Ketone advice

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Barbara

Barbara

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For several weeks my cat has been showing trace ketones on the pee strips. She's showing no other symptoms & I've had her to the vet twice & they keep saying she's fine. I put water in her food to the point it's soupy. I have been raising her insulin but didn't change last week since I was out of town. I raised her dose today by .2 & now her PMPS is 125 then 20 mins. later it was 129. I got the Precision Xtra meter the other day & started testing her ketones. On Sunday it was 2.0 then 4 hrs later it was 1.2, Monday it was 1.4 so off to the vet she went. She had a fever & some faint "crackly" breathing so they put her on antibiotics. She's had 2 doses of Zeniquin. When I did the second BG tonight I decided to check ketones thinking for sure they would be better. Not so, now it's reading 2.3 the highest reading I've gotten. Anyone have any idea what might be going on? She's acting fine & eating well. No vomiting & not dehydrated. I'm totally confused! She just got her 3rd dose of med & I had to feed her so no shot tonight. I will check BG in a couple of hours.
 
Barbara said:
For several weeks my cat has been showing trace ketones on the pee strips. She's showing no other symptoms & I've had her to the vet twice & they keep saying she's fine. I put water in her food to the point it's soupy. I have been raising her insulin but didn't change last week since I was out of town. I raised her dose today by .2 & now her PMPS is 125 then 20 mins. later it was 129. I got the Precision Xtra meter the other day & started testing her ketones. On Sunday it was 2.0 then 4 hrs later it was 1.2, Monday it was 1.4 so off to the vet she went. She had a fever & some faint "crackly" breathing so they put her on antibiotics. She's had 2 doses of Zeniquin. When I did the second BG tonight I decided to check ketones thinking for sure they would be better. Not so, now it's reading 2.3 the highest reading I've gotten. Anyone have any idea what might be going on? She's acting fine & eating well. No vomiting & not dehydrated. I'm totally confused! She just got her 3rd dose of med & I had to feed her so no shot tonight. I will check BG in a couple of hours.
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Hi Barbara,
Someone sent ,me a pm and asked me to check this post out. When I first read it I was hesitant to answer because of my own personal experiences with ketones and how I prefer to test but that's not really fair. Usually when I make my personal feelings on this subject known, I get slammed but OH WELL :) As the mom of a very ketone prone kitty I have to say this is confusing. First of all, are you sure you're reading the sticks correctly? There's a fine line between negative and trace and lighting can make a lot of difference. As far as the urine testing goes I spoke to my vet on your behalf(who happens to be my ex) and he suggested that you bring a urine sample to your vet and you test it with your ketostix and let him do a test on the same urine and see if you get the same result. I used to use the Precision extra also until I got so frustrated with it I wanted to flush it down the toilet. I have gotten readings as high as 3.8 when two minutes earlier I got trace on the ketostick...and Alex never got sick...at all. I realize they are supposed to be more accurate but I don't know.With that kind of ketone activity for 'weeks', you should have a very sick cat on your hands...yet you don't. Alex should have been near dead at 3.8..he wasn't. That's all I'm going to say about that.

Has your vet gotten blood work? My vet suggested that perhaps he might have some kind of kidney thing going on? And that's all he could think of other than the usual stuff..too little insulin, infection, thyroid, dehydration, etc. Maybe she has thyroid issues? It could be a coincidence that you kitty was getting sick that time you happened to bring her to the vet and her breathing was weird...or not. When Alex has been in DKA or even had ketosis, he acts SICK. There is no question that he doesn't feel well. He is lethargic and has no interest in food. I have to syringe feed him to support his insulin. That doesn't sound like your kitty. After weeks of ketones it should. (well maybe not trace ketones but the ones you're describing on the meter are not trace).

I think the best bet is to have a complete blood work up with t4 and everything...if you haven't already.

Please keep us posted.

Hugs~
Caryl
 
Ketones, the great mystery :) My cat Payne has had four DKA's and one DK (almost the same but pH normal). I use both the sticks and the meter and most of the time I feel like Caryl, let's just chuck it!! But I do use it.

When Payne was in DKA the meter averaged 6.1+ and once she was off the meter totally! She can range now in the 3.0+ .... 4.0+ .... and be perfectly fine, don't know why. But if the urine sticks get up in the moderate range, I start to worry and if she quits eating we are at the vet.

My new vet that Hope help me find and I love, thinks ketones are just a part of the picture. He thinks some cats are more prone and when other conditions are added, such as infection and not enough insulin, etc. a ketone prone cat will start the road to DKA. It makes as much sense as anything else.

But what I have learned is this .... it is the whole cat we need to look at. I don't think we will ever do DKA again because I know her signs so well (and have made all the mistakes ..... :( and even though we have run every test in the book, we still don't know why, why ketones?

Nancy and Payne (doing really, really well and FINALLY doing cat stuff again :)
 
Nancy and Payne said:
Ketones, the great mystery :) My cat Payne has had four DKA's and one DK (almost the same but pH normal). I use both the sticks and the meter and most of the time I feel like Caryl, let's just chuck it!! But I do use it.

When Payne was in DKA the meter averaged 6.1+ and once she was off the meter totally! She can range now in the 3.0+ .... 4.0+ .... and be perfectly fine, don't know why. But if the urine sticks get up in the moderate range, I start to worry and if she quits eating we are at the vet.

My new vet that Hope help me find and I love, thinks ketones are just a part of the picture. He thinks some cats are more prone and when other conditions are added, such as infection and not enough insulin, etc. a ketone prone cat will start the road to DKA. It makes as much sense as anything else.

But what I have learned is this .... it is the whole cat we need to look at. I don't think we will ever do DKA again because I know her signs so well (and have made all the mistakes ..... :( and even though we have run every test in the book, we still don't know why, why ketones?

Nancy and Payne (doing really, really well and FINALLY doing cat stuff again :)
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Don't you think there's something strange about that? If the sticks are anywhere near getting purple Alex gets sick. Period. I take it that's how it is with Payne also.The information on the meter says 1.5 is when you should start to worry, yet at almost 4.0 Alex has been fine! I use it just to tell me if ketones are present if I can't get Alex to pee. Otherwise, I trust the sticks....but that's just me.
 
I think I may be loosing my mind but I swear I have posted 2 replys but don't see them. I don't know what the heck is going on. Hopefully this is showing up. No telling where I posted the others! :roll: Thanks for the info. I'm gonna test this before I go typing out another long post that I don't know what happened to!
 
Barbara said:
I think I may be loosing my mind but I swear I have posted 2 replys but don't see them. I don't know what the heck is going on. Hopefully this is showing up. No telling where I posted the others! :roll: Thanks for the info. I'm gonna test this before I go typing out another long post that I don't know what happened to!
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I see this Barbara but no others.... :?
 
Dear Barbara, and, of course, you too, sweet Thumper,

Barbara said:
I think I may be loosing my mind but I swear I have posted 2 replys but don't see them. I don't know what the heck is going on. Hopefully this is showing up. No telling where I posted the others! :roll: Thanks for the info. I'm gonna test this before I go typing out another long post that I don't know what happened to!
Click to expand...
You might want to click "Expand View" before submitting a new post. That way, you'll see everyone's post including your own. Also, if you submit a post while someone else is submitting a response, and you don't see your post, click submit again.

The FDMB was my first message board experience. I've survived three incarnations/reincarnations of it. Hold steady. You are not losing your mind.



I'm not familiar with the Precision Xtra meter. I am familiar with Keto-Diastix and Keto-Stix and catching pee because Giz was diagnosed extra-sweet and DKA in the same breath. Like Caryl, I discovered lighting made a huge difference between negative and trace. Morning tests always worked better and truer because I'd hold the strip to the window and could actually see the difference between negative and trace.



Because I didn't know the signs of diabetes back then, Giz became DKA. She was lethargic, not eating, and walking on her hocks. Her vet always told me to not bring her in the second I suspected anything unusual. He always told me to wait 24 hours until there might be actual symptoms as opposed to my gut feeling. I waited, spent two nights sleeping on the floor because I didn't know if she could jump on the bed. Both mornings, I was greeted with Gizzie looking down on me from the bed as I was a human pretzel on the floor. I said, well, probably a word I shouldn't post here the second morning and took her in for tests. Took another day to to get the results and discovered I was whisking her to the ER hospital where she spent three days/nights in ICU for DKA...

Yet, we danced for four years. Giz was 14 at diagnosis...

I always preferred natural lighting for testing pee...


Love and hopeful, encouraging hugs for you and Thumper,
Deb and Nikki -- and, Giz, forever dancing in my heart...






Hi Caryl!
 
It is my understanding that ketones occur when fat is broken down for energy.

This may happen if not enough insulin is on board - but can't it happen at other times? Like when a cat is more active now that it feels well? Or if the diet is exceptionally high in protein and fairly limited in carbohydrate & fat?

If a human is following the Atkins diet (high protein, ultra-low carb, minimal minding of the fat), s/he tests for ketones to make sure that fat is breaking down.

In other words, does the urine ketone test strip for anything else that determines it is ketoacidosis? Or just the presence of ketones?
Ditto with the blood meter.
 
BJM said:
It is my understanding that ketones occur when fat is broken down for energy.

This may happen if not enough insulin is on board - but can't it happen at other times? Like when a cat is more active now that it feels well? Or if the diet is exceptionally high in protein and fairly limited in carbohydrate & fat?

If a human is following the Atkins diet (high protein, ultra-low carb, minimal minding of the fat), s/he tests for ketones to make sure that fat is breaking down.

In other words, does the urine ketone test strip for anything else that determines it is ketoacidosis? Or just the presence of ketones?
Ditto with the blood meter.
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Ketones don't occur in cats for the same reasons that they occur in humans. I went on the Atkins diet when I was in my early twenties so I know exactly what you're talking about and to me...purple was GREAT!

Ketones can and do occur in cats for other reasons than not having enough insulin. But not because they are burning fat to look good for bikini season :razz: Usually because there is an infection or one brewing (after not having enough insulin and too high blood sugar), dehydration or a kidney problem, the thyroid being out of whack can cause a whole bunch of issues including ketones...or a combination of these things. USUALLY it's because of too high blood sugar and too little insulin for too long.

beyond the things I mentioned, I'm really not sure. Our kitties are already on pretty high protein diets ;-)
 
Thanks for all the good info! I still have no idea what happened to those 2 long posts! :smile:

Deb, your post made me smile & brought tears to my eyes at the same time! Thank you!

Caryl, she has had blood work but I'm not sure when the last time they checked her thyroid was. It might have been Sept. She was at the vet for suspected urinary/kidney problems when she was diagnosed so that is always in the back of my mind. They did an xray looking for stones in April but nothing & all blood work came back ok then....except diabetes.

Nancy and Payne said:
But what I have learned is this .... it is the whole cat we need to look at. I don't think we will ever do DKA again because I know her signs so well (and have made all the mistakes ..... :( and even though we have run every test in the book, we still don't know why, why ketones?
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Nancy, thanks for this statement...it's helped me quit worrying so much about these darn ketones! I wish I could find a vet I love. I used to love this one, I've been there 15 years & they were a great help with my 2 sickly dogs. I just don't think they know much about feline diabetes...just the basics. Although they did originally encourage me to home test....which sent me on a search and I found my way here! So that's a good thing! She also said the time before last when I was there that maybe I was testing too much??? :roll: I know everyone in there on a first name basis & they know me....they are really very good to me....down to each receptionist....and the best part is I get a discount! So I find it hard to leave there. And when I tried to get some info from another vet they said someone would call me back with some answers but they never did.

Thanks to each one of you....you gave me good info & I appreciate it!
 
Barbara said:
Thanks for all the good info! I still have no idea what happened to those 2 long posts! :smile:

Deb, your post made me smile & brought tears to my eyes at the same time! Thank you!

Caryl, she has had blood work but I'm not sure when the last time they checked her thyroid was. It might have been Sept. She was at the vet for suspected urinary/kidney problems when she was diagnosed so that is always in the back of my mind. They did an xray looking for stones in April but nothing & all blood work came back ok then....except diabetes.

Nancy and Payne said:
But what I have learned is this .... it is the whole cat we need to look at. I don't think we will ever do DKA again because I know her signs so well (and have made all the mistakes ..... :( and even though we have run every test in the book, we still don't know why, why ketones?
Click to expand...

Nancy, thanks for this statement...it's helped me quit worrying so much about these darn ketones! I wish I could find a vet I love. I used to love this one, I've been there 15 years & they were a great help with my 2 sickly dogs. I just don't think they know much about feline diabetes...just the basics. Although they did originally encourage me to home test....which sent me on a search and I found my way here! So that's a good thing! She also said the time before last when I was there that maybe I was testing too much??? :roll: I know everyone in there on a first name basis & they know me....they are really very good to me....down to each receptionist....and the best part is I get a discount! So I find it hard to leave there. And when I tried to get some info from another vet they said someone would call me back with some answers but they never did.

Thanks to each one of you....you gave me good info & I appreciate it!
Click to expand...

Barbara the best think I can tell you is as long as your kitty doesn't have a heart problem, and do discuss this with your vet, fluids! Number one, I happen to agree with your vet about something because of what I read in a Veterinary medical book. If you see trace ketones but your cat is acting fine there is no need to run to an ER every time. If your cat is acting like she may be sick, that's a different story. You can always give sub Q fluids 50 ml bids which will help flush the ketones out of her system if they are there. Get her blood re-tested and most important get a urine sample and bring it in to test with him like I already said. Bring your ketostix in too so you can compare and let vet check for infection. A bladder infection can absolutely cause ketones to show up,even a slight one.If anything shows up then go for a sterile swipe so the vet can find out exactly which ab to give. This may be the answer. UTI's are hard to get rid of and come back a lot with diabetic kitties(like with mine), and again, could be the cause of the trace ketones. As for testing too much...that wont change the results..so that was a silly remark IMO just to get you to stop worrying so much. However, the remark about the whole cat was right on, unless of course the stick is PINK or PURPLE..things can change fast.

I hope this helped.
 
Thanks again Caryl! This cat is gonna be the death of me! She has been all over the map since her April 1 diagnosis....maybe that's it....April fools! I'm also a worrier so I tend to "hover". :smile:
 
Should my civvie have any ketones? I'm getting the same reading from her that I do from Thumper.
 
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