New Member - Valentino

Tillie and Valentino

Tillie and Valentino

Member
Hi all, I've been reading your threads for a week or so and it's been so incredibly helpful. I just found out that his IGF-I test came back high (295) on Sunday. It's been heart-breaking to think of and mind-boggling to consider what to do next.

He's only almost 11 years old and has been very active and healthy until about 2 months ago when he was diagnosed with diabetes. He weighs 10.9 lbs up from a norm of 10 lbs. He's been constantly ravenous and begging for food, and has been difficult to control his blood sugar. He is up to 3 units Prozinc / 2 x a day but he's never been in normal range.

Not sure exactly what questions I have yet, but wanted to introduce ourselves.

Tillie & Valentino
 
Hello and welcome Tillie and Valentino. Out of curiosity, what led you do to the IGF-1 testing? Any chance you got the test done for IAA (insulin auto antibodies) as well? The blood goes to the same lab for testing as the IGF-1, some cats have both - like my Neko did.

Being ravenous for food is very common - I had to put the kitchen under lock down. :rolleyes: I found getting an automated feeder help divert the attention from me as the feeder. And feeding several smaller meals though out the day/night also helped. Once Valentino gets regulated, it will also help his hunger.

What food are you feeding now?
 
Hi Wendy & Neko,

My new vet, who has an only feline practice, mentioned it as we have not been having much success managing his diabetes, he had been gaining weight, his paws were huge (which I had noticed earlier on) and she said his head was broad and he has a ravenous appetite. She wasn't sure and said we could wait but I was anxious to know if we can rule it out. All the signs were there but I was still in denial. I don't think she did do IAA tests, I can ask about it.

That's great advice to divert from me as the feeder. I just hope I can get him regulated. Since diagnosed he's been having Purina DM canned original. And some Tiki cat low carb can in between meals.

I am thinking of radiation treatment and have an appointment to speak with a radiation oncologist on Monday. It's all so overwhelming.

Thank you for welcoming me. I'm sure I'll have a lot of questions in the coming weeks.

Tillie
 
Tagging @JeffJ who is in your part of the world, though he took his Leo to Colorado State University for radiation therapy cause that's where it was available at the time. BTW, I went there too, even though it was a long drive it was the gold standard at the time. I was really happy I got the treatment done. I think it helped add some time and quality of life for Neko.

Sounds like you've got a great vet who thought to mention the possibility of acromegaly. A lot of cats have no symptoms on diagnosis. Neko's only symptom was the hunger and eventually a higher dose.

The Purina DM is not required. Any low carb will be just fine. I used the Petsafe 5 auto feeder, on sale now on Amazon for Black Friday,
 
Hi Tillie - you are doing good so far. And getting good info.

I'll PM you my info. I'm in NW Austin.. My Leo had severe Acro - a large tumor, and got another 33 months after radiation. It can be expensive, but worth it, if you have a high dose kitteh. I would do it again in a heartbeat. Note that Texas A&M has recently had an SRT (stereotactic radiation therapy) available. It is important to regulate your kitteh though. SRT doesn't solve everything.
 
Wendy&Neko said:
Tagging @JeffJ who is in your part of the world, though he took his Leo to Colorado State University for radiation therapy cause that's where it was available at the time. BTW, I went there too, even though it was a long drive it was the gold standard at the time. I was really happy I got the treatment done. I think it helped add some time and quality of life for Neko.

Sounds like you've got a great vet who thought to mention the possibility of acromegaly. A lot of cats have no symptoms on diagnosis. Neko's only symptom was the hunger and eventually a higher dose.

The Purina DM is not required. Any low carb will be just fine. I used the Petsafe 5 auto feeder, on sale now on Amazon for Black Friday,
Click to expand...

Thanks for the tip on the feeder! Good to know about the diet. I am quite nervous about putting him through the radiation treatment... the anesthesia and how he will feel during it, so it's helpful to hear that you thought it was the right thing to do. I will be finding out more on Monday about the specifics here in Austin.

Anyway, thanks so much,

happy Thanksgiving!
 
Before anaesthesia, they will need recent blood work, and quite possibly want to check his heart with an echocardiogram. Enlarged heart is a possible side effect of acromegaly and they will want to make sure his heart is up to the anaesthesia. I am sure we were all nervous about the radiation. For me (and Jeff) it was four days. One day of a CT scan, followed by 3 days of radiation. The first day is the longest one under anaesthesia.
 
Hi! With acro you may have to be fairly aggressive with dosing to get his numbers under control. You can see my crazy spreadsheet going back several years. She's been doing well this past week though I must say... Until the tumor ramps up again anyway. But doing great right now. She was diagnosed acro about 19 months ago but had it much longer.
 
Thank you @Wendy&Neko !

I'm waiting to hear results from an initial catscan of his pituitary as I decided to go ahead with SRT here in Austin. Unbelievably and crushingly the radiologist told me yesterday that he saw a large mass on his lung which he decided to inspect while he had him in the machine. He is going to get back to me to tell me what the full radiologist report on that is. I'll be devastated if this is lung cancer. He thought the 2 conditions would be independent of each other. Not sure how much he can go through! Is there any connection by any chance that you all know of?
 
That is great news that there is a go-ahead for the SRT. (And the SRT is in Austin).

For Leo, within about a year, he manifested small cell lymphoma. It was confirmed with direct biopsy, and was in his gut area. There can be different manifestations from Acro. I don't know if lung masses / cancer is one of them. Many Acro kittehs have enlarged abdomens.

I wouldn't rule out the effects of IGF-1 to cause issues with other organs. The article below states
"As the disease progresses organs such as the kidney, liver, and heart may become affected by the IGF-1 effects, as well. "
http://zimmer-foundation.org/sch/csf.html
 
The update is that the ct scan diagnosis was preferential for a primary or secondary neoplasm and differential for a chronic pulmonary granuloma. Because it's too far back in the lung there is no way to biopsy to know for sure what it is. We are doing an abdominal ultrasound in a week or so to find out if there are any other masses that we should be aware of. I'm still hopeful that whatever it is is benign.

The weird thing is that the pitutary gland was only mildly enlarged. Because of all the other signs of acromegaly they recommend treating that with the SRT, but how do they do that if they can not visualize a mass? Do they just radiate the whole gland? I'll have to ask more questions when we get to that point, I guess. In the meantime, he seems okay and is enjoying some nice weather here in Austin while he sits quietly in the backyard.
 
Neko's tumour was called "tiny" by her radiation oncologist. Sometimes the CT doesn't even show a tumour and they have to go to an MRI scan to see it. At CSU they told me they even had a case of a cat where the tumour didn't show in either CT or MRI, but still had symptoms, so they radiated anyway (caregiver's choice).
 
Thank you @JeffJ and @Wendy&Neko . I think they did not see a tumor but that the gland was mildly enlarged. I will have to confirm that with the radiation oncologist. He said he had a colleague who had a cat similar that didn't show a tumor but that needed treatment.

Jeff - your SRT description was very enlightening.

I decided to go with treatment in Austin at VCA Capital Area Veterinary Specialists in North Austin on Shoal Creek Blvd. The cost was to be for the initial ct scan and three SRT treatments for $7000 in total. I also asked if Single Dose radiation was available, and though he said it is, he prefers to go with the 3 doses for safety reasons while enabling the most radiation as well as success. In Valentino's case he said he could do the 1-day treatment after all. Maybe because it's not visible? Dr. Trueil is the radiation oncologist and he had his residency in Radiation oncology from Colorado State University and got a master's in Radiobiology from there as well.
 
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The 1 day treatment has a higher level of radiation, vs. three day which is overall more, but quite a bit lower per day. I think the 3 day gives preferred results, but the 1 day can be used if anaesthesia concerns, or other issues. Your quote is quite reasonable, I think most people are seeing quotes over $8000 now for 3 days of radiation.
 
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