12/20 - Freckles - AMPS 234, 185 @+3.5, 200@+5.5 - liking the world SS better than US SS and teeth ?

[Judy and Freckles]

last post

I got up several times after I went to bed last night trying to catch my little girl, Freckles, in the blue zone. No such luck, but I had a feeling that after having a AMPS of 234 there may be some blue in her forecast for the day. I requested that DH try and get a test or two in this morning as he was around and sure enough, Freckles saw a different cooler colour! YIPEE! However, for the @+5.5 test, my preference is the world SS as it showed her number in the blue but with the rounding on the US SS it showed another yellow. Apparently, colour is everything to me!

Thanks to @Marje and Gracie and
@Wendy&Neko for the "corporate knowledge" of this board that they shared with me in my last post. Very comforting to know that Freckles is not the only one who has been a flat colour for some time. We will continue on our trek with TR and follow that protocol.

We do have a dental cleaning scheduled for January though. Vet told me no insulin and no food after 10:00 pm? I'm thinking there are likely guidelines somewhere on this forum for sugar cats that have to go under anesthetic? If someone can point me in the right direction, I would appreciate it.

I'm tagging
@Sienne and Gabby (GA)
seeing as they had posted the original information on dental procedures, but other's opinions/suggestions are certainly welcome!

 

[Sienne and Gabby (GA)]

Vets vary with their instructions to caregivers. Some vets will say no food after midnight, others will let you feed early in the AM. Some will say give half of the usual dose. In part, the instructions may vary depending on what time the dental is scheduled.

There are two big "musts" - IMHO, you should have pre-procedure x-rays. This lets you and the vet know if there are any immediate problems. Freckles should also have a blood panel no later than a month before the dental. If extractions are needed, post-procedure x-rays are a must. If shards of a tooth remain, they can cause an infection.

If there are extractions, typically antibiotics and pain meds are prescribed. Do NOT allow the vet to give Convenia (it's a 2 week shot and once the antibiotic is in, you can't get it out nor can you neutralize it. Thus, it's a problem if your cat is allergic or has a reaction. (It's only indication is for skin infections.) No Metacam (meloxicam). This is a nonsteroidal anti-inflammatory that in the US, carries an FDA black box warning for causing acute renal failure in cats.

 

[Wendy&Neko]

It really is best to follow what the vet suggests in terms of food. However, there is nothing wrong with trying to convince them that they should be following the anesthesia guidelines for diabetics. I often heard the earlier food cutoff times for anesthesia from front desk staff and when reminding them to check with the vet because it was a diabetic cat, the times were changed. Modern anesthesia protocol for diabetics is a small amount of food first thing AM, but it also depends what time of day they are doing the procedure. And vets do differ. My dental specialist vet had different guidelines from the general practice vet.

Nice blue, but you can still increase to tomorrow unless Miss Freckles puts on an impressive show tonight.

 

[Judy and Freckles]

Freckles should also have a blood panel no later than a month before the dental.

Thanks @Sienne and Gabby (GA)
and @Wendy&Neko

1. What are we looking for in a blood panel? What does a "blood panel" test for? We had blood work done before (attached to the SS) that included thyroid, blood count, and blood chemistry etc. is this what should be done again (FYI -this blood work was almost $600 and with the dental cleaning over $550, that's a fair chunk of change all at once about $1400 USD - maybe I need to shop around for prices?)
2. When you say "no later than a month before the dental" you mean within 1 month prior to the dental appointment right?
3. The dental is originally planned for a cleaning as there is some tarter on the back teeth - I know that things may change if the vet finds something else when Freckles is under anesthetic. I've been reading some journal articles and some research articles say cats with FD that are unregulated should postpone elective anesthetic until the diabetes is regulated. While the AAFP suggests that "Anesthesia can be performed safely in diabetics, regardless of whether the disease is controlled". Maybe I should postpone the dental cleaning for a bit - It's scheduled for Jan 10? Thoughts?
4. The vet wants me to give Doxycyline 5 days prior to dental appointment. He said it's better for the cat to have antibiotic in it's system because bacteria can easily enter any little wounds that occur during the cleaning. What are your thoughts on this?
5. Normally, Freckles gets her insulin @ 5:30 am. Should I request the earliest time in the day for the dental appointment? So she can get her insulin and eat ASAP. Plus, there is no way I will be able to bring her shot time back to 5:30 am if the vet gives her insulin at say 10:00 - because I leave for work @ 6:00 am. How do I work this?

Sorry for so many questions but I would like to be prepared as best as I can. I go in to see the vet on Monday regarding another of my cats, so I can clarify things with him then.

 

[Judy and Freckles]

Nice blue, but you can still increase to tomorrow unless Miss Freckles puts on an impressive show tonight.

I'm impressed but others may not be. lol We are seeing blues.... lots of blues today!! Whoot! Whoot! Still increase right? I'm away tomorrow helping a friend move during the day but will be at home in the evening.

 

[Wendy&Neko]

Still fairly high blues, you have room for that increase.

Blood panel is looking for possible reasons anesthesia would be a bad idea. A sudden change in kidney function is one such. You should be laying no where near $600 for that kind of bloodwork, chemistry for sure. And yes, every time Neko had anesthesia, the b/w had to be recent.

I’ve been reading some journal articles and some research articles say cats with FD that are unregulated should postpone elective anesthetic until the diabetes is regulated. While the AAFP suggests that "Anesthesia can be performed safely in diabetics, regardless of whether the disease is controlled".

Hogwash. A cat that bad teeth is hard to regulate. Infection or inflammation can cause insulin resistance. Neko had several anesthesias when her numbers were much worse than Freckles. Actually, there are vets out there who would consider Freckles with occasional blues to be regulated enough for them.

If there are signs of inflammation/infection! I have seen people give ABs before hand.

I always stuck to my shot schedule and shot at home in the morning, then took Neko to the vet. As early a surgery as possible is a good idea with diabetics. Typically no more than 1/2 dose the morning of, less if you think kitty might go low. Some people skip to be safe.

 

[Sienne and Gabby (GA)]

I agree with Wendy about not postponing. Gabby had a dental every year during her diabetes.

The blood panel is to make sure there's no medical problem (e.g., high WBC indicating an infection, liver values are off) present that could complicate anesthesia or the procedure itself. It's a way to minimize risk. The same thing is done with humans -- you need pre-surgical labs so there are no ugly surprises.

There shouldn't be a problems with giving an antibiotic ahead of time. Just an FYI -- antibiotics can cause diarrhea. You may want to give Freckles a probiotic just in case the AB upsets his GI track. I use ReNew Ultimate. Just separate the probiotic from when you give the AB by at least an hour. I use 1/4 of a capsule mixed into food. (There are also alternatives if Freckles gets bad diarrhea from the AB. I always have S. boulardii -- same company, ReNew -- in the house.)

I always skipped the AM shot. I did not want to give insulin on an empty stomach given that Gabby could be rather dramatic with her numbers. Just an FYI, anesthesia can lower BG numbers. This is one of the reasons the vets don't want you to give insulin before the dental. Also, if it ends up the Freckles has extractions, he may not want to eat if his mouth hurts. I always bought a couple of bottles of baby food (all protein, no veggies in the food -- usually Stage @ Gerber or Beechnut) just in case.

I'd talk to the vet about not giving Freckles a shot while at the clinic. The worst thing that could happen is that if the vet doses and your off schedule, skip the PM shot and get back on schedule in the AM.

Also, when you bring Freckles home, he will likely be starving from to having eaten. Feed him SLOWLY. Anesthesia slows down the GI track. If he scarfs down his food, he's likely to barf. Also, if the vet gives pain meds, som cats get agitated from the meds. A darkened, room that's free from a lot of stimulation can help.

 

[Judy and Freckles]

Wow! Thanks so much for the information @Wendy@Neko
and @Sienne and Gabby!
Very, Very helpful and your information gives me more faith in what my vet asked me to do! I will keep the dental appointment for January. Thanks sooooo much!

I use ReNew Ultimate

Is ReNew Ultimate a probiotic for people or cats? I can't seem to find it for cats when I went to their website. I did find the following which I can order off of Canadian Amazon.

I always have S. boulardii

Same question - human is Saccharomyces boulardii for humans or cats?

 

[Sienne and Gabby (GA)]

They are for humans. I use it. I give it to Gizmo. One size fits all!!

With either, I'd suggest starting with 1/4 of a capsule. If the problem persists, go to 1/2 capsule. I'm linking information on using probiotics. S. Boulardii is great if diarrhea is truly problematic. A standard probiotic is typically all you would need.

 

[Judy and Freckles]

They are for humans. I use it. I give it to Gizmo. One size fits all!!

With either, I'd suggest starting with 1/4 of a capsule. If the problem persists, go to 1/2 capsule. I'm linking information on using probiotics. S. Boulardii is great if diarrhea is truly problematic. A standard probiotic is typically all you would need.

Great! Thanks for the info. Probiotics are ordered and will be here this week.