9/8 Leo AMPS 176

Sonia & Leo

Member Since 2018
Yesterday

Good morning!

Leo had such a perfect green day yesterday, a flat cycle between 58 and 65 and two nice blues to start and finish! Too bad we’re going to lose momentum with his dental surgery coming up, but we’ll get him right back on track once this is behind us!

The specialist vet, Dr. Gagnon called me yesterday afternoon to talk about the plan for Leo’s upcoming procedure and also to talk about his BW results. We were on the phone for over an hour.

Leo needs dental surgery on at least one tooth, that we’re sure of and the x-rays will tell if anything else is required. They want him in on Monday night so they can start a drip and fast him starting at midnight. The surgery is scheduled for the next day, Tuesday.

We’re working his dose time back by 15 mts at a time until Monday pm shot so that I can give him his shot and get to the clinic by 7:30pm. Dr. Gagnon also asked that we cut his dose in half for the Monday pm shot so we’re also working at draining his depot a bit working up to that.

He’s on 4 units lately so last night I reduced by .25 and I’ll probably do the same tonight and so on and then Monday’s PM shot will be 2 units.

The rest of the conversation was about his BW results. Dr. Gagnon said cats that have come back from remission once, will never go back into remission ever again so we should immediately change his diet to DM food and forget about remission and low healing numbers and concentrate on his CKD. I was going to beg to differ about the remission part but didn’t bother, that can be done later.

I don’t have a copy of the labs yet but will input the information in Leo’s workbook as soon as I get them.

In the meantime, it’s a gorgeous fall day out, the sun is shining and Leo seems to feel fine so all is good!

I hope everyone has a beautiful Sunday! Surf safe all you little kitties!
 
Interesting that he'll be on drip overnight! I'm excited for Leo's dental and seeing the effects of it afterwards :)
 
Sonia,
I don't understand why both diabetes and kidneys can't be cared for simultaneously. Rough balance maybe. Good diabetes control is important for kidneys. He shouldn't have said never, regarding a second remission, but could have said he hadn't personally seen it. I guess he is saying he believes the benefit of tight control, isn't as important as a prescription kidney diet? I contemplate that balance, and just make sure you review Tanya's website (I'm sure you have). Its given me some confidence.

When I first started Tina on insulin, the vet told me to keep her on the kidney diet (24% carbs I think).
On my own, I eased off, then quit all KD food, and chose Weruva LC, low phosphorus. Next time we saw the vet, he agreed with what I had done. Her creatinine was 2.8 when diagnosed.

You are Leo's best friend!
 
Not sure why the vet requires Leo to spend the night?
He said so that they could start hydrating him before the procedure to protect his kidneys. If he was at home the night before, we can't be sure he would drink water and he'll be fasting from midnight so no hydration there either. My sister who highly recommended this vet told me there's always someone there at night to care for any patients and I asked again to make sure.
 
Glad the Vet gave you time on the phone and reviewed things with you. Wishing a safe dental for Leo. I know it is a lot of preparation, but it will be worth it when you bring home Leo with pearly white teeth and then his BG levels come back on down.
Yoyo wishes you "Best of luck" Leo:bighug::bighug:
 
Boomer has been in remission 3 times. I think Bubba @Bobbie And Bubba has also been in remission 3 times and is close to a 4th.
I guess if he gives the same advice to all his diabetic/CKD patients and the parents switch over to the HC food as per his recommendations, the patient would not go into remission or good numbers, so there's his proof. He doesn't know about Boomer and Bubba, but he will, trust me, as soon as this all over and Leo's back safe. He was shocked that I had Leo's bg hot off the press and was able to tell him Leo's bg from a half hour ago. I guess his clients don't test or they don't tell him about it. :rolleyes: Thanks Judy. :bighug:
 
I wish vets would be more supportive and not so negative - how does he know 'they never go back into remission' ??? Really? How many cases has he studied that do or don't for that matter?

Sounds like he and my first vet might have attended the same school. My vet said that if she was his cat, 'he'd put her down'...that she would never allow us to test or give her insulin...too hard to get cats regulated, etc.etc.etc. Dr. Negative :mad:
 
So great that you have a strong path forward for Leo’s dental. I’m glad that xrays have been done so that you can take care of everything all at once. I’m sending pre surgery vetty vines!

I’ll be thinking of you both this week :bighug:
 
Good luck with the upcoming dental. I hope it really helps.

A couple things. First, you don’t need to step down his insulin dose. I would have just done the same dose until you need to cut it in half. Second, Neko also had CKD when she had her dentals by a vet dental specialist, who also teaches about veterinary dentals. Neko was allowed to eat 1/3 of breakfast until 6AM the morning of surgery. That is the newer protocol for feeding before anesthesia for diabetics. And worked for her kidneys. I too felt some comfort in going to a dental specialist. They do have more experience in “complicated” kitties.
 
Second, Neko also had CKD when she had her dentals by a vet dental specialist, who also teaches about veterinary dentals. Neko was allowed to eat 1/3 of breakfast until 6AM the morning of surgery. That is the newer protocol for feeding before anesthesia for diabetics.
My vet's office began telling us to feed 1/3 breakfast to all (non-diabetic) our cats before dentals, about a year ago. I believe they said it was better for their stomachs. (?) I like the idea for our cats with diabetes too.
 
Neko was allowed to eat 1/3 of breakfast until 6AM the morning of surgery
That certainly sounds better. Leo’s Dr. wants him in the night before to start a drip to prepare for the surgery. He’s my sister’s vet and she brought her kitty in for a dental about a month ago (also CKD) and it was the same, come in the night before, have the procedure the next day and kept him overnight again. I will try to tactfully find out why he uses this method instead of the newer protocol, but from what I recall it was mostly about protecting Leo’s kidneys. Maybe his kidneys are worse than I thought? He had BW at his regular vet two Thursday’s ago and she didn’t seem that concerned. She said his numbers were slightly higher than the last time. I’m going to add both lab results in Leo’s workbook as soon as I get the ones from this current clinic.
 
My vet's office began telling us to feed 1/3 breakfast to all (non-diabetic) our cats before dentals, about a year ago. I believe they said it was better for their stomachs. (?) I like the idea for our cats with diabetes too.
Thanks Jan, as I said to Wendy, I'm going to try to find out why this Dr. has a different method. Leo had a dental cleaning at a different clinic last October and he was allowed to eat the morning of. Maybe it's because this is surgery, not just a cleaning? Length of time under anesthesia?
 
One of Neko’s dentals under the 6am feed protocol was a removal of a bony growth from her jaw. Pretty major surgery. And she had CKD a couple years at that point. It is true anesthesia can be hard on kidneys.
 
One of Neko’s dentals under the 6am feed protocol was a removal of a bony growth from her jaw. Pretty major surgery. And she had CKD a couple years at that point. It is true anesthesia can be hard on kidneys.
That was definitely major, poor little Neko. :( I'm glad she had you as her mama bean, you sure fought for her and you went through so much together.

All I can do is ask why he wants to do it this way. I don't want to insult him or start telling him how to do his job, the last thing I need is a pissed off surgeon the day before surgery.

I also don't want to have to try to find another Dr. to do this, we would loose too much time and my main concern is that Leo is in pain and so I want to get this done quickly for his sake.

Thanks again Wendy :bighug: Have a good evening!
 
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