Dentist - Should I change his insulin? Update

[Merlin]

Hello - it is me again asking another dental question. Merlin's dental appointment is tomorrow at 7:30am. The dr. told me to give him his insulin tonight at his normal time (7pm) but not to feed him after 8pm. He usually eats about 3-4 mini meals throughout the next 12 hours. In my last thread, it was mentioned that I might want to consider not to give him insulin the night before. So I was wondering if it would be ok to go ahead and give him the full shot, half a shot or none at all?

 

[Elizabeth and Bertie]

Re: Dentist - Should I change his insulin the night before?

Hi,

I did reduce Bertie's insulin shot a tad on the evening before both of his dentals.
He's prone to having BG drops and I wanted to make sure that didn't happen on the night preceding the dental, since I'd not be able to give him any food to bring his numbers up. Bert is on a sliding scale dosage and I reduced his shot to the next dose down the scale.
(I'd be interested to hear what other folks have done, though...?)

Oh, and do be aware that, occasionally, cats can have lower BG values following the anaesthetic. It doesn't seem to happen that often but certainly has happened to cats on this forum. So, you may want to keep a closer-than-usual eye on Merlin's BG after you give him a shot tomorrow evening.

Good luck with the dental tomorrow!
Let us know how it goes.

Eliz

 

[Rebecca & Jose]

Re: Dentist - Should I change his insulin the night before?

My Jose just had a dental that included 4 extractions on 4/16. My vet instructed me to give half of his breakfast the morning of the appointment and half the usual amount of insulin. His breakfast was at 5:00AM. I gave Jose his usual dinner and insulin dose the night before, 5PM. My appointment was at 9 but the vet didn't work on Jose until noon, so that his stomach could empty a bit before the surgery. During surgery my vet has an IV set up so that if his BG does drop she can give some nutrical to bring him back up.

I was able to pick Jose up at 5:30. They instructed me to feed 1/4 of his dinner at the usual time which was 6:00, so I did that and gave 1/4 of the amount of insulin. Jose's PMPS was 463 which was very high for him but in the morning it was only 126 so I obviously did not give insulin. Jose was one of those that had a low BG following his anesthesia. I was instructed to gradually increase hi meal amounts so that morning I gave 1/2 his usual breakfast and then I gave 3/4 his usual lunch. That night his PMPS was back to his normal range at 214. I gave him his full dinner and a usual dose of insulin.

The following few days gave me some pretty high numbers however. I'm thinking it was from a combination of pain/stress, the antibiotics, and some spots of bouncing that caused such high numbers. At his follow up appointment 8 days after his dental the vet gave another 10 days of antibiotics because his incisions weren't healing as quickly as she had hoped. He gas another follow up appointment this week as well. Just yesterday and today Jose has started to get lower numbers that are more of his norm.

I'm not sure if sharing all of this helps but my experience seems to be different from what I've heard of others so I thought I would share.

I hope everything goes smoothly tomorrow!

 

[Merlin]

Re: Dentist - Should I change his insulin the night before?

Thank you Eliz and Rebecca. I have head your advice. I typically would give him .8U tonight according to his PMPS number (on a sliding scale) so I gave him a .6U. I also gave it to him about 20 minutes earlier than usual so hopefully I can give him something to eat at 7:55pm. Thanks again for taking the time to share your experiences.

 

[Deb & Wink]

Re: Dentist - Should I change his insulin the night before?

Sending good dental vines for Merlin. Let us know how he does at the vet today.

You must be anxious to have him back home.

 

[Merlin]

Re: Dentist - Should I change his insulin the night before?

I just got a call from the vet and they are not going to do the dental today. The initial tests show kidney disease; something about BUN and creatinine elevated? Also he saw a little blood and pus coming from his nose (which could be from one of his teeth) or something else, they are not sure. I am to pick him up in three hours after they do a urine test and feed him (I gave them some of my food). He also says that the diabetes need to be under control. They took his BG and it was 533. He said something about a change in diet to help the kidney disease something like a low protein diet I told him that he was on higher protein and low carb for the diabetes but I guess with kidney disease you need lower protein. They are going to try first with Clavamox for two weeks to help with the infection. Not sure what else but will find out more later this afternoon.

 

[BJM]

Friskies Special Diet are both low carb and low phosphorus (a mineral you monitor for excess).

Tanya's Feline CRF web site has tons of info on renal disease.