1/25 - Gen, AMPS >400, +6 370

[Allie & Gen]

Yesterday

Hello friends! I hope you're having a pleasant Sunday - and if you're with me in the path of this snowstorm, a cozy one without power outages. And safe surfs for the kitties!

It is a beautiful white-out outside. I'm so tempted to take a walk and enjoy the rare hush, but it's also only 11 degrees.

Gen is bouncing, sigh. He's eating, also, but a little more fussily than normal - I've had to swap out one flavor at each meal for the last several, which is going to be an issue if it happens on a day I have to be in the office. (And we're working with the same four flavors; this morning he preferred one that he rejected last night. I think maybe he's over having it heated, which I'd been doing on my vet's advice and which seemed to appeal for a few days.)

I've managed to keep successfully medicating him (I'm grateful that I can fit three pills into one capsule for him), though if I have to keep pilling, I'm going to need gauntlets or something ... he's done a number on my right forearm with his claws. Poor lad, it doesn't look pleasant; if only he would take the pills in food the way I keep trying to give them to him, with absolutely no success. His ears are so red, too, from the mirataz.

Here's a question if anyone has a moment (@Wendy&Neko, @Christie & Maverick, @Sienne and Gabby (GA), @tiffmaxee): if I were to switch to TR, how would I go about it? Would I look at his current dose, say this is his sixth cycle on it (counting from after the skipped AM shot on 1/22), and then increase tonight by 0.25u? (When you're making a decision to increase, do you average the nadirs over the given period? For example, Gen has had 4 nadirs between 200-300, 1 nadir below 200, and it looks like this cycle's nadir will be above 300.)

Also, is it a good idea to switch to TR with him dealing with whatever he's had going on since Wednesday night (possibly a pancreatitis flare)? And surgery scheduled for a week from tomorrow? Is there any reason to wait?

 

[Sienne and Gabby (GA)]

The surgery is for his periodental disease? Are they planning on extractions? My only hesitation would be that Gen might have some difficulty eating if they are planning on extractions. Given that TR is more aggressive than SLGS, I might consider waiting until you're past the surgery.

With only one nadir in the "blue" zone, I would increase the dose. Basically, if your cat's nadirs largely aren't in a normal range, it's time to increase the dose.

 

[Allie & Gen]

The surgery is for his periodental disease? Are they planning on extractions? My only hesitation would be that Gen might have some difficulty eating if they are planning on extractions. Given that TR is more aggressive than SLGS, I might consider waiting until you're past the surgery.

With only one nadir in the "blue" zone, I would increase the dose. Basically, if your cat's nadirs largely aren't in a normal range, it's time to increase the dose.

They are definitely planning on extractions, possibly quite extensive ones. (I'm not kidding about calling his case "severe," unfortunately. ) I need to discuss how feeding is supposed to work during recovery (we're having a pre-surgery vet visit on Wednesday), but that makes sense as a concern. Maybe I should wait, then.

Thank you for clarifying! I thought that was probably the case, but he's so all over the place at times that I've been a little uncertain. (Hopefully after the surgery his BG will be a little less chaotic anyway.)

 

[Allie & Gen]

 

[Mary & Jude]

Allie, We've had several members whose kitties have had multiple extractions. I'll tag some that I can remember, and perhaps they can tell you how the recovery went for them; @Laurie&Petey @Brianna & Xander and I'm thinking that @Tim & Pookey and @Christie & Maverick too, but I might be wrong on that.

 

[Tim & Pookey]

I bet he’s going to feel a lot better! Good luck, overall it was scary for us but for the best I think.

 

[Staci & Ivy]

Love the photo of Gen being so sweet

Are you alternating the dose on his ear to the opposite one every time? And cleaning the one you’re not using each time?
Make sure to do that religiously.

Also @Karolina & Nestle had dentistry done last year too.

Info on Dental Procedures (including pictures)

Have you read the information on dentistry here on this website?
I know there’s information for the protocols with insulin etc.

Good to discuss with your vet before the day of that procedure.

Hope you both stay warm and cozy in this storm

 

[Allie & Gen]

Are you alternating the dose on his ear to the opposite one every time? And cleaning the one you’re not using each time?
Make sure to do that religiously.

Alternating, yes, but I wasn't aware that I was supposed to clean them. Oh no, poor boy! So each ear waits a day to be cleaned (the day the alternate ear gets the application)? Just soap and water, or do I need something else? He's going to hate it either way, he's not a fan of me messing with his ears (you know, or most other parts of him).

Have you read the information on dentistry here on this website?
I know there’s information for the protocols with insulin etc.

Good to discuss with your vet before the day of that procedure.

Oh, I have! Including going over insulin and anesthesia protocols in multiple places. I'll want to review, though, and bring some highlighted notes to our Wednesday appointment. Thank you for the reminder!

 

[Christie & Maverick]

Like Sienne mentioned, I think I would wait to switch to TR until your past the dental surgery. Mary has a good memory . Maverick did indeed have 9 extractions; his problem was resorptive lesions.

I had some Tiki mousse on hand which he liked. I bought it thinking the mousse texture would be helpful for his eating but luckily Mav seemed to take to his usual food fairly quickly. I just kept offering him really small meals often. You’ll want to make sure the vet gives you pain meds. My vet had offered Onsior for pain, but I was able to get them to give me Buprenorphine instead. Hopefully as part of Gen’s dental, they will do both pre and post op x-rays. The post extraction x-rays are necessary to make sure they got the whole root and not leave anything behind which might cause an infection.

Hoping Gen’s appy issues continue to stabilize.

 

[Staci & Ivy]

Alternating, yes, but I wasn't aware that I was supposed to clean them. Oh no, poor boy! So each ear waits a day to be cleaned (the day the alternate ear gets the application)? Just soap and water, or do I need something else? He's going to hate it either way, he's not a fan of me messing with his ears (you know, or most other parts of him).


Oh, I have! Including going over insulin and anesthesia protocols in multiple places. I'll want to review, though, and bring some highlighted notes to our Wednesday appointment. Thank you for the reminder!

Yes you must clean the ear you’re not using to remove buildup of the medication (probably why it’s so red).

You can use a cotton ball with warm water (or witch hazel if you have it)

 

[Staci & Ivy]

Yes, come home with Buprenorphine for pain!!
Make sure you get it.
@Karolina & Nestle had a hell of a time after the fact getting pain meds

 

[Allie & Gen]

Like Sienne mentioned, I think I would wait to switch to TR until your past the dental surgery. Mary has a good memory . Maverick did indeed have 9 extractions; his problem was resorptive lesions.

I had some Tiki mousse on hand which he liked. I bought it thinking the mousse texture would be helpful for his eating but luckily Mav seemed to take to his usual food fairly quickly. I just kept offering him really small meals often. You’ll want to make sure the vet gives you pain meds. My vet had offered Onsior for pain, but I was able to get them to give me Buprenorphine instead. Hopefully as part of Gen’s dental, they will do both pre and post op x-rays. The post extraction x-rays are necessary to make sure they got the whole root and not leave anything behind which might cause an infection.

Hoping Gen’s appy issues continue to stabilize.

Thanks, Christie! When I've asked before in passing, various vets have always told me he's not going to have trouble eating, but I'm dubious. I wonder if he'd like the Tiki mousse ... he sadly is not a fan of Tiki broth. Do you have a sense of the timeline of his recovery? I may ask for some extra wfh time, but it's generally rather hard to get that approved at my job, so I'm not sure how many days I'll be able to stay home for. (I had originally scheduled his surgery for a Friday for this reason, but now that we've had to wait so long I jumped on the first available date, which is unfortunately a Monday.)

Yes you must clean the ear you’re not using to remove buildup of the medication (probably why it’s so red).

You can use a cotton ball with warm water (or witch hazel if you have it)

Oh, is witch hazel okay on cats? I have witch hazel wipes at home, which might be the easiest thing, since I could avoid dripping water into his ears. I should have thought of this/researched it already tch.

Yes, come home with Buprenorphine for pain!!
Make sure you get it.
@Karolina & Nestle had a hell of a time after the fact getting pain meds

I am positive my vet will have planned for pain meds, but I'll check about it on Wednesday and make sure I can get it the day of the procedure. I'm guessing it was hard to get afterwards because it's an opiod? I take medication for ADHD, so I'm unfortunately quite familiar with the hoops they make you jump through to get (needed) controlled substances from human pharmacies.

 

[Allie & Gen]

@Sienne and Gabby (GA) @Christie & Maverick @Wendy&Neko - am I still good to do an increase per SLGS, though, do you guys think? (Also, does the missed AM shot on the 22nd affect the increase schedule? If you ignore it, we're at about a week on the current dose.)

Given the nerves various vets have had about surgery with unregulated diabetes, I'm imagining that it might be a good thing if I can get his BG a little lower (big if, though). And if I increase tomorrow there will be a full week of adjustment time before surgery.

 

[Albert & Xander]

Oh, is witch hazel okay on cats? I have witch hazel wipes at home, which might be the easiest thing, since I could avoid dripping water into his ears. I should have thought of this/researched it already

I'm pretty sure its fine, i've used it to treat acne every now and then on Xander's chin. I just made sure to dry it a little afterwards and not let him lick at it.

I've been wiping the mirataz off with either a damp paper towel with just water or these baby wipes I have for pets. I've been waiting until the next day to wipe them off, but from the product insert it mentions not to come into contact with it for 2 hours to avoid absorption so im assuming most of it has been absorbed within those 2 hours? Not sure how soon is best to remove it.

 

[Karolina & Nestle]

I am positive my vet will have planned for pain meds, but I'll check about it on Wednesday and make sure I can get it the day of the procedure. I'm guessing it was hard to get afterwards because it's an opiod? I take medication for ADHD, so I'm unfortunately quite familiar with the hoops they make you jump through to get (needed) controlled substances from human pharmacies.

When you go in on Wednesday just ask which painkillers and antibiotics they will send you home with.
My vet gave us Onsior which was good for the first 3 days and an antibiotic (just in case) .
My vet also prescribed Codeine and after coming home and doing some research I refused to give it to Nestle. That's why I needed to get something else for pain. Originally I wanted Buprenorphine but my vet didn't have it on hand and it was a lot of back and forth and calling different clinics to see who can fill the script from my vet. Eventually I ended up getting Gabapentin but didn't have to use it as Nestle only had 1 canine (plus 1 small front tooth) removed and he bounced back pretty quickly.
And I know days leading up to and day of is very stressful but it's actually the day after the dental that was worse and scarier for me. Nobody really talkes about it but just so you're prepared.

 

[Allie & Gen]

And I know days leading up to and day of is very stressful but it's actually the day after the dental that was worse and scarier for me. Nobody really talkes about it but just so you're prepared.

What made it so scary, if you don't mind my asking? I do like to be prepared!

 

[Karolina & Nestle]

What made it so scary, if you don't mind my asking? I do like to be prepared!

The night after the dental Nestle ate well but then he just sat there with his mouth open and tongue sticking out. They just look so out of it. I know some kitties don't sleep cause they're so high.
Not knowing how much pain they're in is scary also, since they can't talk.
And administering medicine orally is a challenge even with the calmest of kitties, as their mouth will obviosuly hurt.
Maybe other members can share their experiences as well as obviosuly ECID and I was lucky by day 3 Nestle was basically back to being himself.
I'm sharing a pic of Nestle the night after the dental

 

[Wendy&Neko]

Yes on the increase.

Neko had three dentals. The first was just a cleaning by her regular vet, the next two by a dental specialist and the more "interesting" ones. Second one was one tooth removed and another tooth shaved. Due to her acromegaly she had some soft tissue gum growth causing a canine to rub against the gum. It was shaved so it no longer rubbed. Second one was the most challenging. I noticed a sudden bump on her jaw line, which turned out to be a bony growth on her jaw bone. In most cases it's cancer, but it wasn't, "just" acromegaly bony growth. Both times Neko was already on daily buprenorphine for her arthritis pain (more darn acromegaly) and after dental it was increased from two to three times a day for a week. I also did antibiotics and got a liquid format, which bupe is already. They were easier to give with a sore mouth. The downside of liquid AB is that the particular med, Clindamycin, tastes horrible so involved some frothing.

Later on when Neko's mouth had more growth and her heart said no to anesthesia, I started using an immersion blender on her food to turn it into mousse like texture she could lick easier.

For a recent kitty surgery, I was given both gabapentin and buprenorphine. The bupe for just three days and gabapentin for a week, so at the beginning both were given. Bupe is better for more intense pain. The upside of the gaba is that it can increase appetite as a side effect.

 

[Allie & Gen]

@Karolina & Nestle @Wendy&Neko Thank you both for sharing your experiences. They sound difficult, and I'm definitely nervous about administering meds when Gen has post-surgery pain (it's hard enough now), I'm glad to have some idea of what to expect, and what to ask my vet about on Wednesday!

 

[Karolina & Nestle]

@Karolina & Nestle @Wendy&Neko Thank you both for sharing your experiences. They sound difficult, and I'm definitely nervous about administering meds when Gen has post-surgery pain (it's hard enough now), I'm glad to have some idea of what to expect, and what to ask my vet about on Wednesday!

Also just a reminder. If they put him on an antibiotic get a good probiotic to give him about 2-3 hrs before the antibiotic.
And if you can have someone to help you in administration of the oral medication that would be easier for everyone involved.
Good luck

 

[Allie & Gen]

Also just a reminder. If they put him on an antibiotic get a good probiotic to give him about 2-3 hrs before the antibiotic.
And if you can have someone to help you in administration of the oral medication that would be easier for everyone involved.
Good luck

He's already on a probiotic with every meal, so that ought to help. Sadly, as always, I will not have any assistance with his care ... but at least I'll have this place for support!