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NadineTheodore

NadineTheodore

Member Since 2023
I’ve been working on Theodore and he just got out of the hospital Saturday afternoon. I have his spread sheet in the link below. My dilemma was today I was going to adjust his dose but my husband asked I do it in the morning so we are alert should anything go wrong…. Anyways now I have even more curious readings
https://docs.google.com/spreadsheets/u/0/d/1-rcQItyW4TPSqj-2xr3j2h9rCGdjeoElaNp0vF_w03k/htmlview

After that…tonight what I’ve been getting.. is it possible bouncing happens so quick???
11Pm- 11 reading
12:37- 22.1 reading
12:56- 10.5 reading
1:00- 19.9 reading

lastly he was released with .9 ketones on Saturday. I don’t have a blood ketone reader just yet but I did the strip test and see attached what I got. Is it possible it went up????

he’s eating drinking and acting normal however he does tend to be a more lazy cat.

Facebook group suggested lowering him to 1.5 which I intend on doing tomorrow however I’m seriously questioning my meter. It’s an alpha track 2
08eZWfKm38LZddPd5g8rdwrag
 
Hi and welcome to the forum. @NadineTheodore
Can you tell me what Theodore was in the hospital with please?
I can’t see what the result of the urine ketones test was…can you tell me again what it was please?.
Looking at his spreadsheet and the fact he had ketones in the hospital, I would not reduce the dose of insulin at the moment.
He could be bouncing at the moment, which would explain the high BG s, and he looks like he could be coming off the bounce with the 11(200) so I would test more frequently and keep an eye on the BG.
You need to be feeding him more food than you normally would do with the ketones in the urine. So offer plenty of food and add a teaspoon of warm water to each snack. Feed him several snacks a day apart from the preshot meals.
I would test the urine daily for ketones and out the result into the remarks column of the SS please so we can see it.
 
https://share.icloud.com/photos/0cfeHSvPzifGFmVp-_kopWDHA Can you view his ketone pic? I’m getting a blood reader because these are way too close.

he was in the hospital Sunday for enema because he has megacolon, seemed fine Monday but then Tuesday he was off completely. Took him to bed, his blood work seemed fine, we assumed he’s still a little constipated which she worked on that.

by Wednesday he was lethargic, took him back his ketones were over 6. Rushed him to emerg for 24/7 care. Released Saturday evening with 0.9 ketones but still high BG 22-29

ultrasound showed some slight enlarged liver spleen and one kidney was slightly on the larger of what’s normal. They didn’t seem to concerned, said we could aspirate it for results however it may come back inconclusive. Suggested the better route might be to do ultrasound 4-6 months from now. Liver had some nodules but they said with cats it’s usually non cancerous. They also offered a test for acromegaly but I held off for now as it doesn’t seem to be what he has

Bron and Sheba (GA) said:
Hi and welcome to the forum. @NadineTheodore
Can you tell me what Theodore was in the hospital with please?
I can’t see what the result of the urine ketones test was…can you tell me again what it was please?.
Looking at his spreadsheet and the fact he had ketones in the hospital, I would not reduce the dose of insulin at the moment.
He could be bouncing at the moment, which would explain the high BG s, and he looks like he could be coming off the bounce with the 11(200) so I would test more frequently and keep an eye on the BG.
You need to be feeding him more food than you normally would do with the ketones in the urine. So offer plenty of food and add a teaspoon of warm water to each snack. Feed him several snacks a day apart from the preshot meals.
I would test the urine daily for ketones and out the result into the remarks column of the SS please so we can see it.
Click to expand...
 
Yes I could see it. It showed a small amount of ketones. Did you read it exactly 15 seconds after you dipped it into the urine? and was that when the photo was taken?
 
I don’t think you need to worry about Acro testing at this point as he is still on a small amount of insulin.
The more pressing problem at the moment is the ketones which need to be brought down. We don’t want them to increase and him get ketoacidosis (DKA)
With those ketones you need to make sure, as I said above, that he is eating plenty of food. He needs 1 and a half times as many calories as he would normally eat. So I would feed him a snack every couple of hours. And add a teaspoon of warm water to each snack.
Definitely do not reduce the dose of insulin in the morning, with those ketones in the urine.
If necessary, if he is dropping low, you will need to feed him some higher carb food to keep the BGs up higher so you can give the 2 units. Test the urine again in the morning and if the ketones are increasing, you may need to increase the dose of insulin to 2.25U but check in here first before doing that.

Can you set up your signature for us please so we can learn about Theodore?
Here is a link to how to do it HELP US HELP YOU
I would post frequently until this problem is resolved. Ketones can increase rapidly if not addressed and we don’t want that to happen.
 
Bron and Sheba (GA) said:
Yes I could see it. It showed a small amount of ketones. Did you read it exactly 15 seconds after you dipped it into the urine? and was that when the photo was taken?
Click to expand...

the photo wasn’t taken right after, I think I dipped 10 sticks losing my mind. I left it dipped for 15 seconds, am I doing that wrong? Then read it
 
Bron and Sheba (GA) said:
I don’t think you need to worry about Acro testing at this point as he is still on a small amount of insulin.
The more pressing problem at the moment is the ketones which need to be brought down. We don’t want them to increase and him get ketoacidosis (DKA)
With those ketones you need to make sure, as I said above, that he is eating plenty of food. He needs 1 and a half times as many calories as he would normally eat. So I would feed him a snack every couple of hours. And add a teaspoon of warm water to each snack.
Definitely do not reduce the dose of insulin in the morning, with those ketones in the urine.
If necessary, if he is dropping low, you will need to feed him some higher carb food to keep the BGs up higher so you can give the 2 units. Test the urine again in the morning and if the ketones are increasing, you may need to increase the dose of insulin to 2.25U but check in here first before doing that.

Can you set up your signature for us please so we can learn about Theodore?
Here is a link to how to do it HELP US HELP YOU
I would post frequently until this problem is resolved. Ketones can increase rapidly if not addressed and we don’t want that to happen.
Click to expand...
My vet actually suggested increasing it yesterday to 2.5 units lastnight but I got scared incase something happens so I figured I would save for this morning. I will try to get a ketone test done but he just peed this morning about 2 hours ago. I have a camera set up now
 
NadineTheodore said:
the photo wasn’t taken right after, I think I dipped 10 sticks losing my mind. I left it dipped for 15 seconds, am I doing that wrong? Then read it
Click to expand...
You dip the stick in and read it exactly 15 seconds later. Take the photo then as it continues to get darker.
To post the result, you can copy and paste the photo into here.
NadineTheodore said:
My vet actually suggested increasing it yesterday to 2.5 units lastnight but I got scared incase something happens so I figured I would save for this morning. I will try to get a ketone test done but he just peed this morning about 2 hours ago. I have a camera set up now
Click to expand...
When is the next insulin dose due?
Is the spreadsheet up to date? If not can you update it please?
 
Just updated my signature!


Only thing not up to date are the results below because I think my alphatrak 2 is wonky now. Just noticed this lastnight unless it’s normal for glucose to change this fast?
https://share.icloud.com/photos/072JWC3CsyrRDhn-4Yu7s1ygA


Spreadsheet is up to date. I tried testing lastnight to see his results
Bron and Sheba (GA) said:
You dip the stick in and read it exactly 15 seconds later. Take the photo then as it continues to get darker.
To post the result, you can copy and paste the photo into here.

When is the next insulin dose due?
Is the spreadsheet up to date? If not can you update it please?
Click to expand...
 
Bron and Sheba (GA) said:
You dip the stick in and read it exactly 15 seconds later. Take the photo then as it continues to get darker.
To post the result, you can copy and paste the photo into here.

When is the next insulin dose due?
Is the spreadsheet up to date? If not can you update it please?
Click to expand...
Next dose is do today in an hour. I just got a new glucose reading (human) freestyle lite delivered 10 mins ago to my door but seems more reliable then alphatrak 2 at this point
 
I can only see the world SS not the US SS. Do you have a US SS set up?
If not I’ll ask @Bandit's Mom to help you with that. It looks as if you have been using a human SS instead of an alphatrak SS with the alphatrak meter.
Also I can only see the +3 in the pm cycle. Did you test after that?
 
Nadine --

Bron asked the question that was running through my head. Do you have the US version of your spreadsheet? Most of us are in the US and the meter readings are calibrated differently. The FDMB spreadsheet (yours in not the same as the one we use) will make the calculations automatically when you enter the World values.

I'm tagging @Bandit's Mom to see if she can help you get this sorted out.

Also, it's more helpful to tell us that his number was 13.7 at +2 and then back to 23.7 at +4. We are all in different time zones so the actual hour could be way off especially because we have international members.
 
I can convert for you. Hopefully this makes sense:

July 27th:
preshot - 29.3 = 527.4
+2 - 24.3=437.4
+3 - 22.3=401.4
+4 - n/a
+6 - 29.5 = 531
+8 - 28.4 = 511.2
+10 - 23.3 = 419.4
Preshot evening 22.9 = 412.2

July 28th:
preshot - 28.7 = 516.6
+2 - 13.7= 246.6
+3 -
+4 - 23.7 = 426.6
+6 - 10.1 = 181.8
+8 -
+10 - 29.6 = 532.8
Preshot evening 24.7 = 444.6
 
NadineTheodore said:
I can convert for you. Hopefully this makes sense:
Click to expand...
Hi Nadine, I can set-up a spreadsheet in our format with both US and World tabs. The US values are automatically calculated based on what you enter in the World tab. What we have seen is that the format you are currently using often crashes on tablets and phones. If you will send me your google ID via PM (just the ID and not the password), I can set up a new spreadsheet and transfer ownership to you.

ETA: You are also using the human meter format of the SS rather than the pet meter one. Will you be switching to the Freestyle Lite soon?
 
Forgot to mention we got this tonight !!!!
https://share.icloud.com/photos/09c4W0ga8aJL8pZixyRRioOAg

:cat::cat:

Bandit's Mom said:
Hi Nadine, I can set-up a spreadsheet in our format with both US and World tabs. The US values are automatically calculated based on what you enter in the World tab. What we have seen is that the format you are currently using often crashes on tablets and phones. If you will send me your google ID via PM (just the ID and not the password), I can set up a new spreadsheet and transfer ownership to you.

ETA: You are also using the human meter format of the SS rather than the pet meter one. Will you be switching to the Freestyle Lite soon?
Click to expand...
 
NadineTheodore said:
Forgot to mention we got this tonight !!!!
https://share.icloud.com/photos/09c4W0ga8aJL8pZixyRRioOAg

:cat::cat:
Click to expand...
That looks like a negative ketone test...is that correct. Good!
I am wondering why you have reduced the dose to 1.5 U tonight? He did not earna reduction and it is not a good idea at all to reduce the dose with ketones hanging around. I would go back to the 2 units in the morning.
How is his appetite? Is he eating lots of food?
 
The vet from emerg called me last night and we spoke for a little. His original starting dose was 1 then bumped to 1.5 which is what he was on at the hospital and we bumped him to 2 because his numbers were still bad but she was worried about a simogi effect. Anyways because the numbers were better at lower doses she suggested going to to 1 but even I was a little concerned about such drop. She also mentioned NO food until his dose. he was starving. In any case his number this morning was the highest yet (33.6 before food), 30.3 15 mins after eating. I wondered if my meter is working so post eating I did another test on my friends meter 28.9 on alphatrack2 and 18.2 on freestyle lite

Is it normal for his numbers to drop so fast post eating?

Also do you only feed your cat twice a day? It's just hard with him, he gets stressed then binge eats which I don't think is great either.

I gave him another 1.5 dose as I didn't see this post prior too. I don't know what to do anymore.
 
Please feed more than twice a day. Test Preshot then give a meal. Then give 2 or3 snacks during each cycle, preferably in the first half of the cycles. Both cycles give snacks. A snack is a teaspoon it 2 of low carb food. Only feeding twice a day is old thinking that went with old insulins.

The reason you are seeing such high BGs is because he is bouncing from the blue BGs. His body is used to higher numbers now and when he gets a lower number his body thinks it is too low. I will post an explanation about bouncing below.
With ketones in the picture I would stay at 2 units twice a day. It is food and insulin and fluids that keep ketones away. So you need to give those please.

if you have no confidence in your meter why don’t you go out and buy a human meter.
 
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
I’m panicking a little. I did a ketone test and now it’s showing 8 after lowering the dose. Behaviour is normal, eating and drinking is normal.

do you think he needs to go to emerg?

Bron and Sheba (GA) said:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
 
NadineTheodore said:
I’m panicking a little. I did a ketone test and now it’s showing 8 after lowering the dose. Behaviour is normal, eating and drinking is normal.

do you think he needs to go to emerg?
Click to expand...
Sorry I am just seeing this.
How did you test for the ketones? Was it a urine test of a blood test? I didn't think you had a blood ketone meter.
If he seems OK and is eating well and not lethargic I would wait and see how he goes. But in saying that, you need to be the judge of how he is. If in doubt, take him to the vet.
Please increase the dose back to 2 units.
And are you giving extra food as I suggested above.
And test for ketones at least twice a day while there are any present.
 
Hi,

Yes urine strips. https://share.icloud.com/photos/0b9nhcSwZbhCTRZ4JtmLuAUIQ This was at 4PM EST so almost 6 hours ago. I'm waiting for him to pee again :)

He has a GREAT appetite ( I am giving him extra food), drinking, I increased his dose to 2 units tonight. He is with us, wagging his tail (yes, wags his tail, he thinks he's a dog sometimes). Jumps on the couch. He even slept on his back being sassy. If I didn't see the strip result, I wouldn't be panicking. I think it was partially removing the food that was the issue as well. He started at 4am walking on us/followed up by clawing us. It was a stressful morning for us. My family vet gave me a hard time about the dose change as well. I feel horrible

Really hoping my blood ketone tester comes soon.
 
When you got the last ketone test, did you dip it in, then read it at exactly 15 seconds against the colours on the side of the bottle? if left longer, it gets darker. Using the urine tests are fine as long as you read them at exactly 15 seconds and you are able to get urine samples.
Having that amount of ketones is concerning.
Can you get another ketone test soon?

NadineTheodore said:
My family vet gave me a hard time about the dose change as well. I feel horrible
Click to expand...
Dont feel horrible. Your vet was giving you bad advice. A cat who has ketones needs more insulin not less.
Let me know if you get another urine test please:)
 
I haven't gotten once since 4:30PM. I am trying to encourage him to pee but still nothing. :(
It was a random vet who called from emerg to do a check in. I am part of a Facebook diabetes group as well and they were all saying to lower it as well....yesterday no ketones and today suddenly we have insanely high ketones. How soon do ketones effect them? He is asking for food as we speak... It's frustrating
 
NadineTheodore said:
I am part of a Facebook diabetes group as well and they were all saying to lower it as well...
Click to expand...
Was it our Facebook group? I doubt the experienced people there would tell you to reduce the dose with ketones in the picture. Please be careful who you get advice from. There is another group that I think can give bad advice.
If your kitty has had DKA or ketones in the recent past you need to be very careful
To monitor the ketones every day. It is lack of food and insulin that causes ketones and if an infection or inflammation is in the picture, that is the recipe for DKA. So it stands to reason that to prevent ketones, you need to give enough insulin and increase the food intake. by monitoring the ketones, they will tell you if you have the balance right.
when you reduced the dose of insulin, the ketones increased.
Please post daily for help and guidance. We have helped many DKA kitties recover from DKA.
 
Bron and Sheba (GA) said:
Was it our Facebook group? I doubt the experienced people there would tell you to reduce the dose with ketones in the picture. Please be careful who you get advice from. There is another group that I think can give bad advice.
If your kitty has had DKA or ketones in the recent past you need to be very careful
To monitor the ketones every day. It is lack of food and insulin that causes ketones and if an infection or inflammation is in the picture, that is the recipe for DKA. So it stands to reason that to prevent ketones, you need to give enough insulin and increase the food intake. by monitoring the ketones, they will tell you if you have the balance right.
when you reduced the dose of insulin, the ketones increased.
Please post daily for help and guidance. We have helped many DKA kitties recover from DKA.
Click to expand...
Nope not your Facebook group. I just found out about your message board recently.
 
I have a question. I finally got my blood ketone reader. It’s freestyle precision. I got home and tested him right away. It went from around 5 the first test then to 4 then to 3. Is this normal? are human ketone readers accurate on cats? Why would it drop so quickly. I fed him right after but still doesn’t make sense to me

https://share.icloud.com/photos/009h3Nl5CZgXYFyteuOUADssQ

Bron and Sheba (GA) said:
Was it our Facebook group? I doubt the experienced people there would tell you to reduce the dose with ketones in the picture. Please be careful who you get advice from. There is another group that I think can give bad advice.
If your kitty has had DKA or ketones in the recent past you need to be very careful
To monitor the ketones every day. It is lack of food and insulin that causes ketones and if an infection or inflammation is in the picture, that is the recipe for DKA. So it stands to reason that to prevent ketones, you need to give enough insulin and increase the food intake. by monitoring the ketones, they will tell you if you have the balance right.
when you reduced the dose of insulin, the ketones increased.
Please post daily for help and guidance. We have helped many DKA kitties recover from DKA.
Click to expand...
 
Last edited:
With a blood ketones meter anything above 2.4 is of concern. It would be good if you were able to get both a urine and a blood ketones test around the same time. The urine one would be from a bit earlier because the urine has been sitting in the bladder but it would be interesting to compare the two.
Is he still alert and eating well?
Keep feeding plenty of food and don’t reduce the dose.. if the ketones don’t go down we may have to increase the dose again but let’s see how it goes today.

I’m glad it was not our fb page that gave you such bad advice. I didn’t think it would be.
That other group has a history of giving bad andvice about dosing.
 
NadineTheodore said:
I have a question. I finally got my blood ketone reader. It’s freestyle precision. I got home and tested him right away. It went from around 5 the first test then to 4 then to 3. Is this normal? are human ketone readers accurate on cats? Why would it drop so quickly. I fed him right after but still doesn’t make sense to me

https://share.icloud.com/photos/009h3Nl5CZgXYFyteuOUADssQ
Click to expand...

I used a different blood ketone meter, but I will say that we saw the number move around a good bit sometimes. Yes human readers are fine to use on cats, I used the Nova Max Plus and it worked fine.

It's good that it's trending down but as Bron just said, anything about 2.4 is usually a concern. Please make sure plenty of water and extra food is given to help keep DKA away.
 
Bron and Sheba (GA) said:
With a blood ketones meter anything above 2.4 is of concern. It would be good if you were able to get both a urine and a blood ketones test around the same time. The urine one would be from a bit earlier because the urine has been sitting in the bladder but it would be interesting to compare the two.
Is he still alert and eating well?
Keep feeding plenty of food and don’t reduce the dose.. if the ketones don’t go down we may have to increase the dose again but let’s see how it goes today.

I’m glad it was not our fb page that gave you such bad advice. I didn’t think it would be.
That other group has a history of giving bad andvice about dosing.
Click to expand...

I realized I am using Freestyle Precision Xtra strips and I have the Freestyle Precision Neo, are these comparable? I didn't notice the xtra part when purchasing it :|

He is eating like normal (or more), jumping, grooming. He's even sun bathed in the window today which he hasn't done for a long time. Very odd given results.

He is also peeing less. 3 times a day which seems more normal. Before it was very frequent!

Lastly he is on Clavamox which I don't know if this impacts ketones but figured I may as well mention...
 
Did several ketone tests (urine) and all were NEGATIVE for ketones:bighug:

However his blood sugar was sky-high. I have two AT2s. One showed 669.6 at my dose time and the other showed 581.4...
 
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