Ana & Frosty (GA)
Very Active Member
The visit went relatively well. We are just waiting to check out now. Frosty is singing me the song of his people, and I am trying to block it out, lol.
Basically, the differential diagnoses are Cushing’s, Acromegaly, or paraneoplastic syndrome. She said she has seen skin tearing with Acromegaly as well, and it's also possible if he has some underlying cancer to have skin tearing due to altered metabolism and malnutrition. Suddenly, Cushing has become a more desirable diagnosis....
So far they have only did the abdominal ultrasound, and they could see one of the adrenals, which means they are likely enlarged. The liver also looked abnormal, more homogenous in quality, which she said is common in Cushing's. (Interesting, because in humans, that's a normal finding). But the concern was the pancreas - it had a lot of cysts. And Frosty wasn’t cooperating so the exam was limited. The vet said it could be due to the long-standing Diabetes, or some other metabolic disease, but it makes me concerned.
For those of you whose cat's abdomen was imaged, did they find abnormalities in the pancreas? I have read that the pancreas can be ENLARGED with Cushing's, but never about cysts. I really hope he does not have pancreatic cancer or something. But if the bloodwork comes back negative, then it could be a possibility.
The next step is the low dose dexamethasone suppression test. Since it is already late in the day, we are going to do it on Monday. Luckily for me, the Animal Hospital is close to my work and since they are open 24/7, I will drop Frosty off before work on Monday, and pick him up after. So that works out. They are going to do another blood test I think, she was worried about sticking him twice due to the fragile skin so she decided not to do it today.
She also told me to slow down or stop testing his sugars all together because she is concerned about his skin condition. I told her I was going to do a curve tomorrow and possibly increase his insulin, but she said to leave it alone at 2.5 units for now, since he went kind of low on 2.75 (72 on the Alphatrack2 meter). She said that since we are ruling out another metabolic disease, it is unlikely that we will get his sugars under control this week anyway. Obviously the other underlying disease would need to be treated first before we can get control of the diabetes. She said I can continue testing for ketones, because it's more important to prevent ketosis right now, and worry about the blood sugars once we have some sort of a diagnosis/treatment plan.
She seemed optimistic about treatment for both Cushing's and Acromegaly - it would be either the medication for Cushing's, or SRT for Acromegaly. They do SRT at this hospital too, and she said they have seen great success in cats. Obviously SRT will be more expensive, since it involves and MRI and the treatment itself and will be around $6,000 or so. The medication for Cushing's will cost about $50 a month or so, plus visits and blood work ($175 for visit and about $200 for the blood work). I figured I'll post prices for others who may need this information in the future. Who needs a savings account anyway, right?
She did say that skin tears are indicators of poorer prognosis regardless of what he has.
Which sucks. His wound is OK, it's closed still but I wouldn't say it's definitely healing. He's still wearing his shirt. She also said any type of surgery is not a good option for him right now because he won't heal. She said if he does well in 6 months and is healing then maybe that could be something to consider if there is surgical treatment available for what he has.
So that's where we are at. I am really hoping it's not cancer and something that can be at least attempted to be treated. The vet was really nice and knowledgeable. I definitely felt like she knew a lot about all the conditions, and has seen all of them before, which is reassuring.
I'll let you know what the results are next week. I think I am going to indeed skip the curve tomorrow and just let Frosty relax until another stressful day on Monday. I'm gonna keep him on 2.5u lantus and just check for ketones. He's had no ketones yesterday or today. I REALLY hope this is not cancer, ugh.. that's actually what I thought about first before the possibility of Cushing's and all these others things came out. He just looked really odd to me. and I don't know enough about feline oncology, but a human with cancer would have a decreased appetite instead of increased... again, not sure if that's the same in animals.
On a less depressing note, his cat onesie came, and it looks like it's gonna be ADORABLE. Frosty tends to have bathroom accidents in the car though so for now I am going to keep him in his shirt, but I'll change him into it on Tuesday. He's gonna look so cute. I will have to take pictures.
Hope everyone has a wonderful CATURDAY and a good weekend
Basically, the differential diagnoses are Cushing’s, Acromegaly, or paraneoplastic syndrome. She said she has seen skin tearing with Acromegaly as well, and it's also possible if he has some underlying cancer to have skin tearing due to altered metabolism and malnutrition. Suddenly, Cushing has become a more desirable diagnosis....
So far they have only did the abdominal ultrasound, and they could see one of the adrenals, which means they are likely enlarged. The liver also looked abnormal, more homogenous in quality, which she said is common in Cushing's. (Interesting, because in humans, that's a normal finding). But the concern was the pancreas - it had a lot of cysts. And Frosty wasn’t cooperating so the exam was limited. The vet said it could be due to the long-standing Diabetes, or some other metabolic disease, but it makes me concerned.
For those of you whose cat's abdomen was imaged, did they find abnormalities in the pancreas? I have read that the pancreas can be ENLARGED with Cushing's, but never about cysts. I really hope he does not have pancreatic cancer or something. But if the bloodwork comes back negative, then it could be a possibility.
The next step is the low dose dexamethasone suppression test. Since it is already late in the day, we are going to do it on Monday. Luckily for me, the Animal Hospital is close to my work and since they are open 24/7, I will drop Frosty off before work on Monday, and pick him up after. So that works out. They are going to do another blood test I think, she was worried about sticking him twice due to the fragile skin so she decided not to do it today.
She also told me to slow down or stop testing his sugars all together because she is concerned about his skin condition. I told her I was going to do a curve tomorrow and possibly increase his insulin, but she said to leave it alone at 2.5 units for now, since he went kind of low on 2.75 (72 on the Alphatrack2 meter). She said that since we are ruling out another metabolic disease, it is unlikely that we will get his sugars under control this week anyway. Obviously the other underlying disease would need to be treated first before we can get control of the diabetes. She said I can continue testing for ketones, because it's more important to prevent ketosis right now, and worry about the blood sugars once we have some sort of a diagnosis/treatment plan.
She seemed optimistic about treatment for both Cushing's and Acromegaly - it would be either the medication for Cushing's, or SRT for Acromegaly. They do SRT at this hospital too, and she said they have seen great success in cats. Obviously SRT will be more expensive, since it involves and MRI and the treatment itself and will be around $6,000 or so. The medication for Cushing's will cost about $50 a month or so, plus visits and blood work ($175 for visit and about $200 for the blood work). I figured I'll post prices for others who may need this information in the future. Who needs a savings account anyway, right?
She did say that skin tears are indicators of poorer prognosis regardless of what he has.
Which sucks. His wound is OK, it's closed still but I wouldn't say it's definitely healing. He's still wearing his shirt. She also said any type of surgery is not a good option for him right now because he won't heal. She said if he does well in 6 months and is healing then maybe that could be something to consider if there is surgical treatment available for what he has.So that's where we are at. I am really hoping it's not cancer and something that can be at least attempted to be treated. The vet was really nice and knowledgeable. I definitely felt like she knew a lot about all the conditions, and has seen all of them before, which is reassuring.
I'll let you know what the results are next week. I think I am going to indeed skip the curve tomorrow and just let Frosty relax until another stressful day on Monday. I'm gonna keep him on 2.5u lantus and just check for ketones. He's had no ketones yesterday or today. I REALLY hope this is not cancer, ugh.. that's actually what I thought about first before the possibility of Cushing's and all these others things came out
. He just looked really odd to me. and I don't know enough about feline oncology, but a human with cancer would have a decreased appetite instead of increased... again, not sure if that's the same in animals.On a less depressing note, his cat onesie came, and it looks like it's gonna be ADORABLE. Frosty tends to have bathroom accidents in the car though so for now I am going to keep him in his shirt, but I'll change him into it on Tuesday. He's gonna look so cute. I will have to take pictures.
Hope everyone has a wonderful CATURDAY and a good weekend
