08/19 George AMPS 170 PMPS 200 IGF-1 402 & IAA negative

Discussion in 'Lantus / Levemir / Biosimilars' started by George’s Mom, Aug 19, 2022.

  1. George’s Mom

    George’s Mom Member

    Joined:
    Jun 25, 2022
    Yesterday

    Today was a little flatter day. I got the results from MSU. IAA was negative. IGF-1 was 402. Commentary on report states this:
    Thank you for the clinical information included on the submittal form. This insulin autoantibody index result is normal or negative for the presence of insulin-binding autoantibodies. The serum concentration of insulin-like growth factor 1 (IGF1) is increased and acromegaly is a likely differential diagnosis. It is recognized that increases in this hormone may occur as a metabolic response to diabetes mellitus in some cats, but this result is clearly higher than what would be expected in that case. Typical physical changes associated with acromegaly would further support such a diagnosis.
    Jean Brudvig, DVM, PhD, DACVP Academic Specialist, Endocrinology

    I will post the actual report once I have time to redact it. I’ve also got his most recent labs to upload as well (labs are in my signature). I will try to upload tonight.
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Rachel. I’m sorry you have the Acro diagnosis for George. I will tag @Wendy&Neko for you.
     
  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Rachel - this latest result is not much of a surprise, given he was positive a year ago. It's some good news that you don't have IAA to deal with as well. Did the vet say anything about the results? Just so you know, the IGF-1 number doesn't correspond to size of the pituitary tumour and the number can go up and down in cats, along with the growth hormone.

    First, what questions do you have?

    I think going forward you should seriously consider giving him cabergoline. It's a daily medication, once a day. We've had a number of cats with good success with it. A few have gone off of insulin, but more important, quality of life has improved and usually the insulin dose goes down. Of course the vet would have to get on board with this, but we can give you some articles to give to the vet if he/she needs convincing it's a good way to go.
     
    Bron and Sheba (GA) likes this.
  4. George’s Mom

    George’s Mom Member

    Joined:
    Jun 25, 2022
    Thank you! Yes, this wasn’t a surprise but really another validation. Thank you for tagging Wendy. She’s my buddy! :D
    We had talked about getting an echocardiogram, so we did talk about that as a next step. The cardiologist was backed up until January 2023 :confused:. So she was going to send in a referral with urgent markings to see if it might help. Otherwise she can get an echocardiogram done at her facility and interpreted by cardiologist. Just not done by cardiologist. So we’ll see how that goes. We discussed SRT being likely best option minus him being so old and it being so expensive. We also did discuss Cabergoline and I think she would be open minded to trying it. She also sent me some white papers on treatment options. I assume all options I’ve already read about, but I’ll let you know if I read anything new or different.

    I don’t have a ton of questions yet. Here’s one: Do you think SRT would be too much for my 17.5 yr old cat?

    Makes sense on the tumor, I figured it does what it wants, sometimes stimulating more or less growth hormone at its will.
     
  5. George’s Mom

    George’s Mom Member

    Joined:
    Jun 25, 2022
    I didn’t get to this. Will try to upload tomorrow.
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Depend on his heart and level of CKD. Places doing SRT will want to see an echo first. SRT consists of between 2 to 4 days with anaesthesia. Neko got to the point her heart could not take anaesthesia. You might want to read the paper outline I linked in this post: Paper on QOL and response to treatment for acros
     
  7. FrostD

    FrostD Well-Known Member

    Joined:
    May 27, 2020
    Have you noticed any of the typical acro side effects?

    Truthfully I think SRT would be rough and not really extend his life by much. That said, if he's got side effects it may help alleviate those...so it's up to you to weigh risk, costs, and quality/length of life.

    I personally would try cabergoline first. Every cat has a different response to it, but my cat has been on it for a year now and I've not seen any signs of progression (he cannot undergo anesthesia for imaging so can't speak to what's actually happening inside, but all physical exams have checked out, his skull changes stopped, etc).
     

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