? What is going on with Charlie?

[Elisha and Charlie]

We have an ultrasound on Charlie tomorrow is there something I should get them to focus on? We don't seem to be getting anywhere with BG levels going down.

Everything is in Spreadsheet under World. All remarks are like a diary.

 

[Diane Tyler's Mom GA]

Previous post
https://www.felinediabetes.com/FDMB/threads/regarding-charlies-dosage.258398/#post-2906224

Sending prayers for Charlie's ultrasound tomorrow

 

[FrostD]

He's an acro cat, that's the "problem!"

Our current highest acro cat is at 60U BID His highest was 70+ BID.

I'd say the majority hit a breakthrough dose by 25-30U BID at most. Just have to keep trudging along, increasing as fast as the dosing method allows. You don't have a method listed anywhere, though to would appear to be TR based on your increases. The majority of cats start to see the effects of Cabergoline within about 6 weeks.

Notes say he's lethargic, not eating well. My mind always goes to pancreatitis or DKA when people mention that and have cats in these high numbers. Have you checked ketones lately?

I'm not sure what's available in Australia as far as possible pancreatitis goes so tagging @Bron and Sheba (GA)

 

[Elisha and Charlie]

He's an acro cat, that's the "problem!"

Our current highest acro cat is at 60U BID His highest was 70+ BID.

I'd say the majority hit a breakthrough dose by 25-30U BID at most. Just have to keep trudging along, increasing as fast as the dosing method allows. You don't have a method listed anywhere, though to would appear to be TR based on your increases. The majority of cats start to see the effects of Cabergoline within about 6 weeks.

Notes say he's lethargic, not eating well. My mind always goes to pancreatitis or DKA when people mention that and have cats in these high numbers. Have you checked ketones lately?

I'm not sure what's available in Australia as far as possible pancreatitis goes so tagging @Bron and Sheba (GA)

 

[Elisha and Charlie]

Thank you. I think I just want a quick fix for him now that we know he is Acro and started medication. I think I just have to be patient (which I'm not good at ). I just went home to see how he was going and had finished breakfast and ate his lunch. He has only been on Cabergoline 50mcg given every 24 hours for 3 weeks on Saturday.

I did ketones this morning and all fine. He is having a CT on 22nd Feb to see how big this tumour is.

 

[Bron and Sheba (GA)]

I live in Sydney.
I’m sorry Charlie is no feeling well.
If he is lethargic, I would test the urine for ketones to see they are not present. If you don’t have any Ketostix you can buy them at most pharmacies. They come in bottled of 100 strips and you can test the glucose as well…..although you don’t need that with home testing.
That’s something I would do today.
Also try and make sure he is eating some food.

You can ask for a Snap fPL (which will tell you yes/ no to pancreatitis and is done in-house) or you can ask for a spec fPL (which will tell you how severe it is with a number and is sent off site and will take a day.) Pancreatitis is treated with subQ fluids, pain meds and anti nausea meds

I’m not sure where you are based but there is a vet in Sydney who treats Acro cats.
I am going to send you a link and if you look down towards the bottom you will see the Acro information.
INFORMATION FOR AUSSIE CAEGIVERS

 

[FrostD]

It just absolutely sucks, I know. It took me almost a year of screwing around between vets to finally get on the right track...and even then it was cab that eventually came to my rescue. From what I've seen, the majority of cats at least get a bit of reduction from cab (I was very fortunate with remission, for now).

Are you considering SRT or hypophosectomy in the future, or just curious about size?

 

[Elisha and Charlie]

I live in Sydney.
I’m sorry Charlie is no feeling well.
If he is lethargic, I would test the urine for ketones to see they are not present. If you don’t have any Ketostix you can buy them at most pharmacies. They come in bottled of 100 strips and you can test the glucose as well…..although you don’t need that with home testing.
That’s something I would do today.
Also try and make sure he is eating some food.

You can ask for a Snap fPL (which will tell you yes/ no to pancreatitis and is done in-house) or you can ask for a spec fPL (which will tell you how severe it is with a number and is sent off site and will take a day.) Pancreatitis is treated with subQ fluids, pain meds and anti nausea meds

I’m not sure where you are based but there is a vet in Sydney who treats Acro cats.
I am going to send you a link and if you look down towards the bottom you will see the Acro information.
INFORMATION FOR AUSSIE CAEGIVERS

Hi Bron,

Thanks for the information, I did read over this and contacted Sash Vets and we had a Zoom meeting with Dr Amy Lam (who was lovely) I'm based in Hobart and Charlie isn't the easiest of patience and it was agreed that we wouldn't send him to Sydney to see Dr Patrick Kenny.

I do Ketone testing at home with the Ketostix and he has non.

I just went home to give him Lunch and he had finished the venison and had the rabbit. BG was 21.4

I will as about Snap fPL is this the Vet or just a phamacy?

Thank you

Elisha

 

[Bron and Sheba (GA)]

will as about Snap fPL is this the Vet or just a phamacy?

Hi Elisha
That is a blood test at the vet….in house
How did you get the blood test done for the acro diagnosis?. Was that through SASH vets? And who organised the Cabergoline for you? I’m interested as we sometimes get cats who could be acro here in Australia and all the information I can get about it will be helpful when helping other Aussies.
I’m glad he is eating some food for you and there are no ketones in the urine….that’s good!
Let us know how the ultrasound goes, will you please?
I’m going to tag @Wendy&Neko as she is our very knowledgeable acro person here. She may have some suggestions.

 

[Elisha and Charlie]

It just absolutely sucks, I know. It took me almost a year of screwing around between vets to finally get on the right track...and even then it was cab that eventually came to my rescue. From what I've seen, the majority of cats at least get a bit of reduction from cab (I was very fortunate with remission, for now).

Are you considering SRT or hypophosectomy in the future, or just curious about size?

No we are not going to do either as we don't have that service where I live and he would have to travel to the Mainland of Australia, this would stress him out to much and probably kill him.

I'm curious to see how big the Tumour is, we are doing a Whole Body CT to have a look at everything. We are planning on every 3 month scan to see what happens.

 

[Elisha and Charlie]

Hi Elisha
That is a blood test at the vet….in house
How did you get the blood test done for the acro diagnosis?. Was that through SASH vets? And who organised the Cabergoline for you? I’m interested as we sometimes get cats who could be acro here in Australia and all the information I can get about it will be helpful when helping other Aussies.
I’m glad he is eating some food for you and there are no ketones in the urine….that’s good!
Let us know how the ultrasound goes, will you please?
I’m going to tag @Wendy&Neko as she is our very knowledgeable acro person here. She may have some suggestions.

Bron,

My vet has been absolutely wonderful and has been very open to my suggestions from this forum and another Facebook page (Acromegaly Felines) as you have stated there isn't enough info for us in Australia and I have done alot of research with my Vet.

Charlie had IFG-1 testing in Brisbane ? I can find out where it was sent to. My vet organised the Cabergoline it had to be made up for him and took 3 weeks to get to me. Dr Amy Lam (SASH) agrees with giving him Cabergoline and that is why we are doing CT so they can see the effects of just Caber only treatment for study so we can help out these Acro babies.

 

[Bron and Sheba (GA)]

Bron,

My vet has been absolutely wonderful and has been very open to my suggestions from this forum and another Facebook page (Acromegaly Felines) as you have stated there isn't enough info for us in Australia and I have done alot of research with my Vet.

Charlie had IFG-1 testing in Brisbane ? I can find out where it was sent to. My vet organised the Cabergoline it had to be made up for him and took 3 weeks to get to me. Dr Amy Lam (SASH) agrees with giving him Cabergoline and that is why we are doing CT so they can see the effects of just Caber only treatment for study so we can help out these Acro babies.

Thanks for that information. There have been a few cats here who have had Cabergoline and have done well on it. That is great you have a wonderful vet on your side.
I did not know that Cabergoline was available here in Australia, so that is really good to know. I know they will do the operation inSydney at SASH but I don’t think there is a place for SRT here in Australia at the moment.

 

[Elisha and Charlie]

Thanks for that information. There have been a few cats here who have had Cabergoline and have done well on it. That is great you have a wonderful vet on your side.
I did not know that Cabergoline was available here in Australia, so that is really good to know. I know they will do the operation inSydney at SASH but I don’t think there is a place for SRT here in Australia at the moment.

Yes there is a place in Melbourne for SRT its Melbourne South Paws and I think one has just opened up in Brisbane, but nothing in Tasmania :-(

It would be good if we knew what causes Acro's in cat to prevent it.

 

[Bron and Sheba (GA)]

Yes there is a place in Melbourne for SRT its Melbourne South Paws and I think one has just opened up in Brisbane, but nothing in Tasmania :-(

I didn’t know that….that is really good to know. Thank you for that information.

 

[FrostD]

No we are not going to do either as we don't have that service where I live and he would have to travel to the Mainland of Australia, this would stress him out to much and probably kill him.

I'm curious to see how big the Tumour is, we are doing a Whole Body CT to have a look at everything. We are planning on every 3 month scan to see what happens.

I suppose I am selfishly curious if cab has an effect on the tumor itself. The two studies I am aware of, I don't believe they did CT scans. The RVC one was short term, the one in south America has been long term but i don't see CTs mentioned.

Reading about humans, cabergoline can in fact alter the way tumor cells grow and reproduce. I didn't have a ton of time to dig, but it seems mixed whether it can shrink it (it did in 13 of 21 patients in a study).

I'm sure Wendy will pop in, but are there concerns about anesthesia that often?

 

[Elisha and Charlie]

I suppose I am selfishly curious if cab has an effect on the tumor itself. The two studies I am aware of, I don't believe they did CT scans. The RVC one was short term, the one in south America has been long term but i don't see CTs mentioned.

Reading about humans, cabergoline can in fact alter the way tumor cells grow and reproduce. I didn't have a ton of time to dig, but it seems mixed whether it can shrink it (it did in 13 of 21 patients in a study).

I'm sure Wendy will pop in, but are there concerns about anesthesia that often?

That is what I have read aswell and why the specialist in Sydney and my vet would like to do the CT scans even though they cost me about $2,200.00AUD a pop, but if it is going to help Acro cats in the future I'm seeing it as my contribution for their well being, but I won't let him suffer and if we see any effects eg heart I will reassess.

I will try and keep everyone up to date on it, that is another reason why the spreadsheet is more a diary.

 

[Wendy&Neko]

Good to know you've got a vet open to cabergoline. We see far too many who have vets that aren't and only want the caregiver to pursue much more expensive treatments.

I'm curious to see how big the Tumour is, we are doing a Whole Body CT to have a look at everything. We are planning on every 3 month scan to see what happens

I honestly don't know anyone who gets a CT scan of the tumour, unless they are planning on doing hypophysectomy or radiation therapy. For one thing, acros are prone to heart problems, anaesthesia can be counter indicated in this case. Speaking as one who's acrocat was cleared for anaesthesia by a cardiologist, a week before a CT scan and had a heart block during the procedure and I was lucky she made it. Save the anaesthesia for medically necessary procedures. Plus, it's really just a waste of money if you aren't going to do anything with the data. Of course, you spending that amount of money would help the vet and specialists curiosity. Not so good for the cat though. I am not alone here in that experience.

 

[Elisha and Charlie]

Good to know you've got a vet open to cabergoline. We see far too many who have vets that aren't and only want the caregiver to pursue much more expensive treatments.
QUOTE="Coombesea, post: 2911675, member: 34907"]I'm curious to see how big the Tumour is, we are doing a Whole Body CT to have a look at everything. We are planning on every 3 month scan to see what happens

I honestly don't know anyone who gets a CT scan of the tumour, unless they are planning on doing hypophysectomy or radiation therapy. For one thing, acros are prone to heart problems, anaesthesia can be counter indicated in this case. Speaking as one who's acrocat was cleared for anaesthesia by a cardiologist, a week before a CT scan and had a heart block during the procedure and I was lucky she made it. Save the anaesthesia for medically necessary procedures. Plus, it's really just a waste of money if you aren't going to do anything with the data. Of course, you spending that amount of money would help the vet and specialists curiosity. Not so good for the cat though. I am not alone here in that experience. [/QUOTE]
Thank you.

I have a copy of his last blood test and reading them at the moment I can see PCT is low and RDW is high so wondering if it is starting to get to his heart, I’m no expert and trying to see what this might lead too.

i won’t be doing anything if it puts him at risk so appreciate you letting me know what happened with your baby

 

[Wendy&Neko]

There is a blood test called a ProBnP that can give early signs of heart issues. Some details about it here. I don't know about the RDW or PCT as indicators. RDW can be high with IBD, and with low levels of B12. Have his B12 levels been tested? It's easy to supplement if needed.

 

[Elisha and Charlie]

There is a blood test called a ProBnP that can give early signs of heart issues. Some details about it here. I don't know about the RDW or PCT as indicators. RDW can be high with IBD, and with low levels of B12. Have his B12 levels been tested? It's easy to supplement if needed.

we start B12 just before the tests were taken so that would make sense. He has IBD and that is why we are doing another ultrasound today to see how all internal are going (last one was September last year)

I will ask about ProBnP while we are there.

thank you

 

[Elisha and Charlie]

Thanks for that information. There have been a few cats here who have had Cabergoline and have done well on it. That is great you have a wonderful vet on your side.
I did not know that Cabergoline was available here in Australia, so that is really good to know. I know they will do the operation inSydney at SASH but I don’t think there is a place for SRT here in Australia at the moment.

Hi Bron,

These are the guys that are compounding my Cabergoline in Sydney not Brisbane https://bovavet.com.au/