Hello all! I need some further assistance please. Yesterday I was encouraged by both his ketone level drop and his curve. This morning, however, he was back to his mid 300s, but at least his ketones were lower. This afternoon his mid day glucose was higher than yesterday, but his ketones dropped again! Tonight, however, his glucose is high and his ketones are rising. My vet doesn’t really understand this and I can’t get him in before this supposed snowstorm, so I’d really prefer your help and assistance before his numbers get into the danger zone again. I got extra test strips for ketones so I can continue to test extra for now, but what do I do? I don’t want him to go backwards. Sorry, I’m just really discouraged right now. Thank you. His spreadsheet is up-to-date.
Ketones - Further assistance needed please!!
- Thread starter Riley813
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Bron and Sheba (GA)
Member Since 2015
Hi,
I can write more later but have to go out now. However to help stop ketones you need to be feeding as much extra food as you can. Also add warm water to the food if your kitty will allow to make it soupy . Food helps stop ketones forming as does insulin and fluids which help flush them out.
feed small frequent snacks throughout the cycles except for the 2 hours Preshot.
Don’t skip any insulin doses. Ask your vet about giving sub Q fluids.
More later.
I can write more later but have to go out now. However to help stop ketones you need to be feeding as much extra food as you can. Also add warm water to the food if your kitty will allow to make it soupy . Food helps stop ketones forming as does insulin and fluids which help flush them out.
feed small frequent snacks throughout the cycles except for the 2 hours Preshot.
Don’t skip any insulin doses. Ask your vet about giving sub Q fluids.
More later.
I feed him as much as he wants to eat. He was strictly dry food when I got him so I’ve got him eating as much wet he will eat and he free feeds young again zero. I know it’s not optimal but it’s the best for now. He eats whenever he’s hungry during the day except for fasts. He drinks and drinks. He won’t allow me to add water to his wet food unfortunately but he drinks so much, I don’t get it. I’m trying to get ahold of my vet but we have a possible historic winter storm on the way, so as of now we wouldn’t be able to get it until sometime next week at the earliest. His numbers were doing so great after the dose change yesterday but now everything is high again. Hoping there’s something I can do here with what I have at my disposal. Sorry, I feel like crying right now.
Becca84
Member Since 2020
I'm so sorry you are going thru this! I can only imagine what u are feeling right now...Prayers!!! Maybe I can tag @Chris & China (GA) ....Can you help?
I know glucose can be wonky after a dose change but it’s higher today than it was before we switched and I was so happy watching the ketone number drop and now this. I literally just want to stay in a ball and cry, but I know he needs me. This is seriously messing with my depression and anxiety. I’m trying so hard. Thank you.
Becca84
Member Since 2020
do you think u could call your vet tomorrow and get a couple of bags of fluids before the storm?
I can call but unfortunately most likely not. They’ve been so slammed my vet hasn’t been able to call me back in days. I cannot guarantee I can get ahold of her. Are fluids the absolute only way? It was dropping so amazing is it going up because his sugars are going crazy again? I guess I need to know if I can’t, I’ll try, but I need to know what to do if not.
Bron and Sheba (GA)
Member Since 2015
Here is your previous thread for continuity
https://www.felinediabetes.com/FDMB/threads/ketone-meter-question-help-please.244323/
It is really good he is drinking well.
It doesn’t really matter what he eats at the moment as long as he eats. Eating is more important than what the number of carbs are in the food.
Can you tell me what the current number of ketones he has at the moment please, and is it with a blood keynote meter?
Are you able to also get a urine test for ketones as well ? So we can see what that says?
https://www.felinediabetes.com/FDMB/threads/ketone-meter-question-help-please.244323/
It is really good he is drinking well.
It doesn’t really matter what he eats at the moment as long as he eats. Eating is more important than what the number of carbs are in the food.
Can you tell me what the current number of ketones he has at the moment please, and is it with a blood keynote meter?
Are you able to also get a urine test for ketones as well ? So we can see what that says?
This started when I tested 2 nights ago he was at 2.7. This afternoon he was at .9, he’s now at 1.3. All blood tests. I think I updated my spreadsheet with all the testing but if not please let me know so I can figure out why.
my urine strips should be here tomorrow. I had to order some online. I’m unsure when they’ll come tomorrow but I’m more than happy to try and get my hand in there when they do lol.
He drinks a bunch, far more than any pet I’ve ever had I think. In the last 24 hrs he ate quite a bit of dry over 5 different food visits and wet food over 4 split up meals. I’ve tried to give him extra wet, he refuses. I’d rather him eat something.
I appreciate your help. Watching him drop from 2.7 to .9 was so encouraging now I just feel hopeless. I bought extra ketone blood tests so I’ll continue to do them tomorrow. I know doses need to settle and this was just day two, but watching glucose and ketones go up is just breaking me a bit. He’ll be starting Levemir Sunday, but I need to obviously figure this out now.
Thanks again.
Alison
Bron and Sheba (GA)
Member Since 2015
So it looks as if what you are doing is working with the ketones reducing.
Keep offering him food (whatever he will eat) and that is good he is drinking plenty.
I’m not sure it is a good idea to be swapping over to Levemir at the moment if he has any ketones. This is because Levemir is a depot insulin and it takes several days for the full effect of that insulin to take effect.
With ketones in the picture you need to have the full effect of the dose working every dose at the moment. It might be better to stay with the vetsulin for a bit longer until the ketones have gone.
Keep offering him food (whatever he will eat) and that is good he is drinking plenty.
I’m not sure it is a good idea to be swapping over to Levemir at the moment if he has any ketones. This is because Levemir is a depot insulin and it takes several days for the full effect of that insulin to take effect.
With ketones in the picture you need to have the full effect of the dose working every dose at the moment. It might be better to stay with the vetsulin for a bit longer until the ketones have gone.
Hopefully they’ll be gone by then, he’s just miserable on the Vetsulin (it doesn’t last past about 7-8 hrs usually) but I’ll do whatever is best for him. Am I looking for zero before switching?
It was definitely working but tonight both his glucose and his ketones were raised again (.9 at +5 to 1.3 at PMPS). I’m discouraged about that and don’t know what to do next.
Bron and Sheba (GA)
Member Since 2015
Yes you want them at zero ketones before swapping over to a depot insulin ( it’s a great insulin btw).
I understand completely that the vetsulin does not have a long duration but it is a better insulin for ketones atm.
Just keep doing what you are doing with the food and the insulin and the fluids.
Is he active and not lethargic?
He’s acting normal, we’ve only had him 2 months but he’s acting the same as he always has. He even played with his toys this morning. He’s not a big player, but he’s alert, purring, snuggling. He goes for water many times all day and night. The night I first tested him and he was high he spent the day exploring the basement and enjoying himself.
Do ketones typically fluctuate like this?
How long do I need to stay on this dose of Vetsulin to know if it’s helping? I know sometimes glucose numbers go up to start, correct? Today they’ve just been higher than normal. I just want him off Vetsulin, I wish he’d never been on it, but I don’t want to hurt him in the process either.
Do ketones typically fluctuate like this?
How long do I need to stay on this dose of Vetsulin to know if it’s helping? I know sometimes glucose numbers go up to start, correct? Today they’ve just been higher than normal. I just want him off Vetsulin, I wish he’d never been on it, but I don’t want to hurt him in the process either.
Bron and Sheba (GA)
Member Since 2015
That is good he is alert, eating and playing. If he was lethargic I would be concerned.
Ketones can fluctuate.
I not a vetsulin user so I will leave the dose of it to someone who uses it but you will need to increase the dose at some point to get the BGs down.
I would not increase in 1 unit increments again though. I think @JanetNJ and @Critter Mom can help with the dose.
You will know the insulin is helping if the BGs go down and the ketones disappear.
Try not to stress too much. We will get you through this bump in the road and once he is on Levemir he will hopefully get into better numbers.
Keep posting daily so we know how things are going and keep asking lots of questions.
Ketones can fluctuate.
I not a vetsulin user so I will leave the dose of it to someone who uses it but you will need to increase the dose at some point to get the BGs down.
I would not increase in 1 unit increments again though. I think @JanetNJ and @Critter Mom can help with the dose.
You will know the insulin is helping if the BGs go down and the ketones disappear.
Try not to stress too much. We will get you through this bump in the road and once he is on Levemir he will hopefully get into better numbers.
Keep posting daily so we know how things are going and keep asking lots of questions.
JanetNJ
Member Since 2016
That's great that he's feeling better. I'd give it Through today and see what happens. If still in the mid to high yellows bump it up to 2.5. What's the ketones today? Vetsulin isn't necessarily bad. My cat was on it. It took until I was on 3 units to see the numbers come down, but then at 4 months she was in remission.
He’s been on Vetsulin for close to 5 years (that’s what they used at the rescue) and it’s never done anything for him really. Sure it brings his mid down, but it wears off and he goes high again. I think this insulin switch is the absolute best thing, if for nothing else to have something that lasts longer, but I don’t want to hurt him in the process.
I’ll post the results after I test his ketones in about 1 hr 45 min at AMPS. FWIW I tested his ketones again before bed, +2 (I had to I was miserable) and it was .9 and his glucose was 291, so it truly seems like his ketones are tied to his BG... I just don’t know if it’ll ever be truly under control with Vetsulin.
Thanks. Appreciate any additional guidance.
Alison
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This morning was 347 glucose and 1.0 ketones. I’ll monitor his +5 and PMPS then switch him to 2.5 if it’s consistent.
JanetNJ
Member Since 2016
I switched from vetsulin to ProZinc for the last three years. Worked well. I like the flexibility of shot time with ProZinc which is why I went with that one.
I honestly hadn’t heard of that one before recently. I’ve already purchased the Levemir so I am excited about the opportunity to change... just need to make it a safe change.
JanetNJ
Member Since 2016
There's no danger in switching from one insulin to another. And since vetsulin is an in and out insulin you could start levemir with the next shot time.
I wanted to switch Sunday but I understand the concern with getting his ketones to zero. I’m hoping we can get there with the slight dose increase. I’ll also need to find a Levemir expert because I know I need to start at a lower dose.
JanetNJ
Member Since 2016
You will most likely start at the same dose, esp since his numbers are still high.
His glucose was still 300s and higher 200s. No night test yet. Ketones are better but again last night is when they went up. I’m going to try the 2.5 to see if it helps...
JanetNJ
Member Since 2016
Sounds good. Get him to drink as much as you can. Is put lots in the food and leave a few extra bowls of water around.
crossing fingers that the new dose does the trick!This boy drinks so much! I’ve never seen a cat drink as much as he does lol. He’s got his own two bowls we refresh twice a day. He refuses it in his food . He’s new to wet food though.Sounds good. Get him to drink as much as you can. Is put lots in the food and leave a few extra bowls of water around.
Bron and Sheba (GA)
Member Since 2015
Normally this is what you would do but with ketones in the picture I would stay with the vetsulin until they have gone. It is because levemir is a depot insulin and not an in and out insulin.
How are the ketones today.?
Appetite good?
@Bron and Sheba (GA) Well this afternoon was great (.6), tonight he’s up again (1.2) (ketones). I just don’t get it. We do nothing different other than I could noticeably see the insulin wear off as his thirst went up. Going to go to 2.5 and pray for the best... he’s eaten fine today. His night glucose was in the lower 300s but he’s still staying in the 300/200 range so I’ll switch and see what tomorrow brings. He did have an upset tummy today. I ordered new probiotics for him.
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Hello all. So, a quick explanation needed please. I upped his dose to 2.5 this evening after his comfortable day in the land of 300/200, and his +2 glucose this evening was a bit higher than his PMPS, but not his ketones (spreadsheet updated). It's been a very long time since I've seen this happen, and I cannot remember if its a bad thing... Is this dose okay for him despite that occurring? Sorry to be a pain, I am not new to diabetes but I'm knew to everything that has to do with testing and home results. I will say that when I saw this occur at the vet when they were doing curves and dose changes, the numbers would jump a TON an hour after the insulin (those two curves are in Feb and on his chart), but they never could explain it. Thanks in advance, just trying to understand whats happening. Could this be new dose strangeness I’ve read about sort of?
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Bron and Sheba (GA)
Member Since 2015
Great that the ketones are down.
311 and 334 ....not a big difference. Well within the 20% variance. Let’s see how he goes in the next 24 hours.
You are doing a super job looking after Jet Li.....what a lucky boy.
As long as he is eating well and he’s is active, and the ketones are down, I would be happy.
311 and 334 ....not a big difference. Well within the 20% variance. Let’s see how he goes in the next 24 hours.
You are doing a super job looking after Jet Li.....what a lucky boy.
As long as he is eating well and he’s is active, and the ketones are down, I would be happy.
JanetNJ
Member Since 2016
keep in mind on a blood meter, it's only considered a trace at 2.4. He's doing ok.
JanetNJ
Member Since 2016
it was probably just still up from food. I found for my cat a lot of times when I gave a higher dose it would kick in later and have a later nadir. I wouldn't be concerned.
He usually drops by +2 but since the ketones went down a bit I’ll try not to be concerned
Oh really? I’ve been going off the chart that basically says anything over .6 is an issue and anything over 1.6 you need to panic. Is there a chart for blood ketones? Of course I don’t want any but it’d nave nice not to panic as often lol.keep in mind on a blood meter, it's only considered a trace at 2.4. He's doing ok.
Thank you, I greatly appreciate it. Hopefully we’ll get it more under control so I can safely transition soon
. I found out you start Levemir at around 75% of whatever the current dose is. If it takes a bit to get there, so be it, I just want to get there . I’m doing normal testing today so I’ll check in as I can.Thanks for all your help!
Alison
JanetNJ
Member Since 2016
https://www.felinediabetes.com/FDMB...oacidosis-dka-and-blood-ketone-meters.135952/
Blood meters are a bit different from the urine scale. Look at the link above. Toward the bottom of the page I'll quote:
"When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra Blood & Ketone meters?
The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:
Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf
Measuring ketones - JSAP_Zeugswetter - 2012.pdf"
Oh nifty! Thanks! Whew for catching him at 2.7 then >.<
Rough morning. He threw up his morning snack (not his pre-insulin meal) and of course his probiotics as well. He’s got an upset tummy (loose stool). We’ll see and hopefully he keeps his after fasting meal down. I’ve got a new probiotic coming today, since he threw up about 5 minutes after he ate do you think I should give him some of the new one this afternoon when it arrives to help his tummy? Sorry, my vet is of course closed due to staffing issues today. Testing in about an hour just letting him relax at the moment. He also didn’t snack overnight. His glucose numbers looked ok before bed.
JanetNJ
Member Since 2016
You could if you want I'm sorry his tummy isn't feeling good.
Alright I didn’t want to overdo it, but I doubt he got any into him in that 5 minutes it was in him. Hoping his numbers aren’t too crazy and he keeps his preinsulin meal down. Poor guy.
JanetNJ
Member Since 2016
A few of my cats have been throwing up haiballs lately as their winter coats are falling out
Makes sense. He’s still playing around so hopefully it was a one off thing... we’ll see when he eats in about 45 :/
JanetNJ
Member Since 2016
Not sure what's happening.
Bron and Sheba (GA)
Member Since 2015
It’s possible he dropped lower last night and is bouncing today with the red AMPS.
If you get a BG at +2 that is lower than the preshot, that is giving you a heads up that it might drop lower, so it is always a good idea to set the alarm and test again around+5 or see the BG hasnt dropped too low.
If you get a BG at +2 that is lower than the preshot, that is giving you a heads up that it might drop lower, so it is always a good idea to set the alarm and test again around+5 or see the BG hasnt dropped too low.
His +2 has always been lower than his PMPS. Same happened with the +2 after AMPS on his curve day. Only once since I started was it higher. Shouldn’t it drop some after 2 hrs since he’s still on Vetsulin? I’m hoping he’s just settling into the new dose but over 400 both mornings confuses me greatly.
Also, his urine is negative for ketones. @Bron and Sheba (GA) I think you asked that before.
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Bron and Sheba (GA)
Member Since 2015
Thanks re the negative ketones. I probably did ask it before.
Cats often drop lower at night, and seeing a higher AMPS makes me think the BG could have dropped lower.
Cats often drop lower at night, and seeing a higher AMPS makes me think the BG could have dropped lower.
Can I do a +5 tonight instead of a +2 or should I do both? It’s just all very confusing.
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