I think my cat may have acromegaly

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ursa68

ursa68

Member Since 2014
So far, Colby has been a high insulin cat. We just started on BCP PZI last Friday. He is already up to 8 units, twice a day, and so far it hasn't even touched his BG. My vet has mentioned that acro was a possibility, but I never really thought he had the symptoms. Just now, I was reading where a broadened forehead (and saw an example of a cat with it) can be a sign of acro. This made me a little sick to my stomach... it looks kind of like my Colby. I thought the change in his appearance was possibly b/c of all his weight loss, but now I'm not so sure.

So, what do I do now? What tests are available and are they very reliable? And if so, are they expensive? And even if he does have a positive test, do I treat him any differently other than trying to control his diabetes? How are people here treating their cat? I've done some searching here on the board and I understand that most switch to Lantus, and do tight regulation. Has anyone tried somatostatin? How much does this shorten his life span? He is almost 15, but was hoping if I got his BG controlled, I might get another few years out of him. I'm sad. :(
 
Hi Cindy. :bighug: I got Ruth's message. She is right that most (if not all) of the active high dose cats here post on the Lantus and Levemir forum. We have information on the high dose forum, but people don't actively post there. I know you just switched insulins, but Levemir is a good fit for high dose cats. My Neko was on Lantus when she got to her highest dose (8.75 units) and I didn't switch to Lev until she got much lower in dose. However, some kitties find that Lantus stings so that's why they switch to Lev. Lantus didn't bother Neko. We do have other high dose cats over on Lantus/Lev forum too: Crystal and Toby are another two. For what it's worth, Neko didn't look acro when she was diagnosed with acromegaly. Her only symptom (other than her dose), was squinting at bright light.

There are a couple of the more common high dose conditions that you could get Colby tested for. The tests are for IGF-1 (tests for acromegaly) and IAA (insulin antibodies). The links show the costs from Michigan State University which is the only place in North America that does the tests. There will also be costs for the blood draw from your vet, and shipping. The ultimate test for acromegaly is a CT scan of the pituitary gland, but it's much more expensive and the IGF-1 test is usually definitive.

Here is a link to one of the most recent papers on acromegaly in cats. You just have to read the first part. It also talks about treatment options. BTW, the author says that research shows that one in 4 or 5 diabetic cats has acromegaly. You are not alone. Realistically, there are currently three options for you for treating Colby if he has acromegaly. The first is to increase the dose and manage the blood sugar, even if it takes large doses of insulin. That is what the majority of people do. If Colby has acromegaly, you'll also want to watch for organ growth, specifically, getting a heart ultrasound is a good idea, but at least have the vet monitor for heart murmurs. There are other side effects of the growth hormone that may also need to be managed. There are two treatment options available in North America. Several of us have taken our cats to have Stereostatic Radiation Therapy or SRT. It neuters the tumor cells. There are several places in North America that perform this. SRT requires a week of treatment. We drove a three days each way to Colorado State University. Where do you live? I could tell you the closest location the dose SRT. The newest option available is something called hypophysectomy (removes the pituitary), but it is only available in LA. There are a few cases we've had where the cat has tested negative for acromegaly and positive for IAA, some have both - like my Neko. IAA is a self limiting condition but it helps to know what you have for dosing strategies.

You probably have lots of questions, I know I did. Feel free to ask. I know it can be overwhelming. How is Colby feeling?
 
Hi Wendy, wow, that's a lot of information! I saw an old post about the SRT--expensive! It's not that I would deny Colby treatment just b/c of money, but I would have to consider the stress it would put on him too, and would it buy him that much more time? I'm in Oklahoma, btw. The more I look at Colby, the more I think he is acro. He has always been a big kitty, but I do kind of think his paws are bigger, and then there is the forehead thing. Looking at old pictures of him, he has changed. Of course, he's probably about half the size he once was--he was up to 23 lbs. at his biggest! So, it's hard to tell what is weight loss or what is really enlarged areas.

In spite of his high BG, he is acting okay. He actually seems to be a little more alert since starting the new insulin.... maybe it's my imagination.

Thanks for all the information. I will get to my reading now! :bookworm:
 
He's on an insulin now that lasts longer, so should be spending less time in higher numbers and feeling better as a result.

Sorry for the info overload. Looking at before and after pictures can be an eye opener. We've had cats with acromegaly, and without treatment other than tightly managing the blood sugar, live up to four years. Cost is definitely a consideration. And so is time and ability to travel. Which you would have to do. Colorado State University would be the closest treatment center to you, the others are in the north east.
 
Funny, I've actually read some of that paper you suggested. I also don't know how I missed all of the acro stickies on the forum! Derp!

If I don't want to go to extremes, it seems as though I just basically need to keep doing what I'm doing. I'll talk with the vet more about it and make sure he's checked his heart and see if he thinks there is anything else we need to check. Here are a couple of head shots of Colby. He has a more angry look to him now.
IMG_2901.jpg IMG_2905.jpg
 
Just want to add my welcome, Cindy. It's a lot to deal with and it's good to have companions on the road. As far as I know, there aren't any high dose kitties on anything except Lantus or Levemir. Feel free to tag me if you want any help. I don't have experience dosing with PZI but can help you with the overall education of taking care of a high dose kitty. You're not alone. :bighug:

It's hard to tell much from pictures unless you're comparing to a pre-diabetic picture.

By the way, one thing people with high dose cats often do is to use a supplemental insulin to help out. On the L/L forum today, you can poke in and see Suki using R with Crystal under the guidance of others who have experience using it.
 
@julie & punkin (ga) Thank you. Yeah, I guess I should have posted a before pic so you could see the change in Colby's forehead. I'll try to find one where you can tell. Anyway, I'm going to give the PZI a little longer (or until pay day!) and see what it does. Lantus and Levemir scare me a little b/c I see people going so low in numbers with their kitties. I just can't be around all the time to monitor him. Even right now, I'm afraid he'll go hypo by some fluke, and I'll come home to a comatose cat. I'll check the thread you were referring to with Crystal.

Looks like the SRT gave you almost another 4 years with Punkin, that's great! I would love to do that for my Colby, but I feel like at his age (almost 15) and in his current condition, it would all be too stressful for him. I'm just going to try to keep him happy.
 
Hi cindy, didn't mean to ignore you. I've been sick and today is the first day I got back online.

Punkin lived 2.5 years after becoming diabetic, 20 months after the SRT for his acro. He didn't die from either the diabetes or acro though. We think he had cancer and he had a crisis where his chest filled up suddenly with fluid.

Many people choose the same path you are choosing and there is nothing wrong with that.

The lower blood sugar range you're seeing on the Lantus /Lev group are not caused by the particular insulin, but from people choosing to dose with the goal of tightly regulating their cat. A cat that is tightly regulated might only have their blood sugar move 10 points in the entire cycle. You can only achieve that level of flatness when a cat is kept under 100 on a human glucometer. Most people with high dose cats don't choose to do that, although some do. Many set their goal as being around 100 instead.

The advantage of Levemir and Lantus are that they have a longer duration in a cat's body. That helps flatten blood sugar. Cats seem to feel better when their blood sugar is flatter.

One other advantage of Lev is that it is ph neutral. As the dose gets bigger, it can be more comfortable for the cat. Lantus is acidity and some cats react as though it stings them. Punkin did ok with it, but some cats seem to do better with Lev.

I'm not trying to twist your arm! Just wanted to respond to your comment about the lower range of blood sugar you are seeing.

Today I posted a photo in crystal/suki's post of before and after acro with punkin's face, if you are interested.
 
I didn't think you were ignoring me, and I'm sorry you've been feeling sick! I hope you're feeling better now.

Thanks for the reassurance about Lev and Lan. I'm seeing no improvement from the PZI so far, and will likely switch to one of those next month. At this point, I'd be happy for Colby to get down in the 200s. We haven't seen those in so long. One we get on one of the "Ls", I'll see what I want to do in regards to tight regulation. I did peak in on the R experiment with Crystal and Suki... very interesting. I will be talking to my vet about that as well, and am sure I will have some questions to ask you all.
 
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