The only thing the vet said was that Walter had the tumor (results from the test for acromegaly) which would explain the BG levels. He didn’t suggest any next steps other then to not do surgery or aggressive treatment because of Walter’s age ( I agree). I’m just wondering if Walter is in any discomfort and if anyone has any suggestions/recommendations. Overall, Walter seems reasonably normal (for a cat of his age).
Thank you so much— didn’t realize that there was a forum for it but now I see it! Will also ask the vet about the medication.
Yes. My Darcy was also on Cabergoline. I think he was headed toward remission when be was taken from me by other causes. He did very well on Cabergoline and his insulin requirements went WAY down! There’s a ton of good information on the Acromegaly forum. Larry posted a piece about cats going into remission on Cabergoline there - fairly recently.
Thank you! I’m catching up on the articles now and there seems to be a lot of information— very helpful.
Research has shown that between 20-25% of all diabetic cats has acromegaly. That same study showed cats with doses as low as 1 unit. Mostly people don't test for acromegaly until the dose gets higher, so it's possible acros with low doses don't get identified. Actually, there have been a couple acros in the literature that weren't even diabetic yet. It's good your vet thought to check it out. Did you hear what the IGF-1 test number was?
Thank you. One of the challenges is that when I do increase the dose, the BG often will drop quite significantly so I’ve been reluctant to be too aggressive on that front. Thank you for tagging Wendy
The vet felt that at Walter’s age it was best to just stay status quo but I’ve asked him about the Cabergoline (waiting to hear back). It’s interesting that you mention the arthritis. Walter has been limping periodically for the past year—several vets said that he had arthritis—I asked about pain medication and they gave me gabapentin— it was hard to know if it was doing any good or not. My current vet (who I had used pre-Covid but had been unable to see due to logistical issues— I finally saw him last week—he was the one who tested for acro)—wasn’t sure about the gabapentin and didn’t know if arthritis was an issue (which I thought was odd). I’ll ask about the buprenorphine. My main goal is to make Walter comfortable and I hate to think that he’s in any pain. I wasn’t given a test number. He’s also having vision problems in one eye (lost his hearing several years ago).Sorry to hear about the diagnosis.
My Neko has stereotactic radiation therapy (SRT) at Colorado State University. It's a slightly cheaper alternative to surgery, though not sure with Walter's age it a great alternative. It's also only offered at certain places so you'd have to check if there is a location near you. I had to drive 3 days with Neko to get to CSU. But she did live 5 years with acromegaly, the most of it with pretty decent quality of life.
The pituitary is close to the optic chiasm. If the tumour gets large enough, it can press on the optic chiasm, and cause vision issues. It's not something I've seen happen much. I have seen a couple other people's cats have gait issues. But I'd also make sure the vet checks for arthritis. Bony growths are quite common for acros - Neko had quite severe arthritis eventually. She was on pain meds (buprenorphine) as well as other meds to help the arthritis. Acromegaly means an output of excess growth hormone, which also stimulates more IGF-1 and resulting soft tissue growth and impacts organs too. Make sure the vet checks Walter's heart and kidney values regularly.
If It were my cat, I would prefer buprenorphine to gabapentin. A lot of cats have problems walking with gabapentin because it is easy to give too much (although some cats do well on it.). So that is kind of self-defeating. I have read that Gabapentin is better for nerve pain. Buprenorphine has a wide margin of safety in cats (the dose can be adjusted).
Hi Wendy, have you posted the study about 20-25 percent of diabetic cats having Acromegaly. That’s very interesting. Where can I find it? Thanks!!Sorry to hear about the diagnosis.
My Neko has stereotactic radiation therapy (SRT) at Colorado State University. It's a slightly cheaper alternative to surgery, though not sure with Walter's age it a great alternative. It's also only offered at certain places so you'd have to check if there is a location near you. I had to drive 3 days with Neko to get to CSU. But she did live 5 years with acromegaly, the most of it with pretty decent quality of life.
The pituitary is close to the optic chiasm. If the tumour gets large enough, it can press on the optic chiasm, and cause vision issues. It's not something I've seen happen much. I have seen a couple other people's cats have gait issues. But I'd also make sure the vet checks for arthritis. Bony growths are quite common for acros - Neko had quite severe arthritis eventually. She was on pain meds (buprenorphine) as well as other meds to help the arthritis. Acromegaly means an output of excess growth hormone, which also stimulates more IGF-1 and resulting soft tissue growth and impacts organs too. Make sure the vet checks Walter's heart and kidney values regularly.
Labs were done on this recent visit (last week)— apparently everything looked ok. The limp is on his front leg—and sporadic. He’s gained some weight so that probably doesn’t help.
But she also had some on her front legs, which I actually got to see when her leg did a cameo in her dental x-rays. Vet might be able to feel it with Walter and save the bother of x-ray. We tried both buprenorphine (vet's 1st choice) and gabapentin (her second choice). Bupe was way better for her. It's ECID and I think it's worth doing the experiment to try bupe.Ever considered a switch to Levemir? It has a later onset and nadir which can be challenging for some (was better for me), and a lot of cats become flatter/more predictable on it. Walter does like the rainbow!
Thanks for sending this link—I’m going to read later today when I’m more awake (!). Still waiting to hear back from the vet but I’m going to also ask him about the bupe. He didn’t charge me for the acro test (he was doing it out of his own curiosity and then it came up positive)! But he’s a good guy and I’m sure he’ll give me the number if I ask him. I considered Levimir a while back but was in between vets and didn’t do it. I just got a refill for the Lantus. Yesterday was a real ride with Walter —not sure what was going on. If this were pre-Covid and I still needed to go to an office to work (and leave him alone), I’d be going nuts. Thank you again for all of your help—I’m very grateful!Neko never had x-rays for arthritis. It was easy to feel on physical exam. Heck, even I could feel it on her spine.
The blood test data belongs to you, you paid for it. You have the right to ask for the IGF-1 number.
Ever considered a switch to Levemir? It has a later onset and nadir which can be challenging for some (was better for me), and a lot of cats become flatter/more predictable on it. Walter does like the rainbow!
@Suzanne & Darcy Acromegaly - the basics see post #7 for the link to one of the articles. I've seen another article on a smaller study in Switzerland that said 20% but haven't read that study. The UK one was good because they were doing a study on something else, and just screening for acromegaly to rule those cats out of the cohort for the study.
I'm so sorry to hear about Walter's diagnosis! But he's always such a trooper and other than loving his trampoline - I've been teasing him about that for years - he seemed to be doing ok.
Thank you, Paula. I’ll check about the limping.
Thanks Sue—real bummer but you’re right: Walter is a trooper. Onward!Oh Zelda
I do hope he's not having pain and that you can get some of his issues resolved by using the Cabergoline...
Sending you hugs and prayers!