3/11 Hugo AMPS 299, +3 193 - booked a visit at new vet

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Tiina and Hugo

Tiina and Hugo

Member Since 2016
Good morning :) Hugo is really liking this number, AMPS again 299. He was also staying flat when I checked him at +9. For some reason he seems a bit stuck right now. But we'll see how it goes, I know, just give it time...:)
 
I have been talking about Hugo with my family, and we have decided to try and book him a dental cleaning for next week if possible (what do you call a dental treatment in English?). We know his back teeth are pretty bad, so if there's a chance that might be keeping the numbers high we want to take care of it.

Is there anything that would prevent us from taking him? What do they need to take into account since he would be going under anesthesia? What if he won't eat or is too long without food on that day. He needs to not eat for 12 hours, isn't that way too long for him?
 
I think folk usually give a reduced dose on the day, if you can book him for an early am appointment that might work better.
I seem to remember reading that the anaesthetic can make their BG a bit low.

I haven't had experience of this if you put dosing advice for anaesthetic/dental on your title along with prefixing it with a question mark I think you will get some response from the folk with experience on this.

Hugo work that dose matey!!
 
My vet recommended giving half a dose of insulin the morning of Furball's dental. I decided to not give any insulin at all just to be safe. Her numbers were really high that evening, but she got right back on track. I'd rather have a high number than her go too low during the dental. Anesthesia can lower BG. You should ask the vet if they will monitor Hugo's BG during the procedure.

After the dental, he may not want to eat right away or eat a lot. You may not be able to give the full dose that evening. Baby food with just meat in it, no vegetables of any kind, can be used if he doesn't want to eat.

Problems with teeth can keep a cat from becoming regulated. You may want to ask for some pre-dental bloodwork to make sure there are no underlying conditions with Hugo.
 
Good morning Tiina

Hugo's numbers are very flat which is exactly what Lantus is supposed to do. Now he just needs to get those numbers down a bit. A dental could very well help with that if he has some issues with his teeth and gums.

When my guy had his dental done I booked it for the first appointment in the morning. The vet and I discussed food and insulin and in my case it was suggested to do an 6 hour fast and only 1/2 of his regular insulin dose. Since I do my shots very early...usually around 4:00 AM this worked out well and I only had to juggle the times by about 1 hour. Some vets want the kitty fasting from midnite so discuss what is the best option for Hugo with the new vet.
 
My vet asked me not to feed Furball after midnight. I tried to make sure she ate something around 11:30PM. It was not a problem with her BG to fast before her dental. Mary Ann is right. You should discuss it with your vet and see how late you can really feed if you need to.
 
Vets differ in how they deal with a diabetic cat. Some vets will instruct you to skip the shot; others will tell you to give a reduced dose. I typically skipped. They also vary in how long you need to fast your kitty.

Anesthesia can lower BG numbers. You need to be sure that Hugo's BG will be monitored during the procedure. The vet should also get labs before the procedure as well as dental x-rays before and after -- after is necessary if there are extractions.

We have a post on what you need to know about a dental procedure.
 
I just called the vet and they refused to do the dental. :banghead:o_O they said his diabetes needs to be regulated first before they can do the dental in anaesthesia (um but what if his diabetes can't be regulated before it's done?). So change in plans and Hugo will go to the vet on Monday for a control visit. This is now a different vet than who diagnosed him, because she just didn't have enough knowledge about FD. This new vet said in the phone that I shouldn't change Hugo's dose without vet decision. I think they'll be angry with me changing it...
 
Hi there

Addressing gingivitis and resorptive lesions were the key to remission for my kitty. I took him to a veterinary dental specialist. If you look at his spreadsheet you can see the impact on his BG. First dental was 12/08/2008 and the second was 05/29/2009. He has been in remission for 6.5 years now. You can also see that although he had a condition that caused relentless high BG that required high doses of insulin I skipped his shot before the procedure as the anesthesia brought his BG very low during the procedure. I was also cautious resuming insulin following his dental.
 
Tiina and Hugo said:
This new vet said in the phone that I shouldn't change Hugo's dose without vet decision. I think they'll be angry with me changing it...
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Most vets don't have clients who home test so they don't want people to change the dose on their own. Hopefully the new vet will be open to you discussing the TR Protocol with them. If they're not, you can do what a lot of us do. Just smile and nod when they tell you about what dose to give and then follow the TR Protocol because it's what is best for Hugo.
 
Tiina and Hugo said:
I just called the vet and they refused to do the dental. :banghead:o_O they said his diabetes needs to be regulated first before they can do the dental in anaesthesia (um but what if his diabetes can't be regulated before it's done?). So change in plans and Hugo will go to the vet on Monday for a control visit. This is now a different vet than who diagnosed him, because she just didn't have enough knowledge about FD. This new vet said in the phone that I shouldn't change Hugo's dose without vet decision. I think they'll be angry with me changing it...
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That is not true. A diabetic cat simply needs extra precautions and monitoring during the procedure. My guy was no where near as regulated as Hugo is and he did fine. You simply need a vet who is familiar with doing dentals on diabetic cats. If dental problems are preventing good regulation then how can you get him regulated if the dental is not done.

As far as being angry with changing doses, you have been carefully monitoring Hugo's numbers and his results are acceptable. Some vets NEVER want the owners testing or making any decisions.
 
carfurby said:
Most vets don't have clients who home test so they don't want people to change the dose on their own. Hopefully the new vet will be open to you discussing the TR Protocol with them. If they're not, you can do what a lot of us do. Just smile and nod when they tell you about what dose to give and then follow the TR Protocol because it's what is best for Hugo.
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Yes the vet tech who I talked first ran to tell the vet about me changing his dose on my own. :joyful: I think I will get a proper lecture! I really think Hugo needs the dental asap but my hands are tied at the moment.
 
Tiina and Hugo said:
Yes the vet tech who I talked first ran to tell the vet about me changing his dose on my own. :joyful: I think I will get a proper lecture! I really think Hugo needs the dental asap but my hands are tied at the moment.
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As Carla said most vets are not used to people who carefully monitor at home. Send the link for your spreadsheet to your vet and have him take a look at just what you are doing. Your tests are far more accurate than any curve done at the vets office.
 
Tuxedo Mom said:
As Carla said most vets are not used to people who carefully monitor at home. Send the link for your spreadsheet to your vet and have him take a look at just what you are doing. Your tests are far more accurate than any curve done at the vets office.
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I won't be able to take him regularly for curves done at the vet financially...i just can't. These big veterinary clinic chains here in Finland just want to do unnecessary tests and they are so expensive it's crazy. But if this is what has to be done in order for them to agree doing the dental, I will take him there and listen to the lecture and pretend to do what they tell me to do until the dental is done. I believe TR is what my boy needs in order to reach the best chances of survival. The vet tech even said that before any dental can be done, Hugo needs to have found the exact right dose of insulin and to be stable with his BG. He will go on Monday at 3.45.
 
Tiina and Hugo said:
I just called the vet and they refused to do the dental. :banghead:o_O they said his diabetes needs to be regulated first before they can do the dental in anaesthesia (um but what if his diabetes can't be regulated before it's done?
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A good veterinary dental specialist can handle it. They understand the relationship between bad teeth/gums and high BG and that it can be a self perpetuating loop.
 
Tiina and Hugo said:
The vet tech even said that before any dental can be done, Hugo needs to have found the exact right dose of insulin and to be stable with his BG.
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That is simply untrue. Feel free to use Black Kitty's ss as an example to support your argument. Or better yet:

image.jpeg

These are average daily doses (Lantus and R combined) month by month for all 21 months he was on insulin. the impact of the dentals is clear - 12/2008 and 5/2009.
 
Thank you @Sandy and Black Kitty. I will print this to take with me too. I will also print documents about the TR although I think they will hate a customer who tries to tell them how to do it. It sounded like they thought my ignorance was harming Hugo. I'm not even that great at explaining things and hate being put to the spot so the outcome of this sounds just fantastic. :facepalm: I'll just tell her that there is a fantastic group of diabetic cat owners online who have been giving me advice. :bighug:
 
Please note - Due to Black Kitty having IAA (an idiopathic condition that causes extreme insulin resistance ) he is not a good example of TR.
He is however a prime example of the impact healthy teeth and guns can have on BG.
 
With all this talk about the dental and the vet's total refusal to do it going on, I forgot to celebrate a blue number we briefly saw today. Hugo +3 193. :) But in two hours it went back to 283 although I fed a no carb food. He is still constantly just resting on the floor.

Perhaps it will be good to get a second opinion from a different vet, she should be a specialist in general internal medicine.
 
So, does your vet think that humans contact their MDs every time they need to change their insulin dose? I don't think so. Most humans learn how to regulate their dose. Whey would it be any different with your cat?

Don't think that an internal medicine vet will be conversant in diabetes. Not all of them are. Ask Marje -- the specialist she took Gracie too gave her some "interesting" information.
 
Sienne and Gabby (GA) said:
So, does your vet think that humans contact their MDs every time they need to change their insulin dose? I don't think so. Most humans learn how to regulate their dose. Whey would it be any different with your cat?
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I know, it's crazy. I will definately keep changing the dose if Hugo needs it and people here advice me to do it. There are only two big chains of vet clinics in my town and when Hugo was diagnosed he was at the first one. Now when I called the second clinic I asked specifically for a vet who knows about feline diabetes. Of course the receptionist answered, they all know it very well. Well my previous vet had to read everything from a book then and there, but she admitted it. I just don't feel comfortable taking Hugo there again when I know I will be paying for nothing. I suppose they will be taking bloodwork now although those were taken a month ago with the diagnosis. The vet tech said the vet wants to test fructosamine. Probably they won't want to do the dental in a while either :( It is what it is and I'm really disappointed. Well if they totally refuse to do it before they think Hugo's BG is stable, there are still other clinics a bit further away I could ask.
 
Tiina and Hugo said:
The vet tech said the vet wants to test fructosamine. Probably they won't want to do the dental in a while either :( It is what it is and I'm really disappointed. Well if they totally refuse to do it before they think Hugo's BG is stable, there are still other clinics a bit further away I could ask.
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With all the testing that you are doing there is really no need for a fructosamine test. The test only gives the average of glucose levels over a 2 week period and your spreadsheet gives them all that information. If they have any good understanding of feline diabetes they will know that any serious dental issues can make it very hard to get a kitty into the ranges that he should be.
 
Hugo PMPS 265 and +2 225

But he has diarrhea now. Can diabetic cats get something that might cause diarrhea? His stomach rumbles and he seems tired, but is eating and drinking. I have some probiotics but the label says it has glucose in it. Probably can't give it then?
 
Tiina and Hugo said:
Hugo PMPS 265 and +2 225

But he has diarrhea now. Can diabetic cats get something that might cause diarrhea? His stomach rumbles and he seems tired, but is eating and drinking. I have some probiotics but the label says it has glucose in it. Probably can't give it then?
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Have you been feeding any new/different foods? Is Hugo still eating and drinking normally?
 
Also I now read his previous labs and his triglycerides were really high a month ago when last October they were normal. Isn't it a symptom of pancreatis? Hugo's triglycerides value was 19 mmol/l when it should be 0,2-4,9 mmol/l.
 
Here is a bit of information on triglycerides in cats:

"
Reasons Why Your Pet’s Triglyceride Level Might Be High (Hyperlipidemia, Hypertriglyceridemia) :

The most common cause of elevated triglyceride levels is a recent meal (post-prandial blood sample). That is why blood samples from your dog or cat, sent for triglyceride/cholesterol assay, need to be obtained no sooner than 6 hours after their last meal. If the levels came back high on a non-fasting pet, run them again after more time passed since its last meal.

Fat, inactive dogs and cats are more likely to have persistently high triglyceride and cholesterol levels. Over time, allowing your pets to remain that way will have negative effects on their health"


http://www.2ndchance.info/dxme-Triglycerides.htm
 
Tiina and Hugo said:
No, nothing new. Just the same Applaws, pollock, Royal Canin Instinctive wet pouch and the low carb Sheba Delicato.
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OK sometimes when changing to a new food or variety of food it can cause some gastric upset in the intestinal tract. I would not give the probiotic if they have sugar in them. Depending on how long the runs last or how bad it is Hugo may need a vet visit, especially if it seems to be dehydrating him.
 
Tiina and Hugo said:
And he is eating and drinking, but seems so tired. I think it's really good to have his blood drawn on Monday.
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Many of the blood tests give more accurate results when a period of fasting is done before the draw. If you look at the post I did on triglycerides they suggest at least 6 hours after eating to give accurate results. See if your vet is aware of the fasting times for certain blood work.
 
Tuxedo Mom said:
OK sometimes when changing to a new food or variety of food it can cause some gastric upset in the intestinal tract. I would not give the probiotic if they have sugar in them. Depending on how long the runs last or how bad it is Hugo may need a vet visit, especially if it seems to be dehydrating him.
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The link you posted did mention newly diagnosed diabetic cats having higher triglycerides levels, but also acute pancreatis . I'm just wondering if the vet missed something since she never mentioned these values being high with Hugo. Perhaps it would be best to make him fast for 6 hours before the vet on Monday?
 
Tiina and Hugo said:
The link you posted did mention newly diagnosed diabetic cats having higher triglycerides levels, but also acute pancreatis . I'm just wondering if the vet missed something since she never mentioned these values being high with Hugo. Perhaps it would be best to make him fast for 6 hours before the vet on Monday?
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Many of the tests give more accurate results on a fasting. Testing for pancreatitis is a separate test that has to be sent out to a special lab. For me in Canada I had to have mine sent to the US since there were no labs here who do the test.

There are 2 types of pancreatitis acute and chronic. With acute usually the kitty will stop eating, act nauseas, sometimes vomit.

This post has some great information on pancreatitis:

http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/
 
Thanks @Tuxedo Mom. He doesn't seem to have nausea, but the lethargy is definately there since he doesn't walk around without resting on the floor and now the diarrhea. I'm going to keep watching him closely.

His +3 is 153 so the good thing is that his BG has come down a bit.
 
Tiina and Hugo said:
Thanks @Tuxedo Mom. He doesn't seem to have nausea, but the lethargy is definately there since he doesn't walk around without resting on the floor and now the diarrhea. I'm going to keep watching him closely.

His +3 is 153 so the good thing is that his BG has come down a bit.
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Hugo may benefit from B12 injections. Many diabetic kitties can develop neuropathy which shows up as weakness in their hind legs. The B12 is given as an injection once a week for 6 weeks then once a month afterwards until symptoms diminish. You can also use Zobaline which is a B12 supplement with no additives. Many people here use the Zobaline on a maintenance plan.
 
Tuxedo Mom said:
Hugo may benefit from B12 injections. Many diabetic kitties can develop neuropathy which shows up as weakness in their hind legs. The B12 is given as an injection once a week for 6 weeks then once a month afterwards until symptoms diminish. You can also use Zobaline which is a B12 supplement with no additives. Many people here use the Zobaline on a maintenance plan.
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Thanks for the tip! Is it expensive, usually?
 
Tiina and Hugo said:
Yikes :blackeye:
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I don't know what the Zobaline costs or if you can get it in Finland but that would probably be more affordable.

Does Hugo walk sort of "flat-footed" walking more on his hocks rather than his toes. That is a good indication of neuropathy. There is a video somewhere here that shows a kitty with neuropathy...I will see if I can find it
 
Wow, that cat is awesome. What a recovery! Thank you for sharing it. I am ashamed to admit I haven't paid attention to this with Hugo at all. But I will now. All I noticed was that he had serious trouble jumping, his hind legs were weak and he simply just wouldn't jump anymore. Now it has improved a bit, but not fully. He still avoids some places. The Zobaline is not available here, unfortunately. But I found some multivitamin tablets for cats that have B12 too, maybe I could give those to Hugo? How about fish oil to lower the triglycerides?

On a sidenote...Can we have a green party now? Hugo just tested +4 92!! That's the first green in a while. :D
 
Tiina and Hugo said:
Wow, that cat is awesome. What a recovery! Thank you for sharing it. I am ashamed to admit I haven't paid attention to this with Hugo at all. But I will now. All I noticed was that he had serious trouble jumping, his hind legs were weak and he simply just wouldn't jump anymore. Now it has improved a bit, but not fully. He still avoids some places. The Zobaline is not available here, unfortunately. But I found some multivitamin tablets for cats that have B12 too, maybe I could give those to Hugo? How about fish oil to lower the triglycerides?

On a sidenote...Can we have a green party now? Hugo just tested +4 92!! That's the first green in a while. :D
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YAH!! On the green!!!
c23_rah.gif


The multivitamins wouldn't have enough B12 in them. Usually with the tablets a kitty gets 3000 mcgs...about 3 mg daily. Multivitamins would have way less than that. Also they may have other additives that are not safe for kitties. If you have a health food store close by you could see what they have available in the B12 Methylcobalamin not the cyanocobalamin form. The methyl form is absorbed orally much better than the cyano form. You have to be VERY careful that they do not have any zylitol in them, since the human methyl form is sublingual and is often sweetened with zylitol which is poisonous to kitties.

A good quality fish oil is always useful.


ETA Before I found out Tuxie was diabetic I noticed him having more and more trouble trying to jump on the bed at night. I put it down to the fact that he seemed to be putting on weight.
 
So many good advices, my endless thank yous continue. :bighug: I'm super happy about the green. I thought I wouldn't see that again. May this please continue...I gave him some LC food and will retest in an hour.
 
Hi there Tiina,

not been around most of the day, (DIY with DH has kept me busy:))
Nice to see that green with Hugo.

I haven't tried to find any of the supplements for neuropathy, so can't help with that.
BFG was having trouble jumping up on things, he tried to jump on the table before diagnosis with FD, and fell off, I didn't realise the significance at the time, he was also starting to show problems with just hopping up on my lap when I was on the sofa, those problems have disappeared after a few months on insulin and being better regulated.
I don't really understand the significance of his BW, BFG also had high Cholesterol on diagnosis but he is 'fluffy', don't know if this has changed, it was one of the the parameters that wasn't done at his most recent BW, his triglyceride was normal on diagnosis.

paws crossed for a Friday night green surf.:D:D
 
Gill & George said:
Hi there Tiina,

not been around most of the day, (DIY with DH has kept me busy:))
Nice to see that green with Hugo.

I haven't tried to find any of the supplements for neuropathy, so can't help with that.
BFG was having trouble jumping up on things, he tried to jump on the table before diagnosis with FD, and fell off, I didn't realise the significance at the time, he was also starting to show problems with just hopping up on my lap when I was on the sofa, those problems have disappeared after a few months on insulin and being better regulated.
I don't really understand the significance of his BW, BFG also had high Cholesterol on diagnosis but he is 'fluffy', don't know if this has changed, it was one of the the parameters that wasn't done at his most recent BW, his triglyceride was normal on diagnosis.

paws crossed for a Friday night green surf.:D:D
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Thank you! Since they sort of forced me to book the follow-up vet visit for Hugo, I have to take him in in order for them to agree to do the dental at some point. This vet we are seeing is also the dental specialist in my town.

I just started looking through Hugo's labs from the diagnosis visit for reference for Monday and I noticed the high triglycerides (man that word is difficult for me). And him being so tired all the time I figured I might as well ask you guys if it's anything to worry about. This sudden diarrhea of his puzzles me too. I haven't given anything that could have caused it. His stomach also rumbles loudly. But he is drinking and eating. Ketones I haven't checked today, but yesterday were negative.

I really hope Hugo improves, he is sleepy and lethargic. Could it be a stomach bug...My other cats seem fine.

I hope he can hold the green, surf I mean!
 
I would definitely query the high result with your vet.

Great that there are no ketones present and that he is eating and drinking.

I haven't got experience to comment on his other symptoms if you reflect them on your thread title,
High triglycerides at BW/ sudden diarrhea advice please, maybe some of the memebers with more experience with this can help you.
 
Higher cholestrol and triglycerides are fairly common in a cat with unregulated diabetes. Since cats are not prone to heart disease the same way that people are unless the numbers are quite high and continue increasing, most vets are not terribly concerned about the readings.

How is the diarrhea situation? Is Hugo still having problems with it?
 
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