8/18~ Skippy Dental Question

[skippy and birten]

viewtopic.php?f=9&t=22082

Hi LL; we had two appointments with dental specialist. She is a fellow of the Academy of Veternary Denistry and Board Certified as a Diplomate of the American Veternary dental College. The procedure will take place on August 30th at 11:30am EST. She checked his vitals this week and said he looked and sounded great. She take his X-ray and then consult with me if there are any extractions needed etc. We are going in just for cleaning and praying that there is no underlying issues. His back teeth look brown with gum redness.

She told me that he should fast 8 hours prior to surgery which means that I will be feeding him at 3:30 in the morning. She said she would prefer that I do not do his insulin shot that morning should he drop etc. It is better to be high than low during surgery. My question to those who have gone through this without him eating from 3:30 am to 11:30 am w/o insulin can he BG drop due to being hungry and not eating.

My second question is since my last posting see above link with 2 dose decreases in less than a week we are YET again in the YELLOWs majority of time. I do not know why this happens ALL THE TIME he goes yellow for a long period I increase he goes green really low and then yellow again. It seems he does not like the decrease. There is a definitely a pattern going on here. Should I up his dose? I am hoping the teeth cleaning will change the pattern.

Thanks again for everyones prior advice on what I needed to know about dental cleaning and all the information.

 

[Roni and Moonie]

First the reason for not feeding is so that cat will not vomit while under anesthesia, stomach should be empty just like a person's
Second BG will rise from stress at vets, so if he runs high this is better because using anesthesia will cause BG to drop after the surgery ,when he gets home, as I have experienced this with Moonie(see ss dated 11/18/09)--I would shoot maybe 1/2 dose that night--No insulin in the am day of surgery..BUT.......
Check with the dose helpers--for dose that nite--
All will be well--Sounds like you have gotten the right advice so far--Post his number when he gets home from dental & decide then...

 

[skippy and birten]

Thanks for the info it does make sense. Of course I thought about this driving home from all the other questions I asked...very nervous but feel good that Skippy is in good hands. She said they wait near him until he wakes up and then puts him in his cage and gives him to me rather than stress out in an unfamiliar cage. She was very gentle and calm with him so I am hoping that will be the case behind doors...keep you all posted that evening when I get home. She was impressed with the FDMB after I went into lengthy discussion on how the group helped and still do ) THANK LL

 

[Libby and Lucy]

it looks to me like your last dose reduction failed. In that case, you can go right back up to the last good dose (2.75).

What some of the long-timers here are doing is trying to feed the curve so the cat WON'T earn dose reductions until he really needs them. You know that when you shoot low, Skippy is going to drop. In that case, if you shoot low then get a +1, and if +1 is the same or lower than PS you can go ahead and feed MC or HC then, to try to keep him from dropping low enough to earn a reduction. You can experiment with other feeding times to see if those work better for Skippy. Just a suggestion, but it might help flatten him out.

 

[Kathy and Kitty]

Hi, Birten! I am so happy for you that you have an expert!

I agree with Roni. Many of us who have gone through dentals gave a reduced dose the night before, just to prevent what you mentioned: going low overnight without food.

Here are some items that Sienne mentioned back in March in another condo:

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=9149#p90397#p90397

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.

There's a lot of info there! Don't worry. Skippy will be fine. And everyone here will help you after the procedure.

 

[Kathy and Kitty]

...and what I mean by after the procedure is...

-- As soon as you get home with Skippy, test his BG. As Roni said, many kitties go low after getting anesthesia -- the famous "nom nom" effect!

You'll want to feed only a tiny amount, not more than a teaspoon, and then wait (20 minutes?) before giving another. This helps prevent, um, barfing.

Many people try to let kitty "sleep it off" in a dark room. I know my Kitty was very hyper-alert after coming home, restless. He walked around for an hour or two, and then zonked out after that.