Jan. 7 Felix AMPS=176, +5.5=227; Dental day; PMPS=93, +2=234

yesterday's fretting (and a photo of Felix and Ethan)

Dental day is here. Felix didn't seem to feel well for a couple hours last evening, but he seemed normal by bedtime. We stayed awake very late, snuggling and smooching and talking about love.

I made a point at the vet's when I dropped him off that his BG probably has some downward momentum going this morning. He had a half dose of insulin just before I took him in.

.....

... Just got a call from the vet. Several teeth will need to come out, including the lower canines. The upper canines have fallen out, looks like within the last few weeks (which is also when I started noticing small spots of saliva where he was sleeping). I'll possibly find them around, but he probably swallowed them.

The x-ray of his lower jaw doesn't look quite right. It's likely inflammation from all this mess, but the vet wants to x-ray it again in the spring to confirm there's not a tumor. I know the vet wants the trauma from today to heal completely so he can reassess, but I'm surprised he'd wait that long--I hope that's a good sign that he thinks it can wait. Felix was on the table under anesthesia, so we didn't discuss it much.

Felix's BG was 206 when they tested, which seems good under the circumstances.

I'm feeling an odd combination of relieved and sickened.

 

Poor Felix, hopefully after he heals from this, he will feel much better.

 

I hope it's just inflammation and everything heals well. Sending prayers.

 

Once Felix has healed up, he will feel much better! Spring is really only 2 months away. It may take that long for all the inflammation to go away.

Rex had his dental last Friday. I'm amazed at one change.. he now rubs on your hand starting with his mouth all the way back to his ears. I didn't notice before that he didn't do that. Cats are so good at hiding their pain.

 

Vet called back--all done! He said a lot of pus came out with the lower canines plus the lower incisors were bad, making him think even more that it's osteomyelitis (bone infection) from the teeth rather than a tumor, and the antibiotic should take care of it. He still wants to look at it in the spring to make sure the jaw doesn't seem bigger and will x-ray if it's questionable. If it were a tumor there, prognosis would be so poor and treatment so unlikely to be successful (surgical removal of the whole lower jaw) that care would just be palliative anyway.

This enlarged lower jaw led me to ask about acromegaly. I don't know what the vet's knowledge/experience with acromegaly is, but he said nothing about Felix makes him think of acromegaly. That's something we could pursue in the spring depending on how the jaw looks then.

He can come home in about an hour (12:30), which is quite a bit earlier than I was expecting, so he must be coming up from anesthesia all right. When our civvie had a dental last year, they wouldn't let him go until their closing time at 6:00; they'd said 3:00 but then didn't want to release him because he was having a bad trip.

 

Home early!! Yay!

 

That made me start to cry! Thank you for breaking my tension!

 

Aww Felix! Sorry about the extractions, but he's bound to feel a lot better with those teeth out. Finger's crossed for osteomyelitis! And yay for coming home early - we love to send kitties home early if we can.

 

How is Felix?

 

How's Felix doing? I hope you have some baby food given the extractions.

 

Hey Felix!! Hope you remembered to bring all those teeth home! The Tooth Fairy is going to owe you a hefty chunk of change!!!

Glad to hear he came out of it well and just think how much better he's going to feel if he had all that infection in there!!

 

I am glad that he is home by the time of my post. And hope that he is doing well. Oh poor Felix losing canines. Forrest lost one upper one. The canines are the corner stone of the mouth. With the upper canines missing, the lip could get stuck upon the site ( think of Elvis) I hope he is doing well!

 

Felix has had a quiet afternoon. He stumbled around at first searching for food, but he settled in pretty well. He isn't supposed to have much food yet, but he enthusiastically ate the small portions of watered-down wet food I've given him. I expect he'll eat all right for insulin time. He's keeping to himself, but if I go to him, he purrs!

They gave me four syringes of buprenorphine, but only one is the prescribed dose; the others are considerably shorted. I understand as well as anyone that bubbles in syringes happen, but I was surprised they were so slipshod about drawing that stuff up; it's not cheap, either. Will have to go back again tomorrow, I guess.

Thank you all for the vines and concern! Felix will be very interested when I tell him about the Tooth Fairy ... and about Elvis.

 

I'm glad he's home and doing fine. Have you used bupe with him before? I usually reduce the prescribed dose to about half the amount because it's less likely to make kitty really loopy but still seems to help pain.

Many years ago I had a kitty who developed an abscessed lower canine. There was a hard lump on his jaw and the vet at that time made some noises about cancer. It turned out to be related to the infection in the tooth and it disappeared over time after the tooth was extracted.

 

Oh, yes Bupe in the syringes are very pricy. I think I would call tomorrow and question why the other syringes are much less if they are all supposed to be the same dose. There is human error in drawing the amounts but, hey..... you shouldn't pay for that mistake.

Hope Felix is comfortable tonight and eats well for you. I know you are relieved this is behind you.

Bubba isn't much of a cook, but he has offered to whip up some mouse mousse for Felix tonight since a soft diet might be a good idea.

 

I haven't used it for him before. I was planning to use the full one tonight (.2cc) and second-most-full tomorrow morning, and take back the two that were half or two-thirds full to show them. Of course it would be easier to use one that's already less full to give a partial dose, but then I'd be destroying the evidence. Hmmm....

That's encouraging. And I'm so glad it turned out that way for your kitty and you! It sounds like Felix's vet expects that for him, too.

 

I'm glad Felix is home and eating for you. Sending prayers for a quick recovery.

 

Bubba, purrty please make me some mouse mousse! Momma is restricting my food tonight, but I want to gobble up as much as I can in case I don't feel like eating so much tomorrow! Mouse mousse would just hit the spot!
Purrs of thanks,
Felix

 

So glad Felix is home! I would give the full syringe of bupe tonight, and adjust tomorriw based on his reaction. You want to stay ahead of pain, and his poor little mouth has got to hurt. Neko’s bupe dose was 0.22 ml, but she was around 14 lbs. dose range is based on weight.

I just have to speak about the jaw. First off, Neko had a bump on her jaw that grew quickly. The dental vet removed it and prepared me for the worst on the biopsy results, but it was benign! It was just a bony growth. Of course, that was due to her acromegaly. Her jaw was otherwise a normal size. Around 35% of acros have noticeable clinical symptoms on diagnosis. The rest don’t. I am going to root for that infection. Odd as that sounds.

You might want to test now and then again at PMPS, to see if he is going down. Some types of anesthesia induction drugs lower the BG, in which case you might want a conservative dose tonight.

 

Shoot--I got back from Test-Feed-Shoot-Bupe and saw your post, Wendy. This was earlier than his regular time because his schedule has been adjusted for this week.

He tested 93 for PMPS and he wouldn't eat any more wet food. I offered him Elsey kibble and he started devouring it. He had a small meal of it but would've eaten more if I let him (he usually gets it for treats, not meals). I'd planned to give him 2.5 units, but I did 2 units instead. (2.5u has been his dose for awhile; 1.25u is what he got this morning.)

As for the bupe, they're all supposed to be .2 cc, but I looked more closely and one is .17 and two are .13. I gave him the .17. His weight today was 11.6 pounds.

I know! The osteomyelitis would probably be freaking me out if that other possibility hadn't come up! It's not what you'd usually think of as a comforting diagnosis.

I'm sorry you had the anxiety of being prepared for the worst; what a relief to find out it was benign. You went through so much together. I wish I'd gotten to know Neko while she was here.

 

Don’t let Felix get too full st this point. Glad he will eat something though. Seen a few peeps give full dose, cats in too much pain to eat, and anesthesia lowering BG.

Neko taught me a lot. She was a wise girl. I hated seeing her have to deal with acromegaly, but she fought a good fight.

 

Glad Felix is home and doing well!

 

I was thinking about you today and hoping that all was going well for you and for Felix. Sorry about the extractions and the infection. Did the vet put Felix on antibiotics? Radar improved significantly once the antibiotics got to work for a couple days. He slept a lot too. I expect that Felix may do the same as his mouth heals. Glad to hear he's home. I know that you are greatly relieved to have another dental behind you both.

 

Felix is already in bed waiting for me. His +2 was a surprise so I'm going to get a +3 just to make sure it was correct, and then I hope to go to sleep because it has been a long day with a long week to come.

Thanks, Jan. Felix got the long-lasting antibiotic shot. I'm wary of it and have declined it in the past for other kitties, but the lower chance of tummy upset and less administering meds made me decide to go with vet's preference this time in Felix's case. And yes, I am relieved dental day is over for Felix and for Radar! And for @Mandy & Rex !