ketones recovery?

newbie proceeding on basics ... just noticing warnings about ketones. Trying to think ahead. One post says hospitalization to address this might cost $2000. I haven't been able to find anything about whether this accomplishes long term quality of life. (does the condition just tend to come back?)

 

Ketones are a product of burning body fat stores rather than being able to convert food into energy. The recipe for ketones is: not enough insulin + not enough food + infection/inflammation/stress. Ketones fairly quickly make the blood acidic which at that point it moves to 'Diabetic Ketoacidosis' also known as DKA. DKA is fatal without quick and appropriate vet hospitalization/treatment via IV's usually for several days. Testing for ketones is an important part of caring for a diabetic cat...it's just a little pad dipped in fresh urine and read at 15 seconds.

DKA is a lot more costly than catching ketones early before blood becomes acidic and just needing a smaller intervention.

 

Yes, if your cat has high blood glucose and then some infection comes along that puts him off his food even a short time, things can turn very dangerous very quickly. Felix was diagnosed with diabetes when he was hospitalized for DKA for five days (it cost a lot more than $2000). Although he improved steadily after he got home and was on insulin, I'd say he was convalescent about three months. Now he's doing quite well! My understanding is that if they pull through it and don't have more episodes--and that means their diabetes is controlled and ketones are monitored--they can go on to have a normal life expectancy. If you're monitoring ketones and blood glucose from the beginning and so catch problems early, you can probably prevent this harrowing experience for your cat and for yourself.

 

Thanks to both of you for the replies.

Can either of you give me a more comprehensive view (or refer me somewhere) of the range of ketone problems?

What is a "smaller intervention"?

 

My kitty developed DKA suddenly (trace ketones can become large ketones very quickly). He was 11 years old, and he was new to being a diabetic, and I was not checking for ketones at the time. He had been throwing up (projectile vomiting) and not eating and lethargic when I returned home from work. I took him to the local ER that night and stayed there while they tried to help him. In the morning, I was told that I had to take him to another hospital (as they were only open nights and weekends) that was over an hour's drive away. He was in critical condition. I just prayed the whole way there. He was in that hospital for 8 and 1/2 long days. I remember it well, the praying, the fear, and the worry, and how all I could think about was him, outside of work. He was at the University of Pennsylvania School of Veterinary Medicine, so maybe that's why it didn't cost as much as maybe another ER. It was about $4500 for his stay. Which I always considered cheap compared to what a human would have to pay for such a lengthy stay in critical care, and then ICU, and then something in between, and then in Internal Medicine, getting round the clock 24 hour care, 2 transfusions, an IV hooked up in each leg, and they said they bathed him ? daily. Anyway, he very very slowly got better and better, but would not eat the entire time he was at the hospital, so he had to come home with a feeding tube. The feeding tube was hard for me the first day. The second day, I went to get him to feed him, and he had pulled the feeding tube out. I was on the phone to my regular local vet to find out what to do and they were telling me they could re-insert it when I looked down and he was chowing away at a bowl of cat food, so no more feeding tube.
I tested for ketones from then on. He never got them again. He was diabetic of 9 years and passed away at the ripe old age of 20.

 

A smaller intervention might involve, for example, figuring out if there's an infection involved and treating it with antibiotics. They'd want to figure out why the cat isn't eating and get that turned around. They might put the kitty on IV fluids and/or fast-acting insulin until the ketones are resolved, but that wouldn't likely last nearly as long as with a full DKA episode.

Felix wasn't diagnosed yet with diabetes and I didn't know about ketones or DKA. He seemed kind of "off" one afternoon, eating only a little, and didn't want his dinner in the evening. He usually had a good appetite, and as you probably know, not eating can quickly lead to hepatic lipidosis in a cat, which is also very serious (even if DKA is not in the picture). I called the vet as soon as they opened the next morning and his appointment was for early afternoon. He acted very thirsty that morning but wouldn't drink. About an hour before we went to the appointment, he was restless and walking around; an hour later in the exam room he got so he could barely lift his head. The vet diagnosed DKA and I took him straight over to the 24-hour animal hospital from there. They didn't release him until the ketones were gone and he was eating (they were about to insert a feeding tube, but then he started eating on his own). His glucose was still very high, but they were afraid of starting him on too much insulin and causing a hypo event. I tested for ketones a lot in those early weeks when his glucose was so high. Now I try to be aware of when Felix is headed to the litterbox and take the opportunity when it comes; I keep a long-handled spoon nearby and slip it under him midstream--you need only enough to dip the test strip in.

Here are sources of more info:
http://www.felinediabetes.com/ketones.htm
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
http://petdiabetes.wikia.com/wiki/Ketoacidosis

 

Ketone's level caught at home at the Trace level could be helped at home with SQ fluids, aggressive insulin therapy w/home testing, guaranteed eating /antibiotics taking.
Ketones caught at home w/urine testing at a Small level might be treated at vet's clinic/ ER clinic by bringing down the BG level asap via Rapid acting insulin (with Dextrose IV intervention available in case of Hypo)+ IV course of antibiotics+ SQ fluids for electrolyte's balance+force feeding regularly (in case of inapettance) in about 24 hours = $950 - $1200 in California.
The full blown DKA - same treatment approach but with 36 hours+ of billable nursing work time=~$4000+ in California.

What do you mean?... ER saved my DKA cat's life.. but she recovered at home..(with no billable hours ).

Did I answer?

 

Tanya covered my meaning of 'smaller intervention'. Those items can be done at home with proper attention to details where full blown DKA requires hospitalization.

I'm not sure I understand your question. Susan posted links to more information. If that doesn't answer your questions, just post again.

HUGS! We all need those...

 

Thanks very much for all the info. I think my post 'crossed' some responses. You've all given me plenty to 'chew on'.

I should perhaps say that Tut probably has lung cancer (if not that, some kind of serious lung inflammation and he has herpes and an immune disorder so typical treatments are problematic), so while I'm not giving up on him, I also will be wary of what I put him through, for what is likely to be a short lifespan.

He is so much better right now than he was before I started the insulin. Lying next to me purring, right now. I do so greatly appreciate the help in giving him more quality life time.