Petsitter seeing ketones rising

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Holly and Sunny Bear

Holly and Sunny Bear

Member Since 2021
We have a pet sitter watching Sunny through the 15th, and she's checking his ketones daily with a blood ketone monitor. We normally see him between 0.3 and 0.7 for ketones. But today he measured at 1. I've asked the sitter to check him again in the am and pm so we can keep a close eye on ketones in case they're rising.
He's eating well, and the sitter is adding water to his meals. And we have him on a safe vacation insulin dose of 1.5u for now. I plan to increase that to 1.75 when I get back.
Anything else we can do right now about that rising ketone number? He has not had an issue with DKA ever in the past. We added a column to his spreadsheet for ketone tracking.
 
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Holly and Sunny Bear said:
We have a pet sitter watching Sunny through the 15th, and she's checking his ketones daily with a blood ketone monitor. We normally see him between 0.3 and 0.7 for ketones. But today he measured at 1. I've asked the sitter to check him again in the am and pm so we can keep a close eye on ketones in case they're rising.
He's eating well, and the sitter is adding water to his meals. And we have him on a safe vacation insulin dose of 1.5u for now. I plan to increase that to 1.75 when I get back.
Anything else we can do right now about that rising ketone number? He has not had an issue with DKA ever in the past. We added a column to his spreadsheet for ketone tracking.
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Just make sure he is eating and drinking enough. If it were me I'd consider asking the sitter to go to 1.75U. Based on the data you have he should still be safe at that dose and it may help keep ketones at bay.
 
JaxBenji said:
I would keep watching the trend but studies show blood meters show ketones in felines between 2.4 and 2.55 - there are some links near the bottom of this post for the articles on this data.

https://www.felinediabetes.com/FDMB...oacidosis-dka-and-blood-ketone-meters.135952/
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If I remember correctly, a lot of people misunderstood that post. It means that DKA was pretty much a given in cats that showed ketones of 2.4-2.55 on a blood meter. It was a debate not too long ago but of course I didn't save the link! If you go to the actual study that's what's in it.
 
FrostD said:
If I remember correctly, a lot of people misunderstood that post. It means that DKA was pretty much a given in cats that showed ketones of 2.4-2.55 on a blood meter. It was a debate not too long ago but of course I didn't save the link! If you go to the actual study that's what's in it.
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I'm no expert here since I haven't had a cat with DKA and am simply passing along information for others to interpret/read/research. I believe that's all any of us can do.

FWIW, I said to watch the trend. For Jax, I tested blood ketones weekly (no DKA history) and placed them along side DKA indicators (there's a post in health here too that has indicators - it's from December 2020).
 
JaxBenji said:
I'm no expert here since I haven't had a cat with DKA and am simply passing along information for others to interpret/read/research. I believe that's all any of us can do.

FWIW, I said to watch the trend. For Jax, I tested blood ketones weekly (no DKA history) and placed them along side DKA indicators (there's a post in health here too that has indicators - it's from December 2020).
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Oh I agree! It just turned out that people were thinking ketones of 2.4+ weren't an issue because that's when they start to show up, but I think it was Marje who stopped by to correct it.

I also test weekly (ish...), also no history. 1 is a little high based on what I've seen from people who blood test, so I agree to watch the tend and just make sure he's eating and drinking
 
Thank you @FrostD and @JaxBenji!
This morning his ketones were at 0.8 which is a little improved since yesterday. The sitter (my dear sweet diligent niece) is going to test his ketones twice a day now, and add more water to his food slurry. If we see that number rising again, we're considering a raise in his dose, but that makes me nervous since he can be rather sensitive to an increase at first, and my niece won't be home all day to check him regularly.
 
Will she be around tonight and throughout the weekend? I know it's asking a lot of your niece.
 
Dyana said:
Will she be around tonight and throughout the weekend? I know it's asking a lot of your niece.
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She is also going to school and working so she's usually gone between noon and 9:30 pm each day. I might be able to get another niece to spend some time with Sunny during nadir hours potentially. Are you thinking that dose increase needs to happen @Dyana ?
 
Ok he just measured at 1.3 for ketones tonight! So my nieces are bumping up the insulin dose to 1.75 tonight and will be with him all day tomorrow, checking bg and ketones often. And they're adding lots of water to his food and making sure he has plenty to eat. Ugghhhh I'm stressed! Wish I was home.
 
Holly and Sunny Bear said:
Should I have them get him to the emergency vet? He's not showing any symptoms
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Eating and drinking ok/peeing and pooping ok? Do they know how to check for dehydration?

If he's dehydrated they should try either syringing some small amounts of water at a time, or putting something like tuna juice or chicken broth in his water (as long as it doesn't have celery or onion or other toxic things). If not eating enough, they could try assist feeding small amounts.

I'd say if ketones go up then yes to be safe. It's the balancing act of paying $$$ for emergency vet or seeing if it can wait til morning.

The thing about DKA is you don't want to get to the point to where there's symptoms. So it's completely up to you, knowing your cat, and what you think your nieces can handle
 
We think he's pooping and peeing normally. Hard to tell bc we're a multi cat household. He's eating very well. We don't see him drinking, but she's adding lots of water to his food. He got his insulin 2 hours late tonight bc my niece had to work late. She will get up and check him tonight a couple times (bg and ketones), and they're prepared to take him to the vet if they don't see that ketone number come down now that they bumped up his insulin and are giving him even more water.
 
Thank you for your advice friends! :bighug: To be on the safe side, my sister in law took Sunny to the emergency vet and they tested his bg (300 at pmps +3) and ketones via urine which were "trace". They were not concerned and said he looks very well, but did agree that we should increase his dose to 1.75 and keep a close eye on the ketones. Sigh. My niece will watch him like a hawk over the weekend. I think that's the best we can do for now. Can't wait to get home from this vacation so I can work on his dose again.
 
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