? Cabergoline/Acro/IAA Information

[Breanna H]

Hello all!

Tigger is a high dose cat (as you can see from his spreadsheet). He is going for his official acro/IAA testing on November 16th. I am looking into gathering as much information on Cabergoline as I can for the vet before I go but I am struggling to find information.

I do have some spreadsheets of those of you using it, but I also would like to provide my vet with information on how to get it. Does the vet prescribe it? Is it a shot or pill? Do I need to get it from a special pharmacy or place? Is it terribly expensive? I really don't know anything about it, other than how it seems to improve the numbers on some kitties spreadsheets. Any links to articles you may have been able to find would be awesome as well!

Are there any other options for acro kitties? Tigger is getting terribly expensive. We started August 30th and paid 198.00 (US) for his levemir from Marks. I have one pen left and I just got my new shipment yesterday, less than 2 months later. That hasn't even been at the 15u the whole time, and we are still going up. His numbers aren't horrible, but he is definitely symptomatic. Litter caked paws, huge clumps in the box and acts starved all the time, as well as his worsening neuropathy (he is on zobaline).

If he isn't acro, and he has IAA, what are my options then? How do I treat him? I haven't read up too much on this.

Thank you all! Just like to be prepared and have information so I can try to do what is best for Tigger.

 

[Wendy&Neko]

Info on cabergoline, places people get it compounded, usually liquid, and some pricing: https://felinediabetes.com/FDMB/thr...ble-treatment-for-acrocats-discussion.184012/

The other options for acros are a lot more expensive, current other treatments mostly 5 figures. Cabergoline is affordable. IAA - nothing much you can do but wait. The antibodies are self limiting after around a year. Or if there is some underlying condition (like needing a dental), treatment of that seems to give a kick start to antibodies going away. After 9 months on insulin, Neko's radiation therapy to treat her acro tumour seems to have also kicked down the antibodies.

 

[Larry and Kitties]

To make insulin more affordable you can substitute some either R or N insulin for some of the Levemir. I used N since I was too scared to use R but other have used R. Mu MurrFee was up to 50 units twice daily and I used 25 Levemir and 25 units N. You can get N from Walmart for about $25 for a 10 ml vial.

 

[Wendy&Neko]

If you would like to try N or R, please post and ask for help. It's an advanced technique and there is lot to learn about it, specifically when not to use it. We suggest that you get an experienced user to help the first you few times you use it. I've also seen caregivers try it on their own with rather poor results. Larry is rather more experienced.

 

[Erin and Moe (GA)]

Hi Breanna. My Moe is an acro cat. We are in week 20 of cabergoline and started seeing an improvement (insulin dose decrease) around week 9. The only side effect we saw was diarrhea on the first day, and he was fine after that.

Cabergoline has to be prescribed by your vet and compounded into the correct dose for your cat’s weight. I believe the dose is 10 mcg/kg. I think a lot of people use a liquid version of the mediation, which makes dose adjustment easier if there is weight gain or loss. Moe doesn’t like liquid meds, so I opted for pills instead. I just got a new prescription for capsules filled at Wedgwood compounding pharmacy (my mail). It was under $200 for a 90 day supply. Using my local compounding pharmacy for a 30 day supply was almost the same cost.

SRT at the facilities near me (southeast Texas) was over $8,000, so that was not an option for us.

There’s a tab on Moe’s SS where I was tracking his food, between meal snacks, side effects, etc. I haven’t been keeping up with it for the last few weeks, but the info might be useful for you and your vet.

 

[Howiesmom]

Hi Breanna, My Howie was diagnosed with IAA on Sept. 30 and I switched him to Levemir on 10/16/20. He’s not anywhere near your doses but his appetite has subsided a bit in the past month or so. He is a little under 10 lbs but I give him 450 calories/day. Make sure you are watching for ketones if you aren’t already (I just got the Nova Max glucose/ketone blood meter but just use it for ketone tests). Also for the neuropathy, have you considered methyl b12 From Vitacost instead? I got it on a recommendation from the forum and give him 1 capsule/day along with half a Crushed pill of folic acid (400 mcg pills) in his food. From what I learned, it does the same thing as Zobaline but is much less $. The methyl b12 I get are 100 capsules for $17.99 and I think the folic acid was around $6.

We tested him for both acro and IAA (my vet didn’t know about the IAA test until I literally had him on the phone and read directly from this forum)! It was a relief to get some test results back to know I wasn’t going crazy. Luckily his acro test was negative.

You’ve been at this longer than me but keep doing lots of research. I love my vet and wouldn’t dream of changing, but I’m schooling him on a few things these days with all that I’m reading! There isn’t much on IAA out there. Big hugs to you and Tigger!

 

[cabreu]

I came here to post about the same thing, so I'll piggyback on this thread. Willow got her acro result today: 329. I am still waiting on the IAA result, but they told me I could call back tomorrow (by the way, very impressed with how easy the MSU lab is to deal with).

A couple of practical questions:
1. How do you administer the liquid form of Cabergoline? Would I be able to squirt it on her food?
2. Should I get Willow a badly needed teeth cleaning, or wait until hopefully getting BG more under control with Cabergoline (assuming I can convince vet to prescribe it). I'm worried about the risks of putting her under right now- should I be?

And another general question about acro cats-- do they usually get sick (vomiting/diarrhea) when reaching new BG lows? Willow seems fine when her BG is at its usually high, but when it dips to a new low she gets sick for days.

 

[JanetNJ]

My cat CC had Acro. Officially diagnosed 18 months ago but has had it for i suspect 3 years which is when she came out of remission.

We opted to just treat with insulin. She's on ProZinc. At her most she was on 12.5-13u. Currently she's on 6-7 units. He acro causes issues with joints and she's bow legged with her elbows sticking out, and a pot belly. To help with that we give her weekly adequan shots which seems to help her feel better and walk better. She also has ckd and hyperthyroidism..... But as long as she is still purring and happy, grooming, and eating we will keep going.

 

[cabreu]

My cat CC had Acro. Officially diagnosed 18 months ago but has had it for i suspect 3 years which is when she came out of remission.

We opted to just treat with insulin. She's on ProZinc. At her most she was on 12.5-13u. Currently she's on 6-7 units. He acro causes issues with joints and she's bow legged with her elbows sticking out, and a pot belly. To help with that we give her weekly adequan shots which seems to help her feel better and walk better. She also has ckd and hyperthyroidism..... But as long as she is still purring and happy, grooming, and eating we will keep going.

I'm curious- why did you decide to treat just with insulin? And does the prozinc work better than other insulins for her?

 

[Wendy&Neko]

I'm worried about the risks of putting her under right now- should I be?

That's a question for the vet, and depends on her heart.

And another general question about acro cats-- do they usually get sick (vomiting/diarrhea) when reaching new BG lows? Willow seems fine when her BG is at its usually high, but when it dips to a new low she gets sick for days.

No, not what usually happens. Some cats who have been in high numbers for a while feel off when they feel normal numbers, until they get used to them.

I'm curious- why did you decide to treat just with insulin?

I can't answer for Janet, but it's really a personal decision and can depend on the cat. Acrocats vary in how many symptoms they have and which ones. For me, treatment of any kind was better than none, as a way to improve quality of life. Plus SRT was WAY cheaper back then.

 

[JanetNJ]

I'm curious- why did you decide to treat just with insulin? And does the prozinc work better than other insulins for her?

Well, once I found her a good dose she was feeling better and the numbers came down.... which is what the cabergoline is for, right? If she had been on some really crazy high 20+ dose I would have tried something else. I chose prozinc because I was used to how Vetsulin worked and like the in and out insulins because it's a little more forgiving with shot times, and like Levemir, doesn't sting at high doses. I get a new vial every 4 weeks, so it is pricier than using levemir.

 

[Breanna H]

Sorry! For some reason, I wasn't getting notifications all of your wonderful responses! Let me catch up!

If you would like to try N or R, please post and ask for help. It's an advanced technique and there is lot to learn about it, specifically when not to use it. We suggest that you get an experienced user to help the first you few times you use it.

I think we will hold off on that for the time being, at least until after I have the blood work done at the vet and I see if he is agreeable to cabergoline, if Tigger is infact an Acro cat. But it is always an option, if necessary, and I would definitely need help.

I just got a new prescription for capsules filled at Wedgwood compounding pharmacy (my mail).

Do you just call them to place the order and then mail them the prescription? I want to be sure on how to do it because I am almost certain the vet I'm going to see won't. He says he has only ever met one other acro cat.

Hi Breanna, My Howie was diagnosed with IAA on Sept. 30 and I switched him to Levemir on 10/16/20. He’s not anywhere near your doses but his appetite has subsided a bit in the past month or so. He is a little under 10 lbs but I give him 450 calories/day. Make sure you are watching for ketones if you aren’t already (I just got the Nova Max glucose/ketone blood meter but just use it for ketone tests). Also for the neuropathy, have you considered methyl b12 From Vitacost instead? I got it on a recommendation from the forum and give him 1 capsule/day along with half a Crushed pill of folic acid (400 mcg pills) in his food. From what I learned, it does the same thing as Zobaline but is much less $. The methyl b12 I get are 100 capsules for $17.99 and I think the folic acid was around $6.

Tigger's numbers seem very close to Howie's. Tigger's numbers are usually never "out of control." Maybe does have IAA. Although, we have been at this for almost a year with no breakthrough, so I am leaning still towards acro, although I would prefer IAA. At least IAA can "go away." I might have to look into the b12/folic acid instead. Any way to help me cut costs would be awesome!

Tigger is now at 16.5u and he gets quite mad at me when I give him his shot. I am worried for the next time we go on vacation and someone has to watch him. I know he won't bite me but he might get mad at someone else. Hopefully I can get something figured out before then since we won't be going anywhere for who knows how long.

Thank you all for your info! I'm sad I didn't see these posts sooner. I'm not sure why I never got any alert messages.

 

[Breanna H]

Moe doesn’t like liquid meds, so I opted for pills instead

I forgot to ask, do you crush the pills or have to give him the pill? If I can crush it, that sounds like my best option. If he has to have it whole, I'll never be able to get him to take it, haha.

 

[Erin and Moe (GA)]

Do you just call them to place the order and then mail them the prescription? I want to be sure on how to do it because I am almost certain the vet I'm going to see won't. He says he has only ever met one other acro cat.

My vet wrote the script and called it into the pharmacy for me. I had to call the pharmacy to give my shipping info and credit card, and they shipped the pills directly to me. Moe is my vet’s first ever acro cat. I’m so lucky that she is willing to learn with me and is open to discussion and trying things that she’s not familiar with.

I forgot to ask, do you crush the pills or have to give him the pill? If I can crush it, that sounds like my best option. If he has to have it whole, I'll never be able to get him to take it, haha.

I understand that the medicine is very bitter. Also very bad for women to handle, so you want to avoid crushing it. Most people here use the liquid form of cabergoline that is flavored to disguise the taste. I tried that and put it in his food; he refused to eat it. I think most people who use the liquid squirt it into the cat’s mouth. Not an option for us...Moe does NOT do liquid meds. Pills are much easier for us, but every cat is different.

 

[Breanna H]

I understand that the medicine is very bitter. Also very bad for women to handle, so you want to avoid crushing it. Most people here use the liquid form of cabergoline that is flavored to disguise the taste. I tried that and put it in his food; he refused to eat it. I think most people who use the liquid squirt it into the cat’s mouth. Not an option for us...Moe does NOT do liquid meds. Pills are much easier for us, but every cat is different.

Thank you. I think Tigger would be fine with some liquid mixed in his food as long as they flavored it, which I see they can. I just would hate to spend the money on the med and then not have him take it

 

[Olive & Paula]

Thank you. I think Tigger would be fine with some liquid mixed in his food as long as they flavored it, which I see they can. I just would hate to spend the money on the med and then not have him take it

I'm late to the discussion. Ollie was on cabergoline suspension for 2+ yrs. It was bacon/marshmallow flavored. She got 0.84 ml which is small amount so easily squirted into her cheek pocket. She was usually sleeping so didn't realize I was giving it until it was already done.

 

[cabreu]

I'm late to the discussion. Ollie was on cabergoline suspension for 2+ yrs. It was bacon/marshmallow flavored. She got 0.84 ml which is small amount so easily squirted into her cheek pocket. She was usually sleeping so didn't realize I was giving it until it was already done.

How did you decide on the flavor? They have a long list, but I'm not sure which to pick.

 

[Olive & Paula]

How did you decide on the flavor? They have a long list, but I'm not sure which to pick.

Talked with the pharmacist. He said cabergoline was on the bitter side so the marshmallow is sweet (without adding sugar or sweetener) and bacon would add the smell. And oil based would give it a longer shelf life than the water based one.

I know the normal meat flavors she wouldn't eat and I don't give fish at all. So those were out. If she didn't like it, I could try something else the next time.

 

[cabreu]

Talked with the pharmacist. He said cabergoline was on the bitter side so the marshmallow is sweet (without adding sugar or sweetener) and bacon would add the smell. And oil based would give it a longer shelf life than the water based one.

I know the normal meat flavors she wouldn't eat and I don't give fish at all. So those were out. If she didn't like it, I could try something else the next time.

I see- I was wondering about the marshmallow! Will try that if my cat doesn't like chicken/bacon.

 

[Breanna H]

Wedgwood compounding pharmacy

Talked with the pharmacist. He said cabergoline was on the bitter side so the marshmallow is sweet (without adding sugar or sweetener) and bacon would add the smell. And oil based would give it a longer shelf life than the water based one.

I know the normal meat flavors she wouldn't eat and I don't give fish at all. So those were out. If she didn't like it, I could try something else the next time.

This is really good to know! Tigger's blood work just came back postive, he is officially an Acro cat I am currently discussing doing of Cabergoline with him and was trying to decide what flavor to choose.

Has anyone found any side effects with it, either short term or long term? Is there any harm in trying it? I haven't been able to find any information on potential long term bad side effects. The vet said we can try it "at my own risk" which made me worried there is something I don't know? Thanks!

 

[Olive & Paula]

This is really good to know! Tigger's blood work just came back postive, he is officially an Acro cat I am currently discussing doing of Cabergoline with him and was trying to decide what flavor to choose.

Has anyone found any side effects with it, either short term or long term? Is there any harm in trying it? I haven't been able to find any information on potential long term bad side effects. The vet said we can try it "at my own risk" which made me worried there is something I don't know? Thanks!

Breanna, there isn't much info on it. The only side effect reported is GI upset which resolves itself in 3 days. I started giving probiotic while waiting for it. Ollie never had a problem with it.

Ollie was on it 2 yrs, and 292 days.

Ollie's original vet would not script it. I call/visited 3 others who wouldn't even see her because she was on Levemir insulin. They wouldn't script it and I was not going to change insulin. When I took Ollie in for consult with Dr A. She read all the papers I have her, examined Ollie very carefully, read some more and agreed it was Ollie's last option to be comfortable. She knew nothing about it and neither did I. I also felt we had nothing to lose and if it didn't work we could stop it. I was willing to try it for 1 yr. Dr A said she was willing if I signed a liability waiver and agreed to regular fructosamine tests. I was more than happy to. She did initial blood test and that's it.

3 weeks after starting I noticed some symptoms lessened. I would say "where's Ollie I can't hear her" I would go looking to make sure she was still alive. Before the cabergoline Ollie's stridor was so bad there was literally not 1 sec she was ever quiet. Took me awhile to realize the cabergoline was helping and for me to get use to not hearing her all the time. Her glucose started to come down. Then one day she trotted into the kitchen for her food. Her walk was not normal before that. It looked like she was testing each step to make sure floor wouldn't cave in, or because of bone and tissue overgrowth it was to painful for her to walk. She would only take a few steps before she had to lay down and rest. Now she was trotting and chasing after a shoelace and flipping toys in the air. I knew Ollie would never go into remission, I didn't care how much insulin she might need. With cabergoline her quality of life improved ten-fold and that's all I ever wanted for her.

 

[Erin and Moe (GA)]

This is really good to know! Tigger's blood work just came back postive, he is officially an Acro cat I am currently discussing doing of Cabergoline with him and was trying to decide what flavor to choose.

Has anyone found any side effects with it, either short term or long term? Is there any harm in trying it? I haven't been able to find any information on potential long term bad side effects. The vet said we can try it "at my own risk" which made me worried there is something I don't know? Thanks!

Moe had diarrhea for one day and that was the only side effect he’s had. He’s been taking cabergoline (capsules) for 25 weeks. It took about three weeks before his glucose started to come down. He was on 8 units BID and is now getting 4 units BID. His current issues are arthritis, aggravated by weight gain, and some wheezing/snoring sounds. We haven’t seen improvement in those issues yet.

Moe is my vet’s first acro cat, so she didn’t know anything about cabergoline until I brought it up to her.

 

[Breanna H]

I knew Ollie would never go into remission, I didn't care how much insulin she might need. With cabergoline her quality of life improved ten-fold and that's all I ever wanted for her.

All I'm looking for is improved quality of life. Between thinking he is always starving, his neuropathy and his constant peeing, I feel bad for him. He's definitely not the cat he used to be

Moe had diarrhea for one day and that was the only side effect he’s had. He’s been taking cabergoline (capsules) for 25 weeks. It took about three weeks before his glucose started to come down. He was on 8 units BID and is now getting 4 units BID. His current issues are arthritis, aggravated by weight gain, and some wheezing/snoring sounds. We haven’t seen improvement in those issues yet.

Good to know. How do you give him his capsules? I can't imagine I would be able to shove a capsule down Tigger's throat every day (which is why I'm considering the liquid form). He's a pretty tolerant cat but I'm thinking that is where he would draw the line. I can barely get him to let me even take a peek at his teeth most days

 

[Erin and Moe (GA)]

How do you give him his capsules?

I give his pill before he eats breakfast every day. I stand behind him, with my feet in a V shape so he can’t back up. I put my left index finger between his front teeth and tip his head back. When he opens him mouth I drop the pill in. Sometimes I have to push it way back into his throat. Some days it takes more than one try. He’s usually pretty good about it. He won’t tolerate liquids squirted into his mouth.

 

[JanetNJ]

Ho

All I'm looking for is improved quality of life. Between thinking he is always starving, his neuropathy and his constant peeing, I feel bad for him. He's definitely not the cat he used to be


Good to know. How do you give him his capsules? I can't imagine I would be able to shove a capsule down Tigger's throat every day (which is why I'm considering the liquid form). He's a pretty tolerant cat but I'm thinking that is where he would draw the line. I can barely get him to let me even take a peek at his teeth most days

your giving b12 methylcobalamin supplements, yes?

 

[Breanna H]

Vet agreed to cabergoline. Wants to start at an every other day dose, which I am fine with until we see how it goes. Any recommendations on flavor I should choose? Tiggers favorite food flavor is the Salmon FF, even though he only gets it once a week so I was thinking the chicken/fish flavor? I know one user recommended marshmallow so reduce bitterness? So I am undecided.

 

[Wendy&Neko]

Why every other day? The standard seems to be every day.

Neko like her meds compounded chicken flavour. She preferred the "chicken soup" variant over the "roasted chicken" flavour. I have also given fish flavour to kitties before.

 

[Breanna H]

Why every other day? The standard seems to be every day.

He said that "most studies" show starting with an every other day dose. I know most I've seen here though do give it every day, so I'll start with every other and increase after a bit of time I suppose.

I just ordered my insulin for $200 yesterday and then just ordered the cabergoline for $220 the vet put the prescription through already. Made my eye twitch a little. But hopefully we can reduce the insulin! He automatically ordered chicken flavor so hopefully he likes it!

Does it matter if I give the dose in the AM or PM? I was thinking PM since I do his Zobaline in the AM.

 

[Wendy&Neko]

He said that "most studies" show starting with an every other day dose

One study of 5 cats only did a every other day dose. There have only been two formal studies, the other did just a bit larger number of cats on every day.

I don't think it makes a difference what time you give the dose. Note that it make take a week or more before you see results. Probably double that if you are going with every other day.

 

[Tillie and Valentino]

Adding to this thread, I am also interested in trying Cabergoline possibly. I'm still not sure how it compares to SRT and whether my cat is truly a candidate for SRT yet. So, I have been researching this. I wrote to the main author of the South American study where it was a successful treatment, and this was his reply:

• Hi Danielle
  I'm very sorry about your cat. I guess he is diabetic. I don't know if you were able to do CT or MRI of the pituitary. Let me tell you that we continue to treat cats with hypersomatotrophism with cabergoline. Our results are much better in cats with a slight increase in the pituitary gland (P: B) as opposed to macroadenomas. We have had remission of diabetes with cabergoline, or decrease in insulin doses in others. However, in few cats the IGF-1 values have been able to decrease, but in the majority not, improving the management of glucose control. The cats in the article, one maintained remission of diabetes for more than 2 years with IGF1 values that increased over time to> 1000 without requiring insulin and died from a liver tumor. The other two required less insulin, but died from cardiac problems.
  We have seen few adverse effects with cabergoline (increased transaminases) so I consider it a good option to try. I hope I have answered your questions. If you start treatment tell me about your experience.
  

Hello Elber,

I am intrigued by your research from 2017 on cats treated with cabergoline. You had great success with it and I wondered if you are still studying it and whether the cats studied continued to achieve remission over time?

My cat Valentino has just been diagnosed with acromegaly and we believe we may have caught it somewhat early and am interested in trying the cabergoline as the first line of treatment.

I'd be so grateful if you could give any more information in terms of the follow-up on the cats studied or whether you are still seeing success with it.

Thanks so much and have a wonderful Friday,

Tillie Policastro
Austin, Texas

dec 2016.jpg
Tillie

 

[Larry and Kitties]

just ordered the cabergoline for $220

Where did you order it from>
What concentration and how many ml?
I just filled my initial script from Wedgewood yesterday. It was about $175 for 15 ml of 300mcg/ml. That is a 60 day supply for my Snuffles.

 

[Wendy&Neko]

@Tillie and Valentino Very interesting information from South America. It'd be interesting to know how many cats they've treated with cabergoline by now. And whether they are still doing the every other day dosing. There have been only the two formal studies, both on small numbers of cats. It'd be good to have something to point to for those people who's vets are reluctant to prescribe it.

 

[Tillie and Valentino]

Yes, I was glad he wrote back so quickly. I can ask how many cats and whether he still recommends the same dosing protocol.

 

[Tillie and Valentino]

@Wendy&Neko I wrote the researcher again, and asked about dosing and number of cats he's treated. Here is his response:

yes. every 48 hours is fine. even some every 24 hours. we are doing work with a larger number of animals that exceeds 50 cases.

 

[Wendy&Neko]

Wow, great news on the numbers! I hope they eventually write another article showing the numbers they've treated. That'll be really helpful for anyone who needs to work to convince their vet.

 

[Tillie and Valentino]

Indeed! There needs to be a lot more published research on this disease.

 

[cabreu]

Adding to this thread, I am also interested in trying Cabergoline possibly. I'm still not sure how it compares to SRT and whether my cat is truly a candidate for SRT yet. So, I have been researching this. I wrote to the main author of the South American study where it was a successful treatment, and this was his reply:

• Hi Danielle
  I'm very sorry about your cat. I guess he is diabetic. I don't know if you were able to do CT or MRI of the pituitary. Let me tell you that we continue to treat cats with hypersomatotrophism with cabergoline. Our results are much better in cats with a slight increase in the pituitary gland (P: B) as opposed to macroadenomas. We have had remission of diabetes with cabergoline, or decrease in insulin doses in others. However, in few cats the IGF-1 values have been able to decrease, but in the majority not, improving the management of glucose control. The cats in the article, one maintained remission of diabetes for more than 2 years with IGF1 values that increased over time to> 1000 without requiring insulin and died from a liver tumor. The other two required less insulin, but died from cardiac problems.
  We have seen few adverse effects with cabergoline (increased transaminases) so I consider it a good option to try. I hope I have answered your questions. If you start treatment tell me about your experience.

Hello Elber,

I am intrigued by your research from 2017 on cats treated with cabergoline. You had great success with it and I wondered if you are still studying it and whether the cats studied continued to achieve remission over time?

My cat Valentino has just been diagnosed with acromegaly and we believe we may have caught it somewhat early and am interested in trying the cabergoline as the first line of treatment.

I'd be so grateful if you could give any more information in terms of the follow-up on the cats studied or whether you are still seeing success with it.

Thanks so much and have a wonderful Friday,

Tillie Policastro
Austin, Texas

dec 2016.jpg
Tillie

Thanks for posting this! It's interesting that even though the glucose control improves, most cats' IGF values don't decrease. I guess this means we should be continuing IGF tests and monitoring for the non-diabetes effects of acromegaly, like heart issues.

 

[Wendy&Neko]

IGF-1 numbers may not improve with SRT either. I've seen a few people retest, with no improvement. I never bothered to retest it due to the cost from Canada, plus I wouldn't have done anything different with the results. But I was happy with the improvement in symptoms. Neko still did get soft tissue and bony growths, and her organs were eventually (almost 4 years later) impacted. I think the SRT delayed things and gave better QOL for that time. I think surgery is a better option, but it's only available in a few places in the world, and is quite expensive.

 

[cabreu]

IGF-1 numbers may not improve with SRT either. I've seen a few people retest, with no improvement. I never bothered to retest it due to the cost from Canada, plus I wouldn't have done anything different with the results. But I was happy with the improvement in symptoms. Neko still did get soft tissue and bony growths, and her organs were eventually (almost 4 years later) impacted. I think the SRT delayed things and gave better QOL for that time. I think surgery is a better option, but it's only available in a few places in the world, and is quite expensive.

I see. Where should I look for tissue/bone growths? And how about scans/ultrasounds to evaluate heart and other organs- are those expensive?

 

[Wendy&Neko]

The organ you really need to care about is the heart, or possibly the intestines. An echocardiogram price does vary but I'm a believer in getting a cardiologist to do the work if you can, otherwise things can be missed. When the regular vet detected a heart murmur, Neko got an echo. My cost was in the $500-800 range. Turned out her heart was just barely enlarged, and since she was a bigger breed, the cardiologist wasn't worried. But it also gave us a baseline for later when she did have heart issues. Quite a few acros have heart issues, so you really want to keep an eye on that. GI issues are also common. Keep an eye on the appetite, and constipation/diarrhea. If off, that could mean an ultrasound.

Bony growths are often along the spine, elbows or knees. It manifested as arthritis. Neko also got a bony growth on her jaw bone - which is a bit unusual. Some cats get longer due to bony growth. Soft tissue growth can be many places. One of Neko's tear ducts was partially blocked, causing her eye to weep, not a big deal really. The more concerning was soft tissue growth in her mouth, on her gums. Any vet doing a dental should know about the acromegaly and possible side effects there. Neko managed to save a tooth because of that. Her regular vet saw redness on the gum line and though 'pull the tooth', the specialist realized soft tissue growth was causing a canine to rub on gum, so filed down the tooth.

 

[JeffJ]

Leo had soft tissue growth on his back tongue, and salivary glands and throat. The growths became excessive. Salivary removal would have led to many other complications. The mouth growths interfered with him eating (anything). Eventually, he was only eating teaspoonfuls per day of food, or not eating at all that day. So the growths contributed to his departure. Acro is such a cruddy disease.

 

[Breanna H]

Where did you order it from>
What concentration and how many ml?
I just filled my initial script from Wedgewood yesterday. It was about $175 for 15 ml of 300mcg/ml. That is a 60 day supply for my Snuffles.

I ordered mine from Wedgewood as well. They just called me back today and said since the vet prescribed it every other day, they can't fill it for the 200mcg/ml in 60ml form, as it would expire before I used it all. It would have to be 30ml. Which ends up being $160. I'm hoping next time I order the vet can rewrite the script and we can go up to every day, as its actually cheaper to buy a larger quantity. And most people do give every day anyway. I think my vet is just being extra cautious as this is his first time using it for an acro cat.

 

[cabreu]

Interesting that people are getting compounded to 200 or 300 mcg/ml- mine will be 100 mcg/ml, which will make Willow's daily dose 0.5ml. Will this be too much oil, and potentially cause diarrhea?

 

[Breanna H]

Interesting that people are getting compounded to 200 or 300 mcg/ml- mine will be 100 mcg/ml, which will make Willow's daily dose 0.5ml. Will this be too much oil, and potentially cause diarrhea?

My dose is 0.4ml every other day. Tigger weighs approximately 18.5 lbs, depending on the day. I'm not sure why he went with that concentration exactly. I guess since Tigger is so large, if we went with the 100mcg/ml, it would be even more liquid I'll have to try to get in him.

I'm really hoping I can sneak the dose in the side of his mouth after his PM sugar checks and be done with it. Interested to see how it works out for me

 

[cabreu]

My dose is 0.4ml every other day. Tigger weighs approximately 18.5 lbs, depending on the day. I'm not sure why he went with that concentration exactly. I guess since Tigger is so large, if we went with the 100mcg/ml, it would be even more liquid I'll have to try to get in him.

I'm really hoping I can sneak the dose in the side of his mouth after his PM sugar checks and be done with it. Interested to see how it works out for me

Good luck to you and Tigger! Willow is enjoying the chicken/bacon flavor on her food. So far, so good. At least for her tolerating it, that is-- she has had some vomiting and diarrhea that started on the third day of cabergoline.

 

[Breanna H]

Good luck to you and Tigger! Willow is enjoying the chicken/bacon flavor on her food. So far, so good. At least for her tolerating it, that is-- she has had some vomiting and diarrhea that started on the third day of cabergoline.

Good to know you're able to mix it in the food. That's my plan for now and I'll see how it goes.
Did the nausea/vomiting clear up? Do you think the cabergoline caused it or was it just a bad day?
I'm still waiting on it to arrive. I only live in PA and I think USPS has managed to lose it in that distance. The tracking hasn't updated since the 10th so fingers crossed it shows up soon!

 

[cabreu]

Good to know you're able to mix it in the food. That's my plan for now and I'll see how it goes.
Did the nausea/vomiting clear up? Do you think the cabergoline caused it or was it just a bad day?
I'm still waiting on it to arrive. I only live in PA and I think USPS has managed to lose it in that distance. The tracking hasn't updated since the 10th so fingers crossed it shows up soon!

Yes the nausea cleared up after about 24 hours! I think she was adjusting to the cabergoline as well as its effect on her glucose, which seems fast and strong, at least for now. Wedgewood took forever to ship mine, but once they did I got it, but yeah USPS is overwhelmed at the moment.

 

[Larry and Kitties]

but yeah USPS is overwhelmed at the moment.

Mine Wegewood order is still in USPS system. Tracking showed it was at one facility for 5 days. Tracking says it will be delivered today today, 12/19. I ordered in on 12/3.

 

[Breanna H]

Hello everyone
I hope you had a good holiday season.

I FINALLY got Tigger's cabergoline and got it started after USPS lost it for a month. Anyway, we are debating on an emergency vet visit. He has been on it for a week. At dinner tonight, he was acting completely normal. Then, while eating, he explosively vomited. Went right downstairs, got in the box and tried to pee. Got out, meowed loudly, vomited again and kept getting in and out of the box. Now he's acting normally. I am trying to decide if we can wait until morning. I've already spent so much money already, I'm not sure what to do. I would much rather wait until morning to go to the regular vet but will take him immediately if necessary. Has anyone noticed any side effects with cabergoline like this? I'm so worried this is my fault and I did this to him by giving him the medication.

He is getting 0.4ml of 200mcg/ml. I started out at every other day based on the recommendation of my vet, so he has had 5 doses so far. I am in the process of updating my spreadsheet for the year but no unusual numbers.

I am cross posting on the Levemir forum in hopes of getting an answer.

 

[JeffJ]

Hi Breanna - I don't have direct experience with cabergoline. I noticed this article lists human side effects
https://medlineplus.gov/druginfo/meds/a612020.html

Sometimes side effects may affect a small percent of the human or animal receiving the drug. For example, I took an oral dose of toenail fungus medication from my doctor (years ago). It was fine. Then on the 5th or 6th day, my body reacted and I vomited 10 minutes after swallowing the pill. I only tried it a second time. We determined that my body had built up some issue with it. My point is that Tigger may be having a similar issue - after some cabergoline has built up, maybe it is causing an issue.

You could consider temporarily stopping cabergoline, if you think that is the root cause.
You have done a stellar job of keeping Tigger regulated given the high doses. I know just how hard that can be. Kudos to you.