06/21 Puddin AMPS 274, +3 331, +10 327, PMPS 313, +3 435 348,

Wendy&Neko said:
Hoping that PM+3 is a typo on the subject line. ;)

How's the reading going? Got any questions?
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It was totally a typo!

I have read through all of the material. I'm very interested in Cabergoline, I plan to present this option to our vet along with all of the study resources you provided because I would rather not have our next step be the IM vet (the appointment would be end of August at their earliest availability). They already reviewed our case and suggest immediately seeing the radiation department anyways - I don't want to do that.

Is it OK if I increase Puddin's food amount? He's still ravenous and he's getting more than 500 calories/day currently. If yes, would this quantity increase affect his BG numbers much?

Is there a point where he will find some regulation despite the diagnosis? Even without Cabergoline in the picture? Will this continue to increase if the tumor continues to increase?

Thank you, Wendy.
 
Bella & Puddin said:
Is it OK if I increase Puddin's food amount? He's still ravenous and he's getting more than 500 calories/day currently. If yes, would this quantity increase affect his BG numbers much?
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Are you weighing Puddin fairly regularly, like every week or two? I would use the scale as an indicator how much to feed him. You might also see if the vet has an ideal weight for him. Feed more or less to get him where he should be. Neko got around 230 calories. I told her she was not allowed to go above 15 lbs. She had some Maine Coon in her so bigger to start. Vet didn't want her below 13 lbs. Some acros can get very large. The problem comes if they get arthritis as one of the acro side effects, then any extra weight can really be a problem. When I started feeding Neko raw food, I found that it did a better job at filling her up, even though the volume was slightly less than that of canned. She got 4 oz of raw vs one 5.5 oz can of canned.

Bella & Puddin said:
Is there a point where he will find some regulation despite the diagnosis? Even without Cabergoline in the picture? Will this continue to increase if the tumor continues to increase?
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How regulated is more ECID. Our saying is that there is a dose out there for every cat. I have yet to see one who didn't start seeing better numbers at some point. Have you looked at spreadsheets of other acros or suspected ones? Take a look at Shooter as an example of one untreated and confirmed acro, Mini Purrl not confirmed but higher dose so probably. Malcolm (confirmed) was starting to make good progress before something else took him away. :(

I have seen an acro cat all the way up to 50 units of Levemir and 30 units of R (total 80) but still well regulated. Seeing a cat get up to 80 units is not common (seen a couple), and Puddin's spreadsheet doesn't look like he'll need to get anywhere near that high. That was just an extreme example of a regulated cat that wasn't treated.

Using R in addition to the Lantus might be something for you to consider. It's an advanced technique that someone would have to help you learn to use. It's a short acting insulin, duration about 4-5 hours, that lowers the BG enough to give Lantus a better number to work with. Typically you'd start on a small R dose given at PS time. Puddin has an unusually late Lantus onset, which makes giving R easier in some ways. R might be in and out before the Lantus onset.

Are you considering not giving cabergoline? For those that can, I would strongly recommend treating an acro. Back in my time, a lot more people could not because the only option was radiation therapy. Surgery came later and even more expensive and even harder to get. If you can treat a cat, the acro side effects can be reduced and delayed. Insulin dose can be reduced in a lot of cats, but over all quality of life can be improved.
 
Wendy&Neko said:
Are you weighing Puddin fairly regularly, like every week or two? I would use the scale as an indicator how much to feed him. You might also see if the vet has an ideal weight for him. Feed more or less to get him where he should be.
I am weighing him weekly and he's stayed around 15lb. I will ask the vet if he thinks the weight should go up - I think he could stand to gain even 2lbs (his spine is still a bit noticeable and his waist goes in a bit much).

Using R in addition to the Lantus might be something for you to consider. It's an advanced technique that someone would have to help you learn to use. It's a short acting insulin, duration about 4-5 hours, that lowers the BG enough to give Lantus a better number to work with. Typically you'd start on a small R dose given at PS time. Puddin has an unusually late Lantus onset, which makes giving R easier in some ways. R might be in and out before the Lantus onset.
Is it called "R"? Do vets know of this one already? I might be a little intimidated to try something like this - I'll think about this one and ask the vet.

Are you considering not giving cabergoline? For those that can, I would strongly recommend treating an acro. Back in my time, a lot more people could not because the only option was radiation therapy. Surgery came later and even more expensive and even harder to get. If you can treat a cat, the acro side effects can be reduced and delayed. Insulin dose can be reduced in a lot of cats, but over all quality of life can be improved.
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I'm very much considering Cabergoline. Especially after reading the study you sent me and knowing that you also see it as a really good idea. I hope the vet is open to trying this with us and providing the prescription - this is something I want to discuss with him ASAP.
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To quote individual items, just highlight the one item, and select the Reply bubble that shows up. Then move onto the next item.
Bella & Puddin said:
Is it called "R"? Do vets know of this one already? I might be a little intimidated to try something like this - I'll think about this one and ask the vet.
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It's also called Regular. Brand is Humulin or Novolin. Vets will use it in cases of something like DKA where they have to get kitty's BG down quickly.

If your vet likes to see the use of R in an acrocat in a paper:
Acromegaly in 14 Cats by Mark E Peterson, Deborah S. Greco, John F. Randolph, Scott D. Moroff, Clinton D. Lothrop
Journal of Veterinary Internal Medicine, Volume 4, Issue 4, Feb. 2008
http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.1990.tb00897.x/pdf
 
Forgot to mention, depending where you live, you might not need a prescription for R. Human diabetics use R to get over the food bump of a meal. It's pretty cheap for a vial, you use the same syringes as for Lantus.
 
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