potential acromegaly, seeking advice in testing/Sx

[Teresa & Cricket]

Hi,
So I am taking Cricket to the vet tomorrow morning (12/20) for follow up on her diabetes.
She is still barely responding to insulin and we are at 4.75
I informed the vet (different one than I normally see, my usual vet moved away) of her current symptoms and lack of response and showed him my SS.
He is concerned about Acro and likely wants me to do the test that gets sent to some lab in the midwest?

I am curious if any of you who are experienced with this have any pointers for testing and looking at symptoms? Especially what tests are less relevant, because I can't afford much at all.

Cricket had bouts of gross, cow-patty stools that stopped when I removed fish.
Now she is showing a dwindling appetite, low energy, and more weak limbs.
It seems like she only wants to eat food that is super smelly. I actually gave her a tiny bit of Origen Red kibble to make sure she ate at all before her shot. She happily ate it and a little canned rabbit, but turns her nose at her usual food, even the raw chicken thighs and Tiki Cat chix!

She is also wheezing/snoring a bit and has some wax build-up in one ear for the first time ever. (thankfully, her respiratory rate is normal)
Her fur is a bit dull. Her stools are back to normal, but she was straining for her first non-mush poop.

I should also mention, she has HCM that was diagnosed with CHF back in February. And after that diagnosis is when her diabetes symptoms slowly started appearing (but I didn't realize it then).
And I just learned there is a connection with Acromegaly and HCM.

Any thoughts?
-Teresa

 

[Wendy&Neko]

The two tests you want done are the IGF-1 test (for acromegaly) and IAA, for insulin auto antibodies. For both those tests, blood is sent to Michigan State University.

Clinical symptoms of acromegaly vary by cat, and many of them have no obvious symptoms at diagnosis. Snoring or whispy breath can be a stridor, which results from soft tissue growth in the throat. A pot belly is also a common symptom. But so also is a ravenous appetite which Cricket does not have. GI issues are not uncommon.

My Neko had mild HCM a couple years after her diabetes started, the CHF came later.

 

[Teresa & Cricket]

The two tests you want done are the IGF-1 test (for acromegaly) and IAA, for insulin auto antibodies. For both those tests, blood is sent to Michigan State University.

Clinical symptoms of acromegaly vary by cat, and many of them have no obvious symptoms at diagnosis. Snoring or whispy breath can be a stridor, which results from soft tissue growth in the throat. A pot belly is also a common symptom. But so also is a ravenous appetite which Cricket does not have. GI issues are not uncommon.

My Neko had mild HCM a couple years after her diabetes started, the CHF came later.

Thanks, Wendy!
She actually DID have a ravenous appetite, up until a few days ago. She was eating a ton, pretty much anything I would put in front of her, plus constantly asking for more. Then a few days ago, she was tapering off on food and now today, it is nibbles...

She does seem to have a pot belly.

I'll see what the vet says tomorrow. Could be an infection.

 

[Wendy&Neko]

I would get the vet to check for pancreatitis too. It is far too common with our diabetic kitties. Good luck at the vet.

 

[JeffJ]

Leo had multiple symptoms, mainly high insulin dose requirement. I had him successfully treated with SRT.

The stickies at the top of the forum - have some good info. Some people continue to treat Acro cats with higher doses of insulin as the BG rises.

Leo's continued symptoms even after SRT have been:
- stridor with loud snoring
- pot belly, which has gone down a lot
- bony forehead and jaw growths
- neuropathy (from unregulation, which has subsided as a result of regulation)
- slightly clubbed feet, and thickened toenails

 

[Teresa & Cricket]

Thanks, Wendy!
She actually DID have a ravenous appetite, up until a few days ago. She was eating a ton, pretty much anything I would put in front of her, plus constantly asking for more. Then a few days ago, she was tapering off on food and now today, it is nibbles...

She does seem to have a pot belly.

I'll see what the vet says tomorrow. Could be an infection.

So the vet is strongly leaning to Acro, we sent out the for the test on Thursday.
He is a different vet than I was seeing before, and he has a lot of experience with feline diabetes, so that makes me feel better. (He greatly appreciated the speadsheet)

He felt pancreatitis was less likely, based on her Sx.

I only got the MCU test because it was so dang expensive. If it is negative, we'll do more extensive bloodwork.

She had a weird appetite shift where she suddenly decided she ABSOLUTELY DESPISES chicken-- any form, even tiki cat and raw thighs--which she had been eating forever w/o a problem.
So she's now doing Vital Farms raw rabbit and was responding well to Hound and Gatos lamb, but then today had loose stools again... including going out of the litterbox (on a towel, thankfully).

Now her ravenous appetite is back.
Her neuropathy is a bit worse and affecting both her front and back right legs.
She's also a bit anxious? paces some, doesn't fall asleep easily.
She also talks alot less, she was always one of the chattiest cats I have ever known.
Also, I've seen her twitch a little too.

 

[Wendy&Neko]

It’s great you found a vet who is knowledgeable about feline diabetes. Paws crossed on the MSU results.

Ugh on the appetite change. Have you tried turkey? I kept a rotation of four different proteins, so if she got bored of one I had others. I also fed venison and kangaroo, sometimes buffalo.

Have you noticed particular times you see twitching? As Cricket’s dose gets up there, you may want to consider a switch to Levemir. Lantus has an acid base that can sting at higher doses. I have heard of a number of cats that just seem happier on Lev.

 

[Teresa & Cricket]

She's back and forth with turkey. Right now she seems to like the chicken again, if I mix in a little lamb
I haven't tried kangaroo, she ate venison once... the novel protein foods are just so expensive for the amount of food she is wolfing down! She is eating between 2.5 - 3 cans of food per day.

I will watch and see when the twitching is happening. Didn't see it today.

Also, she's talking more today... I think whatever was happening with her guts has passed.... at least for now.

That's good to know about the levemir, I was wondering why it seemed so many folks on this forum used it.
She doesn't react so far during the shot, and since we've gotten higher I push the dose in slowly.
However, if I was going to switch, it wouldn't be for a while because I have a stock of 3 Lantus pens and can't really afford much right now... but perhaps later on.... esp if this test comes back positive.


Thank so much for all your words and wishes!
Have a great holiday!

 

[Teresa & Cricket]

It’s great you found a vet who is knowledgeable about feline diabetes. Paws crossed on the MSU results.

Ugh on the appetite change. Have you tried turkey? I kept a rotation of four different proteins, so if she got bored of one I had others. I also fed venison and kangaroo, sometimes buffalo.

Have you noticed particular times you see twitching? As Cricket’s dose gets up there, you may want to consider a switch to Levemir. Lantus has an acid base that can sting at higher doses. I have heard of a number of cats that just seem happier on Lev.

Just got the IGF test results back today and she has Acromegaly. I started a new thread seeking advice.
(I will look into the Levemir once I get low on Lantus)