1/23 and 1/24 Stash updates - and ketone questions

yesterday: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=3626

1/22 AMPS 420 s.5u
+5 323
+6 341
+9 347 (at the vet's with our meter)
from the arterial blood draw - 317

PMPS 350 upped to .5u
+4 127
+7 83

1/23
AMPS 261 .5u
1 tsp FeloVite vitamin - expect this to cause a rise
1 22.7mg Baytril

So now I'm thinking that by staying with a skinny .5u for so long I've hurt Stash overall. However, the level part of my brain is telling me the infections are keeping him from dipping too low at nadir with the .5u.

Who can help with the term "ketonurea" ? I've not read that here anywhere and I'm not sure what I should do about it. Edited to add: Vet said it measured 3 and his urine pH was 6.

 

Re: 1/23 Stash AMPS 261 - Ketone question

Causes of Keton urea

a. Diabetic ketonurea - indicates ketoacidosis and if unchecked may gone to coma.

Ketonurea = ketonen in the urine.
Since they show up first in the blood and later on in the urine I would go to a vet asap.

spacey didn't have ketones yet (knock on would), so I can't give any other advice.

 

Re: 1/23 Stash AMPS 261 - Ketone question

Thanks Ella. The vet is who found the ketonurea - but indicated the FeLV+ diagnosis was more important to treat. So I'm trying to figure out whas a +3 reading means.

 

Re: 1/23 Stash AMPS 261 - Ketone question

I would try to get as much water into Stash as you can. While the FeLV may be more important to treat, ketones are not trivial. Most of us who have cats that have had DKA will tell you that ketones can develop into DKA quickly and the condition can cause cats to become metabolically unstable to the point that they can't recover. Not enough insulin and infection can do this. Fluids will help to "wash" them out. You might want to talk to your vet about sub-Q fluids. There are several beans here who give sub-Qs routinely at home.

 

Re: 1/23 Stash AMPS 261 - Ketone question

I told my vet I was going to do my homework, and digest all the information over the weekend. I've upped the mixture of FF/water to 1:1 and I'm adding more when I see the FF has "dried out".

 

Re: 1/23 Stash AMPS 261 - Ketone question

Hi Sherri,

how's Stash doing today? Any updates? Have you been able to get some spotchecks in for this cycle?

Hope you get some answers on your questions, hang in there ((Sherri))

 

Re: 1/23 Stash AMPS 261 - Ketone question

Sherri:

From what I can tell, the urine pH seems like it's normal. It sounds like there's some variability in the literature with the range being about 5.5 - 7.0.

It's not clear how your vet tested for ketones -- urinary or blood. If urine, using a Ketostix, if you look on the side of the bottle there is a guide to what the color coding means. A reading of 5 mg/dL is a trace reading -- which is fine. You don't want a reading to go above this. Take a look at this site on Pet Wiki.

 

Re: 1/23 Stash AMPS 261 - Ketone question

Hi again,

sorry to be a pest, but Im worried about u

talk to us Sherri, hows Stash? How are u?

 

Re: 1/23 Stash AMPS 261 - Ketone question

Hi Sherri,

I'm sorry that Stash is having some problems. I hope you can get things figured out and a plan of action in place really soon.

 

Re: 1/23 Stash AMPS 261 - Ketone question

omg ((((sherri))) i just went back a few days to see that you just got this FeLV+ dx.
damn it. this is not good. :sad:

okay both are very important to treat, but positive ketones are more urgent of an immediate matter. have you tested his urine at home for them? need to do that every time he pees. a bottle of 50 urine ketone strips is like 12-13 bucks at drugstore. if he still has ketones we need to move to emergency treatments since he already has infection i think i am reading in your posts and the formula for DKA is insufficient insulin (which positive ketone test will tell you) + too few calories + infection = DKA. cannot go there, just can't. he is in no condition to try to battle DKA.
get as many calories in as possible, get those AB's in, get as much water as possible in.

i will be back tomorrow to check on you. hope to see a negative urine ketone test when i come back!

and sherri sometimes a cat chooses his own life path. he needed to go outside, that was his nature, he is stash the fearless hunter, the cat that is a lion in his mind, and FeLV is just one of the many dangers out there. it is like my feral yard cats, sure i would love to bring them all in and have them safe from everything, heck wrap them up in bubble wrap, i love them, but they would not be happy. they are out there because they choose to be, it is their nature. stash has always been the very independent sort, promise me that you will always remember that although you might have regrets...he does not.
((hugs))
~jojo

ps. the ketone test was a urine test that vet did, hence the term ketonurea was used. am a bit concerned why vet gave you urine pH, it is not urine pH that one is concerned with when trying to determine if a cat with ketones is headed towards DKA it is blood pH, very different thing. but maybe he was just throwing some results from the in house u/a they did? those strips measure a variety of things, 2 of which are ketones and pH.

 

Re: 1/23 Stash AMPS 261 - Ketone question

Just getting caught up as it's been a busy weekend with DD's baby shower among other things...

1/23 readings:
AMPS 261
+8 276
PMPS 249

1/24 readings:
AMPS 343
+3 421
+6 328

JoJo:

DD had Stash at the vet as I was sick in bed. I was talking to the vet on the phone and trying to listen through the haze what he was telling me. I requested he do a clean urine test (with a catheter) and they called back to tell me there was blood in the urine and the pH was 6 and ketonurea was 3 and he rattled off a list of other things. DD did not bring any paperwork home with lab results; I will get that on Monday/Tuesday.

As much as I would like to test his urine every time he pees... he absolutely refuses to use the litter box if we are at home. Don't know how to accomplish this short of closing him up in one room 24/7 with a litter box containing fish gravel - if he would even use it then. And I simply cannot close him up like that. He is too independent.

The antibiotics have obviously kicked in. He is more alert and active, even trying to scamper away from test times. He’s jumping up on furniture again, instead of bedding down next to the sofa. The syrupy vitamins are obviously working against the BG… and even though we just upped the dose to .5u on Friday evening, I’m thinking we are going to need to move up again prior to the standard 10 cycles. We are feeding, feeding, feeding. Pumping as many calories in as possible. And his appetite has increased since the a/b started. I feed him anytime he asks.

The vet had to order the ImmunoRegulin and said it would be available on Tuesday. I’m going to plan on starting that course of treatment (the vet said 4-6 weeks; 2x weekly; then re-evaluate).

Thank you all for thoughts and concerns. I know this turned into more of a Health post than LL post… but you guys know us here… and we do need to decide what to do about his Lantus dose.

 

It doesn't matter that this may be more of a Health post. Frankly, so what? We do know you here and we would hound you mercilessly if you only posted on Health because we want to know how Stash is doing. Jeez, we'd just let Ronnie loose and she'd probably figure out your phone #, where you live, the names of your neighbors and your vet. Cross post on Health but keep us in the loop. We care about Stash and we care about you.

It sounds like Stash is feeling better. If Gabby's experience with DKA is any criterion, he wouldn't be jumping around. If you are concerned about ketones and he won't let you urine test, you can get a meter that will allow you to test for both BG and ketones. The strips are expensive but it may be an option.

 

I agree with Sienne. When Alex has been in DKA he hasn't been running around... has been lethargic and sick. He has turned down food and I had to syringe feed him water as well. If you can't get urine samples I agree that you should think about the Precision Xtra meter. I got the meter on Ebay for 6.95 plus shipping and I just got 2 boxes of 10 strips each for $20 a box (they retail for like 59.00 for a box of 10). It has been a lifesaver for me when I've needed to get a ketone check...which is pretty often. You can find this stuff for not so much if you look around.

Hope Stash is better soon ♥

 

sorry about all you and Stash are going through. :sad:

With ketones in the picture, and probably an infection, I would up the dose. Let's see where he is at PMPS before deciding how much to increase. Test a lot, ok? He might get low numbers and if he does you can control them with food. Keep pushing food and water, and I agree with the suggestion to get a blood ketone meter if you can't consistently catch urine.

 

1/24

Don't anyone yell... AMPS was actually +15 (343). I chose to go ahead with our normal schedule for PM (6pm) which was +9. I figured with the infections and the glucose-based vitamins it wouldn't hurt.

PMPS 381 DD shot .5u
+4 155 - PLUS a mousie head minus the body! THAT is the best news in days! We're thinking about mounting the head for display. :mrgreen:

Libby... we have a bladder infection; a ruptured cyst in the mouth; gingivitis... so there are plenty of infections the a/b are working on.

And Ronnie... we're the house on the corner with the hole in the outside wall. :razz:

I will check in with our AMPS report and see what the suggested dosage is. DD will be at home all day Monday and I will stress to her tests every 3 hours. I will also start looking for a Precision Xtra meter.

You're all the best. And I don't know if I will post on Health (unless you guys are adament that I do so).