3/14 Checkers..amps 280..PMPS 225

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Barb & Checkers (GA)

Barb & Checkers (GA)

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PMPSHello All, I've been around the Health forum for over a year, when Checkers was first diagnosed.
He's been diet controlled (80''s to mid 200's)....until Jan of this year. He was then found to have UTI.
Clav for 2 weeks. No reduction in bg. It was consistently in hight 200's to low 300's.

On 2/8/10, he was put on 1 u, Lantus. Doc was not very familiar with Lantus. Never heard of cartridges.
He gave me a sliding scale. No insulin under 200, which I ignored. I learned enough on this board to come here and read until my head felt like it would explode.

I am glad that his numbers are lower than before insulin, but of course would like to see more green. I'm not in any hurry to increase dose, if I should give more time on 1u...sometimes slightly fat 1u.
I will if it is advised!!

In my quest to find an answer to why his bg rose in Jan., I am having a dental done again, after only 6 months. I need to rule out mouth issues.

My question is, he's not allowed food or water ofter 9PM
What do I do on morning of dental?
No food, no shot?......even if number is high?

Thank you for all advice.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Maui just had a dental done and I was told no food after 10 pm and no water after 8 am (of course by that time we were on our way to dentist).

I know others who have cats still on insulin either give a reduced shot or nothing the morning of. however, I'll let others guide you on those specifics.

I'll just chime in about food/water removal.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Water is OK. No food until after the dental is completed. (I'm presuming you know to not feed in quantity -- only a teaspoon or two at a time after anesthesia otherwise, you may end up with scarf and barf.)

My vet advises no insulin the morning of a procedure. Anesthesia can lower BG. Some vets suggest a half dose. Looking at Checkers' current BG, I'd say skip the shot. Depending on what time you shoot, can you check with the vet before you bring Checker's in? Also, after you pick him up, get a BG test in as soon as you get home and then another at PMPS. If the numbers are low due to the anesthesia, you will probably need to reduce the dose. Not all cats are effected in this way by anesthesia.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

I do not agree with the no water. None of the vets I have had restricted water the night before especially diabetic ones. What you do in the morning depends upon your vet's experience and the time of the actual dental. My vet says give 1/2 dose if BG is as expected. Also, I could give 1/2 food too.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

It was the receptionist that told me , "no food or water". It's what they tell everyone. I neglected to remind her Checks was diabetic; didn't think of it 'til later.
I have an appt. for a consult with his vet tomorrow, with questions. I wanted 'real' opinions here, so I can go armed with more info.
If his dental shows no problems, (or if it does), I'll be back here, looking for more info about dosing; okay?
I haven't joined the LL family sooner, because I don't keep good records about his feeding schedule, and everyone else does.
I don't know how to edit my SS, to add info as the day progresses. *sigh*
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Barb -- I talked specifically with our vet before his dental last month, and discussed it with others here. These are just opinions, but I was told that there should be no food ideally within 8 hours of anesthesia. In our case, i dropped Kitty off at 9:30 for an 11:30 procedure. So you may want to pose the question to your vet that way: Exactly how many hours without food, and when will the procedure really begin?

Good luck. Remember Sienne's advice to get the BG immediately upon his return home, to watch for that dropping BG (even without having eaten).

Also... I picked up a couple of cans of A/D at the vet's. It is high carb -- 13%! -- but the consistency is so smooth, it was easy for Kitty to eat when his mouth was sore. If you decide to feed your usual food, you may want to mash it up well, or even, as Sienne suggested to me, put it in the blender. Checkers will appreciate being able to lap it up easily.

And it bears repeating: Feed just a bite at intervals, even if Checkers is hungry.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

If it's a consult, I pulled together some info from Jill and Jojo along with updated info from Dr. Lisa that was on the Health board:

Dental info (what to ask about)

• X-rays: either before or the day of the procedure. Also x-rays after to make sure there are no tooth fragments left after an extraction.
• Bloodwork: prior to the dental to rule out anything that would prevent the procedure
• Pre-anesthesia sedation/induction: Ketamine (some has been recalled), propofol, valium. Induction should be with an IV drug vs. a gas.
• Anesthesia: Sevo or Isoflurane (these should not be used for induction, however, only for general anesthesia)
• Blood pressure monitoring (Doppler or Cardell monitor)
• Cardiac monitor: pulse oximeter or cardiac monitor
• IV catheter for fluid access
• Post-procedure antibiotics if necessary. (See Dr. Lisa’s commentary on Health)
• Pain meds: administered post-procedure and to take home: Buprenex, no metacam due to the potential for renal failure. A fentanyl patch may be excessive for the purpose of this kind of pain management.

Warming: make sure there is a means of circulating warmth vs. one warm spot. The latter can cause burns.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Sienne, that's a great review.

I have a question -- what do you mean by warming? Warming of the fluids? Or warmth in the bed?
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

mocha is scheduled her first dental this friday nailbite_smile the vet said no food after midnight, no restriction on water. She wants us to do a half dose as we leave the house. Unfortunately her shot is going to be about 40 min. early because of the time we have to leave to get to the appt on time.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Lots of good advice here. Thank you all so much.

The consult is because I won't be seeing Check's regular doc on the day of dental. I need questions anwered in advance.

I've been watching for advice for Mocha; I knew she had a dental this week. Checkers' is on Wed.
He's had dentals every year for at least ten years...at the same clinic. He will be 14 in July.
My poor baby has had so many extractions, because of FORLs. His trouble with teeth is what makes me suspicious about his bg sudenly raising in Jan.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Hi So GLAD you asked about the dental because I have been wondering about it myself! Great info here, Scrabble has never had a dental and the vet suggested one when he was first diagnosed with diabetes. Hope all goes well. I am going to talk to my vet about getting one for us myself! Let us know how it goes!
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Barb, I think it's wonderful that you've managed to stay on top of Checkers' dental issues. Did you find a dental specialist this time?
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Kathy, I do not go to a specialist. Check's teeth are always x-rayed, and I always opt for the full panel blood workup.
I will post his results, on Wed. nite.
I will stop using this thread, so it doesn't come up to top again. It's time for the PM's to start showing up.

Michelle, it's important to make sure Scrabble has no bad teeth, and that he has no mouth pain, as it can raise bg.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

PeterDevonMocha said:
mocha is scheduled her first dental this friday nailbite_smile the vet said no food after midnight, no restriction on water. She wants us to do a half dose as we leave the house. Unfortunately her shot is going to be about 40 min. early because of the time we have to leave to get to the appt on time.
Click to expand...

Nova had a dental about 2 weeks ago.. we had the same instructions as above.. no food after midnight and no restrictions on water.. Nova went in early to be put on fluids for a while before surgery because she wakes up real nasty from the anesthetic.. so they actually did her shot at the vet that morning (1/2 regular dose).

Nova also stayed for the rest of the day for monitoring, so I packed up some diabetic safe food and took it with her (pieces of cooked chicken and ham cut up tiny, and 1 can of FF).. they gave her the chicken and ham snacks in the afternoon a couple hours after she woke up. That's the only suggestion I have that wasn't mentioned.. I think most vets are like mine, they don't have much for diabetic friendly foods on hand, and Nova was insanely hungry by the afternoon and eager to eat dispute the ouchy mouth.
 
Re: 3/14 Checkers..amps 280..Dental Advice Please

Regarding warming, some vets will use a type of "heater" since body temp may drop during/after surgery. I think it was Michelle/Doodle or maybe Hillary/Maui who's dog went in for a procedure and came out with burns. There was a constant heat source but it wasn't circulating heat and burns resulted.

I wasn't referring to fluids but I believe these are typically warmed to close to body temp.
 
It was Michele's dog Chloe that was burned, because they used water bottles and did not monitor them.

Maui went to a board certified dentist. I went to his lecture, saw and learned about his procedures. He has a warming bed that water flows through it constantly and it's about 97 degrees. I too asked about the burning issue and he said that his set up is designed to prevent it and the water is only 97, not hot enough to burn.

The dentist also said that ideal food removal is 12 hours prior to anesthesia. Water removal the morning of.

Here is the post on general health that I started in February on this subject. It's long, but you may find it useful. viewtopic.php?f=29&t=5390
 
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