10/2 Cleo Dental Update- +5 80!

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Cleo & Jane (GA)

Cleo & Jane (GA)

Member Since 2013
Hi LL,

I received a call from the vet who said that Cleo did not need any extractions. She said that she had a lot of tarter, and the start of some lesions, but felt that they did not warrant extractions. (but they do not xray there - :sad: ) She feels Cleo's mouth is now good for a few years.

Vet was most concerned with Cleo's BG. Wants me to start her on insulin right away. Does not think her teeth were bad enough to be causing elevated BG. I did bring my back up meter (Contour) (Thanks BJ, saved me some $) and it read 100 below their meter. An accu-chek that they suggest I go out and get. I told them I will continue with my regular meter. Vet is worried that Cleo's BG was 100 higher than I thought all along. I did not have the energy to explain the allowable meter variances, especially at high numbers. I promised her I would check it with testing solution when I get home.

She said there was some trace protein in Cleo's urine, that her BP was 40 points higher than last test. She wants me to start her on enalapril or benazepril. So I will be picking up a script to take to a compounding pharm.

I am sure I will think of more later, once I pick up my baby, and her lab results. Just feeling drained now.

Thanks again for all good thoughts~ and I think they gave her some R before the dental.

And I almost forgot, what dose would I start Cleo at? 1U again? She was 9.3 pounds. Thanks!
 
Re: 10/3 Cleo Dental Update- Dosing ?

Glad that helped.

The formula is 9.3 / 2.2 * 0.25 = 1.056818182, rounded is 1 unit, so not more than that.
How high is she? Maybe try 0.25 to 0.5, given that it builds up in the depot.

Feel free to share the following with the vet.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Re: 10/3 Cleo Dental Update- Dosing ?

She's only been in solid blues for a bit over a week, so I personally would start on a minimal dose, especially since she had a dental and her BGs could very well improve rather quickly. If she stays in the pink zone, then consider being more aggressive with dosing. My opinion only.

MJ
 
Re: 10/3 Cleo Dental Update- Dosing ?

I believe Jill suggested 0.5u when we were discussing whether to start Cleo on insulin the other evening. I would go with the 0.5u. We can always fast track the dose.

FWIW, having a dental this year doesn't mean that Cleo's teeth will be fine for several years. A lot depends on the cat. Gabby needs a dental on a annual basis.
 
Re: 10/3 Cleo Dental Update- Dosing ?

I picked up Cleo at 3:30, and was pleasantly surprised at how good she looked :-D She was walking good right away, but didn't want me to get near her. She didn't trust me yet. Very quickly hunger drove her up to her feeding spot :-D She let me test her and then ate some and drank some water. She is still not settled, walking around a lot. I think her tummy is still a little upset from the AB.

They did switch her antibiotic from Clavamox to Clindamycin. I hope it is easier on her gut. She will be on it for 10 days.

They gave her 1U of R at about 10 am to bring down her BG before the dental. Her reading was 464 on Idex and 454 on a human AccuChek. My Contour gave them a reading of 360, and that was a concern to the vet. She tested Cleo's BG with the AccuChek right before we left, and it was 174, and when I checked it as soon as I got home, it was 207 with the Relion.

Her PMBG was 179, so I am not starting insulin tonight.

Her vet wrote on the exam sheet that Cleo has "early cervical lesions." I may be reading that wrong, but that is what it looks like. :?:

I have a script to have benazepril compounded into a chicken flavored liquid, and I found a compounding pharmacy close by. :-D

Her bun was 39, and creat was 2.0. They did not do a phosphorus.

Sorry to have been such a basket case this past week, but I know you all understand like no one else would.

I will recheck Cleo's BG later tonight. Would the R have worn off by now?

Thanks so much for such positive thoughts!!
 
Re: 10/3 Cleo Dental Update-

Jane, I'm glad Cleo didn't have to have any extractions. I'm sure you're relieved to have her home safe and sound. Good luck with the insulin when you start it.
 
Re: 10/3 Cleo Dental Update-

Glad to hear Cleo needed no extractions and was looking so good.
She sounds like Hoots Momma with the trust thing, but they eventually come around ;-) Silly kitties.
Good luck with whatever dose you decide and sending ♥vines♥ for a very short visit and then back to the Falls!! Maybe her and Hoot could go back together ;-)
Have a great night Jane and give Cleo lots of scritches fo us cat_pet_icon
 
Re: 10/3 Cleo Dental Update- +5 80!

First time I tested it read 77; did it again and read 80! I don't think any of the R could still be in her from over 12 hours ago?
 
Re: 10/3 Cleo Dental Update- +5 80!

Her vet wrote on the exam sheet that Cleo has "early cervical lesions." I may be reading that wrong, but that is what it looks like. :?:
Click to expand...

Wonder if it's some form of feline odontoclastic resportive lesions....
Since you were talking about teeth and she had a dental today.....
Here's some info about it....http://en.wikipedia.org/wiki/Feline_odontoclastic_resorptive_lesion

Shadow has it. Gabby has it. ( Betty and Hank too had a dental today and he has it)
 
Re: 10/3 Cleo Dental Update- +5 80!

Thanks Rhiannon, that has to be what it means. I may have to look for someplace that does xrays for her next dental.
 
Re: 10/3 Cleo Dental Update- +5 80!

I agree with that.
Xrays are very key in dealing with FORL.
They get hairline cracks that can only be seen that way in the early stages. Plus is you read on what Hank went thru today. It can be in the roots as well.
One of the signs that they have it, and the pain that goes with it....is If you scratch/scratch along their face/jawline and the mouth chatters ( much like shivering),
it means they have pain.
Shadow had that for a year before we knew she had FORL. I just thought it was an odd quirk but it was an indicator that she was in pain. She masked it very well because
she actually wanted me to rub/scratch her jaw all the time. I wouldn't have expected her to want it if it hurt.
 
Re: 10/3 Cleo Dental Update- +5 80!

Did she have a lot of teeth removed? I am not going to let myself get crazy now, but I will call around and find a different vet for next time. Was Shadow eating ok? Could you see anything on her teeth? I just saw tarter on Cleo's.

jane
 
Re: 10/3 Cleo Dental Update- +5 80!

Nice report on Cleo's dental and return home! Anesthesia can lower BG, but we'll keep paws crossed there's more to it than that. :-D :-D
 
Re: 10/3 Cleo Dental Update- +5 80!

the BG 80 is a great sign! glad she got the dental done and super glad for you that it's over.

a heads up on the clindamycin - it is the best to kill oral bacteria. punkin used it a few times and it works well against dental stuff, but it can kill all the good bacteria in the gut too, resulting in diarrhea. punkin got c. difficile from using it, which is really difficult to deal with.

i'd recommend giving fortiflora or another probiotic (yogurt or ?) at the same time to prevent that from happening.

and SO glad for the good blood sugar this evening. hoping that's a great sign.
 
Re: 10/3 Cleo Dental Update- +5 80!

Did she have a lot of teeth removed? I am not going to let myself get crazy now, but I will call around and find a different vet for next time. Was Shadow eating ok? Could you see anything on her teeth? I just saw tarter on Cleo's.
Click to expand...


She ate fine. Better than she does now.
I couldn't see it but she's not one to let me look in her mouth. About the only one I saw was one of her fangs had a line in it.
 
Re: 10/3 Cleo Dental Update- +5 80!

Do the probiotic about 2 hours after the Clindamycin, so the good bacteria aren't killed off by the Clindamycin.
 
Do a search to see if there is a dental specialist in your area. I only have dentals done by a board certified vet dentist. I don't use a general vet for dentals as they are not as up to speed on latest techniques and a dentist does this all day long a general vet doesn't.

While it may cost more money, it's a small price to pay for that peace of mind and knowledge that you are taking them to the best.

If you want to come to NJ, I'll give you the name of mine.... ;-)
 
Hillary,

I am from NJ!!! And took many of my pets to Red Bank Veterinary before it was big and new!! I loved my vet in NJ - she made house calls and I miss her still :-D My pet sitter worked at Red Bank Vet for a few years, when it was first redone.

I will have to do some FL researching for a dental specialist~

Jane
 
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