? Super high BG's after dental

[Mitzelplik's Mom]

So Mitz had her dental on Tuesday. She had 2 teeth taken out and it went very smoothly. She's on a fentanyl patch for pain (which comes off tomorrow). Since the regular vet had given her Convenia 12 days earlier, the dentist didn't want to give another AB unless it was really necessary so the patch is the only medication she's on.

Mitz's BG was actually really good the day of the procedure but it's been going rapidly up since then and this evening's pre-shot of 460 has me worried. Is this a normal response to fentanyl? I've nudged her insulin dose up a little starting yesterday because the pre-shots have been getting so high and she's not coming down that much at PM+4 (normal nadir is around +5). She appears to be doing fine - she's been very hungry, asking for food and eating more than usual. Could the extra food be a factor? Drinking, peeing and pooping seem normal. She's sociable, alert.

What can I expect after removing the patch tomorrow? I'm thinking I should probably just give her normal 1 unit dose even if the AMPS is still high in case her numbers drop back down but I have no experience with this patch so I'm not sure what to do? I'll be home all day to monitor. Any input is much appreciated!
Thanks,
Joan

Update: PM+4 is 303. Some 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 . 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!

 

[Sue and Oliver (GA)]

I think I would give it a while. See if after a few cycles the numbers settle in. (Although testing for ketones is an excellent idea) Who knows what might be going on - eating vs not eating, the patch. If she were mine, I would err on the side of caution and keep the doses a little low until you see what the trend is.

Making the food wet is good for her kidneys. You might also look at this kidney site for some ideas:

http://www.felinecrf.org/index.htm

 

[Mitzelplik's Mom]

Thanks Sue. She was 341 this morning and I gave her a skinny 1.5 units. I remembered my other question from last night - when I first got home from the dentist with Mitz I focused on her for a couple hours because she couldn't stand up or walk by herself and I forgot to put her insulin back in the fridge (the dentist asked me to bring it so he'd have it case of an emergency). It was wrapped in towel in my handbag but I wondered if 2-2 1/2 hours unrefrigerated would be long enough to harm the insulin.

Now I'm going to see if I can get that patch off.

 

[Sue and Oliver (GA)]

The insulin should be okay. Unfortunately the only way to really know is whether you start getting wonky numbers (I'd suggest it is too early to determine that yet) or whether you start to see big floaties. I'd give it a while.

 

[Mitzelplik's Mom]

OK, I'll just keep monitoring.
Thanks,
Joan