Newly Diagnosed Acro
- Thread starter LPJ
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Sharon14
Very Active Member
HERES your welcome post @Wendy&Neko can give you some great info on treatment options.
Hi there and welcome Sue and Spunky. 
Here is the link to your intro post for people to read the background. http://www.felinediabetes.com/FDMB/threads/acromegaly.196841/
First off, I'm going to recommend a change in insulin. Sorry bout that, abut Vetsulin is not a great insulin for large dose cats. I started there. Lantus is OK, but it's acid base can sting at larger doses. Levemir is a better choice. Your first goal should be to try to get him in better blood sugar numbers. You do want to get him to a dose where he is spending minimal time over renal threshold. There are a lot of sticky notes at the top of the Lantus/Levemir forum that are worth reading.
Since you are home testing - could you start a spreadsheet to record the numbers? That spreadsheet will help us help you get him better regulated. Here are the spreadsheet instructions. If you wish, and want to save money, you could change to a human blood glucose meter. The test strips are significantly cheaper.
I just wrote this post yesterday to someone who lives in Canada, about treatment options. Where do you live? That might help us narrow down choices.
As for pain, are you talking pain from arthritis? My Neko had arthritis. She was getting acupuncture (with me doing acupressure) and buprenorphine daily for her pain. Before it got to that point, she was getting cartrophen (Adequan in the US) and fish oil.
Snoring, wheezy breathing could be stridor, caused by soft tissue growth in the throat. They are a fairly common acro symptom, though Neko didn't really see them. She had radiation therapy on her pituitary (SRT, stereostatic radiation therapy) which helped her.
Here is the link to your intro post for people to read the background. http://www.felinediabetes.com/FDMB/threads/acromegaly.196841/First off, I'm going to recommend a change in insulin. Sorry bout that, abut Vetsulin is not a great insulin for large dose cats. I started there. Lantus is OK, but it's acid base can sting at larger doses. Levemir is a better choice. Your first goal should be to try to get him in better blood sugar numbers. You do want to get him to a dose where he is spending minimal time over renal threshold. There are a lot of sticky notes at the top of the Lantus/Levemir forum that are worth reading.
Since you are home testing - could you start a spreadsheet to record the numbers? That spreadsheet will help us help you get him better regulated. Here are the spreadsheet instructions. If you wish, and want to save money, you could change to a human blood glucose meter. The test strips are significantly cheaper.
I just wrote this post yesterday to someone who lives in Canada, about treatment options. Where do you live? That might help us narrow down choices.
As for pain, are you talking pain from arthritis? My Neko had arthritis. She was getting acupuncture (with me doing acupressure) and buprenorphine daily for her pain. Before it got to that point, she was getting cartrophen (Adequan in the US) and fish oil.
Snoring, wheezy breathing could be stridor, caused by soft tissue growth in the throat. They are a fairly common acro symptom, though Neko didn't really see them. She had radiation therapy on her pituitary (SRT, stereostatic radiation therapy) which helped her.
LPJ
Member
Thank you for responding. I've read just about everything here regarding difficult to regulate cats and acro. I've suspected the diagnosis for a few weeks.
As far as pain is concerned , at this point I see evidence of headaches (squinting , avoiding bright lights) as well as moving carefully, slowly , stiffly . He's had an ongoing prescription for Gabapenton for a while, now, because of what we thought were onky FIV flare ups. I dose .5 to 1ml as needed. Sometimes without necessity for weeks. Unfortunately , his high numbers of recent days seem to have caused his pain symptoms to flare up. Mostly wondering if i should suggest a change with my regular vet. We are learning to treat acro together.
The internal medicine specialist is the one who switched him to Vetsulin from Lantus. Initially it produced a high curve that has ceased in the last few days. We never got any pattern if curve on Lantus and, until acro was confirmed, I think she was concerned we were overdosing glargine and causing him to somojoi.
As far as pain is concerned , at this point I see evidence of headaches (squinting , avoiding bright lights) as well as moving carefully, slowly , stiffly . He's had an ongoing prescription for Gabapenton for a while, now, because of what we thought were onky FIV flare ups. I dose .5 to 1ml as needed. Sometimes without necessity for weeks. Unfortunately , his high numbers of recent days seem to have caused his pain symptoms to flare up. Mostly wondering if i should suggest a change with my regular vet. We are learning to treat acro together.
The internal medicine specialist is the one who switched him to Vetsulin from Lantus. Initially it produced a high curve that has ceased in the last few days. We never got any pattern if curve on Lantus and, until acro was confirmed, I think she was concerned we were overdosing glargine and causing him to somojoi.
LPJ
Member
I was leaning toward levamir for the reasons you mention. Do you have any suggestions for transitioning from Vetsulin as far as dosing? I know there's no resting period with Vetsulin, as it's pretty much used up 12 hours after a dose.
His stuffiness is in his sinuses. Wish I knew something to reduce inflammation for him. Sometimes he really struggles.
Unfortunately , because of his age and FIV , I don't think radiation would be a fair option for him. (And finances won't permit it anyway) My goal is to do what I can to improve and enhance his quality of life for as long as it's possible .
His stuffiness is in his sinuses. Wish I knew something to reduce inflammation for him. Sometimes he really struggles.
Unfortunately , because of his age and FIV , I don't think radiation would be a fair option for him. (And finances won't permit it anyway) My goal is to do what I can to improve and enhance his quality of life for as long as it's possible .
Cabergoline might be a treatment option to consider. It's still early days, so not a lot of data on it, but there have been a f ew successes. It just manage the symptoms as they appear and try to find a good insulin dose. That is the most common approach and until recently the only one available.
If you had a spreadsheet with data, I would be more comfortable suggesting a Levemir dose. Symogyi is a myth. Again a post on that today, it's a common misconception. With Lantus,you probably never got near a good dose. With data, we have ways of fast tracking the dose.
Some cats do better on gabapentin, some on buprenorphine. I tried gaba, didn't do much. You could try a dose increase first. Neko also did the avoide bright light thing before SRT. Some of her symptoms seemed to get better with better blood sugars.
If you had a spreadsheet with data, I would be more comfortable suggesting a Levemir dose. Symogyi is a myth. Again a post on that today, it's a common misconception. With Lantus,you probably never got near a good dose. With data, we have ways of fast tracking the dose.
Some cats do better on gabapentin, some on buprenorphine. I tried gaba, didn't do much. You could try a dose increase first. Neko also did the avoide bright light thing before SRT. Some of her symptoms seemed to get better with better blood sugars.
LPJ
Member
Thanks. I'm pretty 'computer disabled' but will try to find someone to help me set up a spreadsheet.
Regarding the Lantus, I, now, realize (isn't hindsight awesome!) the dose never got big enough but am dealing with a wonderful vet who hasn't had a lot of clients willing to treat their cars for diabetes. She's awesome and learning along with me. We both started worrying about the possibility of having increased his dose too quickly, because he was so high and unresponsive, initially. The internal medicine vet she sent me to was super expensive. Sent out the acro blood test, did an ultrasound that determined enlarged bowel and one enlarged kidney which she felt confirmed possibility of acro. She also switched us to Vetsulin. At first I was excited he had a curve, even though BGs were still too high. But the reality is, they were, on average, lower on 5u glargine and he appeared to feel better. Even though there was no discernible pattern to his BGs, I wish I'd left him on Glargine, had my regular vet send blood to Michigan etc... Once that came back - no need for an ultrasound.
Regarding the Lantus, I, now, realize (isn't hindsight awesome!) the dose never got big enough but am dealing with a wonderful vet who hasn't had a lot of clients willing to treat their cars for diabetes. She's awesome and learning along with me. We both started worrying about the possibility of having increased his dose too quickly, because he was so high and unresponsive, initially. The internal medicine vet she sent me to was super expensive. Sent out the acro blood test, did an ultrasound that determined enlarged bowel and one enlarged kidney which she felt confirmed possibility of acro. She also switched us to Vetsulin. At first I was excited he had a curve, even though BGs were still too high. But the reality is, they were, on average, lower on 5u glargine and he appeared to feel better. Even though there was no discernible pattern to his BGs, I wish I'd left him on Glargine, had my regular vet send blood to Michigan etc... Once that came back - no need for an ultrasound.
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