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ittybitty

ittybitty

Member Since 2021
I am posting looking for advice on what to do next. Tuko has been off insulin for 2 years and I have periodically been checking glucoses (not as much as I should though and most were random checks without food withheld). Over the last few days, I’ve noticed him eating rapidly and begging for more and some increase in urination (hard to judge most of the time because he uses the exact same spot in the box every time so it ends up being one large chunk of litter). He doesn’t appear to have lost any weight recently and has been overweight since diagnosis. So last night I checked and he was 181 and today was 255 with food withheld for 2hrs prior. He is not really on a schedule with feedings at this time, meaning I add food when I get up and when I go to bed but it’s definitely not the exact same times every day. He eats FF pate and it’s typically 1/2 can every 4 hours during the day and 1/2 can every 3-4hours at night. I use the petsafe5 feeder. I plan to take him for a checkup asap and rule out any other condition (he hasn’t seen a vet since initial diagnosis). For now, I’m writing this assuming we have just fallen out of remission and I would like to have insight from this group before seeing a vet. Also, I know I should have started new spreadsheets for each year but it was easier for me to have it on one. I’ll have to fix that now with more frequent checking.

With his initial diagnosis, he was given Vetsulin and I dosed it based on the advice I got here because his vet seemed uneducated regarding feline diabetes. Coincidently, I was off work due to 2 separate illnesses and was able to do ample glucose curves and checks. This time around, I’m not off work. I am gone 14hrs on work days with no option to come home to check on him. I typically work 3-4 days in a row with those hours. I’m very nervous how this will work with a dosing schedule. I know Lantus was more widely recommended (but I had already bought Vetsulin last time) so I’m also looking for advice on which insulin would be best to start him back on with my schedule limitations. I’m also curious to know if many people have achieved a second remission?

Thanks for any help!

Tagging a few of you that helped me so much last time and/or may know who else can help!

@JanetNJ @Bron and Sheba (GA) @Diane Tyler's Mom
 
The biggest reason that a kitty will fall out of remission is the need for a dental. If Tuko has gingivitis or anything else dental going on, the inflammation can cause BG levels to be higher. Even if it's not the need for a dental, my first suggestion to anyone who's cat looks like he's falling out of remission to a vet visit. You could be catching the early signs of an infection.
 
Thanks for the reply! I am definitely taking him for a visit.. just wanted to be prepared on what insulin to ask for if this is something that will require restarting insulin.
 
Lantus is a more gentle longer lasting insulin so that would probably be the safest option for you. Is there someone else who could give him the injections at the 12 hour mark on the days you’re working 14 hours?
 
I agree with the others. ProZinc is a good insulin. I used it for a few years. I like it's flexibility. But don't panic just yet.

Lots of things could effect bg. A checkup and blood panel is a great idea. Definitly check the teeth, and since the eating habits have changed ask for a thyroid panel too on top of a senior panel. Let us know how it goes.
 
I have an appointment scheduled for tomorrow with a new vet. They have given instructions to not give food/water after midnight in case sedation is needed. Is that typical? Last time I went to a vet they sedated him and never asked about last food/water intake so I didn’t know that would be required for a mild sedation. I’m not sure how withholding food from a hungry kitty will go all night :( Although he hasn’t eaten as rapidly today, he’s never been that long without food. He looks like he doesn’t feel well so I’m eager to get some results in the morning.
 
Vet visit is done. I really like this new vet but we do have some differences of opinion I hope we can work through them. She was not concerned about glucoses 200-250s and said that upper 300s-400s would be more concerning. And she seemed to push a little toward a change to prescription diabetic food “wet or dry” to help lower his glucose levels before she would start him back on insulin. That was our major difference. I told her I felt like I had gone as far as I could go with changing his food and we are settled on flavors that he likes and I really wasn’t up for changing that again. I did mention cost being one reason for not changing again. She kindly stated that I would likely be spending money on prescription food or insulin. I just don’t see where a diet that’s kept his glucoses in an acceptable level would all the sudden elevate them.

They did sedate him with anesthetic gas via mask and got his blood work and urine. Everything was performed outside of the room with me, which I wish I could have seen more of what was done. And I could hear him down the hall screaming/hissing/growling bc his gas wore off before they got his carrier fully put together with him in it so he returned all jumbled up laying sideways and still hissing. He weighs 17.6 lbs (he was 17.5 2 years ago). She did not do any X-rays. Labs are listed as Feline Comprehensive Wellness Profile (which she said covers CBC, electrolytes, kidney/liver labs and thyroid function) and she added fructosamine. She said I could get more blood work for less price by sending them out to a lab so we should start getting some results back tomorrow but none were run “in house” today. She said she had never seen dental issues cause an end of remission/elevate glucoses but agreed to look at his teeth. When she returned with him she said his teeth looked bad- lots of plaque and some gingivitis but she wanted blood work and urine results back first to rule other stuff out. I’m not surprised as his teeth have never been cleaned and it was never mentioned 2yrs ago when he was diagnosed but his breath is not pleasant.

I also noticed really late last night that my test strips expired last July. This AM I opened a new bottle but they expired 12/31/22 but are at least newer and he was 261 on my meter with fasting for 9hrs. I have more in shipment now and can always get some new ones quickly if needed.

Will post blood work as I get it back.

Two main questions I have now.
1.Can someone point me to the direction of how to help him lose weight. I know it was discussed when he was first diagnosed- how many calories to give for desired weight.
2. If she calls with results and this does require insulin- am I better to choose prozinc over lantus due to my schedule. I’ve read through the sticky’s and it seems to be lantus has a more strict schedule.

@Sienne and Gabby (GA) @JanetNJ
 
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Lantus is a lot less forgiving than Prozinc if you have a challenging schedule. I'd suggest going with Prozinc.

This is a way to approximate the amount of calories your cat will need per day: Required calories per day = [13.6 X optimal lean body weight in pounds] + 70. However, I'd suggest reading this link about obesity and safe weight loss.

Well, I'm not sure how many diabetic cats your vet has treated. We've seen a lot of cats that fall out of remission due to dental issues.
 
Vet called and verbally gave some results. She was not concerned with any results. She said to let her know if his glucoses are ever above 300 but anything under 300 is well controlled and she read some research that she had looked up that justified that in a cat that has ever been diabetic anything under 300 was okay. She again expressed how important a “high quality” high protein and low carb diet is and recommended Hills Science Diet MD wet or dry or Purina pro plan diabetic. She said Fancy Feast was not a high quality food.

She didn’t bring up anything dental related but I did get prices for a dental cleaning and I feel like that likely needs to be done. If for no reason other than they’ve never been cleaned and he has bad breath.

The only actual results I have are the following. The office is supposed to be emailing me all results.
Fructosamine 399
Serum glucose 228
SDMA 18.8
And “no glucose in his urine”
 
Unfortunately, many vets get their knowledge about nutrition from the pet food sales people who visit their offices. Your vet needs to read the ingredients in Hill's food. These are the first several ingredients: Pork Liver, Pork By-Products, Water, Chicken Fat, Corn Starch, Potato Protein, Calcium Sulfate, Powdered Cellulose, Natural Flavor, Guar Gum, Fish Oil, Iodized Salt, Potassium Chloride, Locust Bean Gum, Taurine, Carrageenan. Liver as a first ingredient isn't great for cats. By-products are not muscle meat. Chicken fat isn't part of a high protein diet. Diabetics do not thrive on corn starch or potato protein. Powdered cellulose is my favorite -- it's the polite name for sawdust! Gums and carrageenan can cause GI problems. The first ingredient in FF Classic Chicken is chicken followed by chicken broth, meat by-products, liver, and fish. I would not even consider the Hills dry food given how high it is in carbs. Please give your vet the link to Lisa Pierson, DVM's site on feline nutrition.

You might want to ask your vet about the blood in Tuko's urine. It could be cystitis or a UTI.
 
I was concerned about the blood… do you think there’s any chance of it being from cystocentesis. I know it was collected that way last time but he was completely asleep and I’m not sure if he was moving or if it could have been difficult to get urine.

I also was a little concerned about the elevated cholesterol too. I’m not sure how important that is.

I looked up carb content of several prescription diets and they all seemed high to me. Is FF the most recommended or is there any higher quality food?
 
A cystocentesis can cause blood in the urine. It doesn't matter if your cat was sleeping or not -- it's a needle into the bladder so there can be some blood.

I wouldn't be overly concerned about the cholesterol. 'This is a link to information on cholesterol from Cornell's cat program.

Most the the prescription foods are higher in carbs and lousy quality. There are great options out there for high quality food. Many people rely on Fancy Feast or Friskies because they are not expensive. Brands like TikiCat, Weruva, and ZiwiPeak (and I'm sure there are others) are high quality but they are pricey.
 
@Sienne and Gabby (GA)

I’m planning to pursue dental cleaning. Is there anything else that I should request to figure out why his glucoses are still elevated?
And at what point should I request to treat with insulin. I don’t feel like it’s okay for him to stay in the 200s long term but the vet was okay with anything under 300. I’ve had varying glucoses over the last week and quite a few in the 150-200 range. So I’m not sure what’s going on.
 
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Sienne and Gabby (GA) said:
A cystocentesis can cause blood in the urine. It doesn't matter if your cat was sleeping or not -- it's a needle into the bladder so there can be some blood.
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To get a +3 blood on dipstick and 21-50 per HPF either means the cystocentesis was poor or the cat has a problem. Is not unusual for a 0-3 per HPF with a neg dipstick.
For OP I would ask the vet what blood was so high.
 
@Sienne and Gabby (GA) @JanetNJ

I called last week to ask about the blood in his urine and the vet I saw was out for the week. I scheduled his dental for this week (I’m quite nervous and this is his first dental). Are there any other labs or tests that I should request while he’s under anesthesia to determine a cause for his elevated glucoses? At what level should I request to start insulin if this doesn’t improve after dental?
 
JanetNJ said:
How did the dental go?
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I ended up cancelling because I called for a few questions the day before and found out they didn’t have X-ray capability and I didn’t want to chance spending the money with a possible extraction with no X-ray. I do not know that he will need any extractions but it’s always a chance. So I’m trying to get him into another vet this week for evaluation and hopefully dental next week with this vet if all goes as planned and I can adjust my work schedule to make these appointments.
His glucoses are still high and I’m still worried :(
I’m not sure what else to do other than dental… so really trying to get it done asap but it’s been difficult with my schedule.
 
ittybitty said:
I ended up cancelling because I called for a few questions the day before and found out they didn’t have X-ray capability and I didn’t want to chance spending the money with a possible extraction with no X-ray. I do not know that he will need any extractions but it’s always a chance. So I’m trying to get him into another vet this week for evaluation and hopefully dental next week with this vet if all goes as planned and I can adjust my work schedule to make these appointments.
His glucoses are still high and I’m still worried :(
I’m not sure what else to do other than dental… so really trying to get it done asap but it’s been difficult with my schedule.
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They are high but I wouldn't panic about it just yet. Hopefully you can see the new vet soon.
 
@JanetNJ

Thanks! I was able to get the appointment scheduled for Thursday. Hopefully it goes well (it will also give me a second opinion) and then can schedule dental.
Would I learn anything from doing midday tests or not really since there’s no insulin involved?
 
ittybitty said:
I ended up cancelling because I called for a few questions the day before and found out they didn’t have X-ray capability and I didn’t want to chance spending the money with a possible extraction with no X-ray. I do not know that he will need any extractions but it’s always a chance. So I’m trying to get him into another vet this week for evaluation and hopefully dental next week with this vet if all goes as planned and I can adjust my work schedule to make these appointments.
His glucoses are still high and I’m still worried :(
I’m not sure what else to do other than dental… so really trying to get it done asap but it’s been difficult with my schedule.
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I am absolutely not an expert as I was in the early stages of learning diabetes when I lost my Pixie. BUT I personally disagree with info your vet is giving. Everything I have read absolutely indicates that if there are dental problems/infection it will impact glucose levels. UTI's impact glucose. The fact that your babies urine showed blood "to me" says he should be on some antibiotics. Certainly his glucose could have been more elevated at the vet due to his anxiety - I would count on your home levels more. My vet was happy when we were finally getting Pixie down in numbers (she stayed over 550 for almost 3 months). My vet also believed levels thru diet alone was rare (that perhaps could be because my girl's level was so high). If the dental shows any infection, tooth removal likely they will put him on antibiotics. That could help point in the right direction. Good luck.
 
ittybitty said:
@JanetNJ

Thanks! I was able to get the appointment scheduled for Thursday. Hopefully it goes well (it will also give me a second opinion) and then can schedule dental.
Would I learn anything from doing midday tests or not really since there’s no insulin involved?
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i mean i doesn't hurt to do tests but not sure you'll see much of a difference. Good practice if you need it though. :)
 
bring those test results to the new vet... and ask about the blood in the urine too. It could be an infection... and that would make the glucose numbers rise. although the wbc is low and it's usually higher if there's an infection... so maybe it was how they collected the urine.

could you add a new tab with the current readings so we don't have to scroll so far down the spreadsheet?
 
Yes, blood in urine is definitely going to be discussed. He doesn’t have any symptoms with urinating- no obvious discomfort, voiding large amount, doesn’t appear to strain. That’s what really makes me wonder if it was the collection. They told me no food or water after midnight and I’m thinking maybe he didn’t have much urine in his bladder and also why it was darker. Is it safe to repeat a cystocentesis this close to when it was last performed?

Yes, I can move 2023 over. Sorry I had not done that already!
 
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ittybitty said:
Yes, blood in urine is definitely going to be discussed. He doesn’t have any symptoms with urinating- no obvious discomfort, voiding large amount, doesn’t appear to strain. That’s what really makes me wonder if it was the collection. They told me no food or water after midnight and I’m thinking maybe he didn’t have much urine in his bladder and also why it was darker. Is it safe to repeat a cystocentesis this close to when it was last performed?

Yes, I can move 2023 over. Sorry I had not done that already!
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Well keep us updated.
 
:)Update with new vet visit:
I met with the new vet for eval and possible scheduling of dental. Initially, she discussed the same info as the last one regarding that he was fine as long as he was under 300 and she highly recommended a prescription diabetic diet (although she was not as pushy). When I asked about prescription diet having higher carbs than fancy feast and why would he be fine on his current diet for years and then all the sudden have high glucoses, I didn’t get much answer other than sometimes things change and a diet that works now may not work forever for him. She was able to listen to his heart while he was in my lap and I was able to put him on the scales (16.2lbs) but there was no other testing performed and no sedation used. The vet tech initially wanted to take him to the treatment room for vital signs and weight but then didn’t as the conversation went on. He questioned who stopped his insulin and how I did that “on your own.” I explained that my cat wouldn’t be alive if I had followed my vet’s instructions.
I scheduled his dental for next week, pending some adjustments to my schedule.
She said she felt like he was likely just out of remission. But she is willing to do a dental first. She had no concern about the blood in his urine and said that was likely from the cystocentesis with no wbc or bacteria she said infection was unlikely.
I asked several questions regarding the dental and possible insulin. I got Gabapentin for the night before and morning of dental. She said he will have an IV placed with IV fluid used throughout the case with blood pressure and vital signs monitored and X-rays are routinely performed.
IF his glucoses continue to rise and insulin is required she said Prozinc would be her choice and likely start at 1unit (but she would look up dosing guidelines to be sure.) She also has Prozinc in her office if needed. She asked if he was on Prozinc last time and I told her no, he was on Vetsulin and she said “well that’s for dogs.” :)
She also said she rarely uses antibiotics with dental unless necessary and is willing to not give Covenia injection and would likely recommend Clindamycin. For pain- Onsior injection and sent home with tablets for post op and she mentioned transdermal bupe if I couldn’t give him Onsior pills. They give Capstar to every animal that has a procedure done. Does anyone know anything bad about that? I’m not sure if I can refuse it though.
After she knew how much I had previously tested him she said she would be willing to start Prozinc if I feel like it’s needed - she obviously is worried about a cat going hypo and owner that doesn’t test which I understand. I told her if he stays in the 300s, I may want to start insulin before next week but if it’s <300, I would like to see how the dental goes and if that helps.
Any opinions or suggestions are welcome!! She said so many things that I was happy to hear and I’m hopeful that we are moving in the right direction.
 
ittybitty said:
:)Update with new vet visit:
I met with the new vet for eval and possible scheduling of dental. Initially, she discussed the same info as the last one regarding that he was fine as long as he was under 300 and she highly recommended a prescription diabetic diet (although she was not as pushy). When I asked about prescription diet having higher carbs than fancy feast and why would he be fine on his current diet for years and then all the sudden have high glucoses, I didn’t get much answer other than sometimes things change and a diet that works now may not work forever for him. She was able to listen to his heart while he was in my lap and I was able to put him on the scales (16.2lbs) but there was no other testing performed and no sedation used. The vet tech initially wanted to take him to the treatment room for vital signs and weight but then didn’t as the conversation went on. He questioned who stopped his insulin and how I did that “on your own.” I explained that my cat wouldn’t be alive if I had followed my vet’s instructions.
I scheduled his dental for next week, pending some adjustments to my schedule.
She said she felt like he was likely just out of remission. But she is willing to do a dental first. She had no concern about the blood in his urine and said that was likely from the cystocentesis with no wbc or bacteria she said infection was unlikely.
I asked several questions regarding the dental and possible insulin. I got Gabapentin for the night before and morning of dental. She said he will have an IV placed with IV fluid used throughout the case with blood pressure and vital signs monitored and X-rays are routinely performed.
IF his glucoses continue to rise and insulin is required she said Prozinc would be her choice and likely start at 1unit (but she would look up dosing guidelines to be sure.) She also has Prozinc in her office if needed. She asked if he was on Prozinc last time and I told her no, he was on Vetsulin and she said “well that’s for dogs.” :)
She also said she rarely uses antibiotics with dental unless necessary and is willing to not give Covenia injection and would likely recommend Clindamycin. For pain- Onsior injection and sent home with tablets for post op and she mentioned transdermal bupe if I couldn’t give him Onsior pills. They give Capstar to every animal that has a procedure done. Does anyone know anything bad about that? I’m not sure if I can refuse it though.
After she knew how much I had previously tested him she said she would be willing to start Prozinc if I feel like it’s needed - she obviously is worried about a cat going hypo and owner that doesn’t test which I understand. I told her if he stays in the 300s, I may want to start insulin before next week but if it’s <300, I would like to see how the dental goes and if that helps.
Any opinions or suggestions are welcome!! She said so many things that I was happy to hear and I’m hopeful that we are moving in the right direction.
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my cat started on vetsulin and moved to Prozinc. Most find prozinc is better because it tends to last a little longer, so I feel that's a good suggestion. 1 unit is a typical starting dose. find out how muich the vet charges for it though. I know my vet always charged a LOT more than ordering it through chewy.com. Glad he will be able to get the dental next week. I'd wait and see what happens in the week or so after the dental as the numbers aren't esp. high. although do keep in mind that human meters read quite a bit lower than a pet meter. so a 250 on a human meter may very well be over 300 on a pet meter. still unless the numbers get higher or he starts showing other symptoms I might wait. Do you test ketones at home at all?
 
JanetNJ said:
my cat started on vetsulin and moved to Prozinc. Most find prozinc is better because it tends to last a little longer, so I feel that's a good suggestion. 1 unit is a typical starting dose. find out how muich the vet charges for it though. I know my vet always charged a LOT more than ordering it through chewy.com. Glad he will be able to get the dental next week. I'd wait and see what happens in the week or so after the dental as the numbers aren't esp. high. although do keep in mind that human meters read quite a bit lower than a pet meter. so a 250 on a human meter may very well be over 300 on a pet meter. still unless the numbers get higher or he starts showing other symptoms I might wait. Do you test ketones at home at all?
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I will ask about price.
I had tested ketones a few times when he was on insulin. It’s quite difficult, unless y’all have some tips/tricks. I tried burying a little cup in his litter since he always goes in the same spot and he filled it in with litter. The only way I’ve ever tested was trying to catch a puddle immediately as he’s getting out of the box and that’s iffy because most of it has soaked in. He has never had ketones on the few home test or either vet labs, I know that could change though. I need to grab a new bottle of strips if I start trying to test again.
Thanks for the reminder about human meters, I didn’t think of that.
She also mentioned a libre, I told her I felt like I could test easily enough that it wasn’t needed at this time. I honestly don’t think it would last on him but he could surprise me. Is there any strong benefit other than seeing trends.. which I could get on glucose curve days from ear pricks.

Also, do those meds sound reasonable? I’ve tried to search this board regarding what to use and not to use as far as antibiotics and pain meds.

Edited to add: the vet I saw is now out on maternity leave and it will be almost 2 weeks before another vet in the group can do his dental. So I’m still trying to get it done but it looks like there will be a delay.
 
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I'm curious why they give flea meds to every animal that has a procedure. Do they have a problem with fleas at their office? I've never had a vet give flea meds to my cat.
 
Sienne and Gabby (GA) said:
I'm curious why they give flea meds to every animal that has a procedure. Do they have a problem with fleas at their office? I've never had a vet give flea meds to my cat.
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I didn’t ask specifically why.. I looked up their boarding agreement online and it states in capital letters that it is a “flea free facility” and that every pet boarding will be given a capstar tablet on admission. This same rule applies to a procedure too. There were so many things I liked and agreed with that I’m not sure whether this is a battle to fight or not.
 
Capstar kills any fleas on the pet. It does not kill larvae or eggs. It is NOT a preventive like the topical Advantage. When my Nala and Boots were treated with the radioactive iodine last Sept one requirement was that my vet has to apply a flea preventative like Advantage during exam/blood work required within 2 weeks of the start of the treatment.
 
I ordered a blood ketone meter… when is the best time to test? Is anytime fine, or do I need to check this when he has been fasting for the 2hrs. Is there anything else important to know about this meter. I’ve read the info on this site about ketones and meters. I plan to try to figure out a way to get urine to test but that maybe a lengthy process. I’ve also ordered some urine dipsticks that appear to test like a urinalysis. Hopefully if I can ever collect urine this will help me determine if he continues to have blood in his urine or if it really was the cystocentesis.
 
Meter should be delivered today and I’m hopeful to try to use it today. If anyone knows if any fasting is required please let me know. I don’t want to waste expensive strips unnecessarily.
 
ittybitty said:
I had tested ketones a few times when he was on insulin. It’s quite difficult, unless y’all have some tips/tricks. I tried burying a little cup in his litter since he always goes in the same spot and he filled it in with litter
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I never used urine to test ketones because my cat would not have liked me by her while she’s in the box. I used a ketone blood meter which just took a slightly larger blood drip than my alpha track meter did. Much easier.
 
JanetNJ said:
I never used urine to test ketones because my cat would not have liked me by her while she’s in the box. I used a ketone blood meter which just took a slightly larger blood drip than my alpha track meter did. Much easier.
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@JanetNJ

I agree, it was much easier. Have you ever used control solution for glucometer or ketone meter?
Do you think I’m still okay on glucoses until dental?
 
@JanetNJ
@Sienne and Gabby (GA)

Dental is completed and he is back home. One pre molar apparently fell out when they went to scrape tartar off but that was the only tooth removed. He said the tooth was reabsorbed and there was nothing left but the crown that came out. There was some anesthetic issues- they ended up replacing the endotracheal tube during the procedure because they kept feeling like there was a leak somewhere and said it was difficult to keep him asleep. There was one molar the vet mentioned he may have pulled if he had great anesthesia but at the time it wouldn’t have been safe to do. He said the X-rays looked fine on that tooth but his heart rate increased when he messed with that tooth. The report was just severe tartar buildup so no meds given (antibiotics or pain meds).

He also mentioned his anal glands were very full and the vet expressed these (I honestly didn’t know this was even such a thing.)

I didn’t check his glucose this morning because I knew I couldn’t give treats and I already felt bad about trying to give the gabapentin last night (that he quickly threw up) and also didn’t want it this morning but I didn’t force it. Their glucose was 413 before the procedure started. I got 423 when we got home. We discussed Prozinc insulin and the plan is to monitor glucoses throughout the weekend and see how they do. He said their practice has several cats on Prozinc and that they have been doing well on once daily dosing. He also mentioned a libre but I don’t feel like that’s necessary at this time.

He also questioned his appearance (this is the first time this vet has ever seen him, as I saw one of his partners last time who is out on maternity leave). He said his appearance reminded him of an acromegaly cat. Interestingly enough when I came home and googled- it seems he may have some symptoms- noisy breathing, increased cholesterol, protein in urine. I’ve looked back at some face pictures but I don’t feel like I see any big differences, although I know in me seeing him all the time it may not be as obvious to me.

I’m not sure what’s next other than probably insulin.
Edit to add: PMBG surprised me, I guess I just keep watching glucoses. Not sure if that’s due to anesthesia or what.
 
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A tip if your interested in seeing if there are really RBCs in his urine:

Human urine test strips. Dip it in urine and follow the chart with the strips. The only untrustworthy reading is leukocytes, even in pet urine strips. For some reason it doesn't work with cats. It has ketones on it too, but I do highly recommend a blood ketone meter. I love mine.
 
Bron and Sheba (GA) said:
Is he managing to eat any food?
I would monitor the BGs and see if there is any improvement after the dental.
Good to have the dental over and done with.
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Yes, he’s eating like nothing happened. He Was so hungry when we got home but I fed him in 1/3 can at a time meals until I was certain he wouldn’t throw it up. I was shocked at low much lower glucoses were last night… and I’m still not sure if it was from anesthesia or what.

Katsallday said:
A tip if your interested in seeing if there are really RBCs in his urine:

Human urine test strips. Dip it in urine and follow the chart with the strips. The only untrustworthy reading is leukocytes, even in pet urine strips. For some reason it doesn't work with cats. It has ketones on it too, but I do highly recommend a blood ketone meter. I love mine.
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Thanks for the tip! I had bought some urinalysis strips, they are advertised as pet but look just like human, just haven’t tried them yet. I was trying to get through the dental before I started trying to get urine. I’m curious to see what they show. And I completely agree that the blood ketone meter was easier for me as well.
 
Katsallday said:
The only untrustworthy reading is leukocytes, even in pet urine strips.
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There are more too:
"Some reagent strip pad assays (eg, USG, leukocyte esterase, nitrites, urobilinogen) are unreliable in veterinary species because they are generally manufactured for use in humans.1,3-6 Leukocyte presence is better determined via sediment evaluation.3 A refractometer provides more reliable readings of USG.1,3,4"
https://www.cliniciansbrief.com/article/urinalysis-error-veterinary-medicine-sample-test-results
 
Larry and Kitties said:
There are more too:
"Some reagent strip pad assays (eg, USG, leukocyte esterase, nitrites, urobilinogen) are unreliable in veterinary species because they are generally manufactured for use in humans.1,3-6 Leukocyte presence is better determined via sediment evaluation.3 A refractometer provides more reliable readings of USG.1,3,4"
https://www.cliniciansbrief.com/article/urinalysis-error-veterinary-medicine-sample-test-results
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Absolutely! Nothing can beat idexx and diagnostic machines lol! But the strips give me some piece of mind. And I also use them lmao! I was engaged to an emergency dr for 7 years and he taught me about the strips forever ago
 
ittybitty said:
@JanetNJ
@Sienne and Gabby (GA)

Dental is completed and he is back home. One pre molar apparently fell out when they went to scrape tartar off but that was the only tooth removed. He said the tooth was reabsorbed and there was nothing left but the crown that came out. There was some anesthetic issues- they ended up replacing the endotracheal tube during the procedure because they kept feeling like there was a leak somewhere and said it was difficult to keep him asleep. There was one molar the vet mentioned he may have pulled if he had great anesthesia but at the time it wouldn’t have been safe to do. He said the X-rays looked fine on that tooth but his heart rate increased when he messed with that tooth. The report was just severe tartar buildup so no meds given (antibiotics or pain meds).

He also mentioned his anal glands were very full and the vet expressed these (I honestly didn’t know this was even such a thing.)

I didn’t check his glucose this morning because I knew I couldn’t give treats and I already felt bad about trying to give the gabapentin last night (that he quickly threw up) and also didn’t want it this morning but I didn’t force it. Their glucose was 413 before the procedure started. I got 423 when we got home. We discussed Prozinc insulin and the plan is to monitor glucoses throughout the weekend and see how they do. He said their practice has several cats on Prozinc and that they have been doing well on once daily dosing. He also mentioned a libre but I don’t feel like that’s necessary at this time.

He also questioned his appearance (this is the first time this vet has ever seen him, as I saw one of his partners last time who is out on maternity leave). He said his appearance reminded him of an acromegaly cat. Interestingly enough when I came home and googled- it seems he may have some symptoms- noisy breathing, increased cholesterol, protein in urine. I’ve looked back at some face pictures but I don’t feel like I see any big differences, although I know in me seeing him all the time it may not be as obvious to me.

I’m not sure what’s next other than probably insulin.
Edit to add: PMBG surprised me, I guess I just keep watching glucoses. Not sure if that’s due to anesthesia or what.
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When my cat came out of remission she had acromegaly. ProZinc is dosed twice a day. Not sure why he would say once.
 
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