Acromegaly treatment - Vet recommendations

Christina & King Chuck

Christina & King Chuck

Member Since 2023
I posted the general group before realizing this one existed. King Chuck was diagnosed with acromegaly and the vet recommend blue Pearl hospital for cyber knife. I just spoke with them and was told a phone consult is $295 and was given a rough estimate of between $13-15k for the cyber knife procedure including the CT scans. The phone consult alone is pretty high and I’m wondering if this is normal for these types of specialists. We’re not scheduled until Monday and curious if anyone has radiation specialists they can recommend in the NY/NJ area. Thanks in advance!
 
Christina & King Chuck said:
I posted the general group before realizing this one existed. King Chuck was diagnosed with acromegaly and the vet recommend blue Pearl hospital for cyber knife. I just spoke with them and was told a phone consult is $295 and was given a rough estimate of between $13-15k for the cyber knife procedure including the CT scans. The phone consult alone is pretty high and I’m wondering if this is normal for these types of specialists. We’re not scheduled until Monday and curious if anyone has radiation specialists they can recommend in the NY/NJ area. Thanks in advance!
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Hi Christina, not sure if anyone's responded in the other forum but thought I'd share a few experiences. Firstly, sorry about King Chuck. Acromegaly is something vile. I have lived with two acro kitties over the past 7 years, Eddie and Blue, and can confirm that the cost estimates are accurate and represent gold standard treatments. The phone consult is relatively cheap in the scheme of things but it's crucial to get as much ahead of the situation and be as informed as possible. A good relationship with your specialist is important and, for the most part, specialists are pleased to work with caregivers who are informed. The $$ for the cyber-knife is within normal range. If you were getting transphenoidal hypophysectomy, the cost would be around $19-20K. I am assuming the radiation is aimed at controlling a smaller tumour. Of course you won't know how many sessions are recommended until Monday so hopefully it will be at the lower end. It's important to know, too, that acrokitties respond very well to radiation. In fact, in the times Eddie and Blue have had Stereotactic Radiation Therapy (SRT), they displayed no apparent effects. Radiation is so wonderfully precise.

I wish you and King Chuck all the best.
 
Jodey&Eddie&Blue said:
Hi Christina, not sure if anyone's responded in the other forum but thought I'd share a few experiences. Firstly, sorry about King Chuck. Acromegaly is something vile. I have lived with two acro kitties over the past 7 years, Eddie and Blue, and can confirm that the cost estimates are accurate and represent gold standard treatments. The phone consult is relatively cheap in the scheme of things but it's crucial to get as much ahead of the situation and be as informed as possible. A good relationship with your specialist is important and, for the most part, specialists are pleased to work with caregivers who are informed. The $$ for the cyber-knife is within normal range. If you were getting transphenoidal hypophysectomy, the cost would be around $19-20K. I am assuming the radiation is aimed at controlling a smaller tumour. Of course you won't know how many sessions are recommended until Monday so hopefully it will be at the lower end. It's important to know, too, that acrokitties respond very well to radiation. In fact, in the times Eddie and Blue have had Stereotactic Radiation Therapy (SRT), they displayed no apparent effects. Radiation is so wonderfully precise.

I wish you and King Chuck all the best.
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Thank you! We had the CT scan today which confirmed a small tumor on the pituitary gland. We’re starting cyberknife radiation tomorrow. Fingers crossed all goes well!
 
Wendy&Neko said:
I hope all has gone well. Keep us posted.
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Chuck finished up cyberknife yesterday without any complications. We’re home now. I’m dreading having him on a steroid the next 6 weeks but understand it’s necessary to combat the potential inflammation from radiation. I’ll keep you posted on how it goes, but now all we can do is wait and see!
 
Glad it went well. :)

What is the dose of steroid he's getting? Neko never had a steroid after her SRT. The risk of inflammation was considered quite slow and they only recommended steroid if symptoms warranted it. I filled the prescription but never used it. But you aren't the first I've seen lately being told to give it regardless. Must be a new protocol.

Did the vet talk to you about insulin dosing?
 
Wendy&Neko said:
Glad it went well. :)

What is the dose of steroid he's getting? Neko never had a steroid after her SRT. The risk of inflammation was considered quite slow and they only recommended steroid if symptoms warranted it. I filled the prescription but never used it. But you aren't the first I've seen lately being told to give it regardless. Must be a new protocol.

Did the vet talk to you about insulin dosing?
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He’s getting 1ml concentration 5mg/mL for 2 weeks then we taper down. I was really hesitant about it but the oncologist kept telling me the inflammation COULD BE an issue. Although it happens more in dogs. She said she rarely sees it in cats.

RE insulin dose…no conversation really. She said we’d monitor and see. She really only wanted to talk about how the CT scan also revealed shoulder degenerative joint disease and how we should do a $1000 treatment. Needless to say we might be finding a new vet. She’s the same vet who asked me to cut his dose by 2 units when I first brought him in with acro symptoms because it was too high of a dose :/
 
Joint disease/arthritis super common in acros. Love to know what $1000 treatment could fix that!

My suggestion about dosing is to be super cautious. I upped the point at which I took reductions. There were times I did a half or 2/3 dose after a reduction to reduce the depot. Not sure what dose Chuck is on now but draining the depot needed even more so for higher doses. I also occasionally did back to back reductions or larger than usual reductions. I found that SRT caused waves of reductions, a bunch followed by a bit of quiet, then the next batch of tumour cells would die off and I'd be chasing reductions again. But I've also seen cats take a couple months before the first reduction happened. Neko's was on the trip back home. :rolleyes: They definitely keep you on your toes.
 
I was so worried about the steroid I wasn’t even thinking about that combined with the effects of the tumor shrinking. Right now Chuck is on 10.5 units of tresiba. His numbers have been in the 200s which has been standard for us the last few months. I’m going to keep a close eye on him and do a curve probably on Monday. Thank you for all of the info!
 
Suzanne & Darcy said:
How is Chuck doing?
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I meant to post an update but completely forgot. He’s doing well, still running high due to the steroid but we’ll be tapered off of that in the next two weeks. Since treatment I’ve noticed he’s less food obsessed which is nice! He’ll actually graze now and will leave his brothers food alone. He’s hiding under the bed a little less and the frequent sneezes are lessening. I’m hoping I start to see lower BGs once he’s off the steroid because it’s been rough. He’s at 11.5 units now :/
 
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