Any advice for agromegaly cat with polyphagia?

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veverich222

Member Since 2014
Hello,
I hope this is the correct posting spot. I originally looked under the agromegaly board, but saw that many posts said to post in the Lantis/Levemir instead.
Our 12 year old cat, Puma, was recently diagnosed with agromegaly (IGF 318) after a little over a year of somewhat unregulated diabetes. We have a wonderful, knowledgeable, vet that reviews Puma's blood glucose levels every week, and makes adjustments as needed. Currently, we feed her Purina DM supplemented with tuna, and this has kept her blood glucose range between 150-300 with about 8-10 units of Levemir twice a day. Not perfect, but stable enough, and we have been lucky not to see any complications from the agromegaly yet, except for the unregulated numbers. Oh yea, and the polyphagia.
From the day we started feeding her twice a day (instead of free feeding - we didn't know better at the time), Puma has had the excessive appetite. Not just excessive appetite, but complete obsession over food. She has to be put in another room whenever we are cooking or eating. She spends every waking minute roaming the kitchen, going from the refrigerator, to the sink, to the microwave, stovetop and dishwasher. If the refrigerator or dishwasher is open, she will jump right in and try to grab something. She starts to meow non-stop about a half hour prior to her meal times, and we have to feed the dog in another room or she will attack our dog for her food.
To take some of the anxiety and obsessive behavior away, our vet prescribed her 10 mg Prozac. It has helped tremendously in that she is less aggressive and actually leaves the kitchen once in a while to be a cat again. However, she still has the polyphagia to a pretty severe degree and I am wondering if anyone has found any strategy to be successful. We attempted to use an automatic feeder at one point, but she managed to break into it. I am wondering if it is worth the cost to buy a more sturdy one in order to either disassociate us from food, or attempt to space out her feedings. I know there are many opinions over different foods to feed agromegaly cats, and am open to suggestions to that as well.
Thanks for any advice in advance!
 
Welcome! Punkin also had acromegaly, so I'm very familiar with that hunger. The benign tumor on his pituitary gland that causes the acromegaly puts out a growth hormone - which makes them hungry. Think teenage boy. Some cats with acromegaly will even eat non-food things. I haven't heard of anyone giving prozac to change that. Very interesting.

Unless the tumor is treated I don't think you can do anything to reduce that hunger. Her body is being flooded with growth hormones and it wants to grow.

I used the PetSafe 5 Compartment timed feeder and punkin couldn't break into it.

You don't need a special food for cats with acro. Just any low carb regular canned food will work. We use the list at www.catinfo.org and keep carbs under 10% for most cats. I fed 4-6% on a regular basis. The one thing you should be aware of is that if Puma has low numbers, you may need more carbs than a "regular" diabetic cat to bring up her blood sugar. Some people find that they do. Punkin responded with just a teaspoon or two of gravy from a high carb can, but this is one of those "every cat is different" (ECID) things.

Are you home testing? That's the best thing you can do to keep her safe. We have several high dose kitties in this group - from just a couple of units to 50+ units per shot. The important thing is to give the cat what it needs.
 
Here's a link to the "New to the Group?" sticky. It has lots of good info for new members. Browse through there, and then down at the very bottom of the thread, there are 3 posts out of the very last 5 on the page, that link to things related to acromegaly.

Oh, and I fed punkin boiled chicken breast to help him have something to eat that had basically no carbs, but helped with his hunger. I simmered 3-4 at a time, cut them in small 1/2" diced pieces and froze most of it. Kept a couple of days worth in the fridge. I gave him a bite after each time I tested his blood sugar, and I often gave him an extra tablespoon or so if he was hungry. You have to find a happy medium in giving enough food to keep Puma from starving and feeling miserable, while not letting her gain too much weight. Fat makes it even harder to get control of blood sugar.

I did have punkin treated with SRT for his acromegaly. Wendy had Neko treated, and Marilyn had Polly treated. Andrea/Tennessee, Peg/Toby, Suki/Crystal all have high dose kitties as well.

Was Puma tested for insulin auto-antibodies? That's a second cause of insulin resistance - some cats have both acro & iaa, some have just one or the other.

The latest study seems to indicate that 1 in 4 diabetic cats have acromegaly, so it's likely more common than we know.

Glad to have you here!

Here's the link to Punkin's SRT Adventure if you are interested.
 
Hello and welcome. Where are you located and what is your name?

Boy can I relate to the polyphagia! :eek::eek: Thankfully our kitchen entrances have pocket doors so we would close them anytime we prepped our own food. One of my favorite pictures of Neko is her on the counter, front paws in the sink, butt end up as she licked the sides of the sink. :rolleyes:

OK - some things about food. You don't have to feed Purina DM. Any low carb (less than 10%) canned or raw food will do. The list here is a compilation of many of the commercial foods available. I'd try to stick to something slightly lower on phosphorus as well, as kidneys can be a concern with acro-cats. Feeding multiple smaller meals seems to help with the hunger. I use the Petsafe 5 autofeeder too. Now Neko spends her time staring at it when it's on the floor, and not bugging me.

Julie's question about home testing is spot on. The acro tumor can wax and wane unpredictably, and insulin needs along with it. The thing that kills the largest percentage of acromegalic cats is a hypo. Running a cat in higher blood glucose numbers is safer from that perspective. However, I try to keep Neko under renal threshold (below low 200's) as much as possible. Testing at home allows me to do that, and is cheaper than frequent vet visits. Keeping her in lower numbers really helps the hunger. The other thing that both Julie did with Punkin and I did with Neko was to have SRT (stereostatic radiation therapy), which was the best treatment at the time for acromegalic cats. That put the brakes on the acro tumor and really helps the crazy hunger.

Good to see you are on Levemir, that's a great insulin for higher dose cats.
 
LOL....do you mean this picture, Wendy:
20150312_203330.jpg
 
Thank you both for your replies! I've actually been following Punkin and Neko's stories behind the scenes :) I definitely think our next step will be to have Pumas IAA tested. We live in San Diego. We've been home testing for over a year now, and we share our Google Docs spreadsheet with our vet once a week, which has been great. A this point, we'd rather be conservative with the treatment, as Puma does not seem to have any other affects besides the polyphagia.
Wendy, thanks for mentioning the Pet 5 Safe Feeder. I had my eye on it for a little while but I was not sure if it was worth the cost or not, and Julie, I may try the chicken. I wish we had kitchen doors! I feel so bad locking Puma up when food is around, but I'm sure you both know you can write a book of stories about things your cat has gotten into or ate that others would not believe unless they were there to see it! :D
 
Yes on the picture, this is the one I mean. :p
nekosink.jpg


Good to hear you are home testing. If you have a spreadsheet, we could probably take a look at it and tell you whether it's worth getting tested for IAA. There is a certain "look" to spreadsheets of kitties with IAA. Here are the instructions for the spreadsheet we all use here.

The reason I asked about where you live is there are options for treatment should you choose to go that route. Dr. David Bruyette of VCA West LA Animal Hospital probably has the most experience in North America with doing hypophysectomy, which is removal of the pituitary tumor. A lot of the other signs, tissue or organ thickening, tend to be invisible unless you really look for them. But maybe you are lucky and it's a slow growing tumor.
 
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Hi and welcome!
I can second the recommendation of the Petsafe 5 feeder.
My Acro kitty, Tennessee, has been obsessed with food. Even years before being diagnosed with FD or Acro he was always under foot in the kitchen begging for food. He will still try to knock food out of your hands while you eat. (my bad for letting him sit next to me while I am eating) A couple of weeks ago he ate a small piece of green pepper that fell on the floor! He used to follow me around the house begging for food constantly. His begging made me feel awful until my boyfriend mentioned that Tennie only whines for food when I am around. So I guess it is not constant.

Having the auto feeder has made a big difference. He still associates me with food, but it is not as bad as in the past. He wakes me up less at night looking for food. the transition was pretty easy too.

This is a great place to be if you need to be. Like others have said, Wendy and Julie are very knowledgeable and helpful with everything Acro and IAA related.
 
Since your spreadsheet is in Google docs you can probably just put the link to that one to your signature for people to have a look at.
 
I'll add another endorsement for the Petsafe 5 feeder as well. It's what we used for Cobb and, after we got it, we were able to feed him much more smoothly...meaning he didn't try to grab your fork. Seriously, we would be eating on the sofa and he would jump up next to you and pull your hand towards him with his paw. :rolleyes: He would also beg for food...frequently and loudly overnight and if you didn't get it fast enough, he would come jump on you and wake you up. We also did boiled chicken to tide him over.

Welcome! You've found a great resource for Puma!
 
too funny on the matching kitchen sink pictures for Puma and Neko! heehee and one of my friends has that same red man knife holder - isn't it called the ex-husband or something like that? ;):eek:

The surgery that Wendy mentioned is the most successful at getting a cat OTJ (off the juice, ie, off of insulin.) When we were looking at choices for punkin, that was still too new for us to consider.

A cat with iaa has a certain "look" to the spreadsheet. The most typical thing we see is that when one increases the dose, you might initially see it bring the cat into better blood sugar numbers, but then it's as though the (in Wendy's words) dose "goes stale." It stops working and the BGs drift higher.

Then you increase the dose again, and you might see better numbers in the first couple of cycles, and then it will "go stale" again. Repeat. With iaa kitties, what helps is to increase a little more rapidly than normal until you've got good blood sugar control. When an iaa cat is kept in good numbers, then you don't need to keep increasing the dose, but you've got to get them into that normal range first.

In any case, please let us know how we can help you. There's a lot of information on here and in people's heads that might be helpful.
 
Ok, I'm sold on the feeder! Because my husband wakes up early (5:00 am) and usually feeds Puma then, the meowing starts anywhere from 4:30 am to 4:45 am. Puma is just lucky she's so cute.
Wendy, thank you for the West LA contact. I will definitely look into that. Regarding the organ thickening, Puma has had several ultrasounds and so far everything is the size it should be so we are hoping it is slow growing.
Did anyone get a CT scan done for the tumor? I've been told and read that it's really the only definitive diagnosis, and even then, sometimes the tumor doesn't show up.
Unfortunately, the Google spreadsheet gets cleared each week (our vet has all the numbers), but I will be updating it tomorrow and can share the link. Actually, if anyone doesn't mind even just taking a look at Puma's dosing guide, I'd be interested on anyone's thoughts: https://docs.google.com/spreadsheets/d/1bjyEN9KIa4fkjtVgNL0Xm5SlCe8wQpTlGERwjKDWPhk/edit#gid=5

Hope that works. Puma pretty much plateaued at 10-11 units max for the past 6 months. Our vet has both increased, and then at times decreased the dose, as Puma's numbers went too low. Again, she generally stays between 200-350, but at times can drop to under 100 (60 was her lowest, we managed it with some dry food) or spike to 400-500 with no rhyme or reason.

Thank you all again for the advice. It feels good to communicate with people who actually know how crazy it can get. In closing, I'll leave you with another picture that is probably a familiar scene to you all :)
10632733_10153279535580715_3771132902640165068_n (1).jpg
 
mmm FOOD! yes, that's familiar!

You'll have to change the sharing on your google doc to "anyone with the link" so we can see it. Right now the access is denied.

It really helps to see previous data with diabetic cats. You might start a new spreadsheet and let it all continue on there so we can see more than a week's worth of tests. Especially trying to spot something like iaa, it would definitely take more than a week's worth of info.
 
oh, and everyone that's had the SRT done has to have the pictures taken first to confirm there is a tumor there. Punkin's was large and pressing on his optic tracks. His pupils had blown open from it. I can't remember without looking back if it was an x-ray or CT scan. I think it was the scan.
 
What type of blood glucose meter are you using? If it's a human one, the 60 is not really a low number. Folks here who follow Tight Regulation don't give high carb food until under 50. On the AlphaTrak, the number used is 68.

If you do contact West LA, I'm interested in what they say. I haven't heard what the surgery costs are. The other site that does the surgery in North America is in Washington State, but the person in West LA has the most experience, and is closer to you.

Due to the cost of the CT scan, most people don't get it done to confirm acromegaly. If any other conditions have been ruled out (needing a dental, eating dry or high carb food, hyperthyroidism), then the chances of having a dose over 6 units and a positive IGF-1 test are pretty indicative of acromegaly. Especially with Puma's IGF-1 number (Neko was higher, but had a smaller tumor than punkin who had a lower IGF-1). You are right that the tumor doesn't always show up on the CT, sometimes they have to go to an MRI to see it. Just for fun, here is Neko's CT scan of her tumor from her trip to Colorado State University. It's the little partial moon shaped gray thing on the bottom of the white square and just above the black squarish thing in the middle of her head.
tumour2.jpg
 
Thanks for letting me know about the link, Julie! Honestly, I hand write everything and then type it in each week so I'm pretty bad with spreadsheets. I can use the form the board uses and type in my handwritten records.

We use the AlphaTrak meter. I don't trust myself not to make a mistake converting from a human meter.

Poor Punkin having the tumor pressing on his optic tracks! That alone must make him so relieved to have been treated. And Neko's CT scan is fascinating. I can definitely make out the tumor.

Puma is currently being seen at the San Diego VCA by an internal medicine vet. She has worked there for years and specializes in feline diabetes. I have a feeling she may already know of Dr Bruyette so I will inquire with her.
 
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