06/20 amps 412 Need help with cat diagnosed with acromegaly, recent hypo event

Baxterandbess

Baxterandbess

Member Since 2025
Baxter had a hypo a few days ago, I caught it AFTER his vet appointment (regular vet was out and we saw two different ones that week) I had got really bad about keeping up Baxter's spreadsheet because my mental health has been down the gutter..and so I am now trying to go back and fill in from what I had scribbled in a notebook from before we switched over to the relion meter with time memory. I need to be using the spreadsheet and do more regular curves.

I feel like every time I get him in a relatively acceptable range he bounces like crazy. Should I be looking into retesting from msu? I can't afford imaging and he has kidney issues..
 
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you are doing GREAT! It isn’t easy, but you are doing the best you can. Acceptable range is a broad term- is it a range you find acceptable? Your vet finds acceptable? Or?? My cat has been dx acro for over a year, and I still get bounces. Sometimes its because he got a high carb treat by mistake, and sometimes it just happens. You caught the hypo event, filling out the spreadsheet, and that is good. Show yourself some kindness and grace, and know that sometimes things happen.
 
Thank you for being so gracious.. I think acceptable for me would be just keeping him within the renal threshold. I'm just so scared that I've missed a hypo before because he seems to always get really high reads closely following anything under 200, but I never know if I'm shooting too high or too low.
 
Can you tell me how you figured he had a hypo? I don't see any numbers indicating a hypo on his spreadsheet. With a human meter like the Relion, we typically give high carb food if they go under 50. I did see this extra information from your post on Feline Health: 6/20 new-ish from before page was reactivated

He is bouncing, and that's perfectly normal. I've seen a cat (non acromegaly) bounce for 8 years on insulin. Try not to worry about the bouncing. Cat's bounce either because they see numbers lower than they are used to, or because their numbers drop too quickly. The way to help them to bounce less is to get them to a dose where they see more lower (but safe) numbers so get used to them, or in the case of fast drops, learn how to use food to slow down the drops.

Cats do not bounce because they get into higher carb food though it can cause higher numbers. I notice on the spreadsheet that he is getting Tresaderm. That includes a steroid and can also raise blood sugar numbers. How much longer will he be on the Tresaderm?

The reason Baxter's numbers are so high now are because you lowered his dose too much. I don't know if you are following a particular dosing method, but at most we would have lowered his dose to 5.25 units. At 3 units, he is spending all his time above renal threshold. His dose needs to be increased.

Somogyi does not exist in cats, there has been research showing that. Unfortunately not all vet are up on that.

Baxterandbess said:
Should I be looking into retesting from msu? I can't afford imaging and he has kidney issues..
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Absolutely no need to retest from MSU. He has acromegaly, that won't change. Also no need to do any imaging. The only people who have had imaging done are those that proceed with either radiation therapy or pituitary surgery, where imaging is needed to figure out how to proceed. What you might want to consider is a medication called cabergoline, which has helped a number of acrocats here. Lots of posts about it on this forum about it.
 
Before I tested him that morning he barfed up a puddle of bile (unless it was just very dilute urine) near his litterbox, close by where it looked like that same night he had some foamy spit up and a hairball, then, later that morning he was crying from the other room and when I came in it looked like he was walking away from his "secondary" litterbox but nothing in it. It may not have been a hypo after all? I was testing him every 15 minutes and it took almost two hours to get his bg to budge after honey and carby food. Poor Baxter... if it's not hard enough his mom is cooky too..


I haven't noticed much correlation between his bg and the tresaderm drops, if anything it seems like his bg is lower. His ears will probably always need the drops the vet said unless we got total ablation. I don't know why they just never stop getting infections. Ceruminous Cystomatosis plus chronic inflammation.
 
Wendy&Neko said:
Can you tell me how you figured he had a hypo? I don't see any numbers indicating a hypo on his spreadsheet. With a human meter like the Relion, we typically give high carb food if they go under 50. I did see this extra information from your post on Feline Health: 6/20 new-ish from before page was reactivated

He is bouncing, and that's perfectly normal. I've seen a cat (non acromegaly) bounce for 8 years on insulin. Try not to worry about the bouncing. Cat's bounce either because they see numbers lower than they are used to, or because their numbers drop too quickly. The way to help them to bounce less is to get them to a dose where they see more lower (but safe) numbers so get used to them, or in the case of fast drops, learn how to use food to slow down the drops.

Cats do not bounce because they get into higher carb food though it can cause higher numbers. I notice on the spreadsheet that he is getting Tresaderm. That includes a steroid and can also raise blood sugar numbers. How much longer will he be on the Tresaderm?

The reason Baxter's numbers are so high now are because you lowered his dose too much. I don't know if you are following a particular dosing method, but at most we would have lowered his dose to 5.25 units. At 3 units, he is spending all his time above renal threshold. His dose needs to be increased.

Somogyi does not exist in cats, there has been research showing that. Unfortunately not all vet are up on that.


Absolutely no need to retest from MSU. He has acromegaly, that won't change. Also no need to do any imaging. The only people who have had imaging done are those that proceed with either radiation therapy or pituitary surgery, where imaging is needed to figure out how to proceed. What you might want to consider is a medication called cabergoline, which has helped a number of acrocats here. Lots of posts about it on this forum about it.
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I could really use suggestions on a solid dosing protocol for Baxter. Would you say it is safe to go back that far up to 5 units from 3 units? I only increased to 3.5 this morning. He eats a moderately low protein and low carb wet food to help with his kidneys. The k/d I kept on hand as emergency carbs. I'm not sure really whether they worked. That could be a good thing or a bad thing?

I want to try cabergoline and my vet finally said she would look into dosing for me. That was before I brought him in for an urgent care visit over what we still have not identified if it wasn't a hypo... I want to make sure I'm prepared to handle any possible side effects because his system has taken a lot of hits. Do you know of many ckd kitties who have been on cabergoline?

I wish I knew a better answer for his ears than the tresaderm. His old vet told me it is not supposed to go through their bloodstream when I asked him your same concern, but our current vet said she doesn't like giving anything with steroids to diabetic cats. His ears never stop getting infected and raw unless I keep him on the drops. If you have any ideas I'm very open.. I really don't like variables.....
 
How much does Baxter weigh? Dosing of cabergoline is 10 mcg/kg of cat. CKD is quite common for acro cats so yes some cats on cabergoline have had CKD. Side effects, mostly at the beginning of using it, are possible Gi issues (vomit or diarrhea). Not all cats see those side effects.
Baxterandbess said:
I could really use suggestions on a solid dosing protocol for Baxter. Would you say it is safe to go back that far up to 5 units from 3 units? I only increased to 3.5 this morning. He eats a moderately low protein and low carb wet food to help with his kidneys.
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We have a couple dosing methods cats here use. Both are described in this Sticky Note: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) Since you are feeding low carb wet food as his primary food, you could use either one. I generally suggest Tight Regulation for cats with acromegaly, just because the tumour growth can mean it's good to have an option for quicker increases than the one week allowed by Start Low Go Slow. But choice of dosing method really depends on your life style and what works for. you. TR requires at least two tests per cycle, the preshot plus one other, both AM and PM. Not everyone can do that.

Side note on food you are feeding him, I'd also recommend a food that is fairly low in phosphorus. This food chart list contains one that has foods good for both diabetes and CKD. Unless he's on a later stage of CKD, low protein is not as important. The diabetes CKD list also shows you the protein if that is something you need to consider.

For the Tresaderm, try creating a new post on the Feline Health forum, asking for suggestions for diabetes safe ear drops.
 
He's about 12 lb! Yes, the food he eats is one of the "start here" foods on the ckd chart (I think similarly to the fdsg page from fb it was from the ckd forum where I'm getting a new spreadsheet started for him) he gets the fussie cat market fresh turkey and guinea fowl... it's fancy pants stuff but it's less expensive than k/d which most cats can hardly stand... I don't know what stage of ckd he is in but his kidney values actually did improve after the switch.. I'll see what I can find from other members about the tresaderm as well. Again I've been terrible about keeping up my spreadsheet so neglected to log that to refer to but maybe someone else has dealt with chronic ear inflammation.
I guess the roomp/rand is TR, point being loosely following doesn't work. I have narcolepsy and trying to stay up late to get another test in starts becoming not able to wake up in the morning and screwing up his dosing schedule. I need to figure out something that works better for my lack of circadian rhythm. It's ok every once and a while or if I see something concerning I will stay up with him, but every night really messes me up.
 
Have you made a change to his spreadsheet? It now says I need permission to open it.

12 lbs is about 5.5 kg, so his dose would be 55mcg of cabergoline. Some vets start with every other day, though most people here end up with dosing every day. You can get it compounded in liquid that mixes in with his food. Apparently bacon marshmallow flavour is well received!

For the CKD, on his last lab results, what were the values for his creatinine, BUN, SDMA (if you have it), and urine specific gravity (or USG)? Those values help determine the stage of CKD. A lot of us keep our lab results in the spreadsheet Labs page. I found it handy for tracking trends.

For the night time tests, many people just get a before bed test. So if you are still up 2-3 hours after the shot, that would work.. If not, then SLGS would be better for dosing. My dear aunt had narcolepsy, I get how your sleep is important to you.
 
Sorry about that! I got a new spreadsheet because I had been using the version someone altered for fb. I fixed it.
Wendy&Neko said:
Have you made a change to his spreadsheet? It now says I need permission to open it.

12 lbs is about 5.5 kg, so his dose would be 55mcg of cabergoline. Some vets start with every other day, though most people here end up with dosing every day. You can get it compounded in liquid that mixes in with his food. Apparently bacon marshmallow flavour is well received!

For the CKD, on his last lab results, what were the values for his creatinine, BUN, SDMA (if you have it), and urine specific gravity (or USG)? Those values help determine the stage of CKD. A lot of us keep our lab results in the spreadsheet Labs page. I found it handy for tracking trends.

For the night time tests, many people just get a before bed test. So if you are still up 2-3 hours after the shot, that would work.. If not, then SLGS would be better for dosing. My dear aunt had narcolepsy, I get how your sleep is important to you.
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Sorry about that! I swapped over from the one I picked up off of fb. It was set to restricted but I fixed it. Can you see it now?
 
I need to get his more recent labs from the vet.. his bun and creatinine went back down to the higher end of acceptable range but then were slightly more elevated last month. I will post those hopefully sometime early this coming week.
 
Baxterandbess said:
Sorry about that! I got a new spreadsheet because I had been using the version someone altered for fb. I fixed it.

Sorry about that! I swapped over from the one I picked up off of fb. It was set to restricted but I fixed it. Can you see it now?
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For the dosing, do I need to follow that starting from where his dose is now? Or would you recommend going back to 5.25?
 
Wendy&Neko said:
Have you made a change to his spreadsheet? It now says I need permission to open it.

12 lbs is about 5.5 kg, so his dose would be 55mcg of cabergoline. Some vets start with every other day, though most people here end up with dosing every day. You can get it compounded in liquid that mixes in with his food. Apparently bacon marshmallow flavour is well received!

For the CKD, on his last lab results, what were the values for his creatinine, BUN, SDMA (if you have it), and urine specific gravity (or USG)? Those values help determine the stage of CKD. A lot of us keep our lab results in the spreadsheet Labs page. I found it handy for tracking trends.

For the night time tests, many people just get a before bed test. So if you are still up 2-3 hours after the shot, that would work.. If not, then SLGS would be better for dosing. My dear aunt had narcolepsy, I get how your sleep is important to you.
Click to expand...
I can definitely manage +2 nightly and go from there if I need to stay up with him longer.
 
Yes, I can see the spreadsheet. Thanks for making the change.

I would go back to either 5.0 or 5.25 tonight or tomorrow morning. Sometimes cats have a strong first cycle at a dose, so you probably don't want that to be tonight.
 
Wendy&Neko said:
Yes, I can see the spreadsheet. Thanks for making the change.

I would go back to either 5.0 or 5.25 tonight or tomorrow morning. Sometimes cats have a strong first cycle at a dose, so you probably don't want that to be tonight.
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I'm still waiting on Baxter's bloodwork results. He is also scheduled for those again on July 7. I did put in his last couple of urinalysis results.
I also tested him a few hours after his tresaderm drops.
Should I be concerned his bg went down right before his pm dose?
While he's still up in these 300's do I need to worry if his +2 isn't going up?
 
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