10/10 Tigger IV sedation tomorrow - insulin & R question

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Tigger's Friend

Tigger's Friend

Member Since 2013
Hi Everyone! I hope all's well in LL.

No change for Tigger's eye - it's pretty large. URI is better tho. AMPS close to an all-time high in BG - 462.

Tomorrow AM I take Tigger in to the vet at 8AM. He is to be FASTING & I'm only to give 1/2unit lantus (instead of normal s1.75u).

The vet said they will sedate Tigger as lightly as possible & aspirate his eye again. If an abscess, they'll drain & flush. Not sure what they'll do if its a hematoma or a cyst.....

He may get a Covenia AB injection (in addition to the azithromycin & clindamycin ABs)

Vet said they'd check his glucose - if he goes too high they can give him dextrose. I asked about R & she said that was a better idea.

:?: Can anyone help me figure out how to handle Tigger's PM dose & any info about the R?
 
Re: 10/10 Tigger AMPS 462 - still swollen-Ques. in Health Fo

Oh geez! I'm so sorry to hear that Tigger is no better. I hope They figure out what is going on and can do something soon. :YMHUG: :YMHUG: :YMHUG: cat_pet_icon cat_pet_icon cat_pet_icon
 
Re: 10/10 Tigger AMPS 462 - still swollen-Ques. in Health Fo

Oh NO! I was hoping the swelling had gone down by now...poor baby! I feel so badly for you both!

Good luck at the vet's .....fingers crossed they can give you a reason and a solution!

Sorry :sad:

looking forward to positive updates!

~kelly
 
Re: 10/10 Tigger IV sedation & exploratory scheduled tomorro

I'll make way for the advice-givers, but just wanted to send you both hugs and comfort and a good, easy outcome.
 
Re: 10/10 Tigger IV sedation & exploratory scheduled tomorro

Ann, Kelly & Lara, Thanks for all your positive thoughts & support - we can use them.
I hate putting Tigger through this, knowing his BG is only going to get worse for a few days, but we need to know what it is & what to do for it. He's starting to scratch at it, so we have to do something. I'll be a wreck - but it'll help to know. Maybe it'll even get better tomorrow.
 
No dose advice from me using R either, but with all of Lantus Land praying for Tigger, I'm sure he'll come through it with flying colors!!

Kind of confused on why your vet would give Dextrose (another form of sugar) if his glucose was high though

Good luck to you and Tigger tomorrow!!
 
Thanks, Chris - Tigger can use all those LL prayers - I've seen how powerful they are!

I'm not sure I heard right about the dextrose - maybe that would be to keep him up if he went low? I don't know. But she did say R was a great idea - THANK YOU MARJE! I guess R lasts 4-6 hours?

Would I give the regular dose at Tigger's regular PM time if he gets the 1/2 unit dose at his regular AM time & R somewhere in-between?
 
Has Tigger had Convenia in the past? If not, it's an antibiotic that comes with several words of warning. It lasts for a long time -- weeks. If Tigger has an allergic reaction, there's no way to counteract the drug once it's injected. Dr. Lisa won't use it. It's only indication is for skin infections. Some vets seem to like it because you don't have to pill your cat.
 
Suzanne - sending :YMHUG: for you and healing vines for Tigger. Paws crossed for a successful operation tomorrow.

Cats react differently to anesthesia - you knew it had to be an ECID. It can lower blood sugar. When Neko has gone under anesthesia, we did the normal dose the night before, and half dose the morning of. Sounds like your vet is a bet more conservative, but that's OK. I once did a fur shot on a morning of. ohmygod_smile When Neko had her dental, the vetty said to skip the dose in the evening after the procedure. When she had SRT at CSU, she did have her full dose that night.

I've asked some others to pop in about any R advice. I've seen that it can last 4-6 hours in a cat and you have to test every hour when you start using it.

Has Tigger had Convenia before? The issue with it, is that once it's in, it's there for two weeks. If the cat has an allergic reaction, it's a long haul.
 
We'll be thinking good, positive thoughts for Tigger tomorrow and sending lots of healing vines his way. Hang in there, Suzanne. I hope that everything will go smoothly and that the lump will just disappear.

Hugs, scritches,

Ella & Rusty
 
Thanks Josie & Ella & Rhiannon for the kind words & support & prayers - Tigger needs it!

Thanks Sienne & Wendy re. Covenia - enough said, I'll leave a note for the vet not to use it - don't want anything that long-lasting that isn't necessary - & Tigger's never had it before.

Thanks, too Wendy (OMG - a fur shot before surgery - you must have gone nuts!) for the caution about anesthesia, I don't know anything about FD & Surgery. That must be why the vet mentioned dextrose. I'll warn them Tigger can drop 100-200 points fast. They are going to check his glucose - I'll ask them to check every hour or so, especially if they use R.

I guess the evening dose will be determined by what happens tomorrow. Tigger really needs an increase, but under the circumstances I don't think I should. Not till he's safe.

Thanks again, everyone, I appreciate you all so much.
 
Here's the general scoop re. anesthesia. Both the pre-anesthesia sedative and the anesthesia can lower BG. My vet generally recommends no insulin the morning of a procedure. With an infection and high numbers, this may differ since the infection can set up a scenario for ketones if there's not enough insulin on board. I think you're wise to warn the vet that Tigger can have big drops. The vets typically do monitor BG during a procedure and make sure they have an IV line in place if dextrose is needed. They also like to use R, which is a fast acting insulin, to offset the effect of the dextrose if necessary.

Depending on what time the procedure is, you should be able to give at least a partial dose, if not a full dose of Lantus in the PM.

The other thing you should consider is that anesthesia slows down the gut and also acts like an appetite stimulant. So, Tigger will be hungry from not having had his AM meal and from the anesthesia. Do NOT give him lots of food when he gets home. Feed him small amounts otherwise, you'll end up with scarf-and-barf due to the slowed GI motility.
 
Thanks for the detailed explanation, Sienne, I feel better knowing more about the process involved & what to expect afterwards.

The vet said they would use an IV sedative & keep it as light as possible, so hopefully no anesthesia. If they have to do a more complex drainage/flush other than an aspiratory / exploratory that may change, so I'll ask.

I'll check for ketones once Tigger's home, too. I have the Novo Max Plus if I can't get a urine, but I don't think its very reliable.

I think he's set for first thing since they want him at 8:00 - am hoping. I'll post as soon as I know something - we'll be shooting & going out the door since vet's 30 minutes away.

Re. anesthesia & scarf-n-barf - I'll do small easy meals & monitor closely. Would enzymes/probiotics help?

Thanks, too Jane for the support - the positive thoughts are reassuring - for both of us!
 
I don't think enzymes or probiotics will make a difference. The intestinal flora are fine. It's just that sedation/anesthesia slows things down. If Tigger eats too much, since his GI track is operating more slowly, things won't be moving along at their usual speed. And since it can't go down, it comes up!
 
Ok, Sienne, thanks again for helping me understand - you are one knowledgeable lady!!!

Tigger's scratching his head now - it's definitely bothering him. That helps me know we're doing the right thing - If its a hematoma or cyst I don't know if they'll just culture it & leave it. If its an abscess they'll open & clean it, & put in a drain. I'd hate to see him come home tomorrow with it still this swollen. Gooseberry size, maybe bigger. One side of his face looks like an alien. :cry: His spirits are much better, though.

Thanks again, everyone. Will keep you posted with news.
 
Suzanne,
Adding more healing vines and prayers for Tigger.
I hope everything goes well tomorrow.
 
Wishing you good luck tomorrow and I hope they can drain it and it stays drained.

Yes, the R is in and out in four hours. If you give Lantus in the morning, please just be sure that if/when they give R, the nadirs do not overlap. If you skip the morning Lantus shot, then it won't matter when they give R as long as they check him because it can drop him fast. I use R and even 0.1u can drop Gracie quite a bit so see what your octor what's to give him.

I think you should see where he is at night before deciding Lantus dose. One thing I want to caution you about: R basically opens the door for the L insulins to work. Many of us who use it find that the cycle after we use it, or even two cycles after, are extremely active cycles. You need to stay on top of the numbers.

Prayers and healing vines!
 
We're thinking of you this morning. I hope the procedure is over by now and everything worked out well and that Tigger is feeling more comfortable.
 
Thanks, Mariko & Ann for the positive thoughts - he'll be in good hands, I owe Ann more thanks!

Marje, I got your post too late to talk with the vet re. the R (Thanks for that info - it's good to know), but I did tell her Tigger could drop v. fast & referenced his 235 to 35 in 2 hours, especially w/ no food. Plus I wrote that down for her for Tigger's file. So ------I think we're covered.

I'd love some input on how to dose once Tigger's home & settled - so far no word yet. nailbite_smile
 
I think we're all waiting for him to come home first before offering any suggestions on dosing. Too many options to even try to guess! Did the vet decide to give him any R? Did she give him any insulin at all? What is his BG at PMPS?

I know it's hard to wait, but we're all waiting here with you.
 
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