Large Ketones, please help!! long post...

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Hosu, Aug 4, 2018.

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  1. Hosu

    Hosu New Member

    Joined:
    Aug 4, 2018
    Hello!
    So my 11yo female cat Kojum weighing 17lbs had been sick this whole week...

    So last Friday I noticed she had anorexia and was not drinking water. No vomiting, no diarrhea.

    Monday: took her to the vet. Xray showed hard stools, bloodwork all OK except liver enzymes that was possibly from liver lipidosis and blood sugar 440... No infection, no ketones in urine, urine culture and urinalysis all good, kidney function ok, etc...sent fructosamine and went home with lactulose.

    Tuesday: still anorexic. still had few kibbles and a few lickfuls of water. Active, slept on the bed with me. Fructosamine 550, told to come back the next day.

    Wednesday: trace ketones. half day hospitalization (10am-5pm) w/ fluids, insulin, and syringe feeding. blood sugar dipped down too low to 60 after regular insulin 1.5units then .75 units 2 hrs later. syringe fed at the clinic, discharged home for overnight. She was doing well in the clinic they said, was ok with syringe feeding. Still anorexic at home... She was so weak I gave her dextrose and honey thinking it was hypoglycemia :( vets did NOT advise to do home sugar testing so wasn't sure and didn't have the glucometer...

    Thursday: Ketones 2+. Half day hospitalization (7am-5pm). Same deal as Wed. Regular insluin 0.5 units dipper her down to 115 (from 372), syringe fed, right before her discharge sugar went back up to 258. Still anorexic at home... syringe fed only 10mL at home per the vet

    Friday: Ketones 3+..... Same deal as Thursday. Regular insluin 0.5 units w/ syringe feeding dipped her down to 78 from 410. Then by the time she was going home sugar went back up to 258... Due to her insulin sensitivity and ketones continuing despite insulin and fluids, the vet spoke w/ internal med vet and he recommended further radiology to rule out pancreatitis/liver issues/cancer.. but they didn't have any radiologists so couldn't do it.. OGAWD. I have an appointment with a vet who sees cats only that I really loved and she has bedside ultrasound, so I said I will follow up with her Monday and manage my cat at home with syringe feeding, sugar monitoring, subq fluids.. Due to her insulin sensitivity, Kojum was discharged with ProZinc 0.5units once a day only starting Saturday. He did not say I needed to hospitalize Kojum at a 24 hour facility this whole time.

    So started home sugar monitoring. Using ReliOn Confirm. Last night (friday) at 12AM it was 210. Still anorexic, syringe fed her about 22mL (didn't think about calorie counting till today :(). Peed about 4 times, but only small-moderate amounts at time.


    Saturday (today): AMPS 255, gave 0.5 units of Prozinc. +2: 263, +5: 218, +7: 218, +11: 221. At 13hr mark it was 209 (30 minutes ago). Throughout the day syringe fed about 128kcal which was about 105mL (FF chunky chicken + FF classic + very little Hill's i/d bland that vet gave me, all blended).. She is so sick of syringe feeding.. I have been giving about 20mL-30mL at a time.

    So earlier she had Large ketones...(160 per Relion ketone strips).. I freaked out but realized she was dehydrated, gave about 100-150mL of SQ normal saline. When she peed again in 3 hours it went down to 80 but still large.. 3 hours later (now) still 80. So far, today she peed 8 times but she only pees small-moderate amount at a time which is abnormal for her? But they ruled out urinary infection...

    Still anorexic, no fluid intake spontaneously... not even responding to snacks or tuna flakes she responded till Friday night.. She is sleepy, but she does sleep a lot usually and is inactive. She hissed at the other cat earlier and it was a weak hiss which is not normal.. I see that she is weaker. Breathing normally at 20times per minute.. I called ERs near and they said they don't have internal med vets overnight so they can't really do ultrasound till the morning etc??

    Please help. Do I still take her to the ER? Her sugar shoots up to 350-400's whenever I take her cuz she's so stressed out.. at home she's been doing well in 200's..... What can they do? just labs more fluids and more insulin to correct the ketones? But her sugar is good now... she doesn't vomit or has diarrhea, just hates syringe feeding now but I can do more.. Better to take her in the morning so they can do ultrasounds and extra stuff? Thank you SO much for reading this!!
     
    Last edited by a moderator: Aug 5, 2018
    Reason for edit: Removed 911 prefix. Kitty taken to ER.
  2. PPCW

    PPCW Member

    Joined:
    May 26, 2017
    Hi Hosu,

    I don’t have experience with ketoacidosis but based on your description and have read many threads on this forum, I would go to the ER. Anything above trace is dangerous.

    I hope someone with more experience will chime in but it is the middle of the night in the US. You can also change the thread title to 911 to catch more attention.

    Many hugs to Kojum and you!!!
     
    beggargirl likes this.
  3. Hosu

    Hosu New Member

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    Aug 4, 2018
    Thank you... yea it's10:43pm already so I posted on fb page also.. I was just skeptical of going back because when she had 2+ and 3+ they still sent her back home with me for overnight... :(...
     
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    The ER docs don't need to do diagnostics at this point.....an ultrasound isn't going to make a difference to her ketone levels

    They SHOULD hospitalize her overnight and use R to bring her glucose down (they can also put her on an IV glucose drip to make sure she doesn't go too low)

    Fluids are needed to flush the ketones but you don't want to give more fluids at home right now if you've already given 150ml....you don't want to overload her heart.

    If this ER doesn't have the ability to keep her overnight, you really need to find one that does. They shouldn't be sending a cat home with positive ketones
     
  5. Hosu

    Hosu New Member

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    Aug 4, 2018

    Thank you, waiting in the 24hr ER now
     
  6. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Your vet was irresponsible to send you home with your cat in dka without suggesting she go to an overnight facility. Keep us updated on how she's doing
     
  7. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Keep us posted. See if they checked for pancreatitis. It could have been the reason she stopped eating which snowballed to what is going on now.

    Kudos to you for starting to home test regardless what vet advised.
     
    Last edited: Aug 5, 2018
    beggargirl likes this.
  8. PPCW

    PPCW Member

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    May 26, 2017
    How is Kojum?
     
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