New Member 9/18/23

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~Tricia

Member Since 2023
Hello! My cat, Neptune was diagnosed with diabetes last November in 2022. In March of 2023 he was diagnosed with Acromegaly. His glucose has never to a normal level but he is adjusting well. His lower jaw is starting to protrude slightly and his teeth are spreading apart. I’m noticing his spine is starting to curve or look like he has a hump back. He’s such a sweet boy. I worry about him constantly. His vet is very supportive. I’m so glad I came across this forum. It’s so nice to have more support.
 
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Hello and welcome. My girl had acromegaly, as well as IAA (insulin auto antibodies), another secondary condition that also causes insulin resistance.

How can we help you? What insulin is Neptune getting? What dose is he on? Are you home testing? Lots more on how we can help with the diabetes part here:
New? How You Can Help Us Help You! A lot of the acrocats here have gotten their diabetes fairly well regulated. Which makes it easier on their bodies.

As for the acromegaly, has your vet talked about treatments? Cabergoline, a daily liquid medicine, is popular here because it does help, is reasonable cost, and doesn't require the travel that other treatments required. The downside of cabergoline is that how fast and how well it helps each cat varies a lot, but we do have a few lucky members whose cat has gone off of insulin. Some of the growth hormone side effects also seem to be reduced.
 
Neptune is currently on Vetsulin. He takes 10 units 2X/day. I don’t test him at home but do have his glucose checked at the vet. He does appear to be resistant as we haven’t been able to get it to drop more than 270. He’s averaging 300-350. H
e acts fine other than being hangry and thirsty. I’m concerned about long term high glucose effects. I’m seeing so much info on this forum that I’ve never heard of. I’m a bit over whelmed.
How would I get him tested for IAA? is it a blood test?
As for the Acromegaly, she knows I’m limited on finances and never mentioned options except surgery or chemo, which I don’t want to put him through that.
I have never heard of Cabergoline. I’ll have to see if she can order it. I’d definitely like to try it, especially if it helps potentially with his glucose and to reduce the likelyhood of any more side effects from the GH. thanks for the suggestion! I will check out the link you provided. I’m sure I’m going to be up late reading everything!
Thank you! Also I love the picture of your tuxedo kitty!
 
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Are you open to learning to home test his blood sugars? Testing at the vet can often produce much higher numbers, due to stress. Plus it's cheaper to test at home, and allows you to learn how to change his dose without the vet. And allows you to get his blood sugars to a better place. Pictures and videos of people home testing are here: Hometesting Links and Tips

Vetsulin is not a good insulin for cats. Check out guidelines published by the American Animal Hospital Assn for the treatment of diabetes. Prozinc and Lantus or Levemir or much better and longer lasting insulins. Vetsulin is only recommended for dogs. At Neptune's size of dose, I'd actually recommend Levemir, as Lantus has an acid base that can sting at higher doses.

IAA is a blood test, which goes to MSU, same place as the test for acromegaly. I'd not worry about it right now, as you do have a positive result for acromegaly. IAA positive can impact how we do dosing, but can be tested later. Do you know what the IGF-1 number was?

What food is Neptune eating now? A proper low carb diet is also key to proper treatment of diabetes.

~Tricia said:
she knows I’m limited on finances and never mentioned options except surgery or chemo, which I don’t want to put him through that. I have never heard of Cabergoline. I’ll have to see if she can order it.
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I'm afraid your vet isn't up to date, not surprising though. There is no chemo option for acromegaly. It's a benign tumour of the pituitary, not cancer. The other options are surgery or radiation therapy, which my Neko had. Back in the day, there was no medical option like cabergoline. The vet doesn't order it in, you can get it compounded. If you pop over to our forum on Acromegaly, you'll see threads about cabergoline. Here's the first thread I posted about it 6 years ago, it is still a fairly new treatment: Cabergoline as a possible treatment for acrocats: discussion

Don't worry about being overwhelmed, it's perfectly natural at first. We can help. :bighug: And yes, I have a thing for tuxies!
 
I am open to testing at home. I’d just need to research the best glucometer. One that is reasonably priced. We started on Vetsulin and switched to ProZinc, but his numbers were better on Vetsulin. I’ll add asking if I can get Levemir on my list. The less insulin and a better insulin is AOK by me.
His IGF-1 was 185… if I have that correct. She gave me the GH level over the phone. Is that what you asked for?
I did mis-speak. I meant radiation not chemo. I know it’s benign. She did mention it can continue to grow.

He is currently getting Purina DM, but I am on the look out for a better product.
Thank you so much! My list of questions to look up on here is getting longer by the minute! This is good though. I’m so glad I found this resource!
 
185 makes sense, that's the IGF-1 number. There is no way to measure GH in cats right now, so the Insulin Growth Factor-1 is a proxy for that. The IGF-1 number can also vary over time. Neko's was 440 when we tested her. Not really a reason to retest it, unless it's on the border of positive. Over 92 is positive in North America.

Is the Purina DM (dietetic management, not diabetic management), dry or wet? The dry is way too high in carbs. The wet is Ok, just not great ingredients and many cats get bored of it. We look for ideally wet or raw food under 10% carbs. This list of cat foods contains many of them. It's a bit old and new ones are coming out all the time, but it's a place to start.

As for glucometers, any human one will do. You want one that needs just a small drop of blood and low cost of test strips. It's the test strips you'll go through. I'm in Canada so don't know the list of US ones, but many people shot at Walmart for the Relion models.

What to expect with an acrocat really varies. We've seen reasonably regulated cats, with no treatment but insulin, survive for 4-5 years after diagnosis. Though those tend to be outliers. Neko did get treated and I had about that amount of time with her, but I think her quality of life was much better with treatment. She didn't ever go off of insulin but most of the time she was on less than 3 units. And I think it really slowed down, and reversed for some time, the effects of the extra growth hormone. You might want to share this paper attached to this post with your vet, many haven't heard of Cabergoline:
New paper on: Cabergoline treatment in cats with diabetes mellitus and hypersomatotropism
 
The Purina DM is wet. I had been giving him dry as a snack but weaned him off. I’m looking for other kinds. I do give him poultry and some fish as well.

I read an article by a vet on this forum ( maybe Dr Amy?) said a human glucometer is not calibrated for cats. I’ve read so much can’t remember where I read it. I do have one. I’ll have to see if I can find out if it’s ok to use.

Neptune just turned 8 yo. I’m hoping he’ll last a long time but I know that that may not be the case. I’m glad your Neko had a good quality of life. I’m sorry for your loss! I can tell you really loved her.
Thanks for the article. I’ll pass it on.
 
The dosing methods we use here were developed with human meters. Including one that was peer reviewed and published in veterinary journals. When I started here, no one used pet meters and most of the vets used human meters. Since then, the pet meter vendors have spent a lot of money on marketing. It is true the meters aren't calibrated for cats, but that's not really important. Some vets like them because the numbers are closer to what they get from the labs. My vet found her Onetouch (human meter) was pretty close to what she got from the labs. I'm not suggesting that you get that one, because it needs a larger blood drop.

What type of meter do you have? We can manage if people want to use pet meters, but you'll spend a lot more money. Most pet meter users switch after a while.
 
The meter is a TruTrack from Walgreens. It only needs a tiny drop which is nice. I’ll try it and see. Especially before his next visit. I can compare readings.
 
If the pet meter is higher, don't worry about that. The meters tend to be closer in lower number. Above a certain value, blood sugar is just "too high". Good luck with the testing trial.
 
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