Unfortunately, vet specialists, including dental, typically need a vet referral. I was lucky that I'd gone to my vet for many years and had a history with her. Though nothing as complicated as Neko was. The vet didn't know FD that well, she was thrilled I actually wanted to treat Neko, many pet parents didn't. We butted heads a few times on some diabetes topics, but she was great on all the other kitty conditions, and willing to learn, so I stuck with her.
When a cat gets to 5 units dose, we typically move to 0.5 unit increases, unless tweaking a mostly good dose that already has some greens. When a cat gets to six units without being regulated, there are some additional blood tests we suggest, though bad teeth can definitely make a difference. Keeping paws crossed you'll see movement before then. Insulin is a hormone and it's a matter of getting to that fitting dose. Sometimes it's like a light switch went on.
