06/26 Simon - AMPS 384 +2 314 +4 196 +6 129 +8 91 +10 64 PMPS 84

salmonlover

salmonlover

Member Since 2026
Sorry to hear about the family emergency. I hope all is good now. Nice to see Simon is still holding onto some greens occasionally - though I'd like to see him overall flatter and ditch those >300.

Interesting on the IGF-1 number. What exactly did the results say? I read that >916 is positive for acromegaly and above 700 is gray zone.

Is 16 lbs what Simon has weighed for a while? Has the vet told you what his ideal weight was? Neko was just under 15, but part Maine Coon. Her vet told me she was a good weight.

Was the IAA also tested?
 
Wendy&Neko said:
Sorry to hear about the family emergency. I hope all is good now. Nice to see Simon is still holding onto some greens occasionally - though I'd like to see him overall flatter and ditch those >300.

Interesting on the IGF-1 number. What exactly did the results say? I read that >916 is positive for acromegaly and above 700 is gray zone.

Is 16 lbs what Simon has weighed for a while? Has the vet told you what his ideal weight was? Neko was just under 15, but part Maine Coon. Her vet told me she was a good weight.

Was the IAA also tested?
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Thank you so much!

The results say: The concentration of insulin-like growth factor 1 (IGF-1) is mildly increased and leaves open the possibility of excess secretion of growth hormone (hypersomatotropism). This result should be interpreted in combination with clinical signs and additional laboratory test results. If the clinical presentation warrants continued suspicion (e.g.,diabetes mellitus and/or typical physical signs associated with acromegaly), rechecking IGF-1 concentration in a few months is one option for further laboratory investigation.

The vet said it is neither ruled out nor supportive.

He's always been a huge cat! It is has been hard to keep him at 16lbs. He weighed up to 20lbs at one point. He's not food motivated and he doesn't eat a lot, he's just very large. Not part Maine Coon, but the animal shelter that took in the litter suspected he is mixed with an oriental breed.

The IAA test failed because the sample wouldn't freeze due it being too fatty.

Looking at some studies it seems hyperthyroidism may also increase levels. I guess I'm going to have to retest in a few months?
 
I think a test in a couple months is a good idea, along with a fasted (if possible late cycle) blood test to try the IAA test again. Maybe the result isn't supportive, but I'd call it suggestive with the diabetes and higher dose than normal. Only about 35% of acros have clinical signs on diagnosis so that's not always a helpful clue. And we've seen confirmed acros with smaller doses.

What was Simon's weight when he got the diabetes diagnosis, vs now?

Could you point me to the link to studies on hyperT increasing levels? Always trying to educate myself. The TSH (thyroid stimulating hormone) is also produced in the pituitary, which is where the benign tumour causing acromegaly resides. Just curious if there is some cross over between the two. It's not uncommon to see hyperT and acromegaly in a cat. I presume he's well controlled on the hyperT?
 
Wendy&Neko said:
I think a test in a couple months is a good idea, along with a fasted (if possible late cycle) blood test to try the IAA test again. Maybe the result isn't supportive, but I'd call it suggestive with the diabetes and higher dose than normal. Only about 35% of acros have clinical signs on diagnosis so that's not always a helpful clue. And we've seen confirmed acros with smaller doses.

What was Simon's weight when he got the diabetes diagnosis, vs now?

Could you point me to the link to studies on hyperT increasing levels? Always trying to educate myself. The TSH (thyroid stimulating hormone) is also produced in the pituitary, which is where the benign tumour causing acromegaly resides. Just curious if there is some cross over between the two. It's not uncommon to see hyperT and acromegaly in a cat. I presume he's well controlled on the hyperT?
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Agree, being right at 916 makes it seem likely it is acromegaly. He was last at 20lbs about 3 years ago, and was at 16.5lbs in November last year and then dropped to 15.5lbs in February at time of diagnosis, and is now at 16lbs. I initially thought the weight loss was good until I could see/feel his spine and realized it was muscle loss.

He's been on 2.5mg methimazole topical 2x per day and his levels dropped back into normal. Not saying that the high IGF-1 is solely related to the thyroid treatment but it is interesting to consider compounding factors affecting the IGF-1 level.
Insulin-like growth factor type 1 concentrations in hyperthyroid cats before and after treatment with thiamazole - PMC

At what IGF-1 level is cabergoline considered?
 
salmonlover said:
At what IGF-1 level is cabergoline considered?
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Ideally when you have confirmation of acromegaly. Though cabergoline is given to female cats to terminate pregnancy, but that is obviously not long term. Interestingly enough, there was a study going on in the UK where non diabetic acros were getting cabergoline to see if it helped. And I just found another study, from the folks in South America who have done larger scale studies on cabergoline. Paper about it here: Successful response to cabergoline treatment in a non diabetic cat with hypersomatotropism and pituitary macroadenoma. Oddly enough, this paper also refers to under 916 as being the reference interval.

Some interesting reading: Cabergoline treatment for acromegaly - side effects. and this one I have a four year old female cat with Acromegaly. Both not diabetic yet, diagnosed acromegaly and on cabergoline.

Thanks for the additional link. As you can tell, I can geek out on acromegaly. 🤣
 
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Regarding the paper on IGF-1 and hyperthyroidism, none of those cats with treated hyperthyroidism were even close to the IGF-1 levels considered to be positive for aromegaly.

And another quote might be of interest to you, from PrimVeterinary - Evidence-Based Veterinary Knowledge Platform
Cabergoline is most effective in cats with "mild" disease, defined as a pituitary height <4 mm and baseline IGF-1 <1500 ng/ml.
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Ashley I’m so glad to see you. I’ve been worried and I’m very sorry to hear about your family emergency. I hope everything is ok now.

Normally, I wouldn’t suggest an increase with a 65. The caveat is that is a 64 on a Libre which tends to run low and that BG doesn’t really fit in with the other BGs in that timeframe. I’d be tempted to raise his dose tomorrow to 8u if you will be around to monitor him and if he doesn’t come back down into lower greens tonight.

I’m glad Wendy is able to help out on the acro question.
 
Wendy&Neko said:
Ideally when you have confirmation of acromegaly. Though cabergoline is given to female cats to terminate pregnancy, but that is obviously not long term. Interestingly enough, there was a study going on in the UK where non diabetic acros were getting cabergoline to see if it helped. And I just found another study, from the folks in South America who have done larger scale studies on cabergoline. Paper about it here: Successful response to cabergoline treatment in a non diabetic cat with hypersomatotropism and pituitary macroadenoma. Oddly enough, this paper also refers to under 916 as being the reference interval.

Some interesting reading: Cabergoline treatment for acromegaly - side effects. and this one Cabergoline treatment for acromegaly - side effects

Thanks for the additional link. As you can tell, I can geek out on acromegaly. 🤣
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Interesting. I wondered if non-diabetic cats could be acro, I didn't know they could.
Ginger was always a petite little thing until I got Jackson when she was about 10 years old. She was always 9 pounds and then when I got Jackson she was 11 pounds and her head and paws grew big. I often wanted to share pictures of how big her paws were.
 
Wendy&Neko said:
Ideally when you have confirmation of acromegaly. Though cabergoline is given to female cats to terminate pregnancy, but that is obviously not long term. Interestingly enough, there was a study going on in the UK where non diabetic acros were getting cabergoline to see if it helped. And I just found another study, from the folks in South America who have done larger scale studies on cabergoline. Paper about it here: Successful response to cabergoline treatment in a non diabetic cat with hypersomatotropism and pituitary macroadenoma. Oddly enough, this paper also refers to under 916 as being the reference interval.

Some interesting reading: Cabergoline treatment for acromegaly - side effects. and this one I have a four year old female cat with Acromegaly. Both not diabetic yet, diagnosed acromegaly and on cabergoline.

Thanks for the additional link. As you can tell, I can geek out on acromegaly. 🤣
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This is really interesting! Thank you for sharing!
 
Marje and Gracie said:
Ashley I’m so glad to see you. I’ve been worried and I’m very sorry to hear about your family emergency. I hope everything is ok now.

Normally, I wouldn’t suggest an increase with a 65. The caveat is that is a 64 on a Libre which tends to run low and that BG doesn’t really fit in with the other BGs in that timeframe. I’d be tempted to raise his dose tomorrow to 8u if you will be around to monitor him and if he doesn’t come back down into lower greens tonight.

I’m glad Wendy is able to help out on the acro question.
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Thank you so much! I'm thinking about holding the dose a little longer as our schedules have been super erratic and stressful the past week to see if he drops into the green again before moving to 8U.
 
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