Need some info on Ketones

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Barbara

Barbara

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I tested my cat yesterday & got a "trace" reading. I raised her insulin by .1 last night then her BG started dropping & I got lots of green last night. I had decided to take her in to the vet due to the trace reading I was getting. Well, don't you know the vet that was there this morning seemed to be clueless. She did say she didn't smell anything on her breath & she is not dehydrated. I'm just wondering what some of you that have had more experience can tell me. She told me my cat's bladder was small & they couldn't get any urine from her but they were just gonna test with a stick the same was I did. She said I could leave her to see if she would pee but I didn't want to stress her anymore than I had to. Is the pee test the only way to test for ketones?
 
Apparently only 1 person in 4 can smell ketones on the breath, anyway, and even then it's not usually detectable until DKA is present. I know of one vet's office (not mine!) who has a vet tech than can smell ketones, and that's how they check! *shakes head*

Using the urine strips or the Precision Xtra is far better. You handled it well - a little more insulin, fluids and a vet check. Too bad the vet wasn't clued in. ;-) Just keep watching.
 
Also, watch that she keeps eating and that the ketones stay at trace or lower. I would also be skeptical of a vet that is treating a diabetic cat and knows nothing about ketones .... I use a meter and urine strips but I only use the meter if she is showing anything on the strips.

Sometimes ketones can be smelled but by then you should be in emergency. Ketones in a diabetic cat is serious .... given the right circumstances and quickly, you are on the road to DKA. You don't EVER want to go there! Raising insulin is good, watch for infection and eating is very important.

When my Payne was Dx. she went immediately into DKA and even though I was at a teaching hospital, she was sent home after six days in ER on the same amount of insulin and still throwing ketones, a disaster waiting to happen and yes, two days later we were back and repeated again. The third time I was a little better informed (thanks group) and I refused to take her home unless insulin was raised and ketones were gone.

Keep on top of it and IMHO I would be checking for a vet that knows the dangers of ketones and diabetes.
Good luck.
Nancy and Payne (who doesn't like even talking about DKA :)
 
Thanks Nancy. I was quite disappointed in the vet this morning. I have been there for 15 yrs, longer than this particular vet. She has treated my hyper T cat just fine....it just doesn't seem like she's as informed about the diabetes. She did say she was gonna discuss Thumper's SS with the vet who diagnosed her, but she won't be back until Wed, and that's a typical schedule for her, soooo...if we have an issue & she's not there we might be in trouble. I'm gonna call her when she gets back in also. She seemed more interested in talking to me about the dose, I told her I wasn't concerned with the dose (which was kind of a lie) my main concern was the ketones. I'm gonna keep on testing at home for the ketones. She is eating well & seems just fine otherwise. I did print out the info on ketoacidosis & might check into getting the meter. Do those strips expire like the regular ones? I don't have any idea how to go about finding a vet that would be better...any suggestions other than just calling around? I'm afraid I wouldn't get a real clear answer that way.
 
Barbara,

If you want to post your city and state, maybe someone knows a FD vet near you. If not, I could interview a few by phone: How many diabetic cats have they treated? Success? How do they feel about hometesting? What insulins do they use? How do they start a beginning diabetic's dose? Just those few questions will help you figure out whether they know as much as you and will be supportive.
 
The meter strips do expire and they are VERY expensive! I can't get over a vet only taking a urine sample for ketones .... I worked with my original vet but there was no give/take and Payne suffered because of it. I agree post your city/state and see if there is a good vet who knows about diabetes. Hope helped me find a new vet and I LOVE HIM! he doesn't know as much as the list does :lol: BUT he is willing to learn. In fact Payne is teaching him daily .... plus, the clinic is 24/7 and has 10 vets!

The problem is that once a diabetic cat throws off ketones, you will always need to pay attention. I use the strips as a gauge, then if that picks up something, I start checking with the meter. With Payne her eyes turn like full moons and she stops eating .... she lives to eat! we are off to ER then.

Nancy and Payne (who is trying to figure out the best way to get to the birds at the waterfall, outside ohmygod_smile )
 
Nancy, so are you saying there is a blood test for ketones? I wish we had a 24/7 vet here! We do have an emergency vet that opens when the others close but they are stupid expensive! I'm going to post my city & state to see if anyone knows any vets nearby. Thanks!
 
Barbara--Kitty's eyes got glazed over and her pupils got very large prior to the full blown DKA episode. And, just like Nancy said-- Kitty didn't totally quit eating, but she ate very little.
 
Barbara did you stay true to the number of seconds that passed before reading. It's on the bottle. usually I think 15 or 30 seconds. After that the color will grow darker but is not the sign for ketones...just past the point of accurate reading.
 
About 5-6 months ago I started a discussion on ketone meters, it is very informative but very combative ohmygod_smile each having strong opinions. But my feeling is practical. Just today I found out the strips I have been using are bad, the tips have turned grey .... so i pulled out my ketone meter, drew blood and knew she was okay, it was 0.6 .... anything under 1.6 is negative. She has run in the 6 and 7's ....

One thing I liked about UC Davis was they checked her ketones in four ways! They checked on the stick, they went into her bladder, used a meter AND the coolest thing, they took blood put it in a machine that spun it around (we spent a lot of time in ER during DKA's) and took a reading at the end. When she was in DKA and hooked up to everything, they checked her blood hourly and adjusted the R insulin as to what that # was.

Nancy and Payne
 
Well, I didn't have a watch with me but counted it out. I compared to the side of the bottle. My gut feeling is she's ok...but I don't really trust myself, which is why I wanted the vet to double check. My hope is when the other vet gets in on Wed. & I call her she will know more about it. It was at her advice that I started home testing & went looking for this site, she didn't know the actual site but told me she knew there was info out there, she actually mentioned Sugar Cats. Thanks!
 
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