? 03/02 Winston Lab results

https://felinediabetes.com/FDMB/threads/02-24-winston-amps-265-4-335.259825/#post-2918421

The Vet called today with Winston's lab results. He confirmed that Winston does have acromegaly. So, what now? He said there is no treatment that can be done where we live and he is not aware of any medication that is available. Do I just keep doing TR as I have been?

 

I'm so sorry, Jennifer. Tagging @Wendy&Neko @Suzanne & Darcy @FrostD, our resident acro kitty specialists. Lots of acromegaly kitties have gotten cabergoline. That seems to be a drug that works well.

 

Thank you, Katherine! Since posting, I have been doing some reading. This drug seems promising. I am going to ask my vet. I don't think he has much experience with acromegaly. Is there an article that I could send him about cabergoline?

 

There are some good, fairly recent articles online, but I'll let the experts point you in the right direction. Here's a condo that could be helpful: https://felinediabetes.com/FDMB/thr...crocats-discussion.184012/page-2#post-2919849

@FrostD's kitty went into remission after starting cabergoline, though I can't recall if we could peg the reduction of his insulin resistance entirely on cabergoline as Mr Kitty had a lot going on at the time.

 

Sorry about the diagnosis but I will say most acro cats still live good lives, so it's by no means a hopeless death sentence!

Wendy is in Canada and will be best to help you there. @Jodey&Eddie is also in Canada, her cats have had both hypophysectomy (surgery to remove the tumor) and SRT (radiation to neuter the tumor) but I believe she brought them to the US for that.

Katherine is right - Mr Kitty did go into remission, and yes it was due to the cabergoline. That's not the norm, but a recent study (linked in the thread Katherine posted earlier) I believe 26% of cats went into remission, 35% had normalized IGF 1 numbers. But I will say - FD remission isn't necessarily the defining goal - you want to manage all the symptoms and side effects of the tumor as best you can (soft tissue growth, organ enlargement, etc). Several caregivers here have noted that cabergoline can improve that.

The Word doc here is a pretty good comparison of the options, with relevant papers linked. It hasn't been updated since it was created, but the info is still pretty accurate: https://www.felinediabetes.com/FDMB/threads/acromegaly-treatment-options.246606/

 

@Jennifer and Winston sorry to hear about the diagnosis. It's hard at first as there's such a learning curve. Melissa is right, I do live with two acrokitties, Eddie (featured here) and his brother, Blue. Both did have hypophysectomy in the U.S and Blue had radiation in the U.S. and in Canada (SRT) a few years after surgery & initial radiation (2018). He's OTJ, though, while Eddie is taking the long way around. After SRT, he's still on insulin meaning that we might yet be dealing with remaining tumour but we'll see. He's had three IGF-1 tests, the first before his surgery, the second after and more recently. Although still over normal, the numbers are decreasing. So, again, we'll see. Are you in Canada? There's a few options and even surgery is now available if you go that route.

All good thoughts for you and Winston.

 

Sorry to hear the results. The most important thing someone said to me at this time I got the same news, Winston does not know he has acromegaly. He is still his same sweet self. Give him a kiss from me.

And in the meantime, keep following TR to get him to a better dose. Over 10 units, I'd increase by 1.0 units at a time, unless you are tweaking an already pretty good dose with some greens. Think of increases as 10-15% of the total dose. Did the vet also test for IAA (insulin auto antibodies)? What was the IGF-1 number?

For you, cabergoline is probably the best choice. I'm trying to see if I can get a copy of this article, this link is just the abstract: https://journals.sagepub.com/doi/pdf/10.1177/1098612X221074924 Your vet might still be interested in the abstract. The very first cat here on cabergoline, Marvin, was from Montreal. Went off of insulin very quickly. Most don't go completely off of insulin, but many have reduced doses and their acro symptoms greatly reduced. Neko had stereotactic radiation therapy, basically the only viable treatment available at the time. We drove 3 days each way to Colorado State University for treatment. It is since more widely available, but not sure if it's in the Maritimes.

 

Hot off the presses from Sienne. Pass this article to your vet.

 

Hi Jennifer. I'm sorry Winston has Acromegaly. I was upset when I first got the confirmation, but Wendy really helped me to adjust to this and to get my boy on Cabergoline. My vet wasn't really familiar with it either. She spoke with a vet at University of Georgia who was supposed to be an endocrine specialist and he really was not up on the latest research on Cabergoline either. I was able to share with my vet some of the information that Wendy gave me and she prescribed the Cabergoline. It really helped reduce Darcy's insulin needs.

Give the handsome Winston some love from me. We are all here for you.

By the way, it looks like you are doing a fantastic job of monitoring and caring for Winston! I'm impressed.