What Are Ketones?
Ketones are substances the body produces when it burns fat for fuel instead of using glucose. This happens when there’s not enough insulin available, and it’s a serious concern for diabetic cats.
Normally, the body filters out ketones through the urine. But when too many build up, it can lead to diabetic ketoacidosis (DKA) — a dangerous, potentially life-threatening condition that requires immediate veterinary attention.
Ketoacidosis Overview
Why Ketones Matter
- Ketones can cause serious problems, even when blood glucose (BG) isn't very high.
- Cats can develop DKA without having super high BG numbers, especially if they are:
- Not eating
- Vomiting
- Lethargic
- Fighting an infection
Symptoms of DKA
If you notice any combination of the following, test for ketones and contact your vet immediately:
- Drinking more than usual OR not drinking at all
- Increased urination
- Lack of appetite (especially over 12 hours)
- Vomiting
- Lethargy or depression
- Weakness
- Rapid breathing
- Dehydration
- Breath that smells fruity or like nail polish remover
Testing for Ketones
Urine Ketone Strips
- Available at most pharmacies or online (e.g., Keto-Diastix, Ketostix)
- Dip the strip in fresh urine and follow the instructions for timing
- Results are labeled as negative, trace, small, moderate, or large
- Trace = monitor closely
- Small or above = contact your vet
- Handle and store strips carefully to avoid false readings
Blood Ketone Meters
- More accurate and can detect ketones earlier than urine tests
- Devices like the Nova Max Plus and Precision Xtra test for β-hydroxybutyrate, the ketone most involved in DKA
- Strips can be more expensive but provide real-time results
Many caregivers use both urine and blood testing depending on their cat's behavior and symptoms.
When to Call the Vet
Call your vet immediately if:
- Your cat tests positive for more than a trace of ketones
- Ketones are present alongside symptoms like vomiting or lethargy
Treating DKA
Mild cases (trace ketones, no symptoms):
- Encourage eating and drinking
- Adjust insulin dose (consult your vet)
- Monitor closely for changes
- Require hospitalization
- Treatment may include IV fluids, insulin, electrolyte support, and 24/7 monitoring
- DKA is fatal without prompt treatment, so do not delay care
Final Tips
- Always test for ketones if your cat isn’t acting normally (even with low or normal BG)
- Keep test strips or a blood ketone meter on hand
- Watch hydration, food intake, and insulin consistency
- Be proactive — early detection saves lives
Questions or need help interpreting ketone results? Post in your applicable insulin forum and someone will assist you.
- Tim
Change Log:
Created on 5/19/2025.
Sources:
Marje and Gracie. "Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones." Feline Diabetes Message Board, 13 Dec. 2020, Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones | Feline Diabetes Message Board - FDMB.
Management of Feline Diabetic Ketoacidosis - WSAVA2013." Veterinary Information Network, VIN, 2013, https://www.vin.com/apputil/content/defaultadv1.aspx?catId=35300&id=5709925&pId=11372.:contentReference[oaicite:3]