4/21 Cobb PMPS 241 +3.5 160

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Suzanne & Cobb(GA)

Member Since 2013
Yesterday

We had a MUCH better vet visit today with Cobb's old vet in S.C. Looks like we'll be making the trip back from now on. No more looking in ATL. After 3 vets, it's just not worth the continued stress.

So, we got Cobb in. I didn't give him any insulin because of the possible anesthesia. But we took it with us, as well as a can of food and his spreadsheet.

The vet asked how his numbers were. I told her he has some visits into the 300s, but we have been seeing some good responses in the 100s as well. She was very impressed. She asked if we were testing at home. I said absolutely. She said if so she isn't worried about any hypo then - which she would be at his current dose. The other vet at the practice had an acrocat. I told her what the ATL vet said she saw with his jaw. Both vets looked extensively at Cobb's jaw and felt organs, and said they don't see any evidence of acro, for whatever it is worth.

I had to laugh when she came in though. Cobb was growling, as usual. She came in, picked up his carrier, took it apart and picked him up out of it. No problem whatsoever. Cobb didn't freak out. They didn't have to use a big glove. Didn't say he was aggressive or difficult to handle of anything. She was able to check his mouth, get a weight, feel everything - no sedation needed at all. Seriously ATL vet???

Dental is done. He had 4 extractions. But she said it wasn't a "must do right now" situation. She went ahead and got it done since we were from out of town. Cobb recovered fine from the anesthesia. They didn't give him a catheter or sub-q fluids. She said since Cobb was agitated, she would rather not do the IV because it would only be in for about 10 minutes and there was no point. He was growling when I picked him up about 30 minutes ago.

We are on our way back home. I'll evaluate his insulin tonight and see how he is...see what his BG is about 30 minutes prior to the shot and if he's low see what everyone thinks.

Thanks for the vetty vines!! They helped BIG time!!

~Suzanne
 
Re: 4/21 Cobb No AMBG - vet update

Wow, what a great vet report. I don't blame you for deciding to go there from now on. You just took the honors for the bean that drives the furthest to their vet - I do 1.3 hours each way for mine.

Sending healing vines for Cobb's mouth and safe travel vines for you all.
 
Re: 4/21 Cobb No AMBG - vet update

Hi there :cool:

So happy to hear you had a good experience at the vet. Were antibiotics and pain meds provided? Any post dental instructions from the vet?

Since anesthesia slows down movement of food through the digestive system I recommend waiting at least an hour after you return before offering any food. Then offer only about a teaspoon of food mixed with enough water to make it soupy. Give it about a half hour to make sure it stays down. If Cobb is still hungry offer another teaspoon of food and wait again to make sure it stays down.
 
Re: 4/21 Cobb No AMBG - vet update

Great vetty report - I'm happy it's done! :-D Way to go Cobb on being not so aggressive. :cool: :lol: Sorry about the extractions but it's better to get it done. Some kitties are a bit awkward at eating at first, until they get used to the new mouth. But it depends which teeth were pulled.

I would test Cobb a couple hours before PMPS as well as at PMPS, to get an idea of whether the anesthesia is bringing his BG down. Did the vet tell you when you could start feeding Cobb? I agree with Sandy on just giving a tsp and then waiting 20-30 minutes before giving another one.

FWIW - often there aren't visible signs of acro. Neko doesn't look much different than she did years ago.
 
Re: 4/21 Cobb No AMBG - vet update

They did give a shot of Covenia, which I'm not happy about, but forgot to say something when we left him. There was a lot going on and it slipped my mind. They said they used to do Clavamox, but stopped using it for some reason. I asked about pain meds. They didn't give any but said to call if I noticed he wasn't eating and they'd prescribe some. Only post-dental instructions were to feed as normal when we got home. I'm guessing between the anesthesia and car ride, Cobb will be a bit seasick later today. It's a 4-hour drive so he won't be eating for awhile. I'll give it to him slowly. He's napping in the car right now.

They pulled premolars. No canine teeth were taken.

I'm definitely not saying Cobb isn't acro. Just reporting back what the vets told us in comparison to the previous vet, especially the one vet who had an acrocat herself. She said we could do the test with MSU, but apparently (according to her) it can return a false positive for acro when the diabetes isn't controlled. And they recommend the CT versus the test to determine acro. Again, just reporting back what I was told. Not that I'm questioning anything I've learned here! :smile:
 
Re: 4/21 Cobb No AMBG - vet update

Ummmm....Cobb needs pain med. I wonder if the vet has ever had a tooth pulled. It's painful -- really painful and it hurts for a few days. Ask for bupe (buprenorphine/buprenex).
 
Re: 4/21 Cobb No AMBG - vet update

I completely agree with Sienna!!! I don't understand why vets just won't prescribe the pain meds as a GIVEN. It really boils my blood.

I am a practicing Buddhist. We believe that are animals are sentient beings- that means that they FEEL pain. If there is a situation that could even *possibly* be painful for one of my cats I will ask for the pain meds first thing.

I hope that you will call your vet and have them prescribe some Buprenor for Cobb at a compounding pharmacy near you. They don't need to add any flavors or anything to the medicine, I just think that a compounding pharmacy might have it in stock whereas I doubt that a regular Big Box pharmacy will have it.

I never had Jomo on the "patch" but even that might be better than no pain meds at all. :cry: Poor boy..
 
Re: 4/21 Cobb No AMBG - vet update

i'm thinking your vet might not be able to prescribe pain meds across state lines. not sure if there's a solution for that.

convenia was developed for skin infections, so that's its primary indicator. not sure if it will do much for dental, so you'll want to watch him and if his BGs go up, that may indicate infection and a need for antibiotics. They probably don't give clavamox as much only because it's oral and most clients want as easy as possible. i think punkin got a shot of convenia long before he was diabetic for a bladder infection. i remember being thrilled at the option of not having to pill him. we didn't have any problem with it - the only concern is that if cobb is allergic, it stays in the body for 2 weeks. if he's not, then no issue, unless it isn't effective against the oral bugs.

what a great vet experience overall! i'm happy you had a positive dental for him. yippee!

i'm gone all evening but just want to send my best for you guys to have an uneventful post-dental-evening!
 
Re: 4/21 Cobb No AMBG - vet update

Hey Julie, I'd agree with no prescriptions across state lines. Cobb scarfed down the teaspoon of food I gave him a few minutes ago, and I'm watching him closely. I'll find a way to get some bupe if he needs it. I'm guessing the vet can probably call a clinic over here, if need be. We'll figure it out.

He's at 181 right now, so BG is looking good too.
 
Re: 4/21 Cobb No AMBG - vet update

Hey Suzanne,

I'm so glad the vetty visit turned out well. Poor Cobb on losing his teeth. I'm sending lots of healing vines his way - and lots of anti-stress vines your way! :YMHUG:

Shelly
 
Re: 4/21 Cobb No AMBG - vet update

Hi Suzanne,
Just getting caught up here. We are very glad that Cobb's vetty experience and dental went well. And we hope and are thinking good thoughts that you will be able to get pain meds for him. 4 extractions are not insignificant! I'm sure he'll do just fine without those bad teeth. Rusty has a grand total of 5 teeth left in his mouth (including the 2 lower canines) and he has no problems eating.

Get some good rest after that long day of driving!

Hugs, scritches,

Ella & Rusty
 
Re: 4/21 Cobb No AMBG - vet update

Sending healing vines for Cobb, and yay for finding a good vetty! I hope you can get the bupe. Have a great evening, Suzanne!
 
Re: 4/21 Cobb PMPS 241

I lowered Cobb's dose a bit for tonight, and ended up with a partial fur shot anyway. My hand was wet and smells like Lantus. Yuck. Perhaps it will be a blessing in disguise. Who knows...

Cobb is eating great! Lounging around, but he's a cat..that's nothing new! :lol: :lol: :lol:
 
Re: 4/21 Cobb PMPS 241

Great vetty visit!! So happy it went well and it's all over now!

I was an absolute pain the the rear when I was calling around to find a vet to do China's...had the whole list of things to ask before I ever let them touch her and one of them was "would they be sending bupe home with her?"

Sounds like Cobb is settling back into home...hopefully he'll continue the good numbers he's been getting...or even get better ones now that the icky teeth are gone!

Have a good rest Suzanne! You deserve it!
 
Re: 4/21 Cobb PMPS 241

Hi there :cool:

Eating great and lounging around (Oh to be a cat in a good home. . .) Glad to hear it.

I too am a bit dismayed that you were sent home without pain meds.
Did they inject him with any pain medication, of either the anti inflammatory type or opioid type, during the procedure?
I'm concerned that if that is the case he may still be buzzed and when it wears off he will be in pain.

Suzanne & Cobb said:
I didn't give him any insulin because of the possible anesthesia. But we took it with us
I was looking at Cobbs ss and it reads like you shot 23u blind this morning at +12 and 12 hours later shot a reduced dose of 20u that ended a up being a partial fur shot. Is that the case?
 
Re: 4/21 Cobb PMPS 241

Good to hear that Cobb is eating fine. If it's just pre-molars he's probably not noticing them missing as much. My Theo had a pre-molar pulled a couple months ago and they gave him a bupe injection at the clinic.

More strange facts on acros: longer term (non-acro) diabetic cats can show elevated IGF-1 numbers above 92 (the normal upper limit), but usually acros are significantly higher. Neko was 440. There is no correlation between the IGF-1 number and the size of the tumor. CSU has seen acro cats where the tumor did not show up on the CT scan. Those they subsequently image on an MRI and see it there, but for one cat the tumor didn't show on either CT or MRI and they treated him anyway.
 
Re: 4/21 Cobb PMPS 241

Sandy, yes...they did give him an injectable pain med at the clinic. Also, when a were there; the get asked us to give him his insulin. I didn't have time to grab a test, but he had been in the mid-200s a few hours earlier and Cobb doesn't usually drop at preshot times. Obviously that's not always the case. The vet was not giving an injectable anesthesia (gas only) and she was not doing an IV or sub-q fluids so she felt it was best to keep him on his regular dose of insulin pre-procedure. That is one of the reasons I took him back to this get so I wouldn't be alone in making these types of decisions. I just can't handle that any more. I asked 4 times if I was understanding correctly and she said yes because it wasn't an injectable anesthetic.

Wendy, the second vet that looked at Cobb (the one that had the acro cat herself) said the IGF-1 test might be pointless on Cobb for that very reason. Apparently it can return a false positive on longer term diabetics who have had uncontrolled numbers. She didn't say why that was but said that's why she would recommend the CT scan instead.
 
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