? 4/10/17Sprocket,AMPS/352,+2/305.+4.5/247.+7.5/239. PMPS/298, +2/284. +9/111 HI ketone strip2 trace

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Do you feel confident this vet can handle ? If not go directly to ER

Or

Call your vet and let them know what is going on. They should either fit you in or recommend ER.
 
This vet yesterday says to talk to vet when she comes in at 8am. I left message.
Jenna from dcin says she will talk to vets to help with what i dont know.
He is acting normal. Eating. 45 mins to get to either vet
 
It's very very good that he's eating right now, and will be getting fluids. Please continue to talk to the vet about this-- a purple ketone test is very alarming, and not something we can really talk you through on the internet.

I do not see anything on the spreadsheet for the shot this morning. What dose did you give?
 
Gave 100ml. He took another med: ursodiol. Just did bg at 846am. +2/305.
Jenna & vet said UTI will spill ketone. Said fluids n monitor.
I will update spreadsheet now.
He ate 3oz. N 4 duck pill pockets. Resting normally,
 
That is a relief to hear. I wasn't on the boards this morning, so it was a shock to see that post when I got here!

I don't know enough about ketones to understand how the UTI would produce them, but I like this explanation because a) it sounds temporary, and b) it fits with the fact that he wasn't acting like a cat with that ketone test.

Keeping fingers crossed!
 
I would let your vet know what is going on. It's good that he is eating, but increase in ketones is worrisome. Can you please post the blood sugars for the night and AM on the spreadsheet and the dose you gave this AM? It sounds like you spoke to the vet and they want to monitor as he is still eating ok. The fluids are good, you can get another ketone check in and hour or two to see if it's helping.

For the night dose, if you are over 300 2 hours prior and at shot time for your PM dose, then I would give 3.5 units instead of 3.25 units. If he's 250+, I would bite the bullet and give the 3.5 too - I know you are scared of going hypo, but he really needs more insulin, and if he goes lower there are ways to deal with that. If its under 250, ask what to do.

It's important that we also try to get those blood sugars lower than the 300s. This will help prevent dehydration. The window we want to be at is 150-250 for DKA cats.
 
The other thing I was wondering was, how common is it to get a "bad strip" with ketone tests? I truly don't know if it's even possible, but in this case, with his behavior so good and the test so bad, I probably would have tried to re-test first thing just in case.

I am really happy that Sprocket is eating well and seems comfortable today. You are doing a great job with him!
 
I used 2 strips this morning. And I did update spreadsheet.
I looked up ketone treatment online n found this..
This can cause your blood levels to become too acidic, which can be deadly. Some diets, such as a low-carbohydrate diet, are intended to release fats and create ketones. Those who don't have diabetes can usually compensate for these changes. However, the excess ketones can be dangerous for someone with diabetes.Jul 11, 2016

So i been feeding low carb so maybe thats why its not working??
He needs more carbs.

1st time sick 2 yrs ago I just fed wet food without knowing carbs. He got better. Yes he has been on higher side awhile. I started feeding really high carbs in gravy foods alot in Jan & Feb this year. That's when he started to act different.
So maybe he needs medium carb diet with more insulin to balance him.?
Maybe since he is ketone prone now he won't be a cat to go in remission.?
Maybe he just needs to stay steady to be healthy? Meaning medium carbs especially since I can monitor now??
Thoughts?
 
Update 1130am.
11:03am/ +4.5/247
Ketone strip medium. Lower than before

Ate about 1oz of wet low carb.

Poop was soft but formed, lighter brown.

His front legs a little shaky but he has had that awhile once in a while.
 
Darnell & Sprocket said:
This can cause your blood levels to become too acidic, which can be deadly. Some diets, such as a low-carbohydrate diet, are intended to release fats and create ketones. Those who don't have diabetes can usually compensate for these changes. However, the excess ketones can be dangerous for someone with diabetes.
Click to expand...


It works a little different in cats than in humans, as cats are carnivorous and are better able to convert fat and protein to glucose and other forms of energy for the body to use, so in general cats can get away with much lower carb diets before weight loss becomes an issue. The low carb diets work for most cats to help lower blood sugars and control diabetes with no problems.

Some cats, however, start to lose weight or are already too thin and can't tolerate very low carb diets. Sometimes this weight loss leads to ketosis and DKA. It's ok for these cats to have a less strict diet as -- extra carbs + insulin = weight gain -- and that weight gain will help prevent complications. In general, most healthy cats, we try to avoid this weight gain as it leads to obesity, but skinny cats are a different bunch.

So if all goes well with blood sugars today, lets try and do 3.5U tonight. Might be a little nerve wracking but you will get more comfortable seeing lower blood sugars after a while.
 
I would be happy with well controlled kitty even if no remission.

Ok vets just called. As long as he eats, looks n acts well. Can do homecare with 100ml 2x a day. His meds.
Under 5% carbs.
4-5 3oz cans is good.
3 units 2xday to see how that one does.
Cause going too low will cause no glucose to brain. (I hope I got the right wording)
Now that infection is got meds to it. Staying with one steady dose to see what it does.
Hang on.
 
So glad the ketones have gone done tonight. *whew* that's a relief!

I'm glad you're being vigilant and continuing to test for ketones.

What was the reason your vet gave for reducing the current dose from 3.25u to 3.0u? Sprocket's not getting into low numbers on the 3.25u.

The "recipe" for ketones is "not enough insulin + not enough food + systemic inflammation or infection."

Interrupt any of those factors and you can prevent the development of ketones. Typically we try to get as much insulin as possible into a kitty that is flirting with ketones, even if it means giving high carb food in order to give that higher dose of insulin.

I'd encourage you to ask your vet more questions.

You're doing a great job Darnell. I wish you a good night's sleep tonight and hope that Sprocket gets over this hump quickly!
 
julie & punkin (ga) said:
So glad the ketones have gone done tonight. *whew* that's a relief!

I'm glad you're being vigilant and continuing to test for ketones.

What was the reason your vet gave for reducing the current dose from 3.25u to 3.0u? Sprocket's not getting into low numbers on the 3.25u.

The "recipe" for ketones is "not enough insulin + not enough food + systemic inflammation or infection."

Interrupt any of those factors and you can prevent the development of ketones. Typically we try to get as much insulin as possible into a kitty that is flirting with ketones, even if it means giving high carb food in order to give that higher dose of insulin.

I'd encourage you to ask your vet more questions.

You're doing a great job Darnell. I wish you a good night's sleep tonight and hope that Sprocket gets over this hump quickly!
Click to expand...

She said, hope i say it right, based on the numbers with going down.
But talked to jenna at dcin.
She told me how to give the vet a link to the spreadsheet so she can see whole picture.
 
I think it was a good move to give him a solid meal when you saw the 111. I probably would have also taken the opportunity to shoot the slightly larger dose (3.5U) this morning with him higher (combination of bouncing and the carbs in the 3am meal), but it's a good sign that the 3.25U was able to get him into the blues (111). We do want to get him into that range-- still very safe, but much better for him than the higher numbers.

Let's see what he does today!
 
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