Any SRT experiences in Ohio?

Is this what you mean? I was going to tag @Sienne and Gabby (GA) for you on this because she lives in Ohio and may know. Or did she give you some leads there already? @Wendy&Neko is on vacation at this time, I believe and she is our Acromegaly expert. Her cat, Neko, had SRT in Colorado, I know. I am not recalling anyone recently whose cat had SRT in Ohio, but that is just off the top of my head. Oh this acromegaly forum, many of our acro caregivers have written about their experiences. Have you read through the threads and articles here?
 
I don’t think anyone will be upset. Our Acro group is not as large as the whole FDMB membership at large, but most people are happy to help. Some who have chosen SRT (or surgery) and have had their cats successfully treated are not very active on the FDMB anymore, and some who have lost their cats are also not very active either. Those who are still around are more than happy to share their experiences. Wendy is an amazing resource as, in addition to being the most well-informed person here on feline acromegaly, she has been here for quite a few years and has an “institutional memory” of acrocats and their caregivers. She will not be around much for the next two weeks.
@Jodey&Eddie&Blue had two boys with acromegaly and can share her experiences. She still stops in from time to time.
 
Neko had SRT in Colorado. The SRT in Canada at the time cost 50% more.

Ohio State University has SRT listed on their website. Teaching hospitals can be friendlier to approach, maybe they will give references?
 
Madm4444 said:
Does anyone have experience with SRT in Ohio?
MedVet Columbus or OSU?
Click to expand...
Hi -- I am in Cincinnati. Our Cat, Fonzie, had SRT in Cincinnati at the Med Vet this past Oct, 2024. We began seeing results in Dec 2024, where he was on 6 units twice a day and we began dropping steadily. Now, Feb 20, he is at 1.5 units AM and 1 Unit PM. We are still trying to find his best dose as we had a low glycemic event last Thursday where he dropped to 65 within 2 hours of Insulin. He is on Lantus. But, we are encouraged by the decreased need for insulin -- just still trying to find his correct dose. It has been a journey -- frustrating at times, but I know we made the right decision to treat with SRT. Med Vet did a great job w/ the SRT. I was a complete "helicopter parent" obsessively calling the IM specialist and Oncologist, but, the treatment seems to be working. It was scary putting him under anesthesia for 3 consecutive days in a row, but, they worked with me on the amount of anesthesia and were in constant contact. Ultimately, they did a great job and have a good team. Fonzie is 14 and otherwise in good health other than IBS and slight pancreatitis and the Acromegaly. We are not planning on doing a follow up CT scan as that was very traumatic for him and we don't want to put him through that again. However, I am planning on re-testing for the HG-1 hormone blood test to see if it has changed since the SRT. We are doing that next week. Let me know if you have any questions, happy to share.
 
Thanks for sharing your story about Fonzie.

Save your money on retesting the IGF-1 values. That’s what I was told by Colorado State University who did a lot of the early research on SRT for acros, including retesting IGF-1. The value doesn’t indicate anything about the size of the tumour, and can even go up after SRT. Which I have seen with the odd person who did retest, and was disappointed by the result.
 
FonzieFremeau said:
Hi -- I am in Cincinnati. Our Cat, Fonzie, had SRT in Cincinnati at the Med Vet this past Oct, 2024. We began seeing results in Dec 2024, where he was on 6 units twice a day and we began dropping steadily. Now, Feb 20, he is at 1.5 units AM and 1 Unit PM. We are still trying to find his best dose as we had a low glycemic event last Thursday where he dropped to 65 within 2 hours of Insulin. He is on Lantus. But, we are encouraged by the decreased need for insulin -- just still trying to find his correct dose. It has been a journey -- frustrating at times, but I know we made the right decision to treat with SRT. Med Vet did a great job w/ the SRT. I was a complete "helicopter parent" obsessively calling the IM specialist and Oncologist, but, the treatment seems to be working. It was scary putting him under anesthesia for 3 consecutive days in a row, but, they worked with me on the amount of anesthesia and were in constant contact. Ultimately, they did a great job and have a good team. Fonzie is 14 and otherwise in good health other than IBS and slight pancreatitis and the Acromegaly. We are not planning on doing a follow up CT scan as that was very traumatic for him and we don't want to put him through that again. However, I am planning on re-testing for the HG-1 hormone blood test to see if it has changed since the SRT. We are doing that next week. Let me know if you have any questions, happy to share.
Click to expand...

Thank you for the info. It's all very overwhelming.

A couple of questions:
Did Fonzie stay in the hospital or did you do outpatient?
How was Fonzie feeling/acting in the days following the treatment?

I will prbly have more questions. I hope it's okay to reach out as they come to me.

Thank you!
 
Madm4444 said:
Thank you for the info. It's all very overwhelming.

A couple of questions:
Did Fonzie stay in the hospital or did you do outpatient?
How was Fonzie feeling/acting in the days following the treatment?

I will prbly have more questions. I hope it's okay to reach out as they come to me.

Thank you!
Click to expand...

Of course — It was so overwhelming for us too! I completely understand.
Fonzie did not stay in the hospital — we did not want to do that and wanted him home with us after each treatment. We did outpatient. It looked like us dropping him off around 9:00am and picking up around 4pm the first day, then shorter days on days 2 and 3 (9am-2pm).

Fonzie has a very hearty appetite and LOVES food, and we found that the anesthesia made him super food aggressive. he was trying to break open his automatic feeder in the middle of the night after the first treatment. He also was loopy and unsteady from the anesthesia, which was really scary. He did not seem like himself. I stayed up with him for the three nights and really did not leave his side as I was on high alert. They kept his IV line in, as they said that that way they did not have to keep sticking him, but then we worried about Fonzie chewing the tubing and ripping it out — it was a very scary 3 days. He is heart healthy and was cleared for the surgery through the cardiologist but I still had fear of him not waking up from the treatment.

I want to add that prior to us choosing SRT, we had the CT scan and the oncologist said that his pituitary tumor was VERY small. They had not seen one that small as usually patients come in with ones double the size. We had caught it very early on. She told us that his percentage rate of the SRT working and shrinking/stopping the tumor was 95%. This is the reason why we chose to do the procedure.

The days following the surgery, he was tired and did not have his usual energy. He did have his appetite — as he always does! But, he was tired and his personality was off. He slowly got better but his entire experience (with the diabetes since August) and the CT scan and the SRT has changed him. He is different. Still a loving and beautiful and wonderful angel, but his personality is a little different. He is also older now (14), as senior, and not as spry or agile. But, slowly some of his old behaviors are coming back (carrying around stuffed animals and mewing in the middle of the night!) He stopped doing that for a while during the treatment.

It was hard and scary, but, for Fonzie’s circumstances, I am really glad we did it!

Please reach out with questions anytime — I am happy to share and hopefully help!
 
Madm4444 said:
A couple of questions:
Did Fonzie stay in the hospital or did you do outpatient?
How was Fonzie feeling/acting in the days following the treatment?
Click to expand...
Neko was not treated in Ohio, but location shouldn't impact how it's done. I stayed in a hotel and took Neko in each day and she stayed with me overnight. Only cats with some risky medical issues (like heart) that needed extra monitoring stayed overnight at CSU. Timing for visits was similar to Fonzie's. After the first day, which was the long one with CT scan, Neko was scared and hid under furniture for a couple hours. But came out at dinner time and settled down. She was fine the rest of the days. Some smaller percentage of cats can get fog or possible headache from the procedure. I was given a prescription for prednisolone as an anti-inflammatory to be given for 5 days if needed. We didn't need it but have heard of one that did. We have had a couple cats here have irritation of the throat due to the intubation. Soft tissue growth, if they have it there, can make the throat more narrow and I've see people recommend kitten size intubation tubes because of that.

Second time with SRT was more scary. In spite of the all clear from the cardio vet and an echocardiogram done two weeks before hand, she had a heart block during the CT scan. The radiation oncologist consulted with a cardiologist (thankfully vet teaching hospital had all the specialists needed to consult), and the team decided she'd get just one larger dose instead of 3 smaller doses as done the first time. But we gave her a couple day break first. They consulted with NCSU who had done quite a few of the single dose procedures - turns out some of those team were CSU grads. :)

Review paper here with more stories:
Stereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly ByTiffany L. Wormhoudt, Mary-Keara Boss, Katharine Lunn, Lynn Griffin, Del Leary, Kristy Dowers, Sangeeta Rao and Susan M. LaRue
J Vet Internal Medicine, 2018 Jul-Aug; 32(4): 1383–1391. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15212

Neko was the first retreated cat mentioned in the paper.
 
Last edited:
Wendy&Neko said:
Neko was not treated in Ohio, but location shouldn't impact how it's done. I stayed in a hotel and took Neko in each day and she stayed with me overnight. Only cats with some risky medical issues (like heart) that needed extra monitoring stayed overnight at CSU. Timing for visits was similar to Fonzie's. After the first day, which was the long one with CT scan, Neko as scared and hid under furniture for a couple hours. But came out at dinner time and settled down. She was fine the rest of the days. Some smaller percentage of cats can get fog or possible headache from the procedure. I was given a prescription for prednisolone as an anti-inflammatory to be given for 5 days if needed. We didn't need it but have heard of one that did. We have had a couple cats here have irritation of the throat due to the intubation. Soft tissue growth, if they have it there, can make the throat more narrow and I've see people recommend kitten size intubation tubes because of that.

Second time with SRT was more scary. In spite of the all clear from the cardio vet and an echocardiogram done two weeks before hand, she had a heart block during the CT scan. The radiation oncologist consulted with a cardiologist (thankfully vet teaching hospital had all the specialists needed to consult), and the team decided she'd get just one larger dose instead of 3 smaller doses as done the first time. But we gave her a couple day break first. They consulted with NCSU who had done quite a few of the single dose procedures - turns out some of those team were CSU grads. :)

Review paper here with more stories:
Stereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly ByTiffany L. Wormhoudt, Mary-Keara Boss, Katharine Lunn, Lynn Griffin, Del Leary, Kristy Dowers, Sangeeta Rao and Susan M. LaRue
J Vet Internal Medicine, 2018 Jul-Aug; 32(4): 1383–1391. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15212

Neko was the first retreated cat mentioned in the paper.
Click to expand...


Thank you, @Wendy&Neko you mentioned "We have had a couple cats here have irritation of the throat due to the intubation.". I had forgotten about this until I saw your post. Fonzie had irritation of throat from the intubation and it scared me as he kept making "gulping" sounds during the three days of the SRT and then for several days afterwards. He has since stopped of course and was better in a few days. But, it was alarming, especially since due to the nature of the entire situation we were on high alert for any abnormal behaviors or sounds exhibited by Fonzie.
 
We had a similar experience as described above… The first day was extra long (in addition to scans and measurements, they had to make the mouth piece and do prep work). Tubby came back to the hotel overnight each night and was delivered back to the university each morning. We managed the insulin shots and dosing decisions around his treatment schedule — Tubby was one of those whose BG liked to drop when under stress.

Tubby looked like he had a headache and brain fog after each treatment. He was bleary eyed and eyes were a bit watery, his personality was more muted, and it just seemed he didn’t feel well. It passed within a week or so, if I recall, but was unsettling to see in the moment. In our case I don’t remember them offering prednisolone.
 
Wendy&Neko said:
Thanks for sharing your story about Fonzie.

Save your money on retesting the IGF-1 values. That’s what I was told by Colorado State University who did a lot of the early research on SRT for acros, including retesting IGF-1. The value doesn’t indicate anything about the size of the tumour, and can even go up after SRT. Which I have seen with the odd person who did retest, and was disappointed by the result.
Click to expand...


@Wendy&Neko just an update -- I decided against the IGF-1 re-test.
 
Good luck on Monday!

I would find out when you can visit. Also find out when you can call or ask to have a resident or the vet (someone who actually knows what's going on with Buster) call to give you an update.

Bring along an article of clothing that smells like you. (In other words, wear a T-shirt that you can make sure is smelly and bring it along.) It may help to keep Buster calm.
 
Did they say why he's staying in the hospital instead of staying with your overnight? Some cats don't eat well in the hospital, though generally not so much an issue with acros. Make sure they've got his favourite food. Also ask if you can come in and give his shots - that's what I did when Neko had to stay in ER for a few days. Not sure I'd trust the clinic to get his shot done on time and make sure he's eating. One morning I came in and Neko was 59 on the AT. :eek: Definitely a skip that morning!

Given that Buster's been seeing some loverly greens, I'd take his dose down, at least one unit, for the duration of his SRT. Not sure I'd trust the clinic to get his shot done on time and make sure he's eating. He should be getting a reduced dose in the mornings, but ....

I'm sure the SRT part will go well, once this is all over you will be so happy you had it done.
 
FonzieFremeau said:
@Madm4444 sending strength and best possible outcome for Buster! I know you are nervous and want to make the best decisions for him. You are doing that! Lots of hugs to Buster!!
Click to expand...

Thank you!

Sienne and Gabby (GA) said:
Good luck on Monday!

I would find out when you can visit. Also find out when you can call or ask to have a resident or the vet (someone who actually knows what's going on with Buster) call to give you an update.

Bring along an article of clothing that smells like you. (In other words, wear a T-shirt that you can make sure is smelly and bring it along.) It may help to keep Buster calm.
Click to expand...

Thank you so much for the tips. I'm getting more & more worried about him staying there. :rolleyes:

Wendy&Neko said:
Did they say why he's staying in the hospital instead of staying with your overnight? Some cats don't eat well in the hospital, though generally not so much an issue with acros. Make sure they've got his favourite food. Also ask if you can come in and give his shots - that's what I did when Neko had to stay in ER for a few days. Not sure I'd trust the clinic to get his shot done on time and make sure he's eating. One morning I came in and Neko was 59 on the AT. :eek: Definitely a skip that morning!

Given that Buster's been seeing some loverly greens, I'd take his dose down, at least one unit, for the duration of his SRT. Not sure I'd trust the clinic to get his shot done on time and make sure he's eating. He should be getting a reduced dose in the mornings, but ....

I'm sure the SRT part will go well, once this is all over you will be so happy you had it done.
Click to expand...

It was actually our idea. We thought with his heart issues & anesthesia, that it would be best if he was under medical supervision. We are rethinking that decision now given all the potential variables related to his bg & insulin... :banghead:
 
I hadn't realized his heart issues were anything more than a murmur. Have you had an echocardiogram done on him? FWIW, Neko had a heart block and they had a hard time getting her out of anaesthesia for the CT scan for her second round of SRT. She still came back to the hotel with me.
 
FonzieFremeau said:
@Madm4444 sending strength and best possible outcome for Buster! I know you are nervous and want to make the best decisions for him. You are doing that! Lots of hugs to Buster!!
Click to expand...
Gosh, I'm a bit late to the conversation so hope all went well. Both Eddie and Blue had SRT at different times and while Blue did better than Eddie while staying overnight, both of them came out ok. All my best thoughts for Buster and you! :bighug::bighug::bighug::cat::bighug::bighug::bighug:
 
Wendy&Neko said:
I hadn't realized his heart issues were anything more than a murmur. Have you had an echocardiogram done on him? FWIW, Neko had a heart block and they had a hard time getting her out of anaesthesia for the CT scan for her second round of SRT. She still came back to the hotel with me.
Click to expand...

He had his echo in Nov. HCM suspected. No medication or interventions necessary at this time. I guess I'm just nervous.

The more I've read, the more inclined we are to bring him home.
We are, of course, concerned about his appetite, nausea & any pain. The biggest physical challenge we will prbly have is the IV catheter. The last time he had one (in the hospital), he couldn't stop messing with it. It was a thing amongst the staff. :rolleyes:
 
Jodey&Eddie&Blue said:
Gosh, I'm a bit late to the conversation so hope all went well. Both Eddie and Blue had SRT at different times and while Blue did better than Eddie while staying overnight, both of them came out ok. All my best thoughts for Buster and you! :bighug::bighug::bighug::cat::bighug::bighug::bighug:
Click to expand...

Thank you! You didn't miss it. Day 1 is tomorrow! :nailbiting:
 
Paws crossed for tomorrow. Neko had "just HCM no treatment needed and no counterindications for anaesthesia" for a couple years before it progressed.
 
@Sienne and Gabby (GA)
@Suzanne & Darcy
@Wendy&Neko
@JL and Chip
@FonzieFremeau
@Jodey&Eddie&Blue

Buster's SRT is done! He finished yesterday & did great. We decided to bring him home each day instead of staying at the hospital. I'm so glad we did.

Since he had his CT scan in February, all the prep work (bite molds, positioning info) was done so the treatments weren't long.

Day 1 was rough. When we picked him up, he was wonky, wobbly, wandering. It took about 4 hours before he was even remotely normal. We didn't understand it b/c he handled the anesthesia so well for the CT scan (fine after about 1-2hrs). We were concerned it was the treatment. We were wrong. When we discussed it the next day with the doctor, she told us that he had to have extra sedation in the morning when they placed the IV catheter. So, coupled with the anesthesia, it must have hit him harder. I stayed up pretty late that night watching him.

They secured the IV catheter with a plastic cover that had velcro. It kept everything in place but he hated it. It drove him crazy every single second. I kept an eye on him all day so he only needed the ecollar for sleeping.

Day 2 & 3 went much smoother. Hardly any effects from anesthesia. Slept a couple of hours & back to his hungry self. He got his bandana (Day 3) for completion of his treatment & all the team signed it.

Unfortunately, he got constipated along the way so we're working on that... but otherwise, he's doing very well.

Regarding his bg, he stayed in the 300s (low, mid & high) most of the time. Ketones creeping up a little but we're watching it. Appetite has been fine.

The facility (The Ohio State University) took great care of him & there was limited downtime. No delays. Communication was a little challenging but all-in-all, a positive experience.

Buster was a trooper through it all. He was so brave! I'm so proud of our boy!

Thank you for your thoughts & prayers!

Now, we wait...
 
I'm SO glad he got through everything with few side effects and that you were pleased with his care. I'm keeping my fingers crossed that the SRT works well and Buster keeps making progress.
 
Woohoo! So glad it's done, what a relief. :) I'm glad he was able to come home with you every night, I'm sure that helped him too.

Now we have a solution for people in the Ohio State area, hopefully one day this thread will help others.
Madm4444 said:
Now, we wait...
Click to expand...
Every Cat is very different. Neko earned her first reduction on the road trip home, most take a little longer. I've seen some as long as 3 months. Keep posting and we can help you through this next stage of the adventure.
 
Thanks for posting this! I’ve been waiting to hear the update. I was looking at your spreadsheet and knew where he was in the treatment. I know you will watch him closely. Be sure to always take the reductions he earns! Keep posting for assistance. Big hugs to you and pets for Buster.
 
@Suzanne & Darcy
@Wendy&Neko
@Sienne and Gabby (GA)

Buster had to be admitted yesterday at MedVet ER for his constipation. It looks like the 3 days of anesthesia for his SRT had a much worse effect than anyone thought. He had started with a few small poops so we thought things were moving. He was eating fine. Then I saw him straining with nothing happening. That's what happened last time (Nov 24).

He is getting a slow dose of Golytely through an ng tube to not overwhelm his heart (HCM) with fluids.

I brought his ProZinc & food to them. We are trying not to disrupt his system with short-acting insulin if we don't need to. He has his Libre & they have his reader. They are checking his numbers every 2 hours.

After getting through his SRT treatment like a champ just a few dsys ago, now he has to deal with this. My heart hurts for him. He has been through so much...
 
Oh no. I feel horrible for Buster. I feel like they should have warned you that this could happen and perhaps it could have been prevented with a little prophylactic MiraLax. I hope they will clear this soon because I can’t stand the idea of him having the NG tube. They didn’t think he needed an enema. I’m so sorry this happened!! Keep us posted.
 
@Suzanne & Darcy
@Wendy&Neko
@Sienne and Gabby (GA)

Buster came home yesterday afternoon. In addition to the 16+ hrs of Golytely, he also get 3 enemas over the 2.5 days. They kept him on gabapentin so when I went to visit on Saturday, he was just chilling. He was totally cleaned out when we picked him up (I saw the radiograph). Yes, he required a lot of "cleaning" when we got home.

In addition to his usual meds (ondan, cerenia, Miralax, methyl b-12/folic acid), they have added Cisapride 2x daily for 5 days. We are unsure what kind of frightening result we will get from the Miralax & Cisapride together... :eek:

Although they had his ProZinc & we were trying to stay on schedule, they ended up being quite creative with his dosing & times.
As Wendy mentioned previously (I think), they tend to keep them higher so the staff doesn't have to contend with possible hypo episodes. He had his old Libre at the beginning but it was running out of time so they put a new one on. It didn't work so they did manual tests with AlphaTrak until we could bring a new one yesterday. Fortunately, he stayed in the 200s then 300s. But he was heading up when we got him. Last night PMPS 412 ketones 0.6. We need to get back on track.

As Wendy said, hopefully this was just a bump in the road. Given all he's been through, he's doing remarkably well. Eating great, has some energy (b/c he's lighter!), talking, purring.

Thank you again for all your support!
 
Good luck with the Cisapride. I hope he will not need it after five days. In human patients, it was banned due to causing heart arrhythmia — an effect that has not been documented in veterinary patients. The Cisapride helps GI motility and the MiraLax softens the stool, so they work on different aspects of constipation (so hopefully no double whammy there for Buster!)
 
Suzanne & Darcy said:
Good luck with the Cisapride. I hope he will not need it after five days. In human patients, it was banned due to causing heart arrhythmia — an effect that has not been documented in veterinary patients. The Cisapride helps GI motility and the MiraLax softens the stool, so they work on different aspects of constipation (so hopefully no double whammy there for Buster!)
Click to expand...

Not sure if you saw my other thread. What did you think of the reduced dose of 14?
 
I noticed the 14 units this morning. I think it was brave of you to shoot 14 units with a 128 AMPS. I know you are eager to get everything back on track. However, we can see now (with hindsight) that it was the end of his long string of blues continued over from last night. He went yellow… and then? I am really hoping he won’t go into pink or red. I will wait for you to update his SS when you get a chance. Did you have to install the new Libre sensor yourselves?
 
Suzanne & Darcy said:
I noticed the 14 units this morning. I think it was brave of you to shoot 14 units with a 128 AMPS. I know you are eager to get everything back on track. However, we can see now (with hindsight) that it was the end of his long string of blues continued over from last night. He went yellow… and then? I am really hoping he won’t go into pink or red. I will wait for you to update his SS when you get a chance. Did you have to install the new Libre sensor yourselves?
Click to expand...

You & I didn't get a chance to connect this morning about his dose. After 15u last night dropped him so fast & 8u didn't do much in the hospital, I thought we had an opportunity to do less.

What dose would you have suggested with the 128 AMPS?
 
Madm4444 said:
You & I didn't get a chance to connect this morning about his dose. After 15u last night dropped him so fast & 8u didn't do much in the hospital, I thought we had an opportunity to do less.

What dose would you have suggested with the 128 AMPS?[/ I thought you did fine to shoot the 14 units. I only meant that not a lot of people would have. I am glad you continued with 14 today. We need to see how it goes for at least 6 cycles (unless he surprises by earning a reduction.)
Click to expand...
 

Ha! I was so confident that he would just go up higher again. Well, the joke's on me! Check out his spreadsheet! Libre=53; AT3=84.
Could changes be happening this soon?

And we have more normalized poops! What a day so far!!

Given this drop, should I still keep things at 14 tonight?
 
I had a feeling! I didn’t think your SS was updated when I looked but I had a feeling. I think you better reduce. Reduce by ten percent at least 1.5 units. If he’s low at PMPS you may need to consider reducing even more.
 
Suzanne & Darcy said:
I had a feeling! I didn’t think your SS was updated when I looked but I had a feeling. I think you better reduce. Reduce by ten percent at least 1.5 units. If he’s low at PMPS you may need to consider reducing even more.
Click to expand...

Given his numbers, what do you consider a low PMPS?
 
Yup, looks like some of those tumour cells are dying off already. :D. Or it's the relief from the constipation. And/or seeing enough greens to start breaking glucose toxicity. Regardless, time to reduce the dose. I strongly recommend taking reductions at a little higher numbers than you would normally when the SRT action might be part of the picture. With Lantus, I used a cutoff of 70 instead of 50. Not sure what to say about Prozinc.
 
You must log in or register to reply here.
Back
Top