SmallestSparrow
Member Since 2024
Hello everyone,
I’m posting here because otherwise I’d need to post in Lantus, PZI, and Cushing forums. Mods feel free to move it if you want.
I want to give you all an update on Methos—PLEASE don’t respond with condolence messages, I am not up to discussing my loss right now. I promise I will post in the grief section in the next few weeks for that. If anyone has questions about his symptoms or tests, because they think it may apply to their kitties I’m happy to explain or give more details but I cannot at this time deal with condolences—Im using compartmentalization to discuss this to give closure to those who wonder about him and have done so much to support us this past year.
As you know Methos had hyperadrenalcortisolism (Cushing’s) and hyperaldosteronism (Conn’s) from a functioning right adrenal tumor—a rare tumor often cancerous in cats. Because he was too old and fragile for surgery he was treated off label with Vetoryl, spiranolactone, and potassium. These conditions led to diabetes, treated first with Bexacat and then insulin. In September 2024 he was changed to insulin because of elevated pancreatic enzymes and spec fPl. Follow up testing over two months showed continued elevations and ultrasound showed his adrenal tumor was much larger, and new abnormalities in his pancreas which could be cysts or tumors. We considered possibly doing doppler flow studies of those tumors if he became stronger, to determine if the they were cancer, but it wouldn’t change his treatment as he couldn’t have surgery and likely couldn’t tolerate chemo. He also had thickening of an area of his bowel, which might be lymphoma but obviously we weren’t doing a biopsy of that either. An internist felt even if it was, he was probably producing his own steroid treatment from the adrenal tumor.
As those in the Lantus and Prozinc groups know, his blood sugar never reached good control, and if I got a decent nadir I had to struggle to keep him from going too low. With each passing month his glucose became more unpredictable, and in the final month there were days I knew I’d given a fur shot and his blood sugar would crash. Other times I knew he had definitely got the insulin into him and his sugar would climb despite additional regular insulin. It was a dangerous balancing act between all of his conditions and medications to keep his potassium levels neither too high nor too low. He had a borderline DKA episode that I treated at home as they felt he would die in the hospital if they admitted him. Throughout this his appetite was less and less, and feeding him was a struggle.
At the end he began having violent vomiting. I took him to the ER in the middle of the night because I was afraid to keep giving insulin to him without knowing his potassium levels. He was again at the slight DKA point, and his WBC was 67,000, 32% lymphs, 62% neutrophils. His abdominal ultrasound showed his abdomen was full of tumors, that appeared to come from the pancreas and was completely obscuring other organs. The ER doctor, his primary doctor and the internist all said he would not be able to recover, whether this was lymphoma, metastatic adrenal cancer, metastatic liver cancer or metastatic pancreatic cancer. I will talk more about his end later, I cannot do it now. I will just say I am so blessed to have his primary Dr Kintworth and if any of you don’t like or trust your vet you really need to work on finding one you do like and trust before things reach a decision point.
His necropsy showed the adrenal tumor, but I told them I didn’t need testing of that to show if it was cancer, since we were testing all the metastatic tumors (even with the discount my vet kindly got for me necropsy testing is hugely expensive and obviously not covered by insurance). He had metastatic growth in the liver and throughout the abdomen and covering the omentum. This was found to be metastatic pancreatic cancer (rare, and especially rare in cats), of the neuroendocrine type (so rare in cats there are just a few anecdotal reports). The lab could only test for insulin and glucagon in the tissue samples, it didn’t make either of those. It could be that his cancer produced somatostatin, which they couldn’t test—this could explain his inability to make his own glucose when he needed it. Or it may not have been functional and his blood glucose swings were from his adrenal tumor, or a combination.
Having had two cats now with “extremely rare” tumors I do wonder if these are more common but not found since they tend to occur in older cats, the tumors don’t produce symptoms or are difficult to see on ultrasound until the disease is advanced, and the testing is very expensive. I don’t know how many cats get treated medically rather than with surgery for adrenal tumors (surgery is the gold standard treatment) but I’m grateful for the extra two and a half years we had, as well as the extra year we had after his pancreatic cancer showed on ultrasound (without any treatment)—I think this is longer than most cats reported.
Again, PLEASE NO CONDOLENCES. I promise to come back in a few weeks for that but I’m barely holding it together right now and talking about him or his end will put me in a dark place.
I’m posting here because otherwise I’d need to post in Lantus, PZI, and Cushing forums. Mods feel free to move it if you want.
I want to give you all an update on Methos—PLEASE don’t respond with condolence messages, I am not up to discussing my loss right now. I promise I will post in the grief section in the next few weeks for that. If anyone has questions about his symptoms or tests, because they think it may apply to their kitties I’m happy to explain or give more details but I cannot at this time deal with condolences—Im using compartmentalization to discuss this to give closure to those who wonder about him and have done so much to support us this past year.
As you know Methos had hyperadrenalcortisolism (Cushing’s) and hyperaldosteronism (Conn’s) from a functioning right adrenal tumor—a rare tumor often cancerous in cats. Because he was too old and fragile for surgery he was treated off label with Vetoryl, spiranolactone, and potassium. These conditions led to diabetes, treated first with Bexacat and then insulin. In September 2024 he was changed to insulin because of elevated pancreatic enzymes and spec fPl. Follow up testing over two months showed continued elevations and ultrasound showed his adrenal tumor was much larger, and new abnormalities in his pancreas which could be cysts or tumors. We considered possibly doing doppler flow studies of those tumors if he became stronger, to determine if the they were cancer, but it wouldn’t change his treatment as he couldn’t have surgery and likely couldn’t tolerate chemo. He also had thickening of an area of his bowel, which might be lymphoma but obviously we weren’t doing a biopsy of that either. An internist felt even if it was, he was probably producing his own steroid treatment from the adrenal tumor.
As those in the Lantus and Prozinc groups know, his blood sugar never reached good control, and if I got a decent nadir I had to struggle to keep him from going too low. With each passing month his glucose became more unpredictable, and in the final month there were days I knew I’d given a fur shot and his blood sugar would crash. Other times I knew he had definitely got the insulin into him and his sugar would climb despite additional regular insulin. It was a dangerous balancing act between all of his conditions and medications to keep his potassium levels neither too high nor too low. He had a borderline DKA episode that I treated at home as they felt he would die in the hospital if they admitted him. Throughout this his appetite was less and less, and feeding him was a struggle.
At the end he began having violent vomiting. I took him to the ER in the middle of the night because I was afraid to keep giving insulin to him without knowing his potassium levels. He was again at the slight DKA point, and his WBC was 67,000, 32% lymphs, 62% neutrophils. His abdominal ultrasound showed his abdomen was full of tumors, that appeared to come from the pancreas and was completely obscuring other organs. The ER doctor, his primary doctor and the internist all said he would not be able to recover, whether this was lymphoma, metastatic adrenal cancer, metastatic liver cancer or metastatic pancreatic cancer. I will talk more about his end later, I cannot do it now. I will just say I am so blessed to have his primary Dr Kintworth and if any of you don’t like or trust your vet you really need to work on finding one you do like and trust before things reach a decision point.
His necropsy showed the adrenal tumor, but I told them I didn’t need testing of that to show if it was cancer, since we were testing all the metastatic tumors (even with the discount my vet kindly got for me necropsy testing is hugely expensive and obviously not covered by insurance). He had metastatic growth in the liver and throughout the abdomen and covering the omentum. This was found to be metastatic pancreatic cancer (rare, and especially rare in cats), of the neuroendocrine type (so rare in cats there are just a few anecdotal reports). The lab could only test for insulin and glucagon in the tissue samples, it didn’t make either of those. It could be that his cancer produced somatostatin, which they couldn’t test—this could explain his inability to make his own glucose when he needed it. Or it may not have been functional and his blood glucose swings were from his adrenal tumor, or a combination.
Having had two cats now with “extremely rare” tumors I do wonder if these are more common but not found since they tend to occur in older cats, the tumors don’t produce symptoms or are difficult to see on ultrasound until the disease is advanced, and the testing is very expensive. I don’t know how many cats get treated medically rather than with surgery for adrenal tumors (surgery is the gold standard treatment) but I’m grateful for the extra two and a half years we had, as well as the extra year we had after his pancreatic cancer showed on ultrasound (without any treatment)—I think this is longer than most cats reported.
Again, PLEASE NO CONDOLENCES. I promise to come back in a few weeks for that but I’m barely holding it together right now and talking about him or his end will put me in a dark place.
