Dental Issues AND Difficulty Regulating BG Levels have me About to go Crazy

Status
Not open for further replies.
Frau Doppel & Juju (GA)

Frau Doppel & Juju (GA)

Member Since 2022
Hello All:

New member as of 01/20/2022.

I'm currently facing a very expensive dental surgery due to what I feel was my vet being so focused on getting my 11 y/o diabetic cat, who was diagnosed with DM in early 2020, regulated that her dental issues were down played despite the fact that I brought up concerns regarding her tartar in April/May.

I had also brought up her drooling (despite her not being a drooler) in the fall and that it might be related to possible dental issues but the vet chalked it up to either "happy drooling" or nausea.

I again brought up that i was anxious to get her teech cleaned and checked in December and the vet simply assured me that we were "almost there" regarding getting her DM regulated.

The vet is well aware that my cat is prone to tarter build up and absorption lesions as she had already lost 3 teeth to them before developing DM. I've attempted to brush her teeth in the past but she was not having it.

She has now lost yet another tooth, which the vet was basically able to yank out because it was so loose on Tuesday (after I left a message regarding the escalation of her dental issues on Sunday) due to absorption lesions and is facing extraction of more teeth and her breath is smelling like bad flatulence.

To make matters worse, my cat has been hard to regulate (either too low or too high) this time around due to me having to wrestle her to take a home glucose readings. This is extremely stressful for the both of us and makes me extremely hesitant to do the recommended every 2 hour, for 12 hours readings for a curve once month.

She is also extremely food motivated and constantly finding a way to get into my other cat's food (he is free-feed on Rx kibble for different medical issue) regardless of precaution taken (putting it out of her usual jumping range, using a modified chip feeder with sides, back, and top blocked and front narrowed to accommodate only one cat, etc.), and her recent dental issues have most likely been a contributing factor.

The vet did full blood work on Tuesday for dental surgery and got back normal results on Wednesday. JJ is now on 2x a day opioid for pain management. Unfortunately, my vet's practice is booked until March for dental procedures and I insisted that they refer me to aother practice or a vet hospital because I insisted on getting this taken care of Asap.

I've taken advantage of the fact that she is more manageable due to being on on Opioids to do a thorough glucose curve, 24 hour, readings every 2/3 hour during the day, one at 3am, and last reading will be at 9am this morning. I wiil report these results later this morning and will discuss the dental surgery with the vet later today.

I am at my wit's end deaing with my cat's diabetes and dental issues.

Am I wrong in feeling that my vet made a judgment error in downplaying my cat's dental issues or also wondering why my vet has not brought up other alternatives to glucose curves, such as fructosamine or A1C tests, or a CGM such as Freestyle Libre, despite that fact that I've informed them that even doing a GC at home is extremely stressful for both the cat and I?

At this point I'm about to seek out an internist or a university vet hospital with a dedicated diabetic department as I don't feel my current vet is equipped to hand both my cat's complicated dental and diabetic issues.

Any insights or advice would be helpful.

I'm seriously at my wit's end, crying, and angry at myself for letting her dental issues get downplayed and not advocating harder for her.

**I realized after the 3am reading that all my results were probably skewed due to me giving her approx .75 tsp of tikicat tun and mackerel no grain or potatoes wet food after each reading in order to keep her as compliant with the ordeal as possible through out the day. *cue another bout of crying* **
 
Last edited:
Frau Doppelganger said:
why my vet has not brought up other alternatives to glucose curves, such as fructosamine or A1C tests, or a CGM such as Freestyle Libre, despite that fact that I've informed them that even doing a GC at home is extremely stressful for both the cat and I?
Click to expand...
The CGM is the only real alternative. The fructosamine test measure the average of about two seeks and value from the test is not directly related to BG value/ The problem with the average is that if the cat spends half the time with really low BG, like in 40s and a lot in high like 200's the fructosamine result will be good. A1C is a human test and is not used in cats, instead the fructosamine test is used. A CGM like the Libre2 is a good choise.

However, I would get the dental done as soon as practicable. I think you vet downplayed the impotence in the past.
 
I heard back from the vet.

She her bloodwork and levels are good enough that the practice's dentist is willing to do the procedure.
The soonest JJ can come in for dental procedure is the second week of Feb.

I called some other places and they are booked even further in advance so the regular vet's practice it is...

I'm still a bit nervous in the event that she ends up needing overnight observation but the receptionist said she would relay my question about the possibility of tranfering JJ to the closet 24 hour hospital for observation if neededt to the vet.

This has all been such a hassle and the worst part is that this semi‐emergency might have been avoided.

I also mentioned the use of fructosamine or Freestyle Libre in addition to BG checks in the curve results I sent this morning in order to get a more comprehensive picture then simply a spot check or one day curve can give and they did not even address my question.

While I will be keeping m my current vet for the bi‐yearly routine general stuff, I'll likely be taking her to Penn for diabetic and dental care in the future.

I'm going to go cry again now.
 
Frau Doppelganger said:
due to me having to wrestle her to take a home glucose readings. This is extremely stressful for the both of us and makes me extremely hesitant to do the recommended every 2 hour, for 12 hours readings for a curve once month.
Click to expand...
My cat Snuffles is very hard to test. I very seldom test BG between shots. He is very food motivated and I can test him right before I feed heim. I bring in the filled food bowl put it on table and then pick him up and place him in my lap to test his ear.. Before that I tested him before I brought the food in and he would run awy when I tried to test him. He has bitten me many times. twice deep bites that required a dr visit and a third time when he ripped my arm up requiring stitches.

I have used Libre CGMs several times on several cats and I found them useful especially for one cat since he would get a big BG spike due to food followed by a steep drop as insulin took effect. THis was over a 3 ½ hr window. He got lower than 40 (lowest the Libre displays.)
 
Larry and Kitties said:
My cat Snuffles is very hard to test. I very seldom test BG between shots. He is very food motivated and I can test him right before I feed heim. I bring in the filled food bowl put it on table and then pick him up and place him in my lap to test his ear.. Before that I tested him before I brought the food in and he would run awy when I tried to test him. He has bitten me many times. twice deep bites that required a dr visit and a third time when he ripped my arm up requiring stitches.
Click to expand...

Thankfully my JJ is not aggressive but she is extremely squirmy and does not like being carried or held. She is also deceptively strong for her small size and will attempt struggle out of anything, including a purrito, to the point where she hyperventilates.

She is a churu fiend so I've attempted to use that in the past to distract her while I attempt to take a reading from her ear but to no avail. She somehow manages to hoover it down while refusing to stand still enough to safely get in an ear prick and a reading.
 
You're obviously on top of your cat's dental issues. While some dental procedures require sedation it sounds like your vet simply didn't take you seriously. This is the "I'm smarter than you" syndrome common in doctors. The longer you wait the worse and more expensive the problems will be including extractions.
It's taken me a long time to communicate to vets what I want, don't want and why. I still sometimes find myself in the parking lot wondering what just happened and it once cost me a cat's life.
As odd as it sounds 'happy drooling' is a real thing. From PetMD https://www.petmd.com/cat/general-health/why-my-cat-drooling
"Cats drooling when they are happy and relaxed, for example, drooling while being petted, can be normal behavior. Usually, these kitties adopt this behavior early in life, so it would not be typical for an older cat to start drooling suddenly if they hadn’t before. If this happens, you should call your vet to talk about your cat’s sudden drooling".
I don't snore, I "blow bubbles". I also drooled at one time, I should have been wearing a helmet. :blackeye: Best of luck.
 
Frau Doppelganger said:
Thankfully my JJ is not aggressive but she is extremely squirmy and does not like being carried or held. She is also deceptively strong for her small size and will attempt struggle out of anything, including a purrito, to the point where she hyperventilates.

She is a churu fiend so I've attempted to use that in the past to distract her while I attempt to take a reading from her ear but to no avail. She somehow manages to hoover it down while refusing to stand still enough to safely get in an ear prick and a reading.
Click to expand...
I could have wrote this in regards to my Juggie, right down to the churu fiend! I swear they put crack in them lol. After many very hilarious and sometimes bloody (me not him) attempts at his ear a dear soul here suggested I try his paw pad. What I do is have everything set up and ready to go (strip in meter but not pushed in, lancet in mouth (sharp end out lol) and churu open and in hand) I put him in a sitting position on the couch between cushion and arm, lift his back paw up and give home tube, I hold his leg and tube in one hand and poke with other. He’s so focused on getting the churu out he doesn’t even care about his leg/paw. Now when my duck alarm goes off he runs to his spot on couch and extends his leg waiting not so patiently for his tube. The only down side is he knows the beep means testing is done so he will kick his foot away sometimes spraying me with churu lol. I usually use coconut oil on his paw pads to keep them soft and have had no issues at all with this method. Might not be something you care to try but just sharing what works with us.
photo top is how he sits, photo botom is me taking his bg
on Flickr
 
Status
Not open for further replies.
Back
Top