Anyone else see high BG with Fentanyl patch?

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Mitzelplik's Mom

Mitzelplik's Mom

Member Since 2015
Mitz had her dental on Tuesday and did great. She had 2 teeth extracted. Her BG on the day of surgery was pretty good but since then, her numbers have been getting higher. This evening's pre-shot has me a concerned (460!). I've increased her insulin dose a little over the past 2 days from 1 to about 1.75 after this last shot. I'm supposed to take the patch off tomorrow. She's been eating really well, in fact she's been asking for more food than usual. Everything else seems normal as far as I can tell. How worried should I be??
Thanks for any input,
Joan
 
I wouldn't be too worried just yet, we often see an increase in BG immediately following a dental, it's more likely caused by pain/inflammation than the patch. Be aware this is frequently followed by a significant reduction in BG as the kitties mouth sorts itself out. potentially this has already occurred, that number you got tonight could be a bounce off a low number during the day. I'm a lantus user so not familiar with prozinc but is it wise to increase without seeing what is happening during the cycle? That is certainly a big no no with lantus.

If numbers remain high after about 10-14 days (or any other symptoms appear) I would want to investigate further. Did the vet take x-Rays following the extractions? If not it is possible that a piece of root gets left behind and causes trouble. But I wouldn't worry yet.
 
Hi @Vyktors Mum,
Thanks for the reassurance! I'm very curious to see what happens tomorrow after the patch comes off and I'll be able to monitor all day. Based on the PM +4 numbers I've been getting, I don't think she's dropping too low (her normal nadir is around +5) but, you make a good point. I will just give her her normal 1 unit in the morning even if the AMPS is still high since I'll be removing the patch then too. Hopefully, she'll start coming back down. She's definitely eating more than usual so I don't know how much that's effecting her numbers either. We went to a dental specialist and they did x-rays and every other kind of monitoring possible. In fact they removed a root remnant that may have been left from a previous extraction.
 
Depending on the numbers you get tonight and how she starts off tommorow and since you will be able to monitor you may not want to reduce right back down to 1 unit - some cats do need a temporary increase after a dental. My understanding is that with prozinc consistency between doses isn't vital like it is with lantus and some people even use a sliding scale. If I was you I would request dose advice from prozinc users.

It's great that you used a dental specialist, they're far less likely to make an error than a GP :)
 
Good thoughts. I'll check in on the ProZinc forum. I'm very glad we went with the specialist too. I was still a nervous wreck but at least I knew they were equipped to handle anything that might happen. I'll post an update tomorrow.
thanks,
Joan
 
Update: (I added a post in the ProZinc forum too)
PM+4 is 303. A couple of things I should add - the dental surgeon said Mitz's kidney levels were borderline high, as in the high end of the normal range, something my regular vet failed to mention to me :mad:. I'm not really sure what this means or what I should be doing about it.

Tonight's litter box looks like she's peed more than usual today. No opportunities to check ketones tonight but will try to do that tomorrow. Hopefully, my ketostix are still good. This could possibly be related to the fact that she's been eating more than usual since Tuesday evening and I've been making her food quite a bit wetter than I normally do. Hoping that's all it is!

There was something else I wanted to add but now I can't remember what. Time to go to bed!
 
Higher BUN may be seen with a high protein diet - what were the actual numbers?
 
Hi BJM,
I have not seen the lab results but I'll be asking for a copy. The surgeon said 2. Would that be the BUN?

This morning's PS was 341, still way higher than I'd like but better than last night at least. Now I've got to see if i can get this patch off...
 
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