acromegaly

Marissa&October

Marissa&October

Member Since 2025
Hi all I have some questions about acromegaly I have really really bad anxiety and diagnosed OCD so when I get a thought I spiral and will obsess and make myself sick. October has IBD diagnosed in 2021, So October was diagnosed with diabetes in January 2025 she was diagnosed from prednisolone. She was actually was on high doses of pred in 2024 when she had a pancreatitis flare up and had glucose in her urine she had a uti at that time as well I started testing as vets recommended an thought it was pred so we decreased pred and her numbers went back to normal. I tested here and there and sadly January 2025 on New Year’s Day I see 240 and she was diagnosed shortly after. We seen internal medicine shortly after diagnosis’s and he wanted her off pred asap. As he thought it wasn’t working to help her IBD she was still having flares being on pred ( 1-2 times a year ) so we took her off after weaning her numbers went from 300s to 200s and after slowly increasing insulin we seen some good numbers. we did blood work a few weeks after pred was stopped and it looked good followed by more bloodwork in June also good. I started noticing blood in her urine no uti so we did an ultrasound in September 2025 liver looked good pancreas looked good gallbladder was good but had sludge in it and some inflammation in her intestines but actually better than 2024 ultrasound. her kidneys he said was about 0.5cm larger than before which oddly i remember in 2021 he said they were on the smaller side but in 2023 about 4cm I don’t know 2024 he said still normal about 4.5cm total they looked good other wise he said they were larger due to diabetes and them working harder bladder looked good he said she has cystitis. In November we did another bloodwork and it showed high liver numbers which is normal with her IBD flares we ran a FPL and it was high showing she had pancreatitis we treated but she was again put on pred for about a month after 2.5mg every other day we did bloodwork and it was much improved so we got her off pred ( total 3 weeks on it ) ever since this flare up her insulin dose has been creeping up. I am of course fearing acromegaly reading all the information I did I’m scared because of the kidneys being larger than before. Her facial features are normal feet are normal I’m not really seeing anything crazy but my anxiety is making me believe she has acromegaly. I would love anyone advice we increase every 7 days if she doesn’t fall below 150 and decrease under 70. She eats Dr elesys clean protein chicken as I strongly believe can food upsets her belly. She is on lactulose ( enulose ) 2 times a day and gabapentin 25-30mg twice a day and her lantus. Thank you in advance and so sorry for the long read i appreciate anyone who took time to read and give me their thoughts and suggestions and feedback 💜 the picture is October we call it “sitting sexy” her signature pose October's Spreadsheet (Marissa)
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Some cats just need more insulin. Inflammation anywhere can increase need. So the IBS may be contributing, has your vet discussed steroids other than pred? As the prednisolone is likely increasing October's insulin need. There are better steroid options for diabetic cats.

Pancreatitis damages the pancreas which is where insulin is made. Higher blood sugars after a bout of pancreatitis is fairly common

How much does October weigh?

In short I wouldn't jump straight to acromegaly when October has so much else going on that is likely contributing to insulin need.
 
One of the issues with IBD can be what you're feeding your cat. While Dr. Elsey's is low in carbohydrates, which is important for diabetes management, feeding an IBD cat novel proteins may be helpful. Chicken is not a novel protein. Think in terms of rabbit, venison, or even pork. There are other options as well.

We don't suggest getting a cat tested for either acromegaly or insulin resistance until the dose is 5 - 6u/shot.

I'm tagging one of the other Moderators who has considerable experience with these conditions: @Wendy&Neko
 
Robo & B said:
Some cats just need more insulin. Inflammation anywhere can increase need. So the IBS may be contributing, has your vet discussed steroids other than pred? As the prednisolone is likely increasing October's insulin need. There are better steroid options for diabetic cats.

Pancreatitis damages the pancreas which is where insulin is made. Higher blood sugars after a bout of pancreatitis is fairly common

How much does October weigh?

In short I wouldn't jump straight to acromegaly when October has so much else going on that is likely contributing to insulin need.
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Yes we spoke about the other steroid i actually spoke with it when we seen the internal medicine he said if she gets back to back flare ups we would try something else so far just this one she’s on 4.25u
 
Sienne and Gabby (GA) said:
One of the issues with IBD can be what you're feeding your cat. While Dr. Elsey's is low in carbohydrates, which is important for diabetes management, feeding an IBD cat novel proteins may be helpful. Chicken is not a novel protein. Think in terms of rabbit, venison, or even pork. There are other options as well.

We don't suggest getting a cat tested for either acromegaly or insulin resistance until the dose is 5 - 6u/shot.

I'm tagging one of the other Moderators who has considerable experience with these conditions: @Wendy&Neko
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Thank you, so far on this food she’s been on it a year we seen only the one flare up and that’s when I was adding soft food in the mix. It seems like the soft food makes her throw up I was seeing her throw up here and there on and off I don’t think much of it tbh. She threw up the morning before bloodwork in November and it showed the pancreatitis I cut the can food back out. I can be wrong but I think it’s something in the can foods. Back years ago when I was feeding dry and can she let getting these sores on her face it was an allergic reaction to something I went through cans and did a trial and error and it seemed the chick didn’t give her the sores so we stayed with chicken it’s possible she is allergic though I have no idea. She is on 4.25u now
 
Which soft food made her throw up? Maybe it was one of the proteins in that particular food. Fish, chicken and beef are common allergies. Sometimes it's the gums added to the can or other ingredients. We've seen some cats see higher numbers with Dr. Elseys dry for some reason and do better when they move to wet.

What type of probiotic are you using? Also, why the lactulose? Some information in your signature might help us, this post has details: New? How You Can Help Us Help You!

As far as acromegaly goes, acro cats can be on smaller doses. It's just when they get up to 6 units, the chances are pretty good they have acro, IAA (insulin auto antibodies) or less commonly Cushings. That cute hairy belly says it's likely not Cushings. The majority (around 75%) of acros do not have clinical signs of acromegaly when they are first diagnosed. We also have a saying here "don't go looking for zebras when you hear hoofbeats".
 
Wendy&Neko said:
Which soft food made her throw up? Maybe it was one of the proteins in that particular food. Fish, chicken and beef are common allergies. Sometimes it's the gums added to the can or other ingredients. We've seen some cats see higher numbers with Dr. Elseys dry for some reason and do better when they move to wet.

What type of probiotic are you using? Also, why the lactulose? Some information in your signature might help us, this post has details: New? How You Can Help Us Help You!

As far as acromegaly goes, acro cats can be on smaller doses. It's just when they get up to 6 units, the chances are pretty good they have acro, IAA (insulin auto antibodies) or less commonly Cushings. That cute hairy belly says it's likely not Cushings. The majority (around 75%) of acros do not have clinical signs of acromegaly when they are first diagnosed. We also have a saying here "don't go looking for zebras when you hear hoofbeats".
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It’s honestly every can food, we’ve tried royal canin, hill, tiki ( treats ) fancy feast. And others when she gets IBD flares I have to normally syringe her urgent care can food. It’s possible it’s one of the gums in it i honestly don’t know when she eats the cans I notice she will start to throw up here and there and the stick treats make her super gassy. We’ve been sticking with chicken back a few years ago she kept getting sores on her face we cut out all flavors cans but chicken and the sores went away. She is on lactulose for her constipation that was where her IBD started was bloody mucus constipation so I have to give it twice a day. I guess my fear here is her dose has been climbing up and I’m worried what if it is acro? The kidney results do you think that plays a roll and why would they be slightly larger this time. Have you ever seen a cat who’s number seem near regulated and then harder to treat ? Was that outcome acro?
 
Wendy&Neko said:
Which soft food made her throw up? Maybe it was one of the proteins in that particular food. Fish, chicken and beef are common allergies. Sometimes it's the gums added to the can or other ingredients. We've seen some cats see higher numbers with Dr. Elseys dry for some reason and do better when they move to wet.

What type of probiotic are you using? Also, why the lactulose? Some information in your signature might help us, this post has details: New? How You Can Help Us Help You!

As far as acromegaly goes, acro cats can be on smaller doses. It's just when they get up to 6 units, the chances are pretty good they have acro, IAA (insulin auto antibodies) or less commonly Cushings. That cute hairy belly says it's likely not Cushings. The majority (around 75%) of acros do not have clinical signs of acromegaly when they are first diagnosed. We also have a saying here "don't go looking for zebras when you hear hoofbeats".
Click to expand...
Thank you I’ll update the information she is on Proviable-forte probiotic
 
Proviable is a good option. I use Visbiome, also good, but needs less volume for the same amount of probiotic.
Marissa&October said:
Have you ever seen a cat who’s number seem near regulated and then harder to treat ? Was that outcome acro?
Click to expand...
Yes to the first question, no to the second. There are many other conditions that can cause insulin resistance: pancreatitis, kidney disease, heart disease, hyperthyroidism, dental disease, insulin auto antibodies, other inflammation or infections to name a few. And glucose toxicity, where kitty's body gets used to higher numbers, but can be resolved over time with more insulin. If her nadirs (plural) are not in the 90-149 range, don't hold the dose any longer than 7 days.
 
Wendy&Neko said:
Proviable is a good option. I use Visbiome, also good, but needs less volume for the same amount of probiotic.

Yes to the first question, no to the second. There are many other conditions that can cause insulin resistance: pancreatitis, kidney disease, heart disease, hyperthyroidism, dental disease, insulin auto antibodies, other inflammation or infections to name a few. And glucose toxicity, where kitty's body gets used to higher numbers, but can be resolved over time with more insulin. If her nadirs (plural) are not in the 90-149 range, don't hold the dose any longer than 7 days.
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She has IBD and pancreatitis she actually lost a tooth recently as well she also has had some recurring UTIs which I might bring another sample in if I don’t see an improvement. Thank you for your reply, I have severe anxiety and ocd so I panic. Actually having another issue a few days ago I seen a floaty in her syringe after drawing insulin in ( I use new syringes every time ) I tossed it. Got a new syringe and I looked at the vial it looked okay I took a better look today with my flashlight the vial has floating particles in it. I got a new one and when I got home i noticed it has the same thing little stringy like floating particles also same lot number I called the manufacturer they want me to send both vials back new one and old one and not use them depending what they said it’s possible these lots are contaminated. The pharmacy only had one glargine pen available so I got it. We normally only use lantus vials. The manufacturer of lantus will be sending me more information and more 2 more vials. I’m not sure if this information should be spread to others yet or not. I have no idea if this was our issue with her numbers only time will tell while on the pen. Lmk if you would like to see videos not sure if I should spread the word to others yet or not
 
Good detective work on the vials. What brand is the insulin? Could be Lantus or one of the biosimilar/generics. If you get a confirmation that there is contamination, then it is definitely worth posting here.
 
Lantus vials, yes there was floating pieces in it. I contacted the manufacturer they want it back I posted on fb. I think it was starting to crystallize. Can I post videos on here ?
 
Wendy&Neko said:
Good detective work on the vials. What brand is the insulin? Could be Lantus or one of the biosimilar/generics. If you get a confirmation that there is contamination, then it is definitely worth posting here.
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Wendy&Neko said:
Proviable is a good option. I use Visbiome, also good, but needs less volume for the same amount of probiotic.

Yes to the first question, no to the second. There are many other conditions that can cause insulin resistance: pancreatitis, kidney disease, heart disease, hyperthyroidism, dental disease, insulin auto antibodies, other inflammation or infections to name a few. And glucose toxicity, where kitty's body gets used to higher numbers, but can be resolved over time with more insulin. If her nadirs (plural) are not in the 90-149 range, don't hold the dose any longer than 7 days.
Click to expand...
She’s still not seeing many greens, just really worried. Do you think that acro is something that might be happening? Or something else? She has IBD and pancreatitis. She also has had teeth issues lost a tooth not to long ago. I guess my fear is she has this acro and I’m missing it or something. Looking at her chart would you think that acro is a possibility? It seems like she was doing so good for so long and all of a sudden we need more insulin and I just don’t understand why. I have bad anxiety so I tend to spiral
 
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Your cat eats kibble - some people have noticed that Dr. Elsey's bumps their cat up. Not all do, just some. She's also gone some systemic inflammation (IBD, cystitis) and sounds like she needs a dental? All sorts of possible reasons you aren't seeing many greens.

This is day 4 of the new insulin? Looks like not that much difference.

When following SLGS, you increase the dose after 7 days if she's not seeing nadirs in the 90-149 range - which she is not. Time for 4.5 units.
 
Wendy&Neko said:
Your cat eats kibble - some people have noticed that Dr. Elsey's bumps their cat up. Not all do, just some. She's also gone some systemic inflammation (IBD, cystitis) and sounds like she needs a dental? All sorts of possible reasons you aren't seeing many greens.

This is day 4 of the new insulin? Looks like not that much difference.

When following SLGS, you increase the dose after 7 days if she's not seeing nadirs in the 90-149 range - which she is not. Time for 4.5 units.
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Yes day 4 on the new insulin going to increase to 4.5 for amps unless she some how shows me some better numbers tonight. Yes she has IBD and cystitis. The teeth issue the vet keeps saying her teeth are “fine” but I see gingivitis and she lost a tooth or it was reabsorbed. The kibble seems to be okay I don’t see spikes after. I mean I’m happy with 200s and high 100s I love seeing blues but I want better it’s like she’s flat at these numbers. She drops some but not a ton In October ( the month ) she was doing so well then after the pancreas and liver flare up and being on the pred for the 3 weeks she just seems to be climbing doses rather than decreasing. You’re thinking her dose is higher due to her issues she already has rather than acro or something else? I know you have alot
Of experience with all of this so I know you’d be honest do some cats just need higher doses of insulin ? What is like the “normal” range of insulin doses ?

Sorry I ask a lot of questions i often get these thoughts and I spiral down and almost make myself believe the worst case even if that’s not the case. I love her with every bit of my life and I don’t ever want to miss something she is my world. I just want to try to do what’s best for her. I’m increasing to the 4.5 for Amps is there anything else you recommend or anything you have thoughts about?
 
I'm think there are many possible reasons her dose is higher. Deal with those common possibilities first. See if your vet can refer you to a dental specialist vet. I've seen needing a dentals make a huge difference. Up to about 6 units, there are a lot of different reasons a cat could need that high a dose.

Have you tested for ketones recently?
 
Wendy&Neko said:
I'm think there are many possible reasons her dose is higher. Deal with those common possibilities first. See if your vet can refer you to a dental specialist vet. I've seen needing a dentals make a huge difference. Up to about 6 units, there are a lot of different reasons a cat could need that high a dose.

Have you tested for ketones recently?
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We are seeing a new vet on the 18th she had a dental last in 2023 they also never did x rays at that time of her teeth. The tooth that fell out recently is the tooth that was bad at that time and they never pulled it out. I can’t see anything to concerning with her teeth but I also don’t know how bad they could possibly be.

I haven’t tested in about a week last we tested they were at 0.2 on Feb 1st we increased to 4.5 today amps and she’s been sitting around 190 all day. How would we know if teeth are an issue ? She’s eating good not peeing a crazy amount just can’t seem to get these number down to much.
 
Wendy&Neko said:
For two of Neko's dentals, problems could not be seen by visual inspection, but showed up on xray.
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So what bothers me is she had a cleaning in 2023 she had a reabsorption tooth the one that’s gone now. The vet didn’t have the x rays for teeth so they did it all by eye they never pulled that tooth looked great after they cleaned but now it’s gone just a bump. I can see 3 other teeth that are currently being reabsorbed. My vet is 72 I love her dearly dont get me wrong but I have an appointment with a new vet on the 18th she also studied internal medicine. I am hoping she will give us some more answers I know she needs a dental and at least 3 teeth pulled. Just scared of her going under but I think we don’t have much of a choice if it’s affecting her BG now. Her breath also smells like a chemical like bleach has for months now. It seemed like every time she was on an antibiotic her numbers got better to if you look at our notes you can see it so I’m going to mention that as well. I tested ketones she’s at 0.2 and 228 for pmps. When Neko had his dental what were you seeing as issues and how many were pulled? My other cat non diabetic he’ll be 4 in April and I already see teeth issues on him he has gingivitis. October has had teeth issues from when she was about 4 or so always had gingivitis. Can teeth be playing a role in this needing more insulin and numbers creeping up? She also has always swallowed her food never chewed hates anything chewy some teeth have some black/greenish coloring not much plaque though.
 
Marissa&October said:
When Neko had his dental what were you seeing as issues and how many were pulled?
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Neko's first dental was with her regular vet, and it was just a cleaning. Later on, after her HCM was diagnosed, she went to a dental vet. Dental vets have extra monitoring during the procedure. She was "complicated". She had what looked like an infected tooth to the regular vet, but in fact was extra soft tissue growth being rubbed by a canine tooth. Dental vet filed down the rubbing tooth, and found one tooth that needed to come out. Next time was more "interesting", a bony growth on her jaw, probably from her acromegaly.

Marissa&October said:
Can teeth be playing a role in this needing more insulin and numbers creeping up?
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Yes. Number one reason cats in remission fall out of remission.
 
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