? 06/ 14/2022 MICIO: AMPS 118 Getting ready for another anesthesia/surgery

MISSY + Simone&MICIO (GA)

MISSY + Simone&MICIO (GA)

Member Since 2021
Following the Echocardiogram performed on June 7th, 2022 (https://www.felinediabetes.com/FDMB/posts/2960852/ ), on June 9th Micio was also seen by the dentist for a check up and Dr. said, although he couldn't feel/see signs of abcess but a harder bump was still there and to keep an eye on it and, if there were any changes, only way to find out what's going on would be x-rays (meaning anesthesia).
Just yesterday I felt a bigger/extended softer bump under his left side mouth and looks like abcess is back again. Micio is now schedule for anesthesia, x-rays and possible surgery for tomorrow, 15 June, 2022.

@Wendy&Neko, on the previous surgery back in February 11th, Micio had to skip the AM insulin cause of fasting and then he was given 1u @ around 1pm during surgery; I remember you made the comment "OK, I see the 1 units was a +7. Depending how he eats, I wouldn't give full dose cause of that 1 unit. Wish they hadn't given it. " .https://felinediabetes.com/FDMB/thr...y-257-3-469-5-1u-insulin-1pm-pmps-185.259225/
Should I try to suggest them not to give any insulin this time? They don't know at what time tomorrow (Wed, June 15th) they will put him under anesthesia and, depending on the x-rays findings, will decide if surgery is necessay (somehow the Dr. believes Micio may have a foreign object or something stuck in there that is causing all of this troubles).

I also updated Micio's labs with the latest blood work done on 7 June, 2022....kidneys not very good though. Micio has been drinking a lot and, despite his numbers aren't that bad lately and I give him 5000mg B12 methylcobalamin daily his back legs/feet are not stable :(

Will appreciate any thoughts or recommendations, tnx in advance
 
I would just skip in the AM and resume dosing in the PM, if he's up to eating then. Just pretend it's a fur shot. Dosing part way through your schedule means you have to deal with two nadirs - too complicating. Worst case if they feel a need to bring down his numbers, they could do a little bit of R or regular insulin. That wouldn't interfere with the L dosing. With Neko we did half dose in the AM before leaving, one time less because she was flirting with a reduction. But she was on Levemir then and generally home by nadir time.

His kidney numbers aren't that bad, but trending up. Has the vet checked him for arthritis? That can also cause unstable walking.

Best of luck to Micio for the dental. :bighug: Remind the vet that he's acro. Neko had both soft tissue growths on her gum from the acro, and a bony bump (benign) on her jaw that needed removing.
 
Wendy&Neko said:
I would just skip in the AM and resume dosing in the PM, if he's up to eating then. Just pretend it's a fur shot. Dosing part way through your schedule means you have to deal with two nadirs - too complicating. Worst case if they feel a need to bring down his numbers, they could do a little bit of R or regular insulin. That wouldn't interfere with the L dosing. With Neko we did half dose in the AM before leaving, one time less because she was flirting with a reduction. But she was on Levemir then and generally home by nadir time.

His kidney numbers aren't that bad, but trending up. Has the vet checked him for arthritis? That can also cause unstable walking.

Best of luck to Micio for the dental. :bighug: Remind the vet that he's acro. Neko had both soft tissue growths on her gum from the acro, and a bony bump (benign) on her jaw that needed removing.
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Tnx...I did bring that up to the dentist a few times already but I don't think he's familiar with Acromegaly. Dentistry team said no insulin in the morning but to bring it and will give him some only if needed. What do you mean by "they could do a little bit of R? and L dosing?
 
MICIO&Simone said:
but I don't think he's familiar with Acromegaly.
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Hmm, maybe he'll look it up. I was impressed with Neko's dental specialist who realized she had soft tissue growth due to her acromegaly. Subsequently saving a tooth.
MICIO&Simone said:
What do you mean by "they could do a little bit of R? and L dosing?
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No L given, just Humulin R or Regular insulin. It's a short acting insulin, lasts around 4 hours and can take the edge off. Honestly, it won't be that bad if he skips. At least once before anaesthesia with Neko I did a fur shot in the AM. :banghead:
 
@Wendy&Neko @Diane Tyler's Mom UPDATE: Micio went through the procedure well and he's home already for a few hours. Dentist did x-rays and noticed demineralization on the bone and he believes it's likely carcinoma but will have biopsy results next week. It wasn't another abcess. At this point I have no idea how long I'll be able to be with my boy, this is a very aggressive form of cancer. I'm at complete loss.
His numbers stayed pretty low: 100@ 6am, 141@ +4.5, 62@ +9.25 and 86@ +11.25. Going to test again right before insulin but if they stay below 90 I do not feel comfortable to give full dose at all cause I don't know if because of anesthesia he could drop very low...maybe a token dose?
I cannot feed him too much tonight...
 
MICIO&Simone said:
@Wendy&Neko @Diane Tyler's Mom UPDATE: Micio went through the procedure well and he's home already for a few hours. Dentist did x-rays and noticed demineralization on the bone and he believes it's likely carcinoma but will have biopsy results next week. It wasn't another abcess. At this point I have no idea how long I'll be able to be with my boy, this is a very aggressive form of cancer. I'm at complete loss.
His numbers stayed pretty low: 100@ 6am, 141@ +4.5, 62@ +9.25 and 86@ +11.25. Going to test again right before insulin but if they stay below 90 I do not feel comfortable to give full dose at all cause I don't know if because of anesthesia he could drop very low...maybe a token dose?
I cannot feed him too much tonight...
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Simone I'm so sorry to hear this, ♥ Hopefully something could be done, I'm sure @Wendy&Neko will see the tag I know she is very knowledgeable about this :bighug::bighug::bighug::bighug::bighug:
 
:bighug::bighug::bighug:I'm going to hope you have a similar outcome as I did. Neko's bone changes were 99% chance carcinoma according to my dental vet. Treatment in dogs is partial removal of the jaw, cat's don't handle that surgery well. The vet was preparing me for the worst. The biopsy proved the vet wrong. It was an acro bone change.

As for insulin tonight, not all anaesthesia induction drugs lower the BG. Test when you get home, then test again at PMPS. That should tell you if he's trending down. Did he get any insulin during the day? It's fine to give a smaller dose if he's not eating well. And it'll give you a chance to not stress tonight. :bighug::bighug::bighug:
 
Wendy&Neko said:
:bighug::bighug::bighug:I'm going to hope you have a similar outcome as I did. Neko's bone changes were 99% chance carcinoma according to my dental vet. Treatment in dogs is partial removal of the jaw, cat's don't handle that surgery well. The vet was preparing me for the worst. The biopsy proved the vet wrong. It was an acro bone change.

As for insulin tonight, not all anaesthesia induction drugs lower the BG. Test when you get home, then test again at PMPS. That should tell you if he's trending down. Did he get any insulin during the day? It's fine to give a smaller dose if he's not eating well. And it'll give you a chance to not stress tonight. :bighug::bighug::bighug:
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The dentist said the same thing but, even if it'll turn out cancer, at his age and all of the health issues, aggressive treatments and all of the stress related not an option. Dr. said he took out quite bit from his mouth, in several places, for the biopsy. And the swalling under his chin may not even go away but could get worse instead...Micio's a strong boy but he's telling me how tired he is. Still hoping is not cancer though.
I did test him when I came home but at almost pmps numbers were @ 86; after 15 minutes I fed him 1/2 meal (he was hungry) and test right the way and he was 92 but still, gave him 5u cause didn't know what to expect after anesthesia. Going to test him shortly and probably lay down on the ground with him...he's pretty pooped this time.
 
@Diane Tyler's Mom, @Suzanne & Darcy, @Wendy&Neko UPDATE: dentist called me today and said the biopsies came back negative! Dr. still not sure what exactly is but think is some sort of "old" infection and diabetes may making it worse and tougher to heal, and, again, he excluded acromegaly cause he believes otherwise would have been in both sides of his mouth...well, @Wendy&Neko , sounds to me what happened to Micio it may be the same as your Neko.
Micio's swelling went down almost all the way now, he just have a little bump but other than that he's back to his "normal"; one thing I noticed is all of his weird skin growths gotten much bigger and I noticed some darkening around his nose but have no idea what that is. His back legs also seems weaker/unstable.
Not sure how else I can help him, he's definitely tired of vet's trips and visits...
Thank you all for the positive vibes :bighug:
 
This is just wonderful news about the biopsies being negative. What a relief! Thank you so much for sharing this great news with me tonight! You are doing an amazing job with him. His spreadsheet looks very good, too. More later...
 
I am concerned about the back leg weakness. So you say you are giving him Methylcobalamin (or is it just cyanocobalamin injections?) Any chance he may be constipated? Has his blood pressure been checked (I'm assuming they checked this prior to surgery)? With the labs you had on June 7, it's not due to high phosphorus levels as that was good. His hematocrit was fine so he was not anemic. I looked for low potassium, but his was fine on June 7. I am linking a page from the felinecrf.org page that is the Alphabetical List of Symptoms and Treatments. Scroll just a little way down to the "B" section on back leg weakness. It lists possible causes and treatments.

http://felinecrf.org/symptoms_treatments_index.htm
 
Whew! So happy for you. :joyful::joyful::joyful::joyful: Neko's bony growth was on one side of her mouth. Her soft tissue growths were also not both sides. As for the bumps, did you ever consider starting cabergoline again?

Weak legs, possibly arthritis? Very common in acros. Did the vet every check him for that? Adequan might help if so. I had a laundry list of supplements I tried with Neko, some worked better than others with her. Simple things like omega-3/fish oil can help. Cosequin only good for mild cases. Hyaluronic acid also an option. And more.
 
Suzanne & Darcy said:
I am concerned about the back leg weakness. So you say you are giving him Methylcobalamin (or is it just cyanocobalamin injections?) Any chance he may be constipated? Has his blood pressure been checked (I'm assuming they checked this prior to surgery)? With the labs you had on June 7, it's not due to high phosphorus levels as that was good. His hematocrit was fine so he was not anemic. I looked for low potassium, but his was fine on June 7. I am linking a page from the felinecrf.org page that is the Alphabetical List of Symptoms and Treatments. Scroll just a little way down to the "B" section on back leg weakness. It lists possible causes and treatments.

http://felinecrf.org/symptoms_treatments_index.htm
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Micio's bp is good now, recently got it checked along with heart echo; we just add a bit more of Amlodepine. Thanks for the info, I'll look into it.
 
Wendy&Neko said:
Whew! So happy for you. :joyful::joyful::joyful::joyful: Neko's bony growth was on one side of her mouth. Her soft tissue growths were also not both sides. As for the bumps, did you ever consider starting cabergoline again?

Weak legs, possibly arthritis? Very common in acros. Did the vet every check him for that? Adequan might help if so. I had a laundry list of supplements I tried with Neko, some worked better than others with her. Simple things like omega-3/fish oil can help. Cosequin only good for mild cases. Hyaluronic acid also an option. And more.
Click to expand...
Cabergoline scares me, tried that twice and both times he had a seizure. Vet told me about recently approved Solensia injection for osteoarthritis in cats but not sure when it'll be avaliable, my other cat for sure could use it.
Always felt that Micio is allergic to fish and, as Omega-3 source, I tried Supersnout Green lipped mussles but seemed to me it was giving him some diarrhea, I'll try that again and I will definitely mention the other options you listed to my vet as well.
Thanks
 
I've heard Solensia should be available soon.

Just wondering about the cabergoline, as that is one way to slow the soft tissue/bony growths. I can understand your reluctance to go that way. I would be too.
 
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