The post I didn't want to make

R

Robo & B

Member Since 2025
Bub has been diagnosed with acromegaly with an IGF-1 over 1500. I have suspected it from him first being diagnosed, due to his heat intolerance.

I think I've read through all the posts on this board already and have read every paper I can find and mostly I've just been crying and not taking a lot of it in.

Financially surgery is unlikely to be an option, my vet is looking into radiotherapy but not even sure if there is anywhere that offers it let alone cost ( I'm in the UK). I have cabergoline to try but with his high IGF-1 the 2022 study results suggest we won't be lucky there.

For those who have used cabergoline what did you find was the best way to give it?

I would also appreciate any dosing advice. I've been following the MPM for a bit now. And have been increasing in .5 units because of high nadirs. At this point I'm happy when I even see yellows. At what point do I increase in whole (or more) units?
 
I’m really sorry to read this, too. I was pretty devastated at first when my boy received his acromegaly diagnosis. We used Cabergoline because it was 2021 and the facilities that did the stereotactic radiation therapy would not even return my calls due to COVID. Cabergoline really helped my cat get into better BG numbers and at a MUCH lesser dose than before. He was well over 40 units of Levemir insulin plus a short acting insulin to help get his numbers down. He ended up at a small dose.
 
We generally recommend increasing in .5 increments as needed until you get to 10 units and then increasing in increments that are about ten percent of the dose. I know Wendy will be here shortly to help you as well. She is extremely knowledgeable about acromegaly.
 
I’m not sure if the above made sense, but 1 unit is ten percent of 10 units. If your dose was, say, 15 units, you would do an increase of 1.5 units, etc.
 
Thanks Suzanne, you've been holding my hand from the start over on my earlier threads. At least this dx explains his lack of response and his other symptoms.

Yes 10% above 10units makes sense thank you
 
Sorry to hear about your boy's recent diagnosis. :bighug: I'm sure you've read how common it it (1 in 4 diabetic cats) and you've caught it fairly recently after his diabetes diagnosis, so good on you.

I wouldn't dismiss cabergoline just yet. Cabergoline does best on smaller tumours, but there isn't any correlation between size of tumour and the IGF-1 number. Neko had stereotactic radiation therapy a few weeks after a couple of other kitties here, which meant getting the CT scan too, so we could compare size of tumour to IGF-1 number. Neko had the smaller tumour by far of the three cats, and the highest IGF-1 number. The folks at Colorado State University, where we went for radiation, also confirmed they haven't seen a correlation. A large percent of the cats on cabergoline do see reduced insulin doses. Which is a good thing.

As Suzanne said on dosing, increases are by 10-15% of the total dose. You can see what works best Bub, and do smaller % increases for doses getting better nadirs. I'm glad you are following MPM now. Sometimes chasing insulin resistance is like chasing after a speeding train. If you can follow a more aggressive dosing method, that's best.

I'm surprised to hear of heat intolerance as a symptom. Neko loved the heat, but squinted her eye at bright sunshine. Until after the radiation therapy improved things.
 
Wendy&Neko said:
Sorry to hear about your boy's recent diagnosis. :bighug: I'm sure you've read how common it it (1 in 4 diabetic cats) and you've caught it fairly recently after his diabetes diagnosis, so good on you.

I wouldn't dismiss cabergoline just yet. Cabergoline does best on smaller tumours, but there isn't any correlation between size of tumour and the IGF-1 number. Neko had stereotactic radiation therapy a few weeks after a couple of other kitties here, which meant getting the CT scan too, so we could compare size of tumour to IGF-1 number. Neko had the smaller tumour by far of the three cats, and the highest IGF-1 number. The folks at Colorado State University, where we went for radiation, also confirmed they haven't seen a correlation. A large percent of the cats on cabergoline do see reduced insulin doses. Which is a good thing.

As Suzanne said on dosing, increases are by 10-15% of the total dose. You can see what works best Bub, and do smaller % increases for doses getting better nadirs. I'm glad you are following MPM now. Sometimes chasing insulin resistance is like chasing after a speeding train. If you can follow a more aggressive dosing method, that's best.

I'm surprised to hear of heat intolerance as a symptom. Neko loved the heat, but squinted her eye at bright sunshine. Until after the radiation therapy improved things.
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Ok I was going on the 2022 study that seemed to show the cats with lower igf-1 numbers had smaller tumours and also responded better. But with only 20? something cats I guess that finding may have been incidental. Thanks for the hope I could really do with some.

It wasn't just the heat intolerance but also that he didn't present as a typical diabetic cat at diagnosis. No non deliberate weight loss (I had him on a diet earlier in the year and he had lost weight but stopped as soon as I reversed the diet changes). When I was down the rabbit hole early on I kept finding the same study about an acromegalic human who's only presenting symptom was heat intolerance and excess sweating and with how common acromegaly is in diabetic cats I was suspicious from the off.
 
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