Cabergoline as a possible treatment for acrocats: discussion

Hi everyone,
I got Malachai's Cabergoline for $100 w/sugar free chicken flavor. I just went on Yelp and searched for compounding pharmacies in my area and about 10 came up so I just called each for pricing.
The pharmacist mixed the Cabergoline with oil (instead of water), I was told it was better and would also extend the life of the Cabergoline.
DOES ANYBODY KNOW IF THIS IS TRUE!?
I was told it could have a shelf life of 6mo. although I was only given enough for 56days.
I just want to make sure that after 30 days I'm not giving him medication thats bad.

Also, I'm mixing his Cabergoline with his breakfast (2 cans of FF). Does anyone know if it's okay to mix it with THAT much food? I'm hoping it won't decrease its effectiveness.
 
Susan G & Jimmy G said:
Does anyone know if the RVC clinical trials for cabergoline have been posted?
Click to expand...

I think it is strange that they have been quiet about the study. It seems like when it started they were open to sharing all the info they had. I'm not sure that any who has emailed recently has gotten any info on how it is going.
 
Chubba said:
I just found a post on the diabetic remission clinic of RVC's webpage that shows Chris presenting the results. Hopefully, we can see the results soon.
Click to expand...
HI How are you? I am trying to get my vet to understand the need for Amethyst to be on this drug How do I access this webpage and post THanks:bighug:
 
I had to dig really deep and I found info that they presented last month. They did not observe any difference in 30 days time. I'm not sure if they are continuing on with the study. However cats on this forum have taken 30 days to earn insulin reductions.
My vet was hesitant to prescribe it and Mav has been on it for about 10 days now. I figured what do I have to lose by trying? If I can get his Insulin like growth factor down and perhaps slow down the progression of acromegaly, it is worth it to me.
 
Mom2Maverick said:
I had to dig really deep and I found info that they presented last month. They did not observe any difference in 30 days time. I'm not sure if they are continuing on with the study. However cats on this forum have taken 30 days to earn insulin reductions.
My vet was hesitant to prescribe it and Mav has been on it for about 10 days now. I figured what do I have to lose by trying? If I can get his Insulin like growth factor down and perhaps slow down the progression of acromegaly, it is worth it to me.
Click to expand...
Hi Where did you find their info?:cat:
 
I have attached the study that convinced me and I sent it to my vet.
I am copy and pasting from EVCIM abstracts.

I hope this helps!

J Vet Intern Med 2017

Research Communications of the
27th ECVIM-CA Congress

Intercontinental, Saint Julian’s, Malta, 14th to 16th September 2017


ESVE – O – 6
PILOT STUDY ASSESSING THE USE OF CABERGOLINE IN THE MANAGEMENT OF DIABETIC ACROMEGALIC CATS. C.J. Scudder, K. Hazuchova, R. Gostelow, V. Woolhead, Y. Forcada, D.B. Church, R.C. Fowkes, S.J.M. Niessen. Royal Veterinary College, Hatfield, UK

Cabergoline is a dopamine 2 receptor (D2R) agonist which is a second line medical therapy for human acromegalic patients. Pasir- eotide, a somatostatin analogue, is the only effective medical man- agement option for feline acromegaly but its cost is a limiting factor for many owners. Our work has demonstrated dopamine receptors within the feline acromegalic pituitary and we hypothe- sized that cabergoline would improve diabetic control and IGF-1 concentrations of diabetic acromegalic cats.

This was a prospective cohort study of client-owned diabetic acromegalic cats, Ethics approval URN 2016 1604. Enrolment cri- teria were: a diagnosis of diabetes mellitus, an IGF-1 concentra- tion >1000 ng/mL and owners declining alternative treatment options for acromegaly. Patients were admitted to the hospital on day 0, underwent pituitary imaging and started cabergoline ther- apy (Kelactin, Kela N.V.) on day 1. Cats were monitored in hospital until day 4 and were discharged to continue treatment at home. Serum IGF-1 and fructosamine were measured on day 0, day 4 and month 1. Any possible medication side effects were recorded. Descriptive statistics and non-parametric tests were used to analyze the data.

Six cats were enrolled. The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline. The median IGF-1 concentration at day 0 was 1797 ng/mL (range 890–>2000) which was not statistically different to day 4 and month 1 (1884 ng/mL and 1754 ng/mL, respectively). The median fructosamine concentration on day 0 was 551 lmol/L (range 454–887) which was not statistically different from day 4 and month 1 (551 to 569, respectively). All cats were receiving PZI insulin (ProZinc, Boehringer) and the median dose on day 0 (1.1 units/kg q12 h) was not different to day 4 and month 1 (1.1 and
1.2, respectively). Three patients experienced a single gastrointesti- nal upset event (inappetence, diarrhea) which resolved within three days. One of the six cats experienced an improvement of diabetic control (fructosamine day 0 was 454 lmol/L and month 1 was 288 lmol/L while insulin dose on day 0 was 1 unit/kg q12 h and month 1 was 0.2 units/kg q12 h) although there was no decrease of IGF-1 concentration (day 0: 890 ng/mL; month 1: 929 ng/mL).

Cabergoline therapy, using the investigated dose and duration, was not associated with a reduction in IGF-1 concentration in the tested diabetic acromegalic cats; glycemic control improved in one. Additional cases, alternative dosing regimens and longer-term follow-up are being assessed.

Disclosures: Disclosures to report.

The diabetic remission clinic is supported by Nestle Purina and Boehringer Ingelheim.
 

Attachments

Mom2Maverick said:
I have attached the study that convinced me and I sent it to my vet.
I am copy and pasting from EVCIM abstracts.

I hope this helps!

J Vet Intern Med 2017

Research Communications of the
27th ECVIM-CA Congress

Intercontinental, Saint Julian’s, Malta, 14th to 16th September 2017


ESVE – O – 6
PILOT STUDY ASSESSING THE USE OF CABERGOLINE IN THE MANAGEMENT OF DIABETIC ACROMEGALIC CATS. C.J. Scudder, K. Hazuchova, R. Gostelow, V. Woolhead, Y. Forcada, D.B. Church, R.C. Fowkes, S.J.M. Niessen. Royal Veterinary College, Hatfield, UK

Cabergoline is a dopamine 2 receptor (D2R) agonist which is a second line medical therapy for human acromegalic patients. Pasir- eotide, a somatostatin analogue, is the only effective medical man- agement option for feline acromegaly but its cost is a limiting factor for many owners. Our work has demonstrated dopamine receptors within the feline acromegalic pituitary and we hypothe- sized that cabergoline would improve diabetic control and IGF-1 concentrations of diabetic acromegalic cats.

This was a prospective cohort study of client-owned diabetic acromegalic cats, Ethics approval URN 2016 1604. Enrolment cri- teria were: a diagnosis of diabetes mellitus, an IGF-1 concentra- tion >1000 ng/mL and owners declining alternative treatment options for acromegaly. Patients were admitted to the hospital on day 0, underwent pituitary imaging and started cabergoline ther- apy (Kelactin, Kela N.V.) on day 1. Cats were monitored in hospital until day 4 and were discharged to continue treatment at home. Serum IGF-1 and fructosamine were measured on day 0, day 4 and month 1. Any possible medication side effects were recorded. Descriptive statistics and non-parametric tests were used to analyze the data.

Six cats were enrolled. The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline. The median IGF-1 concentration at day 0 was 1797 ng/mL (range 890–>2000) which was not statistically different to day 4 and month 1 (1884 ng/mL and 1754 ng/mL, respectively). The median fructosamine concentration on day 0 was 551 lmol/L (range 454–887) which was not statistically different from day 4 and month 1 (551 to 569, respectively). All cats were receiving PZI insulin (ProZinc, Boehringer) and the median dose on day 0 (1.1 units/kg q12 h) was not different to day 4 and month 1 (1.1 and
1.2, respectively). Three patients experienced a single gastrointesti- nal upset event (inappetence, diarrhea) which resolved within three days. One of the six cats experienced an improvement of diabetic control (fructosamine day 0 was 454 lmol/L and month 1 was 288 lmol/L while insulin dose on day 0 was 1 unit/kg q12 h and month 1 was 0.2 units/kg q12 h) although there was no decrease of IGF-1 concentration (day 0: 890 ng/mL; month 1: 929 ng/mL).

Cabergoline therapy, using the investigated dose and duration, was not associated with a reduction in IGF-1 concentration in the tested diabetic acromegalic cats; glycemic control improved in one. Additional cases, alternative dosing regimens and longer-term follow-up are being assessed.

Disclosures: Disclosures to report.

The diabetic remission clinic is supported by Nestle Purina and Boehringer Ingelheim.
Click to expand...
 
Pamela & Amethyst said:
HI How are you? I am trying to get my vet to understand the need for Amethyst to be on this drug How do I access this webpage and post THanks:bighug:
Click to expand...
I just emailed Chris at RVC and then sent that email to my vet. I can't remember the webpage, but I will try to look it up later. Although, it looks like @Mom2Maverick already posted a link to the study. Thank you! :):bighug:
 
I was reading the Argentine paper on cabergoline for cats with acromegaly.
It says:

"After Cbg treatment, all three cats showed reduction of IGF-1, fructosamine and insulin requirements along with resolution of clinical signs by the third and sixth months. These results are similar to those by Gostelow et al. (2017) with short-action and long-acting pasireotide injection and, apparently, are more promising than thoseobtained with radiotherapy (the most commonly used treatment for cats with acromegaly), where no such improvement in IGF-1 levels has been observed despite improving clinical signs with reduction of insulin requirements (Reusch, 2015). "

I am surprised that it says radiotherapy does not improve IGF-1 levels. Is that correct? Did you folks who did SRT have your cats' IGF-1 retested? Or does this line throw the whole paper into doubt?

The paper also says:
"Future studies should evaluate pituitary size in acromegalic cats after Cbg treatment, given the known antiproliferative and proapoptotic e ects of Cbg on corticotropinoma, somatotropinoma and prolactinoma neoplastic cells, both in humans and dogs (Castillo et al., 2008; Marazuela et al., 2014). "

Wow. I didn't realize that the drug treatments might shrink the tumor.
 
Very few people get the IGF-1 rested now after SRT, as it does not reduce the number. I didn't cause it wouldn't change how I did anything and was quite expensive. Julie's punkin's numbers actually went up a little. One of RVC's goals with cabergoline was to find a drug that did reduce the IGF-1. I haven't seen their results to see if it happened. The paper you quoted only had 3 cats in the study, not enough to be statistically significant.
 
Last edited:
I went through the abstracts listed above, and pulled the content for the RVC presentation:

ESVE–O–6
PILOT STUDY ASSESSING THE USE OF CABERGOLINE IN THE MANAGEMENT OF DIABETIC ACROMEGALIC CATS.


C.J. Scudder, K. Hazuchova, R. Gostelow, V. Woolhead, Y. Forcada, D.B. Church, R.C. Fowkes, S.J.M. Niessen. Royal Veterinary College, Hatfield, UK


Cabergoline is a dopamine 2 receptor (D2R) agonist which is a second line medical therapy for human acromegalic patients. Pasireotide, a somatostatin analogue, is the only effective medical management option for feline acromegaly but its cost is a limiting factor for many owners. Our work has demonstrated dopamine receptors within the feline acromegalic pituitary and we hypothesized that cabergoline would improve diabetic control and IGF-1 concentrations of diabetic acromegalic cats.


This was a prospective cohort study of client-owned diabetic acromegalic cats, Ethics approval URN 2016 1604. Enrolment criteria were: a diagnosis of diabetes mellitus, an IGF-1 concentration >1000 ng/mL and owners declining alternative treatment options for acromegaly. Patients were admitted to the hospital on day 0, underwent pituitary imaging and started cabergoline therapy (Kelactin, Kela N.V.) on day 1. Cats were monitored in hospital until day 4 and were discharged to continue treatment at home. Serum IGF-1 and fructosamine were measured on day 0, day 4 and month 1. Any possible medication side effects were recorded. Descriptive statistics and non-parametric tests were used to analyze the data.


Six cats were enrolled. The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline. The median IGF-1 concentration at day 0 was 1797 ng/mL (range 890 – > 2000) which was not statistically different to day 4 and month 1 (1884 ng/mL and 1754 ng/mL, respectively). The median fructosamine concentration on day 0 was 551 lmol/L (range 454–887) which was not statistically different from day 4 and month 1 (551 to 569, respectively). All cats were receiving PZI insulin (ProZinc, Boehringer) and the median dose on day 0 (1.1 units/kg q12 h) was not different to day 4 and month 1 (1.1 and1.2, respectively). Three patients experienced a single gastrointestinal upset event (inappetence, diarrhea) which resolved within three days. One of the six cats experienced an improvement of diabetic control (fructosamine day 0 was 454 lmol/L and month 1 was 288 lmol/L while insulin dose on day 0 was 1 unit/kg q12 h and month 1 was 0.2 units/kg q12 h) although there was no decrease of IGF-1 concentration (day 0: 890 ng/mL; month 1: 929 ng/mL).


Cabergoline therapy, using the investigated dose and duration, was not associated with a reduction in IGF-1 concentration in the tested diabetic acromegalic cats; glycemic control improved in one. Additional cases, alternative dosing regimens and longer-term follow-up are being assessed.


Disclosures:

Disclosures to report.

The diabetic remission clinic is supported by Nestle Purina and Boehringer Ingelheim.
 
Yes, isn't that discouraging from the RVC? I'm wondering if they are continuing to give Cabergoline. The cats I have followed here took about 30 days to have improved blood sugars. My cat also, but I switched to Levemir around the same time. My vet is planning to repeat the IGIF-1 around the 3 month mark. Mav has had about 64 doses so far.
 
I'm glad they are researching it. And glad you all are posting the studies. It's too bad they didn't test more cats. For diabetic cats, there is a significant percentage which have Acro. They should have looked for 10-20 cats to be in the study.

Leo has not been retested for IGF-1 levels. It was over $100 for the test. And the results will not affect his current treatments.
 
What doses are you folks using?
What dose interval?
What form? Compounded liquid?
(I only see the information for Malachai here.)
What does "q24 h PO" mean?

The Argentine paper was
An oral dose of 10 μg/Kg Cbg every 72 h (Wanke et al., 2002) was prescribed,

The RVC study was
The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline
That study was only for 1 month, so I am not completely discouraged.

Apologies. I only reviewed page 2 today. I see Wendy posted in the first entry that everyone is using liquid compounded cabergoline.
 
q24 h po means every 24hrs by mouth

The Argentine paper gave 10mcg/kg every 3 days
The RVC gave 5mcg/kg every 24hrs by mouth or 10mcg/kg every 24hrs

I get mine compounded from Wedgewood pharmacy. The concentration is 100mcg/ml. I give 0.9ml or 900mcg daily because Maverick is 20lb. It is pricey, $135 per bottle with shipping. It lasts a little over a month.


I am giving 10mcg/kg daily
 
MJW said:
What doses are you folks using?
What dose interval?
What form? Compounded liquid?
(I only see the information for Malachai here.)
What does "q24 h PO" mean?

The Argentine paper was
An oral dose of 10 μg/Kg Cbg every 72 h (Wanke et al., 2002) was prescribed,

The RVC study was
The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline
That study was only for 1 month, so I am not completely discouraged.

Apologies. I only reviewed page 2 today. I see Wendy posted in the first entry that everyone is using liquid compounded cabergoline.
Click to expand...
Hi there,
My cat Tiffany has been on Cabergoline, liquid form,
MJW said:
What doses are you folks using?
What dose interval?
What form? Compounded liquid?
(I only see the information for Malachai here.)
What does "q24 h PO" mean?

The Argentine paper was
An oral dose of 10 μg/Kg Cbg every 72 h (Wanke et al., 2002) was prescribed,

The RVC study was
The first three cats received 5 μg/kg q24 h PO and the second three cats received 10 ug/kg q24 h PO of cabergoline
That study was only for 1 month, so I am not completely discouraged.

Apologies. I only reviewed page 2 today. I see Wendy posted in the first entry that everyone is using liquid compounded cabergoline.
Click to expand...
Hi there,

This is my experience with the Cabergoline drug:
My cat, Tiffany has been on Cabergoline liquid form, compounded at Diamondback Pharmacy in Scottsdale, AZ. She is on .26ml daily and is 14 pounds. This has been a miracle drug for her. She was on 16 units of levermir 2x daily when we started and is now at 5.5u. We saw our playful, purry cat return after about 2 weeks into it. This drug is not a cure, but definitely has helped her live a better quality of life. My vet is also quite happy with her progress.

Jadi & Tiffany
 
Last edited:
Jadi & Tiffany said:
Hi there,
My cat Tiffany has been on Cabergoline, liquid form,

Hi there,

This is my experience with the Cabergoline drug:
My cat, Tiffany has been on Cabergoline liquid form, compounded at Diamondback Pharmacy in Scottsdale, AZ. She is on .26ml daily and is 14 pounds. This has been a miracle drug for her. She was on 16 units of levermir 2x daily when we started and is now at 5.5u. We saw our playful, purry cat return after about 2 weeks into it. This drug is not a cure, but definitely has helped her live a better quality of life. My vet is also quite happy with her progress.

Jadi & Tiffany
Click to expand...

I am thrilled to hear Tiffany is still doing well!
 
My vet has been busy reading articles quoting Stijn Niessen at RVC from 2016 and 2017.
She said he says cabergoline doesn’t work, nor is he in favor of radiation therapy.
He promotes hypophysectomy. Of course, he is cofounder of the hypophysectomy center at RVC.
My vet is encouraging me to investigate the surgery.

I started Yum on cabergoline yesterday. 45mcg per day in a compounded liquid, mixed into food. There's a chance she threw up a bit of it, but a civvie is also throwing up around the house so not sure.

My vet suggested that some vets in the US believe IGF-1 just goes up with blood glucose. Has anyone else heard that?
Maybe acromegaly isn’t well accepted as a cause of diabetes in the US.

Just a thought: some veterinary research student should mine this forum for data on cats with acromegaly.
 
MJW said:
My vet suggested that some vets in the US believe IGF-1 just goes up with blood glucose. Has anyone else heard that?
Click to expand...
I got a copy of Yum's IGF-1 and IAA test. It has 2 sentences:
"The serum concentration of insulin-like growth factor 1 (IGF1) is increased and is a likely differential diagnosis. Are there physical changes that are consistent with acromegaly? It is recognized that increases in this hormone may occur as a metabolic response to diabetes mellitus in some cats, but this result is clearly higher than what would be expected in that latter scenario"

I guess that validates my vet's saying that sometimes IGF-1 goes up with blood glucose.
 
IGF-1 competes with insulin at the cellular level. When the pituitary gland outputs excess IGF-1, we have to dose additional insulin to overcome the IGF-1.

I'm not sure I agree with that statement that IGF-1 goes up with BG. You could have a an example cat which has high IGF-1, but has not eaten a lot of food. So excess BG would not accompany the high level of IGF-1.

Excess BG occurs because there is insufficient insulin for the body to absorb it. So the body pushes more glucose into the bloodstream, then it gets filtered out by the kidneys.

There is no surprise that your vet is pushing hypophysectomy if he started some clinic which focuses on that. There was a recent case in the Acro forum of a lady who had a hypophysectomy done on her kitteh. The results were 100% cure of the diabetes (and IGF-1). That was in the last 12 months.

From my participation on the forum here in the last 18 months or so, it seems many vets are inexperienced with diabetes. Very few of them seem to really know about Acromegaly. There are a lot of things that can go wrong with a cat, so maybe Acromegaly is considered an edge case.

I hope the Cabergoline works for Yum.
 
Re my earlier question re IGF-1 being elevated in all cats with diabetes:
In a 2015 paper by Scudder on Paseriotide I see the statement:
"A previous study indicating that diabetic cats treated with insulin long term have increased serum IGF‐1 concentrations compared with diabetic cats receiving insulin treatment over shorter periods of time."

Yum has mild diarrhea today, possibly from the 3 doses of cabergoline.
 
That is an interesting quote from the paper. Did they mention the IGF-1 levels associated with the observation? The other component of this - is that 20-30% of all diabetic cats have Acro. So it would need to be correlated with that as well. I know you are quoting from a paper, but maybe they didn't include all the pertinent content.

Sorry that Yum has diarrhea. In the 2000 timeframe we had Squeaky. She would get diarrhea and run thru the house with it coming out. Just really a bad deal all around.
 
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JeffJ said:
Sorry that Yum has diarrhea. In the 2000 timeframe we had Squeaky. She would get diarrhea and run thru the house with it coming out. Just really a bad deal all around.
Click to expand...
Bwahaha. Made me laugh. What we do for our cats.
 
The American Cancer Society has a pdf about treating pituitary tumors.

https://www.cancer.org/content/dam/CRC/PDF/Public/8791.00.pdf

It says cabergoline is very successful at treating prolactin secreting tumors, usually making surgery unnecessary.
It is not as successful at treating growth hormone secreting tumors.

"Dopamine agonists: Drugs like cabergoline or bromocriptine can reduce growth hormone levels in about 1 out of 3 patients. But higher doses are needed for these tumors than for prolactinomas, and some patients have trouble with the side effects they can cause (discussed above). An advantage of these drugs is that they can be taken as a pill. "

Hey. 1 out of 3 is something. It doesn't say if cbg reduces tumor size when it does reduce growth hormone levels.
 
That is an interesting find. For the low cost of the cabergoline, it is worth the probability that it can resolve the growth hormone levels.
 
Jadi & Tiffany said:
Hi there,
My cat Tiffany has been on Cabergoline, liquid form,

Hi there,

This is my experience with the Cabergoline drug:
My cat, Tiffany has been on Cabergoline liquid form, compounded at Diamondback Pharmacy in Scottsdale, AZ. She is on .26ml daily and is 14 pounds. This has been a miracle drug for her. She was on 16 units of levermir 2x daily when we started and is now at 5.5u. We saw our playful, purry cat return after about 2 weeks into it. This drug is not a cure, but definitely has helped her live a better quality of life. My vet is also quite happy with her progress.

Jadi & Tiffany
Click to expand...
So glad to hear Tiff is doing well !! :bighug:

I'm a fan of Cabergoline. It was reducing Beenie's insulin needs and she was dropping down the dose ladder. I feel it is so worth a try for Acro cats based on cost and the success I've seen here. Not a cure but us it was getting and keeping my girl in healing numbers.
 
@Bronx's dad
Your spreadsheet says you started Bronx at .4ml then upped him to .8ml cabergoline once a day.
Was the .8ml 10mcg/kg? I'm not sure they are all compounded at the same mcg per ml, and I don't know Bronx's weight.
Thanks!
 
MJW said:
@Bronx's dad
Your spreadsheet says you started Bronx at .4ml then upped him to .8ml cabergoline once a day.
Was the .8ml 10mcg/kg? I'm not sure they are all compounded at the same mcg per ml, and I don't know Bronx's weight.
Thanks!
Click to expand...
Bronx was about 17-18lbs and yes, we doubled to .8ml which is 10mcg/kg. We started at .4ml (5mcg/kg) which is half the dose that most kitties start at now.
 
Bronx's dad said:
Bronx was about 17-18lbs and yes, we doubled to .8ml which is 10mcg/kg. We started at .4ml (5mcg/kg) which is half the dose that most kitties start at now.
Click to expand...
His chart does suggest that he might have been responding to it.
It's interesting that the cats in Argentina responded to that dose delivered just every 72 hours. I will ask my vet what the medical argument would be for longer or shorter intervals between doses. The longer interval makes me think of terror strategies where they strike, wait for recovery to start, then strike again.
Has Bronx's polyphagia subsided with his BG coming under control and/or lower insulin dose?
Yum's polyphagia/polydipsia seem to fluctuate in real time with her BG.
I guess there are 2 sources though: the BG and the mitogenic stuff.
 
MJW said:
Has Bronx's polyphagia subsided with his BG coming under control and/or lower insulin dose?
Click to expand...
Yes, his hunger is under control now that his numbers are lower. It was hard keeping up with him this time last year, he was eating insane amounts of food. The acro also makes them hungry, they think they are like a growing teenager.
 
I can only speak for myself, I worked with Chris at RVC unofficially for my Marvin, and cabergoline was a miracle for him too. He has been off insulin since July I think.... and still doing well. Went from a cat who's quality of life was about done, he could barely walk due to neuropathie caused by diabetes, he could climb in his litter box, the 5 P's were no longer there.... 5 weeks after cabergoline and support from here, he was off insulin, normal range, eating, showing attitude again ... He is still improving, neuropathie is almost gone, he plays, purrs, grooms, pee and poop in litter box and oh ya his coat is super soft now (must be the oil wendy told me to add to his food).... the only thing he hasn't done is jump, not sure if he can or he thinks he can't. Cabergoline is not a cure, but helps to manage acromegaly.
 
Marvin's Mom - Nat said:
I can only speak for myself, I worked with Chris at RVC unofficially for my Marvin, and cabergoline was a miracle for him too. He has been off insulin since July I think.... and still doing well. Went from a cat who's quality of life was about done, he could barely walk due to neuropathie caused by diabetes, he could climb in his litter box, the 5 P's were no longer there.... 5 weeks after cabergoline and support from here, he was off insulin, normal range, eating, showing attitude again ... He is still improving, neuropathie is almost gone, he plays, purrs, grooms, pee and poop in litter box and oh ya his coat is super soft now (must be the oil wendy told me to add to his food).... the only thing he hasn't done is jump, not sure if he can or he thinks he can't. Cabergoline is not a cure, but helps to manage acromegaly.
Click to expand...
There is evidence it can reduce the tumor size in some humans. So not a full cure, but a partial cure.
I remember when you joined the forum, when Yum was a simple diabetic, with no suspicion of acromegaly. You were debating putting Marvin down. Marvin's miracle was a wonderful story to watch unfold.
 
Marvin's Mom - Nat said:
I worked with Chris at RVC unofficially for my Marvin, and cabergoline was a miracle for him too.
Click to expand...
Chris Scudder of RVC didn't mention Marvin's case in his rather negative 9/17 abstract on cabergoline testing. Was that just because Marvin wasn't officially part of the study? Did Marvin inspire the study?
 
He wasn't on the study officially, however Chris had asked me if he could mention Marvin at the conference this summer and asked for some pictures. I haven't seen the study abstract. I had checked a few times but haven't found it.
 
Marvin's Mom - Nat said:
He wasn't on the study officially, however Chris had asked me if he could mention Marvin at the conference this summer and asked for some pictures. I haven't seen the study abstract. I had checked a few times but haven't found it.
Click to expand...
Mom2Maverick posted it above on Dec. 6. Chris Scudder was the first author.
 
It is in post 109 above
They only used 6 cats in the study. So not statistically significant. Too bad they didn't do 20 or 30 cats. Probably just too much work.
 
Yum is a bit lethargic today, so I've been googling cabergoline side effects in humans. Almost all the articles describe it as a long lasting drug, usually prescribed to be taken twice a week. Hmmm. I am still worrying over the dosing frequency differences between the Argentine abstract and the RVC abstract. At very large doses it can cause heart valve problems in humans.
I think I also read it can lower blood pressure, but not dramatically.
 
Yum's respiratory rate has been elevated (dyspnea). It was high 40's to low 50's yesterday. This morning it is mid 30's.
Mid 30's is high for a resting cat, but not an emergency.
I read dyspnea can be a side effect of cabergoline in 1% to 10% of humans.
Has anyone else had side effects?
Yum doesn't seem to feel great.
I think I will cut her back to every other day as a trial. The cats in Argentina took the cabergoline once every 48 hours.
[I have been writing 3 days, but on a more careful reread, it is 2 days.]
It is considered a long acting drug.
 
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Sorry, don't know about Cabergoline. However, Leo is on Leukeran (chemo) which is typically one of the following doses:
- small dose every other day
- or larger dose every 10 days

He is responding well. So my vet called an internist, and they recommended moving him to every third day. Just using this as an example. Some adjustments can be made depending on the patient's response - for some drugs.
 
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I contacted RVC about cabergoline.
I will post more later. Chris says cabergoline only works in a few cats.
He did have success combining it with octreotide (a somatostatin analogue which does not work well on its own in cats). It's a combination used for humans.
 
CSU did a study on the use of octreotide with acrocats. Somewhere on this forum is a link to the study. Interesting that the combination might work better.
 
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