? 4/2 Simon PMPS 350 KETONES 2.8

S

simonsugar

Member Since 2025
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Please help: Simon's ketones are at 2.8. PMPS 350. PM injection due 20 minutes ago at 730PST. Emergency vet not answering their phone. Only one near us for 2.5 hours in any direction. Do I give insulin (Lantus) or rush to the vet and hope they can get him in? He's otherwise acting normal, eating, drinking, using litter box appropriately. Not as playful as some days but not lethargic.

Give lantus or hold and rush to ER?
 
simonsugar said:
Most recent post/history

Please help: Simon's ketones are at 2.8. PMPS 350. PM injection due 20 minutes ago at 730PST. Emergency vet not answering their phone. Only one near us for 2.5 hours in any direction. Do I give insulin (Lantus) or rush to the vet and hope they can get him in? He's otherwise acting normal, eating, drinking, using litter box appropriately. Not as playful as some days but not lethargic.

Give lantus or hold and rush to ER?
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I finally got through to ER Vet. Gave lantus 30 mins late, will adjust appropriately tomorrow AM. They recommended a regular vet appointment tomorrow since he's acting normal, eating and drinking.
 
Mary & Jude said:
Can you call and ask?
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I couldn't get through for 30 minutes! I almost started calling other towns to see if they could just give me an opinion, but since he's acting normal they don't think he needs to be rushed in. Which makes me wonder if this has happened before, and I never knew since I wasn't testing? I will be doing at least daily (2x most likely) ketone checks going forward, as soon as the extra strips arrive.
 
Sorry. Just reading. So glad you got some guidance from them! I hope everything goes well with Simon tonight. When you get a chance, please remove the 911 from your title 🥰
 
simonsugar said:
I couldn't get through for 30 minutes! I almost started calling other towns to see if they could just give me an opinion, but since he's acting normal they don't think he needs to be rushed in. Which makes me wonder if this has happened before, and I never knew since I wasn't testing? I will be doing at least daily (2x most likely) ketone checks going forward, as soon as the extra strips arrive.
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You handled this well. That would have frightened me too.
 
I’d like to get some feedback about the ketones—so I’m glad you left your “?” Up in the title. Jude doesn’t have ketones, so it’s not something I’m well acquainted with. I do know that when a cat has had ketones in the past, they don’t like them skipping insulin, as the absence of insulin (plus other contributing factors) can increase the chances of DKA. When to seek medical care is my question.
 
Mary & Jude said:
I’d like to get some feedback about the ketones—so I’m glad you left your “?” Up in the title. Jude doesn’t have ketones, so it’s not something I’m well acquainted with. I do know that when a cat has had ketones in the past, they don’t like them skipping insulin, as the absence of insulin (plus other contributing factors) can increase the chances of DKA. When to seek medical care is my question.
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Yes, you're saying exactly what I'm thinking. I thought anything over 1.5 requires immediate intervention, but the question of him being asymptomatic (so grateful) threw out everything I thought I knew about ketones. And if I was only urine testing, it likely wouldn't show up?

He's sprinting around and doing his nightly parkour moves, literally bouncing off the walls, you'd never guess he is brewing ketones.
 
Bandit's Mom said:
With a history of ketones, you want to get him to a good dose sooner. Would it be possible for you to ditch the dry and switch to TR?
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I can try. I have some other topper options that I can substitute but I have to continue to rotate food and toppers (purr pops, bonito flakes, nutritional yeast, fortiflora) or he will refuse to eat. I'm willing to try TR. I guess I haven't been able to get over the anxiety of shooting at lower thresholds but I'd force myself if you think it will help him and avoid this type of situation
 
How about trying freeze dried meat as a topper? It has the same crunch as kibble and you could follow TR.

I know that TR can seem very daunting at first, but you could try it till you are able to get Simon to better numbers and then if you think it's too much, you could switch back to SLGS at any time.

I'm just concerned about him hanging around in higher numbers when throwing ketones.

With TR, you needn't wait 7 days to increase. You could increase every 3-5 days based on his numbers.
 
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