Lizzie Dental Wed - Insulin or Not? - Opinions Needed

[Jacquie & Lizzie]

Liz is going in Wednesday morning at 7:30 for a full dental including pulling some teeth. Vet's office said no food Tuesday night or Wednesday morning. How will not feeding her with her morning shot affect her glucose? They suggested not giving the shot, but her morning numbers have been pretty high, so even if she drops a couple hundred points I don't think she is in danger of hypo.She had blood work done less than two weeks ago, so they don't need to that again.

Her spread sheet has her current numbers. I went with 3 units this morning & will check +6 at around 1:00 pm.

BTW, I really need to vent, it's finally hit me that I have another cat with this disease & I'm super frustrated! We'll be ok & I'll do what needs to be done, she's my baby & I love her. I just wish it was easier to monitor & regulate. Someone really needs to invent a continuous monitoring system for cats so we don't have to poke them all the time!

Ok my pity party is over, now back your regularly scheduled program! ;-)

Thanks everyone

 

[Sienne and Gabby (GA)]

I would get some clarification from your vet. Usually they don't want you to feed your cat within 6 - 8 hours of the procedure. So, when they say Tuesday night, do they mean after midnight, 3 AM, or when? I doubt that they mean to skip the PM meal. If Lizzie is the first procedure of the day, skipping the AM meal makes sense.

I would probably not shoot the full dose. Part of the reason that vets are very careful regarding the AM shot is that anesthesia lowers BG numbers. They would probably prefer to not have to put Lizzie on a dextrose drip if between her shot and the anesthesia her numbers dropped way low. Do you know if they will be taking BG readings throughout the procedure?

Sorry if you already know this, but make sure you get pain meds (e.g., buprenorphine) if Lizzie is is having extractions. Please make sure the vet does not use Metacam (meloxicam). This pain med is still being used by many vets despite the FDA black box warning due to its causing renal failure in cats. I usually tell my vet's office at least 2 - 3 times per procedure and write it all over the surgical consent form. Likewise, unless Lizzie has been given Convenia as an antibiotic, most of us opt for a different antibiotic. Convenia is a shot that lasts for 2 weeks. If your cat is allergic, once it's in, it can't be gotten rid of. It's typical that an antibiotic is given after extractions. My vet uses Clindomycin.

I'd also suggest getting a bottle or two of baby food. Any type, as long as all that's in it is meat and broth, is fine (no onions or any veggies). If Lizzie's mouth is sore, baby food goes down pretty easily and most cats like it.

When you get Lizzie home, she'll likely be hungry. Some of the meds that are used stimulate appetite. However, anesthesia slows down the GI track. If you give too much food, Lizzie will scarf-&-barf. Feed a teaspoon or two at a time spread out roughly every 30 min. or so until the anesthesia has begun to wear off.

 

[Jacquie & Lizzie]

Wow thank you! Yes it's ok to feed her dinner Tuesday night but nothing after 10 pm. They called back & said to skip the shot Wed morning. I honestly don't know if they'll be monitoring her during the procedure, I doubt it, but...

I'm putting your notes on antibiotics & pain meds in my phone so I can ask about when I drop her off. I'll pick up some baby food & limit the amoung given to her until the pain meds wear off. I really hate picking up cat puke!!!

Anyway, time to do her +9 test. Need to see if I can lure her out from under the dresser...Thanks again

 

[max&emmasmommie]

Hi. I've had an experience recently that I want you to know about.

My cat had a teeth cleaning after having high BG that required 2.75 units of insulin and still wasn't regulated. The cleaning alone (with no extractions) plus antibiotics seems to have made a huge difference in his BG. I had him on antibiotics prior to the cleaning with the hope that I could guess if he had an infection making it impossible to regulate his blood sugar. No dice. However, after the cleaning and another course of a different antibiotic for about two weeks, boom. About 10 days after we finished the antibiotic, his BG started falling fast. I've been dropping the dose, and dropping the dose meanwhile dealing with near hypos off and on for over a week now.

Our theory is that he had an infection in his pancreas. He was diagnosed with pancreatitis shortly before the dental. We think the infection in his mouth plus an infection in his pancreas was too much for his body's immune system to handle. When the teeth were cleaned and he got another course of antibiotics, his body was able to deal with the infection in the pancreas. Just a theory, but it is true that an infection of any type can result in higher BGs.

I want you to be prepared just in case you have a similar situation. The vet did not warn us that he could suddenly hypo or even mention that we should watch him carefully, and he knows we home test. It was very unexpected that 10 days after the antibiotic was discontinued his insulin needs decreased so vastly. When we finished the antibiotic, I was disappointed, and assumed we would be giving him even more than 2.75u very soon.

Good luck tomorrow.

 

[Sienne and Gabby (GA)]

After a dental, depending on the state of your cat's teeth, insulin needs can drop. A lot will depend on if there is a dental infection, gingivitis, etc. I don't think you've been here long enough to see what happens to some cats' numbers if they have something like a UTI and then start antibiotics. Once the meds kick in, numbers drop.

However, there is no guarantee. Max was not on that much insulin. Pancreatitis (which is in inflammation, not an infection) can certainly effect numbers but not all cats need antibiotics for it's management. Max may have also hit his "good" dose which can cause numbers to start coming down rapidly.

Ultimately, every cat is different (ECID). I do think if there is an important point in Dale's post it's to be attentive to Lizzie's numbers, especially if you see them start to change.