Shaikha's ketones = 1.0 on meter... what now?

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wombat88

wombat88

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Shaikha is throwing ketones again, but this time they are above the 0.6 level on the meter. She is eating and acting normally. I tested twice just to be sure. I had just tested her mid-day glucose (189) and had a large blood drop so I did ketones as well. That was 0.9 on the meter. I thought that maybe the blood wasn't fresh enough so I tested a different ear and got 1.0 on the meter this time. My meter says 0.6 - 1.5 means a problem requiring medical attention may be occurring. From the user manual, it seems that 1.5 - 6 is means see the doctor and above 6 is get to the hospital now. I can't test her urine, I've tried. She runs away from the litterbox if I try to get near her with strips so the best I can do is use the blood ketone meter. What should I be doing to ensure we don't have a problem?

Her glucose the past two days has actually been decent, with mostly yellows and blues. I did cut her dose a little from 0.9 to 0.8 because she was swinging too much. I was going to hang out at 0.8 and not try for greens until I was sure she was settling down some. Her appetite was poor a few days ago but actually picked up some the past two days. She does have running poo now because I let her eat Fancy Feast the past two days in order to get her to eat better. I switched her back to her hypoallergenic food this AM. I don't know if the food change could have contributed or not. More likely responsible is the fact that she hasn't gotten subQ fluids the past 2-3 days. She had developed a swollen area (not painful) where fluid sometimes migrates so I was trying to give her skin a rest from them in order to let it heal. It is less puffy now but maybe that wasn't a great idea.

She's still on antibiotics. I also added Fortiflora two days ago in an effort to try to perk up her appetite. That's a probiotic mostly so I wouldn't think that could trigger an increase in ketones. My guess it is pancreatitis.

What should I do? I plan to give her 100ml of subQ fluid now. Anything else I need to do? How often to monitor these levels?
 
Hi Wendy
I am sorry but I dont know what todo for Ketones,
hang in there I am sure someone will be on soon to help
Sending healing vibes your way!

Densie and Shakes
 
Thanks, Denise. I've cross-posted on Health so hopefully someone can tell me what I need to do. The FAQs don't really tell you much other than to test for them.
 
Give the sub qs--great defense against ketones

I use urine strips, so I am no help on the meter. Hopefully Nancy will be along shortly.
 
I have no experience with a low ketone levels, only with large ones and you certainly don't want that to happen.

Seems lots of people are active around the 6:00-6:30 timeframe, so hang out until then.

Good luck!
 
UPDATE: I just talked to a vet hospital nurse who then relayed the info to their doctor on call. They felt that it was not an emergency given that she's eating and is acting normally, but they did want me to give subQ fluids and suggested I bring her in to my vet tomorrow morning.

My regular vet then called me back (I'd left a message on his mobile previously, which is why I called the vet hospital as well). Since she's eating and acting normally, he also thought she'd be okay but wants me to retest her ketones at 6pm my time. If they are still high, then we'll take her in for blood tests and fluids tonight if he doesn't like what he sees. He thought that the subQ fluilds would make a big difference as would the food and insulin she got mid-day.

She's been laying in the sun and acts like nothing is wrong, so I'm hoping that continues. Will post again after I check ketones in an hour from now.
 
I think the fact that she is behaving normally is very good. They really can tell us when something's wrong, can't they?
 
Wendy, I didn't read everything & it looks like you're not on but Nancy told me anything under 1.6 on the Precision Xtra meter was nothing. I'm sure you need to keep an eye on it though.
 
I am crazy about Payne's ketones, so I actually called Abbott because I kept getting the same thing, need medical attention ..... ?? and yet on the urine, nothing.

It took them 2 days to get back to me but they claim on cats the safe zone is under 1.6 ..... apparently human diabetics are measured differently.

I have run urine/blood #'s together and it really does work out that way for me ..... I would try and get a urine also. SQ fluids are good also and unless it goes higher and you are getting above small on the urine, I would just keep monitoring.

And yes, BREATHE!!!
 
Just retested her and she's back to 0.0 ketones on the meter! So perhaps the subQ fluid, mid-day food and insulin all worked together as my vet suggested they might. Would ketones disappear that quickly? I am sure they existed though because I'd retested with a new box of strips and the reading was virtually the same (0.9 then 1.0). She's drank water a few times since the fluids, but I'll be sure to put extra water into her canned food tonight (she likes soupy food anyway) too.

I will definitely NOT skip her fluids again, that's for sure. My vet wanted to see her tomorrow even if her levels dropped just to be safe. I'll leave her at the clinic so he can monitor her throughout the day, but hopefully if I keep up the subQs she'll not throw them again. Thanks for all the suggestions!
 
I don't know much but I do think I've heard they can come on quickly so I guess they might go away just as quickly? So glad she's back at zero! I still haven't read the whole thread...I've got too much going on!
 
Nancy and Payne said:
I am crazy about Payne's ketones, so I actually called Abbott because I kept getting the same thing, need medical attention ..... ?? and yet on the urine, nothing.

It took them 2 days to get back to me but they claim on cats the safe zone is under 1.6 ..... apparently human diabetics are measured differently.

I have run urine/blood #'s together and it really does work out that way for me ..... I would try and get a urine also. SQ fluids are good also and unless it goes higher and you are getting above small on the urine, I would just keep monitoring.

And yes, BREATHE!!!
Click to expand...

Thanks so much for this information, Nancy! I will have to figure out how to get urine tests on her. I've got a high-sided box that I will try to put that hydrophobic sand in. Not sure if she'll use it but I can try. I really want to use the urine strips because the blood strips are so darn expensive!

How do you use the two together, Nancy? Do you usually use urine strips and then go to blood if above a certain level? I thought you'd said something like that before. Sorry, feeling a bit scrambled here. Breathing now.... This was not excitement I needed today!
 
I have a theory on ketones .... there are some cats that routinely throw off ketone, like Payne. When you add the second thing to ketones .... like less insulin, infection, etc. then you have problems.

But for Payne (ECID) she cycles ketones and we don't know why?? It can start trace with the urine and I will do the blood and it will be 2.4 or more and then! off we go!! I can give her R and SQ fluids and by evening it will have cycled up to 4.0+ on the meter! regardless of what I do .....why? who knows but I have stopped giving her R for it anymore UNLESS there is a second problem. Then by her last shot at 10PM she is starting to go down again and the next morning nothing.

I use the urine strips every day .... then if I catch something there I will do the blood meter, strips are cheaper on eBay. And with Payne, ketones are not actually a really bad thing, like I said unless something else is wrong. I have messed up her BG#'s trying to totally get rid of ketones and now I'm working on her being as healthy as possible. Disclaimer ..... ECID and Payne has had DKA four times and I have a lot of experience with ketones and R.
 
Well, this evening she's back to not eating again. Ugh. Not sure why but she was acting like she wasn't feeling too well (nauseous-like). I assist fed her canned food and gave insulin. I retested for ketones and the meter read 0.1 so that's normal. I'm not sure what is going on with her, but will take her to my vet tomorrow anyway. I can't monitor her that closely tomorrow due to work so this way they can at least do some urine ketone tests and ensure she's not getting into any trouble. We've had a few incidents the past few days with pee on the floor, so I wanted to have him check her for a bladder infection anyway. The lack of appetite may be a food strike of sorts in order to get Fancy Feast, but I need to keep her on the hypoallergenic food since she's developed soft stools from the other. Then again, the soft stools from the Fancy Feast may be making her feel poorly and causing inappetance as a result, or it could simply be the anemia or pancreatitis causing the problem. :?

At least I got food into her. Hoping for a better day tomorrow!
 
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