Gomez's curve and a ketone question.

Yesterday and today, I did a curve for my vet. If you look at his spreadsheet, you will see 2 sets of numbers for yesterday and today. The second set was taken on the AlphaTrak. My vet asked me to use the AlphaTrak for the curve since she is more familiar with those readings. Anyway, yesterday was a really bad day. I have no idea what happened, but he was very high all day. Today looks more normal. Has anyone seen this type of curve before or this type of extreme variation in a curve?

Also, I have been worried about ketones since his readings are so high. I bought a NovaMax meter, but I have been afraid to use it. I was afraid - if it was high - that I wouldn't know what to do. Anyway, I took it to the vet's office today and took a reading there. It was 0.7. (My vet is also testing for ketones via a urine sample.) Can anyone tell me exactly what a 0.7 means? I know that I don't have to worry if the reading is below 2.5, but what does 0.7 mean? Does it means that he does have some ketones but they are not at a dangerous level? Is this normal for a diabetic cat - or should I have been looking for 0.0?

 

Can not speak for the ketones but was wondering what did the vet say about dosing after checking the curve? It happened to us as well, having different numbers after performing a curve, going lower or higher. Maybe you can mention to the vet the new numbers you got after testing today.

 

My cat had been giving me 0.6 and 0.8 the past couple of weeks. It's a small trace of ketones. Nothing to worry about but keep watching. I would test every couple of days or if the behavior is odd or numbers really high. My highest rating was a 1.3 and I could definitly smell it on her breath. (Smelled fruity which is how I knew something was off.) Thankfully it went down after that.

 

The vet did see today's numbers. I kept recording the curve right up until my appointment time. She has suggested that I increase his dose to 2.5 units. We agreed that I would continue at 2 units for a few more days to see if today's results become more of the norm.

 

I agree with your vet. Go to 2.5. Esp if you're getting trace Ketones.

 

Looking at your notes I'd think it was the RC dry that bumped the numbers up.

 

Hi there,
about ketone's reading - 0.7 on Nova Max=negative.
With such high numbers it's worth keep checking for ketones daily.

I know of a cat who, being very well regulated, all of a sudden produced ketones whilst being in good Blue numbers.
You 'll never know where it hits with ketones. Testing at home is the best way to stay ahead.

If the Nova blood ketone tester - BTW, a really good tool to keep on eye on things ( I wish I can afford one for my cat!) - is too intimidating do try very simple ketone test strips for urine (human pharma) - you either catch a sample of urine by placing a ladle or a spoon under the stream and then dip the testing strip into it, or you place the testing strip itself under the stream of urine whilst cat is at it but many cats are too private for this method. I think it is easier for us, the caregivers to use strips but medically speaking - the blood test is more accurate/ current on the Nova tester then on any strips available OtC.

I can totally relate to your concerns.
But
...If you caught the ketones raising in their early stages - then it is better chance for your cat to recover.
Going acidic is tough on them, and many vets will kill - , oops, sorry, Moderator, I meant "euthanize" - rather then burden you with really sickly cat to care at home. It's hard and hurts but really - it is better for the cat if you to know the bitter truth and act ASAP then rest in wishful thinking that the ketones will dilute or dissolve themselves and not to test because it is hard on you.
If you caught ketones in their lowest level at home - then some action like SQfluids+extra insulin+extra food can help it.
Otherwise - thousands $$$ for hospitalization that DOES NOT guarantee a recovery.

0.7 in my understanding is Negative, and all it means, IMHO, is that you have to stay vigilant with ketone testing - daily until BG# improves, and then weekly, and also that you have to assume that your kitty is forever ketones prone and you are to get more aggressive approach in dosing and to establish ketone testing as your regular, your daily routine. Does it make sense?

Wishing you both the very best!


PS. It does look to ME ONLY like an increase in insulin is due but you 'll know better.

 

Hey there, you are using a blood ketone meter so the important thing to remember is that with cat blood on a human meter, ketones do not start until 2.4 -2.5 so that reading you got today was no ketones! So, that is good news.

It looks like the nice blues you got today on the human meter has thrown Gomez into a bounce since he is not used to being there. It's been a while since he has seen even a blue number.

See how the numbers are higher with the AT2? The cat meter runs higher than the human meter, but since the protocol here is written for a human meter, those are the numbers we are going to be concerned with for dosing increases and /or decreases.

If it were my kitty, tomorrow morning I would increase to 2.25 u. I think he needs more insulin.

 

Thanks to all of you for your responses. I think Gomez was really stressed at the vet yesterday afternoon and that, combined with a bounce off the blues may account for his outrageous preshot number last night. I am glad to see that he has gone down since then.

About ketones -- Gomez is in congestive heart failure and can't receive sub-q fluids per the cardiologist. I am afraid of the meter because I'm pretty sure that if his ketones get dangerously high, there will be little I can do for him to bring it down. I guess the good news is that the cardiologist increased his Lasix dose yesterday because his respiration rate was high. With the Lasix - and the diabetes - Gomez drinks a lot of water and pees a lot. I am hoping that if he does get trace ketones, the drink and pee cycle will flush them.

His appetite was good this morning and he seems to be resting comfortably.

 

I am so sorry that Gomez is in congestive heart failure.

Remember that knowledge is power and if he starts showing ketones on the meter ( cats start at 2.4 - 2.5 on a human meter) then you can help him by feeding him a little more and adding some water to his food, ( even though you think he is drinking enough) and making sure that he is getting enough insulin. Then you can immediately get a handle on things and prevent him from a DKA event.

The recipe for DKA is not enough insulin + in appetence + a systemic stress.

You would post for help and peeps here will assist you.

Use that meter Fluff Bunny especially while he is in higher numbers.