New member & Diagnosis

[Melissa&Moka]

My cat Moka has been diagnosed with acromegaly after her glucose numbers saw no improvement at 5 units of Lantus. We dropped her to 2 because she had better results way back when, but I suspect we will go back up. In hindsight, I should have pushed to test her for acro harder since her breathing was different and her jaw changed a lot. I feel like an awful cat mom and I can't stop crying. It's all so overwhelming, and I'm scared for my baby gremlin.

I requested an appointment with a cardiologist to see if she'll be able to go under for a CT/MRI not sure which is best in this case.

Weighing the options: radiation, surgery or medication. I've been a long time lurker on the forum, but posting now.

Moka is 8.5 years old
Diagnosed in December, tried to regulate with food.
Started insulin in June
Based in Oregon

 

[Dyana]

My kitty Jackson started being extra hungry and his fur was spikey this past December and since he was due for a scheduled appointment I asked my vet for bloodwork because I suspected diabetes and sure enough..
We tried the food change because he was getting lots of Temptations and such, until January when I tested for ketones and he had Trace to Small. That's when we started insulin. After going up in dose to 8 units, I took him back and told my vet I wanted him tested for Acromegaly and IAA, and sure enough..

Jackson is currently on 13.5 units. I opted for the Cabergoline treatment. He has been on it for 3 months now. His jaw seems the same (I may imagine this) but he seems to lick his chops more. His snoring has become less frequent and much quieter since starting the Cabergoline, so I think it is helping.

 

[Melissa&Moka]

My kitty Jackson started being extra hungry and his fur was spikey this past December and since he was due for a scheduled appointment I asked my vet for bloodwork because I suspected diabetes and sure enough..
We tried the food change because he was getting lots of Temptations and such, until January when I tested for ketones and he had Trace to Small. That's when we started insulin. After going up in dose to 8 units, I took him back and told my vet I wanted him tested for Acromegaly and IAA, and sure enough..

Jackson is currently on 13.5 units. I opted for the Cabergoline treatment. He has been on it for 3 months now. His jaw seems the same (I may imagine this) but he seems to lick his chops more. His snoring has become less frequent and much quieter since starting the Cabergoline, so I think it is helping.

Wow 13.5 2x a day? Happy to hear his snoring is improving, from what I've read the physical changes probably wont change with treatment even surgery/radiation. I'll stay tuned for your Cabergoline journey <3

 

[Wendy&Neko]

Hello and welcome. Don't blame yourself for what has happened. Not all vets are familiar with acromegaly or think to look for it, so good for you on insisting on getting the testing done. I had to practically beg for tests for my Neko way back when. The study showing about 1 in 4 diabetic cats have acromegaly is somewhat new (2015).

13.5 is not a big dose for an acrocat. Dropping back down is dose is the wrong direction. Are you home testing her for ketones? Regarding her insulin dose, if you are home testing her blood sugars and interested in our help, we can help you get her to a good insulin dose more quickly.

I requested an appointment with a cardiologist to schedule a CT/MRI not sure which is best in this case.

The cardiologist will check her heart with an echocardiogram, which is a type of ultrasound. Given she has acromegaly, and heart conditions are common, this is a good idea. If nothing else, you will get a baseline. Oregon State U veterinary program teaches cardiology, Neko's cardiologist vet got his degree there. Just mentioning that cause sometimes services are cheaper at vet schools.

The CT or MRI would check the pituitary tumour and be a different type of specialist. It is also quite expensive and I'm not sure you need it at this time, unless you just want to know how large the benign pituitary is. Cats with small tumours do better with the cabergoline and surgery options. My girl had SRT radiation therapy, as that's all that was available at the time of her diagnsosi. We drove three days to Colorado State University at the time cause it wasn't available many places.

 

[Melissa&Moka]

Hello and welcome. Don't blame yourself for what has happened. Not all vets are familiar with acromegaly or think to look for it, so good for you on insisting on getting the testing done. I had to practically beg for tests for my Neko way back when. The study showing about 1 in 4 diabetic cats have acromegaly is somewhat new (2015).

13.5 is not a big dose for an acrocat. Dropping back down is dose is the wrong direction. Are you home testing her for ketones? Regarding her insulin dose, if you are home testing her blood sugars and interested in our help, we can help you get her to a good insulin dose more quickly.

The cardiologist will check her heart with an echocardiogram, which is a type of ultrasound. Given she has acromegaly, and heart conditions are common, this is a good idea. If nothing else, you will get a baseline. Oregon State U veterinary program teaches cardiology, Neko's cardiologist vet got his degree there. Just mentioning that cause sometimes services are cheaper at vet schools.

The CT or MRI would check the pituitary tumour and be a different type of specialist. It is also quite expensive and I'm not sure you need it at this time, unless you just want to know how large the benign pituitary is. Cats with small tumours do better with the cabergoline and surgery options. My girl had SRT radiation therapy, as that's all that was available at the time of her diagnsosi. We drove three days to Colorado State University at the time cause it wasn't available many places.

We dropped down because the internist thought she was experiencing a Somogyi effect at 5 units, I expect to go back up. I am testing her ketones, they have been pretty high but the internist said that because we changed her dose her numbers may be all over the place. Now I need to figure out how to increase insulin and by how much and when for Moka while we get the labs/imaging done.

The internist wants to get an echocardiogram done, then to get an MRI or CT scan to see how large the tumor is. The options she gave after that were surgery or radiation, though I emailed her about cabergoline in the interim since surgery and radiation are super expensive and I'm not sure how I'm going to cover these costs.

How did Neko respond to the radiation?

 

[Wendy&Neko]

Not necessary to get the MRI or CT scan done, unless you plan to proceed with surgery or radiation. And then the place you get it done will want to do their own CT or MRI so you will pay for it twice. Back in the day, Neko's first SRT cost $4000. Now it is more like 4-5 times that cost, depending where you get it done. Neko's dose was at 8.5 units when she had the SRT done. She responded really quickly and got down to about 0.75 units over about a year or so and hovered around there. Most important, acro symptoms faded and she became a happy cat again. Then 3 years later the tumour grew again. Not rare, but uncommon. I got SRT done again, by which time the cost had doubled. And don't forget your own travel and hotel costs if you have to go anywhere outside your town.

Somogyi has been proven to happen rarely in case, especially those started at a low dose, increased in safe amounts, and have their blood sugars monitored. Since your kitty has acromegaly, it is likely Moko needs more insulin. I'd be worried about higher ketones too, that can be dangerous. And those higher ketones are another sign her insulin dose is too low.

If you want help with insulin dosing, we can help. You'll see that most of us have spreadsheets in our signatures, where we can share blood sugar data. More detail on how to create on here: New? How You Can Help Us Help You! We also have a couple Lantus dosing methods and most of us follow one or the other as a way to get your cat into good blood sugar numbers as quickly and safely as possible. I got tired of waiting for the vet to get back to me on dosing and seeing Neko in high numbers. A locum vet told me to follow the Tight Regulation dosing method on FDMB, so I did.