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Susan & Claudio

Susan & Claudio

Member Since 2019
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FINALLY got him to a new vet. Yeah !! Very difficult when you don't have a car. It's a major hassle just to get a gallon of milk or loaf of bread. Takes 1/2 hour to walk one way to the store. Then another 1/2 hour to walk home. Oh, and there are no sidewalks here. Gotta walk on the edge of the road.

Anyhoo... Got his IGF and IAA results. No IAA. IGF is 151.
At least now I know for sure. That's half the battle there. Now I know what we are dealing with.
The vet hasn't had any experience with acro cats. So she referred me to an IM vet.
Must have made 2 dozen calls to various IM vets. Seems they don't have acro experience either.
So how important is it that I take Claudio to an IM vet? Can't afford SRT nor surgery. The only other thing is cabergoline. That would be the only reason to go to an IM vet.
Thoughts ???
 
Hi Susan, good to hear from you and get a Claudio report. I'm so glad you managed to get a new vet! It's so hard to do in COVID times, much less without transport.

Sorry to hear about the acromegaly, but as you say, now you have an answer for why he's been needing the dose he dose. However, you've been doing a great job with him pretty well regulated. :) Is he showing any other symptoms? Nice to see a fairly low IGF-1 number. And most important, don't tell Claudio, he doesn't know anything is different. :bighug::bighug:

On the IM vet, absolutely not required if your vet will get on board with treatment. My vet tried to set up an IM appointment for me. And I got a call from them for a consult for a diagnosis and treatment plan. I called back, said, "no thanks". I knew the diagnosis, by that time I'd already contacted CSU for SRT treatment. FDMB helped me get the diagnosis and treatment plan. I put that IM consult fee back in my pocket and spent it on treatment. I can't imagine how hard it would be for you to get to an IM vet either. :rolleyes: We can help you with treatment, if your new vet is willing to prescribe the cabergoline. And we can get you papers if that's what your vet needs. We have several peeps here who get it compounded through their general practice vet.

Susan & Claudio said:
Must have made 2 dozen calls to various IM vets. Seems they don't have acro experience either
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I don't know New Jersey well, but there are Red Banks there that do SRT and have experience with acros. In case he stops in Paul @Bronx's dad (GA) lives in NJ. My vet didn't have acro experience but was willing to learn. Shortly after Neko's dx, she realized there was another acro kitty in the clinic. If they've had more than 4-5 diabetic cats, chances are there's been other acros. Neko's vet also handled the kidney disease, but fired me to an IM once the heart and lymphoma got added to the mix.
 
Wendy&Neko

Sorry to hear about the acromegaly, but as you say, now you have an answer for why he's been needing the dose he dose. However, you've been doing a great job with him pretty well regulated. :) Is he showing any other symptoms? Nice to see a fairly low IGF-1 number. And most important, don't tell Claudio, he doesn't know anything is different. :bighug::bighug:
I don't know New Jersey well, but there are Red Banks there that do SRT and have experience with acros. In case he stops in Paul @Bronx's dad (GA) lives in NJ. My vet didn't have acro experience but was willing to learn. Shortly after Neko's dx, she realized there was another acro kitty in the clinic. If they've had more than 4-5 diabetic cats, chances are there's been other acros. Neko's vet also handled the kidney disease, but fired me to an IM once the heart and lymphoma got added to the mix.
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I'll feel he's better regulated when those yellows go bye-bye. And yes I am pleased that his IGF is 151. I've looked at others and saw 300's and up. His only other thing is bad arthritis. But I got a script for Adequan.
I did call Red Bank today. But the IM wasn't in today. I will call again tomorrow. I also have another practice(s) to call tomorrow.
I must have picked a lot more from this board than I thought. The vet didn't question me on anything. She was impressed. Now if I can impress her enough to convince her to treat him, acro and all. :rolleyes:
I have a myriad of questions, but I'll do one at a time.
What is cabergoline for ? Is is to bring the bgs down ? I'm afraid if I use it, it will bring his numbers down to the limes. Prefer not to do that.
 
Cabergoline seems to limit growth hormone output. Excess growth hormone does a number of things, including contributing to diabetes. A lot of cats on in have their doses go down, so far three here have gone OTJ. And yes, with doses going down, limes are a risk. I usually suggest people raise their reduction point a bit if they start to see lower numbers. It can take a while for dosing to be impacted, or not. Sort of an ECID thing. One of the other important things it seems to do is ease some of the side effects such as excess tissue/bone growth. That's important for their QOL. @Olive & Paula saw a lot of improvements there. I've seen a few people report their breathing seems to be easier as a result and they just seem to feel better.
 
I realize it's my decision, but would I be an irresponsible cat momma if I wanted to try the cabergoline. With caution of course. I am so afraid of the "limes".
If it could help in any way with his arthritis that's a plus. And he snores like a foghorn when he is sound asleep. So it might help with that.
Question #2.... If/when the tumor pulses, does that raise his bgs?
 
Susan & Claudio said:
I realize it's my decision, but would I be an irresponsible cat momma if I wanted to try the cabergoline
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Absolutely not. You would be in good company. There are a few kitties here on cabergoline, @Pamela & Amethyst @Howiesmom @Suzanne & Darcy and one about to be @FrostD And probably more, those are just the top of my head from a quick scan down the forum.
Susan & Claudio said:
If/when the tumor pulses, does that raise his bgs?
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I don't understand completely how the tumour works, but one of the things it can do is impact the part of the pituitary sending out growth hormone. If that part pulses, then yes, more growth hormone typically means more insulin needed. See Neko's 2015 SS, starting mid July. She just went off the rails.
 
Welcome to the "club"! Even though you expected it, I know it's still a diagnosis you don't want to hear

As Wendy said, we'll be starting cabergoline next week, as both SRT and surgery are beyond our means as well.

I've been fortunate that I found a vet that really just kinda lets me do my thing. He has open access to my spreadsheet any time he wants to see it, and for the most part kind of stays on the sidelines unless I need something (opinions, bloodwork, prescriptions, etc). Once Mr Kitty got the diagnosis, my vet had done a lot of research about treatments on his own - Mr Kitty is his first known acro kitty.

He said if I wanted SRT or surgery he'd have to refer me to endocrinologist or IM because that was too far outside his comfort zone, but was more than happy to prescribe the cabergoline provided I knew about the lack of published research for Acromegaly treatment. They'll compound it in-house, I just reminded them he's diabetic so don't use the compounding liquid with any sweeteners (there's a a separate one for diabetics).

I think he's just interested to see what happens and how it goes

Edit: those low greens and limes are scary the first few times, but after awhile not as nerve wracking. I barely even blink at 60s and 70s now, and 50s are just like any other part of the day (even though we haven't seen those in a little while).

I've kind of just accepted that this will be unpredictable, and I'll just roll with the changes/punches as they come. And hope that my patience pants have a lifetime warranty

Edit 2: I see you've seen your fair share of limes now that I got the SS open, so ignore me :rolleyes:
 
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Welcome to the club/community! Howie has been in cabergoline since Feb. I haven’t seen the dramatic dose decreases like some have, but he has dropped from a high of 55 units BID to now 30 units BID. So I hope it’s the cabergoline that keeps him from such high doses. He also snored so loud and had put on a bit of weight (but I was also trying to fatten him up a bit too as he had lost a lot of weight last fall). The snoring and weight gains have stopped since being on the Cabergoline. I also use an automatic reduction point of around 70 per recommendations from Wendy. I’ve been lucky that he is pretty flat in the greens and low to mid blues. I’m also lucky that my vet lets me do what I want as Howie is his first acro kittie too. Keep asking questions! That’s how we’ve all learned!
 
Sorry to hear about diagnosis. Now you know and you can decide on treatment.

I actually thought Olive was IAA. The vet didn't order that test. Acro was done. It was 382. Dr told me that was normal. When I got results I called back and said in US measure it's acro. The over 1000 he referred to is UK measure. If you convert the results, Olive is over 2000.

My mindset total changed and although getting her regulated is important. Olive being comfortable and not struggle to breath and walking was more so to me.

The only reason I used cabergoline was to manage the symptoms so Ollie was comfortable. It was never ever about less insulin or possibly remission. That would have been a bonus. They need the amount of insulin they need.

Her vet would not order cabergoline. I called 3 other practices and none would. One even told me that I would have to change insulin to Prozinc (Olive did get lantus and got aggressive when we hit 6 units) so she was on levemir, I was not willing to change that. And he told me I had to treat their way. So I said goodbye. The IM who did an ultrasound before the acro dx said her insulin dose was way to high @ 5 units and I was killing her. Goodbye to you too.

I found the 4th vet, who once she saw Olive and all the results of blood, ultrasound, cardiologist report and the spreadsheet agreed trying cabergoline, she agreed it was Olives only hope. She said she knew nothing about it but was willing if I was.

After a few office visits, she let me manage the diabetes as I kept her informed of dose changes and curves etc.

Olives acro was severe. She constantly struggled to breath, her walk was painfull, headaches, light sensitivity, laid around like a blob.

After cabergoline started, all the symptoms started being less until one day they stopped altogether. Then she started running, playing, allowing me to pick her up, brush her. She was a normal cat.

Her insulin dose was cut in half. When it first started coming down, she barreled down big time. But I knew what to do, had everything needed in house. And people here who would stay with me offering support and advice. Yes the first time seeing a lime is scary. But started to think of it as a good sign (not that I wanted limes) but it meant a decrease of insulin. Ollie could go from pink to lime in 3-4 hrs. At times there was no indications what she might do. Because of that I knew I couldn't leave the house the first 4 hrs of getting her shot. I tested before walking out the door and immediately when I got back. Always tested PM +3 and before I went to bed which was +6 or +7.

I think the amount of testing automatically increased because you want to catch those limes early. I was lucky as I only worked 1 day a week. I could be home or change plans very easily. For the few times I couldn't and she was questionable, I took her with me to appointments. She had her own purse with equipment, strips, honey, food, dishes, puppy pads, etc. everything and anything I would need if she got seriously low. She had a pet stroller to make it easy. Few times she came to office with me. I would take her to visit my dad at assisted living where I also worked. Once to hospital when my dad was taken there.

I think it's important to find a vet willing to script it and will work with you regardless if they are an IM or a primary vet.

Once you come to terms with diagnosis, you can decide what is best for you and Claudio.
 
Hi Susan. Bronx used Blue Pearl in Paramus for an IM. Doctor Christian Ericksson was very familiar with Acromegaly and allowed Bronx to try Cabergoline. We used Dr Dustin Lewis at Red Bank Hospital for SRT. Not sure where you are in NJ but these 2 doctors were great.
 
Bronx's dad (GA) said:
Hi Susan. Bronx used Blue Pearl in Paramus for an IM. Doctor Christian Ericksson was very familiar with Acromegaly and allowed Bronx to try Cabergoline. We used Dr Dustin Lewis at Red Bank Hospital for SRT. Not sure where you are in NJ but these 2 doctors were great.
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Thanks Paul. Paramus is way too far away. I live about 30 minutes north of AC.
I am going to try Northstar Vets. The one closest to me has horrible reviews. The other 2 locations are in Maple Shade or near Trenton. Both locations have IMs experienced with feline acromegaly. Just so incredibly backed up with appts.
 
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