02/14 Gizmo PMPS=191, +2=247, +4=174, +11=283

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Worked 1/2 day - on are way to the vet in about 30 min.

Full senior blood panel, urinalysis and discussing dental (at least cleaning). Anything else???

I am not sure if the blood work will show any indication of pancreatitis unless the specific test is requested (can't remember FPL-??) - not sure that is necessary but suspect it may be an indication of what is going on.

Going to go change out of work clothes and get him ready. I wasn't going to let him eat (his +6.5 snack) but I think I will now that I see his BG. I didn't want to risk him getting car sick (which he doesn't do very often so I think we will be ok).
 
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Doodles & Karen said:
I have zero experience with it. If you're going to the vet I'd include every test under the sun so you don't have to go back again.
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I agree. Anything else I should request or Discuss?

Also going to schedule dental cleaning or at least discuss it while I am there - anything related to that?
 
LizzieInTexas said:
I agree. Anything else I should request or Discuss?

Also going to schedule dental cleaning or at least discuss it while I am there - anything related to that?
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Not that I can think of. The Sr. panel and urinalysis covers most everything. Make sure they include the SDMA which most do anyway.
 
For dentals, it's good if they do dental X-rays before the procedure. It's amazing what can hide below the gum line. For two of Neko's dentals, a visual inspection showed only cleaning needed, but X-rays told a different story. In one it was a tooth that needed removing and the other a bony bump on her jaw (from her acromegaly).

Has Gizmo had anesthesia before? Just wondering if they've had a good listen to his heart. Just my paranoia speaking from experience.

SDMA is only included if the vet send the blood to Idexx.
 
Everything went well. Gizmo was actually well behaved. :eek:

Dental is scheduled for Thursday - pending nothing unexpected shows up in the labs, which we will get back tomorrow. She will call with results and have them e-mailed to me.

Wendy&Neko said:
it's good if they do dental X-rays before the procedure. It's amazing what can hide below the gum line. For two of Neko's dentals, a visual inspection showed only cleaning needed, but X-rays told a different story.
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I don't think they did an x-ray today but they may before they do the actual procedure. There is only one area that she is concerned about that may need more than just a cleaning (upper left side). In previous exams (limited) of the teeth it has been the same opinion.
Wendy&Neko said:
Has Gizmo had anesthesia before? Just wondering if they've had a good listen to his heart. Just my paranoia speaking from experience.
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He was fixed when he was a kitten and then they sedated him when they did the ultrasound a couple of years ago - that is when he died on the table. Vet (different but same office) called me at work and told me they couldn't get him to breath on his own and I had to make the decision if I wanted him to continue to attempt to revive or let him go. I told him to let him go - he (vet) called me back in 5 min and said that he was breathing on his own.

Trust me - this is my biggest fear with all of this. I am scared to death. I spoke with Dr. Pratt about it and she is well aware of my fears and concerns. He does have a heart murmur and I am going to ask about that when I talk with her tomorrow when she calls about the bloodwork. I am making a list of stuff I forgot to ask or talk with her about.

Poor baby made it all the way back, within two blocks of the house, and got car sick. It wasn't too bad but still. I am going to add SEB to his dinner tonight and then nothing added except his digestive enzymes and B-12 until after the surgery.

Since I shoot so early I am going to give him 1/2 dose and feed at shot time and feed at +2 before I take him in on Thursday AM. Surgery will be between 12-3p. Then we will just see how he is doing for PM. I am going to take Friday off so I can be home with him and I have Monday off (holiday) - so that will be four days to get him back eating and on back on insulin schedule if we don't skip (shot late) Thursday PM.

Any suggestions on preparation? I think I am going to feed just straight Weruva Cats in the Kitchen Fowl Ball Thursday AM - I think it is the blandest/easiest on tummy food I am feeding him.

What about after? I am thinking the same thing but really open to any suggestions to make this as easy on him (and me).
 
Pick up some all meat baby food for afterwards. In case they find something in the before procedure X-ray and he ends up with an extraction, or if he's just not feeling like eating. It's usually a good one for tempting them to eat. When you get home after the dental, take his BG, and then again at PMPS. That way you can tell if he's had one of the anesthesia induction drugs that lowers the BG's. If so, you'll want to be conservative for the PM dose. And feed small meals when he gets home. Just a tsp or two and wait 20-30 minutes between the next one. Anesthesia also plays with gut motility.

Play it by ear for dose on the morning of the dental. Some people skip if the numbers are low. I once gave Neko a token 0.1 dose only cause I didn't trust her and she almost hit the reduction point on the AT while there. I am glad you can feed him before hand. Your vet sounds pretty up to date on that. Neko could eat until 6AM the morning of her dentals.
LizzieInTexas said:
He was fixed when he was a kitten and then they sedated him when they did the ultrasound a couple of years ago - that is when he died on the table. Vet (different but same office) called me at work and told me they couldn't get him to breath on his own and I had to make the decision if I wanted him to continue to attempt to revive or let him go. I told him to let him go - he (vet) called me back in 5 min and said that he was breathing on his own.
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OMG - what a scary thing to happen! :bighug: With Neko being Maine Coon mix and having acromegaly, the heart was always my big worry. She did have several dentals, in spite of having a murmur. I also took her to a dental specialist who did special heart monitoring. I had to cancel her last dental cause vetty discovered a second degree heart block a month before the dental.
 
Wendy&Neko said:
Pick up some all meat baby food for afterwards.
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I have three jars of Gerber 2nd Foods. 2-Turkey, 1-Ham.

She is suspicious that he has, or just getting over a mild pancreatitis flare - the BG numbers and flat cycles being the reason. She said he is looking really good. :) The BW will tell us for sure. His current weight is 11.2#'s. He is probably the healthiest he has been (unless something shows in BW) in a good while. Last BW was 12/20/16 and he has held his own for about 4 months so dental is NOW! I don't want to miss the opportunity. Plus it is 15% off until 03/10!

What about antibiotics and pain meds afterward? I know I have seen it discussed here before but I didn't put it in my notes.
 
LizzieInTexas said:
then they sedated him when they did the ultrasound a couple of years ago - that is when he died on the table. Vet (different but same office) called me at work and told me they couldn't get him to breath on his own and I had to make the decision if I wanted him to continue to attempt to revive or let him go. I told him to let him go - he (vet) called me back in 5 min and said that he was breathing on his own.
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What a horrible thing to have to go through. Sending prayers things go well with the dental. :bighug::bighug::bighug:
 
LizzieInTexas said:
What about antibiotics and pain meds afterward? I know I have seen it discussed here before but I didn't put it in my notes.
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No to Convenia and Metacam. Usually Clindamycin is what's given for mouth infections - start a probiotic before hand if you aren't giving before hand as it's a strong antibiotic. It comes in either pills or foul tasting liquid so pick which is easier to give. For pain relief, request buprenorphine. It may not be needed if no extractions.
 
Wendy&Neko said:
start a probiotic before hand if you aren't giving
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Thanks for the info - I am not giving any probiotic. He does take PancreaPlus which is digestive enzymes that are mixed in with his food.

What probiotic? Is it ok to give with the digestive enzymes and B-12? I will probably do the liquid if I can get it. I will add it to my list to discuss with her when I talk with her tomorrow.
 
Wendy&Neko said:
OMG - what a scary thing to happen!
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carfurby said:
What a horrible thing to have to go through.
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It was horrible. It was Dr. Whitmore that was doing the ultrasound and he is an older gentleman and it shook him to his core. When I finally got there and he brought Gizmo in to the room he was visibly shaken. Said in his many, many years of practice it had never happened to him. I was a complete basket case. This was during Gizmo's first pancreatitis attach. He was so sick but the exams and bloodwork were not showing anything. Dr. W suspected panc. and was doing the ultrasound to try and confirm. Eventually the lab work started showing the numbers for panc. Dr. W was the first vet that treated Gizmo there and then after the diabetes diagnosis Dr. Pratt took over as she is more of the cat specialists.
 
LizzieInTexas said:
that is when he died on the table
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OMG! I can only imagine the anxiety you have to put him under again. Glad the vet knows of this and understands your concern.
Can't even imagine going through that . I agree with Wendy, NO to convenia ( injectable AB) and metcam ( anti-inflammatory not to be given to cats) Rather you want clindamycin or Clavamox for the go to AB for pre and post extractions.

Hope the dental and possible extractions helps his BG's After the dental, it is not uncommon for their BG's to be too low to shoot so if you need to skip, no worries. The meat baby food is a good thing to have on hand afterwards.
 
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Bobbie And Bubba said:
NO to convenia ( injectable AB)
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He has had it twice before (before I knew better). He had no adverse reactions but won't be given again unless it is a last resort deal.

Bobbie And Bubba said:
Rather you want clindamycin or Clavamox
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Oh I am so glad you posted that. He has had Clavamox before and has done well on it! Yay! It has probably been almost 6 months since he has had it so it would be an option.

Bobbie And Bubba said:
Hope the dental and possible extractions helps his BG's After the dental, it is not uncommon for their BG's to too low to shoot so if you need to skip, no worries.
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I am going to be very conservative. He is generally a good eater but it makes me extremely nervous giving insulin with this until I know he is eating and eating well.

Bobbie And Bubba said:
The meat baby food is a good thing to have on hand afterwards.
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I am really going to try and stick with the Foul Ball. I just don't want to add something more that could mess up his tummy. But won't push it if there is hesitation with getting back to eating.

ETA - the vet offce will not/does not prescribe Metcam to cats.
 
This page has a good discussion on probiotics, and lists some available in the US.

If he's had Convenia before, he's probably OK with it. It's just designed for skin problems, not mouth. It's more of a worry if kitty has never had it before because it can last several weeks and kitty is allergic that's a long time.
 
Glad to hear Gizmo will be getting a dental.

Addressing BKs teeth and gums was paramount to his going OTJ

Check out these dates on his ss:
10/23/2008 - while under anesthesia for removal of a lump his vet took a good look into BKs mouth.
A rotted tooth (molar) fragment was discovered and removed.
Vet referred us to a veterinary dental specialist since BK was an unregulated diabetic and his mouth was beyond the scope of what the vet felt comfortable handling.
The BG downward movement begins.

11/03/2008 - Insulin sensitivity returning - IAA breaking :nailbiting:
12/08/2008 - dental
12/17/2008 - post dental antibiotic finished.
The downward momentum picks up.
..
01/04/2009 - First taste of HC (after nearly 1 year!)
we begin 7 weeks of tumbling and stumbling down the dosing ladder as momentum builds and builds
I learn about sleep deprivation
HC fests occurring more and more frequently - BK tips the scale at 13 lbs!

02/19/2009 - Down to 3 units Lantus only, (from 13.5u Lantus combined with up to 10uR)
visitors to our condo making good humored cracks about BK turning into a micro-dose kitty

02/27/2009 - started a period of increasing and decreasing and increasing and decreasing. . .
05/22/2009 - up to 5.25u :(

05/29/2009 - dental #2

06/03/2009 - on the way back down (seat-belts fastened!)
06/22/2009 - its all blues and greens from here on out...
10/09/2009 - OTJ trial begins
10/23/2009 - officially OTJ.:D

you can see on the ss how I handled pre dental and post dental shots and meals as well. I was conservative with the insulin, particularly since he was a high dose boy.
ECID

From that point on he had dentals done by his vet and eventually, over the course of a couple years, all teeth were removed.
 
@Sandy and Black Kitty
That is very impressive. Did you not know he had issues with his teeth before that?

Both vets have looked at his teeth during previous exams. Both commented they were not bad but headed that way. I have known for about a year that he needs a cleaning. Was just trying to get him healthy and stable. I think I am as close as I can get (for now).
 
LizzieInTexas said:
Did you not know he had issues with his teeth before that?
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No, I didn't. When we took BK in off the streets he was at deaths door. In the first 24 hours we found out he was FIV+, had an upper respiratory infection, conjunctivitis and diabetes. He was hospitalized with DKA twice in the first 6 months. It was a struggle to keep him alive. Once he got on the other side of all that it was time to try and figure out why he was such a 'big gulper' (high dose yet still swimming in a sea of pink). He did however have breath that could knock over an elephant.
LizzieInTexas said:
Both vets have looked at his teeth during previous exams.
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since kitties don't 'open wide and say ahhh', the only way to know what lurks below the gum line is by exam and X-ray while kitty is under anesthesia.
 
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