11/25 Muffin Amps 359 +3 278 +7 197 Pmps 331 +3 301 +6 330

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Hi..a couple of things going on with Muffin and I would appreciate advice.


She is due for an increase tomorrow but we won't be able to test other than amps and pmps. Is it better to hold the dose at current level 4.0 and wait because we can't test? Better high than unknown?
In addition, on Monday she is having surgery for a growth on her gums. This is something new as she had a dental a few months ago and it wasn't there. Several questions on this:
1. Could that be affecting her glucose level?
2. We cannot feed her after midnight on Sunday. The vet wants us to hold her shot but bring it with us and they will give it to her later. Time unknown. This could put us in a real bind changing it so late in the day. Is it better to consider it a skipped dose and wait until pmps? Testing all night isn't an option.
3. If we don't increase the dose then should we hold until she is past the surgery. They are of course worried about cancer and they will be taking a biopsy.

Her vet visit other than that was good. Her frutosamine was 388 which they consider good glycemic control.

This is a tough situation right now. Any help always appreciated.

Thanks.
 
What does the growth look like? Usually cancer lowers numbers, not raises them. But an infection or inflammation can raise the BG. I hope it's something simple.

It's fine to wait before an increase, especially if you can't monitor.

As for the shot, for all of Neko's dentals, the vet said half dose in the AM. Are you taking her in to the vet before your normal AMPS time? I had to do that once and gradually moved preshot time so I could still shoot before leaving for the vet. However, I would tend to do what the vet expects, but maybe "forget" to bring the insulin with you. Skipping before surgery is an option. Another option is to let them give the shot, skip the PMPS and resume at normal AMPS time the next morning. That might not be a bad option. Some types of anesthesia induction drugs lower BG, and if she has a sore mouth and doesn't feel like eating that night, it'll be less stressful with a skip. Or you could decide which option based on her morning test before you go.
 
I agree with Wendy about waiting to increase. I also like the options she gave you about giving insulin before surgery.

Sending good surgery vines. Please keep us posted on how she does.
 
What does the growth look like? Usually cancer lowers numbers, not raises them. But an infection or inflammation can raise the BG. I hope it's something simple.

It's fine to wait before an increase, especially if you can't monitor.

As for the shot, for all of Neko's dentals, the vet said half dose in the AM. Are you taking her in to the vet before your normal AMPS time? I had to do that once and gradually moved preshot time so I could still shoot before leaving for the vet. However, I would tend to do what the vet expects, but maybe "forget" to bring the insulin with you. Skipping before surgery is an option. Another option is to let them give the shot, skip the PMPS and resume at normal AMPS time the next morning. That might not be a bad option. Some types of anesthesia induction drugs lower BG, and if she has a sore mouth and doesn't feel like eating that night, it'll be less stressful with a skip. Or you could decide which option based on her morning test before you go.

Muffin will be at vet before amps. I hadn't thought about letting them give shot and skipping Pmps...I think that is a good option for Muffin. The vet did not want us to give her insulin before surgery. They will monitor her during the procedures.

The growth looks like an abscess but no confirmation from vet it is an infection. I have to check with my sister to make sure as she took Muffin this time.

thanks so much for your help and insight.
 
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