5/24 Ann & Maggie PMPS 103/Question on dental surgery!

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Ann & Maggie11 (GA)

Ann & Maggie11 (GA)

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Morning! Maggie's AMPS is a little higher than normal for her. I tried a different area of her ear and got a big drop. I wonder if it made a difference, or maybe I did a fur shot last evening. She moved a little when I inserted the needle, but I didn't smell any Lantus. It's time for me to get a new vial. The vial can last up to several months if refrigerated properly. I should have the results of her urine culture today, fingers and paws crossed this antibiotic took care of her infection.

Yesterday
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Re: 5/24 Ann & Maggie AMPS 156

I always thought that the right side of the ear yielded higher numbers, but that's not so... Hey we gave it a shot :lol: :lol:
Blood is the same no matter where we test on the ear! except of course, meter variance.
Looked at your ss, & see that you just made dose a fat 0.5--You only have done 4 cycles, so just wait till the whole 6 cycles to let the dose settle, & really get a chance--Moonie does well with small increases & decreases, but she waits till the last moment to show it in bg..
Hope you have a green day!! :mrgreen:
 
Re: 5/24 Ann & Maggie AMPS 156

I always thought that the right side of the ear yielded higher numbers, but that's not so... Hey we gave it a shot
Blood is the same no matter where we test on the ear! except of course, meter variance.
Looked at your ss, & see that you just made dose a fat 0.5--You only have done 4 cycles, so just wait till the whole 6 cycles to let the dose settle, & really get a chance--Moonie does well with small increases & decreases, but she waits till the last moment to show it in bg..
Hope you have a green day!!
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Hi Roni & Moonie,
He, he, and I do the left ear and can't seem to get blood from the right! She has this tiny bump on her right ear where I kept pricking, so I try and not prick the bump! Thanks for the info on the dose settling. I may miss her Nadir, as I will be gone several hours, but will try and work it around her Nadir. Have a nice day.
 
Re: 5/24 Ann & Maggie AMPS 156

Thanks Pat. Maybe she got into my potato chips. She likes potato chips of all things! One accidentally fell on the floor and she grabbed it and ate.
 
Re: 5/24 Ann & Maggie +7 107 - E-Coli infection cleared!

Hi,
I spoke with someone in the Vet's office, and good news the culture showed her infection has cleared up. Now I have an appt. this Friday for her to have her teeth cleaned and the one infected tooth pulled after they first do X-rays. He said no insulin that morning, as she cannot have food the night before as she will be under anesthesia. I'm a bit, no a lot nervous about the whole thing. Those of you whose cats had dental surgery - did it throw your cat off too terribly much with the diabetes? Maggie is 11 years old, so anesthesia at her age is always a risk, but that infected tooth does need to come out.
 
Re: 5/24 Ann & Maggie +7 107 -Question on dental surgery!

Hi Ann
glad to hear the good news!

I know there's tons of beans here who have gone thru the dental, keep asking in your daily condos till the day of, that also helps for a reminder for everyone that Maggie has a dental friday...add it to your SS too in the comments "DENTAL DAY"
I would also suggest you cross post ur dental questions/concerns in the health forum too.

Nice numbers today!
 
Re: 5/24 Ann & Maggie +7 107 -Question on dental surgery!

Here's the info on dental's:

Dental info

• 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)
• 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)
• 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.

Since you know the one tooth is infected, you may want to have Maggie get an AB ahead of time.
Dr. Lisa had a thread in Health on the use of ABs for dentals. Here's a cut-and-paste of some of the info:
Dr. Lisa said:
Some thoughts on minimizing any complications from dentistries.

1) Only on a case-by-case basis are pre-dental antibiotics recommended. ABs are NOT being routinely used - they are being reserved for cases where oral infections have been documented In the case where an AB is needed, I recommend that the cat get a dose the night before, if possible, but at least an AM dosage the day of the dental. This usually means picking up the antibiotics the day before the procedure or asking your vet to be sure to give the antibiotics upon the arrival of your pet to establish a blood level pre-dental.

Taking it one step further, I do not necessarily agree with always giving AB's post extractions - per the boarded dentists on VIN and from everything else I have read on this subject. If the nidus for infection (the bad tooth) had been removed, the ABs are often not warranted. All that said, keep in mind that NO 100% blanket statements can be made regarding this issue. Guidelines can be discussed but this issue still needs to be considered on a case-by-case basis. The problem is....*generally* speaking....that there is FAR too much CYA ('covering your butt....) going on in this profession with respect to handing out ABs and we need to pull back on handing them out like candy and start to critically evaluate each case more carefully to decide if their use is warranted.

That said, if you have a cat with a serious concurrent health issue or a cat who is on immunosuppressive drugs, a good talk with your vet is in order. Some drugs and underlying diseases can predispose animals and humans to post-operative infection.
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Re: 5/24 Ann & Maggie +7 107 -Question on dental surgery!

Tizon will be getting a dental on June 3 and the instructions Sienne gave you were exactly the ones I used to discuss the entire procedure with my vet.

The only thing that is not on the list and that you should get ahead of time is food, and that's a tip from Jojo... get food that Maggie likes. The biggest thing will be to get her to eat post surgery (not necessarily same day but the days after). So, I've purchased a few cans of HC, MC (won't use them unless I have to), lc or different flavor... and because Tizon has a weakness for fish, I picked some of those up to. Meat (only) baby food is also a good one.

Maggie will be fine.
 
Re: 5/24 Ann & Maggie +7 107 -Question on dental surgery!

Hi Ann,
For what it's worth, see Shadoe's ss on Mar19/10, she had her first dental ever.
The nice vet did a visual and saw 4 iffy teeth. She did Xrays and found that only one molar, upper right I think, needed to go.
I think Shadoe did pretty well; her ss shows her no shot and reduced shots. We went easy on the foods after, giving her soupy slop so she could have the nourishment but not have to worry about any chunks.
Shadoe's a wee bit different being acro, so I don't know how much her big drop at the time had to do with that single extraction. I bet a fair bit played into the picture as she must have felt alot better after the extraction. Anybody who has had a tooth pulled knows how it feels eventually: much better!

I know it's nerve racking, but gather up all the info from those around here and make sure your vet sticks to the do's and don'ts you provide.
And get your sunglasses out to be ready for those shiny choppers after!
 
Thanks Ronnie, Helene and Sienne. Very good information. She had bloodwork two weeks ago when I took her in for what I suspected was the UTI infection, so that's one step. I believe he used Sevo over a year ago when she had some dental work. Thanks I'll make sure I have all the foods. She loves baby food, especially beef. She is still on Amox/Clavulante, and I'm waiting on a call to see when I need to stop. Thanks everyone. I really appreciate all the help.
 
A difficult thing for us is the "No food" from midnight on...the morning we have such a routine with the ear test and then food....so, when there is no food for many hours, it is a big signal to them that something is very very wrong with their day.

I usually get the carrier out a couple of days in advance and have it ready for the quick departure in the morning. Sometimes, i think it is far worse for ME than it is for them....

Big thing is this: YOU know that the tooth has to come out. YOU know that she needs to go.
So, the entire scenario is non-negotiable. Each kitty acts differently after the anesthesia....and some suggest you keep them quiet in a darkened room once you are home. Feed slowly with small amounts depending what the vet says. It will be much better for Maggie when that tooth is out...
Check her BGs in the morning as usual. Then, do it again when you get home. People will be here to help you at each step of the way...don't worry....it will be okay...
 
Re: 5/24 Ann & Maggie +7 107 -Question on dental surgery!

Gayle and Shadoe"]Hi Ann,
For what it's worth, see Shadoe's ss on Mar19/10, she had her first dental ever.
The nice vet did a visual and saw 4 iffy teeth. She did Xrays and found that only one molar, upper right I think, needed to go.
I think Shadoe did pretty well; her ss shows her no shot and reduced shots. We went easy on the foods after, giving her soupy slop so she could have the nourishment but not have to worry about any chunks
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Thanks Gayle. I will check on Shadoe's SS on those days. That's what I was worried about with no shot in the am. The Tech said they would give her a shot there after they feed her. This may be why she's just sucking the juice of the Sophisticat and FF, although the FF has less to slurp! This tooth must be painful, although they never show their pain.
 
I did forget to add that I used baby food as a treat since Gabby had an extraction and I thought it would be easier than the jerky treats she likes.

There are a couple of additional things when you bring Maggie home. Get an "in the door" BG test. Anesthesia can drop BG so you will want a number to compare with her PMPS to know if her BG is dropping. Anesthesia also slows gastric motility. She will be hungry when she gets home. Feed in small amounts - like a teaspoon at a time and don't keep filling up her bowl as she finishes. Spread it out over time. Otherwise, you will have scarf-n-barf. Some cats react to the meds. Maggie may want a low stimulation environment -- a quiet, darkened room.

Please discuss the issue of their giving a shot. It will throw your shot schedule off hugely! Frankly, I think it's an ill informed response from the tech since you use a 12/12 insulin UNLESS they are planning on giving R. My vet did not give insulin after Gabby's procedure. We waited until PMPS. I don't recall anyone here who's cat was given insulin after the procedure because of how anesthesia and insulin can interact. In fact, I can't remember now who just had a dental. They ended up administering dextrose because numbers dropped.

If they are going to feed Maggie, bring LC food 'cause you know they will not give her what you would.
 
Please discuss the issue of their giving a shot. It will throw your shot schedule off hugely! Frankly, I think it's an ill informed response from the tech since you use a 12/12 insulin UNLESS they are planning on giving R. My vet did not give insulin after Gabby's procedure. We waited until PMPS. I don't recall anyone here who's cat was given insulin after the procedure because of how anesthesia and insulin can interact. In fact, I can't remember now who just had a dental. They ended up administering dextrose because numbers dropped.
If they are going to feed Maggie, bring LC food 'cause you know they will not give her what you would.
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Yes, you're right Sienne. It sure will throw off my schedule. I wondered about that statement with the insulin. I will request they not give her a shot. That didn't sound right to me. I'm not even sure he realized she was on Lantus insulin. It doesn't make sense for them to give her the shot after recovering from surgery. I probably won't hear back from the vet until tomorrow as he has not yet called.
 
Moonie has had 2 dentals in 2 yrs..I used all the info from here & we got through it quite well both times...
The anticipation before it is worse than the actual event, but Maggie will get through it just fine.
They are so so much better after, you will see.
We did learn that there is the Nom Nom effect--Anesthesia has a lowering effect on BG's(it like eats up the blood sugar) so you need to be careful what you shoot when you get her home, see what her bg is after surgery & decide at home, what to shoot--Look at my ss on 11/18/09 & you will see that event.

Otherwise, clavamox after the dental is what we gave Moonie both times(orally) & she was fine..She had 5 teeth out the 1st time, & 4 the second time..Without much stress to her! She got Buprenex for pain the second time & it worked very well!
Ann, believe me It is harder on us than them!! Dont worry we will be here for you! HUGS!!! :mrgreen:
 
For sure say NO to the shot after the dental - I don't know why that would be ever a good idea.
Shadoe had a weee bit of a DROP in her numbers after the dental :roll: , as I was told due to the anesthesia likely having a big effect on their BG.
For sure I asked for the vet to take her BG just before and then also after, and WITH OUR METER.
I gave Shadoe her shot in the evening like normal and she went all GREEN so that the next morning she got no shot at all. I would sure prefer to err on the side on not enough insulin than finding out later that it was way too much and I had to worry about bringing numbers up while already worrying about recovery from the dental procedure.
 
My experience totally supports the NO SHOT by the vet. In fact, we ended up having to skip the shot the NIGHT of the procedure, because Kitty was still very low that night.

As for food -- we bought a can of the stuff the vet sells for post-procedure. Does anyone here have a functioning memory about the name of it -- A/D, I think? It's fairly high carb, but the consistency is nearly whipped. Kitty was able to eat that nicely.

If you prefer to use your own food, you can even put it in the blender first. (I think Sienne originally suggested that.)

Last comment: Kitty got right back on track after a day or so. I'm sure Maggie will too!
 
Oh my gosh, thanks everyone. You all have been so helpful and I am so grateful for everyone's help and experience. Yes, now I can see why the no shot makes sense. I will tell the Vet that for sure, no shot, as suggested by his Vet Tech. what was he thinking? Maybe he assumed she was on another insulin. I am thinking of rescheduling the dental for Monday vs. Friday. On Saturdays the Vet is only open until noon. Just in case there are some side effects, it would be more reassuring knowing the Vet's office will be open, and Saturdays they are super busy. Fridays just seem like a bad day for some reason...end of the week, people are more tired. I'm not procrastinating but am thinking of rescheduling.
 
If Maggie is not in any pain from the tooth, then maybe postponing a few days is OK and it gives you time to sort out all your notes and be prepared to tell your vet what you want and don't want and why. You can make a list of questions to ask at the time you change the appt. For example you can ask why the vet tech said they would give a shot, plus you can talk about the procedure and ensure pain meds will be made available for you for after, etc.

it's best to be prepared and sure of everything and you will not be so stressed on the big day :lol:
 
both of my cats that had dentals recently, I purposely scheduled for Friday so I would have the next 2 days to sit at home and watch them like a hawk! Of course it was unnecessary in my case, neither of them needed extractions and they were perfectly fine by the next morning. I still enjoyed watching them all day though. :smile:

Good luck with the dental, hopefully it will make Maggie's numbers come down even more!
 
If Maggie is not in any pain from the tooth, then maybe postponing a few days is OK and it gives you time to sort out all your notes and be prepared to tell your vet what you want and don't want and why. You can make a list of questions to ask at the time you change the appt. For example you can ask why the vet tech said they would give a shot, plus you can talk about the procedure and ensure pain meds will be made available for you for after, etc.
it's best to be prepared and sure of everything and you will not be so stressed on the big day Shadoe's Profile
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Thanks Gayle. Yes, I sure will ask the Vet why the Tech said they would give her a shot post surgery! The last dental surgery she had pre-diabetes, they did give her pain meds, but I will make sure they will do so again. We really have to be our own advocates here for our kitties. She doesn't seem to be in pain, as far as I can tell, and is eating/slurping better since the infection cleared up. I didn't get a call back, so in a way that's good, as I will be better prepared in asking questions with all the information acquired here. Many thanks again to you and everyone.
 
HI Ann and Maggie, as you may remember Scrabble had a dental a couple of months ago. It was a last minute decision that we decided to do while he was having his absess removed. So he did have insulin that morning and did eat. The dental and the anethesia did not affect his numbers at all. I did not give a shot for the pm after the dental since his pmps # was low and everyone on here advised me not to shoot that night. Scrabble did not need to have any teeth pulled so that was not an issue. I probably did not help you but I know our situation was quite different than most!

Glad to hear that Maggie's culture was good. When are you getting the dental? I am sure she will do fine!!
 
...and just because you need something else to ask questions about - :lol: -- the bupe (pain med) comes in pre-filled oral syringes. I remember a lot of discussion here about how much Kitty would need; I think it's based on the cat's weight. Sienne knows about this, I think. Oh, Sienne... :mrgreen:
 
HI Ann and Maggie, as you may remember Scrabble had a dental a couple of months ago. It was a last minute decision that we decided to do while he was having his absess removed. So he did have insulin that morning and did eat. The dental and the anethesia did not affect his numbers at all. I did not give a shot for the pm after the dental since his pmps # was low and everyone on here advised me not to shoot that night. Scrabble did not need to have any teeth pulled so that was not an issue. I probably did not help you but I know our situation was quite different than most!
Glad to hear that Maggie's culture was good. When are you getting the dental? I am sure she will do fine!!
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Hi Michelle,
Thanks. I forgot about the dental, but I well remember the absess being removed. Thanks as it does help. Her dental is scheduled for Friday, but I'm thinking of rescheduling for Monday. There was a comment the Vet Tech mentioned about giving an insulin shot after her surgery that I have to clear up with the Vet tomorrow when I talk to him. I'm glad Scrabble did not need any teeth pulled.
 
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