? Update- Ketones

Julie mueller

Member Since 2019
My cat was at the vet today due to not having an appetite for a week . They did a bunch of tests .. I wont get the results until tomorrow but they did say he has a double ear infection and they treated him for it . And said he has "trace ketones" (I dont know what that means ) Now tonight he ate half of his dinner and his BGL is 191 . Should I give his shot ? Or skip the dose
 
Can you get a test at +2 or +3 tonight, to see where he's going? Again, these are safe numbers right now, we just want to make sure he keeps it that way, especially if his appetite isn't back yet.

I'm so glad you took him in to get that ear infection treated! Hopefully he'll be back to himself soon, but you will have to do some extra monitoring until he's back on track.
 
Ketones:

When a cat is not eating enough, or not getting enough insulin so their body can properly process the food they are eating, there is a process that happens. Not a pretty one. The cats body starts to cannibalize it's own fat and muscle tissue to produce energy to feed the cats body needed nutrients. That breakdown of tissue gives off a byproduct called ketones. The ketones build up in their body and can make them really, really, sick. Ketones are a waste product. They can cause a life threatening illness, DKA. Expensive week long emergency care, at the 24 hour vet clinic, expensive is often required.

Run, don't walk, but hurry out and buy yourself some urine ketone test strips. Use them to test your cat.

Urine Catching Tips

You certainly don't want anything more than trace ketones. You need to be testing for ketones at least 2 times a day.

Those ketones are telling us that your cat is not eating enough, not getting enough insulin, and has an infection/inflammation. Classic setup for ketones. Which can lead to DKA (diabetic ketoacidosis).
 
I removed the 911. Could anyone explain to me more about what " trace ketones " means ?

Ketones develop in a diabetic cat as a toxic by-product of inappropriate fat and protein breakdown when cells can't get proper nutrition due to: not enough food, not enough insulin (to help bring glucose into the cells), and some other stressor (like the ear infection) throwing things out of whack. Some key things to keep in mind about ketones are 1) they can develop very very quickly under the right conditions, quickly reaching a life-threatening situation, and 2) once they really get going, and in particular once a kitty is in what is called diabetic ketoacidosis (DKA), they are really really hard (and really really expensive) to treat.

So, catching them at the "trace" level, and taking immediate steps as you did, is definitely the way to go if you can!

More details here:

Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters
 
There is a blood monitor that also tests for ketones in the blood. There are separate test strips that are available for that type meter.
 
Several folks here have used the blood ketone monitors. The strips are super-expensive, but you don't have to use lots of them, most of the time (you may have to test a couple times a day in your current situation, though). They can be a little finicky to use, requiring large drops of blood (leading to more wasted strips when the amount is insufficient, arrggh!), but are good tools to have for cats that are difficult to test using the urine strips.

As for the urine testing, it might not be as bad as you are thinking, there are lots of ways to do it: Tips to catch and test a urine sample
 
So, the 4T of gravy food plus around half his usual Friskies pate dinner? That should be a decent base for when the insulin hits. I would test again at +3 or +4 to see how he's doing, but this is a great start.

Are you able to leave food out for him to nibble in his own time?
 
Are you able to leave food out for him to nibble in his own time?[/QUOTE]

No I'd say more like a quarter of a can of pate. And then the 4T since the shot . And yes I leave it out for him all night but he doesnt usually go back to it once he goes to sleep unless I wake him up haha .

Now let's say i test at like 12:30 (+3.5) and his number is around the same do you think I'm in the clear? Or no?
I have 2 very small kids so staying up all night and then doing normal motherly duties in the morning is rough.
 
Totally understand.

The numbers to keep in mind are 50 for the human meter, 68 for the AT. Those are our "take action" numbers, when the BG drops below them, it's time to pull out some high-carb food or honey to bring it up.

He's quite far above those danger lines. I would expect him to go down a bit more from where he is now at +3.5 (not making an actual prediction on that, after all, he's a cat so he's always going to do the unexpected!), but as long as he's not going down rapidly (50-100 pts in the next hour and a half), and especially if you can convince him to eat some more of his dinner :rolleyes:, I think you should be good.

I probably won't be around much longer tonight, as I also have early-morning duties, but I think @Christie & Maverick said she was going to be up, so there will be at least one person you can bounce the actual numbers off of when they come in.

Hope he's feeling better soon!
 
Totally understand.

The numbers to keep in mind are 50 for the human meter, 68 for the AT. Those are our "take action" numbers, when the BG drops below them, it's time to pull out some high-carb food or honey to bring it up.

He's quite far above those danger lines. I would expect him to go down a bit more from where he is now at +3.5 (not making an actual prediction on that, after all, he's a cat so he's always going to do the unexpected!), but as long as he's not going down rapidly (50-100 pts in the next hour and a half), and especially if you can convince him to eat some more of his dinner :rolleyes:, I think you should be good.

I probably won't be around much longer tonight, as I also have early-morning duties, but I think @Christie & Maverick said she was going to be up, so there will be at least one person you can bounce the actual numbers off of when they come in.

Hope he's feeling better soon!


Thank you so so much !
 
Yes, considering that he's staying very flat, if he were planning on dropping with an active cycle, he'd have likely done it by now. It is a bit harder to analyze since I can't see much of his regular patterns on the SS. I'm glad you have food available overnight, and I think you can head to bed now yourself.
 
Does Smokey sniff at the food like he is interested in eating, and then turn his head away? Walks away from whatever food you have out for him?

If so, he may have some nausea. Any other symptoms, like licking his lips or lots of salivating or drooling, swallows alot? Excessive meowing or vocalizing, restlessness are other possible signs of nausea.

You may want to ask you vet about an anti-nausea medication.

p.s. We gave you a lot of information last night, and you were in super anxious worry mode, so you probably did not take all that info in. Might be useful to you to go back and read through this thread from the beginning.

Then ask questions for anything we said that you do not understand.
 
Does Smokey sniff at the food like he is interested in eating, and then turn his head away? Walks away from whatever food you have out for him?

If so, he may have some nausea. Any other symptoms, like licking his lips or lots of salivating or drooling, swallows alot? Excessive meowing or vocalizing, restlessness are other possible signs of nausea.

You may want to ask you vet about an anti-nausea medication.

p.s. We gave you a lot of information last night, and you were in super anxious worry mode, so you probably did not take all that info in. Might be useful to you to go back and read through this thread from the beginning.

Then ask questions for anything we said that you do not understand.


He will eat people food and canned dog food but wont eat his cat food ‍... I'm going to go out today and get some fancy feast. Maybe the change in brand will be enticing. I'm also going to get some tuna so I can put a little juice on top of his pate to make it more appetizing .

I ordered a ketone blood monitor today and it will arrive tomorrow so I'm going to test tomorrow for that . I've been going through old posts and trying to learn about ketones.

I also should be getting a call today from the vet with the blood panel results to find out if it was just the ear infection or something more .

As of now the trace ketones is what has me the most worried .

Other than him being difficult at meal times hes acting completely normal.
 
Trace ketones has us worried too. Did you get some ketone test strips at your local pharmacy?

This document, although written from the perspective of Transitioning a Dry Food Addict to Canned Food, does have a lot of suggestions to get a cat to eat.

I'm very familiar with that transitioning food document, since my diabetic cat Wink was a founding member of DFAA (Dry Food Addicts Anonymous). ;)

These documents may be useful to you also.
Suggestions on How to Stimulate Kitty's Appetite
Syringe/Assisted Feeding (Video and Tips)
THE '~LIVER SHAKE~' FOR SICK CATS

Does he like a different texture than the pate? Have you tried adding some water to the cat food, to make it a bit soupy?
 
Trace ketones has us worried too. Did you get some ketone test strips at your local pharmacy?

This document, although written from the perspective of Transitioning a Dry Food Addict to Canned Food, does have a lot of suggestions to get a cat to eat.

I'm very familiar with that transitioning food document, since my diabetic cat Wink was a founding member of DFAA (Dry Food Addicts Anonymous). ;)

These documents may be useful to you also.
Suggestions on How to Stimulate Kitty's Appetite
Syringe/Assisted Feeding (Video and Tips)
THE '~LIVER SHAKE~' FOR SICK CATS

Does he like a different texture than the pate? Have you tried adding some water to the cat food, to make it a bit soupy?


I got the blood meter and strips from Amazon.. it arrives tomorrow.

I will read through those links . Thank you .

Does trace ketones happen and then go away and end up being nothing?
 
The trace ketones can either get worse or get better. Resolve quickly or take time. And they can happen or occur again, when the same or similar conditions present themselves.

Sometimes, if you catch the ketones early enough, it can be quickly resolved.
When you are fighting ketones, you are trying to eliminate/get rid of/ reverse the 3 main causes of their formation. How successful you are at doing that determines how quickly or slowly the ketones can be resolved.

The 3 main causes are 1. lack of food (or not enough), 2. lack of insulin (or not enough) and 3. presence of some type of infection or inflammation. Dehydration can make the presence of ketones worse, because when a cat's body is dehydrated, there are not the fluids needed for those waste products to be filtered out of the blood by the kidneys.

It's why subq (subcutaneous) fluid therapy is an important part of treating ketones. Adding water to the food, or syringing small quantities of water into a cat's mouth cheek pouches can also help re-hydrate a cat. Or putting out a dish of some sort of low-sodium broth or calm juice could help too.

Sometimes a cat is not very interested in drinking water, but some chicken broth may be tempting to them. It's easy and quick to boil up a bit of chicken thigh (dark meat is more flavorful) in a bit of water and let your cat drink some of that water. Cut up the piece of chicken into small pieces, and use as a treat or topper on the food. Excess pieces of chicken can be frozen.

Tools/medications for fighting ketones include:
  • food and plenty of it (so the fat and muscle cells are not cannibalized for energy)
  • insulin and plenty of it (so the body can process that food)
  • antibiotics (to treat the infection/inflammation)
  • anti-nausea meds (so cat feels like eating. upset stomach means no one wants food)
  • appetite stimulant (to get cat to eat on their own)
  • fluids (to re-hydrate)
  • pain medications (if cause of not eating is from something like pancreatitis)
  • assist feeding or hand feeding (if cat will not eat on their own)
I'm sure I have forgotten to mention some things. Hopefully if I have, someone else will chime in on this thread.
 
The trace ketones can either get worse or get better. Resolve quickly or take time. And they can happen or occur again, when the same or similar conditions present themselves.

Sometimes, if you catch the ketones early enough, it can be quickly resolved.
When you are fighting ketones, you are trying to eliminate/get rid of/ reverse the 3 main causes of their formation. How successful you are at doing that determines how quickly or slowly the ketones can be resolved.

The 3 main causes are 1. lack of food (or not enough), 2. lack of insulin (or not enough) and 3. presence of some type of infection or inflammation. Dehydration can make the presence of ketones worse, because when a cat's body is dehydrated, there are not the fluids needed for those waste products to be filtered out of the blood by the kidneys.

It's why subq (subcutaneous) fluid therapy is an important part of treating ketones. Adding water to the food, or syringing small quantities of water into a cat's mouth cheek pouches can also help re-hydrate a cat. Or putting out a dish of some sort of low-sodium broth or calm juice could help too.

Sometimes a cat is not very interested in drinking water, but some chicken broth may be tempting to them. It's easy and quick to boil up a bit of chicken thigh (dark meat is more flavorful) in a bit of water and let your cat drink some of that water. Cut up the piece of chicken into small pieces, and use as a treat or topper on the food. Excess pieces of chicken can be frozen.

Tools/medications for fighting ketones include:
  • food and plenty of it (so the fat and muscle cells are not cannibalized for energy)
  • insulin and plenty of it (so the body can process that food)
  • antibiotics (to treat the infection/inflammation)
  • anti-nausea meds (so cat feels like eating. upset stomach means no one wants food)
  • appetite stimulant (to get cat to eat on their own)
  • fluids (to re-hydrate)
  • pain medications (if cause of not eating is from something like pancreatitis)
  • assist feeding or hand feeding (if cat will not eat on their own)
I'm sure I have forgotten to mention some things. Hopefully if I have, someone else will chime in on this thread.


That was all super helpful . Yesterday they gave him subq fluids and did the meds for his ear infection.
Today I'm feeding him small amounts of food through out the day . Only thing hes been super interested in is my pups canned food so I'm letting him eat that . I'm going out today to get different options for cat food and tuna. Plus I'll cook up some chicken and broth for him .

His +3 number was 248
 
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