Breathing issues related to Acromegaly? Vet thought it was Asthma

C

colin72

Member
Hi all

Midas has had breathing issues I'd like to get your opinions on. I believe it may be related to Acromegaly.

In October 2021 (two months before he was diagnosed with Diabetes), Midas was breathing rapidly, sometimes with an open mouth. My vet did an exam and x-ray and thought Midas had Asthma. My vet suggested it might be seasonal and prescribed an Albuterol inhaler. Midas used the Albuterol for about 6 weeks as needed and then his breathing was fine (seeming to indicate it was Asthma and was seasonal).

Midas had no breathing issues until May 2022. I tried using the Albuterol again but his breathing would seem OK for awhile but then he'd go back to rapid breathing. The Albuterol wasn't helping. I closed all windows thinking the high pollen count was making things worse and bought an air purifier. It didn't help. A couple weeks ago Midas was given a Flovent inhaler (250 mcg). I was told it could take 2 weeks to see an effect. He was on 1 puff twice a day but with no change in his breathing, he just went up to the max dose of 2 puffs twice a day.

This past Wednesday, Midas' was open mouth breathing a lot. In the past I would see him do it every few days for maybe 5 seconds at a time. After advice from a Yahoo Asthma Group and my vet, I took Midas to an ER vet Thursday morning.

Basically, the ER vets weren't sure why Midas is having respiratory issues. I forget the terminology they used but they showed me an x-ray and explained that if it was Asthma, they weren't seeing signs they would normally expect to see. Blood work was done and everything was generally fine. They did mention a slightly enlarged heart but didn't act as though it was significant.

Midas was prescribed Terbutaline and Cyclosporine (which he hasn't started because it had to be ordered online). Also, I was told to continue using the Flovent inhaler and use the Albuterol as a rescue inhaler as needed.

They suggested Midas see a specialist in internal medicine ASAP.

I've never taken a pet to a specialist. Those on the referral list I was given by the ER vet are all about 1 hour 30 minutes away (Midas will not be happy about that drive). I was warned that the wait time to get in could be long. After calling several and finding the earliest I could get in was 3-4 weeks, I found one that said I could show up early Monday to their ER and after Midas is seen there, he would likely be able to see their specialist if needed. So that seems to be my best bet (the specialist ER hospital is BluePearl in Rockville, MD).

I wanted to get your opinions on what has been going on. Midas tested positive for Acromegaly and IAA. I've had his Cabergoline for about a month but was afraid to start it with everything else going on. I didn't want to possibly cause him GI problems in addition to his breathing issues. I kept thinking his breathing problems would be resolved "soon" but things kept dragging on and I have delayed giving him the Cabergoline.

Similarly, I haven't increased his insulin dose for a long time because I expected him to start the Cabergoline.

I know that's a lot of info but does anyone have any thoughts? I'm scared and sick to my stomach over all this. Thank you.
 
colin72 said:
Hi all

Midas has had breathing issues I'd like to get your opinions on. I believe it may be related to Acromegaly.

In October 2021 (two months before he was diagnosed with Diabetes), Midas was breathing rapidly, sometimes with an open mouth. My vet did an exam and x-ray and thought Midas had Asthma. My vet suggested it might be seasonal and prescribed an Albuterol inhaler. Midas used the Albuterol for about 6 weeks as needed and then his breathing was fine (seeming to indicate it was Asthma and was seasonal).

Midas had no breathing issues until May 2022. I tried using the Albuterol again but his breathing would seem OK for awhile but then he'd go back to rapid breathing. The Albuterol wasn't helping. I closed all windows thinking the high pollen count was making things worse and bought an air purifier. It didn't help. A couple weeks ago Midas was given a Flovent inhaler (250 mcg). I was told it could take 2 weeks to see an effect. He was on 1 puff twice a day but with no change in his breathing, he just went up to the max dose of 2 puffs twice a day.

This past Wednesday, Midas' was open mouth breathing a lot. In the past I would see him do it every few days for maybe 5 seconds at a time. After advice from a Yahoo Asthma Group and my vet, I took Midas to an ER vet Thursday morning.

Basically, the ER vets weren't sure why Midas is having respiratory issues. I forget the terminology they used but they showed me an x-ray and explained that if it was Asthma, they weren't seeing signs they would normally expect to see. Blood work was done and everything was generally fine. They did mention a slightly enlarged heart but didn't act as though it was significant.

Midas was prescribed Terbutaline and Cyclosporine (which he hasn't started because it had to be ordered online). Also, I was told to continue using the Flovent inhaler and use the Albuterol as a rescue inhaler as needed.

They suggested Midas see a specialist in internal medicine ASAP.

I've never taken a pet to a specialist. Those on the referral list I was given by the ER vet are all about 1 hour 30 minutes away (Midas will not be happy about that drive). I was warned that the wait time to get in could be long. After calling several and finding the earliest I could get in was 3-4 weeks, I found one that said I could show up early Monday to their ER and after Midas is seen there, he would likely be able to see their specialist if needed. So that seems to be my best bet (the specialist ER hospital is BluePearl in Rockville, MD).

I wanted to get your opinions on what has been going on. Midas tested positive for Acromegaly and IAA. I've had his Cabergoline for about a month but was afraid to start it with everything else going on. I didn't want to possibly cause him GI problems in addition to his breathing issues. I kept thinking his breathing problems would be resolved "soon" but things kept dragging on and I have delayed giving him the Cabergoline.

Similarly, I haven't increased his insulin dose for a long time because I expected him to start the Cabergoline.

I know that's a lot of info but does anyone have any thoughts? I'm scared and sick to my stomach over all this. Thank you.
Click to expand...
I will tag
@Wendy&Neko for you who is our expert on this

Can you add tested positive for Acromegaly and IAA to your signature it's important

To add this tap on your name then tap on signature and add it then tap Save
 
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I think a visit to an IM vet or a cardiologist vet is a good idea. Many acros have heart issues, and those breathing issues could be caused by the heart as well. The BluePearl group seem to have a decent reputation, I'm glad you can get him in their sooner. Maybe consider increasing his insulin dose once you've had him to the specialist. Let us know what they think is going on. They may suggest a CardioPet ProBNP test that will give a bit better clue what is happening with the heart, though an echocardiogram would be the definitive answer.

Other than the breathing, how is Midas feeling? Eating OK? Any lethargy?
 
Wendy&Neko said:
I think a visit to an IM vet or a cardiologist vet is a good idea. Many acros have heart issues, and those breathing issues could be caused by the heart as well. The BluePearl group seem to have a decent reputation, I'm glad you can get him in their sooner. Maybe consider increasing his insulin dose once you've had him to the specialist. Let us know what they think is going on. They may suggest a CardioPet ProBNP test that will give a bit better clue what is happening with the heart, though an echocardiogram would be the definitive answer.

Other than the breathing, how is Midas feeling? Eating OK? Any lethargy?
Click to expand...


Other than the breathing issues, he seems fine. He has been drinking more water than usual which I guess is understandable with his breathing. He's eating great. No lethargy.

I'm feeling like there are going to be no good answers coming from the trip this Monday (assuming they can find answers). Am I wrong to be so pessimistic? This just feels really bad and hopeless. Does anyone think there are any scenarios where the cause of his breathing issues can be resolved and I can go back to concentrating on his issues with Diabetes and Acromegaly?

Thanks so much for the advice and feedback. It is greatly appreciated.
 
Yes, if certain types of heart issues is the answer, there are medications that can help. In preparation for the visit, you might want to find a time when Midas is relatively relaxed and count the number of complete in and out breaths he does per minute. This is called the resting respiration rate, often referred to as RR. Ideally it should be in the 20-30 range. It's often higher at a vet (Neko could be a lot higher), so it's a good test to do at home. I just set a 1 minute timer on my phone and counted while Neko's snoozed.
 
I doubt if you have yet, but I would not give either of those prescribed drugs (by the ER vet) to my cat without checking with the IM vet first. They're associated with potentially serious side effects. You are probably already doing this (waiting, I mean.) I read through this thread and have been thinking about it all weekend. I hope things go well today. I imagine it will be a long day.
 
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