12/13 Eddie AMPS 319 +8 382 PMPS 369 +8 241

@Wendy&Neko From your experience (even on FDMB) of Cabergoline use, can you speculate on what's happening with Eddie. The spreadsheet suggests a few things and I"m just hoping to hear your thoughts as neither the IM vet nor the regular vet have any experience with Cabergoline.

Do you have a sense of how dose (amount/timing) is to be evaluated? How does one make decisions in these cases??
 
First of all, it's likely Eddie is bouncing from the PM cycle of the 11th. Bouncing is a fact of FD life, regardless of cabergoline or not.

Any thoughts on restarting his ABs for his dental issues? That might also be impacting his numbers.

I never used cabergoline, it was pretty much too late for Neko to use. All I can relate is what I've seen from others. And there are a very wide spectrum of experiences. From action within 7-10 days to months before anything happened. I've read a paper that says that cabergoline does better with small pituitary tumours. Not sure what to say about Eddie's tumour size. Hypophysectomy and two SRTs make him kind of unique. ;) There also haven't been extensive studies comparing tumour size with results. It could just be that some large tumour cats take a lot longer to respond. This is all a guess. I've also seen a study saying it's effective in only 40% of cats, but maybe those studies didn't wait long enough. Very few (if any) people here paid for a CT scan before starting cabergoline. That's a luxury of university studies, but they don't have huge numbers, though the South American study is a good sized one. One goal of cabergoline is a cheaper treatment that doesn't require travel, hence few scans before treatment.

Eddie is also on every other day dosing, and had just 14 doses, so equivalent of two weeks worth. He's barely started with the drug. Most people here have used cabergoline every day, though the South American study had cats using it less frequently, and still good results. Dosing of cabergoline generally isn't changed, but people have moved to every day, or even tapered to less if OTJ. Summary, have patience, stay the course. Let's put any GI issues well in the rear view mirror first.
 
Wendy&Neko said:
First of all, it's likely Eddie is bouncing from the PM cycle of the 11th. Bouncing is a fact of FD life, regardless of cabergoline or not.

Any thoughts on restarting his ABs for his dental issues? That might also be impacting his numbers.

I never used cabergoline, it was pretty much too late for Neko to use. All I can relate is what I've seen from others. And there are a very wide spectrum of experiences. From action within 7-10 days to months before anything happened. I've read a paper that says that cabergoline does better with small pituitary tumours. Not sure what to say about Eddie's tumour size. Hypophysectomy and two SRTs make him kind of unique. ;) There also haven't been extensive studies comparing tumour size with results. It could just be that some large tumour cats take a lot longer to respond. This is all a guess. I've also seen a study saying it's effective in only 40% of cats, but maybe those studies didn't wait long enough. Very few (if any) people here paid for a CT scan before starting cabergoline. That's a luxury of university studies, but they don't have huge numbers, though the South American study is a good sized one. One goal of cabergoline is a cheaper treatment that doesn't require travel, hence few scans before treatment.

Eddie is also on every other day dosing, and had just 14 doses, so equivalent of two weeks worth. He's barely started with the drug. Most people here have used cabergoline every day, though the South American study had cats using it less frequently, and still good results. Dosing of cabergoline generally isn't changed, but people have moved to every day, or even tapered to less if OTJ. Summary, have patience, stay the course. Let's put any GI issues well in the rear view mirror first.
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I've been putting off restarting the ABs for dental because of his diarrhea issues. Wanting to get that stabilized...which is where we seem to be headed.

As for the Cabergoline questions: not in a hurry to make any changes but gathering info. I mentioned i was going to be chatting with WSU and I did: Tina Owen and Sarah Guess and Sarah is an IM vet at WSU on the team and she said that truly Eddie is in the N=1 category but that we are learning from him. She even went so far as to say she'd like me to contribute to a paper on the N=1 situation as he is the only cat they know who has had 1) hypophysectomy; 2) SRT (twice) and now 3) Cabergoline.

We are all learning from Eddie. Anyway, my point was to open a discussion about how to evaluate efficacy, etc. in relation to dose/frequency. Again, Eddie is N=1 and I'm just trying to gather data/info.
 
We did have N=1 member who increased the cabergoline dose a bit, maybe 10%? But only after seeing insulin dose go down and acro symptoms subside. Then she saw some acro symptoms return. I can't remember how far into treatment, maybe a year. Her spreadsheet has been deleted, so I can't get the exact details. And she was giving cabergoline every day.
 
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