitty is still losing weight. It is very upsetting to watch our cats waste. About the ketones: one more urine test is out and should be back tomorrow. If there is a UTI then that could be the source of the ketones. I will be very surprised it there is one. Then the next step would be to repeat all the blood work and see if something has developed like thyroid issues. I hope we will get to the bottom of it. Tomorrow he will be bumped up to 3 units.
 
Sorry that you and Bubba are having a rough time I hope you can get it figured out soon and get him back on track.
 
Thanks Sharon. I have him isolated in the basement to get a urine sample to test for ketones and of course he isn't going. Drats! Also, I increased him to 3 units this AM as he was up to 286. After I increased I second guessed myself as I did not get any test in last night from +2.5 through +8 so, it is possible that he went down lower than he's been thus the higher number this AM. Sigh. I just looked at Colin's SS and the looks the same.......here's hoping to lower numbers for both of us!
 
I'm sure the increase will be fine since you'll be testing. Colin will get a much overdue increase tonight. I wanted to wait until after Thanksgiving so I could monitor. Hope you get that urine sample soon. Let us know what the vet says today.
 
Bobbie And Bubba said:
I love your new pic!! He's doing okay as far as eating well (he's actually starving) doing all the P's. Just weighed him and he's down to 14 lbs! I am getting scared. He will get some more blood work on Friday if the urine culture doesn't show anything. He is stumping the vet too to have him in the 200's stuck and have ketones.........Thanks for asking.
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I think the increase is a good idea.
In terms of the weight loss, maybe a probiotic with enzymes, like the kind Shane uses, would help him digest and absorb stuff better? It might be a long shot, but it might be worth a try? Please let us know what happens at the vet. Sorry it's a stressful time! We're thinking of you!
 
SpecklesandMe said:
I think the increase is a good idea.
In terms of the weight loss, maybe a probiotic with enzymes, like the kind Shane uses, would help him digest and absorb stuff better? It might be a long shot, but it might be worth a try? Please let us know what happens at the vet. Sorry it's a stressful time! We're thinking of you!
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He is all ready getting digestive enzymes with a probiotic. I will look and see which one Shane uses. Anything is worth a try.
 
I sure hope the tests have some answers for you, Bobbie. It is true that we usually see higher levels with ketones, but not always Also, as you know, inappetite and an infection, usually make for a perfect storm. As he is eating and acting normal, it is a puzzle to me.
 
I just got off the phone with the vet. Good new, NO Ketones now. She said all his blood work looks fine. The glucose in the blood work was 405. She used the AT2 and my meter with the same sample and got 369 AT2 and 268 Relion. BIG difference. So, of course she wants me to buy a AT2.......I haven't decided on that yet. She thinks that my meter is really off and that he is just requiring more insulin. I took him up to 3 units today and so far, +6. no real difference. She wants me to hold that dose through the weekend and call her Monday afternoon. If we can't get him to start coming down, we will switch to Lantus. She thinks ProZinc just isn't doing it for him anymore. It still leaves me with the question as to why he stayed high and flat on 3 units and 3.5 units back 11.10th. It just doesn't make sense.
 
So glad to hear the Ketones have resolved!

There are quite a few threads on here about the difference in numbers between human and AT2, so I don't want to cause any trouble....but...my vet was pushing the AT2 as well, and we did a few samples at different times with both meters. Somewhere on here it is suggested that the difference is *roughly* 30%, and if you look at your 268 x 1.3 = 348.4 which is pretty close to what your vet got. If you factor in the margin of error on either/both meters, the difference between the 348.4 and the 369 is withing the margin. So the difference is smaller at lower numbers and seems bigger at those higher numbers, but it's still a relatively consistent 30% - at least that's what I found with my meter and my vet's meter. And how I convinced him that I was getting usable numbers at home. I also just started converting all of my numbers up 30% before giving them to him so we could avoid the argument. Just remember that the protocols and hypo numbers on here are written for the human meter numbers, not the adjusted numbers. I do realize it's more complicated than that, and there is always a danger in over-simplifying, but thought it might be helpful as a rough guide when comparing numbers with your vet.

Or you could just get the AT2 ;-)
 
Djamila said:
So glad to hear the Ketones have resolved!

There are quite a few threads on here about the difference in numbers between human and AT2, so I don't want to cause any trouble....but...my vet was pushing the AT2 as well, and we did a few samples at different times with both meters. Somewhere on here it is suggested that the difference is *roughly* 30%, and if you look at your 268 x 1.3 = 348.4 which is pretty close to what your vet got. If you factor in the margin of error on either/both meters, the difference between the 348.4 and the 369 is withing the margin. So the difference is smaller at lower numbers and seems bigger at those higher numbers, but it's still a relatively consistent 30% - at least that's what I found with my meter and my vet's meter. And how I convinced him that I was getting usable numbers at home. I also just started converting all of my numbers up 30% before giving them to him so we could avoid the argument. Just remember that the protocols and hypo numbers on here are written for the human meter numbers, not the adjusted numbers. I do realize it's more complicated than that, and there is always a danger in over-simplifying, but thought it might be helpful as a rough guide when comparing numbers with your vet.

Or you could just get the AT2 ;-)
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Thanks for this information. I appreciate you taking the time to explain this and you saved me trying to find the information for the differences between the two meters. I will keep the 30% diff in mind when talking to the vet. I really don't need the extra expense for the AT2 meter and strips right now with all the recent vet bills :banghead:
 
The differences between the 2 meter types have not been established, other than to note the pet meters generally read higher than the human ones. The differences are between 30-40% according to an annecdotal report by a researcher (Rand) who did not state how she came up with those numbers.
See my signature link for info on respective reference values from the Merck Veterinary Manual and our guidelines here. Note that our color coding of the spreadsheets above 100 mg/dL is mainly to help you see color changes as the glucose levels drop, not because there is any particular significance to the ranges.
 
BJM said:
The differences between the 2 meter types have not been established, other than to note the pet meters generally read higher than the human ones. The differences are between 30-40% according to an annecdotal report by a researcher (Rand) who did not state how she came up with those numbers.
See my signature link for info on respective reference values from the Merck Veterinary Manual and our guidelines here. Note that our color coding of the spreadsheets above 100 mg/dL is mainly to help you see color changes as the glucose levels drop, not because there is any particular significance to the ranges.
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I wish it were more clear cut. However, knowing now, that there is a 30 % difference between human and animal, ( human being lower, and that both the human and the animal meters have a 20% +/ - variance, I can see the difference and as Djamillia pointed out, the difference is smaller with smaller numbers. And that said, the vets are really stuck on the AT2. As Djamillia said, she times her numbers on the human meter by 1.3 to give to her vet so they were speaking the same language. I think that is what I will start to do as well. BJM, you and Sue have been at this for a long time. Do you think I should jump ProZinc ship to Lantus or give the ProZinc some more time at higher doses. I am very lost.
 
It isn't a straight 30% difference, so doing that is quite likely to underestimate higher numbers. It might be more useful to give your vet our human glucometer reference numbers for the various insulin guidelines, so she could understand. The cost of the AT2 test strips is $1 a pop (and you'd be spending $6-$8/day), or more. Unless your vet is going to give them to you for free, she should just realize that too high is too high and the actual number doesn't matter.

About the only other things you might try besides Lantus or Levemir would be dosing every 8 hours, or split and lag by 2 hours, both of which increase the complexity of testing and shooting.
 
I and and several others on here use Freestyle Lite strips in our AT2 meters. They're made by the same company and the numbers seem to run very close. They cost half what the AT strips cost, but still more than human meter strips. I'd suggest you get both and do your own comparisons, but that's all I use now. I'll still retest any wonky numbers with an AT strip, but it usually comes up pretty close to the same.
 
Sorry for butting in....

THERE IS NO REAL DATA THAT SHOWS A 30%-40% DIFFERENCE BETWEEN A PET METER AND A HUMAN METER!!!!

The 30%-40% difference applies to one single specific BG range, and only applies if you are following the Tight Regulation protocol for Lantus/Levemir. At the "target range" for that protocol, which would be "50" for people using TR, the "conversion" is to add 18 points if you are using a pet meter. A 68 on an AT means that the dose should be reduced if the nadir is below that line. On a human meter, people reduce if it goes below 50.

OUTSIDE OF THAT, NOBODY KNOES, OR SHOULD BE GUESSING WHAT NUMBERS ON AN AT CONVERT TO ON A HUMAN METER.

This point has been posted countless times on this board by moderators, and people have been asked repeatedly to STOP posting any such "conversions".

Any time, in the future, this type of speculation is posted, that post (assuming I see it) will be reported to Robert directly.

It is nothing but misleading, and confusing, to new members especially.

Again, sorry for butting in, Bobbie. But every time this gets posted, it causes a " hijack" of a thread, and distracts from the actual subject at hand.
 
Bobbie And Bubba said:
She used the AT2 and my meter with the same sample and got 369 AT2 and 268 Relion. BIG difference. So, of course she wants me to buy a AT2.......I haven't decided on that yet. She thinks that my meter is really off and that he is just requiring more insulin. I took him up to 3 units today and so far, +6. no real difference. She wants me to hold that dose through the weekend and call her Monday afternoon. If we can't get him to start coming down, we will switch to Lantus. She thinks ProZinc just isn't doing it for him anymore. It still leaves me with the question as to why he stayed high and flat on 3 units and 3.5 units back 11.10th. It just doesn't make sense.
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Hey Bobbie, try not to get caught up in just the numbers. I don't "read" spreadsheets and cats certainly don't read the instructions when it comes to their BG values. Pinpointing one day will just confuse you - try to keep the trends in mind. As someone who switched insulins (albeit from Caninsulin to Lantus) I can attest that the best insulin is the one that works in your cat. We both know Squallie responds very nicely to Vetsulin (same as Caninsulin) but Genghis did not. I don't think the AT2 will necessarily give you better results - I got Genghis OTJ with a human meter - I think the vet just wants the numbers so she can understand better for herself.

But the numbers are not the whole picture and if you can catch ketones and prevent DKA at higher values or prevent hypos at lower values, THAT is the job of the meter. The rest is trends, I think. As Carl has said, the values cited at the low range are for dosage changes on TR protocol. For everything else, high is high, low is low. It really is that simple. You will drive yourself bonkers if you try to live only by the numbers. Best thing is to identify trends and watch Bubba as you already do.

If you decide to switch, definitely hop over to L/L Land and ask for advice on an initial dose for Bubba. I am not dissing your vet in any way, just I know the folks there have years and years of seeing how cats respond. And they have formally brought 337 cats into remission (Genghis was #337!). Best of luck, Bubba has been through a lot and I know you guys will get through this.
 
Brashworks said:
Hey Bobbie, try not to get caught up in just the numbers. I don't "read" spreadsheets and cats certainly don't read the instructions when it comes to their BG values. Pinpointing one day will just confuse you - try to keep the trends in mind. As someone who switched insulins (albeit from Caninsulin to Lantus) I can attest that the best insulin is the one that works in your cat. We both know Squallie responds very nicely to Vetsulin (same as Caninsulin) but Genghis did not. I don't think the AT2 will necessarily give you better results - I got Genghis OTJ with a human meter - I think the vet just wants the numbers so she can understand better for herself.

But the numbers are not the whole picture and if you can catch ketones and prevent DKA at higher values or prevent hypos at lower values, THAT is the job of the meter. The rest is trends, I think. As Carl has said, the values cited at the low range are for dosage changes on TR protocol. For everything else, high is high, low is low. It really is that simple. You will drive yourself bonkers if you try to live only by the numbers. Best thing is to identify trends and watch Bubba as you already do.

If you decide to switch, definitely hop over to L/L Land and ask for advice on an initial dose for Bubba. I am not dissing your vet in any way, just I know the folks there have years and years of seeing how cats respond. And they have formally brought 337 cats into remission (Genghis was #337!). Best of luck, Bubba has been through a lot and I know you guys will get through this.
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Thanks for that explanation because it all gets so confusing. Something has to change because this morning we went up to 3 units again and he is getting worse. I don't get it. I will post a new thread about that.
 
You're welcome Bobbie - it must be so frustrating. I don't know a thing about Prozinc - but it looks like you are faced with either upping his dose as the vet suggests, or trying something new.

I know Bubba loves to go outside, but that is one factor that comes to mind as you can't control what he gets into out there. Though I think the monster mice/voles he catches so beautifully are very low carb :D
 
Question...
Bubba has lived his whole life with two eyes until recently. Does anybody think trying to adjust to life with only one eye might cause a great deal of stress? Especially when he goes outside where the wild things are?
I don't think stress is behind all of his numbers. But it must be screwed up at his age to try to relearn everything he sees.
I had a totally blind cat, but he was that way from birth. So he never realized he was "blind", and lived an active playful life for 14 years or so. The only adjustment Winkie had to make was when we rearranged the furniture. That was entertaining to us, but I don't imagine too much fun for Winkie!
 
Bobbie And Bubba said:
AT2 and my meter with the same sample and got 369 AT2 and 268 Relion. BIG difference
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Actually, not such a big difference given that ALL home glucometers, pet or human, are allowed to read within +/- 20% from what a lab would get 95% of the time. Be sure to let your vet know that, as I doubt that was emphasized in marketing the AT2.

Also, if 1.2 * the low number is greater than 0.8 * the high number, the values may be considered the same, and these could be.
0.8 * 369 = 295.2 Low estimate for AT2
1.2 * 268 = 321.6 High estimate for Confirm Micro
 
BJM said:

Actually, not such a big difference given that ALL home glucometers, pet or human, are allowed to read within +/- 20% from what a lab would get 95% of the time. Be sure to let your vet know that, as I doubt that was emphasized in marketing the AT2.

Also, if 1.2 * the low number is greater than 0.8 * the high number, the values may be considered the same, and these could be.
0.8 * 369 = 295.2 Low estimate for AT2
1.2 * 268 = 321.6 High estimate for Confirm Micro
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That will be helpful when talking to my vet. Thanks BJM.
 
Carl & Polly & Bob (GA) said:
Question...
Bubba has lived his whole life with two eyes until recently. Does anybody think trying to adjust to life with only one eye might cause a great deal of stress? Especially when he goes outside where the wild things are?
I don't think stress is behind all of his numbers. But it must be screwed up at his age to try to relearn everything he sees.
I had a totally blind cat, but he was that way from birth. So he never realized he was "blind", and lived an active playful life for 14 years or so. The only adjustment Winkie had to make was when we rearranged the furniture. That was entertaining to us, but I don't imagine too much fun for Winkie!
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That's a good point and I agree with it being a source of stress to him. Poor guy. And I am picturing Winkie trying to navigate in a newly rearrange living room.......
 
Bobbie And Bubba said:
After the one urine test came back from the vet's with a +3 Ketone, she asked me to get a ketone test in yesterday and I got one after he ate dinner and it came back Moderate. Yikes. I am to call her today with his BG and the ketone results. I raised him from 2.6 to-2.8. The test before last I got on him was apparently not good as I did not know how long the urine was on the saran wrap. This time I emptied the box and use noabsorb beads. (apparently the ketones can evaporate)

He is eating great (always hungry!) Peeing like a race horse, drinking lots of water (and I add water to his food) and otherwise seems normal except his numbers won't come down. This makes me very nervous and now I know why he's continuing to lose weight. Is there anything else I can do?

Posted in ProZinc also.
Click to expand...
Not a solution only a comment. The precision xtra meter u can get from amazon about $30 has special test strips for ketones. I use this and prick ear instead of urine.
 
The Nova Max Plus also can test for blood ketones, as well as glucose. The strips can be pricey, but when you've got a cat that is prone to ketones, or at risk of them, testing the blood will detect them sooner than a urine test.
 
I just ordered the Precision Xtra and two boxes of strips on Amazon. The strips work out to be $3 buck a pop. A lot easier than trying to get a urine sample......
 
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