Old Member, New Kitty (SRT Treatment Advice)

ToddyTiger

ToddyTiger

Member Since 2010
Hello!

I'm an old member of this group/board. My kitty Todd passed in 2011 after a long battle with diabetes and CKD.

But I am back today because in early Nov 2024 our 14yo female cat Amelia was diagnosed with a small pituitary tumor. It was caught completely by chance. She had gone in to see a local oncologist (she has a history of mast cell tumors) to have a CT done of her head and chest due to two small masses found in her mouth. The masses turned out to be stomatitis, but they noted a pituitary tumor. The doctor was not concerned because Amelia was not showing any other signs with it and no diabetes. But within a month I started noticing she was SO hungry all the time and drinking a ton of water. I knew.. I took her in for a fructosamine test, which showed diabetes. She was started on insulin Dec 14th. But I was still concerned and had the oncologist do a IGF-1 test. Came back high. I do not know the exact number, but I was told over 1200.

Since then I have been doing a ton of research. Joined the FB group. I have a phone consultation next week with a doctor in Oregon (I'm in WA) that does the SRT treatment. My goal is to slow this down AND if we're lucky, maybe she won't need insulin anymore. Surgery was not advised by her oncologist.

I'm here to get support, but would also like to hear from folks that have had this treatment done for their cat. How did it go? What changes if any did you see? How long did it take to see changes? Is this a safe treatment? Have you used VCA Northwest Veterinary Specialists in Clackamas OR for this treatment? Are there any questions or concerns I should talk to the doctor about (we speak on the 11th of Feb). I want to make sure I am doing the right thing for her. She does not travel well at all, so this is a BIG deal. She is doing well on her 1 unit twice a day of Lantus. I'll be doing a at home curve this weekend to see how that is going. I do have a spreadsheet. Before she started getting insulin, she was in the 300-400 range, but it now in the mid 100's to 250.

Thank you all!
 
Neko had SRT (twice) at Colorado State University. I had to drive down from Vancouver, BC. Second time I flew down with her. After three years, the tumour started growing again. She was the first cat to have double SRT, but not the last. Neko didn't travel well, but she learned to tolerate it. She started earning reductions on the drive back home. Normally it takes longer to start seeing the impact, and doses can climb for a few months until the SRT kicks in. Neko got down to 0.75 units first time, and about 0.1 units the second time. Never got remission but her quality of life was better. Hardly any acro side effects for several years. Having said that, she still got a laundry list of acro side effects towards the end as you can see from my signature.

Speaking of which, a few other things will help in the signature, as per:
New? How You Can Help Us Help You!

Tagging @Jodey&Eddie&Blue who had two kitties have hypophysectomy (surgical removal of the pituitary) at Washington State University. They used to do SRT, but I think no longer. We did have a member go to WSU for that. Worth asking anyway.

The clinic should ask for a recent blood work (to check kidneys) and an echocardiogram. I would ask them how many acros they have treated and for how many years. What were the outcomes, and where did the radiation oncologists train. I'd like to hear that it is from one of the places with considerable acro knowledge. And how many doses of radiation they do, and why. Each one requires anaesthesia, along with the initial one for the CT scan.

In case you are interested, there is a third option now, called cabergoline. A daily medication, meaning no travel and considerably cheaper. We've seen a half dozen cat go off of insulin. But it doesn't help all. Since her tumour is small, it's most likely it would help her. We've even had a kitty here on cabergoline with the pituitary tumour and other symptoms but before his kitty got diabetes. Apparently they were doing a trial in the UK on not yet diabetic acros with cabergoline.
 
Thank you!

I was told this clinic does 3 treatments. I know they plan to do a CT scan and I would assume labs.

I did also speak with WSU about treatment. They do SRT again. However, it would be multiple trips there over the passes with our cat (She can hardly make it down the street) before the actual appointment for the treatment, where I was told it could be anywhere from 1 treatment to 18 (over the course of 3 weeks). Sadly that is not doable for us. But at least in OR I can stay with a friend and its only a 3 hour drive. Our insurance will cover her treatment at the OR clinic as well, which is a bonus.

I did talk to our oncologist and regular vet about the Cabergoline, but they had never heard of it. :/

For sure going to ask they about how many acros they have treated. Our oncologist said both clinics (VCA and WSU) and doctors are great.
 
I snooped the clinic. The radiation oncologist looks nice, but where she went to school isn't a hot bed of acro. So depends on what she's done lately.

Good to know about WSU, might be an option for some. I'm surprised at the multiple trips though. Everyone else does all days in a row, which is what they used to do. The 18 treatments would not be SRT. Typically it's 1 or 3 days of treatment after one of CT scan. 18 days of anaesthesia on an acro is crazy.

Here is a good paper on SRT:

Stereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly By Tiffany L. Wormhoudt, Mary-Keara Boss, Katharine Lunn, Lynn Griffin, Del Leary, Kristy Dowers, Sangeeta Rao and Susan M. LaRue
J Vet Internal Medicine, 2018 Jul-Aug; 32(4): 1383–1391.
https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15212

Last post in this thread has a paper on cabergoline attached:
New paper on: Cabergoline treatment in cats with diabetes mellitus and hypersomatotropism
 
I'll for sure ask her questions about others she has treated.

I would love to take her to WSU. It was a much cheaper option, however the uncertainty of if it would be 1 to 18 treatments was just not an option for me and at her age, going under that many times didn't seem like a good idea. If they for sure thought 1 would be good, I would do it. But they wanted me to drive out (this week actually) with her for a consultation, then we would come back at some point for the CT scan and then treatment. boy am I glad I changed my mind with the snow in the mountain passes right now. Would not have made it.

Thank you for the links!
 
@ToddyTiger
Hello -- I am in Cincinnati, Ohio. Our Cat, Fonzie, had SRT in Cincinnati at the Med Vet this past Oct 2024. We began seeing results in Dec 2024, where he was on 6 units twice a day and we began dropping steadily. Now, Feb 20, he is at 1.5 units AM and 1 Unit PM. We are still trying to find his best dose as we had a low glycemic event last Thursday where he dropped to 65 within 2 hours of Insulin. But, now he is going into the 400's pre shots, so we are trying to find the right combination. He is on Lantus. We are encouraged by the decreased need for insulin -- just still trying to find his correct dose. It has been a journey -- frustrating at times, but I know we made the right decision to treat with SRT. Med Vet did a great job w/ the SRT. I was a complete "helicopter parent" obsessively calling the IM specialist and Oncologist, but, the treatment seems to be working. It was scary putting him under anesthesia for 3 consecutive days in a row, but, they worked with me on the amount of anesthesia and were in constant contact. Ultimately, they did a great job and have a good team. Fonzie is 14 (Male) and otherwise in good health other than IBS and slight pancreatitis and the Acromegaly. We are not planning on doing a follow up CT scan as that was very traumatic for him and we don't want to put him through that again. However, I am planning on re-testing for the HG-1 hormone blood test to see if the tumor is still secreting or if the number will have changed since the SRT. We are doing that next week, as it is non-invasive. He is a strong boy, loves to eat and play, but his hind legs have muscle waste and weakness due to the High BG's that have been going on since late August 2024. Let me know if you have any questions, happy to share.
 
Not SRT but Chuck had CyberKnife in August and is officially off insulin this month. At first I didn’t see any changes, Chuck’s insulin needs actually increased up to 12.5 units 2x daily then about 3 months after the procedure I began seeing his numbers drop significantly. I halfed his dose ant the end of November and from there slowly decreased. He was on a unit for all of January, then a half unit and now none.

Before the procedure Chuck was not himself, he would sneeze a lot, always ravenous, and would hide under the bed which is completely unlike him. He was also pretty snappy with his brother. Post procedure he started playing more, was less concerned with food and the constant sneezing stopped. The ravenous hunger was the first symptom to improve. That happened 1-2 weeks post CyberKnife.

I realize I’m a little late to this post, but I hope the conversation with the vet went well, please feel free to reach out if you have any questions about Chuck’s journey!

ToddyTiger said:
Hello!

I'm an old member of this group/board. My kitty Todd passed in 2011 after a long battle with diabetes and CKD.

But I am back today because in early Nov 2024 our 14yo female cat Amelia was diagnosed with a small pituitary tumor. It was caught completely by chance. She had gone in to see a local oncologist (she has a history of mast cell tumors) to have a CT done of her head and chest due to two small masses found in her mouth. The masses turned out to be stomatitis, but they noted a pituitary tumor. The doctor was not concerned because Amelia was not showing any other signs with it and no diabetes. But within a month I started noticing she was SO hungry all the time and drinking a ton of water. I knew.. I took her in for a fructosamine test, which showed diabetes. She was started on insulin Dec 14th. But I was still concerned and had the oncologist do a IGF-1 test. Came back high. I do not know the exact number, but I was told over 1200.

Since then I have been doing a ton of research. Joined the FB group. I have a phone consultation next week with a doctor in Oregon (I'm in WA) that does the SRT treatment. My goal is to slow this down AND if we're lucky, maybe she won't need insulin anymore. Surgery was not advised by her oncologist.

I'm here to get support, but would also like to hear from folks that have had this treatment done for their cat. How did it go? What changes if any did you see? How long did it take to see changes? Is this a safe treatment? Have you used VCA Northwest Veterinary Specialists in Clackamas OR for this treatment? Are there any questions or concerns I should talk to the doctor about (we speak on the 11th of Feb). I want to make sure I am doing the right thing for her. She does not travel well at all, so this is a BIG deal. She is doing well on her 1 unit twice a day of Lantus. I'll be doing a at home curve this weekend to see how that is going. I do have a spreadsheet. Before she started getting insulin, she was in the 300-400 range, but it now in the mid 100's to 250.

Thank you all!
Click to expand...
 
You must log in or register to reply here.
Back
Top