Hypophysectomy Queries.

[lozenge89]

Hello everyone, just checking in again. I would like to know of those of you who have gone through with a Hypophysectomy, what was the post-op like? such as how long is recovery? was it successful? any downfalls? regrets?

Flynn has slowly deteriorated over the last couple months. His BG has come down a little, but we are now up to 12 units. His hunger has subsided a tiny bit meaning he is not so frantic and aggressive but i'm not sure whether that is just down to him feeling worse and more tired. He is very ill everyday. He lays around on cold hard surfaces, his cry is very weak and sometimes doesn't even make a sound, just opens his mouth to attempt to cry. He looks miserable all the time, he has no life or joy left in him. The only time he purrs is went he's eating or when i give him cuddles. I cannot not afford to increase his insulin anymore, the bottle is gone within 2.5 weeks and he has no insurance left.

My vet spoke to the RVC in London and they agreed Flynn is a good candidate for the surgery. It will cost us between £5,000 - £6,000, before complications (if any arise). We're calling his insurance tomorrow to see if they will cover the surgery as it's due to renew in September. If they won't cover it, I'm heartbroken to say but he will have to be put to sleep. I'm going back to school in September and will not be around to look after him during the day or to do testing.

I've read through the other posts about peoples experience with the surgery, however they are quite old. I was wondering if anyone has had a more recent experience with it. I'm aware he will be on medication for the rest of his life but right now I am desperate. Desperate to keep my boy alive but to also help him feel better.
Thanks.

L & F

 

[Wendy&Neko]

Sorry you haven't gotten any answers yet - I've been away on holiday where there is no cell service.

It's been almost a couple years since the last people reported here about hypophysectomy results. So if those are the ones you've read, you've seen the latest.

Have you ever talked to your vet about getting Flynn off of Caninsulin and onto a better long lasting insulin? Most high dose cats end up on Levemir - don't know how the cost compares for you. Some stick with Lantus, though it can sting at higher doses, and we get one or two on Prozinc. Neko was much happier when we switched off of Caninsulin to Lantus, even happier on Levemir.

 

[sbluhrs]

Hi Lauren, my Sophie will be 2 years post op from getting her pituitary yanked out in September of 2018.

Recovery was actually not too bad. Granted she was in the vet hospital for about 5 days, but, at that point, when we drove home (6 hrs), she was way down in her insulin requirements. Ultimately, looking at my spreadsheets, it took about 2 months for her to be totally off of insulin, with spot testing required after that. You can look at her spreadsheet. Surgery date was Sept 25, 2018.

After the surgery, she was needing desmopressin shots twice a day until her brain could start making that hormone to regulate her kidneys. Her peeing really wasn't much worse than she was prior to surgery as she was drinking and peeing a lot due to her uncontrolled blood glucose levels. I started tracking her shots, and when I could get a sample, her urine specific gravity levels, starting in late November of 2018. At that point, she was only getting needle juice of the desmo twice a day and that went to once a day in January of 2019. We eventually tapered to once every 36 hours for the nj of desmo.

Some cats get off the desmo quickly, some take a while and some never do. Sophie was about the same age as Flynn when she had her surgery and had no other medical issues.

At this point, she also gets levothyroxine twice a day, and prednisone once a day. She had been on prednisolone, but her dosage was too high, even with the smallest pill that we could get, and we can get a smaller dosage with the prednisone, which metabolized to prednisolone. These pills are way less expensive than the cost of insulin.

Cats definitely can have a behavior change after the surgery. After we went through some extreme thirst issues initially after the surgery, she settled down with this and I can use her water consumption now as a marker when I am figuring out whether to extend her desmo shot as we hope to get her off of it one day.

Prior to surgery, she was extremely food oriented and was always looking for something to eat, but never really seemed to get fat or be over an appropriate weight for her size. After, over a period of time, she has definitely improved in this area and we can actually leave the dishes out after we prepare food and she will not steal any (though there is nothing better for a good laugh than seeing a cat walk down the hall meowing in happiness because she has caught a corn cob prey after Mama ate her corn on the cob). And she has become quite lovey and will sit on my spouse's lap and purr up a storm when in the mood.

Please remember, this is just what happened with Sophie. I don't know enough to say that she is the norm for the recovery. I know that Amanda's Shmee had many more issues than Sophie, but he also was several years older than her when he had his surgery a month earlier, with the same surgeon at the same facility.

 

[lozenge89]

Hi again, @Wendy&Neko thanks for the reply, I've asked him a few times however he doesn't want to move him on to another insulin. His reasoning was that he wanted to find a right dose for him first, and with using another insulin we would have to start from the beginning again. We have had lower numbers with Flynn, around the 15 mark, but his hunger has never wavered. Our vet said his hunger should be coming down as his dose increases. I really wanted to try prozinc, however another problem we have with that is prozinc isn't available through online pet pharmacy here (UK) so we would have to get it through the vet, as we have no insurance left we are managing to get caninsulin online for a third of the price. If we had to buy it from the vet, we couldn't afford him to be on insulin at all, as he goes through a 10ml bottle every approx 2.5 weeks. It's just an all round awful situation.

@sbluhrs thank you for taking the time to reply! my last cat was called Sophie! I'm glad her recovery sounded to be smooth. We're not sure our insurance will cover it (at least part of it - i will still have to pay £2,000) I'm hoping so because we seem to be trapped in this horrible limbo. Flynn is up and down a lot, every day is a roller coaster. He gets extremely unresponsive during hot weather, and other times he just looks so miserable lying flat on the floor, doesn't want to lift his head. To catching birds and venturing out into the garden. He has recently started to go out again (beyond our garden) which he used to do all the time, he was an outdoor cat. He hasn't done this since February, so i silently had a tiny celebration. It's like he is too ill too carry on keep on going like this but he's definitely not unwell enough for me to consider putting him to sleep (at least not at the moment, we've had a good few days) surgery seems our only shot at making him feel well again, as we cannot afford to keep him on higher doses of insulin in the long run. I said to my mother if Flynn was any older i probably wouldn't consider surgery (the RVC is also 4.5 hrs from us) but he has only just turned 8 yrs old. He has so much more life and love to give.

 

[Wendy&Neko]

His reasoning was that he wanted to find a right dose for him first, and with using another insulin we would have to start from the beginning again.

Actually, you don't have to start at the beginning. When we switch insulins we usually do it around the same dose as the other insulin. Except if going from Lantus to Levemir or vice versa when we take a small reduction. My girl started on Caninsulin, it wore off early, so she spent hours high and hungry. I did make the mistake of starting at the beginning, I shouldn't have when I switched. Now I know better. We do have UK kitties here on Lantus and Levemir. It is possible, maybe RVC can help you with your vet?

I hope you get positive answers from insurance soon.

 

[JeffJ]

Like Wendy said, lot of people switch their cats off short acting insulins into the longer acting insulins like Levemir and Lantus. For Leo, it was very helpful to get him onto Levemir.

I know insulin can be expensive. In the U.S. and Canada we have access to inexpensive purchase options.

 

[John Irene and TITAN]

TITAN is today 2 years post surgery at the RVC.
It's nearly all good news. His general well being continues to improve slowly. Apart from excessive drinking and deafness he is a perfectly normal 15 year old cat. He is a very happy cat, purrs whenever he meets a human, goes outside to patrol and mark his territory, eats well, plays with his sister most mornings, comes to find us and sit with us at regular times of day. He has developed a liking for Goat's cheese and Goat's Yoghurt, and can be quite vociferous in asking for a taste.

He is still on lots of medication, but no blood testing and no injections.


All in all we have no regrets about the surgery. We had some doubts for the first few months, but TITAN has given and received so much love and a affection, and continues to do so, that it all seems well worth it.

 

[JeffJ]

Happy surgery anniversary to Titan. What a great success story.

That is such a cute picture of the fluffy fellow. He looks amazing.