11/15 River (AMPS 262, and hello ketones)

Paigeworthy

Paigeworthy

Member Since 2018
Yesterday's thread.

Y'all, I'm bereft. I buckled and emailed the vet last night when the new meter showed ketones. This morning her number had nearly doubled. I still don't really know what the numbers on the meter mean, but I know they're not good.

Started her on 2 units of Lantus this morning. I just want her better.

EDIT 12:44 p.m. (+5)
If the comments are TL;DR — I have spoken with the vet and she does not think River needs to be seen today based on her blood ketone levels. I will be finding a new vet because she patronizes me and doesn't seem to be doing half the work I am.

But in the meantime, I am keeping a close eye on River and have moved the litter box out into the living room by where I am working so I can see when she gets ready to go and catch some for a urine strip.
 
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I"d call the vet now - not wait for a response to the email. I would bring her in this am - maybe they can bring down her blood sugar and stabilize her so you wont' have to take her to the emergency vet

Is she eating/drinking?
 
Carol & Murphy said:
I'd call the vet now — not wait for a response to the email.
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Just got off the phone with the receptionist. Dr. Jenny has been out for the past week and is catching up this morning. I asked the person at the desk to escalate my note and have the doc call me back.

Carol & Murphy said:
Is she eating/drinking?
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Her appetite is definitely less than it has been. Drinking, yes. She ate about half a can this morning.
 
Definitely encourage her to eat every time you walk by. I hope the vet calls you back with a plan.

ETA: And I'm glad you increased. That's what we would have recommended with ketones in the picture now.
 
Mandy & Rex said:
Definitely encourage her to eat every time you walk by.
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I actually had to leave the house — I'm sitting at a Starbucks right now. I won't be able to take care of River at all if I lose all my clients because I can't focus ;)

Will be heading home again soon, and my husband is home with her right now. Just waiting for a call from the vet. Hoping we can test her BG one more time for good measure then take her to the clinic.

Mandy & Rex said:
ETA: And I'm glad you increased.
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I sent the vet the page on the website about TR — last time we spoke she really pushed on me waiting a full week to change the dose.
 
Carol & Murphy said:
I wish my vet's office was open - they'd take care of you.
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Will you let me know when they notify you that they've opened up again? I definitely want to look into switching to them.

Carol & Murphy said:
here are the emergency clinics my vet recommends
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More to the point they're kind of the only emergency clinics in town :(
I don't know if I can ever go back to MedVet again — I have heard better things about Premier. But perhaps the devil you know…
 
I didn't realize you were at MedVet before - I've only been there to see a feline cardiologist - in any case, let's hope it won't come to that
 
MrWorfMen's Mom said:
All fingers, toes and paws crossed here the vet can see River shortly and get her (and you) feeling better! :bighug::bighug:
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Thanks lady!! For what it's worth, she IS eating voluntary right now and we've seen a nice dip with the 2 units of Lantus. If we can get her back on track with the ketones I think she will be doing great. Still waiting for a call back from the doc.
 
Vet called back and said she didn't need to see River since she has such good energy and is eating a fair amount still. She doesn't know about the reference points for ketones in the blood (and says that any research about the validity of testing cats on human ketone meters is emerging at best) and wants me to check for ketones in the urine. And if I find them THERE I will call her back.

She also said my anxiety is why she recommends people don't home test quite so often. GFY, lady.
 
Once ketones are at about 2.5 on the meter they can show as "trace" on a strip. Once they're above 4 the risk of ketoacidosis is high. It's great that she's eating. If she stops and begins to look lethargic/droopy the vets MUST see her.

I find the meter to be a mixed blessing. You just don't have the fine gradations you can have with a strip. Apparently, zero to below 2.4-2.5 is negative. Around 2.4-2.5 you might get trace on a strip. Over 4 on a meter is high on a strip. There's no in between to speak of. Also, vets don't use meters for ketones and don't understand the numbers.

I bought a meter when Teasel was so ill in May and June but haven't used it much. I prefer the urine test strips. Mind you, he's easy to test that way.
 
Are you testing on a Blood meter for the ketones?

This is from my notes:
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

Do you have any sub-q fluids? If so you may want to give her some.
 
Paigeworthy said:
Yup. Nova Max.
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That is what I use too, and though Gizmo has NEVER had ketones (believe it or not with all his issues :rolleyes:), when his appy is off, BG running higher I still try and check JIC.

I sure hope you can get River's ketones down. I sure wouldn't wait too long to get her to a vet. My understanding, with ketones, the situation can go from so-so to life threatening pretty quick.

Many hugs. :bighug:
 
LizzieInTexas said:
I sure hope you can get River's ketones down. I sure wouldn't wait too long to get her to a vet. My understanding, with ketones, the situation can go from so-so to life threatening pretty quick.

Many hugs. :bighug:
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She had a SUPER weird BG day yesterday but is in great shape today, in the yellows and blues. We upped her dose.
Can ketones just…come down on their own? Can her body just decide, "Nah, never mind"?
 
Paigeworthy said:
She had a SUPER weird BG day yesterday but is in great shape today, in the yellows and blues. We upped her dose.
Can ketones just…come down on their own? Can her body just decide, "Nah, never mind"?
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Yes, they can. It helps to have her really well hydrated - lots of extra water in her wet food. She also needs a high enough insulin dose and that can mean feeding higher carb food to support that.
 
Kris & Teasel said:
Yes, they can. It helps to have her really well hydrated - lots of extra water in her wet food. She also needs a high enough insulin dose and that can mean feeding higher carb food to support that.
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This girl will not TOUCH wet food that has water in it. Not lately anyway.
 
Not sure if anyone has shared this link yet, but it is excellent reference with additional links.

With a history of DKA, I'd want to have the ability to deliver fluids in my tool box (just in case that is necessary).
 
Carol in Chicago said:
Not sure if anyone has shared this link yet, but it is excellent reference with additional links.
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Thank you, Carol! I've seen it just a couple of times ;)

BriskIdenticalHamadryas-size_restricted.gif


Carol in Chicago said:
With a history of DKA, I'd want to have the ability to deliver fluids in my tool box (just in case that is necessary).
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Totally agree. I need to find a vet who doesn't treat me like garbage, and after that I'm definitely going to make sure that gets in my toolbox.
 
Paigeworthy said:
She had a SUPER weird BG day yesterday but is in great shape today, in the yellows and blues. We upped her dose.
Can ketones just…come down on their own? Can her body just decide, "Nah, never mind"?
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I hope someone can come along and give you more definite info but my understanding is too little insulin, too little calories and infection is the perfect storm for ketones.

https://edenseffort.files.wordpress.com/2014/04/dka-graphic.jpg
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
http://www.felinediabetes.com/ketones.htm

http://www.felinediabetes.com/FDMB/threads/newly-diagnosed-with-neuropathy.8003/#post-79718
^^This one is good - I hadn't read it before, just skimmed it but will go back and read it tonight.
 
Paigeworthy said:
I need to find a vet who doesn't treat me like garbage, and after that I'm definitely going to make sure that gets in my toolbox.
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I'm in Kane County which might be a bit of a drive, but I would highly recommend my vet. He is an excellent teacher and very supportive of home care and testing. We met many years ago when he was just starting out. He has since become the owner of the practice and cared for every member of my furry family. Please PM me if you want a referral.
 
On your spreadsheet it shows a second ketones test. How far apart were they? Just wondering when the tests were compared to what her blood glucose was at the time.

Another one for your library, a little video watching in advance, Giving SubQ Fluids.
 
MrWorfMen's Mom said:
If River won't eat food sullied with water, could you syringe some extra H2O into her? Might be worth a try.
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How much do you like to add when you need really soupy food? I was able to add a couple of teaspoons to her dish just now and she's chowing down. Will wonders never cease.
 
If it's been quite a few hours since the last ketone test and she's now blue and drinking a bit, maybe another ketones test?

Glad you were able to get a bit of water in her. I used to add a couple tablespoons to the cycles food. Another trick I've used is water from a boiled chicken breast, or tuna water from unsalted tuna in plain water. Whatever might be yummy water.
 
Wow! Just read through the thread, and I was just hoping for a happy ending! Sooo glad River is ok.
You should definitely take the time to replace that lousy vet so that you can have proper support if this ever happens again, although hopefully it never will.
:bighug:
 
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