2/1 Chispa, 137 +11, 126 AMPS, 91 +3, 132 PMPS, 111 +1.75, 100 +3.5, 103 +4.75, 128 +11

Discussion in 'Lantus / Levemir / Biosimilars' started by Karen and Chispa, Feb 1, 2023.

  1. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    https://www.felinediabetes.com/FDMB/threads/1-31-chispa-99-amps-83-3-112-pmps-97-3-5.273651/

    Good morning, everyone! :bighug::coffee::cat:

    I got up a little too late to feed Chispa at -2, so I tested at -1 and then gave her breakfast. I don't quite understand how her score could be higher at +11 on an empty stomach than an hour later, after breakfast, at AMPS ... but there it is.:confused:

    In other news, I just got a call from the vet's office: they had a cancellation for a dental appointment tomorrow morning. Back in mid-December, we met the vet that I thought was going to do the procedure, but somehow it turned out that they scheduled her with someone else, and though the vet she was scheduled with was the head of the dental department, I wasn't entirely comfortable not having met him. I was so impressed with the one that we did meet that I asked them to call if she had a cancellation. So now the worrying begins. On the bright side, Bast willing, Chispa will be home tomorrow with a bright and shiny smile, and the worrying will be over one week sooner than it would have been.
     
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  2. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    By -2 and -1, do you mean PM+10 and PM+11? So she ate at +11 and her AMPS is lower? Some cats on Lantus see a second dip at the end of the cycle - so the numbers go down to till the nadir and then up after and then at the end of the cycle there is a small dip which is shallower than the nadir. This is called the Lantus "double-dip".

    Did the vet will you what time they want you to drop Chispa off and whether she needs to be fasted and for how long?
     
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  3. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Morning Karen Good luck with the dental tomorrow, I'm sure Chispa will do well .
    It's normal to worry, I worried when Tyler had his dental.:bighug::cat:
     
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  4. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    Sending good thoughts for Chispa for her dental to go well tomorrow. I’m glad she is having the dental with the vet you really like. :bighug::bighug::bighug:
     
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  5. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Yes, sorry -- +10 and +11. I tested at +11, then she ate, then I tested again at AMPS, so the "double dip" would make sense. I'm surprised that it happened in spite of the meal, but Chispa often doesn't seem to register much of a food spike.

    I'm supposed to drop her off between 7 and 8 am. Fasting starts tonight at 10 pm. They said to give her half of her usual insulin dose in the morning. I'm also supposed to give her a Cerenia before bed to help with the nausea that she sometimes gets on an empty stomach. Poor baby ... she is not going to be happy about skipping 4 mini-meals.
     
  6. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Thanks, Diane and Jackie. I'll pass along your encouragement to Chispa, and I'll try not to worry excessively (easier said than done) ... :bighug::bighug::bighug:
     
  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    @Karen and Chispa
    Are they actually going to start the dental at 8 AM , poor Chispa is going to be starving if you have to stop feedung at 10 PM
    When Tyler had his dental I had to stop feeding by midnight
    I see most members had to stop feeding at midnight
    @Karen and Chispa

    I'm curious to see what some other members say about it, but I guess you have to listen to what the vet told you

    @Wendy&Neko

    @tiffmaxee

    @Suzanne & Darcy

    @Ti-Mousse (GA) and Pepe
     
    Last edited: Feb 1, 2023
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  8. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    That seems like too long a fast. I think you can feed till midnight. And half a dose in the morning and no food? :eek:
    @Wendy&Neko
     
  9. Karen and Chispa

    Karen and Chispa Well-Known Member

    Joined:
    Jul 22, 2022
    @Diane Tyler's Mom @Bandit's Mom

    I know, it does seem like such a very long time to fast. Here are the instructions I got from the vet:

    1. Chispa should not have any food after 10PM the night before the dental.
    2. Administer a dose of Cerenia (maropitant) the night before the procedure to prevent vomiting on an empty stomach.
    3. Administer a dose of gabapentin (100mg) the morning of the procedure in a VERY SMALL amount of food.
    4. Administer HALF her usual dose of insulin the morning of the procedure.
    5. Skip her telmisartan and prednisolone the day of the procedure; resume the next morning.

    Check-in is between 7AM and 8AM on the morning of the dental. We strive to have Chispa ready to go home by 7PM, but cannot guarantee an exact discharge time in advance. In some cases discharge may be earlier than 7PM, but in some cases it may be later. We will call you after the dental is complete and let you know how things went and when you can pick Chispa up.
    It only just now occurred to me that I probably should have given her a reduced dose of insulin tonight as well, because without being able to feed after 10 pm, I have no way of preventing her from diving. I'll get up and test at +4 and +5 to make sure she's not going too low. For the same reason, should I skip the dose in the morning? @Wendy&Neko

    They were not able to say what time they would be doing the procedure. I hope it's early -- all the more so since the Cerenia will be wearing off if they wait too long. I asked if I should bring a can of her food for afterwards, but they said that as soon as she was up and around, they would call and I could bring her home.
     
  10. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Why do you have to give gabapentin for?
    @Karen and Chispa
    Hopefully @Wendy&Neko will be on soon
    I think you can still feed until midnight
     
  11. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    I usually give her a small amount before vet visits (not 100 mg though, more like 25-50, which they said was fine). It will help take the edge off her anxiety if she has to wait around before the procedure.
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry, was out working most of the day and just got back.

    Vets differ in instructions for fasting before anaesthesia. I would try not to differ too much if possible from what they expect you will be doing. Though I think feeding until midnight should be OK. I used to feed a larger meal and sometimes MC to tide Neko over. Almost every time Neko had anaesthesia, I had to remind them that she was diabetic and asked what the instructions should be. Typically there are different guidelines for diabetics. That usually means eating later. Neko's dental specialist vet let her eat up to 1/3 of her breakfast up until 6AM of the procedure, which typically took place around noon, so a 6 hour fast. I also asked a vet once what would happen if kitty went low, and the answer was to feed as you need to to keep them safe. And let the vet know how much and when they ate.

    As for how much to shoot in the AM, you kind of have to play that by ear when you see the morning AMPS number. One time I knew Neko was angling for a reducie and instead of half dose, gave her a token 0.1 unit dose. And the vet tested her at 72 on the AT during the day. :eek: Her normal dose then was lower than Chispa's is now. Most times Neko got her half dose in the AM.

    I would absolutely take a can of what Chispa normally eats with you in the AM. Too often I've herd of kitties getting inappropriate food at the vet. Besides the diabetes, you have the IBD to be concerned about. And she will need a bit of food, especially if they are keeping her so late.

    Also when you drop her off, mention again that she is diabetic and ask if she could be done as one of the earliest procedures of the day. I never had to wait later than 4PM to pick Neko up.
     
  13. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Thanks so much, Wendy. They had me print out and sign some forms to bring with me in the morning, so I made a note on a neon green post-it that CHISPA IS DIABETIC and stuck that onto the first page of the form. I also placed a can of Weruva in the pocket of her carrier and noted that on the same post-it. I'll be sure to ask if they can do her first (or at least early) when I drop her off. I'll also confirm that they will test BG during the day.

    That's scary that Neko went to 72 on a 0.1 unit dose. I'll see what her numbers say in the AM, but I am really tempted to skip it!
     
  14. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    I skipped Bandit's dose on the morning of her dental because she had to be fasted and so no breakfast.
     
  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Neko's lower number that day was due to the larger depot. She had been seeing 70's on her dose at the time (slightly under 1.0 units), and gave me a lower AMPS than expected. All the other times she had anaesthesia she was good for the regular half dose, in spite of being fasted.
     
  16. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
  17. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    GOOD LUCK!! :bighug::bighug::bighug:
     
  18. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Thanks, Bhooma! :bighug::bighug::bighug:

    Dropoff made, Chispa very calm after 1/3 of a gabapentin mixed with chicken dust and water. I verbally reminded them (in addition to my neon post-it) that Chispa is diabetic and hasn't eaten since 10 pm, and could they please try to do her on the early side. They told me that they do all of the dentals before calling anyone so as not to have the cats under anesthesia any longer than necessary, which is great, though I think I am going to have to be anesthetized myself to get through the day until they call me. They said pickup is no earlier than 6 pm, aaagh!!

    I tried to feed her large meals starting yesterday noontime so that she would have as much fuel in the tank as possible. And I think it worked, because she did not meow at all during the night, which is pretty unusual even when she's not fasting. I thought she would be ravenous and yowling by this morning, but no, she came in to wake me up and get snuggles, then hung out on her crinkly paper under the table until it was time to go. Minor protest upon being put in the carrier, but no complaining at all on the way. She is the very best girl.
     
  19. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Good Luck , I'm glad she wasn't hounding you for food. She is a good girl.
    Try and keep busy today so the time goes faster for you. .
    Keep us posted :bighug::bighug::bighug::cat:
     
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  20. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Thanks so much, Diane. You all will be the first to know as soon as I hear anything! :bighug::bighug::bighug:
     
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  21. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    I think a skip was a good call. I skipped for Biggie the morning of his dental too. His evening pre-shot was 54 that night and I think that may have had to do with the residual anesthetic. They did test him at the clinic and he was in the 200s (AT) so wouldn’t have expected him to be so low that night. I am sending good vibes to Chispa. I have been thinking of her today! :bighug::bighug::bighug:
     
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  22. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Jackie, thank you so much for your support and good thoughts. I am very glad I skipped the shot! Still waiting impatiently for news, but work has been super busy and provided a good distraction today.
    I've been thinking of you and Biggie too -- and I am going to hop on over to the OTJ party right now! See you there!!! :bighug::bighug::bighug:
     
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  23. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Just checking in on Chispa :cat:
     
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  24. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Diane, thank you so much for checking in. I got home with her about an hour ago and have been following her around making sure she's ok. The poor baby had to have SIX extractions (!!) and I can tell that she's feeling it. They gave me some liquid gabapentin to mix with her dinner but I'm afraid to give her the full dose because it really knocks her out -- but I'm also afraid that it isn't going to work if I give her only half a dose. I have some buprenorphine on hand and am waiting to hear back from the vet to see if maybe I should give her that instead. The folks at the front desk said the Dr. who did the procedure had gone home, but I should send an email and she would see it. It's been an hour and I'm still waiting. I guess I will give her the gabapentin (half dose) if I don't hear within another hour.
     
  25. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Hi Karen, poor Chispa , I can tag a few members for you about maybe the buprenorphine would be a better choice. I feel awful she's in pain
    @Wendy&Neko

    @Suzanne & Darcy
    Post #24
     
    Last edited: Feb 2, 2023
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  26. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Thanks so much. I feel awful too. I know it's the best thing for her, but it's going to take a while for the benefits to outweigh the difficulty. :(
    On the good news side, they said she did great with the anesthesia and that her blood sugar was stable throughout the procedure. She seems happy to be home and is eating and drinking -- I think she would eat a whole can in one sitting if I let her, but I'm doling it out in small amounts so she doesn't get sick. Also, I tested her just now and got 208, which I guess is not bad for not having had a shot in almost 24 hours.
     
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  27. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    It's great to hear she's eating and drinking and that she did great. The 208 BG doesn't seem that bad at all .
    Don't forget to enter it on your SS and title :cat:
    You would think that the vet would have seen the E Mail you sent by now
    If they are still open I would tell them to get in touch with her and have her call you.
    It irks me when vets don't get back to you!
     
  28. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    I am going to call them now. Too much waiting already.
     
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  29. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    Aww poor Chispa! When cats mouths hurt, they often feel a whole lot better after the dental when it seems like they would be raw. I hope that is the case for Chispa, and so glad to hear she is eating and drinking and did well with the anesthesia. Sending out good vibes that she will continue to feel better. I have always heard of giving buprenorphine for mouth pain…hope they answer you soon. :bighug::bighug::bighug:
     
  30. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  31. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Thanks, Jackie and Diane.:bighug: The update is, I called and got someone on the phone who said yes, go ahead with the buprenorphine -- so that's what I did. She wasn't thrilled with having it squirted into her mouth, but I gave her a big spoonful of Weruva chicken gravy to make up for it. She ate it all and had a little drink and now she is hanging out under the table on her crinkly paper.:cat:
     
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  32. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    I'm so glad you got the go ahead to give the buprenorphine ! Hopefully she'll feel better. She loves her crinkly paper doesn't she :p
    Keep us updated ok :bighug:
     
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  33. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    A long day at the vet certainly doesn’t stop her from being extra adorable! I hope she doesn’t get loopy from the meds but I’m sure she will feel good. You might know this already but in case you don’t, bupr. can make them constipated.
     
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  34. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    She loves her crinkly paper all right! I put a toy mouse and a catnip pillow on it so it has "all the comforts of home." :joyful:

    Chispa says, "Why thank you!" She was still loopy from the anesthesia when she got home -- she went straight to her water dish and sat down to drink from it, which I have never EVER seen her do. It was kind of funny, until it started to look like she might actually fall asleep with her chin in it, which would not be funny at all. What to do?? I went to the cupboard and way in the back, I found a tall, skinny glass with a stem. Perfect! It's tall enough that she has to stand up to drink from it, and the opening is small enough that she can't get her whole face in it. Now she thinks she is a very fancy lady, and I will not be surprised if she insists on having her breakfast served on fine china.

    I did not know that bup. could make them constipated, so thanks for the heads up! I'll have the Miralax ready, just in case.

    IMG_6763.JPG
     
  35. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    That makes me smile to think of her standing all proper to drink her water. :oops:
    Biggie really likes to drink out of people’s glasses, too. I have never offered him such a fancy glass but I’m sure he would love that too!
     
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  36. Carole & Indigo

    Carole & Indigo Well-Known Member

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    Feb 4, 2021
    Glad to hear all went well with Chispa’s dental today, I hope the recovery is quick :bighug:
     
  37. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    What is it with cats and people's water glasses? Or mugs ... :p

    C0549D0F-B061-4908-A1BF-FF766A6106E2_1_105_c.jpeg
     
  38. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Aww, thanks Carole! :bighug: I hope so too. Luckily she has lots of support. Here she is with DBF, both recovering from the day's ordeal ...
    IMG_6764.JPG
     
  39. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Aww I see they are both taking a cat nap :p
    She looks nice and cozy in her carrier :bighug::cat:
     
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  40. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry, was away all day and just got back so didn't see your tag. I'm glad you gave some buprenorphine for the pain.

    Did you dose tonight?
     
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  41. Jackie and Biggie

    Jackie and Biggie Well-Known Member

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    Aug 17, 2022
    So adorable! I hope she rests up and feels better today. :bighug:
     
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  42. Karen and Chispa

    Karen and Chispa Well-Known Member

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    Jul 22, 2022
    Hi Wendy -- I gave her 3.5 last night and again this morning. Her numbers are surprisingly good considering the skipped dose! She is eating, but not as much as usual, so I've been giving her MC to make up for the calories/carbs she is missing.

    Taking this thread over to a new day. Thank you all so much for your support throughout the long and anxious day! :bighug::cat::bighug:
    @Wendy&Neko @Diane Tyler's Mom @Jackie and Biggie @Carole & Indigo @Bandit's Mom
     

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