Risky amps 383--trace Ketones +2 +4 +6

Status
Not open for further replies.
kse

kse

Very Active Member
9/19
amps 383 shot f1.5 (the f is due to trace ketones)
+2 434
+4 354
+6 401




Good Morning....good news first on Risky--amps 383
Now the concerning news---Ketones are trace (ketostix)--this might not be concerning....but, he has been a true negative until today--so, something is different


Martha is testing for Ketones and realizes the importance of not letting these increase significantly without vet intervention. My advice to her was if they go up another level that Risky might need some sub q fluids, but I also told her that many here have seen trace ketones with no issues. I am a terrible one to advise on Ketones--- I will never get passed Kitty's DKA.

So, Nancy and all of you with experience or knowledge with ketones......throw your ideas out...when does she get concerned? She is adding water to his food also.

She shot 1.5 Units last night and due to the trace ketones is going to fatten that 1.5 up a little this morning. She is not doing this to influence the BG--but, to try and help with the Ketones.

I have yesterday's curve posted at the bottom.

Please give me your thoughts.




9/18

amps 450 (eating tuna and some DM dry) Ketones negative shot 1.5 Units
+2 510----looks a little better than yesterday...food spike I am sure
+4. 448
+6. 405
+7. 404
+10 395
pmps 419 shot 1.5
 
Re: Risky amps 383--trace Ketones

No experience with ketones, but find the numbers discouraging. Wonder if we have underestimated the amount of insulin needed to counteract the dry food.
 
Re: Risky amps 383--trace Ketones

She quit feeding the Science Diet (41 percent carb) yesterday and has switched to dry DM (13 percent carb). I was actually thinking we might see the numbers come down with the diet change.

I don't want the ketones around.

Thoughts guys---should she increase the dose more to counteract the Ketones?
 
Re: Risky amps 383--trace Ketones

I am really torn. Want to give the dose time, but ketones present......guess I would say 2 units, lots of water offered (wish he was eating more wet so she could add - no adding wet to dry), frequent tests and ready for the vet if increase in ketones.
 
Re: Risky amps 383--trace Ketones

She is adding water to the tuna.....so, she is getting some additional water in him.
 
Re: Risky amps 383--trace Ketones

When Cass came home from his bout with DKA, here's what they told me about ketones. One reading of trace on ketones isn't a problem. If the next test also shows ketones, then you worry. If anything higher than trace shows, then there's a problem, too. Don't worry unless you get trace ketones again today.
 
Re: Risky amps 383--trace Ketones

One ALWAYS worries about ketones .... this is not good and if we get a second trace reading, we may need to adjust the dose up.

It could be his body reacting to everything that we are doing OR he needs more insulin now while everything is settling? Even ONE trace reading means he throws off ketones, I was hoping he wouldn't.

Kim, she needs to really watch this because he doesn't have the megadose of insulin to protect him, as bad as it was for him.
 
Re: Risky amps 383--trace Ketones

At the trace level would you suggest sub qs? She increased the dose some this morning...but, not to 2 units.... nailbite_smile
 
Re: Risky amps 383--trace Ketones +2

When i decided to test blood for ketones i was told they show up a day or two sooner that way vs. in urine. That means he may have started throwing them as soon as the dose was lowered. Asmuch as i wanted to be able to keep the dose real low and climb a lot slower, i think she's gonna have to kick it up to two, probaby tonight.
Carl
 
Re: Risky amps 383--trace Ketones +2

I would do SQ fluids now to give his body more to fight with. I would hold up on the dose worrying until we see what the day brings and IF he throws off a second trace .... at least we know if he needs it, we could add a little R to the mix.
 
Re: Risky amps 383--trace Ketones +2

The only option for sub qs is a vet---she is out of town and Risky is with her. She is trying to get another test now....but, if he tests trace would you take him in for sub qs or hold off? Like I said...she increased to a fat 1.5 this morning--so maybe the slight increase will help.

I have made a decision......I don't want to be a vet in my second life.......this is hard when you know the owner and the cat....and they are out of town
 
Re: Risky amps 383--trace Ketones +2

I would wait for a second test .... but if it is trace I would think about a vet if that's all she can do, where is she?

Yes, when it gets personal, it does get harder .... but you are doing a good thing. Relax and worry about the voting! ohmygod_smile we'll figure this out.
 
Re: Risky amps 383--trace Ketones +2 +4

Second test for ketones still showing trace. She is going to take Risky to the vet to try and ward this off. I told her to get a blood test and to expect them to do sub q fluids.

For the good news--his +4 is 354.

Anything else she should request at the vet (test) or be aware of?
 
Re: Risky amps 383--trace Ketones +2 +4

At least it's just trace--maybe we caught it soon enough it won't get worse. This may just be because his body is used to the mega dose of insulin. He's showing reasonable numbers otherwise, given where he started.

I don't know his whole history--if it were Cassie I'd have them check for UTI since he tends to have them.
 
Re: Risky amps 383--trace Ketones +2 +4

They may want to put him on a R drip .... if he is still trace I would wait because she can always do the R herself. I would have her buy SQ fluid stuff from the vet and it would be interesting to see what he is on a ketone meter .... which will give us some idea the direction he is going.
(the drip would put us back to square one ..... so don't do if he is still at trace)

Kim, can you buy R without an RX in NC? If not she should get some R from vet to have on hand, remind her to get syringes for the R (U100's). If she can, I would have her pick up a meter. It is easier to get a true idea of where the ketones are going using both.
 
Re: Risky amps 383--trace Ketones +2 +4

Where can you buy a blood ketone meter? I thought you had to order them.
 
Re: Risky amps 383--trace Ketones +2 +4

Well in CA .... WalMart carries them usually on the shelf, I can't speak for NC .... that's in the south? right? :lol:
 
Re: Risky amps 383--trace Ketones +2 +4

I have never seen them in Walmart here.....they even put the ketostix behind the counter here---NO JOKE!
 
Re: Risky amps 383--trace Ketones +2 +4

I bought my meter at walgreens if that helps
Check with Lori. She may have one in the newbie kit stockpile.
Carl
 
Re: Risky amps 383--trace Ketones +2 +4

So Risky is at the vet, thankfully. The only info I have at the moment is his temp is 104.2--high.

I told her to be sure they checked for a UTI or any other infection (with the fever it appears one is evident), blood ketone test, and to expect or request sub q fluids. I also told her NO convenia shot if they offer.

She just text---they are going to give him fluids.

I will post as I learn.....

Thanks for the help.

Any additional thoughts?
 
Re: Risky amps 383--trace Ketones +2 +4

There are two types of meters I've seen that also test ketones--you need different strips (which are expensive--$5/strip or so).
Nova Max and Precision Xtra. Both are glucose meters that also test for ketones if you have the strips.
I've been looking at them but I can't find either in stores around here, so I would have to order them.
I think the last time this came up someone said Lori had some for Newbie Kits as well.
 
Re: Risky amps 383--trace Ketones +2 +4

She is good on the newbie kit---she has purchased everything needed. BUT, I have never seen the ketone meters in stores where I live---of course, unlike some, I don't have the pleasure ohmygod_smile of living on the West Coast.
 
Re: Risky amps 383--trace Ketones +2 +4

So is ER putting him on a drip? checking for infection? on the path to DKA he has two strikes maybe 3 ..... I would throw everything at him, SQ, R drip .... catch it now.

I also hadn't realized he was not eating earlier, big red flag and my line in the sand for Payne .... the MOMENT she won't eat, she's at the vet. Our prayers are with you big guy!
 
Re: Risky amps 383--trace Ketones +2 +4

Update----Risky has a bloody UTI. It probably has been present for some time and the high insulin dose probably was keeping the ketones at bay. They gave a Convenia shot prior to telling Martha. Convenia is not labeled or very effective for UTIs, so she is trying to get Clavamox for him. She is on her way to a second vet that uses Clavamox. He also received fluids and the vet offered to teach her to give them at home.

Just for curious conversation.....her local vet called today and told her Risky's bloodwork results were back and Risky's BGs were still high and she needed to increase to 8.5 units. Uggggg....

She is retesting him now for a +6. It is my thinking that we need to increase his insulin dose tonight and continue testing vigilantly for ketones. Obviously, the UTI needs the correct antibiotic and needs to clear.

We need to be careful, because once the UTI clears and the High carb food is out---he should need significantly less insulin.

Suggestions? Advice? Concerns?

Thanks!
 
Re: Risky amps 383--trace Ketones +2 +4

One more thing I left out....She said the vet said the ketones were at 1+ ???? Nancy??? I have no idea if this was on a ketone blood meter or what.
 
On a meter.....
.6 and below is ok.
.6 to 1.5 is "yellow" and you should be calling someone.
Above 1.5 is a high risk of dka and immediate care is critical.
that's for the nova max meter.
They also recommend testing regularly any time bg is 250 or higher.
carl
 
Kitty must eat and get plenty of fluids. Especially if she ups dose
Carl
 
Since I haven't been around much this weekend I don't know the whole story but it looks like she found you just in time Kim! Hope he gets the care he needs from the second vet!
 
Status
Not open for further replies.
Back
Top