Hyper-extension on front paws

Krista & Copernicus

Krista & Copernicus

Member Since 2026
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Walking on hocks is one thing but he has significant hyper extension on front paws now? Anything I can do? Vet said rehab but their first consult is a month out.
 
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Wow that is terrible. I am so sorry. Are you giving methylcobalamin daily? It’s not in your signature so I was wondering.

Can you try a daily dose of Cabergoline instead of every other day? It looks like he’s had a response but could do better.

Is he in pain? Can you try a little Buprenorphine? Does he have arthritis?

@Wendy&Neko
 
Nothing to add to what Suzanne has suggested so far. Other that he needs to get into better blood sugars as soon as safely possible to do so.
 
Suzanne & Darcy said:
Wow that is terrible. I am so sorry. Are you giving methylcobalamin daily? It’s not in your signature so I was wondering.

Can you try a daily dose of Cabergoline instead of every other day? It looks like he’s had a response but could do better.

Is he in pain? Can you try a little Buprenorphine? Does he have arthritis?

@Wendy&Neko
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I started b12 again daily. But he is often in the ER and the vets never support supplements or never continue to move them in the hospital. They also blamed his supplements having magnesium stearate as a reason for having high magnesium levels. He has arthritis in hips. That is the referral I'm waiting on. He is in pain. Once again, we are considering euthanasia as he only is awake a few minutes a day and can only walk a few feet now that all 4 paws are effected.
 
Many acrocats end up on buprenorphine full time for pain, Neko had to. It was a game changer for her. She starting interacting a lot more with us and playing. For some cats full time gabapentin works. Even your local GP vet should be able to prescribe something for arthritis pain until he sees the specialist.
 
Wendy&Neko said:
Many acrocats end up on buprenorphine full time for pain, Neko had to. It was a game changer for her. She starting interacting a lot more with us and playing. For some cats full time gabapentin works. Even your local GP vet should be able to prescribe something for arthritis pain until he sees the specialist.
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I just spent time and money at a new internist. She is who referred me back to rehab. So now I am back to emailing vet school about arthritis. once again we are being just passed around and drug seeking. The primary vet took the hip X-rays but wouldn't prescribe anything for arthritis. So many vets have failed him. And I failed him by not doing the radiation sooner. He's really progresses from that 700 event and I will die on that hill.
 
I'm sorry. :bighug:I have been following you a long time since we both have acro cats. for
I agree with what Suzanne said. To me, that looks like neurophathy and the B12 type you need is methylcobalamin, but it can take a while to start showing improvement.
I just recently changed my cat to every day dosing of Cabergoline because it seemed to quit working as well as it did previously.
I would tell them to prescribe some Buprenorphine for pain, as opposed to Gabapentin which causes more sleepiness.
I have also read your posts on Facebook, and I have seen cats on 100 units as I have been here a long time. Also, if you decide to use a bolus insulin like R please post here and have someone guide you for help and don't just buy it and do it on your own.

Wishing and praying all the time for Copernicus to get better.
 
Since he is in pain, I would insist that he receive Buprenorphine. The doses are small. It is very easy to slip an oral dosing syringe into the cheek pouch to give the dose, and cats don’t even seem to mind the taste. I don’t think it has much taste. As Dyana mentioned, it’s a lot less sedating than Gabapentin. Copernicus already has trouble walking, so you really don’t need a pain med that can cause a wobbly gait or instability in walking!
 
Suzanne & Darcy said:
Since he is in pain, I would insist that he receive Buprenorphine. The doses are small. It is very easy to slip an oral dosing syringe into the cheek pouch to give the dose, and cats don’t even seem to mind the taste. I don’t think it has much taste. As Dyana mentioned, it’s a lot less sedating than Gabapentin. Copernicus already has trouble walking, so you really don’t need a pain med that can cause a wobbly gait or instability in walking!
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They have him what they called an intermediate dose of that in the hospital and he was falling all over the place and drooling and nauseous.
 
Suzanne & Darcy said:
They obviously have no experience or knowledge about cats with acromegaly.
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I'm at the vet school. One of the known centers for acro. But his first IM was a criticalist on a rotation who increased his dose by 5 units with no days for a depot. His second was good but conservative and she left for a rotation. His third was a first year and she made a mistake with him that I can't forgive.
 
Krista & Copernicus said:
Doesn't gaba go through the kidneys more?. And Copernicus hates anything squirted in his mouth. He is really tired of it all. :(
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buprenorphine is such a tiny amount that generally they don’t notice it. It’s supposed to be squirted into the cheek pouch (buccal pocket) and it’s usually like a drop of liquid (depends upon your cat’s weight.) Of he was asleep he would not even notice it I dare say. I currently have a cat getting 0.1 mL. I mean really small amount!
 
I’m so sorry for everything that you’ve been going through with Copernicus. It sounds really really hard. I completely understand the caregiver fatigue also. I really do.
 
Neko got .22ml, chicken flavoured bupe. I had no problem giving it. I have seen some people use buprenorphine compounded into an ear cream.

Krista - you should look at Darcy's spreadsheet in Suzanne's signature. He was living in mostly pink a long time.
 
Baxter has this too, thankfully it's been relatively slow to progress. I think solensia shots provide him some relief.. but it made him nauseated the first time so I give him zofran beforehand and that seemed to work.
 
I really feel you with the vet stuff and care fatigue. There was a period of last year that really felt like an actual waking nightmare.
Baxter spent a LONG time, like months on end, well over 400's. You can see some of that from 2025 ss, but it was worse before I got him on lantus and started testing him at home. He lost over a quarter of his weight at one point.
I think his kidneys were already hit pretty hard but his values did improve some as he started getting more stable and getting his weight and energy back.
I'm not sure if any of this helps.. but know you're on the right track. I'm so glad you've made it here especially seeing just some of the similarities our kitties have had.
 
JL and Chip said:
Neuropathy can definitely affect front feet too. Worth a watch:

I would NOT try Solensia given Copernicus’ other medical issues. Adequan injections might be an option for arthritis.

How is his swallowing?
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I agree with you 100% @JL and Chip on the Solensia. I was going to say the same thing. I would not risk it with all of the very complex conditions that Copernicus has. In fact, I wrote that same thing a few days ago but forgot to click “post reply.”

I use Adequan in my cats due to the long established safety profile.
 
JL and Chip said:
Neuropathy can definitely affect front feet too. Worth a watch:

I would NOT try Solensia given Copernicus’ other medical issues. Adequan injections might be an option for arthritis.

How is his swallowing?
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Swallowing ok. It's defintely more than neuropathy. The joint is sticking out of the side of the front legs (almost bent appearance) so it looks like joint broke down. This all started happening quickly once his BGs went up to 700 and have been hard to get back down below 400. From what in can tell there is no fix. He would need rods and screws in both paws. Conservative measures aren't a thing.
 
Dyana said:
I also agree on the NO Solensia. I kept saying no because it was a new drug and eventually I let my vet talk me into, and I regret it.
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What happened? :( Several vets said it's been life changing for their senior cats. (But those cats don't have all these issues.)
 
Wendy&Neko said:
Neko got .22ml, chicken flavoured bupe. I had no problem giving it. I have seen some people use buprenorphine compounded into an ear cream.

Krista - you should look at Darcy's spreadsheet in Suzanne's signature. He was living in mostly pink a long time.
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He was ok living in the purple. It's when the blacks and reds enter, that is when he starts going down hill fast. I was looking at his spreadsheet and Copernicus was handled wrong from the beginning. The vets switched his insulin quickly, he was never left on one dose for the correct amount of time even from the first days at 1 unit. The vets increased him so quickly. And then I remember time at State where he went in at 3 units and they just increased him by several units every 12 hours. I wonder what kind of damage that did. His body is probably producing so much cortisol that is raising his BG on top of having insulin resistance.
 
Krista & Copernicus said:
What happened? :( Several vets said it's been life changing for their senior cats. (But those cats don't have all these issues.)
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I don't know. She got the Solensia shots for about 10 months. She was 19 when she started them. Around 20 years old her kidneys got worse, and she started to have anemia. I stopped the Solensia after she was hospitalized on IV fluids for 4 days and sent home on "hospice care". She lived another 5 weeks. She was 20 years and 5 months, so I think of it as just old age, but ... The oldest cat I've ever had.. I would just not choose to "trial" a new drug again. I miss my Ginger 😢 tears.
I'm sure the vets get information (and pushed) from the drug manufactuers (just like the "prescription foods", but I won't be a "guinea pig" again.
I would choose Adequan. I gave that to both J.D. and Ginger. It's been around a while.
 
Krista & Copernicus said:
He was ok living in the purple. It's when the blacks and reds enter, that is when he starts going down hill fast. I was looking at his spreadsheet and Copernicus was handled wrong from the beginning. The vets switched his insulin quickly, he was never left on one dose for the correct amount of time even from the first days at 1 unit. The vets increased him so quickly. And then I remember time at State where he went in at 3 units and they just increased him by several units every 12 hours. I wonder what kind of damage that did. His body is probably producing so much cortisol that is raising his BG on top of having insulin resistance.
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I'm just concerned that you have so many different vets seeing him and most are not well educated or have experience or training in diabetic cats and they may give you all kinds of different information or advise.
I tend to get most of my information here, and tell my regular vet what tests I want and what drugs or prescriptions I want to try. She is "my partner" and has known my cats for a long time.
 
Dyana said:
I'm just concerned that you have so many different vets seeing him and most are not well educated or have experience or training in diabetic cats and they may give you all kinds of different information or advise.
I tend to get most of my information here, and tell my regular vet what tests I want and what drugs or prescriptions I want to try. She is "my partner" and has known my cats for a long time.
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That's the problem. I went with the vet school because everyone said they were "the best of the best" and it will be one of my biggest regrets. I also never found a partner as his primary. I was told no a lot. Remember the whole fluid quest when he had pancreatitis. 😡They often gave up on him and just everyone in town refers back to the vet school. The vet school is a rotating door. And I am shocked at how little I was told about acro and managing acro. He should have been on arthritis medicine from day 1. I failed him. And I will never forgive myself. I'm not trying to be dramatic, but I have huge regrets.
 
I understand.
When J.D. was in critical condition from DKA, decades ago, I took him to the Penn State School of Veterinary Medicine. I went to visit him every day for the 20 minutes allowed, even though it was more than 1 hour drive each way for me in the snow at Christmas time of 2005? My regular vet at the time didn't seem to have a hole lot of experience with diabetic cats and I was desparate of course. He slowly got better after 8.5 days of hospitalization and they saved him. The vet there said "I will be his primary vet" from now on.. and I replied that I can not just drive there to Philadelphia PA during commute traffick for an 8:00am appointment and she said I could get the required tests done and email them to her and she would respond, and then she moved on to California. My regular vets were used to doing what she asked.
My local vet were so used to her directives that they just asked me what tests I needed done.
I am worried that you get 18 responses from 18 different vets and maybe 1 of the 18 of them actually "knows what they are talking about" and the others are just doing their best... with what they learned in vet school which is little at best.
My primary vet is used to me telling her what tests I want and works with me and discusses with me, what I want.
 
Dyana said:
I understand.
When J.D. was in critical condition from DKA, decades ago, I took him to the Penn State School of Veterinary Medicine. I went to visit him every day for the 20 minutes allowed, even though it was more than 1 hour drive each way for me in the snow at Christmas time of 2005? My regular vet at the time didn't seem to have a hole lot of experience with diabetic cats and I was desparate of course. He slowly got better after 8.5 days of hospitalization and they saved him. The vet there said "I will be his primary vet" from now on.. and I replied that I can not just drive there to Philadelphia PA during commute traffick for an 8:00am appointment and she said I could get the required tests done and email them to her and she would respond, and then she moved on to California. My regular vets were used to doing what she asked.
My local vet were so used to her directives that they just asked me what tests I needed done.
I am worried that you get 18 responses from 18 different vets and maybe 1 of the 18 of them actually "knows what they are talking about" and the others are just doing their best... with what they learned in vet school which is little at best.
My primary vet is used to me telling her what tests I want and works with me and discusses with me, what I want.
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My brother went to Penn State. :) And another thing that happens here is I don't get to pick the ER when he had those AKl, I went with the hospital that had a bed or cage at that moment.
 
I got talked into Solensia too. I won’t go into detail right now, but my guy had a dramatic reaction and I was seriously concerned that I might lose him. And I’m not one to overreact to medical stuff.

Since you’ve been floating the “E” word, I’d encourage you to continue working up the dosing scale as quickly as possible and not hesitate or hedge with incremental increases. I think Wendy said you could go up in 2u increments every 6 cycles? At this point, do you really have anything to lose?

For what it’s worth, I don’t recall ever seeing a cat who didn’t have a breakthrough dose. Sometimes it was a huge dose, and sometimes it took seemingly forever to find it, but it was always there.

As for regret, yep, I get that. I think many of us do, and it can be a hefty burden to carry. But please give yourself some grace. You’re not a vet, you’re not supposed to be an expert in these topics, and diabetes/acro/AKI/DKA/etc is certainly not in most of our wheelhouses when we initially step through the FD door. You have fought hard and advocated for Copernicus at every turn, and even though knowing that doesn’t take away the angst, please cut yourself a break.

Please give Copernicus a scratch on the chin for me. Hugs to you too.
 
JL and Chip said:
Neuropathy can definitely affect front feet too. Worth a watch:

I would NOT try Solensia given Copernicus’ other medical issues. Adequan injections might be an option for arthritis.

How is his swallowing?
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I watched the video again. I think it if it was just diabetic neuropathy that is one thing, but he has the added joint growth complications from acro. He is just getting hit with so much. 😢 and his mid cycle was so high today. He has been that high is almost 12 days. Ugh.
 
Krista & Copernicus said:
I watched the video again. I think it if it was just diabetic neuropathy that is one thing, but he has the added joint growth complications from acro. He is just getting hit with so much. 😢 and his mid cycle was so high today. He has been that high is almost 12 days. Ugh.
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In acromegaly, it really can feel like you are constantly chasing the numbers trying to keep them in check with increases.

Can you switch to daily Cabergoline. You can’t know if it would help unless you try.
 
It also would be worth considering adding in a little Novolin R insulin. It’s given at the beginning of the cycle and it can help to lower the BG and give your Lantus lower numbers to start working on at the time it onsets. You start with a very small dose of R and monitor for the for the first four hours of the cycle to see the response and you can work your way up from there.
 
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