Has Marvin ever had an echocardiogram? Heart murmurs can be benign, or not. You really need an echo to determine which it is. Even with a heart murmur, Neko had several dentals (and her second SRT) under anesthesia. But she had a cardio workup first. At some point her heart got to the point where she was having heart blocks, and could not have anesthesia any more. One thing vets have to be aware of, acros can have soft tissue growth in their throat, and may need smaller intubation.
You really don't have to wait for better numbers to have a dental. Neko had her first dental when she was still a frequent visitor to the reds. Some vets seem shy to deal with unregalated cat dentals. I don't know why, Neko's vet was OK with it. For the second dental, I went with a dental vet specialist, cause her heart murmur started after the first dental. And I knew I was dealing with acromegaly at that point, which my vet had no experience with. You do want a vet who will do dental X-rays first, as many issues can lie under the gum line and not visible to visual inspection. Neko twice had issues that the dental specialist couldn't see until after X-rays.
He also has a bump like an abyss or cyst on his right side of his mouth, however when vet check it's not infected and she called it something I can't recall, but said as long as it's not bothering him she didn't want to touch it.
I wonder if this is soft tissue growth due to acromegaly. Neko had some in her mouth, but it looked more like thickened gums.
As for cost, it depends what has to be done. Extractions add to the cost. Dental specialists cost more, but Neko's had a person dedicated to her anesthesia and heart monitoring during the operation. That, and his knowledge, was worth it to me.
Nice PMBG.
I think it's time to call this experiment a formal OTJ trial. Today is day 5.
Typically people will post the OTJ Trial Day # in their subject lines. Here are the instructions, you can ignore the first one.
Start the trial on the next green pre shot.
If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.
Good luck with the trial!!!
Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
) his ambg can be higher than normal. 
