About 30 minutes after I posted yesterday, Collin went a weird color and started acting strange and shaking and pooping a lot and retching until he turned blue. Just to preserve some variety in our lives.
I checked his blood glucose and ketones and both were quite high, which was strange, because usually if one is high the other is low and you know how to fix it. So, I called our awesome keto nutritionist at the hospital, who immediately called the neurology nurse practitioner. They confirmed my decision to give him a bit of juice to bring down his ketones, but also recommended that we see our pediatrician as soon as possible, thinking that Collin was coming down with a bug. I didn't think this was the case due to the sudden onset, but definitely wanted to get the doctor's opinion and they worked us in within the hour.
In the meanwhile, I gave Collin half an ounce of apple juice and he immediately fell dead asleep. When we got to the doctor's office, he woke up and was smiling again within a few minutes. I rechecked his blood levels and his glucose had stayed the same but his ketones had dropped. The doctor didn't find anything suspicious and suggested it might be viral.
My theory is that something made his ketones skyrocket and he reacted to that change. His ketones increase throughout the day and by 1:45, they were already what they usually are by the time he goes to bed and high ketones or fast ketone changes can cause nausea and all sorts of yucky side effects. As to what made them increase in the first place, I don't know. I have noticed that his ketones have been generally higher since we started making his food in the Vitamix blender. I'm not sure what the connection would be - either making the fats more easily absorbable or more evenly distributed is all I can think of. Regardless, I mixed his next batch of meals at a slightly lower ratio.
All of Collin's blood levels were normal by the time he went to sleep last night and he's very much himself this morning, but I will definitely be keeping an eye on things for a while.