One Urine Test Back

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Bobbie And Bubba

Bobbie And Bubba

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Just got a call from the vet. Bubba has a +3 ketone. She was quite surprised giving that his numbers are in the 200's. She is having me monitoring him with another ketone test at home today and to call the results in tomorrow. So, no wonder he has been starving! And losing weight, and drinking lots of water. Scary........
@Carl & Polly & Bob (GA) well, you were right........good Spidey senses........
 
Wow Bobbie - was that from the urine sample from yesterday? Have you ever found ketones in his urine at home? That seems kind of surprising to be 3+
 
I know! She was surprised too. Do you know how high do the numbers go up? She wants me to check again today and call her with the results and his BG. I did just increase yesterday morning 4 hours before the test.
 
Carol & Murphy said:
I think 4+ is the highest the dipstick goes - did she also do blood work?
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No she just did urine since he had all the blood work in Sept. But maybe we need to do it again. With the urine, she sent one out for a culture that takes 3 days so, I should know by Friday about that one. This is why he was staying stuck, peeing so much and eating everything he could get his mouth on. Poor boy. To have that number with his numbers in the 200's is odd. I did test him not too long ago but I don't know how long the urine was there. I am going to be the pee pee police tonight.
 
The issue with ketoacidosis is that it messes up the acid/base balance in the blood, among other things - so I would imagine if his urine is still positive for ketones, he may need blood work. Your checking his urine tonight would be important to confirm that finding It really does seem odd for the urine to be 3+
 
I asked how to resolve it and she said by getting his numbers down. Since I just increased yesterday morning right before the visit, she wants me to call tomorrow and give her his numbers and the ketone test result. I hope it resolves and his numbers start coming out of the yellows.....
 
Carol & Murphy said:
The issue with ketoacidosis is that it messes up the acid/base balance in the blood, among other things - so I would imagine if his urine is still positive for ketones, he may need blood work. Your checking his urine tonight would be important to confirm that finding It really does seem odd for the urine to be 3+
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I wish I knew more about it. She said that it can quickly turn into an emergency. It makes me on edge as if I wasn't all ready!
 
They should also have done a urine analysis - where they look for markers of a urinary track infection like white and red blood cells leukocyte esterase, and other tests. These results would be available (way before the culture result) - did she say anything about the results of the urine analysis?
 
Carol & Murphy said:
They should also have done a urine analysis - where they look for markers of a urinary track infection like white and red blood cells leukocyte esterase, and other tests. These results would be available (way before the culture result) - did she say anything about the results of the urine analysis?
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I believe the one that showed the ketones showed no bacteria present and everything looked good except the ketones at +3. I think she said something about proteins, and something else and everything looked good except the ketones and to tell you the truth, after she talked about the ketones being +3, I lost everything else because I got a bit freaked out. The urine culture won't be back until Friday. When I talk to her tomorrow, I will ask again what all the urine test that showed the ketones told her. I was driving when the call came in or I would have taking notes.
 
Hi Bobbie, sorry for the Dx, but good you caught it early. I don't know if there are different ways to measure ketones, but my test strips have up to 5 as being 'trace'. Definitely worth watching and treating, but again, you caught it early so I'm sure Bubba will be fine. How is he feeling?
 
He seems fine, went out today for about 3.5 hours, had a mouse snack, still drinking a lot, still hungry, he was up on the stove again about 30 minutes ago. ..... this makes me nervous. Apparently, if they are not exhibiting any of the DKA symptoms, give insulin as normal and provide plenty of food and water.
 
Glad he's feeling ok. I understand why it's making you nervous, especially since you tested him not that long ago. I tested Colin yesterday, but I have gotten lax-I will start back up with daily testing. I saw, in another thread, you were worried about his weight loss. Have you increased his food?
 
Bobbie And Bubba said:
I believe the one that showed the ketones showed no bacteria present and everything looked good except the ketones at +3. I think she said something about proteins, and something else and everything looked good except the ketones and to tell you the truth, after she talked about the ketones being +3, I lost everything else because I got a bit freaked out. The urine culture won't be back until Friday. When I talk to her tomorrow, I will ask again what all the urine test that showed the ketones told her. I was driving when the call came in or I would have taking notes.
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I hate cell phones and getting important news on it while you are doing something else - that must have been a stressful drive
 
Carol & Murphy said:
I hate cell phones and getting important news on it while you are doing something else - that must have been a stressful drive
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I know what you mean, it never fails that an important call comes in when your driving. One time I was awaiting pathology to come back for myself and the results came while I was driving, squamous cell carcinoma. I had to pull over. :blackeye:
 
Sharon14 said:
Glad he's feeling ok. I understand why it's making you nervous, especially since you tested him not that long ago. I tested Colin yesterday, but I have gotten lax-I will start back up with daily testing. I saw, in another thread, you were worried about his weight loss. Have you increased his food?
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yes- whenever I am worried about Murphy because his numbers are sky high, I give him extra food (usually boost with a little YA as it is so high in calories) - I'm not saying that is necessarily the right thing to do, but if he is losing weight and has ketones, seems like a reasonable thing to do
 
He was acting starving tonight again, so I tested 1/2 hr. early and he was 270 so I fed and shot. Yesterday, I gave hime stella and chewy rehydrated as a mid day snack after he had been outside.
 
Bobbie And Bubba said:
I know what you mean, it never fails that an important call comes in when your driving. One time I was awaiting pathology to come back for myself and the results came while I was driving, squamous cell carcinoma. I had to pull over. :blackeye:
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OMG Bobbie - are you okay? of the skin I hope! once I was in the check out line in a grocery store, and the phone rang, it was the vet who did an ultrasound on my last very sick cat (who I adored)-told me the cat had pancreatic CA so I very sadly PTS right then as he was suffering, then on the phone call in the grocery store he told me he didn't have pancreatic cancer after all, and in fact, in his necropsy, they couldn't really find anything wrong. I still get upset when I think about that one
 
Carol & Murphy said:
OMG Bobbie - are you okay? of the skin I hope! once I was in the check out line in a grocery store, and the phone rang, it was the vet who did an ultrasound on my last very sick cat (who I adored)-told me the cat had pancreatic CA so I very sadly PTS right then as he was suffering, then on the phone call in the grocery store he told me he didn't have pancreatic cancer after all, and in fact, in his necropsy, they couldn't really find anything wrong. I still get upset when I think about that one
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OMG!!! Carol, how can that happen!??
 
Carol & Murphy said:
OMG Bobbie - are you okay? of the skin I hope! once I was in the check out line in a grocery store, and the phone rang, it was the vet who did an ultrasound on my last very sick cat (who I adored)-told me the cat had pancreatic CA so I very sadly PTS right then as he was suffering, then on the phone call in the grocery store he told me he didn't have pancreatic cancer after all, and in fact, in his necropsy, they couldn't really find anything wrong. I still get upset when I think about that one
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Yes, it was the skin, that area has started to itch again so I am keeping an eye on it, no visible signs.
 
Bobbie And Bubba said:
I know what you mean, it never fails that an important call comes in when your driving. One time I was awaiting pathology to come back for myself and the results came while I was driving, squamous cell carcinoma. I had to pull over. :blackeye:
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Thank goodness you're ok, keep an eye on that spot!
 
Carol & Murphy said:
OMG Bobbie - are you okay? of the skin I hope! once I was in the check out line in a grocery store, and the phone rang, it was the vet who did an ultrasound on my last very sick cat (who I adored)-told me the cat had pancreatic CA so I very sadly PTS right then as he was suffering, then on the phone call in the grocery store he told me he didn't have pancreatic cancer after all, and in fact, in his necropsy, they couldn't really find anything wrong. I still get upset when I think about that one
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Carol I'm so sorry that happened. A similar thing happened to me once and I still get upset about it too.
 
I got a ketone test on Bubba tonight with the noabsorb beads. He rated moderate, the 3rd color from negatie with Trueplus Ketone Strips. :blackeye: Does anyone know if those beads rinsed and can be reused? They are very pricey. I remember Sue saying that she used aquarium gravel.
 
Mine was a young vet just out of school on a weekend when no other vet was around. The other vet there was my regular vet and he was out of town. My horse was at the clinic with kidney failure, so I was already emotionally stressed then my cat started with problems and I brought her there. He said she had kidney failure and there wasn't anything to do about it. I had her PTS so she wouldn't suffer anymore. When the regular vet came back I learned that while she did have KF, there were things we could have done to help her. The young vet no longer works there. I don't know if he's still in practice at all(hope not!)
 
Bobbie And Bubba said:
This is terrible! I am so sorry for you and Carol. I don't understand how something like that happens.
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Veterinary medicine
Bobbie And Bubba said:
I got a ketone test on Bubba tonight with the noabsorb beads. He rated moderate, the 3rd color from negatie with Trueplus Ketone Strips. :blackeye: Does anyone know if those beads rinsed and can be reused? They are very pricey. I remember Sue saying that she used aquarium gravel.
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Bobbie - I am so sorry I was hoping the first test was a mistake If I were you, I'd either PM or tag a wise one, or post on health to see if there is anything else you can do - like pushing calories/fluids etc.
 
Such very sad stories. I can't imagine getting that phone call either in the car or in the grocery store. So sorry Carol.

I am hoping that everything is ok with you too Bobbie and of course with Bubba. I think Carol has a good idea by posting on health and seeing if anyone has any short term suggestions. I would hope that the vet would be able to start "something" tomorrow so whatever Bubba has, it won't progress.
 
@Merlin On the short term at least, I am going to have to keep Murphy's poking to the absolute minimum - he's fine until I poke the ear (even with a 33 gauge lancet) then he growls and tries to bite - My arm from his bite yesterday is a mess - I had to start antibiotics (just happened to have a supply) I will need to find a new place to test because now he associates the old place with "biting" Looking at his ears, they are a mess I've tested him so frequently these past 3 1/2 months, I need to back off as much as possible for awhile :nailbiting:
 
Bobbie, believe me, I didn't want to be "right". I just got home from work and saw this. I'll post what I know about ketones after I get settled.
 
Carol - that is a good idea regarding find another testing site. So sorry that it has been hard to test. I hope you scratch gets better too.
 
Bobbie
Start by reading this. Don't let it totally freak you out. "Ketones" is not DKA. But it can go there fairly quickly. I'll be back.
Bob survived one DKA. He was about there a 2nd time when I see him free two years ago.

http://www.felinediabetes.com/ketones.htm
 
Bobbie, a few questions:
  • How long has it been since you opened your vial of ketone strips? They do expire. Some 6 months after opening. Some 3 months after opening.
  • Has the vial been closed tightly so the strips are not exposed to air?
  • Did you follow the directions (dip, wait 15 seconds to read, compare to strip vial to get reading)?
  • Is Bubba eating normally or has his appetite recently decreased? I'm asking because I thought I remembered you posting that he's always hungry.
  • How's he acting?
 
Thanks Jill, great questions. What sounds "out of place" is that he's really hungry. When Bob had ketones, he didn't want to eat at all. I had to syringe "liver shakes" the last few days.

Bobbie, when you talk to the vet in the AM, ask if they have a blood ketone meter (instead of a complete blood work up). Testing the blood tells you what the ketones are "now". Urine tests can be less than current because the ketones don't show up in the urine until the blood is filtered by the kidneys. I had a Nova-Max blood glucose/ketone test meter so I could check Bob at home without having to chase him around the house with a stick, lol.

The presence of really high BGs is not a requirement for ketones to show up. Usually they go together, but not all the time. The important things right now are to give insulin, maybe a tad more insulin than you would normally give, to make sure that he eats well, and that he stays hydrated. You can add a little water to his food, and make sure he's got access to bowls of water if he wants them.
 
Carl & Polly & Bob (GA) said:
The presence of really high BGs is not a requirement for ketones to show up.
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This is really important for everyone to know! High BGs scream "test for ketones!", but the worst cases of ketones/DKA I've seen since joining this board have been when kitty has been hanging out in the mid 100s.

The basic recipe for developing ketones = an insufficient supply of insulin + inappetance + infection OR other systemic stresses.

Signs of Diabetic Ketoacidosis (DKA)
  • Drinking excessive amounts of water OR no water
  • Excessive urination
  • Diminished activity
  • Not eating for over 12 hours
  • Vomiting
  • Lethargy and depression
  • Weakness
  • Breathing very fast
  • Dehydration
  • Ketone odor on breath (smells like nail-polish remover or fruit)

Carl & Polly & Bob (GA) said:
What sounds "out of place" is that he's really hungry.
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That's what has me puzzled. Something seems off here...
 
Aww, Bobbie, so sorry to hear that Bubba tested positive for ketones. :( I know how worried you must be, but you did catch it early and knowledge is power. You will beat this and get Bubba feeling better again. I always worry about ketones, since Rupert has a lot of high numbers. He is always hungry, drinks a lot, but that has been true since day one. I test at least a couple times a week, I will test more now. I think the strips are hard to read though, the color difference between negative and trace is difficult to tell. I know you will give Bubba the best of care and he will be positive again soon. I am off to the woods, so won't have access to computer, take care of yourself and your sweet boy! :bighug:
 
Carol & Murphy said:
@Merlin On the short term at least, I am going to have to keep Murphy's poking to the absolute minimum - he's fine until I poke the ear (even with a 33 gauge lancet) then he growls and tries to bite - My arm from his bite yesterday is a mess - I had to start antibiotics (just happened to have a supply) I will need to find a new place to test because now he associates the old place with "biting" Looking at his ears, they are a mess I've tested him so frequently these past 3 1/2 months, I need to back off as much as possible for awhile :nailbiting:
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Have you ever tried the large pad on his back paw? I actually started testing on Rupert there, I was having trouble with his ears. It worked and he didn't seem to mind it much. Good luck!
 
Lynn & Rupert said:
Have you ever tried the large pad on his back paw? I actually started testing on Rupert there, I was having trouble with his ears. It worked and he didn't seem to mind it much. Good luck!
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I can't imagine he would let me test his paw but I'll look into it I agree with the ketostix being hard to read - mine consistently give a color tint that doesn't match the negative or trace (definitely not the pinkish maroon of actual ketones) I am not so careful about always leaving the container closed and not exposed to light - so I think I'm going to buy a new vial of the ketostix.
 
Bobbie, how's Bubba doing? Did you get any results from the vet today on the 2nd culture?
 
Carl & Polly & Bob (GA) said:
Bobbie, how's Bubba doing? Did you get any results from the vet today on the 2nd culture?
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Hey Carl, I am just now getting the post from you and Jill and Alex posted on Friday, I don't know how I missed them....He went back to the vets on Friday morning and was retested, she took urine with a syringe from his bladder and the ketones were gone! Thank goodness. All the blood work came back normal. The urine culture showed nothing. It really freaked me out and she was surprised that he had ketones in the 200's. She ask me to bring my meter and did a comparison with the same blood sample and found mine to be really low compared to the AT2. So what looked like mid 200's were really closer to the mid 300's. Of course she wanted to sell me a AT2. She thought he just needed more insulin also. I bumped him up to 3 units after Thanksgiving and look at his SS. He went up! His two lowest readings on 3 units were the pre-shoot reading and he went up at onset/peak. It is very clear that 3 in too much. I went back to 2.8 today and he came down. I am interested to see what tonight's cycle does. BUT, 2.8 isn't taking him low enough. This is why I decided to try a depot insulin. Thanks for the link about ketones, I haven't read it yet but, I will.

Today, I ordered the Precision Xtra blood and ketone meter and strips because I too find it difficult to get a sample from the box and this way I will test often. I had just read today that the blood ketone test was a better way to do it.

Thanks for everyone's concern and suggestions, I truly appreciate it! :)
 
Jill & Alex (GA) said:
Bobbie, a few questions:
  • How long has it been since you opened your vial of ketone strips? They do expire. Some 6 months after opening. Some 3 months after opening.
  • Has the vial been closed tightly so the strips are not exposed to air?
  • Did you follow the directions (dip, wait 15 seconds to read, compare to strip vial to get reading)?
  • Is Bubba eating normally or has his appetite recently decreased? I'm asking because I thought I remembered you posting that he's always hungry.
  • How's he acting?
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Hi Jill, I am just seeing this post now, don't know how I missed it.

My vail of test strips were open is Sept and were always kept closed tightly. I read the strip in exactly 15 secs Bubba was eating perfectly, starving in fact as he is still losing weight. Other than begging for food all the time, he started drinking excessively again and urinating large amounts again which looked sticky. Acting normal, wanting to be outside as much as possible. Just ordered a ketone meter today so I will be able to stay on top of it better. Thanks for your post and concern.
 
Bobbie, glad to hear Bubba's ketone test came back negative! Seems like a good idea to get a more accurate test for ketones, especially since he had them. He has had pretty good numbers, but not good enough. He sure is sensitive to a too high dose, hope the depot insulin will help make finding the right dose easier. We will all be keeping our fingers and paws crossed for you both!
 
Bobbie,
Glad you got the ketone meter. I used a Nova Max meter on Bob. No way he was letting me anywhere near him with a dipstick! Strips are expensive, but peace of mind is priceless.

Best wishes as you begin your Lantus journey! I'll keep an eye out for you there.
 
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