12/28: Pablo's PMPS 381; increase?

Status
Not open for further replies.
Holly and Pablo

Holly and Pablo

Member
I'm sure everyone's overwhelmed with all the board issues right now, but I need advice. It's not urgent because tomorrow is dental day, so no shot will be given in the morning, and he's already had tonight's.

I haven't seen blues or greens in four days. I upped him to 3.25u ten days ago, and we were seeing some really nice numbers. Then, the pinks came back...and then I got a RED yesterday. It's the first red in almost a month. What is that about?

Also, what is the protocol for dosing following a dental? Should I keep him at the 3.25u and see what happens after the dental tomorrow? I'm concerned that he's staying so high in the yellows and pinks.
 
tomorrow after the dental, test him as soon as you get home, then test again at PMPS. Some cats drop a lot from the after effects of anesthesia, so those two tests will let us know if he is rising or falling, and how fast. You might need to shoot a reduced dose again tomorrow night, it depends.

Once tomorrow is over, then yes, you'll go back to your regular dose. You'll need to step up your testing, because a lot of cats do earn dose reductions fairly quickly after a dental.

Allow me to point out that the really high numbers came after a night that did not have a before bed spot check. ;) He could easily have gone green that night and the 408 and the pink that followed could be his bounce. Don't skip your before bed tests!
 
Yeah, I kinda slacked on that night's testing...I went to sleep after his PM shot and almost slept through the next AM one...12 hours later! That'll teach me to lay down for a "nap" at 9:00 at night!

The kitty dentist is three hours away, but I'm bringing my own glucometer and they'll be testing him before, during, and after the procedure. And I will be paranoid enough to stop at rest stops between NC and SC to get spot checks too! Wish me luck with the drive and my nerves while he's under anesthesia.
 
A couple of dental tips from Jill.... (you've probably already seen this but

1). pre-dental antiobiotic - clindamyacin (begin 5 days prior to dental)
2). have pre-dental x-rays done.
3). have bloodwork done.
4). monitor blood pressure with doppler machine.
5). monitor heart rate.
6). IV fluids - only if needed. place an IV cath prior to procedure so there is quick veinous access, but don't need fluids unless kidneys are compromised.
7). anesthesia - Isoflurane? or sevo? either of these are good choices.
8). do you administer pain meds during the dental and after? would like buprenex if there are extractions.
9). post dental antiobiotics - administer clindamyacin for 5 days post-dental. do not give 14 day covenia shot.
10). use fortiflora (probiotic) while on antibiotics.
11). perform post dental x-rays to make sure nothing was missed.

vet told me to fast her for 8 hours before the procedure. water was allowed. give full dose of insulin the night before... half dose or skip shot in the morning (depending on her numbers).

also, do not overfeed her when she gets home, one of the drugs (valium) commonly use to knock them out for intubation is a strong feline appy stim, and anesthesia slows down the motility of the gut. listen to drugged cat and overfeed, there is no place for the food to go and a vomiting cycle can start, the last thing you need with possible dropping BG's that night and a cat that might not have full use of motor skills.

keeping her in a dark, quiet room will help if she has over excitation from one of the other drugs (ketamine) used to knock out for intubation (lights and noise trigger more excitation). the best thing to do is feed them a small amount and then let them sleep it off.


The other tip that can help is if there are extractions, most treats are pretty chewy and won't be recommended. Pick up some baby food as a treat for when you test.
 
I've probably asked you this before and I think you answered but I forgot. I'm curious where you are located? I ask because I am about 3 hours away from Charlotte in SC too. I'm in Charleston. Lived in Charlotte for a few years but moved to SC two years ago.
 
Honestly, I think that ketamine and valium are incredibly antiquated and would never allow them to be used in my cat! Ketamine in particular is excreted entirely by the kidneys (bad for elderly and RI/CRF kitties) and is incredibly slow to get out of the system. It also cannot be rapidly reversed, which is dangerous, IMO. The clinic where I work does not use it, though we do use the combo drug Telazol for cat spays and neuters. But never on my cats!

The clinic where the dental is being performed uses only propofol for induction (widely considered one of the safest induction agents...but expensive!) and sevoflurane for maintenance following intubation. He will likely be wide awake within 10 minutes of being removed from the inhalant, albeit probably a little dazed and confused! He has been sedated similarly at my clinic twice before and was completely back to normal within 30 minutes.

I know from experience that those injectable cocktails can behave differently and dangerously for different cats, and seriously...why would you want a cat who comes home "drunk," stumbling, and with dilated pupils for twelve hours? I'll be glad when those drugs are reserved for quicky S/N clinics and not routinely on pets when much better drugs are available.

Just my thoughts...gathered from the last four years of working with a vet who (mostly) shares my opinions on the subject and lots of first-hand experience.
 
Libby...I'm in Clemson, SC. It's about 30 minutes from Greenville, if that's familiar to you! I've only vacationed in Charleston, but I've loved it every time. Wish I could spend more time down in the lower part of the state. I don't get away very often, unfortunately.
 
I know where Clemson is, but it is in a different direction from Charlotte than I am. You're probably one of my closest LL neighbors anyway. :)
 
Status
Not open for further replies.
Back
Top