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Human and animal diabetics both use ketostix or ketodiastix. These are reagent indicator strips that test urine for only ketone (ketostix) or for both ketones and glucose (ketodiastix). These links show examples of Ketostix[1] and Ketodiastix[2].

These stix are available at any brick-and-mortar or Internet pharmacy that sells human diabetic supplies. Stix do expire, so check the unopened expiration date when you buy them and record the date you open them. Keep the bottle tightly closed when not in use; prolonged exposure to air can produce false negative urine ketone test results[3].

If the foil-wrapped Ketostix, rather than the ones in vials are purchased, you may find it less wasteful. After the bottle is opened, the remaining unused strips have only a 6 months' life. By using the foil-wrapped ones, you can extend the "life" of your purchase. The singly-wrapped ones can have a unopened expiration date of up to two years. You are then only using what you need when you need it, having the rest still sealed and potent until the indicated expiration date[4].

Testing reasonsEdit

You should test your pet's urine for ketones for the reasons discussed at ketones. You may test your pet's urine for glucose because (1) you've been instructed to do so by the vet as a method of gauging regulation, (2) your pet is undiagnosed and you want to determine whether there is hyperglycemia, or (3) your cat is in remission and you want to determine whether there is hyperglycemia.

Urine Glucose TestingEdit

Some reasons for preferring testing glucose levels by using blood over urine testing is that the urine used in testing may have been in the bladder for hours. Because of this, it may not be a reliable indicator of what systemic glucose levels are at the time of testing[5]. What's seen when testing urine for glucose is an average of what the level of glucose has been over a period of about 5-8 hours (the time period from last urination)[6].

Urine testing[7] also makes it more difficult to determine whether any hyperglycemia noted is the result of a Somogyi rebound pattern or a true need for an increase in insulin dosage. Urine only tests positive for glucose when the renal threshold has been exceeded for a length of time[8].

There also must be some degree of glycosuria (glucose in urine) present in order for a urine test to detect development of hypoglycemia[9].

Reading ResultsEdit

Evaluating the results. The stix bottle has instructions and color charts to show you how the color on the stix will change given the level of ketones/glucose in the urine over 15 (ketones) or 30 (glucose) seconds. Be sure to read the colors at those time intervals because the colors will continue to darken and a later reading will be an incorrect result. Timing with a clock or watch second hand instead of counting is said to be more accurate[10].

  • If you see a "trace" or more of ketones, see ketones.

In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day.

When testing urine for ketones, the sample needs to be as fresh as possible. Ketones evaporate quickly, so there's a chance of getting a false negative test result if you're testing older urine[11].

At low levels, ketones can be detected in the urine (ketonuria) before they are found in the blood (ketonemia/ketonaemia)[12].

Ketodiastix

Ketodiastix--measures urine glucose and ketones.

  • The glucose portion of the stix measures your pet's glycosuria--that is, the glucose that has collected in your pet's bladder since s/he last urinated. If you see any color change in the glucose portion of the stix, that means that your pet has exceeded its renal threshhold since it last urinated. The darker the color, the higher your pet's BG level has been since its last urination. Note that positive urinary glucose results are not indicative of your pet's blood glucose level at the time it urinated. No meaningful conversion between urine glucose and blood glucose readings is possible.


Ketostix

Ketostix--measures urine ketones.

  • If you are testing urine for glucose, the time you test likely affects results in this way: mid-day urine glucose tests would reflect the nadir of glucose in the system--this also represents the peak of the insulin. Morning urine glucose tests are frequently high. Seeing negative urine glucose test, especially repeated negative ones, can mean the pet is approaching hypoglycemia[13].

False Testing Results-Urine GlucoseEdit

See Urine testing stix, Reading Results for examples of ketodiastix and ketostix color charts.

Possible False Urine Glucose Test Results
Antibiotics

Antibiotic[14]/Sulfa[15][16][17] drug name Effects
cephalexin, Keflex[18]
Cephorum (UK),[19]Rilexine[20]
Cefixime/Suprax[21]
Cefotixin/Mefoxin[22]
Cefpodoxime Proxetil/Simplicef[23]Cefotaxime/Claforan[24]
other cephalosporin antibiotics[25]
enrofloxacin[26]
Baytril[27]
less than accurate
(false negatives & positives)
urine glucose test results[28]
Gantrisin, Septra
Bactrim, Albon[29]
Chanoprim (UK)[30]
Duphatrim (UK)[31]
Tribrissen (UK)[32]
Trinacol (UK)[33]
more names at link[34]
can alter urine glucose
test results[35][36]
Chloramphenichol[37]
Chloromycetin[38]
can produce false
urine glucose test results[39].
Tetracycline[40]
Helidac,Sumycin[41]
Doxycycline[42]
Doryx, Doxy 100
Monodox, Vibramycin
Vibra-Tabs, Ronaxan (UK) [43]
Doxyseptin (UK)[44]
false urine glucose test results[45]
Penicillin and its derivatives
ampicillin
carbenicillin
ticarcillin
penicillin G
other names at links[46][47]
can produce false positive
urine glucose test results[48].

Possible False Urine Glucose Test Results
Other Drugs

Acetaminophen[49] (brand names)
Tylenol
Common use:
Pain reliever.
Aspirin[50] Common use:
Pain reliever.
False positives possible (With urine test brand name Clinitest.)
False negatives possible (With urine test brand names Clinistix or TesTape.)
Salicylates
Pepto-Bismol, etc.[51]
Common use:
Diarrhea.
False positives possible (With urine test brand name Clinitest.)
False negatives possible (With urine test brand names Clinistix or TesTape.)
Phenazopyridine
Pyridium, Geridium, Pyridiate, or Urogesic
Common use:
Urinary tract infections.
False positives possible (With urine test brand name TesTape.)
Delayed reactions possible (With urine test brand names Clinistix or TesTape.)[52]
Diazepam[53] (brand names)
Valium
Negative.
Common uses:
Seizures, anxiety, muscle relaxant, appetite stimulant.
(With urine tests brand names Diastix and Clinistix.)

Vitamin C Supplements[54][55]

Possible False Test Results

Blood Chemistry Decreased blood glucose and cholesterol test levels.
Urine Testing False high urine glucose test results

(With urine test brand name Clinitest)[56].

Urine Testing False negative urine glucose test results

(With urine test brand name Clinistix)[57].

Urine Testing False negative urine glucose test results

With other urine test brand name strips[58].

Possible False Urine Glucose Test Results-Other Reasons

Moderate Ketones[59] Negative if glucose is only slightly elevated.
Increased Urine Specific Gravity[60] Negative.
Decreased Temperature[61] Negative-refrigerated samples.
Very Concentrated Urine Negative[62].
Expired Test Strips[63] Negative.
Old Urine Sample[64] Negative.
Bacterial metabolism of urine at room temperatures for extended periods.
Contaminated Sample[65] Positive with oxidant contamination such as bleach or hydrogen peroxide.
Feline Urinary Obstruction[66] Positive-pseudoglucose[67].


If your pet is taking any type of vitamin supplements, it should be noted on his or her medical records. Knowing that he/she is using them means being able to factor them into interpretations of test results.

False Testing Results-Urine KetonesEdit

Possible False Urine Ketone Test Results
Drugs and Supplements

Valproic Acid (brand names)
Depakene, Depakote, Divalproex Sodium[68]
Positive.
Common use:
Treatment of epilepsy.
Cefixime/Suprax[69] Positive with nitroprusside-based urine testing.
Common use:
Antibiotic.
Levadopa Metabolites[70] Positive with high concentrations[71].
Tricyclic Ring Compounds[72][73] Positive.
Common use:
Treatment of depression.
Captopril
other drugs with
free sulfhydryl groups[74]
Positive.
Captopril Common use:
Hypertension
(high blood pressure),
various heart conditions,
preserving kidney function
in diabetic nephropathy[75].
Phenazopyridine
Pyridium, Geridium, Pyridiate, or Urogesic[76][77].
Positive.
Common use:
Urinary tract infections.
Glucocorticoids/Steroids[78] Positive.
Common use:
Allergies, replacement therapy, others.
Vitamin C Supplements[79] Negative.

Possible False Urine Ketone Test Results-Other Reasons

Pigmented Urine[80] Positive-Any other color except yellow or clear[81].
May be the result of other disease processes.
Dehydration[82] Positive-
lack of fluids can concentrate ketones
Old Urine Sample[83] Negative-ketones can evaporate rapidly.

Getting samplesEdit

How to catch urine. Some people place the stix under their pet's stream when s/he is urinating. Others catch urine in a dedicated spoon, ladle, or other collection device and dip the stix into the urine. Sometimes, catching urine from a cat requires stalking it. This can be a challenge in the UK where many cats are allowed outdoors to relieve themselves. Still others confine the cat to a small space (a bathroom) with an empty or almost empty litter box covered with plastic wrap that will catch the urine. Intervet has Internet pages with some ideas for performing urine tests on cats[84] and dogs[85]. More tips[86] on collecting uring samples for dogs.

Further ReadingEdit

Wikicat3


Wikicat3Wikidog3

ReferencesEdit

  1. Hocks.com Website: Ketostix
  2. Hocks.com Website: Ketodiastix
  3. Precision Xtra-Blood Ketone Test Strips
  4. Understanding Diabetes-Ketone Testing
  5. Pet Education.com-Drs. Foster & Smith-Blood Glucose Curves
  6. NOAH Compendium UK-Caninsulin Dosage & Administration
  7. DVMNews:Glucose Testing-Blood vs Urine Tests
  8. Caninsulin-Monitoring-Page 5
  9. NOAH Compendium UK-Caninsulin-Dosage & Administration
  10. Ketone Testing
  11. Urinalysis Dipstick Interpretations-University of Georgia-Ketones
  12. BMJ Student Archive-Glycosuria and Ketonuria
  13. Better Medicine E-newsletter June 2006
  14. Cephalexin/Keflex, Enrofloxacin/Baytril & Inaccurate Urine Glucose Testing in Dogs
  15. PetTalk.com-Sulfonamides
  16. PetTalk.com-Trimethoprim
  17. PetTalk.com-Ormetoprim
  18. Cephalexin/Keflex Information
  19. NOAH Compendium-UK-Cephorum
  20. NOAH Compendium-UK-Rilexine
  21. RXList.com-Suprax/Cefixime
  22. Cefotixin/Mefoxin=Petplace.com
  23. Cefpodoxime Proxetil/Simplicef-Petplace.com
  24. Cefotaxime/Claforan Petplace.com
  25. Merck Veterinary Manual-Dose Rates of Cephalosporins
  26. PetTalk.com-Enrofloxacin
  27. Enrofloxacin/Baytril Information
  28. Merck Veterinary Manual-Cephalosporins and Cephamycins-Special Clinical Concerns
  29. Medi-Vet.com-Albon
  30. NOAH Compendium-UK-Chanoprim
  31. NOAH Compendium-UK-Duphatrim
  32. NOAH Compendium-UK-Tribrissen
  33. NOAH Compendium-UK-Trinacol
  34. Merck Veterinary Manual-Dose Rates of Sulfonamides
  35. Sulfa Drugs by Brand Name & Hypoglycemia
  36. Merck Veterinary Manual-Sulfonamides and Sulfonamide Combinations-Special Clinical Concerns
  37. PetTalk.com-Chloramphenichol
  38. Chloramphenichol/Chloromycetin & Blood Glucose
  39. Merck Veterinary Manual-Chloramphenicol and Congeners-Special Clinical Concerns
  40. PetTalk.com-Tetracycline
  41. Tetracycline Medications & False Urine Test Results
  42. PetTalk.com-Doxycycline
  43. NOAH Compendium-UK-Ronaxan
  44. NOAH Compendium-UK-Doxyseptin
  45. Doxycycline Medications & False Urine Test Results
  46. Merck Veterinary Manual-Dose Rate of Penicillins-More Generic & Brand Names of Penicillin Family Drugs
  47. US National Institutes of Health-Medline-Penicillins
  48. Merck Veterinary Manual-Penicillins-Special Clinical Concerns
  49. Health.com-Acetaminophen,
  50. Aspirin-elephantcare.org
  51. Bismuth subsalicylate-elephantcare.org
  52. Merck Manuals Online-Phenazopyridine
  53. Diazepam/Valium Elephantcare.org,
  54. PetTalk.com-Vitamin C
  55. Vitamin C & False Test Results in Pets
  56. Vitamin C & False Test Results in Pets-Provet-UK
  57. Vitamin C & False Test Results in Pets-Provet-UK
  58. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  59. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  60. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  61. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  62. District of Columbia Academy-Veterinary Medicine Nov 2006-Urinalysis: Glucose
  63. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  64. Optimizing Results with Urinalysis Dipsticks
  65. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  66. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  67. District of Columbia Academy-Veterinary Medicine Nov 2006-Urinalysis: Glucose
  68. NetDoctor UK-Valproic Acid
  69. RXList.com-Suprax/Cefixime
  70. Drugs.com-Levadopa
  71. Urinalysis Dipstick Interpretations-Ketones-University of Georgia
  72. District of Columbia Academy of Veterinary Medicine November 2006 Clinical Lab Medicine Harvesting The Gold: Interpretation and Techniques of Urinalysis
  73. Wikipedia-Tricyclic Antidepressant
  74. District of Columbia Academy of Veterinary Medicine November 2006 Clinical Lab Medicine Harvesting The Gold: Interpretation and Techniques of Urinalysis
  75. Wikipedia-Captopril
  76. Diabetes Explained-Ketone Test Explained
  77. Merck Manuals Online-Phenazopyridine
  78. Medline Plus-National Institutes of Health-Ketones
  79. Precision Xtra Blood Ketone Test Strips
  80. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  81. District of Columbia Academy-Veterinary Medicine Nov 2006-Urinalysis: What Is Abnormal?
  82. Diabetes Explained-Ketone Test Explained
  83. Urinalysis Dipstick Interpretations-Glucose-University of Georgia
  84. Intervet-Urine Test Hints for Cats
  85. Intervet-Urine Test Hints for Dogs
  86. Healthypet.com Collecting Urine Samples

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