? 2/16/21 Kierra Best time to measure ketones

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Diane and Kierra, Feb 16, 2021.

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  1. Diane and Kierra

    Diane and Kierra Member

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    Jan 10, 2010
    Is there a best time of day to measure ketones (with a meter)? Pre-shot, nadir???
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    You can measure for ketones any time.
     
  3. Diane and Kierra

    Diane and Kierra Member

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    Jan 10, 2010
    So it doesn't matter - it doesn't fluctuate throughout the day? I thought maybe I should measure it when it would most likely be highest.
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    There should be no ketones in the urine at all.. the test should be negative.

    With the meter it shows up as a number.
    A well cat should not have ketones in its system at all.
    Ketones are a by product when the body burns fat instead of carbs. Ketones can show up if any diabetic cat is not burning carbs for fuel.. So the time of day doesn’t matter.

    If your kitty is not eating, is lethargic, you are skipping doses of insulin, looks dehydrated or has a history of ketones I would test for them regardless of the time of day.
     
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  5. Diane and Kierra

    Diane and Kierra Member

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    Jan 10, 2010
    If you use the strips, the trace=0.5, small=1.5, and moderate=4 mmol/L. So when using strips, how do you know there are no ketones? And isn't it ok if you see the small to moderate strip levels (like it is not an emergency)? Kierra is positive for acromegaly so not sure if ketones will ever be zero but if someone knows better, I'm all ears. I measure the ketones AMPS usually. Her highest ketone ever was 7.7 but lately has been less than 3. The very first time I measured her ketones with a meter they were 2.7 and I freaked out because of things here on the board saying just what your saying, they should be zero, and so I took her to the emergency vet because I thought she was dka. She wasn't. So since then, I haven't been so freaked out. I have read some other posts that some kitties throw off ketones and it isn't an emergency.

    I posted this converter here a while back:
    https://felinediabetes.com/FDMB/threads/online-mmol-l-converter-to-mg-dl.239310/#post-2689747

    Edit: the KetoBM ketone meter test strips are within 15% (100% of time), within 10% (90% of time) and within 5% (80% of time) for >= 1.5 mmol/L
     
    Last edited: Feb 16, 2021
    Reason for edit: add info on meter accuracy
  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If you are talking about urine strips....the colours will show none, trace, small, moderate and large. Anything above a trace needs vet attentions as ketones can multiple quickly.
    With the blood meter it is my understanding that if you get a reading 2.4 to 2.7 you need to pay attention as ketones are forming.

    I’m not sure that being an acro has anything to do with getting ketones more frequently. I haven’t heard that but I am not an acro expert.
    I think as Acros are in higher numbers for longer than most cats it is wise to test for ketones.
    I will tag @Wendy&Neko as she is very experienced with Acros and will be able to tell you more.
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    The only thing about being acro, is that if kitty needs a higher dose, they can spend longer times in high numbers. They can still get ketones. From this post on Ketones, DKA and Blood Ketone Meters:
    The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter
     
  8. Diane and Kierra

    Diane and Kierra Member

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    Jan 10, 2010
    The link Wendy&Neko posted above is what I was talking about.

    Here are a couple quotes from that link:

    "Mishka can also throw ketones ranging from trace to max and still act fine, no vomiting, eating and playing well, and then come back up negative. If she doesn't eat, she goes to ER and I don't even bother with the testing. I truly believe some cats, no matter how high, will just never throw them, and some cats, even with good numbers will throw them."

    "That's exactly how I treat Alex...except that I can smell when he has them 98% of the times which, although I HATE it when my cat smells like a bottle of nail polish remover, it is a big help. If he is not eating..he needs more help than I can give him, and there is a difference between ketosis and DKA."

    Kierra has a good appetite but if she ever quits eating etc, she will go to the vet. What I was wondering is whether ketone levels might vary when they are being "thrown", like if they might be higher pre-shot, after a meal, at the nadir time, etc. I guess I could do a "curve" like we do with bg to see if they vary that much during any of these times but the strips are $1 each so kind of pricey and not sure how useful it would be. I was hoping someone might know the answer already.
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Tagging @Lisa & Oberon to see if she has an answer about time of day testing on ketones making a difference.
     
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  10. Lisa & Oberon

    Lisa & Oberon Well-Known Member

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    Jul 14, 2020
    Not that I've noticed. With Oberon, ketones go up gradually when he spends a long time (more than a day or two) in higher numbers (over 300 or so). Then as soon as he drops into better numbers, the ketones clear right out within about half a day, maybe. I don't think they fluctuate as much as glucose.
     
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