Meatball--Trace Ketones

Good Evening!

As maybe you know, Washington, DC has been hit with major amounts of snow this week, causing mail to be out of service. I have both ordered more strips for my Alphatrak and ordered a ReliOn form Walmart, which were both supposed to have been here today at the latest.... and of course I think mail was not delivered 3 days this week so everything is behind, and tonight I used my last strip!

But tonight PMPS was 413, so things are steadily creeping lower! Also, last night and tonight I was able to test Ketones... both tests read "trace." Is this acceptable, or shoud it really be none?

Thanks!

Edited by moderator to make a separate post. The earlier post on Meatball is here. Meatball came to the Board last Saturday on 10U BID of ProZinc. Respondents to Molly's post recommended that she start over at 1U BID and test for ketones.

 

Ketones really should be none, but sometimes it is difficult to properly read "trace." You might test the strips with tap water and with your own urine. Use good lighting. Read exactly at 15 seconds.

I would also try to get another ketone test on Meatball.

Trace ketones can be a problem because it can escalate. Does Meatball's breath smell like nail polish remover? That is a sign of troublesome ketones and he should go to the vet.

Is his appetite way off? Is he dehydrated (does his scruff not snap back when pulled, are his gums tacky)? If so, he should go to the vet.

I know about snow. Is there anyway you can get to a pharmacy to get a glucometer and strips? If it were me, that would be my first step.

After I had a glucometer and test strips, and if Meatball were over 400 (as he is likely to be), I would raise the insulin to 1.5U. That is still a low dose and going reasonably slow.

I would also syringe water to ensure hydration.

Here is the wiki article about ketones.

 

Hi, I'm going to PM (private message) you. I live in DC maybe I can help you with supplies.

 

I was just able to test Meatball's Ketones tonight, and i got a reading of 'small' which is higher than yesterday. His skin still seems very elastic-y, his breath smells like fish (dinner), and he seems to be acting otherwise pretty normal. He ate a normal amount and I mixed some of his wet food with water so he would get some extra fluids ... I hate not being able to test his BG! I am praying the strips &/or new meter get here tomorrow.


Advice??

 

Meatball--now SMALL Ketones

I would say that, meter/strips on the way or not, you need to get supplies to test Meatball's BG levels NOW.

Call Abbott Animal Health 888-299-7416 (phone lines open at 8am Central) to see whether any other Abbott strips work in the Alphatrak. If so, go to the pharmacy and buy them. If not, go to the pharmacy and buy a meter and strips.

You DO NOT want Meatball to have a ketoacidotic event. A few dollars saved at the pharmacy waiting for your mail is going to look like a terrible tradeoff if you have to have Meatball treated for DKA to the tune of several thousands of dollars. Not to mention the suffering of DKA.

If you cannot or will not have the supplies NOW to test Meatball, I suggest you take him to the vet. Ketones can escalate to a life threatening situation quickly. The vet will test Meatball's blood for sugars and ketones, and get him on fluids and fast-acting insulin to get his sugars down and stabilize his electrolytes. If the ketones are small, the vet likely can have them cleared quickly. Do not let them berate you for dropping the insulin dosage from the outrageously high level of 10U BID. However, be prepared for an increase in dosage (not too big) to keep the ketone beasties at bay.

Let us know how it goes. Please.

 

Molly, where in DC are you? Maybe I can help since Metro is open now. I live by Reagan Nation airport, I can lend you a meter and strips.

 

Okay, I've put in a call to Abbott, they should call me back with the hour to let me know if there are any other strips I can get for the meter. It did not even occur to me that I might be able to do that, or I would have gotten some a few days ago. If that does not work out, there are two local people who have extra meters and have graciously offered to let me borrow. If I cannot buy strips at the pharmacy, I will definitely take one of them up one their offer. If tests come back too high (since I'm not exactly sure what "too high" is, I will post here as soon as I get a result), I will take Meatball to the vet tomorrow morning.

Will keep updating as things progress.

 

Just tested Meatball's ketones again.. they are back down between none and trace, same as day before yesterday, but I'm going to go get a meter, just to be sure.

Thank you all again, and again, and again for all of your advice and support.

Molly

 

And we've tested...

363, this was 3.5 hours after 1.5u ProZinc

 

Whew. Great. How's Meatball feeling?

 

Meatball seems to be feeling good. He was being really wild last night actually!

This am:
AMPS 419 1.5u

I'm trying to make him drink lots of water for the time being. I just mix a bit of wet food into a bowl of water and he loves it!

 

Hey Meatball,
I hear your good at drinking lots of water, keep it going. Paws crossed for better numbers today.

 

Sounds good Molly.

When my Ennis first became REALLY diabetic (he flirted with it once but just a couple days of insulin took care of it), he had built up a fair amount of glucose toxicity. He was on BCP PZI at the time, and we got as high as 3.5, maybe 4.5U (I can't remember which and after 4 years, I don't keep a spreadsheet anymore) before he started responding/being regulated and I could start reducing his dose.

However we lost regulation and got back up to 3.5/4.5U before I switched to Levemir. I'm talking about a maybe 6 month timeframe from first DX to switch to Lev. On Levemir, we started low but went fast and again got up to 3.5/4.5U before we were able to once again break glucose toxicity. He's now been down to the 1U range for a couple years.

The point of my story is to illustrate the adage "this is a marathon, not a sprint." Some cats regulate/go OTJ very quickly, and some need more management. I know you are going to get very frustrated with Meatball's numbers soon, but I do encourage you to continue to go slow with the dosage increases. Someday, things will just "click" and Meatball will be regulated and show good preshot numbers. That may be on PZI, or it may require another insulin. But you will get there.

Just keep checking the ketones.

Venita

 

Molly,

What's up with Meatball?

Venita

 

How are things?

 

Meatball is doing well, still getting pretty high numbers, but I think he's feeling okay - he's definitely acting okay. I have not tested ketones yet tonight, but have been doing it at least once a day, with all of the results being between none and trace, apart from the 11th when they were low. If nothing else, his numbers seem to be much more consistent on the lower dose.

I think I am going to switch Insulin when this one runs out or expires... to Lantus, b/c I've heard about the high remission rate with that type.

 

Meatballs numbers have been steadily increasing over the last week, tonight PMPS 492 1.5u.

How many days should I wait in between dosage increases?

 

ProZinc Right? Wait 3-8 cycles.

Please also check out the sticky at the top of the PZI Insulin Support group [especially the "start low go slow" bit]:
viewtopic.php?f=24&t=1979

Also if remission is on your mind you might read about the recent remissions on PZI:
viewtopic.php?f=24&t=5659

Please keep in mind, you will lose time re-regulating if you switch insulin [may be worth it depending on what you have in mind].

Please feel free to join us/post in the PZI Insulin Support Group.

 

Molly,
I was just checking your ss to see how things are going for you guys, but noticed no new data for a few days. It does look like things are coming down pretty rapidly from the preshots you posted in January. It would be great if you could catch some mid cycle data, like anywhere between +4 ---> +8.

Please keep encouraging the water. The high numbers do tend to dehydrate kitties as they use water---> pee to flush the glucose out of their systems. I add a lot of water to the wet food, and even use a 5ml medicine syringe to give 20ml warm water, several times /day. I like your idea of mixing food in to encourage drinking-- very clever. Mine love the fish bowl :lol:

I hope you stick with prozinc awhile, I think you're progressing pretty well! Show us that ss!

 

SS Updated! FYI - I'm going to start a new post in the PZI forum

 

Awesome - we'll be happy to have you!

In your spare time ;-) can you put together a profile for you and Meat-bizzy? Instructions can be found in the Tech Support forum.

 

Ouch, Molly, those numbers still remain fairly high. Might you be able to get some mid cycle tests, maybe over the weekend?

 

Yes, Venita, I will do a curve tomorrow.