Preventing DKA?

[CLM1975]

I've been reading everything on the forum about DKA, with George's numbers for the most part staying low and his sensitivity to insulin I'm often skipping shots. Last go around he went into remission within 2 weeks so I didn't even get into worrying about ketones.

This go around, he is doing good, trending towards a possible remission but I don't want to make a mistake. I ordered a blood ketone tester, my boy is so easy but getting him to pee on a strip, welp I just can't see it.

Is it really just a matter of testing for ketones? He vomits occasionally but he's had a great appetite and has had decent energy for a 17 yo cat. Bc of his kidney issues I give 100 ml of subq fluids every 2-3 days, he gets a potassium supplement as well, both things that seem to help with DKA.

Anything I'm missing?

 

[Dyana]

I think a blood ketone meter is always a good thing to have in your back pocket, and would use it whenever he seems off. I do always worry about ketones when I see someone mention their cats are throwing up, especially if it's projectile vomiting or the cat is otherwise acting off.
Has your cat's thyroid been tested? Often a cat with hyperthyroid will eat more than normal and have more energy than normal and throw up.
DKA is caused by not enough insulin along with a stress of some kind like an infection, and not enough calories. IF there were ketones, the fluids would help, but I have not heard of a potassium supplement helping directly with ketones, but they will help him if he is low in potassium. The potassium levels should be monitored by a vet.
As far as testing ketones with the urine test strips, I used to just have a small plastic cup handy by the litter box. When I saw my cat going towards the litter box, I would get up quietly and without crowding him (so he didn't abandon the litter box), I would wait until he started peeing, and then hold the cup under his pee stream. You only need a few drops to test. Some people use a soup ladle or spoon the same way.
I think you're doing great, and I'm glad you're being proactive.

 

[Critter Mom]

I've learned recently that the ketone body most involved in DKA is beta-hydroxybutyrate, and that's what the blood meters test for. Urine test strips detect acetoacetate. Here's a helpful PDF:

Urine vs Blood Ketones

The following table from the above document gives a good side-by-side comparison of urine and blood ketone measurement:

Mogs
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[CLM1975]

He was just at the vet 1/6, didn't get a copy of the lab results but just got off the phone with the office and his T4 levels were normal then.

It seems a lot of these health issues have similar symptoms, very hard to untangle!

Guess I'll await the ketone meter and keep doing what we're doing. He did vomit since I posted this, gave him 100 ml of fluids. Vomit frequency has been about 0-4x a week, going to start recording on SS to see if any patterns develop or it increases.

 

[Hercule's mum]

@Critter Mom - which ketone blood meter do you use? and how often?

 

[Critter Mom]

Hi Karen,

@Critter Mom - which ketone blood meter do you use? and how often?

I've got the Freestyle Optium Neo. It's easy to use and doesn't require a huge BG sample.

Saoirse wasn't ketone-prone so I didn't need to test all the time, but if she had something going on I'd test once or twice a day - especially if she was having difficulty eating and her BG numbers were trending upwards. The test strips are pricey but the more I learn about ketosis and DKA, the more I consider a BBK meter to be a really sound investment. Testing is on demand, results are real time, and it gives a non-subjective reading of the level of the most significant type of ketone body. All with added peace of mind!

BTW, I checked with a local chemist to see whether they carried test strips for the Neo. They were able to get them in next day any time I needed them (Sundays excepted) so it's a good idea to check that you can get strips locally if you need them. There wasn't much of a muchness in price between the chemist and online vendors.


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