Charlie trace ketones diarrhea is back +4 394 dose increased

[EllieKozak]

Hi guys. Thank you all for the suggestions and advice for Charlie. The good news is that he's eating more of the LC food instead of the hc. Starting to act a little more like himself but he has diarrhea again and he's still showing ketones. Yesterday was moderate and today is trace. I'm glad the ketone situation is better but I'm worried about the diarrhea seeing how acute it was before seeing the internal med dr that put him on marbofloxacin. Hoping it's just a result of the higher carb food. I gave 100 ml lrs and also increased the l tonight by 0.25 u. Thank you all.

 

[Wendy&Neko]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

I'm glad you increased Ellie. Sorry about the diarrhea. My Neko has problems with the gluten in the Fancy Feast gravy, so I've switched her to Merck Cowboy Cookout for an HC. Same % carbs, but from not from wheat. And less mess in the LB. Is Charlie still getting meds from the diarrhea?

 

[julie & punkin (ga)]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

Hi Ellie,

Glad you went ahead and increased. He is not out of the woods yet. He obviously has a propensity towards the ketones.

At this point, I think you should be re-evaluating the dose every 4 cycles - don't let it go longer than that without talking with us about an increase. He might need to go 6 cycles before increasing, but until we're seeing significantly different numbers and zero ketones, i don't think we would suggest going more than 4-6 cycles without increasing.

It's not uncommon for kitties to get diarrhea from grains or the gluten in cat food. The Merrick's is a good option to try. You could also try raw - you can buy it premade from pet stores. I don't know much about those different food options - Wendy has done both, but if you have questions, put them in the subject line so the right people with experience in those foods see it.

 

[Sienne and Gabby (GA)]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

Any chance the fat content in whatever you're feeding is contributing to the diarrhea? You might want to see if there's a food with a lower fat content that Charlie likes.

I want to strongly encourage you to keep increasing Charlie's dose based on the protocol. I really think you're holding on to the dose too long given where the nadirs are coupled with Charlie's sensitivity to developing ketones.

 

[EllieKozak]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

I'm glad you increased Ellie. Sorry about the diarrhea. My Neko has problems with the gluten in the Fancy Feast gravy, so I've switched her to Merck Cowboy Cookout for an HC. Same % carbs, but from not from wheat. And less mess in the LB. Is Charlie still getting meds from the diarrhea?

Hi Wendy, the diarrhea is better today and he is eating ravenously, like his "normal" self, trying Purina DM savory cuts. He LOVES it. He turned his nose up at all of the Merrick line! He is an odd duck. He is still on marbofloxacin and metronidazole. I am going to update his spreadsheet tonight with more detail in the notes about daily meds. His routine changes so much that I think it would be most effective to have everything in one place. Thank you for your suggestions!

 

[EllieKozak]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

Any chance the fat content in whatever you're feeding is contributing to the diarrhea? You might want to see if there's a food with a lower fat content that Charlie likes.

I want to strongly encourage you to keep increasing Charlie's dose based on the protocol. I really think you're holding on to the dose too long given where the nadirs are coupled with Charlie's sensitivity to developing ketones.

his diarrhea is much better today so I am assuming it was caused by the high calorie food he was eating during his "epidose" this week. I have increased a half unit starting today and will increase as directed by the board. The few days he had "good numbers" the specialist recommended we drop to 4 units, I thought that was too much of a decrease and only gave 4.5 for one shot and it completely backfired and threw Charlie 2 steps back. There is no doubt in my mind that Charlie wouldn't be here today without the help and guidance from this board.

 

[Sienne and Gabby (GA)]

Re: Charlie trace ketones diarrhea is back +4 394 dose incre

For the time being, Charlie is exceptionally ketone prone. Hopefully, once things stabilize, this will be much less of an issue. For now, though, you are going to need to be hypervigilent (and I'm not suggesting you haven't been vigilant). It always helps if you can keep in the forefront of your thinking that ketones can occur if there's an infection/inflammation, a cat's consuming enough calories (so stored fat is being burned which then produces ketones), and not enough insulin is on board.

I'd suggest increasing Charlie's dose every 4 - 6 cycles until you start seeing nadirs that are below 200. We can help you decide if you need to increase the dose by 0.5 or 0.25u. This is aggressive but it's one way you can keep the ketones at bay.

Make sure Charlie is eating. If you have to feed him ice cream, it doesn't matter at the moment. (I'm only slightly kidding!) He needs calories. This may be a balancing act with the diarrhea.

Fluids, whether they come from adding liquid to Charlie's food or sub-q fluids can also help to flush ketones.

Finally, figuring out if there's an infection brewing or if there's an inflammation and getting an antibiotic or resolving the issue will reduce the risk of ketones.