? Moe has dental scheduled...what do I need to know?

Moe has a dental scheduled for 3/23, and I expect that he will need to have a few teeth extracted based on remarks by the vet at his last physical. She suspects some resorptive lesions.

What do I need to prepare for? I’ve already asked about insulin prior to surgery (normal shot time is 6 am and pm) and am waiting to hear back. I might take the day off from work the day after surgery so I can monitor.

What should I expect and plan for?

 

Here is a compilation of links about dental procedures:

http://www.felinediabetes.com/FDMB/threads/info-on-dental-procedures-including-pictures.144338/

I would make sure they do xrays both before and after, especially if they suspect extractions, to make sure there’s nothing left behind that could cause future complications. Sophie ended up needing 4 extractions during her dental. I was a nervous wreck but she was perfectly fine I have her bupe for a few days so she mostly spent that time just sleeping and eating

 

Jonesy just had a dental. Bunch of comments in his threads here, from over in the Lantus ISG.

3/2 Jonesy AMPS 281-1.75u; PMPS 310-1.75; 239@=4.5
3/3 Jonesy AMPS (Dental today) 1st test 47, after dental PMPS 464 - 1.75u UPDATE
3/4 Jonesy (post dental) AMPS 315-1.75u (When can I increase to 2.0u?)

 

I just spoke to my vet about the upcoming dental. She wants me to try and get Moe’s diabetes better regulated before we do it. She wants me to do a curve this weekend and send her the results, then possibly increase his dose from 0.5 to 1.0.

Since his mouth is “not critical” she would rather wait until he’s better controlled.

 

My vet has done extractions on two of my other cats. Pixie has stomatitis and had all but three canines and the little front teeth removed. JuneBug had seven removed due to FORLS. She gave bupe both times.

My vet does do before and after X-rays, and she’s the same doc who is treating Moe’s diabetes and early CKD. I trust her to do right. Doesn’t stop me from worrying of course.

 

My vet always starts pets on antibiotics 5 days before a dental and then continue with them afterwards. She is really good. So far neither of my diabetic cats have needed a dental.

 

So what is your vet expecting for "better regulation" before doing the dental?

Can be a bit of a catch-22 situation. The bad teeth keep the BG (blood glucose) numbers higher, so the vet says no dental. But if you don't have the dental done, the BG (blood glucose) levels don't come back down.

Maybe it's time to try TR with Moe, or at least bump the dose up to 0.75U. Dose increases don't have to be made in 0.5U increments.

You are simply a normal, worried cat mom. Like the rest of us.

 

I just want to second what Deb said about the catch 22--I wasn't able to get Bandit well regulated until after his dental, and I was doing TR with Lantus. If you check out the 2009-2011 tab on his spreadsheet, you can see his numbers looked a lot like Moe's before the dental (his dental day is highlighted in purple in the notes). About 10 days after the dental, all of a sudden his numbers leveled out and he became very well regulated and on the road road to remission.

Moe hasn't been on insulin very long, so it wouldn't hurt to spend a little time testing and adjusting his dose for better regulation, but I wouldn't put off the dental for more than a month or two because it's likely he won't see good regulation until after the teeth are taken care of. Good luck!

 

Thanks all. I’ve been away from the board a few days. I still have Moe’s dental scheduled for 3/23. I think the vet wants to see more stable numbers and not the bouncing around I’ve been seeing. Maybe? I’ll do a curve this weekend with a slightly higher dose (between 0.5 and 0.75) and see how he does.

 

Giving a little bit more, or a little bit less is what we call "skinnying" the dose (for less) or "fattening" the dose ( for more).

So the dose you gave him is called a "fat" dose. Most people record that as F0.5. You can think of it either way actually.

Looks to me like that black this morning is Moe in a bounce.
Black = bouncing. Hard.

 

I am at a loss with these numbers. I don’t know how to help him even out. I can tell he’s feeling awful.

 

See your condo for comments please.
Thank you.