Grayson 2/25 Ketone update

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Grayson & Lu

Grayson & Lu

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Good morning all - checking in and offering my post-ketone scare observations.

Grayson is doing well this morning...

Friday night at 8 pm he was throwing moderate ketones.
Up half the night with him, ER vet on phone 4x. In to the vet yesterday morning.
Blood & Urine tests, SubQ fluids, anti-biotic (snotty nose) and an amazing consult w/ my vet.
BG has been staying in the 300s all day Thurs and all but one 296 Friday... so 300s. Too flat; needs more insulin.
We upped from .6 to .75 units last night.
During a REALLY huge pee, he tested with only a trace of ketones. Yeah! I THOUGHT we were out of the woods...

This morning:
AMPS 335 Shot .75
+1.5 345
FINALLY peed (I think he's avoiding me!). Throwing SMALL to MODERATE ketones; 100 units SubQ fluids given. And his Clavamox.
He's not been sneezing, eyes aren't runny, so on just a couple of doses, that may have nipped those symptoms (at least the visible ones) in the bud. However, it was probably enough to interact w/ his flat cycles to give him the ketones.

So I guess I'll be chasing him to the litter box every time I can - to keep on top of the ketones.

This is an easy PRO-ACTIVE test that we all should be doing regularly. And I'm VERY fortunte that I caught them early enough. Someone told me their cat went from 2 days of NONE to HIGH on the third day, so don't put it off! TEST! TEST! TEST!
 
Glad Grayson's symptoms seem to be improving. Hope you guys get to relax a bit today!
Good day and good numbers ( with no ketones!) to you!
 
Still another flat day for Grayson... he hasn't broken 300 yet.

AMPS 335
+1.5 345
Sub Qs
+3.5 340
+4.5 312
SMALL ketones
+5.5 307
 
With the infection in play-- the numbers might be elevated. BUT, with the ketones in play...I would increase the dose. I hate to encourage anyone to shoot more insulin, but with the ketones ranging between small and moderate and the flat high BGs, I think more insulin is needed.

Let's see what others think.....But, I do not like the small to moderate ketones and the flat pink numbers.

I have stated many times before....Ketones have my full respect.
 
I agree with Kim. Grayson needs more insulin. It's not about the BG numbers, it's about the ketones....ketones need more insulin, period. SubQ fluids are helpful also to flush them out, but more insulin is crucial. Even if you have to feed HC food to keep his numbers up, you need to increase the dose.

Here's a great post that explains it...I hope you find it helpful.

Jill & Alex said:
good morning, lydia.

one of the benefits of using prozinc is not having to shoot the same dose consistently. dropping the dose to 0.75u is a good idea when you won't be around to monitor, but with sid's history of ketones and multiple episodes of DKA you'll want to get as much insulin into him as safely possible when you are around to monitor... even if it means feeding him high carb food throughout the cycle.

low levels of insulin + inappetence + infection/other systemic stresses is the recipe for developing ketones. when a kitty is prone to ketones resulting in repeated episodes of DKA you'll find you almost have to ride the edge with how much insulin you're giving. with ketones, the BG number doesn't matter. the amount of insulin getting into the cat is what matters. so if you have to feed HC throughout the entire cycle in order to get more insulin into the cat... so be it.

BG numbers and ketones have no connection. a cat can throw ketones at a BG number of 120 or 520. the only reason BG numbers seem to have a connection is that a BG number of 520 sends up a red flag that not enough insulin is getting into the cat while a BG of 120 doesn't arouse concern. a diabetic cat can be in full blown DKA with a BG of 120 from not eating, vomiting, and being septic. most won't, but it can happen.

when you get a chance, please take a look at Grace's ss: https://docs.google.com/spreadsheet/ccc?key=0Ah416fWwiPUwdHc0RzFnRkVZaHlwNkRSYjlVSVpVWkE&hl=en#gid=0.
grace is very prone to ketones. her ss illustrates the need to get insulin into the cat even if you have to manipulate the curve with food to prevent kitty from going too low.

it's imperative to get an adequate supply of insulin + food into him to avoid ketones.


just some thoughts. hope today is a good one for both you and sid!
Click to expand...
 
So we never got out of the 300s again today, and ketones kept rearing their ugly little faces:

AMPS 335
+1.5 345
Sub Qs
+3.5 340
+4.5 312
SMALL ketones
+5.5 307[/quote]
+6.75 340
+10 307
TRACE/SMALL ketones
PMPS 374 Shot 1.0 Fed FF
+2 352
SMALL ketones
Fed FF
Sub Qs

The secret to giving SubQs by yourself; let them put their face in a bowl of food - no resistance at all! (this morning he was extremely wiggly, while yesterday he laid there and didn't move an inch - showing off for the vet, I guess!)

I found it kinda funny that he looked like "The Hunchback of Notre Dame" after the fluids... but didn't remember him leaking when we were at the vet. A little direct pressure seemed to take care of it. I guess I shouldn't be surprised - that's a REALLY big needle! He seems pretty cozy right now - on the chair w/ the little dog, probably dreaming of YET ANOTHER can of FF! Nope, no loss of appetite here!

Lu
 
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