Pumpkin- Acro DX and Lantus/Cabergoline

KAC

KAC

Member
Also posted this in Lantus forum...........

Pumpkin has been diagnosed with Acro. Had test from MSU. His neuropathy has gotten pretty bad because he is staying in the 400/500 range with 13 units Am/Pm of Lantus. I really need to find some relief for his wonky up and down numbers so neuropathy can improve............he is such a sweetheart.

Looking for info on cabergoline or other medicines that can help counteract the hormone storm from the tumor. Would love info on dosing for cabergoline, etc. Also, I read somewhere on a message (can't find it now) that B12 shots help with neuropathy and the muscles.

Any help anyone can give me on any of these topics is very much appreciated. :cat:
 
See https://felinediabetes.com/FDMB/threads/cabergoline-acro-iaa-information.237336/
The dose seems to be 10mcg/kg

My vet is considering Cabergoline for my Snuffles who was Dx'd last week. The radiation treatment or gold standard drug
Medical Treatment Using Pituitary Inhibitors

Using somatostatins to inhibit GH secretion by the pituitary tumour has proven very effective in humans suffering from acromegaly, but has previously proven ineffective in cats. Previously tested dopamine agonists and somatostatin analogues, including long-acting formulations such as lanreotide, have not resulted in detectable clinical improvement. Nevertheless, a novel somatostatin analogue Pasireotide (Novartis, Basel) has been tested in the author's Acromegalic Cat Clinic and found to be effective, leading to insulin dose reduction in all cats, decreases in IGF-1 and even diabetic remission in 25% of cases when using a once monthly preparation. However, somatostatin treatment was also associated with gastrointestinal side effects in a significant number of cats, including diarrhoea, rendering this not a miracle solution, especially considering its considerable expense and the fact that the pituitary tumour is left in place.
https://www.vin.com/apputil/content/defaultadv1.aspx?pId=12886&catId=57097&id=7054862

the yearly cost of Pasireotide for human is about $62K/year
https://www.ncbi.nlm.nih.gov/books/NBK349163/table/T30/
 
Leo had bad neuropathy before I got him regulated. It is really disheartening, so I know how challenging this is.

As Janet said, mid-cycle numbers are critical to determining dose effectiveness. Zobaline (B12) is a B12 that is often given. These are frequent topics. You might consider searching the general forum for past discussions. Just giving B12 will not resolve the issue. Your kitteh has to get regulated.
 
I used cabergoline for Ollie. GI upset is most common and resolves on its own in a few days. I used probiotic while waiting for it to arrive (compounded into suspension) and continued probiotic the 1st week she was on it. Ollie never had any gi upset.

It really depends on what yours and vets goal are for using it. For me it was to lessen her symptoms which were really awful. It worked for that very well once we reached a good dose. She even had a few good months of being "normal" walking properly, playing, enjoying life. Her insulin dose did go down by half. Ollie had other issues that caused her insulin to go up and down. But her acro symptoms remained gone.

Pamela and Amethyst are on it a few years now. Her insulin dose is quite high. Erin and Moe are on it, Moe's dose has gone down some.

The cabergoline (which is different than pasireotide) to me was affordable it was $125/month. Using both together has much better results. Then there is one that's starts with "o" don't know the spelling that has promise when added to cabergoline. My vet was afraid to add a new med she wasn't familiar with.
 
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Olive & Paula said:
I used cabergoline for Ollie. GI upset is most common and resolves on its own in a few days. I used probiotic while waiting for it to arrive (compounded into suspension) and continued probiotic the 1st week she was on it. Ollie never had any gi upset.

It really depends on what yours and vets goal are for using it. For me it was to lessen her symptoms which were really awful. It worked for that very well once we reached a good dose. She even had a few good months of being "normal" walking properly, playing, enjoying life. Her insulin dose did go down by half. Ollie had other issues that caused her insulin to go up and down. But her acro symptoms remained gone.

Pamela and Amethyst are on it a few years now. Her insulin dose is quite high. Erin and Moe are on it, Moe's dose has gone down some.

The cabergoline (which is different than pasireotide) to me was affordable it was $125/month. Using both together has much better results. Then there is one that's starts with "o" don't know the spelling that has promise when added to cabergoline. My vet was afraid to add a new med she wasn't familiar with.
Click to expand...
My cat's dose has gone down significantly this year. Makes me wonder if the hyperthyroidism meds that she started a year ago effected it in some way... or it could be a coincidence. Either way, CC only needed 5 units today, so i'm a happy camper.
 
JanetNJ said:
My cat's dose has gone down significantly this year. Makes me wonder if the hyperthyroidism meds that she started a year ago effected it in some way... or it could be a coincidence. Either way, CC only needed 5 units today, so i'm a happy camper.
Click to expand...

Probably will never know.........
 
Olive & Paula said:
Then there is one that's starts with "o" don't know the spelling that has promise when added to cabergoline.
Click to expand...
The "o" is likely "octreotide "

The somatostatin analogue octreotide has been evaluated in a few cats with acromegaly with limited success. In a study of four cats with acromegaly, no change in serum growth hormone concentration was noted after treatment with octreotide.2 Another study, which measured the short-term effects of octreotide in five cats with acromegaly, found a decrease in growth hormone concentrations for up to 90 minutes after octreotide administration.3 However, a recent study evaluating a long-acting somatostatin analogue (Sandostatin LAR Depot—Novartis) showed no benefit in cats treated for three to six months.4
https://www.dvm360.com/view/feline-acromegaly-treatment-options
 
Larry and Kitties said:
The "o" is likely "octreotide "

The somatostatin analogue octreotide has been evaluated in a few cats with acromegaly with limited success. In a study of four cats with acromegaly, no change in serum growth hormone concentration was noted after treatment with octreotide.2 Another study, which measured the short-term effects of octreotide in five cats with acromegaly, found a decrease in growth hormone concentrations for up to 90 minutes after octreotide administration.3 However, a recent study evaluating a long-acting somatostatin analogue (Sandostatin LAR Depot—Novartis) showed no benefit in cats treated for three to six months.4
https://www.dvm360.com/view/feline-acromegaly-treatment-options
Click to expand...
Thank you so much!!
 
Larry and Kitties said:
The "o" is likely "octreotide "

The somatostatin analogue octreotide has been evaluated in a few cats with acromegaly with limited success. In a study of four cats with acromegaly, no change in serum growth hormone concentration was noted after treatment with octreotide.2 Another study, which measured the short-term effects of octreotide in five cats with acromegaly, found a decrease in growth hormone concentrations for up to 90 minutes after octreotide administration.3 However, a recent study evaluating a long-acting somatostatin analogue (Sandostatin LAR Depot—Novartis) showed no benefit in cats treated for three to six months.4
https://www.dvm360.com/view/feline-acromegaly-treatment-options
Click to expand...

Even when given with cabergoline?
 
Larry and Kitties said:
I could not find anything about trials of cabergoline AND octreotide together.
Click to expand...
It came in private correspondence between one of our members and a researcher at Royal Veterinary College. In this post and that one. Octreotide is NOT cheap either.

The price Larry quoted above for pasireotide is a bit high, as that is a human dose. Cats need less. Plus the quote was for the daily version and the Signifor LAR (long acting, once a month shot), got better results in trials. When I got a quote for Canadian prices several years ago it was "only" about $5000 for 3-4 months worth. :eek: Cheaper to save your money and get surgery if you have that kind of money.
 
Wendy&Neko said:
It came in private correspondence between one of our members and a researcher at Royal Veterinary College. In this post and that one. Octreotide is NOT cheap either.

The price Larry quoted above for pasireotide is a bit high, as that is a human dose. Cats need less. Plus the quote was for the daily version and the Signifor LAR (long acting, once a month shot), got better results in trials. When I got a quote for Canadian prices several years ago it was "only" about $5000 for 3-4 months worth. :eek: Cheaper to save your money and get surgery if you have that kind of money.
Click to expand...

No wonder I couldn't find it.

When I checked price for octreotide a couple of years ago, it was quite reasonable.
 
In the study described in this old post they were just starting to trial octreotide at CSU. They were using the long acting, once a month shot version. The trial of octreotide by itself did not work. They had finished the trial when I was there. At some point, it would be interesting to contact RVC and see if they also used the long acting version, what the dose was, and how many cats they tried it on.
 
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