? What's the insulin protocol when cat goes to surgery

[Silvina]

Hello all!!

I asked this on the group, but I guess this is dosing related issue so I decided to post in here.

Markies has to go to surgery for a dental. We went to the vet today and he said he has:

- periodontal disease
- FORL (this is impossible for me to translate, in Spanish is resorcion odontoclastica
- gingivitis (caused by the periodontal disease)

It will require 12 hours fasting, inhalation anaesthesia.

Before this we need to do blood work.

My questions are, what the insuline protocol should be. The vet doesn't know much about diabetes. He first said that we should proceed as usual with insulin, but then when I asked about previous fasting he said Markies should have ideally 12 hours fasting but 10hours would be ok. So I told him that if he has to fast for so long, he wont be able to eat at nadir, so I told him that probably Markies will have to skip that dose.

He said ok, clearly doesn't know much about diabetes.

We are on Levemir, 1.75 units.

So, what should I do my dears about insuline that day?

Thank you in advance for your help.

Silvi

 

[Larry and Kitties]

What ever the vet is comfortable/has experience with. For diabetic cats my vets says 1/2 food and 1/2 insulin (if morning BG is as expected) the morning of a dental.

 

[Silvina]

What ever the vet is comfortable/has experience with. For diabetic cats my vets says 1/2 food and 1/2 insulin (if morning BG is as expected) the morning of a dental.

Dear Larry, Markies has to fast for 12 hours. THis is an entire cycle. What would you do, would you skip dosing at night? Dosing time is at 1AM / 1PM and surgery will probably will be at +9. (at nadir).

 

[Sharon14]

Colin just had a dental, with 2 extractions. He had to fast for 10 hours. My vet said either no insulin, or 1/2 dose. I went with the half dose because Colin is a high dose cat.

 

[Chris & China (GA)]

Usually, the night before we give the regular dose and then either no insulin the morning of surgery or some vets will say 1/2 dose (but those usually also say it's OK to give a light breakfast)

Since you shoot so late, I'd probably just give the 1pm dose and skip the 1am dose the morning of the dental...that way you can take his food up around 11pm and he should be good to go for the dental in the morning

 

[Silvina]

Usually, the night before we give the regular dose and then either no insulin the morning of surgery or some vets will say 1/2 dose (but those usually also say it's OK to give a light breakfast)

Since you shoot so late, I'd probably just give the 1pm dose and skip the 1am dose the morning of the dental...that way you can take his food up around 11pm and he should be good to go for the dental in the morning

Thank you, now it's clear. I will skip the dose then.

 

[Silvina]

Colin just had a dental, with 2 extractions. He had to fast for 10 hours. My vet said either no insulin, or 1/2 dose. I went with the half dose because Colin is a high dose cat.

Sharon what's Colin's dose? At what time was shot time previous to dental and at what time was the surgery? What was the time he last ate? Sorry for so many questions.

 

[Sharon14]

Colin is on 5.75u Levemir BID. I gave his AM shot at the usual time-5:30AM. And had him to the vet for 8:30 AM his was the first procedure of the day- I requested that. I fed him last at 9:45 PM the previous night. I gave him a full meal of 1 can Fancy Feast Classic.

ETA I gave him 2.5u that AM, and the usual 5.75 that evening

 

[Silvina]

Colin is on 5.75u Levemir BID. I gave his AM shot at the usual time-5:30AM. And had him to the vet for 8:30 AM his was the first procedure of the day- I requested that. I fed him last at 9:45 PM the previous night. I gave him a full meal of 1 can Fancy Feast Classic.

ETA I gave him 2.5u that AM, and the usual 5.75 that evening

Thank you Sharon!!

 

[Sue484]

When Frankie had a dental in February, the vet said no food from 10pm the previous night and half dose insulin in the morning with no food if his reading was in the 20's. He would be first on the list at 9am and given an appetite stimulant as he woke so the first thing he would do was eat and then he could get the second half of the insulin. That was while he was on Caninsulin though.

 

[Silvina]

Thank you Sue!!
I guess Caninsulin is different from Levemir but what is most different is your vet from mine!!

Mine is actually someone that is only a dental specialist and he doesn't know anything about insulin and doesn't know Markies either. I once took my dog for a dental any years ago.

I like the idea of half dose insulin and food at previous night dosing time. But it't hard to decide what would be the best. I guess, since I am the one to decide, I would probably skip dosing.

Or may be I will call the endocrinologist, may be she says something. I feel bad since I only consulted her once but well, may be she has some good advice.

I see that experiences are different.

Thank you all!

 

[Sue484]

Well I dose Frankie at 6.30 am and pm, so he had his full dose at 6.30pm and I left food down until 10pm. Then only half dose and no food at 6.30am. Bearing in mind, he was always sky high on Caninsulin, it was like I was injecting water, so his levels were always high 20's or 30's.