09/06 Blue AMPS 238 +2 191 PMPS 171 +2 185 (HELP was NEEDED RE:Timing of presurgery dose)

Got all fingers, toes, paws and tails crossed here for the dental surgery. Looked like a good day weather wise for travelling. Enjoy the sunset tonight.
 
@Wendy&Neko @
Well, we made it to Vancouver and English Bay, which is really nice. I need some advice, however, regarding dosing in the morning.

I spoke again with the dental vet staff and, especially the anesthesiologist who relayed the message that no insulin was to be given to Blue and no food in the morning. I said I was not happy with that and that I wanted him to have some insulin on board, especially he might not feel like eating tomorrow evening and then I couldn't give him insulin at all.

They relented and said, ok, give 1/2 dose (1.75u) with some food at 6:00 am. The problem with that is that Blue gets insulin @ 8:00 am and it would mean giving him insulin 2 hours before he get his regular dose and I don't know what that would mean for later in the day tomorrow.

What do you recommend? I can give him insulin 15minutes earlier tonight but that still leaves me with giving insulin at 6:15 (even if I cheat a bit and go for 6:30am).

What do you think? Advice really appreciated on timing and dose! It's now one hour from Blue's PM shot.

@Rainbow Conti @FrostD @Wendy&Neko
 
What time is he scheduled to start?

The reason I ask - I want to double check they're considering the typical Lantus pattern and accounting for when nadir might be...I would hate for that to be while he's under.

Will they check his BG during?

Unfortunately I'm seeing this a little too late, I probably would have moved the shot up an hour (or the full two) tonight depending on BGs...just perhaps done a reduced dose.

Truthfully I can't say what to do in the morning. While I wouldn't want to skip, a lot depends on what he does tonight and where he's at with shot time tomorrow. Remember you still have a full 3.5U depot sitting there, so a one-time dose of 1.75U might not make much of a dent. He's had nice numbers, and who knows how much the dental will help things.

I have thoughts on what I would do, but hoping Wendy comes by as she's better to advise. I'll check later and if not, I'll give you my thoughts so you at least have something to consider.

*And remember, no food does not necessarily mean no insulin. So even if he doesn't want to eat tomorrow night, you may not have to skip (again depends on BG, what shape he's in, etc)
 
What time do you have to be at the vet's clinc? I gave Neko some food (vet said up to 1/3 of meal) at 6:00 am, but didn't shoot until her regular AMPS, which was 7:30 at the time. Of course, I was lucky with the dentals in that she was on Levemir at the time, and didn't onset until 5 hours later. For all anaesthesia's she had, she got 1/2 dose, except the one where I though she was flirting with a reduction, in which case she just got a token dose.

To reinforce what Melissa said, no food does not mean no insulin. You can always give at least a half dose, which is what most diabetics get before anaesthesia.
 
Wendy&Neko said:
What time do you have to be at the vet's clinc? I gave Neko some food (vet said up to 1/3 of meal) at 6:00 am, but didn't shoot until her regular AMPS, which was 7:30 at the time. Of course, I was lucky with the dentals in that she was on Levemir at the time, and didn't onset until 5 hours later. For all anaesthesia's she had, she got 1/2 dose, except the one where I though she was flirting with a reduction, in which case she just got a token dose.

To reinforce what Melissa said, no food does not mean no insulin. You can always give at least a half dose, which is what most diabetics get before anaesthesia.
Click to expand...

I'm to admit him at 9:15 tomorrow morning. I am assuming (you know how that goes) that his dentals will be relatively soon after that as they are aware I have to drive back to Kelowna when I pick him up.

I can feed him @ 6:00 (1/3 meal) but can I give him insulin (even if it's 1/2 dose) at say, 7:45 without any more food? I was told they will monitor his BG during the surgery...

AND, am I understanding correctly: if he doesn't feel like eating tomorrow on the way home or when we get home, I can still give half the dose?
 
You could probably give insulin at 7:30 tomorrow morning. Of course, let's see what his numbers dictate too. Would have been interesting to have gotten a test when you arrived at the hotel, given that PMPS was lower than AMPS+2.

The way the dental clinic works (at least when last I was there), they do intakes in the morning, then start surgeries after that. It could be a couple hours later. Since you have an earlier morning appointment, you probably have one of the early surgery starts. They have to prep him and do x-rays before hand too. You should get a call from the dental vet after the x-rays, and before they start surgery. Neko also had a BG test before they gave anaesthesia.
 
FrostD said:
What time is he scheduled to start?

The reason I ask - I want to double check they're considering the typical Lantus pattern and accounting for when nadir might be...I would hate for that to be while he's under.

Will they check his BG during?

Unfortunately I'm seeing this a little too late, I probably would have moved the shot up an hour (or the full two) tonight depending on BGs...just perhaps done a reduced dose.

Truthfully I can't say what to do in the morning. While I wouldn't want to skip, a lot depends on what he does tonight and where he's at with shot time tomorrow. Remember you still have a full 3.5U depot sitting there, so a one-time dose of 1.75U might not make much of a dent. He's had nice numbers, and who knows how much the dental will help things.

I have thoughts on what I would do, but hoping Wendy comes by as she's better to advise. I'll check later and if not, I'll give you my thoughts so you at least have something to consider.

*And remember, no food does not necessarily mean no insulin. So even if he doesn't want to eat tomorrow night, you may not have to skip (again depends on BG, what shape he's in, etc)
Click to expand...

Yes, they'll check his BG during surgery, I'm told. I don't know if they are considering an insulin pattern necessary because they were willing to let him have the half dose instead of no insulin.
Tonight's numbers a bit off as I gave him some food when we arrived which was about 2.5 hours before shot time.
Wendy&Neko said:
You could probably give insulin at 7:30 tomorrow morning. Of course, let's see what his numbers dictate too. Would have been interesting to have gotten a test when you arrived at the hotel, given that PMPS was lower than AMPS+2.

The way the dental clinic works (at least when last I was there), they do intakes in the morning, then start surgeries after that. It could be a couple hours later. Since you have an earlier morning appointment, you probably have one of the early surgery starts. They have to prep him and do x-rays before hand too. You should get a call from the dental vet after the x-rays, and before they start surgery. Neko also had a BG test before they gave anaesthesia.
Click to expand...

Right, I had forgotten you know this clinic!

It is totally interesting that his BG was lower as it just shows how chill he can be, what with a long car trip and being hauled up an elevator in his cat carrier to a place he's never been before. 68420937471__6318D66C-CD9C-4A6C-A47F-A299F6FDB4AA.jpg Mr. Blue at the Sylvia Hotel.
 

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