3/14 Shooter AMPS 153 - diagnosed with Acromegaly :(

So I just heard back from the vet and they're saying his fructosamine was 499 (unregulated) and that his Insulin Growth Factor 1 was elevated (acromegaly). I'm also going to take him off of lactulose and try something else because even though it's not supposed to raise bg I'm wondering if it is. I didn't give it to him for a couple days and that's when his bg's were lower. Now I've been giving it again and it looks like he's climbing. Do any of you give anything for constipation? She recommended miralax or chia seeds.

@Wendy&Neko
 
Sorry to hear the news Heather. :bighug::bighug::bighug: Did the vet mention what the IGF-1 level was? MSU has recently changed their reference ranges, so just curious. Did the vet talk about treatments? We might be able to help you there, now that you have a diagnosis. Since he's on a relatively small dose, cabergoline might be a good option.

Lastly, the Lactulose is fine, we've had kitties here on it before. If it works, keep him on it. It doesn't impact the BG's. Miralax is fine too, some people give both. Instead of chia seeds, you can try psyllium husk fiber. It's finer and might be easier to mix into food.
 
Wendy&Neko said:
Sorry to hear the news Heather. :bighug::bighug::bighug: Did the vet mention what the IGF-1 level was? MSU has recently changed their reference ranges, so just curious. Did the vet talk about treatments? We might be able to help you there, now that you have a diagnosis. Since he's on a relatively small dose, cabergoline might be a good option.

Lastly, the Lactulose is fine, we've had kitties here on it before. If it works, keep him on it. It doesn't impact the BG's. Miralax is fine too, some people give both. Instead of chia seeds, you can try psyllium husk fiber. It's finer and might be easier to mix into food.
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On the phone she said it was elevated but on the paperwork it says >1200 with a range of 61 - 196 so that sounds like extremely elevated to me... ? She mentioned surgery and I said definitely not with him being 17. Another site I looked at mentioned radiation but again, at 17 I'm not doing that either. She basically said we just continue to monitor BG and adjust dose as needed. I will look into this cabergoline you mentioned. Does anything else influence IGF-1 or it is definitely pituitary tumor related?

If Lactulose doesn't influence BG then I might just use less and add miralax like you said. Thank you so much for your help and if there's anything else you think of or run across please keep me in mind.
 
Hi Heather, I’m sorry to hear one more complicated piece of news for Shooter. Sending you hugs as I’m sure you could use some :bighug::bighug::bighug:

We use psyllium husk and I just add 2 pinches into the wet food and mix well with all the supplements I add.
Ivy has never complained (except for the stinky digestive enzymes).
:bighug::bighug::bighug:
 
Elevated IGF-1 like that will be from a benign pituitary tumour.

Neko had SRT (stereotactic radiation therapy), as it was the only treatment around at the time and considerably cheaper than it is now. Plus she was only 11 at the time and otherwise healthy. We've had cats have surgery, but there are only a couple places in the US that do it., the gold standard place for surgery is in the UK. The more experienced the surgery, the less the risk of bad side effects. We've only seen a few people here do surgery. Also very spendy.

You might want to read, and give a copy to your vet, of the paper attached to this thread:
New paper on: Cabergoline treatment in cats with diabetes mellitus and hypersomatotropism

Another paper was a survey of caregivers of acros, comparing quality of life with the various types of treatments:
Paper on QOL and response to treatment for acros
 
Staci & Ivy said:
Hi Heather, I’m sorry to hear one more complicated piece of news for Shooter. Sending you hugs as I’m sure you could use some :bighug::bighug::bighug:

We use psyllium husk and I just add 2 pinches into the wet food and mix well with all the supplements I add.
Ivy has never complained (except for the stinky digestive enzymes).
:bighug::bighug::bighug:
Click to expand...

Thank you Staci! For both the hug and the info.
 
Wendy&Neko said:
Elevated IGF-1 like that will be from a benign pituitary tumour.

Neko had SRT (stereotactic radiation therapy), as it was the only treatment around at the time and considerably cheaper than it is now. Plus she was only 11 at the time and otherwise healthy. We've had cats have surgery, but there are only a couple places in the US that do it., the gold standard place for surgery is in the UK. The more experienced the surgery, the less the risk of bad side effects. We've only seen a few people here do surgery. Also very spendy.

You might want to read, and give a copy to your vet, of the paper attached to this thread:
New paper on: Cabergoline treatment in cats with diabetes mellitus and hypersomatotropism

Another paper was a survey of caregivers of acros, comparing quality of life with the various types of treatments:
Paper on QOL and response to treatment for acros
Click to expand...

Thanks Wendy! I will definitely read these.
 
Wendy&Neko said:
Keep asking questions, I had a ton at this point. :bighug:
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If I'm reading this article correctly, it sounds like only cats with mild to moderate acro benefit from Cabergoline. Shooter's IGF-1 was >1200 which makes me question if this will help at all. I did message the vet this morning, so we'll see what she says. Now I'm wondering if I should have a body scan to see if the tumor shows or if he has an enlarged heart. :(
RVC - Use of Animals in Research - Case Studies
 
I'm sorry to hear about the news you just got from the vet, Heather. Sending you strength and warm hugs :bighug::bighug::bighug:

I used miralax when Fistuk is constipated. And give regularly 1/8tsp of psyllium to keep him regular.
 
I wouldn't call >1200 a really high number unless you know more. Also, the size of the IGF-1 number doesn't have anything to do with the size of the tumour, according to the specialists I talked to at Colorado State University. At the time, they had done the most studies on acros. On the old IGF-1 scale in North America, above 92 was positive and Neko's IGF-1 was 440, so fairly high. Her tumour was what they called "tiny" on a scan. A couple cats from here who went to CSU a couple weeks before Neko had IGF-1 almost half that number but also much larger tumours on the CT scans. Neko's insulin dose was smaller than theirs, meaning likely less growth hormone output so insulin dose might be more indicative a number. Shooter has an even smaller insulin dose than Neko's max.

It'll cost you north of $1000 to get a CT scan, and you'll know within a few months how well he's responding to cabergoline for much cheaper. There is no down side to giving cabergoline - the current count is 5 at OTJ so far. Pretty much all the cats here who have been on cabergoline have shown some improvements in both insulin dose needed, and acro side effects. The cats here that have started cabergoline and been on smaller insulin doses seem to have done better in terms of results.

As for getting an echocardiogram done, I would if there are any possible signs like a heart murmur. You can start with a blood test called the Cardiopet proBNP for a cheaper early test of heart function.
 
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Fistuk & Shelly said:
I'm sorry to hear about the news you just got from the vet, Heather. Sending you strength and warm hugs :bighug::bighug::bighug:

I used miralax when Fistuk is constipated. And give regularly 1/8tsp of psyllium to keep him regular.
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Thank you for the hugs. It's hard not to worry about these little buggers. According to the articles I've been reading, it sounds like often times the excessive hunger, thirst and urination are because of the acro. I wish I would have known and had him tested several years ago.
 
Wendy&Neko said:
I wouldn't call >1200 a really high number unless you know more. Also, the size of the IGF-1 number doesn't have anything to do with the size of the tumour, according to the specialists I talked to at Colorado State University. At the time, they had done the most studies on acros. On the old IGF-1 scale in North America, above 92 was positive and Neko's IGF-1 was 440, so fairly high. Her tumour was what they called "tiny" on a scan. A couple cats from here who went to CSU a couple weeks before Neko had IGF-1 almost half that number but also much larger tumours on the CT scans. Neko's insulin dose was smaller than theirs, meaning likely less growth hormone output so insulin dose might be more indicative a number. Shooter has an even smaller insulin dose than Neko's max.

Ok thank you! I will definitely give Cabergoline a try then. I looked for it on Chewy's pharmacy but didn't see it. Two different vets said Shooter has a grade 3 heart murmur which (from what I'm told) isn't too bad.
It'll cost you north of $1000 to get a CT scan, and you'll know within a few months how well he's responding to cabergoline for much cheaper. There is no down side to giving cabergoline - the current count is 5 at OTJ so far. Pretty much all the cats here who have been on cabergoline have shown some improvements in both insulin dose needed, and acro side effects. The cats here that have started cabergoline and bee on smaller insulin doses seem to have done better in terms of results.

As for getting an echocardiogram done, I would if there are any possible signs like a heart murmur. You can start with a blood test called the Cardiopet proBNP for a cheaper early test of heart function.
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Mikanmama said:
Heather,
:bighug::bighug::bighug::bighug::bighug:
I'm glad you are in the forum - there are good people with the experience with this. As @Wendy&Neko says, keep asking questions. Information is your ally!
It is a hard journey, I'm sorry. Shooter is lucky to have you as his mom though.
You are so caring and dedicated.
Sending you :bighug::bighug::bighug::bighug::bighug:
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Thank you so much! I appreciate ALL of you! :kiss::bighug:
 
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