Newbie~ High keytones~ dosing? help appreciated

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Louieorangetabby

Louieorangetabby

Member Since 2011
We're new to this! now in week 2. The vet told me that Louie had high keytones when he first diagnosed him, and suggested a 2 day treatment for $300 flushing out the keytones? not sure~ I decided against it since I could not afford it with all the other expenses to support a diabetic kitty~
as you can see by Louie's SS, the vet put him on high doses of insulin (Lantus), and then I found this community and reduced him back to 1 unit.....day two off the big doses and the lowest BG ever of 48. The vet told me to call the clinic if his levels were below 60.
this is still all so new to me~
any insights?~
should I be worried and increase Louie by a small amount when this happens? Just started taking a mid day test to see the nadir levels yesterday.
this is where I've been worried about the keytone issue, but I know nothing about it...I was concerned that this could harm Louie if I'm missing something important~
thanks,
Tracy
 
High ketones is not generally something that can be treated at home. His numbers look better now, so that is good. Have you tested his ketones? They sell ketone sticks at pharmacies, and you test his pee (requires litterbox stalking and some trickery if he doesn't cooperate). Does his breath smell like acetone or fruity at all?

MJ&Donovan
 
Hi there,,
I'm at work and can't see Louies ss but wanted to let you know that ketones can be very serious.
Please get to the pharmacy asap and ask for Ketostix - they are test srips you use to check his urine for ketones, which you need to do.

Please tell us -

1)how is Louies appetite? any vomitinng?
2)does he seem lethargic?

Also please start mixing some water into his food - hydration is important
 
There is a very teeny bit less worry since the glucose level has come down so much, BUT you are going to need 3 -7 days to see how the 1 unit shakes out as a regular dose - it can take that long for the new dose level to stabilize. Meanwhile, frequent testing will let you know if he's going too high or too low.

Please use ketone testing strips on his fresh urine to monitor the ketone levels as elevations indicate he could go into ketoacidosis, which can kill him. He's not stable yet.

Some questions - is he:
eating?
drinking?
peeing?
poohing?
purring?

These 5 'P's give you clues about how the cat is doing. If 1 or more of those 5 behaviors isn't working right, especially the 1st 4, you are NOT out of the woods.

Also, we recommend new users not to give insulin when the cat has a pre-shot level less than 200. AFTER you have lots of data, that cutoff number may be decreased.
 
quick cut-and-paste of SS numbers below

10/26/11 AM N/A 3.00U PM 326 3.00U
10/27/11 AM 498 3.50U PM 401 3.50U
10/28/11 AM 412 4.00U PM 170 3.00U
10/29/11 AM 437 3.50U PM 394 3.50U
10/30/11 AM 433 3.50U PM 446 3.50U
10/31/11 AM 424 3.50U PM 470 4.00U
11/01/11 AM 191 4.00U PM 124 3.50U
11/02/11 AM 281 1.00U +6=374 +11=349 PM N/A 1.00U
11/03/11 AM 289 1.00U +5=48
 
Louie seems to be fine in all areas~ although I can't be sure about pooping since he goes outside during the day to roam around the garden....and we have 4 other kitties using the litterbox. I just visited him and he purred happily. He is always hungry and seems to be drinking water and peeing.
will test again soon~
thanks!
Tracy
 
Tracy --

Seriously, get Ketostix or have someone pick them up for you NOW. Gabby was diagnosed with diabetic ketoacidosis at the time I found out about her diabetes. Three days on the ICU and $3000 later, she survived. I had 2 vets tell me how lucky we were. I'm not trying to scare you but trying to impress upon you how serious ketones can be. They can be lethal. Checking for ketones is the best prevention you can do. Go get the strips and stalk Louie to the litterbox to get a sample. Ketones can develop even if a cat is in lower numbers.
 
Tracy, I too, can not impress upon you enough the importance of getting the ketone test strips tonight, if you do not already have them. I would keep him indoors in a closed in area with a litterbox (for me it would be my livingroom)
and watch him constantly and be ready to get a ketone test. Ketones are very serious and life threatening.
I don't mean to scare you, but I have been around for a while. My cat had DKA and was hospitalized for 8 1/2 days.
I would monitor and test for ketones twice a day, if you can.
 
How long ago was the 48? Have you tested again to be sure he came up?

With a recent history of high ketones I would feel MUCH better about offering advice if we knew the ketones are gone. His numbers do look better now and that is a good sign. Ketones are *usually* more of a threat in high numbers, but they can form at low numbers too. Better safe than sorry. It's possible that reducing his insulin could make them come back so you need to be vigilant now.

For what it's worth, while on first glance it looks like your vet did not understand Lantus dosing, it is also possible that they were doing the best they could to try to help you beat the high ketones at home since you couldn't leave him at the vet. At the vet, they would have treated him with IV fluids and relatively high doses of fast-acting insulin. The treatment for ketones is food, fluids, and insulin and usually that means giving more insulin than would normally be appropriate in a non-emergency situation. The difference is that at the vet's office they can monitor around the clock and give glucose to counteract the extra insulin.

I'm not saying that was a great idea for home treatment, with a caregiver who does not have access to IV glucose and constant monitoring, but they might have felt it was the only way to try to save him. Just playing devil's advocate. ;-) I obviously have no idea if that's what your vet was thinking, or if they really just don't know. For sure, if that was their intent, it would have been helpful if they had explained that to you so you could make an informed decision.
 
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