911 Emerg ketone Q

im regulating my neighbors cat. His BG was high today. He has between low-moderate jetones. Should he go to ER

Amps 288
+8. 439
Pmps +11.5 544
+1.75 504
+3 465

Has. Not eaten since p.m. pre-shot. Is wobbly and is very tired and weak. I caught his urine and used the keto strip.

Is on vetsulin 0.6u bid dose (1.5u

 

Anything over trace is usually an emergency.

I'd hate to have anything happen to your neighbor's cat while in your care.

I'd take him in...especially if he's not eating and looks like he's tired and weak.

 

Oh shoot, ok, didn't know that. OK, yes, she is taking him right now and should be arriving any minute. I called them to let them know in advance that he was coming in.

 

His numbers are in the first link in my signature...

 

I'm glad she took him in....ketones are nothing to play with.

Keep us informed...we care!!

Prayers for Chewy

 

OK, update, my neighbor just called. Doc took copies of all my BG test sheets (in a notebook) with all the BG numbers for the past 4 weeks that I've been regulating Chewy. (Prior to the past month, Chewy was put on 5U BID of Vetsulin using a u40 needle. I was pretty sure he was going into hypo every day. He was running away from the shots, biting those who tried to give him one.) She asked me to catsit over thanksgiving and I started doing BGs (she had never been doing them) and I started him on 0.75U using a u100 needle with 1/2 unit markers. Had NO IDEA that these needles gave different doses. Over the past month have gotten him ALMOST regulated on 1.5U of Vetsulin using u100 needles (which works out to be 0.6U using the u40 needle--compared to his 5.0U dose before!!)

anyway, this ketones thing is scary.

But apparently, doc said she agreed with everything I had been doing! And said that yes the 5U dose was crazy. She said Chewy should be fine barring anything unforeseen but they were going to test for pancreatitis and do a urinalysis. Putting him on fluids. She was going to hold off on giving more insulin. He had dropped another 30pts or so since I last test him 30-45m prior.

anyway, so I think he'll be ok. Don't know why he got the ketones though? She says her vet has never told her he had them before and also never told her to check for them (I'm the one that told her to get the keto strips)

Any ideas on why he suddenly could have developed ketones esp as he was almost regulated?

phew.

 

The recipe for ketones is not enough food + not enough insulin + an infection/inflammation....so I'll be interested in hearing if he has a UTI

But ketones can be produced even in a cat with normal numbers.....it's not as common, but it can happen

 

Well his kitty friend whom he lives with had diarrhea for past week or so, although seems to have resolved in past few days. Wondering if he caught something from the other cat?

So maybe infection making him not hungry, then not eating plus low insulin dose...?

I guess we'll see. Hopefully he will be ok. The vet sounded hopeful apparently.

 

Sounds like you caught this early which makes treating it a little easier. With the other kitty having been sick, seems logical this is likely a case of Chewy picking something up from the other kitty. Do keep us posted!

 

YES, he has a UTI. Vet said it was a combo of not eating, either high or low BG and the UTI that caused the ketones. His potassium was really low. apparently he is better and they started him back on insulin (not sure how much) at 9am (around regular shot time yesterday morning. Kim, his mom, went to visit him last night. She didn't think he looked very perky, but his prognosis is good. BUT turns out he also has pancreatitis, not sure Kim knew that, she had not mentioned it. So that is a bit of a worse outcome.

Not sure when he is coming home, might be later today. I'll keep you posted. Don't know what the vet did insulin dose wise. But apparently he was in the mid 200s all day yesterday after they gave him his 9am dose. Since the one vet seemed to think my dose was good (and that the 5U doses were 'crazy'), maybe they kept it low.

 

Keep us posted.

 

Thanks for the update. All paws, fingers and toes crossed for Chewy's recovery!

 

I am heartbroken to report that Chewy had to be put to sleep.

He went to ER on Wednesday night and when I spoke to the vet on Thurs morning she said he had done well and potassium was balanced, etc. And that he had pancreatitis and was now on a painkiller and antibiotic for the UTI. She said he had perked up. Then when his mom when to see him after work on Thurs night she was not so hopeful, said he looked lethargic. She said he had not eaten but a vet tech had syringed some baby food.

Then yesterday Friday morning, I guess they called her at work and said he had taking a bad turn over the night, apparently with jaundice and hepatic lipidosis. This was all through text and she did not want to talk but she said that they all agreed had to be put to sleep She said the vet and vet techs were all crying (I'm sure she was sobbing.)

All of our communication was through text, she did not want to talk. I asked if the vet had said if I had done anything wrong and she said no, it was not my fault.

I am in shock and heartbroken I had fallen in love with the little guy in the month that I had been taking care of him and seeing him 2x or more a day.

I just am confused...ok, so how did he get the UTI? And I am assuming that she never knew he had pancreatitis...so perhaps he got a bout of it, was in pain and stopped eating..and that brought on the lipidosis. This happens in a matter of....2? days I think because he was FINE on Tuesday and then Wednesday he wasn't. (although she had thought he wasn't eating--that neither of her 2 cats were--in the few days prior to Wed...I just wasn't sure. He had eaten treats from me and so hard to tell whose eating.

His blood sugar numbers were fine-in the 200s- until Wed night when he went into ER and had ketones. Suddenly skyrocketed. (and on no food I guess)

So I am still not sure why they were not force-feeding him at the animal hospital? Surely they know the risk? And since I have not talking to my friend I have no idea about all the details, but not sure why more could not have been done? I had a cat in the animal hospital for 2 weeks with hepatic lipidosis (a new rescue pulled from the kill shelter who had also stopped eating or been eating less and he was an obese cat and I didn't notice with 7 cats..he also had had multiple vaccinations at the kill shelter, too many in a row and I think that led to the organ failure, too) I had to put Lenny down in the end and I do wonder if that 2 weeks (and $12,000 even with rescue discount) was worth what he went through. But I have his sister, Chloe, and they loved each other so much that I wanted to keep them together...

But WHY can't the vets get calories into the animal in this state? Why no kcals in the IV line??

Heartbroken. Poor Chewy. So sad that I will never see him again. I know that my neighbor is a wreck. She retreats during times of stress (has happened before) so I don't expect to speak to hear anytime soon. I'm sure this will take her a long time to get over.

 

I'm so very sad to read this. You did all you could for this kitty.

 

Unfortunately, there are often too many questions that go unanswered in these situations. Perhaps Chewy wasn't eating well for more than a day before he got sick. Developing a UTI is not at all unusual for a diabetic cat. It's very common. A combination of not eating enough, and infection despite less than exceptionally high BG could lead to ketones.

My heart goes out to you and your neighbour. These little creatures wrap themselves around our hearts and it's crushing when they leave us. They are never with us long enough. Please know you did everything you could to help the little guy and this unfortunately was out of your control.

 

Sending purrs and prayers