Ketones, Ketoacidosis and Diabetic Cats: A Primer on Ketones Signs of Diabetic Ketoacidosis (DKA) Drinking excessive amounts of water OR no water Excessive urination Diminished activity Not eating for over 12 hours Vomiting Lethargy and depression Weakness Breathing very fast Dehydration Ketone odor on breath (smells like nail-polish remover or fruit) Pet Diabetes Wiki "Ketoacidosis": What is it? Is it dangerous? When to go to the vet? How do you test for it? Please go to the link to read all about ketones and diabetic ketoacidosis. "The Hows and Whys of Ketones" by Kathy and Cashew (GA) "6 of one, 1/2 dozen of another....ketones, ketosis, etc." by Hope + (((Baby)))GA Hope + (((Baby)))GA, "The normal pH for a feline is 7.4 and is necessary for the normal function of many enzyme systems. When pH drops below this value the cat is referred to as being acidotic." "Feline Diabetic Ketoacidosis" by Christi Benigni, Zimmer Feline Foundation "Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter, may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly." http://petdiabetes.wikia.com/wiki/Ketones Do I need to worry about kitty developing ketones if kitty is OTJ (off the juice) or when blood sugar numbers are not high? Yes, even if a cat is not on insulin, he is still a diabetic, and it is possible that ketones and DKA can develop especially if he is skinny and not eating right. Sometimes, cats blood sugar goes into the "normal" range for the wrong reasons (like poor appetite or illness) and they actually still do need insulin to help them gain weight, heal and prevent ketones. The basic recipe for developing DKA = an insufficient supply of insulin + inappetance + infection OR other systemic stresses. https://edenseffort.files.wordpress.com/2014/04/dka-graphic.jpg Tips to catch and test a urine sample When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra 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: Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf Measuring ketones - JSAP_Zeugswetter - 2012.pdf Suggested reading: FDMB thread - 4/3 Barsa AMPS 10.4 (187), ketones and Levemir starting dose issues. - Thread includes names of fast-acting insulins used in other countries and an "Activity profile of various insulins" (translator may be required). FDMB thread - 4/7 Barsa PMPS 7.2 (130), +3 - 3.5 (63) How long will it keep going down? FDMB thread - 7/7 Tigger PMPS=452+testing positive for ketones - need help - Thread includes how to read results from a blood ketone meter. FDMB thread - Was frustrated, now is ketones have spiked! in over my head!