Jimmy Stewart Has a Follow-Up with Vet Post Dental Surgery

Jimmy is recovering well from dental surgery.  He had blood drawn last Thursday and the vet called Friday to say she doesn't think he's pre-diabetic.  His glucose was normal at 92.  All other values are normal.

When he was at Michigan State on August 20 for surgery, his glucose was 320-but that was after he had been in the car for over an hour and at MSU for over an hour before they drew blood.  So, it could have been elevated due to stress.   But the surgeon was concerned that he was pre-diabetic. The fructosamine test was also high.

The regular vet thought the elevated glucose was due to stress because whenever he's had blood drawn at the regular vet's office-because it's close to home and he has less time to be stressed-the glucose has been normal.

And it has nothing to do with how well the kidneys are or are not functioning (in his case, at this time.) The regular vet said that when glucose gets above 250-280, that the "extra" will spill over into the bloodstream regardless of kidney function.

However, we had also been feeding him a different cat food for the two weeks between surgery and the blood recheck which could have affected the outcome.  The food was Fancy Feast Classic which has no gravy, therefore, fewer carbs.  And we were also feeding Purina Naturals grain free food which supposedly has fewer carbs.   That could have caused the difference.  We will know more when we recheck the fructosamine at the end of the month.

When kidney function has declined, it is possible that sodium, glucose, magnesium, and many other blood values will increase.  If all blood values are normal except glucose, then it is possible that a cat is diabetic.  If there are spikes in glucose, then the cat could be pre-diabetic.  And while the fructosamine test is suppose to be the standard for determining if the cat is diabetic, it acts as a historical aggregate of glucose levels.  So, even when glucose is falsely elevated due to stress, the fructosamine will reflect that history.

Jimmy Stewart

Jimmy Stewart to MSU for Dental Surgery-He Might Also Be Diabetic

At MSU for Jimmy Stewarts dental surgery. He was very calm in the car. Nervous being examined but so well behaved.

Despite June's fructosamine test that showed normal glucose-after the regular blood test showed an elevated level; and last weeks glucose was normal-Jimmy's glucose today is high, urine glucose is present and high (shouldn't be present) and fructosamine shows high. They believe he might be pre diabetic. Inflamed teeth could be causing pancreas reaction-it deals with body's inflammatory response; and stress does add to elevation; and internal dehydration-which shows in high albumin level-when that is not related to liver disease-may add to higher glucose. But fructosamine level is key. Once home and healed, need to retest blood and urine but now need to feed a diet low in carbs, high in fiber like humans. Control of spikes of sugar levels is key with diet and control of diabetes in the future.

Four teeth to be removed. Vet says we must brush every day every cat's teeth. If you can decrease gingivitis you can slow effects and resorption when it is active.

From the doctor's notes: "Feline resorptive dental disease...this incurable condition is the result of infection and inflammation at the gumline causing cellular growth that degenerates tooth crowns. Unfortunately, the only therapy is the removal of the affected teeth.  Daily home care and regular dental cleanings...are recommended..."

This is why I go to MSU for dental surgery and this is why it is important to take blood work and take it again.  Yes, we had normal blood values a week prior to dental surgery but MSU wasn't happy with the glucose levels. Had we not retaken both the blood work and the fructosamine tests, we may not have known about the possibility of a pre-diabetic existing condition.  Any other vet would have done the surgery; I would never have had the informative discussions with the dental surgeon about glucose and urinating out of the box (it can be a leading cause because the sugar spikes and makes the bladder feel full and creates an urge to dump the urine/sugar) and how spikes in glucose work and why diet is key.