Newly diagnosed cat Vinny

Wendy&Neko

Wendy&Neko

Member Since 2012
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@AspenMarshall I've moved your post to this thread so you have your own.

Wendy&Neko said:
The IGF-1 number has no correlation to the size of the tumour. MSU has changed their reference range units lately, but back in Neko's day, positive was over 92. She tested at 440 for her IGF-1 number. A couple weeks before she went to CSU for radiation therapy, a couple other kitties from FDMB went to CSU. Both of them had IGF-1 in the 200's. On CT scan, their tumours were a lot larger than Neko's. I asked the acro experts there, and they said the IGF-1 number had no correlation to tumour size. It's the tumour getting large and pressing on the optic chiasm (near the pituitary) that can cause vision issues. But that's something that's been very rarely seen here.

Cabergoline was found in research to work best in cats with smaller tumours, but we've also seen cats on much larger doses than Malcolm see a lot of improvement. Without the expensive CT scan, you can't really say how large the tumour is. Not worth getting the scan done.

Good to hear his BP was normal - that can be a concern in some acros.

Some acros are thought to possibly get headaches - human acros do. You might want to see if pain relief would help him, buprenorphine or gabapentin.
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Hi! My cat Vinny was diagnosed with acromegaly last week. The specialist hasn’t sent me the official test results yet but just said they were high. (I have requested the actual values). In your post, you say it is not worth getting a CT scan. Why? Too much money? Our vet is recommending it but we are having a hard time wrapping our head around the cost. For context, Vinny is 6 years old and was diagnosed with diabetes in April 2024. Thank you!!
 
There are several reasons I told Malcom's caregiver Heidi it was not worth getting a CT scan, at that point in time. That was on the post you tagged onto. First, Malcolm's Lantus dose at the time was 8.5 units, so we knew there was insulin resistance going on. Plus he had some clinical symptoms suggestive of acromegaly. So a CT scan, which is $$$, would just confirm what his IGF-1 result had already told us. Second reason I'm not fond of CT scans just to "find out for sure", is that heart disease is a far too common side effect of acromegaly, making the required anaesthesia risky. I know of a couple acrocats that have passed away during the long anaesthesia required for a CT scan. My Neko had a heart block incident during anaesthesia, in spite of getting the all clear with an echocardiogram a few weeks before hand.

The time it makes sense to have a CT scan is if you are going to have radiation therapy on the pituitary gland in the very near future. Radiation therapy is one form of treatment. The CT scan is used to map the radiation pathways, and the CT is only good for a limited period of time. So getting a CT now and later just costs you more and doubles the anaesthesia risk.

There is another treatment option, specifically cabergoline, which are cheaper and don't involve travel or anaesthesia.
 
Thank you! This is helpful and kind of what my gut was telling me. I do have some new questions if anyone can help:

I have asked for a cabergoline prescription and it’s in the works, but I haven’t been able to get clear instructions from our vet. I know there is a chance it could cause him to need less insulin. How should we strategize for this?

We have never done the ear prick home testing before. We have always done the freestyle libres. I’m a bit nervous to switch to the ear prick method as I am not sure how well he will tolerate it, and I’m nervous about doing it wrong. Let me know your thoughts. Part of me wants to just schedule an appt to put another Libre on for shortly after we start the cabergoline and go from there and maybe change to ear pricks in the future? Let me know your thoughts.

I’m also interested in just general feedback on how your cat responded to cabergoline if you tried it and how you managed any side effects if there were any. Thank you in advance to anyone who can reply.
 
Cabergoline came out years after Neko was diagnosed. But I have seen quite a few cats on it since it did come out. One of the cats here, Marvin, was the first cat to go completely off of insulin on cabergoline. How cats have reacted to cabergoline has ranged all over the place. From being off insulin 7 days after starting to 3 months before the dose came down a bit. It works best in smaller tumours, but it's not worth the risk to scan just to find out the size. Try cabergoline and see if it works. It's not a big costly experiment.

You will need to monitor closely. If you have the Libre, that will be OK. Just so you know, before the Libre came out, we all had to learn how to test with a BG meter.

Read through some of the cabergoline threads on this forum, and you'll be able to see people's experiences.
 
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I’m just going to throw this out there but you might want to consider learning how to do ear testing and trying it occasionally—so you have the equipment and skill just in case. My cat was on Bexacat before changing to insulin. While I had to start testing right away (being forced to start doing something so important immediately and do it correctly is stressful), I only had to do it a few times a week. Not multiple times a day. So it gave me a chance to get better, for him to associate it with high value treats, for me to figure out a system etc—when I had to start doing it every day, several times a day the testing was the least of my worries. I wish I’d started touching his ears when his tumor was diagnosed (long before he developed diabetes)—I didn’t know I’d need it, my last Cushing’s cat was decades ago when all we did was check urine for glucose and ketones.

Just like when we learn to trim nail, the time allows you to get him used to touching his ears, then move onto actually pricking them. For instance, Methosbdoesnt mind the lancet but he hates being restrained and really hates me touching his ears (always has, hates getting mirataz). So I try to block escape by positioning rather than holding and touch his ear only for quick jab…mostly I hold his head still during testing by chin scratches.

anyway, if it were me I’d research what meter I’d prefer, order it (it could take a few days), and get familiar with it an testing just in case. It beats trying to order one and anxiously wait for shipping, then you and cat get stressed bc you need to fumble through multiple times in a day—vs taking your time to get confident in using meter, try once and if unsuccessful take a day or 3 break and try again.

edit: I’m not knocking a Libre, I’d give anything to be able to use one for my poor boy…but I’ve also read posts by members who had the Libre fail right as their cat went very high or worse very low. So I think it’s a good idea to have a meter and be familiar with it just in case
 
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Hi! Thank you for the advice so far. We ended up taking it and ordering home testing supplies. We have done it a few times successfully but last time Vinny got overwhelmed so we took a break. Hoping to try again tomorrow. He is getting a new Libre 2 put on on Tuesday.

He started the cabergoline capsules this week, every 48 hours. I gave him his 3rd dose tonight. So far he has had two accidents outside of the litterbox this week and I’m wondering if this is a known side effect? I plan on speaking to his specialist about it. I hope that this is something that will go away.
 
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