Moderate ketone reading Bubba starting insulin today help

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chubbabubba

chubbabubba

Member Since 2012
Hi, Please see Bubba and Jackie post below
Starting insulin in a hr when we go to vet
Ketones reading moderate this morning
What else should vet be giving him other then insulin?
Amps 300. Eating ok. Please advise. Is it just insulin at this pt
Or does he need other need to?
Sorry I'm Freaking out and can't find on board
Jackie
 
Re: Moderate ketone reading Bubba starting insulin today hel

Make sure the vet knows about the ketones.

Bubba may need to stay at the vet for fluids to prevent further complications. It sounds like Bubba needs the insulin and may need IV fluids to help clear the ketones out of the bloodstream.


If the vet says he needs to stay, listen to the vet. Ketones can be a dangerous life threatening condition. Catching them early can prevent an expensive ER trip and potentially death.

I don't mean to post this to scare you, but to not make a wrong decision because 'it's the holiday.'
 
Re: Moderate ketone reading Bubba starting insulin today hel

We are going to the vet now. This happened last time n fatty liver.
No chances here. Fluids ok. I'm off, shaking.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Hi Jackie. Good decision, best of luck! Prayers for Bubba!
 
Re: Moderate ketone reading Bubba starting insulin today hel

Best of Luck at the vet. Ketones are serious, especially anything above a trace. I'm glad you're going to the vet right away.
Keep us posted.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Are there injections of fluids vs iv drip? I'm Freaking out here
 
Re: Moderate ketone reading Bubba starting insulin today hel

chubbabubba said:
Are there injections of fluids vs iv drip? I'm Freaking out here
Click to expand...
I'm no expert here, but my civvie Justice has had
a "bolus", an injection of fluid under the skin....
 
Re: Moderate ketone reading Bubba starting insulin today hel

Are there injections of fluids vs iv drip? I'm Freaking out here
 
Re: Moderate ketone reading Bubba starting insulin today hel

Ketones indicate the kidneys are not able to clear things up.

They will likely do IV because the electrolytes etc. are all out of whack and they will want to monitor him or send you to a 24/7 facility to have that done.

Again it sounds like you caught them early and it may mean a very short stay.

Paws and prayers up for you two.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Take a deep breath, and try and stay calm. The calmer you are, the more relaxed Bubba will be, too. Remember, cats are extremely intuitive and can pick up on our emotions just as quickly as a horse can. I'm glad that you caught the ketones early. Once the ketones are under control, you'll want to monitor him at home by getting a urine sample (or holding a ketone strip in his pee stream... I've done that with Blackie, or switching the litter out with aquarium gravel to collect the urine sample that way.. Make sure that the gravel is rinsed thoroughly from all the dust before using it). This is done when the BG's are on the high side. Insulin is all that is needed for him, unless the vet finds another complication, which may require another medicine. Best of luck, and post when you can. My thoughts and prayers are with you both.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Ok, I'm very scared and upset . We went, I brought the urine sample and the Dr used there strips to test.
It came back trace. He gave him fluids under the skin
200 cc and although he was suppose to start w lantus
Told me he is starting him w Humilin 2 units and fluids until ketones are gone.
I'm so confused as this is nothing I've read here before.
Bubba was on this insulin before and went into remission
For two yrs . But I'm lost and don't want to loose him.
I did question it, and he is going back at 1 for a check .
And Sunday as well. I'm not sure what to think here. Normally his choice is lantus.
Bubba is my life, my heart is breaking.
Money is so tight I don't know if I could go to emergency
Why not a drip, why humilin?
I'm beside myself .
 
Re: Moderate ketone reading Bubba starting insulin today hel

Ok, I'm very scared and upset . We went, I brought the urine sample and the Dr used there strips to test.
It came back trace. He gave him fluids under the skin
200 cc and although he was suppose to start w lantus
Told me he is starting him w Humilin 2 units and fluids until ketones are gone.
I'm so confused as this is nothing I've read here before.
Bubba was on this insulin before and went into remission
For two yrs . But I'm lost and don't want to loose him.
I did question it, and he is going back at 1 for a check .
And Sunday as well. I'm not sure what to think here. Normally his choice is lantus.
Bubba is my life, my heart is breaking.
Money is so tight I don't know if I could go to emergency
Why not a drip, why humilin?
I'm beside myself .
 
Re: Moderate ketone reading Bubba starting insulin today hel

Going to the vet is a good thing right now. And, make absolutely sure the vet gets a blood ketone reading. (It's more up to the minute than urinary ketones.) The vet should get a blood panel that will test the levels of electrolytes, especially potassium and phosphorus. The presence of ketones is different than diabetic ketoacidosis (DKA) and you want to try to avoid this developing into DKA. If the electrolyte levels are off, then DKA is a concern. I'd also encourage you to make sure the vet checks for any source of infection.

The treatment usually involves an IV of fluids as long as the electrolyte levels are not out of whack. Have the vet show you how to do this. It's not that complicated and you can give fluids at home. It's a good skill to have. If the electrolyte levels are effected, those levels need to be carefully adjusted and constantly monitored.

In all likelihood, this is happening because the vet has waited overly long to get Bubba started on insulin. Ketones can develop when there's an infection or inflammation (a source of physiological stress), not enough insulin, and your cat isn't eating. Fluids will help Bubba to flush the ketones out. Making sure Bubba's eating will also help and, most importantly, getting him started on insulin is key.
 
Re: Moderate ketone reading Bubba starting insulin today hel

I suspect he went with humilin because it is going to be much faster acting than lantus at this point.

Once he knows the ketones are under control, he'll likely transition you to the lantus.

It sounds like you've been on this dance once before...are you hometesting the BG's? I would with the humilin and expect to see a pretty decent swing in numbers.

Also ask you vet about the duration factor with humulin. If I recall it can be as short as 6-8 hours, which means you could leave Bubba without sufficient insulin for 8 hours. Again, this would be a great reason to be hometesting several times a cycle. You won't know the full duration without testing him.

It is good news that the vet reading came up trace! Whew! But it does need to be watched closely. It sounds like your vet is coming in on a Sunday to help you monitor?
God Bless Great Vets!
 
Re: Moderate ketone reading Bubba starting insulin today hel

The vet is most likely using the Humulin on a short term basis to get his BGs down quickly. Once that happens, and the ketones go away, you will still be able to use Lantus as planned.
Carl
 
Re: Moderate ketone reading Bubba starting insulin today hel

I thought that's why he went with Humulin. I do home test, have since 2010
With Alpha Trak. Last time was a nightmare and I aged like 20 yrs
In the process. Bubba will be watched, Insulin should have been given earlier but he was running
A temp, and signs of uri. So infection was a factor.
My fault, I held off because of that and wanted to be home when he started so I could test.
Not a great time to be alone at work and not be able to call in.


My vet is a saint, I don't use that word lightly.
It's never been about anything but my pet.
He's come out on holidays, Sundays you name it.
I wish he would adopt me.!
I trust him yet my questions only come because I want to know everything
This chubby guy has me wrapped! ( Bubba)
His appetite decreased a bit since arriving home.
I gave him ff, with a little warm water in it and some halo treats mixed in
He ate most of it. I'm off to get some fresh syrup to have in the house, can't think of the name but Karo something.
Thanks again, will report back after next visit.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Deep breath. You may not have seen this scenario but many of us have. You're doing all of the right things.

Humulin N, like others said, is a faster acting insulin than Lantus. It's also more potent but shorter in duration. Lantus is gentler but longer acting. Right now, there should be 1 goal: get rid of the ketones. FWIW, trace levels can be managed at home. There are 3 key things for you to pay attention to.

Fluids: Subcutaneous fluids are how this is usually treated, especially if the cat is at home. An IV drip may be used if the cat is hospitalized. You aren't equipped to put your cat on an IV. It's a positive sign that the vet found only trace levels and sent Bubba home. You can ask your vet to show you how to administer sub-q fluids. We have videos of how to do this. Adding as much water to his food as Bubba will tolerate will also help.

Infection/Inflammation: You noted on your spreadsheet that the vet gave Bubba clindamycin. Please talk to your vet about this. Was there actually a URI? Is Bubba's temp back to normal? Was a blood panel run to see if an infection was present? You also noted Bubba's gums were inflammed. You may want to ask your vet to re-check this. It may also be contributing to the problem. Now may not be the time to consider a dental but you may need to think about it sooner rather than later.

Food: Getting food into Bubba is essential. Ketones develop because a cat is metabolizing fat, not protein. Fats breakdown into fatty acids. The more fat is being metabolized, the more these fatty acids build up and they throw the body's pH (acid-base balance) off. If not dealt with, not only do ketones develop, the risk for DKA increases. By making sure Bubba is eating, protein will be metabolized and the cycle doesn't occur.

You may want to order a blood ketone meter so you can keep an eye on Bubba's levels and so you don't have to keep stalking him to the litter box. NovaMax makes a good meter. Just be aware that the strips for any ketone meter are expensive. Blood ketones meters tell you exactly where the ketone levels are at the moment you're testing. Urinary ketone levels are hours old and aren't as precise.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Thank you everyone!
Also, thank you so much for the detailed breakdown
And I'm getting that meter for ketones! It's ok on the cost, ill figure it out.


I will continue to follow the guidance from my vet and here
And hopefully Bubba will be on the road to recovery
In no time. I know this board has helped both of us in the past and I'm so very grateful
Then and now!

Priority is ketones, got it..
Update after 1pm.

I guess i will be buying this insulin as well.


Going to look for those videos you mentioned.

Bubba is sending a high paw for all of the help.
 
Re: Moderate ketone reading Bubba starting insulin today hel

If you're going to buy the Humulin N too, and your money is tight, you might want to ask for a prescription and buy it from Walmart where I think it is less than $25.00. You probably won't be using it for long.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Thank you ! You just saved me like 70.00
Cvs n walgreens, 92 and 83!
Walmart is far, but that's a huge difference!
Thanks again.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Call around for prices. I think the price on Humulin N has gone up.

Let me see if Marje can link the video for you. I don't have it bookmarked.
 
Re: Moderate ketone reading Bubba starting insulin today hel

The Nova Max can test blood glucose as well as ketones. There are two different types of strips for it. While the ketone strips are expensive, the blood glucose strips are much cheaper than the Alpha Track you are using now. You can also get the strips on eBay at a good discount.

W/ Bubba's tendency for ketones another good option is the Tidy Cats Breeze Litter System. The "litter" is non-porus pellets and the urine is caught in a pad below. When you want to test for ketones simply remove the pad from the tray or put a pice of plastic wrap over it (you only need a few drops). It's on sale at PetSmart now and that link has a $7 coupon you can print. Added plus is there is the least smell from any litter box I have ever had and no dust or tracking!
 
Re: Moderate ketone reading Bubba starting insulin today *up

We just got back from vets. Bubbas glucose at the vets was at 189
From 300 ( at home this morning)
He would need to be tested a few more times today and given insulin tonight
And back at 8 am to vet to look at urine n exam.
The vet said ideally he would only be on Humilin for a few days and then start lantus.
I will have him take a look at his gums and teeth tomorrow
As it will be less of a crazy house tomorrow.
I will update soon. Praying the new strips get here today.

The ketones unit looks great, but I wonder why only 10 strips, that's crazy.
I will also look into that litter box. It's not hard to catch his urine as he has no shame in his game ;)
Thank you all for helping!
 
Re: Moderate ketone reading Bubba starting insulin today hel

Jackie

Sienne asked me to pop on and help you out with the subqs. Here is a video we did with our kitty, Gus. It should help you but please ask if you have more questions.

[youtube]TtSzMuDgx78[/youtube]

It's important that you stay calm because Bubba will be able to sense it if you are nervous. I would also be adding extra water to his food, ok? For every helping of canned food you give him, put a tsp or two of water in it and stir it up really well.

Sending you both calming prayers and healing vines. Let us know how we can help. We've helped many kitties through trace ketones and much worse so you are in good hands between your vet and us :-D
 
Re: Moderate ketone reading Bubba starting insulin today hel

Jackie sent me a PM and I told her I'd reply in her condo.
Jackie said:
Bubba ate ok today, not great but not bad. His glucose was at 311 before shot and he ate very little, I know this shot requires food before . I texted my vet and he said give him shot and keep trying to feed. Ketones were between negative and trace tonight. I don't know what to do? He was at deaths door last time and that feeling is overcoming me. I tried everything. Now I'm in scared giving him the shot without Food is going to do harm then good. He is a big cat, although he ate some today, I dont want to get fatty liver. If i had funds he would be in emergency right now. Any advise ?
Click to expand...

It's been quite some time since I used N but you're right -- you need to have food on board before you shoot. I would see if Bubba will eat. I don't really care what he eats, as long as he eats. If he'll eat low carb, that's great. If he'll eat high carb, baby food, roast chicken, your dinner, whatever -- getting food in him is more the issue when it comes to ketones. See what he'll eat and if he eats a reasonable amount, then you can give a shot. Just keep offering him food every hour and remember to add water to the food. It takes more than just one or two meals for fatty liver to develop. Food is important with regard to managing the ketones.

If you want to try baby food, get a type that's just protein and broth -- no veggies. Many cats really like baby food.

If it were me, I'd also be getting at least hourly tests until you're past the lowest point in the N cycle.

Do you have strips and high carb food food in case they're needed?
 
Re: Moderate ketone reading Bubba starting insulin today hel

Now I'm beside myself. The shot was given as per the vet
I tried baby food, friskies, ff, boiled chicken ( he ate maybe two teaspoons.
Fancy feast chicken appetizers, I shouldn't have listened, he ate maybe 3 bites
Before the shot. I'm so scared right now I'm shaking.
Don't mean to be insane here.
 
Re: Moderate ketone reading Bubba starting insulin today hel

what about fish?
My cats love fish-flavoured food - they won't touch FF appertizer chicken but love the tuna, or Friskies or FF fish ones.
Or human tuna but only in fresh water.

I also try with crumbling parmesan cheese on top or any favourite treat that you can 'sprinkle'
 
Re: Moderate ketone reading Bubba starting insulin today hel

He doesn't need to eat a huge amount all at once. Small amounts frequently can be fine. It's ok is Bubba "grazes."

How about trying something high carb?
 
Re: Moderate ketone reading Bubba starting insulin today hel

Ok, Bubba ate about a half of can of fancy feast ( spoon and hand feed and about a half a chicken tender boiled.
I'm going to keep trying small bits of chicken.
I did not receive the strips as it stated on the delivery tracking
So I have one Alpha Trak strip left.
I went to Walmart and purchased the Relion confirm.
I couldn't get to set the time etc but the code for the strips did match.
Problem is this, alpha takes the blood from the side where this does not.
It's way to hard and long to obtain the sample. Drop blood on top of it?
He hates testing, so I need to be in and out.
I did get a reading at 9 of 153: add 30 pts vs alpha and 183
I don't trust this as I don't even know if its set up right?
Any good monitors out there that take blood from the side?
I don't know if I could test him every hr with that meter

He is laying down , I'm going to let him rest for a bit.
Any suggestions on another monitor? I will need it until Monday night.
I have a 24 hr walgreens not to far.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Here a trick you can try with the relion. Test as normal, but instead of trying to get the blood to sip up the strip off of his ear, see if you can get the drop of blood on a fingernail. Then you can let him go, and you can take your time with the blood and the strip. You want to just put the tip of the strip at the edge of the blood drop, and it will "sip" up the strip until you hear the meter "beep". Bubba could be half way across the room at that point, but it won't matter.

Carl
 
Re: Moderate ketone reading Bubba starting insulin today hel

I use a Bayer Contour meter. The strips are more expensive than the Relion strips especially if you buy them at Walgreens. (Walgreens prices for strips are 3 or 4 times more than what you'd pay on Amazon or ADW or EBay.) But, you can always get strips at a pharmacy if you run out. What you're running into with the AlphaTrack strips is what most people experience. The strips are expensive and not readily available.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Hi. I use the Bayer Keto-Diastix strips that my vet told me to use. My bottle of 50 strips were very inexpensive at Rite Aide Pharmacy. I asked the vet for an actual script so the pharmacy would use my AAA discount. I even have scripts for Pepcid for my cat. The AAA discount is ususally more than the loyalty cards but you need a script for any OTC drugs... Or the pharmacy will only use the loyalty card. Make sure you get a script and tell the pharm tech to run the AAA as they will not always offer it. I hope you have AAA. :) My personal health insurance does not cover any OTC drugs. So, I get a script say for Zantac and use the AAA discount. I tell the doctor to give at least 60 pills in the bottle,as they charge per bottle with stuff like that. My vet tech argued with me about the Pepcid script but then I explained why and they gave me the script. I am so happy that you caught your cat in time. My cat went into DKA two weeks ago and came home with a feeding tube. I think you are a great mom your fur baby. Good luck. This is a great group to belong to.. I am a newbie too.
 
Re: Moderate ketone reading Bubba starting insulin today hel

For today, can you begin to go back and fill in Bubba's spreadsheet? That will help us enormously. It's very hard to go back through all of your posts to sort out what's going on with Bubba's numbers. You can also keep notes about Bubba's ketones in the "Comments" section. The spreadsheet is a great way for you to begin to see trends and not have to sift through pieces of paper or get the numbers off of your meter. Everything is in one place and easily accessible.

That's good information about the AAA card.

You may also want to start a new thread for today since this one has gotten long.
 
Re: Moderate ketone reading Bubba starting insulin today hel

Started a new thread. Katlyn Great idea with AAA but I dont have it. How is your kitty? Is she holding down her food?
First time around they were going to give Bubba a feeding tube but he started eating with a stimulant and a lot of finger feeding,
He did have tummy issues as well and was on Pepcid. They gave him dm but Bubba hated it and we switched to classic FF. ( chicken and turky) He got sick from the beef. I found out later a lot of cats have problem w beef, ( I think I learned it from this board two yrs ago :) )
Bubba also has asthma. Please let me know how kitten is, ok.

This board is great, everything I have learned both past and present is from this board!

I did update his spreadsheet :)
 
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