04/30 Shmee AMPS 333, +6 123, more dental talk

[Amanda & Shmee]

Previous condo: http://www.felinediabetes.com/FDMB/...278-dosing-during-dental.194851/#post-2180990

Hi everyone,
Shmee had a nice blue streak today, which is nice to see after that red. He seems pretty spunky today too, and has been running around from window to window really trying to get the birds!

In reply to yesterdays condo;
@Gill & George - "Just a reminder now that he is up to 5u, if you do not see any green, take him up in 0.5u steps. Once kitties get over 5u we switch to 0.5u changes, think of it as a percentage increase in dose.
If kitty were on 2.5u then a 0.25u increase is a 10% increase in dose
Once kitty gets to 5u a 0.25u increase would only be a 5% increase in dose/ going up in a 0.5u step would be a 10% increase."
Thank you, I did not know this. I just went over my binder and don't see this mentioned anywhere! Although I just found in the Tillys Diabetes Homepage website that increases should be .5 for "higher doses". I still increase by .5 if he sees greens too? I guess Shmee is considered a high dose kitty at this point so it makes sense.

@Wendy&Neko , @Tricia Cinco(GA) & Harvey , @Stacy & Asia , @Juliet , @Shawna & Davidson -
From what I learned yesterday, I will be increasing him by .5 from now on. Is this the case for if he sees greens too? I emailed my vet asking her opinion on the Wednesday PM and Thursday AM doses, and asked her if I could let him eat until midnight. That would make me feel better about giving him the full shot Wednesday PM too, since he should eat a decent amount by midnight. I was under the impression that insulin could not be giving when they don't eat, but it seems like the 1/2 dose is common for the fasting state so we will see what my vet recommends too. As for what happens after the dental, I will keep the dose the same as of right now, and play it be ear / post here with questions when the time comes. I also asked the vet about AB's. I didn't see AB's on the estimate, only the pain meds (which is a shot that lasts three days?). So I asked the vet if AB's would be given if the x-rays show an infection, or if I can get them as a precautionary measure.

Thank you all for the comments and advice yesterday, your time and knowledge is appreciated! I am loving being able to learn as much as possible from people who are experienced.

 

[Wendy&Neko]

I was under the impression that insulin could not be giving when they don't eat, but it seems like the 1/2 dose is common for the fasting state so we will see what my vet recommends too

Not all the insulin given is used to counteract injested carbs. Insulin helps the brain get the food it needs, same with other parts of the body. You also have to use some judgement. If Shmee were to give you an unexpected low number the morning of the dental and you are worried the vet won't be monitoring as much, then you can cut the dose more.

only the pain meds (which is a shot that lasts three days?

Sounds like that might be Metacam. I would nix that. I had No Metacam on my cat's file. It's got a FDA black box rating in the US - it's hard on kidneys. Ask for some buprenorphine to take home. That way you can give pain meds, if and when needed.

If you do get antibiotics, start Shmee on a probiotic before hand. ABs can mess with the tummy flora and make them not feel well. Give the AM and the probiotic a couple hours apart. I'd be curious which AB they might prescribe too.

When you get home, just feed a small amount about 20 minutes or so apart. Anethesia also messes with the GI system temporarily, and you don't want him barfing. Some people stock up on a bit of all meat babyfood (plain, no veg or flour). It's very easy to eat if they have extractions and cats seem to love it.

 

[Gill & George]

. I still increase by .5 if he sees greens too? I guess Shmee is considered a high dose kitty at this point

Depends on the green, to decide you'd like at how low the dose is taking him and make a decision on whether you have the wiggle room to take him up. There may also be instances where you may want to find time a dose, and move in smaller steps.

Lovely run of blue, today lower than he's been in a while, I wonder whether you should hold the fosd? I'm undecided, what with the surgery scheduled....
@Wendy&Neko what are your thoughts, still ok to go up in dose?

 

[Wendy&Neko]

With low blues, it's OK to hold the dose 6-10 cycles before increasing. Regardless what you do, the half dose day of dental will mess with the depot. One thing I've noticed, Shmee seems to often react to a dose increase on the 3rd cycle. If you increase tomorrow, and he stays true to pattern (don't tell Shmee he's predictable!), then Wednesday should be a better day. Course, this last increase he waited to cycle 5, which would put that on dental day.

As far as how much to increase when you start seeing green, you'll have to see what works for Shmee. If the greens are still high greens, I would still do the 0.5 unit increase, especially if that green was fleeting. Low greens, you could experiment with a smaller 0.25 unit increase to see if you can bring the overall numbers down just a tad. Also, some cats are more sensitive to smaller increases. Neko was.

 

[Amanda & Shmee]

Sounds like that might be Metacam. I would nix that. I had No Metacam on my cat's file. It's got a FDA black box rating in the US - it's hard on kidneys. Ask for some buprenorphine to take home. That way you can give pain meds, if and when needed.

If you do get antibiotics, start Shmee on a probiotic before hand. ABs can mess with the tummy flora and make them not feel well. Give the AM and the probiotic a couple hours apart. I'd be curious which AB they might prescribe too.

Thanks for this advice. I am going to give my vet a call tomorrow and see if we can do buprenorphine instead. I looked up both and it definitely seems to be the better option. Is it a pill? How to you give buprenorphine to your cat?

She hasn't answered my email yet so I am unsure if he will be getting AB's. Unfortunetely since the dental is already on Thursday I dont think I have time to order probiotics beforehand. If he will be on ABs then maybe I can start them after the dental, if it will help?

Lovely run of blue, today lower than he's been in a while, I wonder whether you should hold the fosd? I'm undecided, what with the surgery scheduled....@Wendy&Neko what are your thoughts, still ok to go up in dose?

With low blues, it's OK to hold the dose 6-10 cycles before increasing. Regardless what you do, the half dose day of dental will mess with the depot. One thing I've noticed, Shmee seems to often react to a dose increase on the 3rd cycle. If you increase tomorrow, and he stays true to pattern (don't tell Shmee he's predictable!), then Wednesday should be a better day. Course, this last increase he waited to cycle 5, which would put that on dental day.

It is a hard decision .. Maybe keep this dose for four days instead of three, and then his increase would be Wednesday? Then dental day is day 2 of the increase instead of day 3 (when he is usually lower)? Or maybe do a .25 increase for now since there are other factors, and start the .5 increases later after the dental?

 

[Amanda & Shmee]

Also just a side note - I had the wrong date listed on my SS for his dental. Its this Thursday the 3rd, not the 2nd. It has been corrected.

 

[Stacy & Asia]

Bupe is a liquid, it’s a very small amount and it is absorbed in the mucosa, you just shoot it in their cheek, they don’t have to eat it. One of the easier meds to give I say.

Good call on trying to get the antibiotics just in case. Probiotics will certainly help after the dental. Make sure you give it away from the antibiotics so they don’t cancel each other out much.

 

[Wendy&Neko]

Is it a pill? How to you give buprenorphine to your cat?

Buprenorphine is a liquid. Usually they'll give you prefilled oral syringes. You squirt it in the mouth, so it hits the sides of the mouth and is absorbed mostly there, rather than something swallowed. I usually approach from behind, tuck the syringe in the corner of the mouth and aim for the inner cheek.

You can get probiotics, like the Renew Ultimate at many stores. I've heard they are available at Whole Foods if you have one near you. People probiotics are fine, doesn't have to be animal ones. The ABs may depend on whether or not he needs extractions so the decision could be made at the time of the dental.