05/02 Shmee, dental tomorrow, +5 61, +11 146, giving half PM dose

Status
Not open for further replies.

Amanda & Shmee

Member Since 2018
Previous condo: http://www.felinediabetes.com/FDMB/threads/05-01-shmee-11-161-amps-200.194953/#post-2181848

*** PMPS update - BG 158, shot little lower than half a dose, 2.5U.

----
The below has kindly been answered :)
----
Good morning everyone and happy hump day,

Good news – the pain meds shot is not Metacam, it is Buprenorphine. So that's a relief. :) She also said I can leave the food out until midnight.
Possible bad news? – my vet wants to skip Thurs AM’s shot before the procedure. She said "don't give any insulin Thursday morning, since he won't be eating at all. Running a bit high is less dangerous then if he got too low. You can check his blood sugar when you get him home and see where it's at, but usually they can get insulin even if they don't feel like eating after the dental." He won't be home until after 4pm... so by after the dental I assume she means the PM shot (which for me is 9pm).

Per @Stacy & Asia yesterday, "See what vet says about a morning dose before the dental, what I’ve often heard is half dose, but your vet should make that call since they are the ones dealing with the insulin effects and anesthesia during the surgery. Remember, cats (and humans) need some insulin for fasting states as well, not just when they are eating."

I tried to find some information to back up insulin is needed during fasting states too, but I couldn’t find much (although I am at work, I have done like no work today my boss is going to kill me!!). The felinediabetes.com website “Insulin 101” says; “Always make sure your cat eats around the time (up to one hour before injection) of the insulin administration. This will insure that the cat has food in her stomach (and rising blood glucose levels as a result) to counteract the action of the insulin.” Another website about dental work in diabetic cats (https://www.diabeticcatcare.com/DCCCOK/Dentals1.htm) says; “Lack of insulin for one shot is easily treated once the cat is back home and able to eat on its own.”

Not sure what to think. I am scrabbling looking through other spreadsheets trying to gather some examples where other cats received dental.

@Wendy&Neko - I found that Neko received a portion of his dose after fasting, .1.
@Tricia Cinco(GA) & Harvey - For some reason my search tool isn't working for your SS. Can you let me know when Harvey received his dental?
@Juliet – I see the vet gave Silver the insulin after the dental. After looking at your SS I see he is back in the hospital, I am so so sorry to see this, and I am sending vines, love, and hugs your way.
@Sandy and Black Kitty didn’t give the shot because her GB was low.
@Chris & China also did not give a shot, her BG was also on the low side.

Who else am I missing that has received dental? I would love to see more data if possible.

From what I am seeing, I think it might be best to just follow my vets wishes and do a NS tomorrow morning before the dental since she is comfortable with that. At this point I don’t think I have enough data to change her mind if I tried. Curious what you all would do / what your opinions are. I feel bad trying to go against her wishes, but I also want what is best for Shmee.

My Shmee only has a dental.... Some of you go through so much more with your kitties.... I really do not know how you do it. :bighug: I am so anxious and nervous, I can only imagine what the ones with other issues have to go through. Thank you all for your help.
 
Last edited:
Previous condo: http://www.felinediabetes.com/FDMB/threads/05-01-shmee-11-161-amps-200.194953/#post-2181848

Good morning everyone and happy hump day,

Good news – the pain meds shot is not Metacam, it is Buprenorphine. So that's a relief. :) She also said I can leave the food out until midnight.
Possible bad news? – my vet wants to skip Thurs AM’s shot before the procedure. She said "don't give any insulin Thursday morning, since he won't be eating at all. Running a bit high is less dangerous then if he got too low. You can check his blood sugar when you get him home and see where it's at, but usually they can get insulin even if they don't feel like eating after the dental." He won't be home until after 4pm... so by after the dental I assume she means the PM shot (which for me is 9pm).

Per @Stacy & Asia yesterday, "See what vet says about a morning dose before the dental, what I’ve often heard is half dose, but your vet should make that call since they are the ones dealing with the insulin effects and anesthesia during the surgery. Remember, cats (and humans) need some insulin for fasting states as well, not just when they are eating."

I tried to find some information to back up insulin is needed during fasting states too, but I couldn’t find much (although I am at work, I have done like no work today my boss is going to kill me!!). The felinediabetes.com website “Insulin 101” says; “Always make sure your cat eats around the time (up to one hour before injection) of the insulin administration. This will insure that the cat has food in her stomach (and rising blood glucose levels as a result) to counteract the action of the insulin.” Another website about dental work in diabetic cats (https://www.diabeticcatcare.com/DCCCOK/Dentals1.htm) says; “Lack of insulin for one shot is easily treated once the cat is back home and able to eat on its own.”

Not sure what to think. I am scrabbling looking through other spreadsheets trying to gather some examples where other cats received dental.

@Wendy&Neko - I found that Neko received a portion of his dose after fasting, .1.
@Tricia Cinco(GA) & Harvey - For some reason my search tool isn't working for your SS. Can you let me know when Harvey received his dental?
@Juliet – I see the vet gave Silver the insulin after the dental. After looking at your SS I see he is back in the hospital, I am so so sorry to see this, and I am sending vines, love, and hugs your way.
@Sandy and Black Kitty didn’t give the shot because her GB was low.
@Chris & China also did not give a shot, her BG was also on the low side.

Who else am I missing that has received dental? I would love to see more data if possible.

From what I am seeing, I think it might be best to just follow my vets wishes and do a NS tomorrow morning before the dental since she is comfortable with that. At this point I don’t think I have enough data to change her mind if I tried. Curious what you all would do / what your opinions are. I feel bad trying to go against her wishes, but I also want what is best for Shmee.

My Shmee only has a dental.... Some of you go through so much more with your kitties.... I really do not know how you do it. :bighug: I am so anxious and nervous, I can only imagine what the ones with other issues have to go through. Thank you all for your help.
Thanks. My word of hindsight advice - insist on antibiotics after the dental.
 
Thanks. My word of hindsight advice - insist on antibiotics after the dental.
Thank you Juliet, I forgot to mention that update from my vet - she did confirm he is getting an AB (Convenia injection).
I hope Silver is able to come home soon :(:bighug:
 
My vet had me skip Max’s insulin the morning if the dental as well. I had to give a reduced dose that night too because he wasn’t eating well. My vet gave convenient too which many here won’t allow. If there’s a reaction it stays with them for weeks and nothing to do. My vet said he’s never seen that happen but I must admit I was nervous. Dental vines.
 
Thank you Juliet, I forgot to mention that update from my vet - she did confirm he is getting an AB (Convenia injection).
I hope Silver is able to come home soon :(:bighug:
I would ask for a different AB. That one is injectable and stays in the system. If any allergic reaction it's hard to fix. DCIN stated no Metacam and no Convenia. Clavaseptin is best for dental and is what Silver is now on. I sent vet with a reduced dose of insulin as I knew there would not be 12 hrs between doses so he got half dose after dental and full dose at night.
 
I would go with what the vet wants regarding insulin. I have give Neko no insulin before anesthesia (courtesy of a fur shot :rolleyes:) and once reduced her dose to just 0.1 unit because I was worried she would go low. She did, just missed reduction point by a couple points.

I second what Juliet says on Convenia - it's really an AB for skin conditions. Clindamycin is also a good AB for the mouth.
 
Clyndamycin comes in either liquid or pills. It's bitter, they won't like the liquid, but it's an alternative if Shmee doesn't like pilling.
 
Clyndamycin comes in either liquid or pills. It's bitter, they won't like the liquid, but it's an alternative if Shmee doesn't like pilling.

He doesn't like it but I have done it for small pills. I give him his Denamarin with pill pockets, but since that probably won't be a possibility with mouth being sore I think pilling him might be a better alternative to the liquid depending on how big the pill is.

@Juliet Is Clavaseptin a pill?
 
He doesn't like it but I have done it for small pills. I give him his Denamarin with pill pockets, but since that probably won't be a possibility with mouth being sore I think pilling him might be a better alternative to the liquid depending on how big the pill is.

@Juliet Is Clavaseptin a pill?
It is. But you'd be surprised. Silver went right to his good after the dental. At the vets. I've heard most cats eat fine after a dental.
 
To dose or not to dose...if so how much...pre and post dental is very much an ECID thing.

BK went to a veterinary dental specialist who advised no insulin the morning of surgery.

Here is how it played out-
BKs PMPS the night before was 349 and he got his full Lantus dose of 13u. At PM+ 7,5 (time to leave the house) he was 248 and at +10 (at the vet) was 156 During surgery (+12+13) he was 50 and post op (+14) he was 30 :eek: I didn’t shoot until+35.5 and that was 7u (slightly over half his dose).

Ketones were negative and 5 ketone
free months were under our belt. The greatest risk for BK was the IAA had started to break about 2 months prior to the dental so rather than be faced with a high dose cat that I could not count on eating after 8 extractions I played it super safe. I did u R regularly due to his high dose condition and knew that I could use it to quickly bring his BG in line if needed.

“Better a day too high than an hour too low “.

We were given liquid clindamycin, which I was able to mix into his food.
 

Here is how it played out-
BKs PMPS the night before was 349 and he got his full Lantus dose of 13u. At PM+ 7,5 (time to leave the house) he was 248 and at +10 (at the vet) was 156 During surgery (+12+13) he was 50 and post op (+14) he was 30 :eek: I didn’t shoot until+35.5 and that was 7u (slightly over half his dose).

“Better a day too high than an hour too low “.

Oh wow! That is scary. Thank you, and this makes me feel a little better about the NS tomorrow morning. Better safe than sorry.
 
Clavamox (Clavaseptin) also comes in liquid form. When I've given it my cats of course didn't like it but didn't act like it's horrible. You might ask to see the size of the pills before deciding.

Anesthesia can bring bg down so you should be cautious about the evening dose, depending on how long it's been since the procedure.
 
Sounds good I have emailed my vet saying I would like to nix the Convenia and asked if we could do Clavaseptin or Clindamycin. I also mentioned the liquid options depending on how large the pills are, so I am going to ask them to show me tomorrow morning if they have them on hand.
 
Update ***

He just got the lowest he ever has, 62! at +4.5. I feel bad - I have been so worried about everything else I totally forgot to check him like I wanted to at +3. I hope he did not go too low. I just made sure he ate a little more LC. He is acting sleepy... but that isn't uncommon for him. Checking again at +5.

I wonder if I should scale back to 5 for tonight since the dental is in the morning??
 
Last edited:
+5.5 69, + 6 71

Of course he has to do this to me right before the dental!! I also have to leave by 5... I can stay if absolutely necessary but hopefully he will be at a reasonable number by then...
 
@CassAndGordy has learned not to give insulin before any vet visits for Gordy. He went low for his annual check-up, even though he was high at AMPS.
Yup, Gordy spikes at the vet and then crashes. I know now just to forgo the insulin on his vet days. Because he typically needs sedation and that makes him nauseous, Id rather not mix not eating with steep drops.

But definitely the cardinal rule of ECID is king here. Just take in the advice you get and then see what you do with it.
 
Sending advanced vetty vines for Shmees dental. He’s going to do great and what a nice cycle he’s given you today! Don’t worry, you’ll see these numbers again and he will recover from the skipped shot.

Another ECID moment, Asia’s AMPS was 366, at the vet today it was 204, as soon as we got home...87! :joyful: She tends to drop after a vet visit and then have several wonky post vet freak out cycles. :facepalm:
 
My +11 update - 146.
Shooting in about 40 minutes

I called and talked to my vet about the AB, and he is not getting Covenia anymore, he will be getting Clindamycin pills I believe.
She also really freaked out about the 61. Much more than I did... haha. Some background, I asked her a while ago how many cats she has gotten into remission before and she said "very few" because most of her patients didn't want to spend the $ on Lantus, and couldn't test often. I think I am her first person that is trying to get their cat info remission, and not just regulated. So I assume most of her diabetic cats have not dropped that low.

Anyway, she said if he is in the low 100's to give him a half dose. I think this is reasonable. Thoughts?
 
On TR, that 156 is perfectly fine to shoot. We suggest that if you get a number below 150 the first time, you stall, do not feed, and post for help. Anyway, water under the bridge for now and special circumstances tonight. Since you can't feed after midnight, you can be sure he'll be safe tonight.
 
PMPS 156, shot 2.5U



Tomorrow morning my vet does not want any shot. Or did you mean tomorrow night?
I meant tomorrow morning. But, this is the lowest pre shot for the 5.25 dose and what if he drops on you after midnight and you couldn't steer? He has had 3 doses of 5.25 so the depot is starting to fill if not filled. Probably safer this way.
 
On TR, that 156 is perfectly fine to shoot. We suggest that if you get a number below 150 the first time, you stall, do not feed, and post for help. Anyway, water under the bridge for now and special circumstances tonight. Since you can't feed after midnight, you can be sure he'll be safe tonight.

Thanks Wendy yes I think I would have been comfortable shooting him if it were a normal night, but since he won't be eating until about 4 or 5 pm tomorrow, I didn't mind following the vet and being cautious.
 
I called and talked to my vet about the AB, and he is not getting Covenia anymore, he will be getting Clindamycin pills I believe.
She also really freaked out about the 61. Much more than I did... haha. Some background, I asked her a while ago how many cats she has gotten into remission before and she said "very few" because most of her patients didn't want to spend the $ on Lantus, and couldn't test often. I think I am her first person that is trying to get their cat info remission, and not just regulated. So I assume most of her diabetic cats have not dropped that low.

The vet that diagnosed Asia and the one after that said the same thing, it’s rare for cats to get remission.

I bet you all of her diabetic cat patients have had a 61 before, if not lower...just nobody knew about it if they weren’t testing much. Even if you try to run them high on purpose, sometimes it just happens that they go much lower than anticipated, cats + insulin = unpredictable. ;)

Can’t wait for you to get your boy back tomorrow with his sparkling new grill! :smuggrin:
 
Status
Not open for further replies.
Back
Top