Ketone meter question - Help please!

[Riley813]

HELP PLEASE!!!

I bought a keytone blood meter even though whenever our guy has had his urine checked at the vet he’s been negative. It came today, so I tested him for the first time tonight and it read 2.7 which was shocking because he’s acting normal, I then tested a second time about 50 minutes later with the same reading. We called our vet and they said to just watch him tonight and test him again tomorrow morning after he eats and then give them a call. He’s on 1 unit Vetsulin because he went through a reset (he was bouncing miserably on 2 and 3 units we believe) and I just started home testing 2 weeks ago. We are also switching him to Levemir on Sunday (week from today). That being said, should I up his dose to see if it helps with the keytone number? (He’s already had insulin tonight, this would be for tomorrow). Do I up his dose even though we are switching insulin in a week? Do I call the vet tomorrow and insist they see him? I bought some urine tests but they won’t be here until Wednesday. I’m not new to diabetic cats but I’ve never heard of keytone until recently. Thanks. If I change up his dose tomorrow, I’ll do a curve... I don’t have 1/2 marks but I’m happy to try a non full number, I just want to hopefully help him here before there’s a problem.

 

[Chris & China (GA)]

Hi Alison....I replied some on your Facebook post but as far as the dose goes, yes, I think you'd be smart to go ahead and increase to 1.5. Usually we'd only suggest increasing by .25, but I think that the "reset" wasn't very good advice.

Also, you need to start getting some PM cycle tests. You don't have to stay up all night testing or anything, but you do need to test enough to have an idea of what's going on during that cycle. Otherwise you're missing half the data (and it could be the more important half...we have no way of knowing without test data)

Since he's eating and acting OK, I'd let him eat as much as he wants tonight (until 2 hours before shot time) and add extra water to the food...as much as he'll tolerate and still be willing to eat it.

If he's still running that high tomorrow, I think it'd be a good idea to get him checked out. It doesn't take much for "trace" ketones to turn into a DKA.

 

[Riley813]

Hi Alison....I replied some on your Facebook post but as far as the dose goes, yes, I think you'd be smart to go ahead and increase to 1.5. Usually we'd only suggest increasing by .25, but I think that the "reset" wasn't very good advice.

Also, you need to start getting some PM cycle tests. You don't have to stay up all night testing or anything, but you do need to test enough to have an idea of what's going on during that cycle. Otherwise you're missing half the data (and it could be the more important half...we have no way of knowing without test data)

Since he's eating and acting OK, I'd let him eat as much as he wants tonight (until 2 hours before shot time) and add extra water to the food...as much as he'll tolerate and still be willing to eat it.

If he's still running that high tomorrow, I think it'd be a good idea to get him checked out. It doesn't take much for "trace" ketones to turn into a DKA.

I don’t have 1/2 units in the U-40, I will have them on the U-100s coming. Is it ok to eyeball it? I got a +2 tonight before bed if that helps. When should I test to see if he’s still high tomorrow? I could be wrong but I thought an insulin change could help the keytones but it takes time? He fasts until 9, eats at 925, then gets his insulin at 945. I’ll do 1.5 as long as eyeballing is ok. So, at what point do I test for keytones and call my vet? Thanks, appreciate the help.

 

[Chris & China (GA)]

I’ll do 1.5 as long as eyeballing is ok

Yeah it's OK but you might want to get a used syringe and use some kind of colored fluid (coffee, tea, juice, water with food color) and decide where you think 1.5 is going to be. Then when you need to pull the real thing, you have a "template" to compare to.

So, at what point do I test for keytones and call my vet? Thanks, appreciate the help.

If he's still eating well and acting fine, I'd test soon after breakfast and keep a close eye on him. If he's still running where he is tonight, call your vet for advice...if he's not eating or acting normally, take him in to see the vet (or if his numbers on the ketone meter start to rise even higher)

 

[Riley813]

Yeah it's OK but you might want to get a used syringe and use some kind of colored fluid (coffee, tea, juice, water with food color) and decide where you think 1.5 is going to be. Then when you need to pull the real thing, you have a "template" to compare to.



If he's still eating well and acting fine, I'd test soon after breakfast and keep a close eye on him. If he's still running where he is tonight, call your vet for advice...if he's not eating or acting normally, take him in to see the vet (or if his numbers on the ketone meter start to rise even higher)

So test around insulin time? Or do I want to wait a bit longer? I’ll do a test run in the morning for 1.5. I’ll update here, hopefully it’s changed for the better somehow (I’m still not entirely sure how they can if the sugars aren’t lower than usual but I’m very new to keytones. They were never even mentioned with my previous girl (different vet) but this new vet mentioned testing him a few weeks back and that was the first I heard of them. Thanks!

 

[JanetNJ]

There's something wrong with your spreadsheet. It shuts down after a few seconds on my phone. I don't see any major bouncing in the numbers you had though so I'm not sure why you reset the dose. Going from pink numbers to yellow v back to pink is normal. Looks like you needed an increase. I'd do 1.5-2 units. I'm leaning more toward 2 units only because he's throwing ketones now.

 

[Critter Mom]

If he's still eating well and acting fine, I'd test soon after breakfast and keep a close eye on him. If he's still running where he is tonight, call your vet for advice...if he's not eating or acting normally, take him in to see the vet (or if his numbers on the ketone meter start to rise even higher)

Agree. And I'd also suggest getting more ketone test strips for the meter if you're low on them (plus some urine test strips as a back-up).


Mogs
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[Riley813]

Agree. And I'd also suggest getting more ketone test strips for the meter if you're low on them (plus some urine test strips as a back-up).


Mogs
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I’ve got more blood strips coming because the kit only came with 10. I’ve also got 100 urine backup on order. I’m hoping that they’ll come soon :/

 

[Riley813]

There's something wrong with your spreadsheet. It shuts down after a few seconds on my phone. I don't see any major bouncing in the numbers you had though so I'm not sure why you reset the dose. Going from pink numbers to yellow v back to pink is normal. Looks like you needed an increase. I'd do 1.5-2 units. I'm leaning more toward 2 units only because he's throwing ketones now.

It was suggested I reset to 1 primarily because I changed his food to low carb but unfortunately was not home testing yet (which I now know is a no no), and the concern was the low carb drop without testing would possibly make his numbers get to a dangerous level. Before I switched the food, on both 2-3 units he was drinking approximately 50 times a day, peeing at least 12-15 times, and unfortunately when I did the curve at the vet (which I’ll of course do at home now) he threw very high numbers (almost 600 after his dose which is unheard of for him). Once he dropped to 1 unit he still drinks more than usual, but it’s far far better than it was.

I do apologize, my spreadsheet works fine on my phone, I’m not sure the issue.

Do I go to 1.5 as @Chris & China (GA) suggested last night or 2? I’ve got about 2 hr 40 min til his shot. If I don’t hear back I’ll do 1.5. Do I test around that time for the keytones again? Do I need to wait to see if the new dose helped? If they are the same I’ll call my vet, if they are higher we’ll just take him in as was suggested. If they are at all lower, I’ll post here. He’s still acting normal this morning. Or with the insulin change should I do a curve or mini curve today and see if there is improvement by tonight as long as he is acting normally? Sorry for all the questions... keytones are a new one for me.

Thanks, I’ll await everyone’s next recommendation.

 

[JaxBenji]

I do apologize, my spreadsheet works fine on my phone, I’m not sure the issue.

I can't advise to dosing but you may want to consider using the spreadsheet posted on this board - here's a link to the instructions. I'm not personally in the Facebook group but I believe you are using a template from there which crashes on a lot of people's devices; since you don't have a ton of data just yet, it may be a good time to switch.

 

[Riley813]

I can't advise to dosing but you may want to consider using the spreadsheet posted on this board - here's a link to the instructions. I'm not personally in the Facebook group but I believe you are using a template from there which crashes on a lot of people's devices; since you don't have a ton of data just yet, it may be a good time to switch.

Thanks, I'll look into it later today.

 

[Riley813]

Ok, I think I fixed the spreadsheet. Any further advice on what to do today? Ive got to figure it out in the next hour.

Thanks.

Alison

 

[Critter Mom]

Hi Alison,

Some questions:

1. Have you switched to Levemir or are you still giving Vetsulin?

2. How many ketone meter test strips do you have left?

3. Do you have a local pharmacy where you could pick up some urine test strips today (or could your vet sell you some of theirs)?

4. Have you tested Jet Li's ketone levels yet today?

5. Is your vet's office currently open?


Mogs
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[Riley813]

Hi Alison,

Some questions:

1. Have you switched to Levemir or are you still giving Vetsulin?

2. How many ketone meter test strips do you have left?

3. Do you have a local pharmacy where you could pick up some urine test strips today (or could your vet sell you some of theirs)?

4. Have you tested Jet Li's ketone levels yet today?

5. Is your vet's office currently open?


Mogs
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I am using Vetsulin until Sunday (waiting on Levemir and don’t want to switch the day before a time change).

I have 7 left but I ordered 60 overnight shipping to arrive tomorrow.

I have 100 urine strips coming Wednesday, I needed to order them online.

No, he eats in 20 min, gets insulin in 40 min, then I was going to test his ketones.

Yes, the vet is currently open, they are about 35 minutes away.

I’m leaning towards 2 units and a curve today... what do you think? Do I need to test ketones sooner?

Thank you.

Alison

 

[Critter Mom]

Thanks for the additional info, Alison.

The quandary I have in thinking of what to suggest to you about the Vetsulin is the need to clear the ketones and the safety of the dose of insulin. Half a unit increase is quite substantial. A whole unit increase is very substantial. If you had more ketone strips I'd have suggested testing before administering insulin to check Jet Li's status and using that info to inform the dosing decision but I don't want you to run out of test strips in case you'd have greater need of them later on.

My best suggestion to you would be to give your vet a ring now and ask for their input on whether to increase the Vetsulin dose to 1.5 or 2.0 today because I'm not sure of the best course of action in this instance. Also, given that you've only a few ketone test strips left and you need to get the best monitoring value out of them, strip situation, I'd suggest asking the vets about the best timing for a ketone level check. I am wondering whether the best time to do the next ketone test might be some time after +1.5 when onset of the insulin dose has occurred and he has digested food in his system for it to work on, but I might be wrong about that. Your vet should be able to give you better guidance on this.

I'm sorry that I can't be more clear-cut on this. What do you think yourself, Alison?


Mogs
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[Riley813]

Thanks for the additional info, Alison.

The quandary I have in thinking of what to suggest to you about the Vetsulin is the need to clear the ketones and the safety of the dose of insulin. Half a unit increase is quite substantial. A whole unit increase is very substantial. If you had more ketone strips I'd have suggested testing before administering insulin to check Jet Li's status and using that info to inform the dosing decision but I don't want you to run out of test strips in case you'd need them more later.

My best suggestion to you would be to give your vet a ring now and ask for their input on whether to increase the Vetsulin dose to 1.5 or 2.0 today because I'm not sure of the best course of action in this instance. Also, given that you've only a few ketone test strips left and you need to get the best monitoring value out of them, strip situation, I'd suggest asking the vets about the best timing for a ketone level check. I am wondering whether the best time to do the next ketone test might be some time after +1.5 when onset of the insulin dose has occurred and he has digested food in his system for it to work on, but I might be wrong about that. Your vet should be able to give you better guidance on this.

I'm sorry that I can't be more clear-cut on this. What do you think yourself, Alison?


Mogs
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Unfortunately I already did his insulin. I apologize, I waited as long as I could. I did 2 units and I’ll monitor him diligently throughout the day. He was at 375 this morning and he’s been up to 3.5 before we adopted him, so I truly don’t think that dose will be a problem. I will wait until 1.5 hrs after the insulin to test his ketones if that’s the best time to do so. Unfortunately my vet is also an emergency vet and she’s on call today. They do their best but for a phone call it would likely have taken until this evening for a response. I’d rather go with my gut on this I guess... considering she wanted me to blind shoot 4 units, I’d rather go with the suggestions here. She’s great but not with diabetes. Edited to add they suggested an hour after insulin when I called last night, so I think 1.5 hrs will still be fine.

 

[JanetNJ]

Unfortunately I already did his insulin. I apologize, I waited as long as I could. I did 2 units and I’ll monitor him diligently throughout the day. He was at 375 this morning and he’s been up to 3.5 before we adopted him, so I truly don’t think that dose will be a problem. I will wait until 1.5 hrs after the insulin to test his ketones if that’s the best time to do so. Unfortunately my vet is also an emergency vet and she’s on call today. They do their best but for a phone call it would likely have taken until this evening for a response. I’d rather go with my gut on this I guess... considering she wanted me to blind shoot 4 units, I’d rather go with the suggestions here. She’s great but not with diabetes. Edited to add they suggested an hour after insulin when I called last night, so I think 1.5 hrs will still be fine.

as long as you can test i think that was a good call. I would also write in the ketone readings. Great job. Your cat is lucky to have you.

 

[Critter Mom]

Sorry I wasn't able to get back to you sooner.

I will wait until 1.5 hrs after the insulin to test his ketones if that’s the best time to do so.

The maximum Saoirse ever got to was 0.7 for blood ketones, thus I only needed to check her every 12 hours (dealing with a post-surgery infection and having difficulty eating at the time - would have tested more frequently had she gone higher), so I've not got direct experience of how ketone levels might fluctuate in a more ketone-prone cat and therefore can't give you more solid suggestions on timing of tests.

I had a look online and found this article on ketone test timing (for humans following ketogenic diets). From the article:

The best time is about an hour after waking to bypass the "dawn phenomenon" but prior to eating your first meal for a daily management level. You should aim for about 1 hour post meal time if you are attempting to see how the meal influences your ketone levels.​

Also, from the Keto-Mojo website:

For the most insightful ketone readings, test right before lunch or dinner, at least 2-3 hours after you’ve eaten any other food or drink (other than water). It’s important wait 2-3 hours after eating because consumption of almost any food, keto-friendly or otherwise, will cause your glucose to go up and your ketone levels to fall a bit. Thus, testing well between meals ensures you get a truer reading of your progress.​

Working with the info from the second article, it implies that you're likely to see the lowest ketone readings by testing somewhere between the time of ingestion of a meal and +2 hours after its consumption. With Vetsulin onset around the +1 - +1.5 area then perhaps between +1.5 and +2 after insulin dose administration might be the time when you're more likely to see the lowest ketone levels in Jet Li. Following through, based on Vetsulin's typical action, you might be more likely to catch higher levels of ketones during the late stages of the cycle, say, +10 onwards when you're fasting Jet Li before his next dose is due and the Vetsulin dose is pretty much exhausted.

Note that all of the above is speculative and not based on experience, only on application of general principles of feline diabetic management. I hope it's of some help to you (and I wish you had more test strips - would be a lot easier to suggest a course of action! ).


Mogs
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[Riley813]

as long as you can test i think that was a good call. I would also write in the ketone readings. Great job. Your cat is lucky to have you.

Thank you, I put it in his notes but I’ll make a column?

 

[Riley813]

Sorry I wasn't able to get back to you sooner.


The maximum Saoirse ever got to was 0.7 for blood ketones, thus I only needed to check her every 12 hours (dealing with a post-surgery infection and having difficulty eating at the time - would have tested more frequently had she gone higher), so I've not got direct experience of how ketone levels might fluctuate in a more ketone-prone cat and therefore can't give you more solid suggestions on timing of tests.

I had a look online and found this article on ketone test timing (for humans following ketogenic diets). From the article:

The best time is about an hour after waking to bypass the "dawn phenomenon" but prior to eating your first meal for a daily management level. You should aim for about 1 hour post meal time if you are attempting to see how the meal influences your ketone levels.​

Also, from the Keto-Mojo website:

For the most insightful ketone readings, test right before lunch or dinner, at least 2-3 hours after you’ve eaten any other food or drink (other than water). It’s important wait 2-3 hours after eating because consumption of almost any food, keto-friendly or otherwise, will cause your glucose to go up and your ketone levels to fall a bit. Thus, testing well between meals ensures you get a truer reading of your progress.​

Working with the info from the second article, it implies that you're likely to see the lowest ketone readings by testing somewhere between the time of ingestion of a meal and +2 hours after its consumption. With Vetsulin onset around the +1 - +1.5 area then perhaps between +1.5 and +2 after insulin dose administration might be the time when you're more likely to see the lowest ketone levels in Jet Li. Following through, based on Vetsulin's typical action, you might be more likely to catch higher levels of ketones during the late stages of the cycle, say, +10 onwards when you're fasting Jet Li before his next dose is due and the Vetsulin dose is pretty much exhausted.

Note that all of the above is speculative and not based on experience, only on application of general principles of feline diabetic management. I hope it's of some help to you (and I wish you had more test strips - would be a lot easier to suggest a course of action! ).


Mogs
.

I went ahead and rushed 60 blood strips to come tomorrow, so I can test a couple times today. What about a +2 and then he starts his fast at +10 so would it be more accurate to test him at +12 with his PMPS? That’s when he was tested last night.

 

[Critter Mom]

What about a +2

If it were me, I'd go around the +1.5 after insulin for the test. My reasoning is that the insulin dose should have well and truly kicked in at that point, but leaving it to +2 after insulin would mean it was later than +2 hours after food, if you get my drift, and there might not be quite as much food influence at that stage (and you're trying to establish whether food and insulin lower the ketone levels with the first test).

What about a +2 and then he starts his fast at +10 so would it be more accurate to test him at +12 with his PMPS? That’s when he was tested last night.

That sounds like a good plan of attack, and the similar conditions for both readings would make for a better day-on-day reading comparison.

I will be very interested to see how Jet Li gets on today, and I hope his ketone levels have come down since yesterday!


Mogs
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[Riley813]

If it were me, I'd go around the +1.5 after insulin for the test. My reasoning is that the insulin dose should have well and truly kicked in at that point, but leaving it to +2 after insulin would mean it was later than +2 hours after food, if you get my drift, and there might not be quite as much food influence at that stage (and you're trying to establish whether food and insulin lower the ketone levels with the first test).


That sounds like a good plan of attack, and the similar conditions for both readings would make for a better day-on-day reading comparison.

I will be very interested to see how Jet Li gets on today, and I hope his ketone levels have come down since yesterday!


Mogs
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Alrighty, I’ll do +1.5 and +12 for ketones today, and a full curve for glucose with the insulin change. I’m hoping I see some change... I’ll keep you posted! Thanks!

1.5 hrs after insulin is approximately 2 hrs after breakfast. Hopefully that’s still ok.

 

[JanetNJ]

Thank you, I put it in his notes but I’ll make a column?

You could put it in the notes. Or I used to just write it in the box of the time I took the test.

 

[Riley813]

1.9 at +1.5. Will do the glucose curve and test ketones again tonight. I know it’s still high but I still am beginning to feel better. Thank you all!

 

[Critter Mom]

That's a bit better.

When you get more strips in, you could do spot checks at different points in the insulin cycle, fasting and non-fasting, and that might give you a better picture of what works to bring/keep levels down.

Fingers and paws it's just a temporary issue. It might be a good idea to get Jet Li checked over by the vets at the earliest opportunity with a view to identifying any underlying issue that might be driving the ketongenesis (e.g. UTI, gum inflammation, other) so that you can get it treated.

(((Jet Li and Alison)))


Mogs
.

 

[Riley813]

That's a bit better.

When you get more strips in, you could do spot checks at different points in the insulin cycle, fasting and non-fasting, and that might give you a better picture of what works to bring/keep levels down.

Fingers and paws it's just a temporary issue. It might be a good idea to get Jet Li checked over by the vets at the earliest opportunity with a view to identifying any underlying issue that might be driving the ketongenesis (e.g. UTI, gum inflammation, other) so that you can get it treated.

(((Jet Li and Alison)))


Mogs
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Thank you! He has really bad ears and they were itching him very badly. We started daily drops and they seem to be helping. Hopefully that was part of the issue. When he was tested at the vet on the 11th he had no ketones in his urine at all. He was also tested for a UTI which came back negative.

 

[Chris & China (GA)]

I'm not personally in the Facebook group but I believe you are using a template from there which crashes on a lot of people's devices; since you don't have a ton of data just yet, it may be a good time to switch.

Just an FYI....the template that crashes on everybody is from another Facebook group that's not associated with the FDMB. The only Facebook group that's associated with the FDMB is the Feline Diabetes group and we have a link to the instructions here in our files. The other group uses a spreadsheet pirated off ours but something they have done to it makes it crash on mobiles.

1.9 at +1.5. Will do the glucose curve and test ketones again tonight.

Good to see some improvement! Hope it continues heading in the right direction!...Down please!!

 

[Riley813]

Just an FYI....the template that crashes on everybody is from another Facebook group that's not associated with the FDMB. The only Facebook group that's associated with the FDMB is the Feline Diabetes group and we have a link to the instructions here in our files. The other group uses a spreadsheet pirated off ours but something they have done to it makes it crash on mobiles.



Good to see some improvement! Hope it continues heading in the right direction!...Down please!!

Thank you SOOOO much for your suggestion on upping his dosage this morning. I sure hope it keeps helping. I'm updating his chart as the day goes on, we are +6 in his curve now. I am kind of curious what it will be at +12 as his Vetsulin is gone from his system. That happens at +7/+8 typically. I will ask for help tonight for tomorrow I am sure!

 

[Riley813]

Alright, his spreadsheet is updated (its the correct one now) and his curve today is complete, and his ketones this evening after the 2 hr fast, which was the same time I did them yesterday, were 1.7. I presume I just keep dosing as is and monitor him normally each day? I was going to at least test ketones tomorrow morning at the +1.5 again, do you think I need to do tomorrow night as well? Lastly, his nadir was obviously at +5 today. I was told to test +4 on a regular basis because then I could at least catch him an hour before his typical nadir in case it was already low. Is that correct? Or do I test +5, which is his typical nadir, to catch that number instead? Also, how often do I get a +2 before bed? Do they need to be done every night? Just a reminder, I am changing insulin on Sunday (hopefully my mail beats the snow storm on its way...), so I'll be asking questions on Friday I'm sure to prepare.

Thanks in advance!

Alison & Jet Li

 

[Critter Mom]

Hi Alison,

Suggestions:

* I think it would help to record the ketone results in '+ time' notation so that you relate the ketone levels to when food and insulin were given.

* Because Jet Li is currently throwing ketones, closer monitoring than once a day is advisable for safety so that you will be in a position to address the situation quickly should levels increase. Once you get enough ketone strips I'd suggest testing at each preshot time (so you'll see how levels are running after the previous insulin dose has petered out and how the 2-hour preshot fast might affect them). If it were me in the situation I'd also want to do a mid-cycle check to see whether food and insulin in the system were working to reduce ketone levels.

On Vetsulin, nadir typically occurs more often than not somewhere between +3 and +6. It can vary from day to day. (Can't help with Levemir nadirs, I've never used it.)

WRT the +2 'before bed' test, it is recommended to get that test every night.


Mogs
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[Riley813]

Hi Alison,

Suggestions:

* I think it would help to record the ketone results in '+ time' notation so that you relate the ketone levels to when food and insulin were given.

* Because Jet Li is currently throwing ketones, closer monitoring than once a day is advisable for safety so that you will be in a position to address the situation quickly should levels increase. Once you get enough ketone strips I'd suggest testing at each preshot time (so you'll see how levels are running after the previous insulin dose has petered out and how the 2-hour preshot fast might affect them). If it were me in the situation I'd also want to do a mid-cycle check to see whether food and insulin in the system were working to reduce ketone levels.

On Vetsulin, nadir typically occurs more often than not somewhere between +3 and +6. It can vary from day to day. (Can't help with Levemir nadirs, I've never used it.)

WRT the +2 'before bed' test, it is recommended to get that test every night.


Mogs
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ok I can add the +2 to his schedule at night. I changed the ketone test times on his spreadsheet as requested.

I can just test ketones along with his AMPS, PMPS, and midday for now. I just didn’t know if the +1.5 was better than the AMPS or midday like we did yesterday?

his Nadir seems to be more often at +5, but I know it can vary. I’m just wanting to verify is it better to check an hour before the more often nadir (+4), or on the more often nadir (+5), for his midday check? To my knowledge the nadir for Levemir is late, approximately +8, so I will alter my midday testing based on what I am told is best now after I switch.

Thank you again.

Alison

 

[JanetNJ]

Thank you SOOOO much for your suggestion on upping his dosage this morning. I sure hope it keeps helping. I'm updating his chart as the day goes on, we are +6 in his curve now. I am kind of curious what it will be at +12 as his Vetsulin is gone from his system. That happens at +7/+8 typically. I will ask for help tonight for tomorrow I am sure!

I look forward to seeing how he does on 2 units today

 

[Riley813]

I look forward to seeing how he does on 2 units today

Me too!

 

[Suzanne & Darcy]

For what it's worth, my cat, Darcy, has had a problem with ketones for a long time. It's only recently that his ketones started to come down to very small/negligent levels. I had the problem that my vet didn't trust the ketone meter. I would do a blood ketone test and find them to be very high (over 6.9), then I would take him to the vet... telling them that his ketones were very high. They would do a urine test and tell me his ketones were negative. This happened a few times. It's a good thing they would just "humor me" when I requested that they put him on IV fluids for the day and give antibiotics. When we checked bloodwork, his white count was elevated. I finally just started managing him at home by giving sub-q fluids to help flush the ketones. This was after he'd already gone DKA. But the real reason he went into DKA was that he had an infection -- that just put him over the top. His fever was over 104 when he was admitted to the ER. He wasn't eating as much (or really was vomiting it all back up again). And when he had the high fever he, of course, was not eating at all. The combination of not enough insulin, not eating enough, and the infection created the DKA situation. Make sure your kitty keeps eating. I share your frustration about the ketones.

Ketones will show up in the bloodstream before they do in the urine.

 

[Riley813]

For what it's worth, my cat, Darcy, has had a problem with ketones for a long time. It's only recently that his ketones started to come down to very small/negligent levels. I had the problem that my vet didn't trust the ketone meter. I would do a blood ketone test and find them to be very high (over 6.9), then I would take him to the vet... telling them that his ketones were very high. They would do a urine test and tell me his ketones were negative. This happened a few times. It's a good thing they would just "humor me" when I requested that they put him on IV fluids for the day and give antibiotics. When we checked bloodwork, his white count was elevated. I finally just started managing him at home by giving sub-q fluids to help flush the ketones. This was after he'd already gone DKA. But the real reason he went into DKA was that he had an infection -- that just put him over the top. His fever was over 104 when he was admitted to the ER. He wasn't eating as much (or really was vomiting it all back up again). And when he had the high fever he, of course, was not eating at all. The combination of not enough insulin, not eating enough, and the infection created the DKA situation. Make sure your kitty keeps eating. I share your frustration about the ketones.

Ketones will show up in the bloodstream before they do in the urine.

Thank you! That’s why I was shocked it was where it was. He had eaten just fine and explored our basement... just thankful it was suggested that I test when I did!

 

[Riley813]

Starting a new thread for ease of responses. Not sure if I should just want to make it easier as I need help again