Cabergoline and ALT Values?

FrostD

FrostD

Very Active Member
We had labs drawn today, ALT was elevated at 188 (normal range 0-100). Everything else came back normal range. Waiting on GI panel results then I'll add to SS.

Vet said when he sees cats in liver failure ALT is 700+, so he's not worried yet but will keep an eye. Also says this is his first cat with acromegaly, first with cabergoline, plus the first with chylothorax to survive, so he's in completely new territory. Wants a recheck in 3 months.

I did some quick searching but really isn't seem to find a relationship between cabergoline and liver issues, in pets or humans. Curious if any of you have seen anything.

@Wendy&Neko @Suzanne & Darcy
 
Not me, but Neko was never on cabergoline. Can't remember anyone else commenting on it.
 
I have never seen anything on it, and I searched a LOT! I did try to find information on kidney failure and Cabergoline; I found some, but there were way too many factors in play for me to determine if Cabergoline could be the culprit. Also this was all relating to humans. Then, I already knew that having acromegaly itself can be hard on many organ systems - so how could I ever know what to do, or if the Cabergoline had caused problems? I did reduce Darcy’s dose to every other day for a time, but then went back to every day as nothing changed.

Having said that, I highly recommend Denamarin as a healing liver supplement. That’s for cats who can be pilled. If not, milk thistle powder can be added to food (but the Denamarin contains additional ingredients that are beneficial to the liver.) I’ve seen lots of cats (including my own Ginger) who had elevated liver enzymes have those enzymes go back down again, so I would say not to worry too much about Mr. Kitty. I would start a liver supplement. Most vets sell Denamarin or similar, bit it’s cheaper at Chewy.
 
Suzanne & Darcy said:
I have never seen anything on it, and I searched a LOT! I did try to find information on kidney failure and Cabergoline; I found some, but there were way too many factors in play for me to determine if Cabergoline could be the culprit. Also this was all relating to humans. Then, I already knew that having acromegaly itself can be hard on many organ systems - so how could I ever know what to do, or if the Cabergoline had caused problems? I did reduce Darcy’s dose to every other day for a time, but then went back to every day as nothing changed.

Having said that, I highly recommend Denamarin as a healing liver supplement. That’s for cats who can be pilled. If not, milk thistle powder can be added to food (but the Denamarin contains additional ingredients that are beneficial to the liver.) I’ve seen lots of cats (including my own Ginger) who had elevated liver enzymes have those enzymes go back down again, so I would say not to worry too much about Mr. Kitty. I would start a liver supplement. Most vets sell Denamarin or similar, bit it’s cheaper at Chewy.
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Thank you!

And re: labs...it's crazy. Vet said "what are we here for today?" And for once I could just say "a regular checkup" lol Poor Mr Kitty was fresh off the e vet visit so he was extra agitated, he went after me too until he realized his mistake :joyful: Didn't think there was any more fluid, and he looks really good. So I'll take good news for now! I'm not sure how many of the proverbial 9 lives he has left
 
FrostD said:
Thank you!

And re: labs...it's crazy. Vet said "what are we here for today?" And for once I could just say "a regular checkup" lol Poor Mr Kitty was fresh off the e vet visit so he was extra agitated, he went after me too until he realized his mistake :joyful: Didn't think there was any more fluid, and he looks really good. So I'll take good news for now! I'm not sure how many of the proverbial 9 lives he has left
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Mr. Kitty is the Eighth Wonder of the World!
 
Suzanne & Darcy said:
And does he snarl and growl at the vet?
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Oh he hisses, growls, and swats, tries to bite but I'm not sure there's true intention behind it (but I sure as heck am not going to find out!). I am thankful they don't want him some form of sedated though, they seem mostly unbothered by him. He's totally fine in car there and back, so it just doesn't seem worth drugging him for 20-30 minute appointment.

The one tech just reached her hand right in the carrier to grab him, that is a level of bravery I aspire to.
 
FrostD said:
Oh he hisses, growls, and swats, tries to bite but I'm not sure there's true intention behind it (but I sure as heck am not going to find out!). I am thankful they don't want him some form of sedated though, they seem mostly unbothered by him. He's totally fine in car there and back, so it just doesn't seem worth drugging him for 20-30 minute appointment.

The one tech just reached her hand right in the carrier to grab him, that is a level of bravery I aspire to.
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Do they know that Mr. Kitty is all bark and no bite? You have to be brave (but not foolhardy) to be a vet tech, right?
 
I've been wondering about Cabergoline, also, in relation to acromegaly and insulin, for as you know I live with two acrocats, Eddie and Blue, both of whom have had hypophysectomy and SRT. I was speaking with the pituitary team at WSU the other day and asked the internist, Sarah Guess, about it and she said she's not come across anything negative but some research says it "did not improve diabetic control or normalize insulin-like growth factor concentration, or improve patient quality of life." I think she's also saying the jury is still out and is taking a conservative stance, which is fine, although anecdotal evidence would suggest that Cabergoline can be effective, in fact. Of course, there's Paserotide, which is recommended highly but then one has to mortgage one's house to afford it.

Melissa, I'm assuming Mr. Kitty has not had surgery or radiation for acromegaly but you've used Cabergoline to achieve remission? I mean, I wonder about using it with Eddie who has gone from 15u to 8.25u using TR and the advice and support here.

I'm following this thread, to be sure. All good thoughts for you and Mr. Kitty!
 
Jodey&Eddie said:
I've been wondering about Cabergoline, also, in relation to acromegaly and insulin, for as you know I live with two acrocats, Eddie and Blue, both of whom have had hypophysectomy and SRT. I was speaking with the pituitary team at WSU the other day and asked the internist, Sarah Guess, about it and she said she's not come across anything negative but some research says it "did not improve diabetic control or normalize insulin-like growth factor concentration, or improve patient quality of life." I think she's also saying the jury is still out and is taking a conservative stance, which is fine, although anecdotal evidence would suggest that Cabergoline can be effective, in fact. Of course, there's Paserotide, which is recommended highly but then one has to mortgage one's house to afford it.

Melissa, I'm assuming Mr. Kitty has not had surgery or radiation for acromegaly but you've used Cabergoline to achieve remission? I mean, I wonder about using it with Eddie who has gone from 15u to 8.25u using TR and the advice and support here.

I'm following this thread, to be sure. All good thoughts for you and Mr. Kitty!
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Correct. We decided to start with cabergoline since it was low cost low risk...no guaranteed results but to us worth a try. We were incredibly fortunate and achieved remission very quickly.

As I understand it the downside is it really doesn't do anything to tumor itself, it just suppresses the IGF secretion. Therefore, ideally, were also hoping to delay the other issues that come with acro - organ enlargement, soft tissue stuff, etc. But we know the tumor may continue to grow and cause other issues.

I had wondered about cabergoline use in post-hypophosectomy and post-SRT cats but I think that's a dangerous combination as far as managing insulin goes. Look how quickly Mr Kitty crashed - I was halving doses practically every day or every other day and he was still ahead of me. With SRT especially you'd then be trying to manage those unpredictable effects as well as cabergoline's
 
FrostD said:
Correct. We decided to start with cabergoline since it was low cost low risk...no guaranteed results but to us worth a try. We were incredibly fortunate and achieved remission very quickly.

As I understand it the downside is it really doesn't do anything to tumor itself, it just suppresses the IGF secretion. Therefore, ideally, were also hoping to delay the other issues that come with acro - organ enlargement, soft tissue stuff, etc. But we know the tumor may continue to grow and cause other issues.

I had wondered about cabergoline use in post-hypophosectomy and post-SRT cats but I think that's a dangerous combination as far as managing insulin goes. Look how quickly Mr Kitty crashed - I was halving doses practically every day or every other day and he was still ahead of me. With SRT especially you'd then be trying to manage those unpredictable effects as well as cabergoline's
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That is so true! It's almost unthinkable to manage insulin dose with Cabergoline after surgery/SRT because, in a way, the BG results provide the most clear and distinct way of tracking the efficacy of SRT.

Sending the best to you and Mr. K.
 
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