Thumper - Mom's home!

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Barbara

Barbara

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Hey everyone! Glad to be back home but sad to have vacation end! I'll update SS later but she's been on .8 since Thursday morning & still running in the highe 200's or low 300's. DH finally got the ketone strips for the Precision Xtra meter & ran that test this afternoon & it's reading 2.0. She's been eating well & keeping it down but she's been mad at him. I don't know what that ketone reading means, for human's it says if BG is over 300 & ketone is over 1.5 consult your doctor. He said he didn't have enough blood but the meter waited 30 seconds for him & he had to stick her again to get enough. I hope I can get a pee test in tonight or tomorrow morning. And I guess I need to raise her up to 1 unit? Welcome home............ :sad:
 
Hmm, I don't know what the ketone meter reading means either, but it concerns me. Can you post on Health and get some info? I know there are others around who have used them, but I don't recall who. I would call the vets in the AM, and if you are thinking of increasing the dose I would move forward with that (I haven't looked at the SS, so no specific advice on dose from me).
 
hi barbara...did the meter come with 2 ketone strips. i thought it did.
if you don't know how to read it...and there were no instructions than please google it and see what the number means.
i'm tempted to do it myself.
 
I have used the precision xtra meter for ketone testing before. Anything around 2 or more you want to be very careful with because that can turn into an issue really quickly. Definitely bump up the dose - with ketones like that you will need to be more aggressive in dosing. Yoda was in that range when I got him, and he was really on death's door (for more than one reason though). Tonight, start mixing lots of water in Thumper's food. You want to increase the water intake to help the kidneys flush out those ketones. Can you test for ketones again in the morning? Once they are in this range, they can bounce up or down fairly quickly. You can look at Yoda's spreadsheet comments for the first week we had him and see how they would jump from day to day. Also, the blood ketone test will be different than urine tests since the urine tests for ketones that have already spilled into the urine, not necessarily how much it has built up in the blood. I have heard that there are three types of ketones, and I think the meter tests only one of these. I do know from experience though, that in the range you are seeing is something to be *very* proactive about, but not necessarily worth an ER trip tonight.

If they are still just as elevated in the morning, you can either increase the dose again to say 1.25u or add an R booster. I used R with Yoda to get those ketones down and numbers down. You start with like 0.25u since it is potent stuff. You don't need a script for it. Any pharmacy will carry it. At walmart a 10ml vial was around $25.
 
Welcome home!

Since your current vet doesn't want to test for ketones, you've tried twice now, is there a different vet at that clinic that you could see or a different clinic. You need to pay attention to those ketones and get them treated sooner than later.

Upping the dose will help but won't make them go away I don't think.
 
getting plenty of fluids in him is helpful.
mix the water into food for that delicious gravy like meal.

sorry to be the bearer of the bad news dear barbara.

ketones, ketoacidosis can be very expensive to treat and very dangerous...altho' i don't remember a fatality here on the board.
still, very dangerous and requires a 2-5 day stay at the hospital.
 
Geez, like I said....welcome home!

I'm not sure of anything....since DH was testing the ketones I just wonder how accurate it was since he waited, stuck her again & added more blood? The only thing different he reports is that she's been griping at him....not really unusual for her. I do add water to her food. I'm planning on getting another test in the morning. I dread calling the vet back or even going there....they acted like there was no need to worry since she didn't exhibit any other signs. Does anyone know if the pee sample has to be within a certain time frame to take to the vet to test for ketones? That seemed to be the only thing they wanted to do but to prevent her from being stressed out by going to the vet I wondered if I could just take a sample in to let them test, then go from there. If they didn't come up with anything from that I would just try to call some other clinic.
 
I would take her in to a new vet in the morning, you need to find someone who will pay attention to this, it can get very serious very fast. They can get a urine sample through a needle, they did that to Harley and he didn't even flinch. Then they can treat it before it get too high.
 
barbara you check the urine ketones yourself at home.
and the symptoms would be lack of hunger..increased thirst...tiredness.
but lets not wait for those.
knowing is good.
let's not worry.
test again with the blood if you can.
you have the keto urine strips right?
 
again let us not worry over it
that never helped anything.
if you cannot get the kitty to urinate in front of you...well, take him in.
if you can get a urine sample, well, that is all you need.
and trace is NOT too bad.
it would be treated with hydration anyway.
 
I agree - no need to take a urine sample to the vet. They will use the exact same strips you will get from the pharmacy pretty much. If you catch a sample, you can put it in the fridge for up to a day before testing, but it has to be kept cold.

As for adding blood to the strip - if it was too long in between sips, the meter would have given you an error message. The ketone strips are pretty forgiving in that area. I wouldn't worry much about the reading being inaccurate.
 
Yes, I have the urine ones & they have been reading "trace" for several weeks. I took her in to my vet & they acted like it was nothing cause she didn't show any other symptoms. I called asking about where to find the Precision Xtra meter & the company sent me one free. The strips I purchased off ebay just arrived yesterday so this is the first attempt to test blood for ketones. She still doesn't seem to be showing any other symptoms so that's why I think taking her to my regular vet is a waste of time unless they could find something in a urine test....they had never heard of doing a test for ketones with blood. They told me last time her bladder was too small to get any urine from. I'm assuming they were just trying to express manually? I don't even know who else to call. Guess I will just have to get on the phone in the morning.
 
Lori - I wouldn't call a 2 reading on this meter "trace". I believe it is more like "elevated". It will be interesting to get a blood reading and urine reading pretty close together tomorrow.
 
why don't we google trace ketones and see what we come up with.
specially feline trace ketones.
 
yeah Kelly, i was thinking of her urine readings.
but even with the 2 on the blood range....still could be minimal.
just want to smooth over nerves.
i don't like nerves and over reacting if i can help it...kwim?
the above link shows that even a mild case of ketoacidosis can be treated at home with hydration fluids.
 
Ok, this is what frustrates the HELL out of me. I just did a test of BG on my regular meter & ketones on the new meter. BG is 232 and Ketones now show 1.2 granted the 1.2 is not great but why the hell is it so much different than th 2.0 that DH got 4.5 hrs ago??? I never know what to do!
 
So according to the info that comes with the meter (for humans, if that matters?) says the range she is in may indicate the development of a problem. The readings from earlier say contact healthcare professional promptly.
 
I would wait until morning and start making phone calls to new vets. Interview them about FD and choose one that has better answers than you are getting now.

Yes, welcome home!
 
barbara, i would trust the number you have now.
and understand that the numbers are not static.
they change.
like the bg's
they get better, they get worse.
 
Lori - no need to google anything. No need to worry about nerves to smooth over. Really isn't anything to worry about in that area. I am very familiar with ketoacidosis actually. I wasn't trying to attack you, nor did I feel attacked, so don't worry! 2 on a blood reading isn't trace. Below 1.5 is technically considered trace. Blood ketone values can bounce around and change *very* quickly, as Barbara now sees. They can spike just as easily as they can lower, which is why I think Thumper needs more aggressive dosing. Ketones are nothing to think lightly of. I know the insert literature says to contact your doctor promptly with a value over 1.5mmol, but it is also on the cautious side to urge humans to do something.

Barbara - add even more water to his food more often and up the insulin dose. You should see a difference with those two things alone. My Oscar is prone to ketones. He threw 0.3 and 0.6mmol readings for a very long time with BGs in the 200s. They never went away until he was consistently riding below 200. With Yoda, his high ketone readings went down with the addition of R and fluids. I went around my vet to get fluids since they refused to give me a script. I was very lucky that Justin (Gator) was in the Indy area at the time and still had a refill left on H's prescription for LRS. He gave me a few bags. I gave Yoda 50ml of fluids every other day until the readings were below say 0.7mmol.
 
Nice welcome back from vacation...guess I'm looking for a new vet tomorrow...as much as I hate it. They have always been good but it seems they don't know much about diabetes. I've been there 15 years & it really bothers me to go somewhere else. Kelly, thanks for the info but I don't know what R is? I'm going to increase to 1 Unit tomorrow so hopefully that will help. This has been such an up & down thing. She was really headed low on insulin then all of a sudden she has gone up & keeps getting higher. I have just stayed confused since her April 1 diagnosis.
 
ha kelly, on the phone with justin right now!
he would be soooo helpful here right now...sigh.
telling me about his drive to see you during a tornado.
and the beautiful rainbow.
ETA: Justin says 'hi everyone...hi kelly...miss you all'

i've told him how hard it has been around here lately and how we could use his help. he gave the awesome clarity to eliminate all the variables first...all of them. then get bold and push the limits a bit.
 
Yes, I miss Justin's advice too - was always *very* helpful.

OMG that day he and his mom came to visit us. Words cannot describe that storm they had to drive through. It was a straight line of thunderstorms. Anyone familiar with thunderstorms knows that the ones in a straight line are the worst. Winds were like a hurricane. Tornado sirens were going off. We had to closet cleared out ready to dash them in there as soon as they got in. I kept calling them to make sure they were ok but everything was so loud they couldn't hear the ringer!

Barbara - if the ketones don't go down with the increased dose today, then we can maybe think about a teeny tiny amount of R. R is the insulin vets use during ketoacidosis because it works just about immediately and is very good at bringing numbers down. It shouldn't be a permanent thing, but something to bring numbers down out of a danger zone until things can be solely managed with a longer acting insulin.
 
Late to this conversation. I know R is used occasionally for a kitty with very high bg levels or by a vet with a kitty in DKA. I would be very reluctant to suggest that it be used with a kitty who is getting less than one unit of insulin and in the 200-300 range. Barbara, I hope you are able to get some readings today and see where you really stand with the ketones. I am hoping things look more settled this am and that adding water and having Mom back home has helped.

Is Thumper still eating well? Does she seem dehydrated at all?
 
Welcome home Barbara!
Sorry you are dealing with this as soon as you get back
Just keep an hangin in there...and you will both get there!

Denise and Shakes
 
Sorry to hear you came back to a stressful welcome home. You and Thumper are in my thoughts, sending healing vibes for some better #'s today. Hopefully, the increase in dose and extra water in the food will help zap those nasty ketones.
 
Just wanted to mention a couple things that jumped out at me as maybe needing some clarification:

1) There is a difference between ketones and DKA. Ketones can be present w/o any symptoms (is that right?), whereas DKA is once it has reached the crisis point and then there are plenty of symptoms, and a fairly low survival rate. So that's where you want to get the ketones down before it can turn to DKA. (Hope I got all that right, please correct me if I'm wrong, I am not an expert and do not have ketone experience).

2) Ketones are caused by a lack of insulin rather than by high numbers. Sometimes I think we get overly focused on the #s and lose sight of other things (myself included). So if there are ketones present you basically have to increase the amount of insulin they are getting, whether it is a higher BID dose, shooting more often, or adding in something like a fast-acting insulin. You would still test of course for low #s to be sure you don't get into hypo danger, but you would approach things differently, for instance probably shooting on PSs below 200, not trying to finesse the dose as much but rather going with the higher range of doses that you think are safe, etc.

Apologies for not helping you more with this sooner. It didn't register for me that he's been seeing trace ketones, or I would have been pushing for more insulin. Sorry about that.

Lori, please give a big hello to Justin!!!!!!!!! Really miss having him here. :YMSIGH:
 
PS If you do decide to use R, be sure to get some info (sounds like Kelly has used it?) about its onset, nadir & duration, and how to use it effectively in conjunction with PZI, as well as starting doses of course. You want it so the nadirs don't overlap I would think. I have never used it.
 
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