? 6/22 Minnie PMPS 322 (0.25R) +1 333 (ketones down to 0.4)

Liz & Minnie

Liz & Minnie

Member Since 2021
Previous post https://felinediabetes.com/FDMB/threads/6-18-minnie-pmps-276.264785/

I've increased her back up to 5 and 2 doses of R haven't made any difference. Should I increase the R to 0.5u or just increase the Levemir to 5.5u? @Wendy&Neko

They both have follow-up with the vet tomorrow morning. I'm wondering if she's got an infection? Her appetite is a bit off compared with yesterday. They gave a shot of antibiotics day of but nothing to come home with, just the buprenex. I gave her an ondansetron today too, just in case.

Thanks

ETA ketones stuck at around 0.6 now, down from 0.8 day after dental work
 
The R dose last night brought her down more than 100 points by +4, that's more of a drop than I'd like to see with R. Might have caused a bounce from the larger drop, or wherever she ended up at nadir last night. And also means I wouldn't increase the R for preshots <350.

Hold this dose at least six cycles. As long as the ketones don't creep up anymore, I'd hold this dose at least two more cycles, then evaluate it.

An infection is possible after the number of extractions she had. Glad to hear she's going in for a follow on checkup. Any chance you can peak in her mouth? When you say "shot of antibiotics", do you mean Convenia? Not my first choice (for use at all), much less for dental infections.
 
Wendy&Neko said:
The R dose last night brought her down more than 100 points by +4, that's more of a drop than I'd like to see with R. Might have caused a bounce from the larger drop, or wherever she ended up at nadir last night. And also means I wouldn't increase the R for preshots <350.

Hold this dose at least six cycles. As long as the ketones don't creep up anymore, I'd hold this dose at least two more cycles, then evaluate it.

An infection is possible after the number of extractions she had. Glad to hear she's going in for a follow on checkup. Any chance you can peak in her mouth? When you say "shot of antibiotics", do you mean Convenia? Not my first choice (for use at all), much less for dental infections.
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Thanks so much. Yes, last night was a BIG drop - I was so exhausted, there was no way I could have woken again at nadir...just made sure she had plenty of food available.

I just re-checked the invoice - they gave her a shot of Onsior (anti-inflammatory i think?) and Convenia. What would you suggest instead of that?

I will try and check in her mouth, will need a magic confluence of her being cooperative and me having the reading glasses at hand! Sam had an infection after his 1 extraction which is what makes me suspicious that's what's going on with her.

PS she ate again. Clearly not nauseous, especially since I found a half-disintegrated ondansetron under the sofa! :banghead::cat:
 
I tried looking in her mouth....temporarily had a really good view while she hissed at me, but not long enough to tell what might be going on. I could see some dark areas - not sure if dried blood or stitches? They didn't mention stitches but I'll ask. She's sleeping now. Also it seems that the buprenex isn't having such an impact on her behavior - she is nowhere near as cuddly and purry as she was the first few days on it.
 
Clindamycin is usually the go to for mouth infections. But it tastes horrible (comes as liquid or pills) and you definitely have to give a probiotic. Probiotics should be given 2 hours apart from the AB. If there is infection, that'll tell you if Convenia worked or not. Onsior is an NSAID for pain, specifically post surgery. But not for ongoing use.
 
Oh hurrah, we love any kind of oral medication :eek:. She is even pretty grumpy with the buprenex though allegedly that has no taste! Will S Boulardii work as the probiotic?
 
Good about ketones being down to Minnie’s more normal level. Convenia is not a great drug for mouth bacteria but what’s done is done. She probably will end up having an Rx of Antirobe (clindamycin) anyway if she does have an infection. What did they give you for Sam?
I am linking an article about Convenia and why I don’t like it (unless no other alternative - I have had to use it on feral cats occasionally.) A one time Onsior injection is probably okay but it can be hard on the kidneys (like pretty much all NSAIDS in cats). Better than Metacam though. How do you manage to get the Bupe onto her gums/buccal pocket? That’s where it needs to go for proper absorption/efficacy. You should get a special order of Transdermal Bupe for Minnie. I hope she won’t need any of it really soon though and things will be back to “normal” (whatever that is :cat:)https://catinfo.org/convenia-worth-the-risk/
 
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