7/30 Jessi BGs, Lantus, surgery w/anesthesia, reduce, hold, other?

Stefania S

Stefania S

Active Member
https://www.felinediabetes.com/FDMB...es-and-keeping-in-touch-while-we-wait.279713/

HI all,

We have a surgery coming up for an SCC tumor removal. They will anesthetize Jessi for the time it takes to remove it which will depend on how much we decide to do, specifically whether we remove lymph nodes and how much margin, which I am still deciding on.

See my thread on this for more background and discussion:

https://www.felinediabetes.com/FDMB...time-sensitive-questions.278911/#post-3089282

Obviously, we will skip the insulin the morning of the surgery. We have to be there at 8:30, she has to have been fasting for 8 hours for tests (blood and x ray) and then surgery at 10:30. They will monitor her BGs during and after surgery, and if she has to stay over, they will give Lantus according to my specifications. They will feed her her normal food, which I will provide, as soon as she is able to eat. Hopefully she can come right home after surgery.

I was wondering about anesthesia, and other aspects of surgery, and any effects it could have on BG levels as well as insulin function.

I have been holding at .5u since the last sensor died, with no monitoring, other than me watching her closely. I have no way to know what her levels have been or will be before and after surgery. I may ask them to assist in putting a sensor on with my guidance, though I was hoping to give her a rest until her wound is healed. But if you tell me it's particularly important to watch the BGs after surgery I will have them put one on.

Ear pricking is not going to happen until things are stable for us, so please assume this won't be possible for at least a couple of weeks. For those who haven't followed our threads, Jessi makes ear pricking very hard and because we had too much going on I stopped making attempts so I could care for her properly in all the other ways I have had to.

Any knowledge, info, experience about surgery and BGs, and Lantus that could help keep her safe, I would very much appreciate.

Thank you!

:bighug::cat::bighug:
 
First, Jessi dropped into low numbers yesterday. Please reduce the dose. (It looks like you are planning on increasing.) There are other reasons for reducing which I'll mention below.

Anesthesia will involve more than one drug. There's a pre-anesthesia and then a general anesthesia. The latter is longer acting.

If Jessi is coming home the same day, you should test her BG. Hopefully, you can get a sensor applied or if she's still a bit sleepy from the anesthesia, you can manage home testing. The reason is that anesthesia can lower blood glucose numbers. Shooting blindly, especially after surgery, could be dangerous. While the pre-anesthesia can sometimes stimulate a cat's appetite, that doesn't always happen. Your cat may still be recovering from surgery and be lethargic or just not feeling particularly well from the stress and may not want to eat. If you give insulin and don't know what her blood glucose level is, it could be problematic. If you do try to feed Jessi, give her a small amount to see if she can tolerate food. Anesthesia slows the gut. If you give her what is her usual amount of food, she may vomit.

Some cats need a quiet, dimly lit area for recovery. Again, it depends on the cat. When one of my cats had abdominal surgery, all she wanted to do was lie on my chest. She wouldn't move for a few hours once we got home.
 
Sienne and Gabby (GA) said:
First, Jessi dropped into low numbers yesterday. Please reduce the dose. (It looks like you are planning on increasing.) There are other reasons for reducing which I'll mention below.

Anesthesia will involve more than one drug. There's a pre-anesthesia and then a general anesthesia. The latter is longer acting.

If Jessi is coming home the same day, you should test her BG. Hopefully, you can get a sensor applied or if she's still a bit sleepy from the anesthesia, you can manage home testing. The reason is that anesthesia can lower blood glucose numbers. Shooting blindly, especially after surgery, could be dangerous. While the pre-anesthesia can sometimes stimulate a cat's appetite, that doesn't always happen. Your cat may still be recovering from surgery and be lethargic or just not feeling particularly well from the stress and may not want to eat. If you give insulin and don't know what her blood glucose level is, it could be problematic. If you do try to feed Jessi, give her a small amount to see if she can tolerate food. Anesthesia slows the gut. If you give her what is her usual amount of food, she may vomit.

Some cats need a quiet, dimly lit area for recovery. Again, it depends on the cat. When one of my cats had abdominal surgery, all she wanted to do was lie on my chest. She wouldn't move for a few hours once we got home.
Click to expand...

Ok, got it, that was what I wanted to know about the anesthesia.

If you're looking at the Spreadsheet, those numbers are 2 weeks old. I haven't filled in any data for that long as we have been without a sensor all this time. The dose remains the same .5u with no intention to raise the dose since we have no monitoring. The long low string of numbers was very likely because of a dying sensor which did quite during that low series. This is typical and has happened before, unfortunately. I attempted several ear pricks at the time without success so I don't have a way to physically confirm or negate those numbers, but they were just too extreme and anomalous.

I will see if they can apply a sensor at the clinic before releasing her. They will monitor her BGs while she is there. If there is a big concern that her BGs will be low after anesthesia, as you say, I could have them keep her overnight even if clinically she looks well enough to return home. Obviously, this is more stressful to her and more costly, but if that will be best, I will do that. They often keep them at least a night anyway.

I will be skipping the AM dose before surgery obviously, because she will be fasting. I could skip the evening dose too, if she were to come home right away, just to be safe. Yes, I could try to get an ear prick or two in while she is lethargic if that's the case.

But maybe it's best they keep her at least one night. What do you think?
 
I'm a nervous wreak if my cat isn't home with me. Obviously, if it's for the kitty's safety that it's an overnight stay, that's what would be best especially if your cat needs to be monitored 24/7. I would ask if someone is there 24/7, though. Not all places have staff available and if that's the case, Jessi would likely be better home with you. I think a lot depends on what her blood glucose numbers look like.
 
I hear you, I'm a nervous wreck thinking about it all and putting her in anyone else's hands!

It's a 24 hour clinic so they will have staff I'm sure, but I have no way to know how efficient they will be about monitoring her closely. I will have to decide on the day based on her condition after the surgery. If she springs back and shows us she's good to go home, I'll have them help me put a sensor on and take her home.
 
And what about other meds that are often given after surgery like pain killers, antibiotics, anti-inflammatories? Any advice, experience, insight on these?
 
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