12/16/14 Keiko AMPS ~412 - Acro(?)

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KeikosHuman

KeikosHuman

Member Since 2014
Hi,
Here's my last post:
viewtopic.php?f=9&t=129755

The AMPS number is an estimate from the Alphatrak reading of 506. I did a curve for the vet with Alphatrak yesterday and finished with the AMPS this morning. I have not heard from the vet about another increase but I increased him to 10.5 this morning. Last night he got into the trash and ate some dry cat food I had thrown out (he hasn't had dry since May 2014). I found it and put it in a plastic bag and into the trash but he discovered it and ate some of it.

Keiko had a vet appointment last Thursday. We did one urine test - he has sugar in the urine (didn't need a test to know that) and it seemed he had a bladder infection. They want to test him for Acromegaly. Apparently Acromegaly it is treated with radiation. Do you know how many treatments? I am in a bind with money right now and did not go forward with the tests. If I had him tested I do not know if I would get the treatment.

His numbers disappoint me but you may have more objective eyes. nailbite_smile
Thank you so much for your help.
M & K
 
Hi Maria - I'm just heading out the door to the vet, so I'll pop in with more info later. We have a few people here who have gone to CSU for radiation therapy: Julie/Punkin, Marilyn/Polly, and me/Neko. Not everyone gets the radiation therapy. It does require travel, time (a week) and $$ that not everyone has. Suzanne/Cobb are just treating with the appropriate amount of insulin. I'll post some articles when I get back. Check out Julie's signature for a description of Punkin's SRT journey.

We do suggest testing for both acromegaly and IAA when kitty gets above 6 units, is on a wet food low carb diet, has gone up the dosing scale according to the protocol (which you have), and have not infection or dental issues.
 
Hi Maria!

You don't have to do the SRT. Others have just addressed the blood sugar issue, ie, give as much insulin as it takes to get the blood sugar under renal threshold to try to prevent damage to the body as much as possible.

We have lots of info on acromegaly. Bookmark this post called Where Can I Find___? Look at the New to the Group sticky and scroll to the bottom for the single topic posts for these posts:

Acromegaly & Insulin Resistance Information
------2010 Special Report from AAHA: Diabetes Management Guidelines for Dogs & Cats
------2014 ~ 39th Congress of the World Small Animal Veterinary Association (WSAVA)
~~~~~~~~~~Which Insulin in Cats - p 156
~~~~~~~~~~Management and Monitoring of the Diabetic Cat - p 160
~~~~~~~~~~Feline Diabetes - p 229
~~~~~~~~~~Diabetes Mellitus and Quality of Life - p 730
~~~~~~~~~~Acromegaly in Cats – p 733
~~~~~~~~~~Insulin Resistance – p 737 (description of mechanisms of resistance on p 738 under heading Pet)
Click to expand...

Acro is the most common cause of a cat needing a high dose of insulin, but others include iaa (insulin autoantibodies) where the cat's body produces antibodies that "bind up" the insulin so it can't be used by the cells, and Cushing's disease. Obesity, pancreatitis, and hyperthyroid are other factors that can make a cat need more insulin than normal, but they are probably not going to be the main issue if the cat is up to 10+ units. Most likely it's one of the big 3 that I mentioned above. One of the hallmarks of acro is that the cat will often gain weight in spite of high blood sugar. In most "regular" diabetic cats, they will have an enormous appetite when their blood sugar is high, but they might lose weight. An acro cat might actually gain weight even with their diabetes uncontrolled.

There are stereotypes of cats with acro, but we have plenty of cats that don't fit the stereotype, so they aren't necessarily helpful. The huge appetite is pretty much consistent with all of them.

If you decide to get any testing done, get both the acro and iaa done at the same time. It does help us help direct you if we know which one it is, but if we don't, we just base things upon blood sugar and dosing.

You can take a look at the link in my signature line to read about our experiences with SRT if you want.

After you've done some reading, let us know what questions you have about how to move forward. There are many of us here with high dose cats and lots of people to help you. You're not alone.

:YMHUG:
 
I'm in the process of putting together a list of articles to add to the post Acromegaly, the basics. I've found quite a few, so it's taking me longer than I wanted. In the mean time, one of the better recent articles I've seen is here. It's a summary article written by Dr. Niessen, who runs the Acromegaly Cat Clinic at the Royal Veterinary Hospital. Starting on page 328 of that article, there is a list of treatment options, including the one to just treat the high blood sugar. With that option, and even cats that have had radiation, you do have to watch for the side effects of the excess growth hormone.

In the US (and Canada) there is only one place that does the hypophysectomy surgery (pituitary removal). It's done in LA and they are fairly new to it. In Dr. Niessen's article in the WSAVA 2014 conference that Julie referred to, it looks like the Pasireotide trial was only partly successful as a significant number of cats had GI issues. And it was only available in England. There are probably a half dozen places now that do stereostatic radiation therapy (done over 4 days) in North America and more that do convention radiation therapy (more side effects and takes longer). Finding the perfect treatment for acromegaly is still in the research phase. Given that recent research in the US and the UK suggest that acromegaly may be in issue in up to 1/4 of difficult to regulate diabetic cats, by far the majority of people treat acromegaly in their cats by managing the blood sugar.

Acromegaly and IAA are the more common conditions we see here, and often cats have both, like Neko. The reason we suggest getting tests for both done, is that the dosing strategy can be a bit different if IAA is involved.
 
Keiko has actually lost weight. This was sharper over the summer and has slowed in the fall. I don't know if that might rule him out of Acromegaly.

How do I move forward, other than continuing to increase K's insulin? I appreciate any ideas. I have increased Keiko to 10.5.

Thanks again. I'll do a new post soon and read.

M & K
 
Maria - some acrocats still lose a bit of weight. Neko lost some at the beginning of her diagnosis. How much has Keiko lost? The other two conditions are IAA (insulin auto antibodies) and Cushings. Cushing's cats tend to have fragile skin and it's a lot less common.

At this point, just keeping on top of increases until Keiko is spending the majority of his time under renal threshold should be your main goal.
 
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