11/15 Chewie AMPS 370 / +4 303/ PMPS 341/ +2 349 - positive for acromegaly

Well, the vet just called, and her IGF-1 values came back at 283, so she does have acromegaly :(
The vet explained all the options, which I already knew thanks to this forum, and I told her I wasn't willing to try radiation or surgery, so I sent her all the info I had on cabergoline.
Next step is for me to save up for the echo, she also wants to retest her kidney values, the SDMA was at the higher end of the normal range in July, and she wants to check in case it's already deteriorating.
She wants to support heart and kidney function with supplements, and depending on results of the echo, we may need to consider heart meds.
I'm obviously devastated but this wasn't unexpected... I made clear that I wanted to prioritize Chewie's quality of life, and that I didn't want to shove a billion meds down her throat every day just to get an extra year or two, she is on board with that.
Really hope she is one of those lucky cats who respond well to cabergoline.

@Wendy&Neko just wanted to thank you once more for pushing me to get the test and for explaining all of this so well. No surprise, you were right all along.
Practical question: is Wedgewood a reliable source for cabergoline, or is it better to get it done locally?
 
I am so sorry! How stressful. I’m glad you had the understanding going in to this to have an informed discussion with your vet! I used Wedgewood for Simon’s budesonide and found them to be a very good, reliable company with excellent customer service. Wishing you and Chewie the best :bighug:
 
:bighug::bighug::bighug::bighug::bighug::bighug:
The most important thing that someone told me when I was in your shoes with a positive diagnosis - Chewie doesn't know she has acromegaly and is the same cat she was before. Absolutely nothing has changed for her. For you, you now have an explanation as to why her greens disappeared (tumour pulse) and size of dose. More important, you have a course of action to help her.

Feel free to ask any questions, I know my mind was racing when I got the diagnosis. Your vet seems to be on top of things so far. That's a relief. Make sure she tests urine protein too.

As for where to get cabergoline, I think most go to Wedgewood, but not sure. This long post has contributions on that topic:
Cabergoline as a possible treatment for acrocats: discussion There are a few other posts on cabergoline on the acro forum that you may wish to read too.
 
Last edited:
Thanks everyone :bighug::bighug::bighug: I'm giving myself the day off being tough and have been crying all day, and I can't tell you how much I appreciate the support and understanding I get here :bighug:

Wendy&Neko said:
:bighug::bighug::bighug::bighug::bighug::bighug:
The most important thing that someone told me when I was in your shoes with a positive diagnosis - Chewie doesn't know she has acromegaly and is the same cat she was before. Absolutely nothing has changed for her. For you, you now have an explanation as to why her greens disappeared (tumour pulse) and size of dose. More important, you have a course of action to help her.f

Feel free to ask any questions, I know my mind was racing when I got the diagnosis. Your vet seems to be on top of things so far. That's a relief. Make sure she tests urine protein too.

As for where to get cabergoline, I think most go to Wedgewood, but not sure. This long post has contributions on that topic:
Cabergoline as a possible treatment for acrocats: discussion There are a few other posts on cabergoline on the acro forum that you may wish to read too.
Click to expand...
Thanks Wendy - I'm trying my best to not let my sadness bleed into our daily interactions. It's tough, especially on days like today when I can tell she's not feeling well and is just sleeping upstairs, only coming down for meals. She is a shadow of her former self, but that's unavoidable with aging, I need to make peace with it. Reading about the impacts of acromegaly on the body, I wonder if her back/spine injury may have been an early sign of damage too, like her stridor that she has had for years. It all adds up.

I read a bunch of the cabergoline posts in preparation for the vet visit, but I'll re-read through them for sure. We placed the order for cabergoline with a local compounding pharmacy, I should have it by Thursday. Taking note of the urine protein test.
 
Virginie said:
Oh and the vet also suggested switching to Levemir once I finish up our supply of glargine, or sooner if she starts showing signs of glargine stinging. I love this vet so much. We got so lucky.
Click to expand...
Yes, awesome vet! Sounds like she's had experience with acros before, or is good at research.
Virginie said:
I can tell she's not feeling well and is just sleeping upstairs, only coming down for meals.
Click to expand...
Many acros end up on regular gabapentin or buprenorphine. Bupe made a world of difference to Neko's QOL. Got her up and interacting and playing again. Human acros often report headaches as well as the arthritis. Her body probably got used to better BG numbers too. 9.5 units tomorrow, if you don't see blue before then.

Even once you start cabergoline, it takes at least a week, if not more, to start seeing impacts. And very much ECID, but if it really kicks in, you can see a wide range of reactions, but it's typical to see some steep drops in dose at some point. Did the vet mention dose or frequency of cab?
 
Wendy&Neko said:
Yes, awesome vet! Sounds like she's had experience with acros before, or is good at research.
Click to expand...
She read the study links I sent her (while the Portland vet poo-pooed the mere possibility of acromegaly), and said she reached to a couple of colleagues experienced with acrocats through some specific vet network to get a better understanding of the options. She was not aware of the use of cabergoline but same thing, immediately read the research I sent and got on board.

Many acros end up on regular gabapentin or buprenorphine. Bupe made a world of difference to Neko's QOL. Got her up and interacting and playing again. Human acros often report headaches as well as the arthritis. Her body probably got used to better BG numbers too. 9.5 units tomorrow, if you don't see blue before then.
Click to expand...
I have been giving her 25mg gabapentin AM and PM, hopefully getting better BGs will help. She was a lot more active just a few days ago, the higher numbers definitely have her feeling crummy.

Even once you start cabergoline, it takes at least a week, if not more, to start seeing impacts. And very much ECID, but if it really kicks in, you can see a wide range of reactions, but it's typical to see some steep drops in dose at some point. Did the vet mention dose or frequency of cab?
Click to expand...
I have been reading every cabergoline thread I could find in the acro subforum, and it’s given me a bit of hope. Very cautiously so, since not all cats seem to get improvement from it, I’m trying to not get my hopes up too much.
The vet mentioned starting with every other day dosing but I forget the dose she mentioned. I will know later this week when the prescription is ready and I will double check with you before starting. The vet has never used it before, but she could see how it would make sense since other meds of the same class are useful for Cushing’s.
 
I just wanted to welcome you to the acro club. My Howie was diagnosed in Jan 2021 and we started cabergoline in Feb. I get mine from Wedgewood as that’s the only pharmacy my vet is comfortable with. I’m very lucky with my vet too…he supports me in things I want to try as he has very little experience with acro. While we have not been one of the lucky ones who have seen the big drop in insulin needs with Cabergoline (been sitting at 34 units BID for a couple months), I was encouraged by members of this forum to not take him off as we hope/assume it is keeping other acro issues at bay.

A couple things about issues you mentioned before (based on my experience). Howie’s SDMA was at 30 in April (so not a good #at all). I’ve been conscientiously feeding him low phosphorus food (Weruva brand pates) and it dropped to 25 at his last exam in October. I wasn’t sure I could get his kidney levels back into a better range just through diet, but it is definitely working. I had a CKD kittie before and it is heartbreaking to watch. I also just started Howie on Solensia injections for his arthritis as gabepentin and Dasuquin supplements didn’t do anything. I’m happy to say that the Solensia has given us some improvements and he’s more social and less ornery as I can tell he’s in less pain. So check with your vet on Solensia. It just got released from the FDA in the States this Fall. I also have him on Levemir (switched him to that even before his acro Dx as he’s an IAA kittie too). I love Levemir and wouldn’t use anything else. Most of us order it from Marks marine Pharmacy in Canada as it’s way cheaper than here in the Stares. Beware that you should place your order about 30 days before you need it due to processing times and then having to go through customs in LA (and then shipping times to your home). I order the max of 3 boxes (15 pens) each time as shipping is about the same and he does through a pen every 5 days.

reach out with questions. So many of us have been in your shoes and this is the best spot to learn and seek guidance/support! Big hugs!
 
Thank you very much @Howiesmom and sorry that cabergoline wasn’t a silver bullet for Howie. I started reading posts in the acro forum and came across the thread where you were asking about the benefits of continuing treatment even though it didn’t reduce his insulin requirements. I am so grateful to be able to get such precious information from you and other acrocats caregivers.

It’s a great tip to watch the phosphorus levels for the kidneys - what’s considered low phosphorus? Right now Chewie is mostly eating this food and their page said it contains 1.10% phosphorus. Canned food is hit or miss with her, we have mostly been rotating Wellness Complete health turkey and salmon and Weruva Chicken fricassée and Fowl Bowl (0.81 and 0.89 dry matter basis). Is that good?

We will very likely switch to levemir once I finish the 3 pens of glargine we just received from Mark’s pharmacy. For now she is “only” getting 9 units twice per day but her numbers are rising so I’m sure the dose will keep increasing too. Financially it all adds up so fast.
Chewie is currently on Adequan once a week and gabapentin twice a day, it seems to help but it’s not working miracles either. I will definitely ask the vet about Solensia once we finish the Adequan vials. I also started giving her favorite joint treat back to her, carbs be damned. It’s called glycoflex 3 and she loooooves it. Worth it to make her happy (and hopefully less painful).

I am sure I will have a billion questions in the next few weeks… thanks again for offering help and support everyone :bighug:
 
Virginie said:
Thank you very much @Howiesmom and sorry that cabergoline wasn’t a silver bullet for Howie. I started reading posts in the acro forum and came across the thread where you were asking about the benefits of continuing treatment even though it didn’t reduce his insulin requirements. I am so grateful to be able to get such precious information from you and other acrocats caregivers.

It’s a great tip to watch the phosphorus levels for the kidneys - what’s considered low phosphorus? Right now Chewie is mostly eating this food and their page said it contains 1.10% phosphorus. Canned food is hit or miss with her, we have mostly been rotating Wellness Complete health turkey and salmon and Weruva Chicken fricassée and Fowl Bowl (0.81 and 0.89 dry matter basis). Is that good?

We will very likely switch to levemir once I finish the 3 pens of glargine we just received from Mark’s pharmacy. For now she is “only” getting 9 units twice per day but her numbers are rising so I’m sure the dose will keep increasing too. Financially it all adds up so fast.
Chewie is currently on Adequan once a week and gabapentin twice a day, it seems to help but it’s not working miracles either. I will definitely ask the vet about Solensia once we finish the Adequan vials. I also started giving her favorite joint treat back to her, carbs be damned. It’s called glycoflex 3 and she loooooves it. Worth it to make her happy (and hopefully less painful).

I am sure I will have a billion questions in the next few weeks… thanks again for offering help and support everyone :bighug:
Click to expand...
The best part about Weruva is that they post all their nutritional info on their website for all their different products. Here is the link to the pates he eats for his main meals (I use the BFF Play pates for his snacks throughout the day). https://weruva.com/nutrition-landing/pates-ni/I was taught to look at the phosphorus info on the mineral/100 kcal (the bottom table). I only use foods that are 250 mg Phos or under. For the protein/carb/fat content, I use their Calories and Metabolizeable Energy (ME) profile instead of As-Fed and Dry Matter. I find that to be accurate (got caught up previously in another food brand who wasn’t giving out accurate %s as they thought they were basically the same). I hope this gives you more to study/look at. I only feed him the Weruva food as he has no teeth (so needs a pate) and can’t have carageenan or a lot of the other gums used as preservatives. Weruva checks all the boxes despite the expense. His “grocery bill” per month is more than mine sometimes!
 
You must log in or register to reply here.
Back
Top