My approximately 10-year-old boy Theo was recently diagnosed with acromegaly following an IGF-1 result of over 1200 (reference range up to 916). He's been diabetic and on Lantus insulin, but his BG has remained difficult to regulate. He started out on Bexacat but had pancreatitis so I had to transition him to Lantus.
Our internal medicine specialist has discussed adding cabergoline and potentially combining Senvelgo with insulin. I'm considering starting with cabergoline first and evaluating his response before deciding on additional treatment.
I'd love to hear from anyone who has experience with an acromegalic cat, particularly:
Have you used cabergoline, and what results did you see?
Has anyone used Senvelgo in combination with insulin? There is a study of a small group of cats that showed some success with this treatment. I was surprised as the SGLT2s are only for cats never on insulin but acromegaly is an exception according to my IM doctor. We will discuss further as I am hesitant about this one.
What kind of monitoring and follow-up has been helpful?
I'm interested in both successes and challenges. Personal experiences would be greatly appreciated. Thank you!
We did have one member with acrocat who posted about giving Senvelgo and insulin. Kitty had started on Senvelgo first. In my response I liked the small study of acros on both. That post is here: New Member. That was the only post I saw from that person so we don't know much how it goes in general.
You'll probably get more luck with stories of cabergoline and insulin by posting in the Acromegaly / IAA / Cushings Cats forum and reading the posts there. Cabergoline came in too late for me to try with Neko. But we've had quite a few people try it. Studies have shown that cats with smaller tumours tend to have better luck. Not that anyone here has done the CT scans to test that theory, but that fact was from a fairly large study in South America. Most people just try it and see how it works. Most people see some reduction in dose and acro symptoms. We've had a small handful of people have their cats go off of insulin, two cases in less than 2 weeks. Cats on larger doses tend to take longer to respond. It can be up to three months before seeing an impact. A European study of owner satisfaction of treatments showed Cabergoline rated fairly highly, about the same as stereotactic radiation therapy (SRT).
As far as how much monitoring is required, the answer is a lot, at least 4 tests per day. Just cause you don't know if you have one of those cats that will have a strong reaction and need a lot of back to back insulin dose reductions. The effect seems to be cumulative, so you can see a slow start, then it can be a quick change. Reactions to cabergoline have varied a lot by cat.
