Beyond the ketones (but of course check them), the inflammatory cascade that happens with pancreatitis &/or triaditis, IBD can literally creep up, CHANGE & then change again drastically over hours/days, so it is not uncommon to end up in a similar situation you were in Dan--even without ketones. We were on top of it with a team supporting us & it was still incredibly complicated & exhausting & there were multiple vet visits. No one missed anything. It was just the nature of the beast of the disease state. It was essentially like operating against a moving target

! We would have a vet visit & change treatment, then something would change with his symptoms at home so we would go back to the vet & the new labs changed as well. Lab values that were off resolved but then there would be new issues. Hospitalization was eventually required to get it under control. When inflammation takes over & infection occurs with multiple organ systems it is becomes so critical so fast

. Such tiny bodies just like a baby--they go down quickly.
You did the best thing you could have done by repeatedly taking Luna back to the vet. Even without ketones, unfortunately, the underlying disease state does cause extremely critical & life threatening issues quickly.
BTW I love that Luna has broken the record for longest Lantus Land Condo History


& Amen to a new thread to leave the bad stuff behind

!