Our Dweezil last year while we were away, got DKA and almost died. Thankfully he was a resilient boy and the vets were able to save him. We had already been testing him for years using Ketodiastix but at the cattery while we're away his stress level seems to rise (though he seems ok, loves the lady and eats well) so he always needs a much higher dose of Lantus than he gets at home. Which we now know. Anyway, last November and again 3 days ago, at home, I managed to get a pee sample at a random time and thank GOD I did, as both times there were ketones. The first time it was 1am and the ketones were "small" on the strip. I freaked out, remembering the other 2 times. I then acted, gave him an extra 1.5 units of lantus (8 hours after his previous shot and 4 hours before his next one), wet food with mixed with water and encouraged him to drink water. I then prayed he would live through the night. The 24 hour emergency vet is...not so good. In the morning at 5am my partner does the feeding and insulin and I said you MUST GET A PEE. YOU MUST. Usually this is easy but some mornings Dweezy just seems not to do one until later. It was down to trace levels. THANJ GOD, I said! He then had his regular insulin and breakfast, seemed happy and not lethargic like the night before and ate well, and although at 11am his next pee still was trace (at which point I called our vet for help), by his 5pm pee, NO KETONES AT ALL, WOO HOO! So THIS time was different. I woke up in the late morning and just knew he felt weird. Quiet. I got a pee after encouraging him to go to the litter box at 11am, and it was trace ketones. DAMMIT. I wasn't sure what to do. He had had 1.5 units of lantus 5 hours earlier but his AM doses often don't seem to work as well as the PM ones. So I gave another one unit and watery food. He seemed to get more lethargic and I just knew this was not going to improve at home this time, so to the vet we went. His ketones were now 2 or "small / medium" so he got subcutaneous fluids with us there, as well as an intra-muscular one unit of lantus. After an hour, we left and he was much more his old self. He had dinner. We went out for a quick dinner (this was Valentine's Day OF COURSE) and when we returned he was our sprightly, excited Dweezil again. SO relieved. Also, that night his 1am pee...NO ketones at all and still none since. So after all of that blather, my point is, if your cat is in high numbers like s unfortunately Dweezil often is, people will say it's ok to test for ketones every 24 hours. NO. I had tested at 1am the night before and there were none. But by 11am the next morning, they were there. Please test whenever you can! Catching it early can and probably will save your furbaby's life.