Kabosu: Newly Diagnosed with Acro

[Dasha and Kabosu]

Hi all,

We've been suspecting Kabosu has acromegaly for a while now. Our IGF-1 results are back now, and they are >2000ng/ml, which means most likely Kabosu has acromegaly.
I do not think we even need a CT scan confirmation at this point. He is currently on 10.25 units of Lantus, and extremely hungry all the time. His personality and habits also changed quite a bit.

We are now studying what our treatment options are. This thread is very helpful here: https://www.felinediabetes.com/FDMB...etes-mellitus-and-hypersomatrotropism.242965/

What was your experience with acro? Did you also notice any personality changes in your acro-kitties?

 

[Suzanne & Darcy]

Hi. I'm sorry that your kitty has acromegaly. My cat, Darcy, does, too. It looks like Kabosu needs more insulin. I know what it's like to just have the numbers stay high (or even go higher) no matter what you do! Did you also have Kabosu tested for IAA?

As for personality changes. I am not sure about personality. I do think that Darcy is different when his numbers are high. Recently, I have been able to get his numbers down to 200 or into the blue 100s. As soon as his glucose gets close to about 100, I start to see my old Darcy come back. Just today (as I said in my post on the Lantus/Levemir group) he started playing on his own when his BG got down to about 200. He just feels so much better. If he's in the mid 300s or higher he just lies around. He will eat. Oh yes, he will eat. I guess the Acro cats are very hungry -- but honestly, I think that any unregulated diabetic who is in higher numbers will be very hungry. So, when his numbers are lower he is much more back to his old self, interacting with people, moving around, playing, grooming, etc. He's a very sweet cat, so I haven't seen any grumpiness or anything -- well, except one morning when I tried to cut his nails and usually he is very good sweet about it, but I think it's because he was feeling sore in his joints that day because he was limping a bit -- normally he's very tolerant of nail trims so I was absolutely astonished at his bad attitude that day.

What kind of changes do you see in Kabosu? It's possible that he just feels really awful. Wendy linked a post a few days ago where a (human) member of this board, a diabetic described how badly she felt when her glucose was too high.

28 days ago, I started Darcy on Cabergoline. I am not sure if I am seeing changes yet as a result of that. Maybe it's too soon to tell. I have been getting blue numbers for the first time, but I also switched to Levemir recently and that could also have something to do with it. Time will tell.

I'm glad you posted on this board. You are not alone. Hopefully, others will chime in about this.

 

[Wendy&Neko]

The biggest thing that changed with Neko was her total focus of food. The kitchen had to go into lockdown. It became much better when she got into better blood sugar numbers. Getting Kabosu to better numbers will really help. In what way has his personality changed? It's said that human acros sometimes have headaches. I know Neko had bad arthritis from bony growths. When it got bad she got more withdrawn and pain relief (buprenorphine in her case), helped bring her personality back.

Did you also have Kabosu tested for IAA?

She's in Ireland, only MSU in the US does the IAA testing.

Some comments on dosing - if you are seeing nothing below 300, don't hold the dose any more than six cycles as long as you can get night time tests or a mid cycle test in each of those cycles. I'd really like to see more "before bed" or at least +2-+3 tests each night. The majority of cats go lower at night so you want to catch when he does that. And now that he's above 10 units, you can increase by 1.0 unit at a time. From 5-10 units it's a 0.5 unit increase. Think of the increases as a % of the total dose - you are good for 10-15% increases.

 

[Dasha and Kabosu]

I'm glad you posted on this board. You are not alone. Hopefully, others will chime in about this.

Thank you for your support! Looks like Darcy is a lovely cat! What do L and R in your spreadsheet mean? Do you split the dose into left and right shots?
How is he tolerating Cabergoline?

Did you also have Kabosu tested for IAA?

As Wendy said, this is not available where I am.

Some comments on dosing - if you are seeing nothing below 300, don't hold the dose any more than six cycles as long as you can get night time tests or a mid cycle test in each of those cycles. I'd really like to see more "before bed" or at least +2-+3 tests each night. The majority of cats go lower at night so you want to catch when he does that. And now that he's above 10 units, you can increase by 1.0 unit at a time. From 5-10 units it's a 0.5 unit increase. Think of the increases as a % of the total dose - you are good for 10-15% increases.

Thank you! This is very helpful! I will also try to test a bit more these days.

About Kabosu's personality changes.
First, of course the extreme interest in food changed him a lot. He was never jumping on the kitchen counter, and now he pretty much lives there.
He also changed his habits. He used to love sleeping on the bed or couch. A neighbour from the ground floor told me he once left the bedroom window open, and then found Kabosu sleeping on his bed. That's our boy - feels like he's the owner anywhere! Now he is only sleeping on the floor, he is not interested in the bed, the couch and even his own box and his dog bed, both of which he used to love.
He used to be very gentle, he still does not scratch or bite, but there were a few times when we refused to get up to feed him in the middle of the night, so then he peed on our clothes as a revenge (I believe)! I am not blaming him, I know he is sick, but this is really not like him.

 

[Wendy&Neko]

About Kabosu's personality changes.
First, of course the extreme interest in food changed him a lot. He was never jumping on the kitchen counter, and now he pretty much lives there.
He also changed his habits. He used to love sleeping on the bed or couch. A neighbour from the ground floor told me he once left the bedroom window open, and then found Kabosu sleeping on his bed. That's our boy - feels like he's the owner anywhere! Now he is only sleeping on the floor, he is not interested in the bed, the couch and even his own box and his dog bed, both of which he used to love.
He used to be very gentle, he still does not scratch or bite, but there were a few times when we refused to get up to feed him in the middle of the night, so then he peed on our clothes as a revenge (I believe)! I am not blaming him, I know he is sick, but this is really not like him.

You see that picture of Neko in my avatar? That's her on the kitchen stool, where she could keep a very close eye on the counter. That was from early days of her unregulated diabetes. I had a squirt bottle handy, so she didn't actually hang out on the counter, but as close as she could.

At one point I got Neko a memory foam bed - she loved it! Her joints were hurting her, and she didn't jump up like used to then. Ramps could also help if it gets to that point.

As for peeing on clothes, I've heard examples that from diabetic cats, not even those with acromegaly. One person learned not to leave clothes or bags lying on the floor! Long story short, getting him closer to regulated will help bring your boy back. I hope you see that owner cat back sometime soon.

 

[Suzanne & Darcy]

Hi Dasha. Sorry about the IAA test. I didn't realize that you couldn't have that test performed in Ireland.

On my spreadsheet, the L just stands for Levemir and the R stands for Novolin R, which is a short acting insulin that I will use in him to bring his glucose numbers down in the early part of the cycle before the Levemir really gets going. It gives the Levemir lower numbers to work with (that's one way I think of it). It has helped us and also is keeping me from using more expensive insulin. I already went through one Levemir pen in less than a week. I really would like to increase his dose, but I don't think I can afford it. If I thought his dose would go down with the Cabergoline, I might try increasing the dose. But 33 units twice a day, where we are now, is a lot of money.

 

[Suzanne & Darcy]

Oh, I forgot to mention that he's doing fine on the Cabergoline. We haven't had any unpleasant side-effects. He takes it with no problems in the morning. It's only .4 mL because the concentration that my vet ordered was 200 mcg/mL (micrograms per mililiter.)

I know what you mean about changes in habits and activity. Darcy doesn't come up in my lap much like he used to. When his numbers come down a bit, like in the last week or so, he begins to show his old self again. He's always really sweet and purrs up a storm any time I come near him. He just doesn't have much energy. I think I already said that in my last post.

As for peeing on clothes, I have heard a few other diabetic cat mamas say the same thing. It was not a frequent occurrence, and they were surprised.

Doing the increases like Wendy suggests after 10 units is a really good way to start getting the numbers down more quickly, which will be safer for your Kabosu. Wendy can really be of help to you with that. I couldn't have done it without her!