2/3 Rui 2 Weeks Post-SRT

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katieroc

katieroc

Member Since 2014
Hello everyone--Hope all is well. I haven't posted for a number of weeks since Rui had SRT (started on 1-12). I fell on the ice, got 15 staples in the back of my head and had a concussion! I just got back to work yesterday. Enough about me! Rui did great through his treatment, although we were so worried about him since we boarded him at the facility for the 5 days and didn't see him for days. He came home on 1-16. His numbers were in the 400's, but they've now been in the 300's for the past week. Well, with the exception of the other day when I totally messed up and gave him a collosal fur shot. His number shot up to 480 the next morning. They've since dropped. Right now Rui is getting 18 u twice a day. I was advised to increase the dose every 3/4 days. The doctor said it could take months for his BG to drop significantly and to try not to be alarmed by (what I consider) the very high dosage increases. He said once his BG starts to fall it will most likely happen very quickly. He's 2 weeks post-SRT and I'm so anxious to get his numbers down! But, I have to trust that it will happen. For those of you who've had kitties who had SRT, when did you seen the numbers drop? As I said I'm so anxious for this to happen. Thanks to all.
 
Hi. My Polly had SRT at Colorado State September 9, 10, 11. Three fractions. They told me it would take two months to see any effect. Doggone good guessing from them. November 11, she started coming down from her highest dose of 10.0 U Lantus (she'd blipped up to 10.5 for just a bit, but hovered at 10.0 mostly) She's now at 4.5 Units.

Polly also has iaa which will undoubtedly impact her slide down the dose scale, too.

Peek at her spreadsheet, '14 tab from November on and you'll see her decreases.

So, be anxious. But be patient!!!!!

More importantly. She's feeling better. Excellent bloodwork just a week or so ago. Stridor diminishing. I'm thrilled.

Keep us posted.

Marilyn and Polly
 
Hi Susan - I was thinking of you guys and wondering how Rui did with SRT. I'm sorry to hear about the fall - I hate ice!

SRT kitties are highly variable as to when they start to see changes in their numbers. Neko had SRT in August 2012 and saw a decrease immediately. And I do mean right away. We had a 3 day drive home and I decreased her part way home because she was going lower than I wanted on the road. She held that reduction and earned another one a couple of days after we got home. One suggestion I got from the folks at Colorado State University was to play it a bit safe, and do reductions when I saw a number below 70, instead of the 50 that the protocol suggests. That strategy worked for us. The other trick that can works after a reduction is earned, is to give 1/2 dose the cycle after a reduction is earned. That helps drain the depot which is a good thing in our high dose kitties. Here's a link to Neko's 2012 SS if you want to take a look. Neko was unusual, in that the CSU folks said it would be at least two weeks before I saw any changes. One thing I want to stress, it's very important to get mid cycle tests, especially when they earning reductions. Neko was/is very bouncy and the first time she went below 50, she started out around 430 that cycle. She had many cycles that started or ended in pink and/or red and went low in the middle.

Another example on the other side of the spectrum is Grayson. He had his SRT 3 weeks before Neko. Lu-Ann had to keep increasing from 16U at SRT itme to 50U. He turned it around 4-5 months later.

When doses drop, it's not like they drop a bunch at once. Neko was earning a couple reductions a week, but I still pretty much followed the protocol other than having a higher reduction point. But most of all, trust your gut when the reductions happen. It's much easier to go back up if you need to. Play it safe.
 
Thanks Marilyn and Wendy. At work and wanted to send a quick reply. I have to def get more mid-cycle numbers, although I can't get them during the weekdays. The lowest Rui has been was 294 at +6 a.m. the other day. He still has a ravenous appetite. Finishes a meal and immediately cries for more. I struggle with knowing how much I'm actually supposed to feed him. I think it's part agromegaly and part well, he's trained us to give him more food! I am seeing acro features in his face. It's broader and longer, so I'm guessing the growth hormone is still being produced. He also has stridor. That may have gotten a bit better. He goes back to RBVH for his post-SRT checkup next Friday. I know some cats have had success changing to Levemir. The doctor didn't want to switch at this time, but I'm going to pursue that issue with him at the checkup. My regular vet just sent a reminder for Rui's annual checkup (shots, etc). Is this advisable so soon after SRT? Maybe it's my imagination (since there's no real drop in BG numbers), but he seems a little more animated. Not jetting across the house animated, but more engaged. That's a positive. Sorry--my thoughts are scattered and all over the place. I just want Rui to feel better!
 
Hi Susan! Glad to hear from you guys!

Punkin was another kitty that started showing effects of the SRT almost immediately. We had to do dose reductions before we even got home from Colorado State University. Your tests will guide you. I'm glad to see you're getting some mid cycle tests now. If you can't get them during the day because of work make sure you always get one in the evening cycle. So many cats go lower at night the evening cycle is really important anyway.

In the meantime I would continue to increase his dose until you see changes (decreases) in his blood sugar that tell you that it's time to begin decreasing the dose.

Thanks for keeping in touch - it's good to hear from you guys.
 
I can so relate to the ravenous appetite! Neko still has a really good appetite, but it's no where near what it was. I found the autofeeder was my friend. Once I started putting her mini meals in that, she'd hang around the feeder (I call it her friend Otto) instead of bugging me. :smuggrin: Part of the appy you are seeing is also from the high numbers. Once Rui starts seeing some blues he'll be less ravenous. Just keep weighing Rui regularly, maybe every couple of weeks or once a month, and feed him enough food to keep his weight stable. Or less or more if he needs to gain or lose a bit. That'll tell you if he needs more or less food. I also have quite a few different zero carb all meat snacks, and one or two of those helped keep the starving tiger at bay.

As for the annual checkup, I'd maybe delay it a bit. The folks at CSU suggested that I get bloodwork done every three months for the first year. Also make sure you get the tests done for hypothyroidism, as that's the most common possible side effects of SRT. If you delay the checkup, you can roll it all into that 3 month visit.

It's great to hear that Rui is getting more animated. Often you'll see some physical and behavioral signs of improvement before the numbers start to come down. You'll continue to see some effects of the growth hormone for a while. The SRT neuters the tumor cells so they can't reproduce, but until they die, they can still send out extra growth hormone.

As for Levemir, a lot of kitties see improvement. Neko did, but I didn't switch until a year after SRT so she had gotten back down to "normal" doses by then. But not all kitties see immediate improvement. Suki just switched Crystal over a couple of weeks ago and her dose is now higher than the Lantus dose she was on, but she is also still searching for a good dose. If you do want to think about Lev some more, let us know and maybe we can help with some answers.
 
I would ask a lot of questions about the test for hypothyroid. I'd asked for it to be done regularly, but cats rarely become hypothyroid. Typically they develop hyper-thyroid (overactive).

In our case, it turned out that the tests punkin had been getting hadn't really been the right thing, and his thyroid had become seriously low before we realized it. The typical senior kitty panel or thyroid test doesn't break the thyroid components down far enough to identify a low thyroid.

Just a heads-up for you - thyroid is extremely important and if/when his decreases from the radiation, you want to know so you can begin to supplement with thyroid meds.
 
Thank you Julie and Wendy--I didn't know about the hypothyroid issue. I will definitely ask about that at the SRT follow up next Friday. Also, about getting regular bloodwork. I guess I'll do that with my regular vet. I so wish I'd see some "blues" with Rui's numbers. A sea of reds and pinks with a lone yellow thrown in on occasion. Well, his dose is now 21 u twice daily. (Sure enough this morning he was at 422 after we'd seen 300's for about a week). As I said earlier, the doctor said not to be alarmed at the high dosages, but admittedly, it's alarming. It's human doses. Well, Rui does think he's human (or maybe that we're very large cats). I'll send an update after his follow up. I absolutely love Otto the auto feeder! That's great.
 
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