Oj's ketones back

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Luxe

Luxe

Member Since 2020
Im so frustrated. He's still eating and being active unlike last week but he's back up to the moderate range. I have absolutely no flipping idea what i'm doing so wrong that his numbers wont go down and the ketones are coming back on what seems to be a weekly basis.
 
Appetite is good. He ate his breakfast, some lunch and he just ate half a can of fancy feast and probably would have eaten more but his pm shot will be coming up in 3hrs and i want him to have an appetite for that. Last week when his ketones went high again he wasnt eating at all and throwing up/laying around. So right bow he's still acting normal just the raised levels. Last week they gave him subq fluids and a pain med shot because he has a bad tooth no one will touch right now in his unregulated state. And within 15hrs he went back to negative and was hitting lows for him of 300s. I noticed sunday he started to act like his mouth was bothering him again and we're back in the mostly 400-600range. I talked to the vet and he told me to give onisor so we started that today. I guarantee a big part of his numbers is the pain or discomfort with his tooth but i cant find anyone who will remove it at the moment.
 
I just looked up onsior, and some of the possible side effects include inappetance and vomiting, so be on the lookout for those. It's the last thing you need.

I do not understand your vet's casual approach to ketones. You've been very very lucky with OJ so far-- we've seen cats go downhill fast with moderate ketones, let alone the high readings he got the other day. It's really not something to just toss off with a days-long course of pain meds :banghead:. I don't really know what to say about this at this point. I would be looking for another vet, at least with regards to this issue, and I'd be looking tonight, and trying to bring him in to be treated. I can remember one other cat who would throw ketones but seem otherwise normal, @Bobbie And Bubba's Bubba, but it's really unusual.

Have you and your vet discussed antibiotics for the tooth at all?
 
Im going to see if i can bring him tomorrow for fluids and the pain injection they gave him last week. He originally was on clavamox for the tooth for 2weeks. The week before he was diagnosed and then the first week after he was. I havent been able to find a vet who feels comfortable doing surgery to remove the tooth. But i really dont see how i can start to regulate him with it still in there causing him distress.
 
I'm logging off for the night, but before I left I want to add one thing:

Luxe said:
I have absolutely no flipping idea what i'm doing so wrong that his numbers wont go down and the ketones are coming back on what seems to be a weekly basis.
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You aren't doing anything wrong. He may need more insulin, and he definitely needs that tooth taken care of, but until that happens, you have a very very tricky job in front of you. Very, very few cats become regulated in days/weeks in any case, and you have the extra challenge of OJ being ketone-prone, which doesn't give you a lot of leeway.

[just saw your reply]

Luxe said:
He originally was on clavamox for the tooth for 2weeks.
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Ugh yes, now I remember-- the clavamox was depressing his appetite, right? which, again, is the last thing you want! There are other antibiotics out there, but this really is a puzzle. Arrgggh....

I hope his ketones clear very soon, with no ill effects. Hang in there!

:bighug: :bighug: :bighug:
 
Thank you. I just feel like im failing him. He was doing so good wed-sunday and then once i noticed the pain meds starting to lose effect it started to all Go back downhill. I just finished giving him what dinner he would eat. Shot at 500. He was interested but mostly just mushing the food around because that damned tooth. I had to keep scooping it into a pile until finally he just gave up.
Im also in the position where i know the tooth needs to go but if vets arent comfortable removing it i dont want to do something that could potentially be awful and that really scares me too
 
Okay so i talked to a different dr at his vets and im bringing him in at noon. She wants to do fluids, find a new course of pain meds that will be longer lasting so we can try to regulate him and they're going to do some bloodwork on him and recheck the mouth. Im still going to call around to some other vets today to see if anyone is willing to give the tooth a try. But i want to get the fluids and pain meds in him to drop these ketones before i have anyone else attempt an extraction on him
 
Oh, I'm so glad you're going to get a second opinion on this! Some pain med options they might suggest: bupe is usually given orally, but @Noah & me (GA) [Dickson] used it topically (ears) on a cat with major dental issues, that might be another option. Another option might be a pain patch with fentanyl (glued to the skin). One thing to watch out for/discuss with opioids is the constipation issue, so anything that's given on a longer time scale should also mean a plan for dealing with that.

I think that's very wise to go after the ketones aggressively. Doing a dental on an unregulated cat is possible to do safely; I wouldn't trust a vet who suggested doing a dental on a cat throwing ketones.

As for doing a dental on an unregulated cat, it might be worth starting a new post asking about experiences with dentals under those circumstances. I know we've had it happen here (often resulting in the cat's insulin needs plummeting and regulation happening almost immediately after the bad teeth are gone!), but I'm drawing a blank on names right now.

Please keep us posted on OJ's day!
 
Thanks. Last week after his fluids and pain injection he was a different cat in less than 24hrs so im hoping for the same turn around. Then once the ketones are out im going to start calling around for that pesky tooth. The vet today agreed on the phone that he's going to be tough to regulate while thats still there.
The vet today wanted me to test, feed and shoot and then bring him in at his +2 so they can check him there. I woke him up and his number was the lowest amps i've gotten at 366 but im attributing that to the fact he didnt eat much last night before his shot. He really wanted to but that darn tooth was bothering him too much. He did throw up a little this morning which he's been doing if he doesnt eat a big dinner. Yellowy liquid so stomach acid im guessing. He wouldnt touch his wet food but he ate about quarter of a chicken breast i cubed up for him. Ketones still there this morning but went from moderate to small. Right now he's having a snooze on the couch.
 
He ate some boiled chicken breast right after and was walking around looking for food a little while ago but i didnt give him any as he tends to get carsick and we had to leave for the vet. So when we get home i'll be sure to give him some of whatever he'll eat
 
Okay so his numbers here were 360 which only went down by 6 from a read 2 1/2 hrs ago. He did scream like a maniac in the car though so im hoping they didnt really change because of stress Still super dehydrated so going ahead and doing fluids again. They're also going to start him up on gabepentin (spelling??) so we'll see how that does. She said it will help calm him down if he's stressed as well as help with the pain. She said if i can keep ketones at bay for two weeks that i'd have a better chance of getting that tooth out or finding someone who will. So heres to hoping he flushes himself out today and goes back into the negatives as fast as he did last time.
 
Glad he's got some pain relief.

(((OJ)))

Fingers and paws crossed that you'll be able to get his tooth sorted soon. Poor li'l fella...


Mogs
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Red & Rover (GA) said:
Did the vet send you home with subq fluids?
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They did not. I asked about it and was told its just a short term fix, only works for a few hours so not worth it. I was like ummmmm... im still looking for another vet but i needed him flushed today while he still has an appetite so we went to his regular place because i knew they'd see him same day
 
I just ordered this. I read it was good for hydrating for ckd so im hoping it would help keep him hydrated as well
 

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@Luxe This is the strength and dose I've been given for numerous cats. It seemed odd to me some vets had never heard of this option but it made everything easier especially for my cats that made more than a fuss over anything oral. Noah in particular acted like I was nailing him to a cross, it was that bad.
I had no problems with his BS numbers, appetite, constipation or getting him stoned. I'd wish you good luck but you won't need it.
Transdermal BUPE
Noah Strength 0.16mg/0.1ml. Dose 0.05ml twice daily.
Andy Strength 0.16mg/0.1ml. Dose 0.05ml Every 8 to 12 hours as needed.
 
Well before i go to bed, the pain meds they gave me i just gave a second dose. He still seems interested in the food but just picking at it. He's probably still in some pain. Does it take awhile for gabapentin to start working?? He did drink a decent amount right after i gave him his insulin. His ketones have been gradually going down. They were moderate last night, between small and moderate this morning and just coming up looking slightly darker than trace but not as dark as small. Hoping it continues to go lighter but if these pain meds dont start to kick in im not really sure. I'll keep everyone updated tomorrow with him as well as my hunt for a vet willing to work with me. Goodnight all and thanks
 
Thank you. I'll ask about that as i dont think this is working for him. He was just a hair over negative today for ketones so he's working himself back down. Blood was in the pink which it normally never is this early in the morning so im hoping maybe his dose increase is finally kicking in. Gave him a little boiled chicken to hold him over until his main meal and shot time. He's usually never up at 6am when im leaving for work so he must've been hungry this morning
 
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