Oscar still has ketones, but asymptomatic

[Kelly & Oscar]

Oscar has had a trace amount of ketones since 3/18. We test using the Precision xtra meter and not the ketosticks. He was 0.3mmol on the 18th, 0.5 the morning of the 21st, 0.3 ugly early on the 22nd, 0.4 on the 23rd, and 0.6 today. These levels are in between "trace" and "small" on the ketosticks. We did not test before 3/18 because we just got the meter. He has a healthy appetite, seems perky, is drinking and eating just fine. His numbers are not that high at all, all considering. We went to the vet for a check up last friday, and we were given clavamox for a possible uti. Why is my baby having these issues with 200-very low 300 #s when other kitties can have 300-400 #s with no ketones? We just took a trip to Tennessee this past weekend to pick my husband up from the Army. Could stress cause ketones like this?

 

[Dana & Lily (GA)]

I think some cats are just more prone to ketones than others for some reason. My Lily got ketones easily even when her bg numbers were pretty decent. You must be watchful over Oscar because of this. Good luck!

 

[Michelle & Prudence]

Oh Kelly, I wish I could give you an answer :YMSIGH: I was just thinking of you and Oscar last night. I will keep you guys in my thoughts and prayers :YMHUG:

Hugs to Oscar cat_pet_icon

 

[Venita]

Kelly, I've never used the blood ketone test, so I'm winging it here. Might it be that the meter isn't mesuring right. Could you test yourself? Could you try the urine stix and see what they say?

If those "control" tests say the meter is likely correct, could you have your vet do a blood ketone test and you check you meter against the same sample?

Welcome home DH!!!!!

 

[Larry and Kitties]

You said:
" He was 0.3mmol on the 18th, 0.5 the morning of the 21st, 0.3 ugly early on the 22nd, 0.4 on the 23rd, and 0.6 today. These levels are in between "trace" and "small" on the ketosticks."

How did you arrive at the equality of the blood ketone values to the urine values? I could not find a relationship via Google. I did however find this document that concluded that: "There are few quantitative figures given in the literature on the relationship between blood and urine ketone levels. The impression, however, is given that there is no correlation."

From:
http://www.ncbi.nlm.nih.gov/pmc/article ... 32/?page=3

 

[Kelly & Oscar]

Oscar is very elusive when he goes to the litter box. My husband and I tried pricking our finger to do a control test on ourselves. We learned that my husband doesn't bleed really well, and you have to poke yourself pretty hard to get a large enough blood sample! I tested 0 for ketones. I have been using the conversion of mmol/L to mg/dl, where you multiply the mmol/L reading by 18 to get the mg/dl reading. I have the mg/dl readings from the ketosticks posted on the ketoacidosis wiki page: http://petdiabetes.wikia.com/wiki/Ketoacidosis. The precision xtra company insert says that 0.3-0.5 is trace, 0.6-1.5 indicates the development of a problem that might require medical attention, and above 1.5 indicates DKA and requires immediate attention. http://www.abbottdiabetescare.com/a...0/general_content/General_Content_0000068.htmHope this helps!

 

[Venita]

OK, looks like you have done your homework on evaluating the readings you are getting. Is Oscar eating OK? Does he seem dehydrated? His BG levels seem OK, but not great, for a PZI insulin.

If he were my cat, and money was not an issue, I would take him to the vet and expect Oscar to get IV fluids to flush the ketones out of his system. I would also expect the vet to check for possible infections--mouth, urinary tract, upper respiratory. I would test my ketone meter agaist the vet's test for blood ketones.

If money were an issue, I would give subQ fluids at home, unless I suspected an infection. If I suspected an infection, I would get Oscar to the vet, regardless of the money issue.

With either action, I would continue to test his ketones, and I would strongly consider a slight dose increase to 1.75U to get his mid-cycle numbers under 200 (into the blues). I also would consider an insulin change to Lantus or Levemir where I might be able to get him in the low 100s, high double digits for most or all of his cycle.

Oscar might be one of the relatively rare cats that can have ketones with lowish BG numbers. I am really glad that you are being so diligent checking for ketones.

 

[Larry and Kitties]

While you can do the units conversion, as stated in the article i quoted, there seems to be no correlation between the blood and urine ketone levels. It is like there si no real correlation between blood and urine glucose levels.

Oscar is very elusive when he goes to the litter box. My husband and I tried pricking our finger to do a control test on ourselves. We learned that my husband doesn't bleed really well, and you have to poke yourself pretty hard to get a large enough blood sample! I tested 0 for ketones. I have been using the conversion of mmol/L to mg/dl, where you multiply the mmol/L reading by 18 to get the mg/dl reading. I have the mg/dl readings from the ketosticks posted on the ketoacidosis wiki page: http://petdiabetes.wikia.com/wiki/Ketoacidosis. The precision xtra company insert says that 0.3-0.5 is trace, 0.6-1.5 indicates the development of a problem that might require medical attention, and above 1.5 indicates DKA and requires immediate attention. http://www.abbottdiabetescare.com/a...0/general_content/General_Content_0000068.htmHope this helps!

 

[Kelly & Oscar]

OK, looks like you have done your homework on evaluating the readings you are getting. Is Oscar eating OK? Does he seem dehydrated? His BG levels seem OK, but not great, for a PZI insulin.

He is eating, though not as much as he usually does when his ketones are less. He is hungry it seems, but nothing I put down must seem that appetizing. He eats about half of what I put down right now instead of licking the bowl clean.

If he were my cat, and money was not an issue, I would take him to the vet and expect Oscar to get IV fluids to flush the ketones out of his system. I would also expect the vet to check for possible infections--mouth, urinary tract, upper respiratory. I would test my ketone meter agaist the vet's test for blood ketones.

If money were an issue, I would give subQ fluids at home, unless I suspected an infection. If I suspected an infection, I would get Oscar to the vet, regardless of the money issue.

With either action, I would continue to test his ketones, and I would strongly consider a slight dose increase to 1.75U to get his mid-cycle numbers under 200 (into the blues). I also would consider an insulin change to Lantus or Levemir where I might be able to get him in the low 100s, high double digits for most or all of his cycle.

Oscar might be one of the relatively rare cats that can have ketones with lowish BG numbers. I am really glad that you are being so diligent checking for ketones.

He is currently on Clavamox because we are suspecting a UTI might be the reason he isn't regulating much on his insulin. He seemed to curve the first few days on the 1.5U, but all of a sudden his curve has become a flat line again. It is so frustrating. He is also being treated for asthma. We are dealing with a persistent mouth breathing (he has done this for years), and we are wondering why his meds aren't making this stop. How do I give subQ fluids at home?

 

[Kelly & Oscar]

While you can do the units conversion, as stated in the article i quoted, there seems to be no correlation between the blood and urine ketone levels. It is like there si no real correlation between blood and urine glucose levels.

Oscar is very elusive when he goes to the litter box. My husband and I tried pricking our finger to do a control test on ourselves. We learned that my husband doesn't bleed really well, and you have to poke yourself pretty hard to get a large enough blood sample! I tested 0 for ketones. I have been using the conversion of mmol/L to mg/dl, where you multiply the mmol/L reading by 18 to get the mg/dl reading. I have the mg/dl readings from the ketosticks posted on the ketoacidosis wiki page: http://petdiabetes.wikia.com/wiki/Ketoacidosis. The precision xtra company insert says that 0.3-0.5 is trace, 0.6-1.5 indicates the development of a problem that might require medical attention, and above 1.5 indicates DKA and requires immediate attention. http://www.abbottdiabetescare.com/a...0/general_content/General_Content_0000068.htmHope this helps!

I understand what that research study states, but there are many diabetes sites that recommend the use of this meter as well for testing. There may not be a correlation, but the presence of any level of ketones indicates that something is not right. I can base my evaluation of the numbers off the manufacturer's guidelines from here on out, if that would make it less confusing.

 

[Larry and Kitties]

I am not saying the that the blood ketone meter is not a good idea. I think the blood ketone meter is very good idea. However, all I am saying is the values obtained via the blood ketone meter are not directly comparable with those obtained via the urine strip. Other people on this board have used the blood ketone meter. I suggest you start a new top with a title asking for experience with the blood ketone meter. They may have some info on what is a "normal" blood ketone reading.