UTI- trace ketones in urine.

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Kiki & Lola

Member Since 2023
Hello! Just took Kiki to the vet for a urine recheck because two weeks ago she was given a Covenia shot for a UTI. She still has a pretty bad infection so they send her home with two weeks worth of Marboquin 25mg. The vet said there were trace ketones in her urine also but it wasn’t a cause for concern since her blood sugars aren’t high. She advised me to decrease the insulin dose by .25. Can anyone tell me why this would be?! I always thought insulin is what kept the ketones AWAY. Why would I decrease it? I didn’t think anything of it until I was driving home and now I’m second guessing it and I wish I would have asked why (they are closed now.) Probably going to call and ask tomorrow but I thought I’d write here to see if anyone has a similar experience? Thank you!
 
I would not decrease the insulin dose. You are correct, the correct dose of insulin is what helps keep away ketones. Make sure she's getting plenty to eat and lots of liquids. Water down her food if you aren't doing that already.

Are you testing for ketones at home now?
 
Did the vet get a sterile urine sample (i.e., a cystocentesis - a needle into the bladder) and then get a culture and sensitivity on the sample in order to determine just what the bacteria is? Unless the bacteria is sensitive to marbofloxacin, the antibiotic may not work.

Also, Convenia is not an appropriate antibiotic for UTIs. Its only indication is for skin infections. Vets like to use it because you don't have to pill your cat. It's also problematic in that it lasts for 2 weeks. If your cat has an allergic reaction, it's a huge problem. My vet won't prescribe it.

I agree with Wendy. I wouldn't reduce the dose.
 
I would not decrease the insulin dose. You are correct, the correct dose of insulin is what helps keep away ketones. Make sure she's getting plenty to eat and lots of liquids. Water down her food if you aren't doing that already.

Are you testing for ketones at home now?

Thank you for the reply. I decided to keep the dose the same for now. She has been eating good and I do water her food down already. I have ketostix but I haven’t used them since she was first diagnosed because she’s been doing so well but I’m going to keep an eye on them now with this infection going on. Thank you again! :)
 
Did the vet get a sterile urine sample (i.e., a cystocentesis - a needle into the bladder) and then get a culture and sensitivity on the sample in order to determine just what the bacteria is? Unless the bacteria is sensitive to marbofloxacin, the antibiotic may not work.

Also, Convenia is not an appropriate antibiotic for UTIs. Its only indication is for skin infections. Vets like to use it because you don't have to pill your cat. It's also problematic in that it lasts for 2 weeks. If your cat has an allergic reaction, it's a huge problem. My vet won't prescribe it.

I agree with Wendy. I wouldn't reduce the dose.
Thank you for your reply! The vet did get a cysto and a culture so I am hopeful the antibiotic will work this time. My main concern was why she wanted me to decrease the dose when ketones were present. I decided to keep her dose the same and I’ll be testing her urine throughout the next couple of weeks. Thank you so much :)
 
Her numbers look very good. I wish there were more mid-cycle tests, but I totally agree with keeping her at her current dose. Have you looked into a blood ketone meter instead of the urine strips? They use a drop of blood from the ear like a glucometer.
 
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