I'm so sorry, MJW. I'm glad you have an answer though and can figure out the next steps. We are so lucky to have @Wendy&Neko she has kept up with all of the research and is such an amazing resource. I hope Yum can get in to better numbers soon. Sending lots of love for you and Yum 
Oh, honey I am so, so sorry! It is not a diagnosis that anyone would hope for, but at least you know where to go. I have been doing a ton of research on acromegaly and treatment options, so if you have any questions please ask. However, I am sure there are a ton on here that know far more than I. But, perhaps, we can learn together!
lots of hugs, sad but at the same time relieved for you that there is an explanation! I hope the road ahead only becomes brighter.
If you like spending money, sure you can. If your vet is using the international level and positive is above 1000, there's a pretty good chance you don't need the CT/MRI to confirm. I never got the CT scan until part of the SRT process. There are some kitties that show false negative on IGF-1, but typically if tested within 75 days of starting insulin. Yum has been on insulin a lot longer. With the spreadsheet and IGF-1 number, it's unlikely to be false. And a CT/MRI involves anethsesia. I like to avoid that unless there is a good reason. A number of our acros have or develop heart issues.
Treatments are a trade off between money, ability to travel, and what's near where you live. Cabergoline wasn't a possible treatment when Neko had her diagnosis. Some kitties have had success with it, some not as much. But it's a cheaper solution than anything else out there. Paul had to stop cabergoline before Bronx had SRT. Some people don't treat their acros, other than getting them to a good dose of insulin and managing symptoms as they arise. That's the most important thing you can do, regardless of doing anything else as well. At some point, Lev may be a consideration.
Please don't forget to take time to breath.
She doesn't want that much love and attention lately. She wants food and food and food and water. She is more lethargic.Please don't forget to take time to breath.
The diagnosis is crappy and no doubt a blow to your gut, but Yum doesn't know what she has. She wants the same love and attention from you today as she did yesterday. Wendy and the other high dose parents will surround you with their expertise, suggestions, advice, and information. Everyone will help as best we can.
Drugs will slow or stop systemic issues. There has been a cat go off of insulin with the long lasting form of paseriotide too. Yes, the tumour if it gets too large can cause issues. It's something I've seen here just once. I had two CT's done of Neko. The second CT 3 years after her first SRT, the tumour was much smaller, and it was described as "tiny" the first time (0.146mm). Size of tumour has no relation to IGF-1 number. Kitties undergoing SRT a couple weeks before her had pea sized tumours with half the IGF-1 number. And both of them needed higher doses than Neko did. ECID. So true with acros.
I have no idea what the rules are for taking cats to England. They have had people go there from Europe. You could contact RVC and see if they know. It's been ages since someone here had a hypophysectomy done in the US - I'm sure the success rates are better now. We did have one person who posted here, went to WSU (Spokane), but her cat had some bleeding from surgery. I didn't hear how that ended up. Here is the story from an English member who had Louie treated at RVC. The surgery itself is cheaper than SRT, but typically cats have to stay longer to recover, up to two weeks. SRT is not invasive.
NCSU is a very good place for SRT. Dr. Kathy Lunn is very knowledgeable about acromegaly. She moved to NCSU from CSU just before we went to CSU, which is the place that had the most SRT experience at the time we went. This post lists some places to get treatment. I don't know about Texas A&M. There are some private clinic chains with SRT, this is one. I don't know of a list of current places to get SRT. Maybe your vet can help? Or an IM vet?
Two days in a row. And that's without R in the picture.
Do the drugs slow tumor growth? Good to know they slow the systemic issues. You think the paseriotide is better than the cabergoline? I read paseriotide causes diarrhea. The cabergoline side effects were even scarier.
The quarantine stopped when they joined the EU. I wonder how likely a candidate Yum is for surgery? She turns 16 in March and she has CKD.
Thanks!
Honestly, the size of the study groups was not very large. And not been done long enough to provide long term data on effects. Some cats had to stop the paseriotide study due to GI issues. I seem to remember that was for the daily version of the drug and the long term one (once a month dosing) was better that way. Some people on cabergoline have mentioned loss of appy, but not much else.
I gave her the .25R at AMPS+11.I see pink.
By the way, forgot to answer your question about dosing above, but increments are by 1.0 units instead of 0.5 units once the total dose gets to 10 units. If you are seeing low blues, you might increase by 0.5 units, or "fatten" the dose. We'll wait to see the results of the IAA before seeing if there are more tweaks to dosing.
I thought I read on a google overview that SRT was one treatment, one day. But I guess you and @Bronx's dad both did 5 treatments at once, one a day? Lots of anesthesia.
Bronx's SRT was 5 days of radiation. Brought him in a month ahead for an x-ray of the heart and a cat scan, so 6 total days of anesthesia. They did recommend an ultrasound too on that day for a better look at the heart since the x-ray did show some enlargement from the acro.
Last time I looked, Bronx's kidneys were in better shape than Yum's. I am also concerned the cardiologist might have been wrong in dismissing her heart murmur last August as nothing. I hope the vets can give me true educated opinions on how well she could handle repeated anesthesia, surgery, and even air travel. I won't put her in a cargo hold. Yum's sister passed away on the operating table because she wasn't healthy enough.
Thanks for this link.
You are strong to keep looking in on the forum. Sometimes it makes me cry.I don't look in much these days but I do keep on eye on any of the acro kitties and I was so sorry you finally got confirmation of Yum's acro, but at least you now know the reason behind Yum's resistance. I wish you the very best of luck with whatever treatment route you decide to go down but in the meantime, listen and learn from the very experienced team here (Wendy and Julie for acro, Marje and Sandy for R dosing), they provided invaluable support for me and Crystal when we arrived here in panic mode after Crystal's dx and their knowledge and expertise allowed us to have more precious time together. The RVC in London were also first class in answering many queries by email; they have a specialist acro clinic and are probably the best in the world, so call on all the experience available to you to enable Yum to have a good quality of life. Many hugs at this stressful time to you and your sweet girl.
Oh great! I read three times though to be sure, but still missed it. This means that it's a country from which you can go through the "normal" procedure for importing a cat.