Re: HELP! Ketones in Urine...
dawn, i'm sorry you're going through this.
first of all, a little bit of history from BudLt's profile on the "old" board:
OK, here is the “quick scoop”…
Jazmine (my Booga-Boo) was diagnosed with diabetes on 6/23/08. She is 8 years old now (birthday is September 3rd 2008), a Tortoiseshell color Persian, weighs about 6 lbs, and loves to tell stories. She has a 17 lb Cream Point Himalayan brother (12 yrs old) that she loves, and a black short-hair domestic sister “Soprano” (is what we call her; about 15 yrs old; not sure-found as a kitten) that yells at both of them just for something to do.
She is on the insulin by the name of HUMULIN N. Her vet started on 1 ½ units every 12 hours. The vet also started her on a low carb, high protein diet and told us to get Hills M/D (I call it kat-kins instead of at-kins – apparently A LOT of people do; I thought I had come up with a good one!). Of course since then I have learned SO much and know better about the Hills M/D and she is on the FF diet now.
As of beginning Oct/08, insulin is up to 3 units per shot. Boo can’t seem to get regulated and she seems unhappy. She will eat, I will give her the shot, and she will actually walk around and meow for the next 2 hours. Her BG is never at a constant range; it HAS to be uncomfortable for her BG levels to be going up and down so much so often. I have got to look into maybe a new vet…
As of beginning Nov/08, I have changed Boos diet to all low-carb, wheat gluten free varieties of Fancy Feast (thanks Janet & Binky's Charts!) and also lowered her insulin to 2 units per shot. I believe this has helped a lot in keeping her BG levels from going as high as they were. They are still not GREAT, but getting better than they were. I still do not think she should be going up and down so much so often. I think it is time for the new insulin.
***UPDATED Dec/08...
THIS IS WHAT HAPPENED AT THE HOSPITAL THRU WHAT WE ARE DOING NOW...
November sucked. Boo was not acting normal; she was sitting by her water bowl and not drinking, and had not wanted to eat so we called the vet and she had us bring her in to check her out. She told us the news – we had to take her immediately to the hospital. She called the hospital to let them know we were on our way.
11/17/08 Boo was admitted into the emergency hospital with DKA where she spent 5 LONG days as I spent 5 LONG days worrying about her. Seeing her each day and the condition she was in crushed my heart more and more. I would hold her and she would instantly fall asleep in my arms due to not having much sleep in a strange place with strange people working around her 24 hrs a day. I would sit with her as long as they would allow with my tears saturating her blankie or t-shirt I would bring to her each day for a reminder of home to keep with her. I knew she was content; she doesn’t like to be held, so when she would stare into my eyes and happily drift into a nap, I knew she was happy I was there with her.
Basically, now she is home and doing better. Do to all the info I keep on her (and I do have FILES) and I have shared with the doctor, we decided to change her insulin to Lantus and started her on ½ unit per day.
Boo had also become anemic while in the hospital, so I am giving her a B-12 shot once a week. As of now, she is also on antibiotics.
In the hospital they performed an ultrasound and revealed an enlarged, bright liver and a nodule in her pancreas. The liver issue is consistent with diabetes in general, but not specific for diabetes meaning there could be an underlying disease. As for the nodule, it could be a benign change due to chronic inflammation, or indicate a malignant cancer. The only way to determine this is with a biopsy. Instead of invasive procedures, we opted to run a blood test for pancreatitis; it came back positive. Pancreatitis it is typically managed long term with diet, and they feel no change is necessary in her diet at this time.
We suspect she may have a disease called triaditis; this is the inflammation in three organs – liver, pancreas, and GI tract. The only way to diagnose this condition is with biopsies of her liver and GI tract (we already know she has pancreatitis), and typically treated with steroids in which she cannot receive due to the diabetes. We decided to wait on the biopsies, however we opted for a maldigestion profile (blood test) to measure her vitamin B levels and detect any bacterial overgrowth. The test came back negative for the bacteria, but low on the vitamin B12.
Overall we are treating her with 3 things for the suspect triaditis; B-12 for 6 weeks, a 4 week course of antibiotic (baytril), and a liver protectant called denamarin. We go back for a check-up in 6 weeks for an ultrasound to check her pancreatic nodule, her liver enzymes, and her vitamin B-12 levels.
you mentioned ketones were "more than a trace"... what were they on the color chart? trace, small, moderate, or large?
a presence of ketones suggests an inadequate supply of insulin and the possibility of infection/systemic stress going on somewhere in the body. given boo's prior history, the behavior you've mentioned, skipped shots, and not eating much... she really should be seen by a vet. there could very well be something triggering the presence of ketones. imho, your vet needs to examine and run tests on boo to find the underlying cause.
i encourage you to call your vet, explain the situation, and try to work out some sort of payment plan.
delaying a vet visit may result in boo's condition worsening... not to mention becoming more costly. once ketones develop, they can escalate very quickly and become life threatening if not treated properly.
just my thoughts...
