8/11 TASHIE PMPS 502 ~KETONES @ E.R. EYES

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tomtom13

tomtom13

Member Since 2013
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Evening all

This is Kelly/Tomcat...I am writing for Bern/Tashie. She wanted me to post a question for her.

First, she took Tashie to the ER tonight for Ketones. She is still there right now...so I don't have an update yet. Tashie is outwardly fine though.

Bern checked Ketones with a stick this morning from the litter~ it was negative.

She happened to find some fresh urine about 7 hours later ...so again, with the stick...she checked and it was maroon.

So she then got the meter out ~which tested HIGH

So she took Tashie to the ER.

The last time this happened was 6/26 ....a full day of Black and then ketones:

https://docs.google.com/spreadsheet/ccc ... BR2c#gid=0

the same as today. A full day of Blacks....

okay...here is her question:


~~~~~~WHICH COMES FIRST? CAUSE AND EFFECT? she thinks that perhaps the Ketones are first....which then, in turn, cause the all day non-movement HIGH BLACK.....

I told her I believe it is the other way around........the BLACK HIGHS all day from the bounce cause the KETONES.

but we are both clueless and newbies....

that is her question:

I will email her this link so she can follow along from the hospital....and when she gets home she will update us all

GET WELL TASHIE!!!

STAY WITH PEACE BERN!!

thanks all

~kelly
 
Usually, at least as I understand it, it's several factors that come together at the same time. With most kitties, there's some underlying infection/inflammation present. It could be pancreatitis, a dental issue, a UTI, etc. but usually, it's something that's brewing and the cat may not be showing symptoms yet. The infection may cause BG numbers to rise. Ketones typically then occur due to the presence of an infection + not enough insulin + a kitty not eating. Food is also an important part of the equation given that there are metabolic changes associated with the development of ketones.
 
FROM BERN:


So here's another question why does the insulin not work on her when she has ketones?
 
UPDATE:

Bern is on her way home.....to go to bed!

Tashie is fine...going to spend the night at the 24 hr. ER for IV fluids. The blood work turned out fine. No underlining infections. She does still have high ketones.

Bern told them absolutely NO DRY.

Bern has an appointment tomorrow morning at 10 am with an internist to discuss what is going on with Tashie and her insulin problems.

Bern will update us tomorrow afternoon or so.... I would imagine.

Thanks all......
 
Kelly, thank you so much for posting for Bern and keeping us up to date!

Ketones - Basic definition -
Ketones are waste products of fatty acids that may build up in the bloodstream and urine of cats with diabetes. Ketones develop when the cat's body burns fat, instead of glucose, to fuel its body.
Click to expand...
http://www.mycathasdiabetes.com/treatment.html

Sienne gave you the "recipe for ketones" earlier:
Some sort of infection + not enough insulin + not enough food

A diabetic cat can't absorb glucose efficiently, due to the pancreas not producing insulin correctly. That's what insulin does - it enables the cell walls to absorb glucose, and turns it into "energy" to allow all the cells to work right. When functioning correctly, their body will absorb most of the glucose out of the bloodstream and the blood glucose will be in the normal (40-120) range. Without insulin around to make the cells absorb it well, the glucose stays in the bloodstream, and then it shows up on your BG meter. If the levels get high enough (200-225 or so), it will also spill over into the urine.

Given the above definition of what ketones are, it looks like two things can happen. 1, the body can't absorb glucose correctly. And 2, because the body needs something to use for energy, it starts to burn fat for energy. I think that's where the "not enough food" part of the equation would come into effect. If the cat isn't eating well, the body still needs something to use. So I assume it will start using "fat stores".

If you look at the symptoms for ketoacidosis:
Drinking excessive water or no water
Excessive urination
Diminished activity
Not eating for 12 hours or more
Vomiting
Lethargy or depression
Weakness
Dehydration
Ketone odor on the breath (may smell like nail-polish remover or fruit)
Click to expand...
...you can see where the body consuming it's own "fat" might show up as a symptom. Lethargy, weakness, vomiting, dehydration....those would all, I would think, show up as signs if a cat was burning up its own fat to fuel its body. If not enough food is going in, it is going to start to be obvious when the cat is weak, lethargic and generally just feeling like crap. You'd also eventually notice weight loss.

And if a cat isn't eating, and its electrolytes were all out of whack, I'd think that would compromise the immune system, making infection more likely, especially if like Sienne said, it's been "brewing" under the surface just waiting for an excuse to flare up.

Then the infection makes the BGs rise, meaning more insulin is going to be needed to control it. But if the cat won't eat, or isn't eating much, then you end up with "too much insulin" short term. Which causes the BG to drop like a rock. Which causes the BG to bounce pretty high afterwards. And you have this vicious cycle in place.

I'm sure I got parts of that wrong, or said it wrong. I'm not a science major by any means ;-) Much more of a "numbers geek". :lol:
 
Hi all! Bern here .... up waiting from a call from the E.R. Just as an FYI - and, thank you Carl for posting! I just wanted to take a minute to address the quote below for "educational" purposes.

Drinking excessive water or no water
Excessive urination
Diminished activity
Not eating for 12 hours or more
Vomiting
Lethargy or depression
Weakness
Dehydration
Ketone odor on the breath (may smell like nail-polish remover or fruit)
Click to expand...

She had urinated a lot yesterday - that really wasn't a "trigger" for me as she was running HIGH and she urinates more when she is in higher numbers
She was pretty perky - in fact, a half hour prior to going to the E.R. she toddled downstairs looking for FOOD - this was about 45 minutes before pre shot
She ate VERY well yesterday! FF Salmon, FF Chopped Grill, some turkey and then some FF Chicken - this was all between 7AM and 5PM
No vomiting
Did not seem depressed - or weak

I cleaned litter boxes at 11 AM and noted on my SS - NEGATIVE for ketones. Since she has urinated more yesterday, I did the boxes again around 6:30/6:45PM and had another "opportunity" to use the urine stick - it turned MAROON! I was shocked to say the least and ran to get the NovaMax blood ketone meter which registered HIGH.

Called the E.R. got "call ahead seating" ..... it was 15 minutes prior to shot time - gave her insulin shot ......... grabbed the insulin, her meds, food and out the door we went.

****VERY interesting note - you all know I have been fighting my vet over the AlphaTrak meter ---- well, in discussing Nataschia's BG numbers, I found myself explaining that we use a human glucose meter and was going to try to "translate" a bit when the vet stopped me and said THEY USE A HUMAN METER THERE****

Meeting with an internal medicine specialist this morning. Will update as I can.

B
 
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