GA how fast can keytones show up?

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Lynn B

Lynn B

Member Since 2015
My newly diagnosed 9yr old female is finishing week2of humulin N injections 2x/day. She's still at 1u each time. I tried to Inc to 2u after 1wk, but she got very lethargic so we went back to 1u for week 2. Urine testing has shown negative ketones and 500-1000 glucose reading for the most part. She was showing signs of improvement, more energy, regular solid poops and urination. Since she got diabetes she's had a ravenous appetite, but tonight she wouldn't eat so I couldn't give her insulin. I tried another flavor of wet food and she still wasn't interested. Gave her deli Turkey and a few treats just to get her to eat something. An hour later she vomited it all up.
she also urinated so I tested urine. Showing slight keytones around 15...Which surprise me given its been negative for days. Not sure if I got a correct reading or if it can really change this fast? She's vomited a small amount again. Not sure how worried I should be. worried I'll be having a sleepless night.
Help.
 
Hi Lynn,

I don't have any experience with ketones but I noticed that you haven't yet had any assistance. If you don't get an answer soon, I'd suggest going back to the first post on the thread, hitting Edit and putting 'URGENT' or '911' at the beginning of the thread title to draw attention to it so that more people will be aware you need help right now. If that doesn't get replies, try posting in the Lantus and Levemir support group forum - it's busier and someone with experience of ketones might see it faster. I'm sorry I can't do anything to help.
 
Ketones can happen pretty quick. When Bob was diagnosed, he was negative for ketones on a Friday. On Monday he was "DKA".
Test again the next time she pees. If you see ketones again, call your vet and let them know as soon as possible.
The vomiting could be lots of things.
Can you tell if she is dehydrated?
 
Ketones can develop in a matter of hours. I don't have a container of keto-stix in front of me, but I believe a reading of 15 denotes "small" ketones. Is that correct?

The combination of not eating, small ketones, and vomiting is concerning.

If I were in your shoes I would:
  • Get as much water into her as you can to help flush the ketones out of her system. Use a needless syringe to give her water. Gently squirt small amounts of water in the side of her mouth. Don't shoot it down her throat.
  • Try to get her to eat... even if it's just little bits of food at a time. Here's some tips: Suggestions on How to Stimulate Kitty's Appetite. If all else fails, let her eat whatever she liked prior to the diabetes diagnosis... even if it's dry food. Sometimes a bit of dry food stays down when wet food won't. Any food is better than none.
  • Continue checking urine for ketones as often as you can.
  • If she gets any worse during the night take her to an ER.
  • Call your vet first thing in the morning to let them know what's going on as well as for advice.
The recipe for developing ketones = an inadequate supply of insulin + infection or inflammation or systemic stress + inappetance.

You also might want to talk to your vet about switching to a longer acting insulin such as Lantus, Levemir, or Prozinc.
 
Humulin NPH lasts only 6-8 hours in the cat, resulting in 4-6 hours of uncontrolled glucose out of every 12 hours. Is there any way you can manage to give insulin every 8 hours to get better control? You would add up the current daily dose and divide by 3, then give that 1/3 dose every 8 hours.
If you can swing it, though, switching to a longer acting insulin will be better for your cat.
 
Thanks for o the advice. We are at the Vet ER right now. Hopefully they can stabilize her as DKA is suspected. Once she is stabilized , she will be put on Lantus. Not looking forward to the ER bill, but relieved to have her getting the best care.
 
I'm sorry you had to take her in to the ER, but it's the best place for her to be right now. You don't want to mess around with ketones.
Let us know how things are going and how we can help.
 
Hi Lynn,

I'm sorry to read that your kitty is in the ER, but relieved that she's in the right place to get immediate help and keep her safe. Fingers and paws crossed she'll be stabilized quickly and back home very soon.
 
Thank you all for the encouragement and information. I wish I had found this forum sooner. Although the ER Vet got her blood sugar stabilized in just a few hours and she began eating again, she started having seizures. Despite all the tests they ran, they couldn't explain why she was having seizures & ongoing tremors. They thought she may have had some other underlying condition like a brain tumor, but even with an MRI to tell me for sure, it wouldn't change her condition. Unfortunately, they didn't feel that she would recover and I'm very sad to say I've lost my sweet baby girl. I regret that my Vet didn't seem to be up-to-date on the current recommendations for feline diabetes care and that I didn't educate myself/act sooner for change. If there was something besides diabetes going on, the end result may not have been any different, but it's hard right now not to feel like I let her down. She was a beautiful, sweet girl who is greatly missed.
 
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(((((Lynn))))))

You did not let her down, you did the best you could and Gabby knows that. Certainly sounds like there was much more that diabetes going on. I'm so very sorry for your loss.
Fly free sweet baby Gabby. cat_wings>o
 
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