9/29 Heart - Honeymoon is over - and Ketones!

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dodgingwrenches

dodgingwrenches

Member Since 2010
Hi all,

I got a call from my parents today to come get Heart because he's sick again (he's been living in Ottawa, I'm in Toronto - 450 km apart). So I picked him up and brought him home. After the five hour car ride, his BG was 14 (250). Heart was first diagnosed with diabetes summer 2010, and I got him OTJ with Lantus. 2011 we had a brief relapse since my parents were sneaking him the occasional dry food and snacks, but they learned their lesson from that. Today, he's thin again, not eating much, lethargic. I just went to pick up some Lantus again, and decided to get some Ketostix. Haven't given insulin yet since I wanted to wait until 8pm to do another BG test (after the travel stress wore off) and then get him started on an 8am/8pm injection schedule. But, he just tested positive for ketones. I had to dip the stick in the litter just after he peed, since I couldn't find the "stream" while he was doing his business, but I don't think he peed much.

I have no experience with ketones, but since he hasn't had any insulin yet and is freshly relapsed, is it safe to try a few days of insulin to see if it gets better? Or is this something stupid serious where I should rush to the vet right away?

Two months ago he had a full workup by the vet, and everything was fine. And today, this...
 
Ketones are serious, if the test was any more than a trace I would get him to the vet. Not eating, raised BG and ketones could be signs of pancreatitis. You could get him checked for that. If is pancreatitis it is painful so ask for pain meds and he may need fluids and an appetite stimulant. Basic treatment for pancreatitis is insulin, fluids and food. There is a stickey w/ full details. He may go off the juice again once it is cleared up.
 
I think you need to take him to a vet to see how severe the ketones are, first thing. What level did the stick indicate?

Today, he's thin again, not eating much, lethargic.
Click to expand...

That was Bob when I brought him to the vet and he was diagnosed with diabetes. On a Friday, and I ordered insulin that day. It didn't arrive until Monday. On Monday he was much worse off, and I brought him to the vet first thing in the morning. He was "DKA" that fast, and spent 3 days in the ER. On Friday, he had "negative ketones". By Monday, you could smell the ketones on his breath. The vet told me that if I'd waited another day, he probably wouldn't have lived.

Is Heart looking like he's dehyrdrated? Bob was, severely. Sometimes, "trace ketones" can be managed at home if your vet feels that's possible. Anything higher than "trace" should be dealt with by a vet. And they can go from trace to bad pretty quickly.
 
What was the ketone reading? Like everyone saying, we will know better what to suggest if we know what the ketostix reading was. If the reading was more than trace, I would get Heart in to an ER to be checked out. He could have an infection that is causing both the rise in BG and the ketones. The only way to know is either with bloodwork and/or a urinealysis. As Carl noted, ketones can become problematic quickly.
 
The reading was between small and moderate ketones. Gave him his first 1.5 units of Lantus as well just now (BG was 243).

No vomiting (small blessing) and he's drinking. Had a small bite a few hours ago but nothing since. I'll try and take him to the vet tomorrow.
 
If possible, I'd call the vet and tell them the ketone level asap.
 
I did call and leave a message, but alas it is Sunday night. He was a bit more perky (begging for the food he didn't eat much of) and he doesn't seem to have a temperature - warm nose from earlier could have been stress from the car. Nose was nice and cool. Hopefully the vet will squeeze me in in the morning. Anyway, BG at +3 is 211, so heading in the right direction.

Update: And he just ate some more. Love watching him eat!
 
Good that he's eating, and good on the 211.
If at all possible, try to catch him peeing in the AM to see if the stick still shows elevated ketones so you can keep the vet up to date.
 
Well we're leaving shortly for the vet. He was up and about when I just got home, probably due to BG of 189, so best he's felt in a few days I bet. Not sure if he'll be staying there though tonight for hydration of if I'll be bringing him home
 
Heart's hooked up to an IV overnight. Ketones level was 2.5 (not sure what that means). Being hydrated and fed overnight so that should help him get better.
 
The ketone reading may depend on what equipment is being used. On a Precision Xtra meter, a reading above 3.0 is serious. I'm presuming your vet also did blood work? You want to know if there's an infection that is causing the ketone levels to rise as well as to know what Heart's electrolyte levels are. If electrolyte levels are off, it could indicate DKA.
 
Yes we should be getting bloodwork results today. He doesn't have a temperature, so probably not an infection.

Found out though that he also needs to get a tooth removed, and should have his hernia repaired (other vet two months ago said not to worry about the hernia, my vet here in Toronto pushed it all back in). But, I want him in remission again first before I subject him to surgery!
 
If there's an infected tooth, it may be what brought Heart out of remission. Dental issues are often one of the culprits for a kitty returning from the Falls.

Could you also take the 911 off of your subject line?
 
Hi guys. sorry to hear heart is not feeling well! I hope the ketones are under control and the bad toofy get's taken care of soon!
 
Ketones tested negative this morning. So that means he's not producing more and flushed the rest out. I pick him up tonight and now I have to get his diabetes under control
 
Yay on negative ketones! But even better, he gets to come home! :-D
 
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