Cinco Update AMPS 291, +2 293

[Tricia Cinco(GA) & Harvey]

Cinco is recovering well from his cyst removal and dental/teeth extractions. He has one more dose of painkillers left and will be on antibiotics for another week. No signs of complications. He was a zombie for the first three days, but today he seems more like his usual self. We are a little concerned that his numbers are still high (for him), and wonder if this is typical of kitties on pain meds and antibiotics. He has been getting a little more food than normal, because we put his meds in a spoonful of baby food so he'll take them with no trouble. This has replaced his normal snack of Bonito flakes or freezed-dried salmon. He has been flirting with pinks, and even stepped into them yesterday AM. I told my DH he must have gotten a fur shot this AM, and he was highly offended :lol: He says he's been doing it long enough to know. This isn't the first time the post shot numbers have been higher, or only slightly lower than the pre shot. Insulin is 4 months old and has been kept in fridge. We did increase his dose from .75 to 1.0, but that didn't help. Should I not worry about it until he comes off his meds? I'd appreciate any feedback from those who have been there. Thanks!

 

[Chris & China (GA)]

Hi Tricia and Cinco!!

This is what I see, and hopefully more people will chime in soon.

1. You're trying to go OTJ too often and too soon. I understand your vet is telling you to stop insulin, but I think Cinco would do MUCH better if you just did smaller doses when his numbers go lower and continue giving his pancreas that support. There are several doses below .5 that I would have tried before trying to go OTJ.

2. You had just started the .75 on 11/13 after skipping a shot at PMPS on 11/11 and then no shot for the day of surgery/dental. By skipping that entire day, you should have held the .75 for at least 6 full cycles after the surgery/dental before going up to 1 unit because sometimes it just takes a little longer for them to settle into a dose, especially after something as stressful as the surgery. It probably would have been better to go ahead and stay at .75 a little longer but...

3. Now that you're on 1 unit, I'd just hold that dose for at least 3 days before making any more changes. Give the depot some time to fill at the new dose and let's see how he's doing in a couple more days

The only thing I'd be concerned with is the antibiotic. A lot of them contain sugar,(especially the liquids) so it's important to make sure the one he's getting doesn't have sugar in it.
Good luck to you and Cinco!! Hopefully now that he's getting to feeling better after the surgery and drugs, his numbers will start to improve too!!

 

[Sienne and Gabby (GA)]

If, in fact, the ABs are liquid, it's entirely possible that the AB is in a sugar syrup base. For some reason, when vets dispense the liquid they seem to forget that you don't want to give the liquid to a diabetic. If you need the AB as a liquid, you can get it compounded without sugar. It's also possible that pain or inflammation are keeping the numbers up. When is Cinco due back to have the cyst site checked? If his numbers stay up, I'd also want to make sure the vet checks his mouth. Were post-extraction x-rays done? If not, if there's a root remaining or if the extraction site is infected, that could be responsible for higher numbers.

Please keep an eye on Cinco's numbers. With the TR protocol, you do want to give a dose change sufficient time to stabilize. It's possible to raise the dose after 4 cycles if nadirs are consistently above 300.

 

[Tricia Cinco(GA) & Harvey]

Re: Cinco Update AMPS 291, +2 293 - PMPS 215, +5 186

I checked the label on the antibiotic, and it says it contains only the active ingredient, clindamycin hydrochloride and ethyl alcohol. It is in liquid form, as is the pain killer, bupenorphine. I don't have the ingredients for the pain killer, but he had his last dose of that this morning. He has 5 more days on the AB.

The incision from the cyst removal looks really good - no seepage or redness or swelling. I haven't tried looking into his mouth - he's not fond of being handled. He's grooming himself and is eating like a horse, so I suspect his mouth isn't bothering him too much - of course he was eating that way before the dental, even with an abscessed tooth! We go back Thursday for a recheck of his mouth. I don't believe post-extraction x-rays were done - I wasn't billed for them. I'll ask about that. They did tell me that they had to dig out the roots on the two teeth that were broken.

His numbers are still high, flirting with 300 this am, but better this evening. We'll keep him at 1.0 for at least 6 cycles, unless something drastic happens.

Thank you, Sienne and Chris, as always, for your advice.