How often to check for ketones?

[Asiina & Alex(GA)]

I've read all the resources about ketones and DKA and that I should be testing for ketones "often" if certain conditions are met, but I'm still not sure about specific numbers.

How fast can DKA start? If there are risk factors, is once a day enough? More often? Can a cat go from negative to more than trace in less than 24 hours? Less than 12? Less than 6?

I've been testing at least once a day, but I don't know if realistically if it's negative at one time it's a waste of my time to test more during the same day. There's better safe than sorry, but there's also worrying and obsessing over nothing.

Has anyone had experience with testing ketones regularly and catching DKA, and how long that took?

 

[Bron and Sheba (GA)]

I think testing once a day is fine if your cat seems well and is eating well. If you get any ketones in the results then you might need to test more often. Ketones can develop quite quickly once they start if steps are not taken to stop them.
Ketones which can lead to DKA, develop when there is not enough insulin, not enough food and an infection or inflammation present.
If I were you I would try getting some tests in in the pm cycle. Cats often drop lower at night. Alex could be dropping lower at night and bouncing up high by AMPS.
Why did you reduce the dose a couple of days ago? You were getting some lovely blue numbers.
Keep asking questions.

 

[Asiina & Alex(GA)]

My vet and I are trying a reduction as a test to figure out why his PS numbers are getting worse and his nadir numbers are getting more unstable, but obviously since it's risky I want to be on the lookout for ketones.

My problem is that "often" and "quickly" are hard to quantify. A bit of an off topic example, but I had an ulcer a few years ago and when I got medication the doctors told me that it should fix it "soon" but what they meant was it could take a few months. Compared to if I had a headache and took a tylenol and expected it to work "soon" I'd expect it to work within an hour. It's hard to know how quickly is quickly, and how often is often.

Hopefully once a day is often enough to catch, but I tend to get those extra tests in anyway. It's just stressful for both me and Alex to fuss over him so much during the day.

 

[Sandy and Black Kitty]

Ketones can go from negative to large in 24 hours - it happened to my Black Kitty.

Recipe for ketones is:
not enough calories + not enough insulin + infection/inflammation or other systemic stress.

The way it works is that when there is not enough energy from food making it into the cells, the body will breakdown fat and protein to try and fulfill the need for more metabolic energy. The sfexcessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA

Has your vet considered that the high PS numbers may be due to lack of duration? Lantus might be a better choice.