? Recommended Cabergoline Strength?

Jaime & Mowgli

Jaime & Mowgli

Member
Hi all,

My vet has contacted me and said he is willing to prescribe Cabergoline for Mowgli at a dose of 10mcg/kg.

Since he has never prescribed this medication (much less in compounded form), we were hoping to see what strength other vets prescribed for you guys. What was the mcg/mL that was used in your cat's medication?

For Mowgli, we will be needing about 60 mcg/day since he weighs about 6 kilos. I was thinking of asking for a compound of 120 mcg/mL so that we can dose at 0.5 mL/day. Does that sound reasonable?
 
My kitty does very well with the fish flavor. Paula's cat, Olive did okay on the bacon marshmallow flavor. Not sure which other flavors people use around here.
 
Thanks again! If we go with 200 mcg/mL, we'd have to dose 0.3 mL per day. That sounds pretty good to me.

Suzanne, I hope you don't mind me asking. Am I correct that you were considering SRT for Darcy at one point? If so, do you mind telling me the vet clinic you were considering as well as any prices you found?

I hope Darcy turns it around for you. Let him know that Mowgli is rooting for him as a fellow Acro brother :)
 
Yes. I had planned to take Darcy to North Carolina State University in Raleigh, NC. They quote a price range of $4500 to $6500 for the treatment. It’s on the vet school’s website. Thank you. We are rooting for Mowgli too!
 
Thanks everyone for the responses and good vibes. I just got off the phone with the local compounding pharmacy that will be taking care of our prescription. Our vet decided on 100 mcg/mL and I decided to give the chicken flavor a try. Fingers crossed Mowgli takes to it.
 
Jaime & Mowgli said:
Thanks everyone for the responses and good vibes. I just got off the phone with the local compounding pharmacy that will be taking care of our prescription. Our vet decided on 100 mcg/mL and I decided to give the chicken flavor a try. Fingers crossed Mowgli takes to it.
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Excellent. I hope Mowgli does really well on the Cabergoline!
 
Suzanne & Darcy said:
Yes. I had planned to take Darcy to North Carolina State University in Raleigh, NC. They quote a price range of $4500 to $6500 for the treatment. It’s on the vet school’s website. Thank you. We are rooting for Mowgli too!
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Thanks Suzanne for the information! That price range would be very doable for my family seeing as my brother and sister agreed to pitch in (he is the family cat after all!). I will be contacting some local specialty veterinary clinics (Southern California) to compare prices and will make sure to post here for others to see.

On a related note. Can we expect better results from doing SRT on top of Cabergoline?
 
Jaime & Mowgli said:
Thanks Suzanne for the information! That price range would be very doable for my family seeing as my brother and sister agreed to pitch in (he is the family cat after all!). I will be contacting some local specialty veterinary clinics (Southern California) to compare prices and will make sure to post here for others to see.

On a related note. Can we expect better results from doing SRT on top of Cabergoline?
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That is a question that I have often wondered about! @Wendy&Neko do you have any information on this? It's so nice how much everybody in your family loves Mowgli!
 
Jaime & Mowgli said:
Can we expect better results from doing SRT on top of Cabergoline?
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I wouldn't do both at the same time. I don't know anyone who has done this so have no idea how it would work or even if it's safe to do so. Paul had Bronx on cabergoline but tapered him off it before doing SRT.
 
Resurrecting this to double check - my vet prescribed 0.25mL of 250mcg/mL. Mr Kitty is 6kg, so it does work out to 10mcg/kg. BUT, he prescribed it every other day...it appears most people give it daily? Is it the full 10mcg/kg daily? Or another dose?
 
Suzanne & Darcy said:
In some of the studies they used every other day dosing. And some used daily dosing. Frustrating, isn’t it?
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Sigh why is nothing ever easy with this?

Something isn't adding up though...vet only charged me $35 for 16mL bottle? The invoice says 8 tablets of 0.5mg cabergoline was $25, and then charged $10 for compounding. My math says it should last a month? Seeing some of the prices others have mentioned makes this seem very low. Although Suzanne I think you said you paid roughly $150 for a 5-ish month supply?
 
FrostD said:
My math says it should last a month?
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I get 2 months ant every other day dosing:
1/4 ml equates to 4 days of dosing.
16ml equates to 4X16 days=64 dosing days which is 2 months since there is little waste. That is 4 months at every other day dosing.

What pharmacy did you use and what is it compounded in? Oil?
 
Larry and Kitties said:
I get 2 months ant every other day dosing:
1/4 ml equates to 4 days of dosing.
16ml equates to 4X16 days=64 dosing days which is 2 months since there is little waste. That is 4 months at every other day dosing.

What pharmacy did you use and what is it compounded in? Oil?
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:banghead: I need sleep, can't even do basic math. Yes 64 doses total, so about 2 months assuming. Has it in my head as 64 days if EOD, not 64 doses.

Vet ordered it and compounded in house, I'm not sure what it's in, just that it's chicken flavor. I did remind them he's diabetic so use the correct compounding liquid
 
FrostD said:
Sigh why is nothing ever easy with this?

Something isn't adding up though...vet only charged me $35 for 16mL bottle? The invoice says 8 tablets of 0.5mg cabergoline was $25, and then charged $10 for compounding. My math says it should last a month? Seeing some of the prices others have mentioned makes this seem very low. Although Suzanne I think you said you paid roughly $150 for a 5-ish month supply?
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Yes. I did. That was using it daily as well.
 
Larry and Kitties said:
I get 2 months ant every other day dosing:
1/4 ml equates to 4 days of dosing.
16ml equates to 4X16 days=64 dosing days which is 2 months since there is little waste. That is 4 months at every other day dosing.

What pharmacy did you use and what is it compounded in? Oil?
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But yours is very concentrated isn’t it, Larry? What’s the strength?
 
FrostD said:
What made you guys decide daily vs EOD?
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The original South American study was EOD, RVC was every day. From people here I've seen start at EOD, it takes longer to build up and start working. So, some people switch to get things working faster. One or two, like Suzanne, have noticed some GI (or other) side effects, and switched to EOD to try to limit that.
 
I started at daily dose. We only really had diarrhea for a day or two as I recall. He had inappetance but that ended up being kidney problems. I only later reduced to EOD because of his kidney disease— because it would take longer to clear through the kidneys. He still maintained a low dose to the very end.
 
Jaime & Mowgli said:
Hi all,

My vet has contacted me and said he is willing to prescribe Cabergoline for Mowgli at a dose of 10mcg/kg.

Since he has never prescribed this medication (much less in compounded form), we were hoping to see what strength other vets prescribed for you guys. What was the mcg/mL that was used in your cat's medication?

For Mowgli, we will be needing about 60 mcg/day since he weighs about 6 kilos. I was thinking of asking for a compound of 120 mcg/mL so that we can dose at 0.5 mL/day. Does that sound reasonable?
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Jaime, how is Mowgli?
 
Suzanne & Darcy said:
Jaime, how is Mowgli?
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Suzanne, thank you for taking the time to check up on Mowgli. It says a lot about you that you would take the time to ask about others in this difficult time. Please accept my deepest condolences.

In regards to Mowgli. Since switching to every-other-day dosing, I would qualify our experience with Cabergoline as a "two-edged sword". My mom, who's Mowgli's full-time caregiver, says that she notices a clear distinction in Mowgli's demeanor the days that we give him Cabergoline. Less interest in food, some signs of discomfort like squinting eyes, etc. So the last two days we have given Mowgli Ondansetron at about 2.5mg every 8 hrs as well as 1/8 tsp of Slippery Elm Bark in the hopes of soothing his stomach. Yesterday he seemed okay, but I wonder if part of the reason was because we didn't give Cabergoline. Today my mom says that she's had to spoon feed him significantly even with the two doses of Ondansetron 2.5mg and the Slippery Elm Bark last night.

My thought is to bump up the Ondansetron dose to 4mg the next day that Cabergoline is on board, as well as maybe giving SEB a few times a day. Is this a good strategy to pursue?

Needless to say, we will not be increasing to the full dose of Cabergoline (in our case 0.6mL) until we can manage these side effects a bit better. As my mom keeps telling me, she will stop giving Cabergoline to Mowgli if she feels it is hurting him more than it is helping him, and I can definitely say that I see her point.

BTW, even though I haven't posted so much lately I have still been lurking on here and I must say that you undoubtedly have a wealth of knowledge that many people here can benefit from. I for one am very happy to see that you remain active on this forum.
 
Jaime & Mowgli said:
Suzanne, thank you for taking the time to check up on Mowgli. It says a lot about you that you would take the time to ask about others in this difficult time. Please accept my deepest condolences.

In regards to Mowgli. Since switching to every-other-day dosing, I would qualify our experience with Cabergoline as a "two-edged sword". My mom, who's Mowgli's full-time caregiver, says that she notices a clear distinction in Mowgli's demeanor the days that we give him Cabergoline. Less interest in food, some signs of discomfort like squinting eyes, etc. So the last two days we have given Mowgli Ondansetron at about 2.5mg every 8 hrs as well as 1/8 tsp of Slippery Elm Bark in the hopes of soothing his stomach. Yesterday he seemed okay, but I wonder if part of the reason was because we didn't give Cabergoline. Today my mom says that she's had to spoon feed him significantly even with the two doses of Ondansetron 2.5mg and the Slippery Elm Bark last night.

My thought is to bump up the Ondansetron dose to 4mg the next day that Cabergoline is on board, as well as maybe giving SEB a few times a day. Is this a good strategy to pursue?

Needless to say, we will not be increasing to the full dose of Cabergoline (in our case 0.6mL) until we can manage these side effects a bit better. As my mom keeps telling me, she will stop giving Cabergoline to Mowgli if she feels it is hurting him more than it is helping him, and I can definitely say that I see her point.

BTW, even though I haven't posted so much lately I have still been lurking on here and I must say that you undoubtedly have a wealth of knowledge that many people here can benefit from. I for one am very happy to see that you remain active on this forum.
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I think that your plan is a good one… to try to manage the symptoms on Cabergoline days with the antinausea medications. It’s kind of like what you do when giving chlorambucil (chemotherapy) to a cat with small cell lymphoma— on chemo days you get the Cerenia and Ondansetron on board before giving the chemo. Have you had Mowgli checked at the vet lately to see if there could be anything else causing his appetite and other problems? You and your mother are right about the hurting/helping thing. You can make adjustments to the dose or discontinue if necessary. I will be thinking of you all.
 
Suzanne & Darcy said:
Have you had Mowgli checked at the vet lately to see if there could be anything else causing his appetite and other problems?
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Our vet just got back from vacation, so I will be making an appointment so that he can do another house call soon. The last two urinalyses have shown a +2 protein level in the urine, so I am pretty sure we are going to be dealing with kidney issues sometime in the future. I want to run a Urine Protein:Creatine Ratio soon to see if we in fact need to add something like Benazepril to treat the proteinuria.

I have also purchased a blood pressure monitor from Amazon to check/monitor BP in response to potentially adding a blood pressure medication like Benazepril for the proteinuria.

However, I have hope that we are not dealing with kidney issues yet. After we stopped administering Cabergoline on 06/02, Mowgli's appetite came back up slowly to the point where we were comfortable starting him on a lower dose of Cabergoline EOD. I am hoping this is just an upset stomach from the Cabergoline and that we can eventually manage it.
 
Jaime & Mowgli said:
Our vet just got back from vacation, so I will be making an appointment so that he can do another house call soon. The last two urinalyses have shown a +2 protein level in the urine, so I am pretty sure we are going to be dealing with kidney issues sometime in the future. I want to run a Urine Protein:Creatine Ratio soon to see if we in fact need to add something like Benazepril to treat the proteinuria.

I have also purchased a blood pressure monitor from Amazon to check/monitor BP in response to potentially adding a blood pressure medication like Benazepril for the proteinuria.

However, I have hope that we are not dealing with kidney issues yet. After we stopped administering Cabergoline on 06/02, Mowgli's appetite came back up slowly to the point where we were comfortable starting him on a lower dose of Cabergoline EOD. I am hoping this is just an upset stomach from the Cabergoline and that we can eventually manage it.
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I was going to mention Benazepril but I see that you are already on top of it! Excellent research! Nice to have a vet that makes house calls. We have one mobile et around here and every time I call her I can’t get an appointment for at least two weeks. So if it is urgent then you are out of luck.
Well, keep me posted on how he is. He is obviously very special to your family! I love that!
 
Jaime & Mowgli said:
Our vet just got back from vacation, so I will be making an appointment so that he can do another house call soon. The last two urinalyses have shown a +2 protein level in the urine, so I am pretty sure we are going to be dealing with kidney issues sometime in the future. I want to run a Urine Protein:Creatine Ratio soon to see if we in fact need to add something like Benazepril to treat the proteinuria.

I have also purchased a blood pressure monitor from Amazon to check/monitor BP in response to potentially adding a blood pressure medication like Benazepril for the proteinuria.

However, I have hope that we are not dealing with kidney issues yet. After we stopped administering Cabergoline on 06/02, Mowgli's appetite came back up slowly to the point where we were comfortable starting him on a lower dose of Cabergoline EOD. I am hoping this is just an upset stomach from the Cabergoline and that we can eventually manage it.
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Oh, I also forgot to mention that I have done a LOT of research on Benazepril and have read vet studies showing that cats on Benazepril live significantly longer than those not on it. So, if it is appropriate for Mowgli, I think that will be a good thing.
 
Suzanne & Darcy said:
Nice to have a vet that makes house calls. We have one mobile et around here and every time I call her I can’t get an appointment for at least two weeks. So if it is urgent then you are out of luck.
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We are very grateful to have found this vet. Even more so that he agreed to prescribe us Cabergoline even though he had never done it before. The only problem I see moving forward is that if Mowgli ends up needing more medications, then the vet might grow uncomfortable being the sole vet on board.

My conundrum is with taking Mowgli to a physical vet office. He is EXTREMELY STRESSED during car rides and also at the vet office that I'm afraid he might go into cardiac arrest or something. He also becomes very aggressive at the vet that I'm afraid of the potential implications if he were to bite someone.

So my hope is to have the vet look at Mowgli the least possible and for us to manage as much as we can in house, hence my recent purchase of a blood pressure monitor. And I will try my best to convince this vet to stay on as our sole vet for the time being.
 
Larry and Kitties said:
Which one did you get?
Have you tried it yet?
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I bought the CONTEC08-VET monitor from Amazon along with the SunTech Veterinary BP Cuff Pack, which has more cuff sizes.

We haven't tried it yet since it just arrived and Mowgli's been more irritable. I don't want the first time that we try it to be a negative experience.

Anyway, I can't attest to the accuracy of the monitor yet.
 
Jaime & Mowgli said:
We are very grateful to have found this vet. Even more so that he agreed to prescribe us Cabergoline even though he had never done it before. The only problem I see moving forward is that if Mowgli ends up needing more medications, then the vet might grow uncomfortable being the sole vet on board.

My conundrum is with taking Mowgli to a physical vet office. He is EXTREMELY STRESSED during car rides and also at the vet office that I'm afraid he might go into cardiac arrest or something. He also becomes very aggressive at the vet that I'm afraid of the potential implications if he were to bite someone.

So my hope is to have the vet look at Mowgli the least possible and for us to manage as much as we can in house, hence my recent purchase of a blood pressure monitor. And I will try my best to convince this vet to stay on as our sole vet for the time being.
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Has the vet been able to see Mowgli this week?
 
Jaime, I hope you will see this. I just looked at Mowgli’s spreadsheet and am thrilled to see so many blues and greens and reduced insulin requirements! ❤️ It looks like y’all have been able to work through the Cabergoline dosing and side effects with every other day dosing and gradually increasing his dose. How is he doing otherwise? I hope you will update us. It’s been a long time, but I haven’t forgotten you and Mowgli.
 
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