4/25 Silver Home PMPS 247

http://www.felinediabetes.com/FDMB/threads/4-24-silver-amps-245-pmps-211.194602/#post-2177764

Just dropped him off for the day with him yelling for his breakfast. Me feeling like a horrible mummy bringing him upstairs for what he expects to be test shoot and foooooood please - only to bundle him in the carrier and take him out in the rain. Not a happy Silver or mummy bean. Don't think I'll be concentrating too hard at work today.

Well he doesn't have bad teeth. He's only going in for a cleaning. No extractions. But thanks.

 

Vetty vines!!

 

Oh, I thought the estimate gave for extractions, was that a just in case thing?

I know that feeling, I had to fast Asia for 12 hours for her ultrasound, it was the longest 12 hours ever. She didn’t understand and kept pleading with me for food and wondered why I ignored her requests.

Hope it goes by in a flash!

 

Sending lots of dental vines to Silver!

 

Sending prayers for you and Silver.

 

Sending vines, hope all goes smoothly.

 

Dental vines....yes, it is so hard on us beans, but he will be back home soon.

 

Dental vines for Silver today.

 

Yes @Stacy & Asia they give you a lowest and highest range of a quote. The estimate gives you the cost per 15 mins if they need to do extractions but they won't know for sure til he is asleep. General looking he said they were good.

 

Hope the dental goes well for Silver.............

 

Vet tech called. Silver doing well. Needs one extraction. Will call me again later when he's in recovery.

 

Hopefully no extractions! We didn't think Rufus needed any but he did and that's when his insulin needs plummeted. Kind of a catch 22. Hopefully he doesn't need extractions, but maybe that is why his numbers and insulin needs are trending higher.

 

Sounds good so far!

 

Looks like he needed one. So @Kris & Teasel @Stacy & Asia @Sandy and Black Kitty @carfurby @Tracey&Jones how do I know what to dose tonight? His needs might have drastically changed and I can't do a curve until the weekend. Thoughts?

 

that could make a world of difference for him, having a bad tooth. Wait for his numbers to decide on dose.
Anesthesia can lower their numbers and you need to know if he'll eat or not. Most do as soon as they can.

 

But we're supposed to dose based on nadir right? So do I dose based on preshot number the next two days?

 

I would maybe give him a half dose tonight depending if he will eat or not.

There may be a more experienced answer to come but I would go back to my normal dose and reduce as those are earned.

It is Wednesday and if he got a half dose this morning and maybe a half dose tonight...the depot is a little drained. So if you give his normal dose starting tomorrow morning that is 4 cycles (5 if you give a full dose tonight) to replenish the depot and then it is Saturday and curve day. His keytone numbers are down but I don't think you want to lose ground in that regard while he is inflamed from the extraction/cleaning - which he will be for a day or two.

Then hopefully by Saturday, if not sooner, things will all get back to normal and you can see what this dose is doing for him.

 

Well he didn't get any insulin this morning as you're not allowed to give it before the anesthetic. I gave a prefilled syringe with 2.75u in it that I am hoping the vet will give once he has eaten. I'm wary about giving a reduced dose this evening as he really needs it due to the DKA and the ketones. Too high a risk. I'm leaning towards giving a full dose tonight. Oh and he will eat. Nothing keeps Silver from his food except DKA.

 

As you can tell - I'm not too focused on my job today. Glad the boss is out!

 

To dose or not to dose...if so how much...post dental is very much an ECID thing.

BKs PMPS the night before was 349 and he got his full Lantus dose of 13u. At PM+ 7,5 (time to leave the house)he was 248 and at +10 (at the vet) was 156 During surgery (+12+13) he was 50 and post op(+14) he was 30 I didn’t shoot until +35.5 and that was 7u (slightly over half his dose).

Ketones were negative and 5 ketone
free months were under our belt. The greatest risk for BK was the IAA had started to break about 2 months prior to the dental so rather than be faced with a high dose cat that I could not count on eating after 8 extractions I played it super safe.

“Better a day too high than an hour too low “.

 

You may need to give a reduced dose tonight because anesthesia can lower BG. You don't want Silver going too low tonight. However, you should wait and see what his PMPS is tonight.

 

Not sure I agree with the better a day too high thing. Not when ketones and DKA is an issue. I have rarely ever seen green so I think we are ok to give full dose. Will see what preshot is as preshot is his lowest number in the cycle.

8 extractions! Wow. Glad Silver only having one.

 

I'm afraid I can't give you a good answer because I have no experience with this. You're between a rock and a hard place with recent DKA and possible lower BG post dental. Maybe wait until his PMPS test time and post here for help?

Aside from that I'm sure you're glad it's over.

 

I’m not glad he had to have an extraction, but the “Silver” lining is that could be just the root of infection and some of his resistance/ketone issues. Paws crossed that’s it and he’s going to have much smoother sailing diabetes wise from here forward. I agree that you need to make a game time decision at preshot on what to give him. Some anesthetic can (drastically) drop numbers, some don’t. I don’t think his insulin needs will change literally the same day from getting the tooth out, never say never, but more likely it would show up after a bit of time. Can’t wait for your work day to be over and you’re reunited with your boy! (Oh and glad the boss is away today too )

 

I have seen a few here say they gave a half dose the morning of the dental. Some kitties got a bit of food and some not.

Either way, he may be very groggy tonight and out of sorts. I would still wait to see how he eats and like others have said - what PS # is he at.

 

Even though you've rarely seen green, this dental could be a game-changer, and it could happen quickly. Another thing to keep in mind is sometimes anesthesia can cause BGs to drop - this happened with my Trixie, the day after her dental. As others have said, definitely wait to see how things are going when Silver gets home - see where his BG is, where is appy, is, etc. Speedy recovery vines!

 

Apparently he came out the anesthesia feeling fine. Not groggy. Anxious to eat and has had his reduced dose. His BG was 315 on their meter which is not bad considering where he is and what he's been through. He has already eaten so that's good. Still gotta wait at work 1hr 45 mins then my two hour commute home to go get him. Quiet night in for us three (poor Sasha is home alone and won't be liking that much!)

 

Really good report!

 

In Canada, they are more apt to use an anethesia induction drug called alfaxalone that does not lower blood sugar. It's a more recent addition in the US. You can always ask the vet what he/she used. When Neko had alfaxalone, it did not impact her BG. It's also a gentler drug. It's great news that Silver is eager to eat already. The worst case is when someone shoots full dose, then cat won't eat due to a sore mouth. Hoping for a quiet drama free night for you.

 

I pre filled a syringe with half his usual dose and told them not to give it until he had eaten. They're giving me a liquid homeopathic something to put on his gums but he hates liquid meds. Wonder what it is. Am on train now to go get him. Need to find out what time he got his reduced dose as I want to get him on schedule again.

 

Sending lots of speedy recovery vines to Silver.

 

Maybe it's Arnica? That's used for inflammation and can be given orally or used as a topical elsewhere on the body.

 

So very happy that all went well and he is doing good and eating

 

That all sounds rather good.
Well done Silver.

 

Yes it was Arnica but I didn't take it. They said he didn't have inflammation so if and when I see any I'll go back for it.

Was told to watch him as he'd be unsteady and not to let him jump up etc. and to feed him very small meals. Lol. Know Thy Cat. As soon as I got him in the door and out the carrier he jumped on the table for his test as he knew food was coming. He promptly ate his usual meal. His BG is a little high but not surprising. 246. Not bad considering he only had half his dose and that was a few hours late. (Hence me halving the dose so I could get on schedule again tonight).

Off to chill with my babies. Glad the day is over.