? Advice plz! Major Dental coming

I made a vet appointment for today. I looked in misters mouth and seeing his gums bright red and swollen. I'm sure today will probably just get antibiotics and schedule for a lot of teeth to be pulled. I seen he seems to be taking longer for insulin to drop lately.
Is there any advice on sugar going out of control after anesthesia and antibiotics? I'm very worried about healing. His mouth looks very bad and I can't believe I missed it.

 

My girlie kitty (15 1/2) had a dental and six extractions a few weeks back. Her appointment was for 10AM and because her glucose was so high (527) I gave her a 3/4 dose of her insulin and a meal at 3AM. By the time she had her dental her glucose was 349 and was at her nadir time. She did fine considering the extent of the work. I refused metacam and was sent home with 3 days worth of buprenorphine shots for the pain. She was pretty groggy when she came home but surprisingly was quite happy to eat so she received her full dose for the evening.

MY vet feels that as long as there has been at least 6 hours since a meal it should not interfere with the anesthetic and dental process. Both my sugar kitties have followed the 6 hour fast and reduced shot with no problems. However many vets will advise a 12 hour fast and only 1/2 dose of insulin before a dental procedure so you should check with your vet for their guidelines.

Both my kitties are on Levemir, so although Prozinc lasts a similar time period there may be a different protocol for it in regards to dentals.

 

There's all kinds of great information in this post on Dental procedures

We were told no food/water after midnight and had her scheduled for the first surgery of the day. Anesthesia can cause the blood glucose to drop, so you should make sure your vet is testing while he's there and when you get him home, make sure he's not running too low

Most of us will have a few jars of Gerber baby food (the meat only kind that just contains meat, water and some contain corn starch) in case their mouth is sore for a few days since it's easy to lap up

 

He got a antibiotic shot today and his sugar started climbing?
He is scheduled for 915a on tues the 19th
He appears to have already swallowed some of his teeth. His mouth smells like rotten flesh and teeth are just falling out
I did a full blood panel today.
I was going to try and up insulin times 30 min each day till I was at 12a- 12p instead of 845a-845p.
If he is on prozinc and gets insulin at 12a ...will be be ok at surgery time?
I'm so worried about healing. He is 13yrs old.
I'm also wondering if he will need as much insulin with this infection gone?
I'll take all the advice I can get.
Thank you

 

The higher number at PMPS could be due to bouncing from the green 94 at +6. Mister is not used to the lower numbers and in many kitties this can cause a bounce, which can take a day or so to clear.

If Mister's mouth is as bad as it sounds he could very well end up needing less insulin after the dental and extractions are done. Any sort of infection can cause glucose levels to rise.

Since you are using Prozinc you have a bit more flexibility with your shot times. Is the 12AM/12PM a better time for you or are you changing because of the dental? If you want to change to the new time on a regular basis you could delay the shot to the new time. He might run a bit higher but since there is no depot with Prozinc you can catch up on that in a day or so. HOWEVER if you change the shot time to 12AM/12PM tonight you will most likely not be able to shoot after the dental, since depending on how involved the work to be done is, Mister may still be out. at the noon time shot. So you will have to skip that shot. My Maxie had 6 extractions...her start time ended up being 10AM and she did not come home until almost 4PM. Shooting at midnight should not create any problem with the dental since most of the effects of the Prozinc will already have taken place before her dental.

My Maxie is 15 1/2 and she did very well in spite of how involved the procedure was. She had 5 extractions and there were 4 teeth missing that I was totally unaware of. It took a few days for her to get back into sorts but she was eating after she came home and she only has two incisors and 2 fangs left.

 

I doubt if the two are related, but do you know what antibiotic they gave? A lot of us are very wary of the shots because the one vets seem to like to give the most is called Convenia and not only is it NOT recommended for oral infections (it's meant for skin infections) but it also is VERY long acting and stays in the body up to 65 days. If your cat has a reaction to it, there's nothing you can do to counter-act it. You might want to read up on it on this page from Dr. Lisa's website

I don't see any 94 at +6 ....but I would recommend getting some more tests especially a "before bed" on the PM cycle....most cats go lower at night, and without that testing, there's no way to know if he might be going lower at night and then bouncing during the day.

You might want to think about changing your shot schedule some more. Although I don't know your schedule or your life, waiting to shoot until midnight every night could mean being up ALL night testing if he should drop too low. When we first started, I was shooting at 11am/11pm because I HATE mornings....after a few nights being up all night and testing until 5-6am, I decided it was worth getting out of bed early so I could always get at least a +2 on the AM cycle before I had to leave and it was easy for me to stay up and get a +6 at night to make sure China would be safe for me to sleep from midnight-6am. I still hate getting up at 6am to shoot, but I can usually go right back to sleep if I want to too. Matter of fact I think most mornings I never fully wake up to shoot....LOL


China just had her 3rd dental and she's 15....getting rid of any rotten teeth and getting Mister's mouth cleaned up could very well help with his numbers and possibly even end up reducing his dose. Infection, inflammation and pain can all cause the numbers to be a lot higher

 

The vet did give convenia because we've always used the shot for him... He is impossible to get pills in!
I don't know where they seen a 94bg because he hasn't had one in quite a while.
I'm on a 830am shot schedule. My husband pain meds are at 730a so I could move his times even more. I seem to always fall asleep around 1045p-1130p and hubby pain meds are due at 2a but I don't always wake.
I was going to move his shot time to 12a and 12p just for the dental day.
If he gets insulin at 840p or 9p and his procedure is at 915a...he would be skipping insulin before surgery.
What would you do?

 

Most of the time, we skip insulin the morning of surgery. Your vet should have a protocol he prefers that you follow, but generally, since we can't feed after midnight, we don't give insulin that morning at all and then we wait to see how they're doing once they're home that night before making the decision to shoot that evening

Occasionally they'll recommend feeding a small meal in the morning and giving a half dose, but with him having that early of an appointment, I don't think I'd personally risk giving food or insulin that morning.

 

I don't think he deals with this much..
He told me to give insulin at 7a and right before that they said no food after 12a.

I texted and said I just realized I can't give insulin without food. And asked about giving insulin at 12a and he said it's ok.

So if he is in the 300bg at 830a it won't be dangerous to get anesthesia an hr later?

 

No it won't be dangerous....especially if he reacts the way a lot of cats do and his blood glucose goes lower due to the anesthetic

It's much safer for him to be too high for the day than too low for a moment

If Mister was my cat, I'd just give his normal dose the night before at the usual time, take his food/water up at midnight and take him in for his dental in the morning

Do you know if your vet can do dental x-rays? Not all of them can and it's a very important part of a good dental to have pre and post dental x-rays done

 

He is doing xrays and I did blood work and antibiotic shot today

 

That looks about right....the one thing I know I paid for with China's that I don't see you being charged for was the IV fluids

 

Typically IV fluids are included the basic dental listed price.

 

Thanks for pointing that out Chris. I was looking at the 2015 last day numbers instead of the 2016. I really need to get more sleep at night...sigh

 

When Fern had his I just fed and gave insulin on his normal schedule. Actually he had a low dose the night before because he was low barely above my no shoot number. His AM number was of course high but I didn't give a shot. 1.5 days of high numbers was better than low especially with Prozinc which doesn't have a depot to maintain.

 

I don't know whether this will be of help to you for the future but some antibiotics can be given with food. Saoirse was prescribed Kesium chewable tablets recently and my civvie had a course of it a little while before. Both of them had no problem taking it mixed in with their grub; it seems to be quite palatable.

Another option might be to get a series of the 3-day duration antibiotic injections if they're suitable for what's being treated.


Mogs
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I dropped mister off this morning for dental. No insulin as you instructed. Any advice for care. Lower dose insulin ..how long after for food etc. ?
I'm so worried

 

They pulled 9 of Misters teeth this morning and I skipped insulin like Chris and China advised. I just want advice from someone on when to offer food, insulin, anything helpful. I'm worried , but he has always been my little fighter.
Thanks, Tina

 

What you do depends upon how easily/fast the cat recovers.
For Patches last dental in Jan, the vet said feed about 1/2 food and 1/2 insulin the evening after the dental. I complied. Patches would have eaten a regular meal. She did have here two upper canines removed along with one or two smaller teeth,

 

When my 15 1/2 yr old girlie had 6 extractions (and she had missing teeth as well so she ended up with only 2 fangs and 2 incisors) she ate almost as soon as she came home. She was on buprenorphine shots (didn't want to pill her after a dental )twice a day for 3 days for pain relief and that seemed to hold her over fine. As far as the insulin shot, some of that will depend on what Mister's numbers do. Some kitties go higher with a dental/extraction, some lower and some don't seem to have any effect. With Maxie I was able to give her full dose of 1 unit in the evening, since she was eating well and her numbers were higher but ECID..every cat is different.

If your vet hasn't given advice on how to proceed, you can always ask for dosing advice here once you get a glucose test done.

 

First you want to make sure he's fully awake

If he seems hungry, it's OK to offer a small amount (like a teaspoon) of food but you don't want to rush it. See how he tolerates the first spoonful and if he does OK, you can give him another one about 20-30 minutes later

As for the insulin, let's see where his BG is when it's time for his normal shot and go from there. You might want to get a test or two in this afternoon if you can too

 

I gave mister 1 tsp chicken baby food at 340p and another at 5p and no vomiting just sleeping , than pacing and going back to sleep with tongue hanging out?
So my question is ... Its been 1hr since last tsp of food. Do I have to wait another hr to test bg? He hasn't been tested today that I know of. Dr. Didn't say

 

Is it time for his usual PM shot now?

Can you wait another hour and still give his shot 12 hours later in the morning?

 

No insulin isn't due till 930p so 3 hrs from now.
I tested bg 1hr 10min after eating 1 tsp of baby food and it was 268. Than I gave 1 tbs of Turkey wellness. He ate half and went back to bed. Just gave pain med

 

That's good...I'd get a +11 so you have something to compare to when it's PMPS time but don't feed him after +10 so you can get a PS reading without the influence of food

And we'll want to see how willing he's going to be to eat too. Hopefully the pain med will help him be more comfortable so he's willing to eat a little better for you

 

I messed up.. He is sleeping so good .
He never had insulin today. I should've check bg 30 min ago. Should I just check and wait Another hr for insulin?
And should I do a lower dose now that infection is removed?
Being only a 268 when he hasn't had insulin since 930p last night is kinda low for him.

 

If you're concerned, you can skip tonight and make sure he's eating better in the morning

We don't know whether his BG numbers will come down for sure after the dental....it's a good chance it will, but until then, you just hold the dose.

Have you ever posted in the ProZinc forum? Since we use Lantus, I'm hesitant to give dose advice on Pro Zinc since it's a totally different insulin

 

To late I gave insulin but only 1.0 u instead of 1.5u. He ate all his normal food though. I was hesitating because his new pmps was 243bg
So he isn't climbing but he never ate a big amount till now. He ate a half of 5.5 oz beef gravey shreds friskies. 14 carbs a whole can .
What do I do now that I gave insulin?

 

That's fine....just get a couple of tests in tonight before you go to bed and make sure he's going to stay in safe numbers

Do you know that the Shreds are really higher in carbs than we like? We like to keep them under 10% and anything with the word "gravy" in it is usually higher than that.

 

Yes I know but he refused to let me give his insulin unless it's that.
I thought about trying to only give a spoon of it . He is just to smart

 

Have you ever tried Fortiflora? I think China would eat sawdust if I sprinkled a little Fortiflora on it

 

LoL! No, never heard of it.
I did try freeze dried meat and he wouldn't even try it.
He eats wellness.. Just refuses it for the shot

 

His pain med is at 245a
That's +5
Is it ok to test than? Or should it be earlier
Sorry so many questions. I know there are 1000s of people on here needing help

 

I think that would be OK to wait until +5 if you want to considering you skipped this morning and gave a reduced shot tonight

I'm a big fan of getting more tests in when you can though....all data is good data when it comes to learning our specific cats patterns

 

sounds like Mister is doing great!

 

Glad to hear that Mister got safely through the dental.




Mogs
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