Ketones??

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trudy66

trudy66

Member Since 2022
Ok, got the ketone reader (Precision Xtra). I checked it using her ear and also did a BG with my one touch verio. Ketones - 2.1. BG 195. This was +5 of AM insulin.

She did have 1+ ketones when vet checked her urine last monday.
Can someone tell me how this monitor compares to what vet checked with her urine.

Some one said feed her what ever she will eat to get rid of ketones. Does that include dry and should it
be low carb or what she was on? She is eating more now and I am adding water to each serving of fancy feast. And I caught her drinking a bit this AM out of her bowl, but not excessive. I want to get the ketones gone.
 
For a cat who is flirting with ketones, you want to make sure that your kitty is eating enough. For post-DKA cats, we suggest 1.5 times the amount of calories and getting as much water into your cat as she will tolerate.

I would also get a test for ketones again either tonight or tomorrow unless you see symptoms that you find worrisome.
 
Sienne and Gabby (GA) said:
For a cat who is flirting with ketones, you want to make sure that your kitty is eating enough. For post-DKA cats, we suggest 1.5 times the amount of calories and getting as much water into your cat as she will tolerate.

I would also get a test for ketones again either tonight or tomorrow unless you see symptoms that you find worrisome.
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Would you feed her dry food to get the calories in?
I am chasing her trying to get the wet food in. Heating it. scraping it into a pile. Adding water to the wet. Pretty much every 2 hours. I got some freeze dried treats in today. Vital chicken.
she loved them. Are they suitable to get extra calories in? Or try higher carb friskies or fancy feast?
 
If numbers are higher, there's a greater risk for ketones. I would try to avoid high carb food. How much is Kloey eating? Keep in mind that high carb doesn't necessarily mean higher in calories. Carbs and calories differ. Eating a cracker may be high in carbs but low in calories compared to a piece of steak that's low in carbs but higher in calories.
 
trudy66 said:
Would you feed her dry food to get the calories in?
I am chasing her trying to get the wet food in. Heating it. scraping it into a pile. Adding water to the wet. Pretty much every 2 hours. I got some freeze dried treats in today. Vital chicken.
she loved them. Are they suitable to get extra calories in? Or try higher carb friskies or fancy feast?
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for much of the wet food I offer Hendrick, that is also my life. Re-present to him 2-3 times a session, scrape into pile, warm it up, sprinkle with fortiflora, re-present one more time....I know exactly how you feel

I've found if he walks away but i give him a few minutes and then return he'll often eat more -- up to a point. There are only a few kinds he just polishes off -- but they are MC not LC. (DM Savory Shreds for example, he destroys...which is great when I need to give him MC - 10%)
 
Sienne and Gabby (GA) said:
If numbers are higher, there's a greater risk for ketones. I would try to avoid high carb food. How much is Kloey eating? Keep in mind that high carb doesn't necessarily mean higher in calories. Carbs and calories differ. Eating a cracker may be high in carbs but low in calories compared to a piece of steak that's low in carbs but higher in calories.
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She is eating around 2 cans of FF Pate during the day. Yesterday we started with a can of glycobalance but she didn't eat much of that. May half. So I switched back to FF Pate. She ate around 2 Cans yesterday. Half a can preshot then 1/4 and +2 and +4. Same for today.
 
I think she needs to be eating more than 2 cans FF a day. Do you think she could be nauseated? It would be worth asking the vet for some cerenia or ondansetron. Ondansetron is better for just nausea so I would ask for that. You will need to get a script from the vet and get it from a pharmacy.
I would try offering her a snack at +6 and +8 to try and get a bit more food into her.

@Sienne and Gabby (GA) what do you think about increasing the dose of insulin to 2.25 units tomorrow morning if it doesn’t drop any lower tonight.?
 
I got a can and a half in her already today. I will be doing her preshot at 815 and then feed her again hopefully she will eat at least 1/2 a can and then I will try again at 10 and right before bed.
I leave for work at 5:15 am, my husband will be here with her and I have told him to feed feed feed. He is very nervous with the insulin, scared of hurting her. So I dont know if I will get readings
tomorrow or not. I am off the rest of the week so maybe shoot for going up after tomorrow. He will be terrified.

She did throw up a small amount around 6pm but there was a small hairball in it. Her hair had gotten so ratty looking last week and she has been bathing something terrible. She is long haired, so she
has always been a hairballer.
 
Bron and Sheba (GA) said:
I think she needs to be eating more than 2 cans FF a day. Do you think she could be nauseated? It would be worth asking the vet for some cerenia or ondansetron. Ondansetron is better for just nausea so I would ask for that. You will need to get a script from the vet and get it from a pharmacy.
I would try offering her a snack at +6 and +8 to try and get a bit more food into her.

@Sienne and Gabby (GA) what do you think about increasing the dose of insulin to 2.25 units tomorrow morning if it doesn’t drop any lower tonight.?
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I have Fortiflora being delivered tomorrow, so I will try that also. I will see if the vet will get me script for zofran also.
 
Will increasing the insulin help decrease the ketones?

I did get 3/4 can FF mixed with water in before her PM shot. I will try again at 10 and before I go to bed. I told my husband to try every hour tomorrow to get some food in her.
 
trudy66 said:
did get 3/4 can FF mixed with water in before her PM shot. I will try again at 10 and before I go to bed. I told my husband to try every hour tomorrow to get some food in her.
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Well done!

trudy66 said:
Will increasing the insulin help decrease the ketones?
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Ketones form when there is not enough insulin and/or not enough food. It can then progress to DKA when there is an infection or inflammation present as well and the electrolytes go out of whack and you are in trouble.
That is why I was surprised when the vet left off starting insulin when he found ketones in the urine at diagnosis.
With ketones present you need to feed lots of food and make sure she is getting enough insulin. Both those things will help stop ketones from forming.
We sometimes need to increase the dose more quickly than normal when ketones and/or DKA is in the picture.
If you can get a ketone test done twice a day at the moment while there are ketones still present, that would be really helpful. Thanks,
You are doing everything right.

Your last post for continuity https://felinediabetes.com/FDMB/threads/nadir.258585/
 
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Ok, so if we cant get more FF down her. Should I give her some dry food and then increase her insulin.
He said he was off the day after she was diagnosed and she was stable, not dehydrated so he said she would be fine to start on Thursday. I was quite irritated.
 
trudy66 said:
Ok, so if we cant get more FF down her. Should I give her some dry food and then increase her insulin.
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Do you have any other low carb food to offer her in case she gets sick of the FF? There are lots of options out there.
I wouldn’t give the dry food unless she refuses to eat the other at this stage.
If you can get another blood ketone test in before you go to bed, that will tell us how she is travelling. If you are not going to be home tomorrow and your hubby doesn’t test, she is eating and the ketones are OK ….we can wait to increase the dose.
 
Bron and Sheba (GA) said:
Well done!


Ketones form when there is not enough insulin and/or not enough food. It can then progress to DKA when there is an infection or inflammation present as well and the electrolytes go out of whack and you are in trouble.
That is why I was surprised when the vet left off starting insulin when he found ketones in the urine at diagnosis.
With ketones present you need to feed lots of food and make sure she is getting enough insulin. Both those things will help stop ketones from forming.
We sometimes need to increase the dose more quickly than normal when ketones and/or DKA is in the picture.
If you can get a ketone test done twice a day at the moment while there are ketones still present, that would be really helpful. Thanks,
You are doing everything right.

Your last post for continuity https://felinediabetes.com/FDMB/threads/nadir.258585/
Click to expand...

Checked her Blood ketones again 1.6. So it is lower by blood. I read a article that said 2.4 -2.5 was considered to be positive for cats. Anything under ruled out ketoacidosis.
I also caught her in the litter and got a pee sample. Ketones were negative.
Praise the Lord!!
 
trudy66 said:
Checked her Blood ketones again 1.6. So it is lower by blood. I read a article that said 2.4 -2.5 was considered to be positive for cats. Anything under ruled out ketoacidosis.
I also caught her in the litter and got a pee sample. Ketones were negative.
Praise the Lord!!
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Well done!!!! Fantastic!
So all that extra food and the insulin is certainly helping.
Keep up the good work.
 
trudy66 said:
Thank you for all the help and advice. I think I will sleep easier tonight.
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Yes I think you have earned a good nights sleep. It’s very reassuring to see those results and know you are heading in the right direction.
Keep up the daily tests as long as they are negative (urine) or not going back up (blood).
 
Great job with monitoring and give Kloey a hug for kicking the ketones to the curb!

If you are able to monitor, it should be fine to increase the dose to 2.25u today if you can monitor.
 
Bron and Sheba (GA) said:
Yes I think you have earned a good nights sleep. It’s very reassuring to see those results and know you are heading in the right direction.
Keep up the daily tests as long as they are negative (urine) or not going back up (blood).
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I am so discouraged. AMPS was 299. My husband said he doesn't know if she got the full dose of insulin today. He is scared of giving her a shot. He tried but didn't know if she got it all. he did do excellent getting food in her, she ate 3 1/2 cans today so far with water added to each feeding. I got home from work around 7pm (had to make a stop to get some diff cat food) he had fed her around 445pm so I didn't check her BG till 730. It was 311. We fed her, she ate great, also got fortiflora in and it was a success also. Gave her insulin 2 units. I caught her in litter again and got a urine. Ketones registered trace. I feel terrible. Will the ketones go up and down? What do I do?
 
Don’t feel terrible. Just keep doing what you are doing. Check the BGs a couple of times tonight and if the BG doesn’t go down below 100 you can increase the dose to 2.25 units in the morning as Sienne suggested.
Keep up the good work with the food and fluids and I would get a blood ketone test tonight if you can as well.
The ketones can go up and down a bit before they disappear so don’t be alarmed. I know you must be disappointed but you have this covered.:)
 
Bron and Sheba (GA) said:
Don’t feel terrible. Just keep doing what you are doing. Check the BGs a couple of times tonight and if the BG doesn’t go down below 100 you can increase the dose to 2.25 units in the morning as Sienne suggested.
Keep up the good work with the food and fluids and I would get a blood ketone test tonight if you can as well.
The ketones can go up and down a bit before they disappear so don’t be alarmed. I know you must be disappointed but you have this covered.:)
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Blood ketones 1.9. BG 173.
 
Bron and Sheba (GA) said:
Don’t feel terrible. Just keep doing what you are doing. Check the BGs a couple of times tonight and if the BG doesn’t go down below 100 you can increase the dose to 2.25 units in the morning as Sienne suggested.
Keep up the good work with the food and fluids and I would get a blood ketone test tonight if you can as well.
The ketones can go up and down a bit before they disappear so don’t be alarmed. I know you must be disappointed but you have this covered.:)
Click to expand...

Do I need to do a curve tomorrow with the increased dose?
 
No. Just test as you normally do starting at +2 I think. Update the SS as you go along as we look every so often. If you have any questions ask. Remember while you are testing, you are in control and can always feed to bring the BG up if needed.
 
trudy66 said:
So would that be +2, +3, +6, and +9?
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Something like that. If you see she is dropping fast one hour, I would test the next hour to see how it is going. We don’t want the BG dropping below 90 so if it’s close, give some food and test again in around 1/2 hour.
Basically what we want to see is the nadir and how low that dose is taking her.
 
Bron and Sheba (GA) said:
Something like that. If you see she is dropping fast one hour, I would test the next hour to see how it is going. We don’t want the BG dropping below 90 so if it’s close, give some food and test again in around 1/2 hour.
Basically what we want to see is the nadir and how low that dose is taking her.
Click to expand...
Ok I'll do that tomorrow.
 
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