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Ketoacidosis/Ketone stench on a horse WTF

Do you think most people on a keto diet have it? If you can detect it, it’s really offensive. I can’t imagine dating someone that smelled like that. It’s one of the things I though when I met that woman because she was with her boyfriend. Maybe most people can’t smell it?

I can smell it on people, but it’s not as strong as on cattle. I don’t tend to ask people about their odour, but if I have prior knowledge of a condition/diet or they volunteer information, I can add 2 and 2.

I would not be surprised if most people can’t smell it.

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chemist here - so, I’ve not smelled this smell on people except on people who have hang overs - to me that smells like a mix between dill pickles and ethanol.

So, does ketosis smell like ethanol (a fruity light smell), acetone (sort of like nail polish remover) or like acetaldehyde (which is very volatile, toxic and has a light fruity smell) or a mix of all 3. I am really curious.

Metabolically speaking, I not sure there is a significant difference between ketosis and ketoacidosis except for the latter, people are also struggling with a shift in blood pH because of the metabolic issues.


Yes? No? Some say it smells like acetone, but to me it’s just a really distinctive smell that I can’t compare to anything else I’ve ever smelled. Helpful, right? If the dill pickle part of what you smell is somewhat sour, then I’d say yes to that component - sour as in acidic, not sour like milk that has gone off. Clingy like sweet flowery smells can be, but not exactly sweet. That’s about as well as I can break it down.

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The time I smelt what turned out to be this, on a human being, the closest way I can describe the smell was it was kinda like bourbon. Guess that could be described as fruity, but then it was also a little sour (perhaps that’s the dill pickle part?).

Not acetone/nail polish remover at all.

It was like “What IS that smell?” “Has he been drinking?”

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It smells like fruit beer or apple cider that got bacteria in it during fermentation and will make you sick if you drink it. That is a light smell that carries a long way. Sometimes its mixed with that pink sally beauty supply nail polish remover but that is more like a whiff, not a constant smell. Some people also smell like what I can only describe as cat pee which is distinct from regular bad BO or bad hygiene because I only smell it when they move, then it dissipates quickly.


I feel like you must work in healthcare.

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Me? No. I may have tried harder in math and science if had realized my true passion for large animals sooner. Back then, it was all about the riding, training, and general horse care.

I tended dairy cattle for years up close and personal and they had terrific vets who were very open and generous with their knowledge and with helping me bridge the gap between my equine knowledge and cows and calves.

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Anorexics definitely have the smell on their breath.

I would think it’s possible for someone on an extreme diet/dropping weight rapidly to have it as well.

It is very common for people to have a nasty BO smell for a couple of weeks shortly after weight loss surgery. I had the sleeve and had it. It is not fun. Mine was sorta cat pee smell I think. It has been since 2015 and it was a smell I like to forget. It was no like sweat or underarm odor. Just something else. The diet after WLS is normally very low carb.


I was thinking of this thread at work last night! I am an RN In Critical Care, and we admitted a person in severe (!!!) ketoacidosis last night. The primary nurse came out of the room exclaiming at how strongly the patient smelled of ketones, and said she could still smell it at the nurse’s station, about 20 feet away. Myself and a few other nurses had to go in and start sniffing - one thought she might smell something, and the other two of us are apparently immune. The patient was a really good sport about us conducting a sniff test, as we all ended up leaning right over them, and was laughing as the primary nurse tried to describe what was to her an overwhelming smell. The patient and their family members could all smell it strongly, which was part of what alerted them to come to ER in the first place.

I’ve never been sure whether I could smell ketones or not (and I have a relatively keen sense of smell), but last night definitely confirmed that I can’t at all! :laughing:


Wow, that’s really weird. I would not have thought there could be that much of a range of ability to smell it. Makes me wonder what other smells other people can’t detect?

Out of curiosity, why were they in severe ketoacidosis?

Paperwhite flowers (narcissus?). BF gave me some; they bloomed while I was at work. Came home, opened the door, and thought, I REALLY have to take out the garbage!

Some think it smells like pretty flowers; others, like me, smell rotting garbage. Like cilantro taste, very different to different people.


That would be me, I mean not literally, I am not a nurse, but that exactly describes how overwhelming it is and how hard it is to get away from!

We had one temp in the lab at the company I work at that couldn’t smell one of the reagents at all (a benzene compound). For everyone else that smell stayed in your nose for the rest of the day if you got too good of a whiff. It was disturbing because that reagent was pretty nasty and cancer causing. So he was banned from doing tests with that reagent. Luckily he didn’t work there long.
I’ve gotten nose blind to a lot of chemicals mainly acetone and ethanol. You’d have to shove my face in it for me to smell it. When I first started as a lab tech those smells were very over powering even with a fume hood running. Now I’m very sensitive to certain smells like bleach, ammonia, and the smell of natural gas from working there. The last one is especially bad because I was gassed at work with sulfur dioxide - same sort of rotten egg odor.
It’d be interesting to see if I could smell Ketones now that I’m so desensitized to acetone.

The patient is diabetic, and also had developed a really awful pneumonia. That lead to less oral intake of food and water, which meant that initially their blood sugar was running a bit low and they took less insulin. Drinking less water caused them to become dehydrated, and as they became increasingly unwell, they also developed nausea and vomiting. Feeling so unwell also meant that this patient who is normally incredibly contentious about managing their diabetes checked their blood sugar less frequently.

The cascade of changing electrolytes, fluid balance, increasing blood sugars, etc becomes a bit like an avalanche once it gets rolling, and the poor patient ended up incredibly acidotic (and chewed through all the normal compensatory measures that your body will try to use in these situations) with a very, very high blood sugar, high potassium, etc.

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Interesting. My husband can’t abide the smell of narcissus or hyacinths. Says its disgusting to him.