8/31 Sushi – Ketones Small to Medium - #s in 200’s

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Sushi (GA 5/05-3/14)

Sushi (GA 5/05-3/14)

Member Since 2011
Good Morning!
I’m glad to say we made it through Hurricane Isaac.  It turns out my apartment never lost power, but family I stayed with was without power until 12:30 last night.  It really wasn’t bad compared to some of the other storms we’ve had!  Unfortunately, I can’t say the same for DD & Tinkerbell.  I hope they’ve been able to post, but they’re under a mandatory evacuation.  Their area has had a lot of flooding and will face severe flooding in the next few days.  Please keep them in your thoughts and prayers.
 
I rushed home and to the vet as soon as the storm let up enough to do so, so Sushi only had to stay at the vet for a day and a half (2 nights). 
 
Unfortunately, Sushi has NOT been in good shape since we got home from the vet.  Here are my questions about our situation described below:
On a scale of 1-10, how bad off are we?
Is this something I can turn around at home?
Will all right itself if I’m able to syringe feed him?
Do I need to rush him to a vet right now?  Or can I bring him first thing in the morning?
 
I could tell immediately when we got home that Sushi wasn’t feeling well.  He seems glazed over, like his personality is completely gone.  There’s a red ring around his eyes.  His breathing seems deeper.  He’s groaning.  His back legs seem to be bothering him.  His bottom and tail were covered with something, probably urine, and his back legs had litter caked to them. 
 
He’s not eating, so we’ve skipped last night’s & this morning’s dose.  I did get him to eat some of his breakfast; maybe 1/8 of what we normally eat, and he was willing (as always) to eat some canned chicken.  I’m trying like crazy to find some feeding syringes, but I’m striking out left and right!
 
But his blood glucose levels have been in the 200’s. 
 
It started storming shortly after we went to bed last night.  Sushi hates storms so he climbed under the bed, got into my box spring, and somehow made it to the opposite cattycorner of the box spring from the opening.  He started clawing the crap out of it, so I had to cut him out. 
 
I tested his urine for ketones this morning and it was in the small to medium range. 
 
I’m very hesitant to bring him back to the vet, because of the stress it will put him through.  And because I just don’t think there’s much they can do for him.  I’m sorry to say that I lose more and more faith in vets every time I go.
I feel like if he can just relax & settle in at home, he’ll start to eat and it will all be okay.
 
Again, here are my questions:
On a scale of 1-10, how bad off are we? 
Do I need to rush him to a vet right now?  Or can I bring him first thing in the morning?
Is this something I can turn around at home?
Will all right itself if I’m able to syringe feed him?
 
Thank you!!
 
You cannot treat ketones at this level at home. Anything above trace requires immediate intervention by a vet so this dose not become DKA.

Skipping shots contributed to the problem. Ketones are more likely to develop when there's in infection present, not enough insulin, and not enough food. Do you have any idea what went on when Sushi was boarded at the vet's office? Was Sushi exposed to a sick cat? (or dog?)

Please get Sushi to the vet or an emergency facility ASAP. They can likely intervene before this turns into DKA which is very expensive and life threatening.
 
Hi guys .. I have to agree with Sienne, this is NOT something you want to try and deal with at home .. a situation like this can turn very serious in a very short amount of time .. I'll be thinking of you guys!
 
Thank you!!! I'll make an appointment right away. Should I bring him back to the hospital where he was borded? That was the vet I brought him to a few weeks ago with his bladder infection. Or try another vet? I hate vet hopping, but I've yet to find one that is on the same page as FDMB.
 
Thinking of you and hope you get Sushi in to the vet asap. Do you have an animal ER? Just a thought. That is what we have used when we suspected ketones. Healing vines for Sushi and hugs to you!
 
Sorry to hear about Sushi! But glad you are taking him to a vet. Without knowing all the circumstances it is hard to say where to take him, but I might tend toward a hospital vs the boarding vet. The hospital would have more critical care services and get him treated quickly. I don't know that for sure... just here in my hometown that would probably be true.
 
Sorry Sushi got sick. I'm glad you're bringing him in. I would tend toward the ER but don't know the quality of what you have around you that's open and whether they're damaged, etc. Good luck.

Melanie & Racci
 
We are at the vet now. I brought him back to where I boarded him. It's actually a 24 hour vet hospital. It's the 2nd biggest hospital in the state other than LSU. It's rIght around the corner from home. I brought Sushi here a few weeks ago as a patient (bladder infection) and boarded him here this week during the storm. I figured that was good history to have at this appointment, so I brought him back to the same place.
I wish I wish I wish I could find a vet I trusted & was on the same page as FDMB!!!

Thanks for all the healing vines! I hope they work & we're catching it early enough.

: )
 
Will be waiting for your update Ashley. I hope it turns out to be a mild case and easy to treat and nothing too serious.

Sending more healing vines.

Melanie & Racci
 
I am sorry Sushi came back to you in such a state and that you are now dealing with this. I am glad you are at the vet now.

Tawny was horribly sick last winter and ketones were one of her issues, turns out she is ketone prone. All the advice you've gotten above is excellent, I just want to reiterate a couple of things I learned when Tawny was so sick, learned here.

Not enough insulin + not enough calories + infection = ketones.

You can pull the needle out of an insulin syringe (or any syringe) & assist feed him if you have to if you can't find feeding syringes. Feed in small doses, no more than 40 mls at a time. Tawny even tho she is diabetic got CliniCare & Recovery RS both for a time even tho they are much higher carb than she should normally have b/c it was absolutely the only thing I could get into her or get her to eat at the time. Once we got the ketones under control and she was not being tube fed anymore she went back down to a higher calorie low carb food.

Stay safe, sending healing vines to Sushi.

Desi
 
((((Ashley)))),
We are sending very strong healing vines to Sushi and hope that they can get the ketones under control at the vet hospital. You did the right thing by taking him there and by getting him in early. We hope that your hurricane damage will turn out to be minimal.
Best of luck!

:YMHUG: :YMHUG:

Ella & Rusty
 
Sending healing vines to Sushi! I hope the ketones are under control soon. Until you find the right syringes for feeding if you ever get stuck again you can use a plastic squeeze bottle (like the ketchup ones) clear is best so you can see how much is there and the smaller the better. Just be very careful not to give to much at once, easy to do w/ a bigger bottle. I put a can of food and an equal amount of water in the blender, and blend really well. Choose a food she isn't fon of anyway, you don't want to use a favorite food or she may refuse it in the future, unpleasant memories associated w/ it.
 
Hi everyone!!
Thanks sooo much for your support, wisdom and healing vines! I learned a lot from today's posts.

Sushi had perked up a bit when I got home from lunch to pick him up to bring him to the vet (yes, I had to work today...). But he still wouldn't eat. I did a BG test before I put him in his carrier and he was still in the 200's. He even stayed in the 200's at the vet! :o
He continued to perk up even during our 2 hour visit at the vet; grooming himself and everything!

The vet did a blood panel and urinalysis on him:
BloodPanel.JPG
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Urinalysis.JPG
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She found a small amount of ketones in his urine, confirming the ketone test I took this morning. She said his urine looked like it had "debris" in it, and that he may have a UTI. We decided to do some sub-q fluids, and he's back on the same antibiotic we finished a few weeks ago for his bladder infection. She also noticed his potassium level was low, so she gave me some powder to add to his food.

I can see a significant improvement in the 3 hours I was back at work this afternoon. When I got home, Sushi went to his food bowl and ate an ounce or so. Yeah!!

:?: The sub-q fluids are actually a little pouch they inserted between his shoulders. That's where I usually give his injection; so what do I do?
:?: The antibiotic he's on is rice-based, so it raises his BG. I learned that from the previous round. So should I increase his dosage until he's off of the antibiotic?

I kind of liked this vet! She (gasp) admitted that canned food is better for diabetic cats. :shock: That's the first time I've ever heard a vet admit that. We just might have a contender for a permanent vet!

Thank you all again for the support! I needed it!! :smile:
 
You can shoot a little lower on Sushi's shoulder or in the flank. Here's a link to the various injection sites you can use.

Does the vet want to see Sushi again soon? I would suggest getting the potassium levels monitored again. Low potassium is one of the dangers of DKA. Also, it would have been better if the vet did a sterile urine draw (cystocentesis) and run a culture and sensitivity (C & S). It the antibiotic didn't clear up the infection before, it may be the wrong antibiotic for the bacteria. The value of the C & S is that you know what bacteria is present and the correct antibiotic can be prescribed.
 
Thanks Sienne! I posted a little too close to shot time so I didn't get this in time; I did it on his neck/right behind his head for our PM shot. Is that okay? I'll switch to his shoulder from now on.

His PMPS was 426; yow! He shot up quick.

He just peed a lake, so I did another ketone test, and it's negative! :o I did 2 just to be sure. Is that possible that he could turn around that quickly??
 
Oh! Forgot to answer your question--the vet didn't say anything about a follow up. She said I could bring him back tomorrow for more sub-q fluids if I thought necessary, or to hospitalize him if he didn't improve. You make some good points and of course great wisdom though.

Also, I mis-typed in one of my earlier posts--the hospital I brought Sushi to is the 2nd biggest in the CITY, not the state. Typing on my phone always throws me off!
 
If the ketone levels weren't high and Sushi is responding to the fluids, yes, things can turn around quickly. This is why I pushed you to get to the vet. DKA doesn't turn around quickly. You did really good by thinking to check for ketones.

I really want you to talk to the vet, though, about the potassium. Potassium (along with sodium) are the electrolytes that are important for the heart to beat properly. Insulin causes more potassium to get into the cells. You're giving a potassium supplement. This all needs to be in proper balance. As Sushi feels better, you don't want things to go further out of whack. How long did the vet want Sushi on the potassium supplement? If it's for a short time, that's fine. If Sushi were my cat, I'd want to talk to the vet about repeat labs.

Also, as far as there being rice flour in the antibiotic, you can always raise Sushi's dose to offset the effect of the AB. I'd wait, though, to see what the numbers look like before you increase the dose because you don't want to end up overdosing your cat!
 
I am so glad you got sushi to the vet and got him some fluids .. You did a great job in taking care of your little furbaby! Fingers crossed no more ketones!
 
Thanks for the encouragement guys!
And for all the healing vines! They worked so quickly and effectively! :-D

Sienne and Gabby said:
I really want you to talk to the vet, though, about the potassium. Potassium (along with sodium) are the electrolytes that are important for the heart to beat properly. Insulin causes more potassium to get into the cells. You're giving a potassium supplement. This all needs to be in proper balance. As Sushi feels better, you don't want things to go further out of whack. How long did the vet want Sushi on the potassium supplement? If it's for a short time, that's fine. If Sushi were my cat, I'd want to talk to the vet about repeat labs.
Click to expand...
She gave me potassium powder; a small prescription bottle's worth. It doesn't seem like it's a long time supply. Is there a way for me to know if Sushi's getting too much potassium?

Sienne and Gabby said:
Also, as far as there being rice flour in the antibiotic, you can always raise Sushi's dose to offset the effect of the AB. I'd wait, though, to see what the numbers look like before you increase the dose because you don't want to end up overdosing your cat!
Click to expand...
Yea!! That's what I was thinking. How long should I wait? A 6 cycle round?

Ohhhh I'm so happy to have my kitty back!! :cool:
 
As far as I know, the only way to know where the potassium level is at, is to get a blood test.

As far as dose, let's see what happens to the numbers. If you seel them getting higher than expected, ask for help so we don't overlook yur condo.
 
I'm so glad you caught it in time! Yay on Sushi being home and no ketones! I would test his ketones every day, make sure he's staying hydrated and eating and if needed, bring him in for more fluids in addition to what Sienne already told you. You want to make sure he stays out of the woods.

Melanie & Racci
 
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