911 Ketoacidosis?

I think Boo may have ketoacidosis. There is no money to take him to the vet. I have to treat this at home.

Reasons why I believe he has this.
1) The day before yesterday, I accidentally double-dosed him with insulin. I gave him a few pieces of kibble (the only high-glucose item I have on hand). I watched him closely. He was very high, but he seemed fine.
2) Early yesterday morning he ate two bites of food then vomited. He refused to eat. He drank water. I managed to convince him to drink plenty of water.
3) He smells funny. Sort of sweet-ish. His blood smells similarly.
4) He is begging for food. Is slightly shaky (this symptom is also a part of an unknown brain condition, so it's hard for me to tell the difference).

Please help. I have no idea what to do. Feed him? Give him insulin? Give him gatorade(I say this last one due to the loss of electrolytes)?

 

Are you testing for blood glucose? What is his number? I wouldn't give insulin without knowing.

If he's hungry... I would go ahead and give him food... but... if you can... test his blood glucose first.

I'm sure others will also offer advise.
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His blood was 280. Should I still feed him?

 

Have you been giving insulin every 12 hours? When was his last shot? Do you have a record of his numbers and shots?

 

I'm testing his insulin every 6 hours. His last shot was at 6PM with dinner. I have a spreadsheet, but I haven't posted it yet. His blood was 353 at dinner. He received his regular dose of 2 units of insulin. (I have since learned that using a cat's back is an ineffective place to inject the insulin.)

 

Is that eastern time?
Are you giving insulin every 12 hours hours?
What is the dosage?
Is the 280 a normal pre-shot number?

 

How long has he been getting the 2 units?

 

Is that eastern time?
Are you giving insulin every 12 hours?
Is the 280 a normal pre-shot number?

 

That's central time. He gets insulin once every 12 hours. I've been trying to regulate him. 280 was becoming a normal pre-shot number.

 

So... you're less than an hour away from his next shot... correct? If so... I would wait until his normal shot time... test him again... and as long as his number doesn't drop below 200... I would go ahead and feed him (If it was me... I would let him eat as much as he wants) and give him his normal dosage (just made sure he eats). I'm sure someone with more experience with ketoacidosis will address your questions with that.

 

By the way... how long have you been giving him the 2 units?
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Since I switched him over to an all-meat diet. He was getting 4 units on kibble just so he could function. When I made the switch, I knew that he would need a lower dose. She he's been on all meat for 10 days. He is getting a balanced diet, including liver, heart, eggshells/bone, etc.

Also, I just tested him. He's at 332. When I feed him, give him as much as he wants for food? Should I feed him a balanced meal or whatever he desires? (Sorry, it seems a bit counter-intuitive to me to feed him so much when he's so high. It's a little confusing.)

 

Can you get to the pharmacy this AM and get some ketone test strips? Definitely feed and give insulin. Ketones develop when there's not enough food and insulin and often there's an infection. So food and insulin is necessary to treat ketones.

 

I could probably swing some test strips - I'm not sure that there's a pharmacy open this early in my area, though. Also, I doled out his normal amount of meat, and he won't eat the rest. Should I substitute deli meat(he's more likely to eat that)? Leave him be?

 

As long as the food is low carb... I would let him eat as much as he wants... since he hasn't been feeling well, sounds like he hasn't eaten much since yesterday and is begging for food.
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If you have a Walmart nearby the Relion ketone strips are $6-7. Getting enough food into Boo is very important, even if you have to use a syringe and assist feed.

 

He did eat a full dinner. And I forgot to add that I did convince him to eat part of his breakfast around 11AM yesterday. Albeit, I had to cook it a tad.

 

So you're feeding raw? Pick up a few cans of food, Friskies or Fancy Feast is fine. He may just want a change in food, especially since he threw up his usual food yesterday.

 

Yes. I'm feeding raw. I'll have to pick up those tins. But it appears I may have found one possible source of the issue. Normally he turns his nose up at chunks of meat smaller than the end of my thumb, so I serve the chunks the way he likes: large enough for him to put a paw on and tear. Today he wants the chunks smaller than the end of my pinky. Also, I have successfully bribed him with deli meat. It looks like he's eaten until full. Should I give him his normal dose of insulin?

 

Since his BG was in 300's, yes give full dose. If you can set up the spreadsheet, it will help us see what's going on. If you need help, just ask and someone will do it for you.

 

Thank you! I'll try to get his spreadsheet up after I've dosed him.

 

How's Boo doing? Have you been able to pick up some ketone test strips?

 

Sort of? He peed in my roommate's cat's litterbox. Which is that pretty litter stuff that makes an indication of acidity of a cat's urine. Boo peed blue, which is alkaline. I'll be going to the store for keytone strips shortly. But since switching to his diet he only pees about once a day. Twice if I've managed to sneak extra water into his food. Which I couldn't this morning.
I did check his blood (227). His blood didn't smell funny when I tested him. His breath smells funny, but it smells like liver (which is surprisingly close to the smell it had at 3 AM). It doesn't have the gross tang in it that it did at 3AM, so I'm hoping it's just the smell of the liver I fed him. I just got done converting the excel sheet I had into the FDMB formatted spreadsheet. I'll be posting this as soon as I get done reading the document on how to post it.

 

Glad the smell is gone! It's good to add the extra water to his food, so try to do that each time you feed. Your spreadsheet (SS) looks good! You're getting plenty tests in and seeing some nice blues. You can post on the Lantus forum for help more specific to that insulin and dosing. Let us know when you get that ketone test done.

 

Hello and welcome!
Let me start by saying what a gorgeous boy Boo is! I never seen Linx point Siamese before and I say beau - u - tiful!
Sorry to hear that you have reasons to suspect ketoacidosis. My cat had DKA episode and just like you - no money for vets; we had to care for her at home.

I am not clear as to what exactly makes you think of ketones?

Would you also call this smell acetone-ish (as in nail polish remover)?

The best way to find out is to get strips and test his urine. As Sharon suggested in her post - get any from Walmart or from any human pharmacy. I use "catch with a spoon" method- my cat doesn't mind me being there ladling her pee any longer. I found it easier to compare the testing pad color against the reference color block on the vile of strips under the day light, not electric one, by going out to balcony. The colors for Trace amounts and for Negative are too close to one another and somewhat hard to read.

Congrats on dodging the bullet. I cannot explain the mechanics behind this phenomenon but it has been reported that some kitties respond with higher BG numbers after large doses of insulin. If that's true for Boo then it explain his higher numbers afterwards. I hope that someone with better understanding can explain it better.

Some deli meats contain corn glucose and might elevate the BG. If Boo has ketones (and I hope that he does not!) he will need a lot water. It is easier to mix a table spoon or two (depending on the portion size) of warm water with grounded meat than it is with chunks. Since Boo shown some interest in smaller pieces perhaps you can grind a portion of his meal and mix it with chunks of various sizes? I don't mean to give you more work - I know for a fact that he needs water and mixing it with food / hidden in ground meats is much easier then to syringe giving...

I do hope Boo doesn't have ketones but even so - you are in the right place to get the best help/ shared extensive experience for him. CLICK HERE for very informative post on DKA/food by someone with profound experience in handling human and feline DKA diabetics. You might also find some useful info in THIS DISCUSSION.

Best of luck to you and Boo!

 

I've usually been getting the water in. Since I started, I would make small batches of food, put it into baggies, then freeze and thaw as needed. When I dump the food out of the baggie, I put a little water in the baggie to rinse it. It makes the water taste like dinner, so he's more inclined to drink it. It's been useful!
I'm glad this template was made. The way I do it is good for notes on why the numbers might be the way they are, why I chose this over that, etc. But this is a better way to show me a condensed version of what's going on and the quality of his numbers. I'll head over to the Lantus forum and see if they have any insights!
Will do!

 

Thank you! I love the lynx-point coloring so much. My family was super surprised when his stripes came in. We thought he was a Siamese.

It's hard for me to describe. Mostly because when I think of acetone, I think of the pure, undiluted stuff used to rinse out lab equipment. But, ketones are known to have a sweet smell, hence why we have certain carbohydrates. And there was a page here on FDMB that mentioned that ketones could have a sweet smell. My roommate was up and mentioned the smell was 'medical' somehow. Coupled with this information and some of the behavioral things (wanting food, barfing, slight shaking, etc), I thought the signs could be pointing to that and thought I should get advice ASAP.

I'll be careful in the future with the deli meat (and I'll check to see if it contains corn or anything like that). I think in the moment getting him to eat was my biggest priority. But now I can look into alternatives like fish skin or something.

Thanks for letting me know

 

UPDATE: Repeated process from morning. Gave him dinner earlier due to the smell on his breath having slightly returned. I let him eat as much meat and organs as he desired. His blood was good: 279 (I'd call that an improvement from the past few days). I gave him his normal 2 units. Had a chance to check ketones. I checked twice. The color was trace amounts both times. Definitely wasn't 'small'.

 

Hi, S. You can try baby food meats (without seasoning like garlic, onions, etc.) in place of the deli meats.