Allie - 1 month on cabergoline - acromegaly treatment advice sought

This was our first post - https://felinediabetes.com/FDMB/threads/stuck.244069/

We've gotten through the acromegaly diagnosis and are now just watching as her insulin needs soar. Any advice is welcome. We're looking for stories about your experiences with the different treatments. I've read most of the forum topics in Acro and Lantus, including the after surgery stories. But I haven't seen anything about radiation treatment. We have access to higher treatment in Latham NY or Burlington VT. Haven't even done a cbc, scheduled for Oct 8.

I don't know how to cross post this to the Lantus group ( or if I should).
I could also use advice on buying Lantus from Canada. I am currently getting a 10 ml vial from Walgreens for $198. I got the cabergoline from Wedgewood, and although its not significantly helping her numbers, she has been way friendlier, and even played with our other cat for the first time in a long time. Pee has decreased as well.

I think my spreadsheet is still attached to my signature but here it is anyway.
https://docs.google.com/spreadsheet...YUfUDXD-yY7iDwQLXoq0eLZGU/edit#gid=1182885903

 

I’ve been using Cabergoline for Howie since Feb. I’m not sure I have/will ever see the drastic decreases in insulin needs, but I hate to take him off it. He was as high as 55 units BID and as low as 17 units. He’s currently sitting at 36 units. As you’ve heard constantly on here, ECID and they need as much insulin as they need. Howie also has IAA so don’t think your kittie will get as high as him! I use Cab every day, so maybe you want to talk to your vet about changing how often he gets it. I can just say to stick with it. Acro can be very frustrating and you can think you’ll never see improvements. But you will! Also keep in mind that the tumor will pulse. So you may be racing up or down the dosing scale depending on what it does at any given time.

I use Levemir and get it from Marks Marine Pharmacy from Vancouver. They sell it in pens (not vials). There is no way I could afford his insulin if it wasn’t for them!

keep asking questions. That’s how you’ll stay sane on here! Big hugs!

 

What do you want to know about radiation therapy? My Neko had stereotactic radiation therapy, which is the type of radiation therapy we'd recommend, along with Cyberknife. I went to Colorado State University to have SRT done. Here's a couple posts on SRT that you might find helpful:
10/11 punkin amps 280 CSU presentation on acromegaly
and
SRT to treat Acromegaly - Punkin 9/2011 & CSU presentation

A good paper is this one, one of the authors is the radiation oncologist who worked on Neko.

Cabergoline can take a while to take effect. What dose are you giving and how much does Molly weigh?

No idea how you are figuring out what dose to give, so can't comment on that. Frankly the lack of night time tests or preshot data scares me.

I would get rid of the W/D if you can, it's way too high in carbs for a diabetic cat and may be making a significant contribution to the dose needed. All low carb wet or raw is best. I'd also think about switching to Levemir instead of Lantus, with such a higher dose. Post on buying insulin from Canada.

 

Thanks so much for the references! I wondered about side effects from the therapy and overall outcomes. I think I had found a chart at one point comparing the therapies.

8/18 she started 1 ml cabergoline, 25mg/ml every other day (see notes on spreadsheet) I saw to expect results within a week to 2 1/2 months so I was waiting for that to see if I should go to once a day.

Allie is 12.5#, a chubby pot belly longhair with a small frame. She is not on w/d. Just Purina DM and Weruva glam 'n punk. I was looking to see more about Levemir but I didn't see much and my vet's not familiar with it.

 

So she's 5.7 kg, dosing is 10 mcg/kg per day, so she should be getting 57 mcg per day. A 25 mg/ml concentration sounds really high.

 

Yup, sorry. type - should have been 25mcg/ml. So it's very low. Maybe time to go to every day.

 

Could you update your signature to indicate you are now giving low carb food? I presume the DM is wet food. Also, that you are now on Lantus.

Good luck with the higher dose of cabergoline.

 

done. We just got a few better numbers so my vet wants to hold off on increasing the cab for now. I did finally get the IGF-1 number, it was 351. No idea what that means, but I'll post it to the thread asking for that.

 

The IGF-1 number is irrelevant, other than to tell you positive for acromegaly. According to the IM vets I talked to at Colorado State University, there has been no link between IGF-1 and anything else. And can vary over time, so it's a waste of time retesting it.