We've decided on SRT for Rocket.

Karen&Rocket

Karen&Rocket

Active Member
This is a tough one, but after a lot of reading, talking with fellow members here, and much soul-searching, my husband and I have decided on SRT for Rocket's acromegaly. His results (IGF-1 = 331) came to us on July 5th, but looking back, he may have had symptoms as far back as last October. The first thing I noticed then was his meow changed, from a low-pitched, loudish meow to more of higher-pitched squeak. I mentioned it to two vets during office visits, but they both pretty much shrugged it off. In retrospect, I wonder if he might have some tissue growth in his windpipe that is causing this. Around the same time I noticed that on occasion his front claws grow in super thick. One grew into almost a circle.

Fast-forward to now - we're barely starting to get a better handle on his numbers, since switching to Levemir on July 16th. But his back legs are getting weak, and he's having accidents from time to time. We were originally thinking of traveling to CSU, but I'm having surgery this Friday and we don't know when I'd be able to handle a road trip. So we've decided to go with Dr. Bommarito at a veterinary cancer treatment center here in Orange County CA, about 30 miles away from home. We've compared his protocols to those at CSU, and they're very similar. Rocket is scheduled for a CT scan on Monday the 29th, with five SRT sessions Mon-Fri the week of August 5th.

This was not an easy decision to come by, as most of you know how expensive this is. We're getting a little help from family, as my mom used to have a beautiful ginger kitty who had her stomach cancer treated at the same facility. But the real decision-maker was the fact that Rocket is only 10 years old. I love him immensely. And I just think he deserves more time.

Thank you so much to (putting these on separate lines; not sure if they tag otherwise)
@JeffJ
@Wendy&Neko
edit: tagging @Bronx's dad too 'cause gray kitties are the best ;) (and because I remembered you had SRT too)

and anyone else I'm not thinking of right at the moment - I know there are more - your stories have really helped us come to this decision as well. I just hope Rocket's story is a good one, and that maybe we can help someone down the line too. Unfortunately I won't see everything first hand since my husband and my folks will be taking him for treatments, but I will document and share as much as I can.

Big hugs to all of you. :bighug::bighug::bighug::bighug::bighug:
 
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I am so glad to hear you have SRT near you. When we made the decision, I had two choices, one three days drive (CSU) and one 13 hours drive, but a lot more expensive with no acro experience. Sounds like Rocket will be in very experienced hands.
 
Good for you guys! It is never an easy decision for SRT, especially because of the costs. Pricing is useful to others too.
Can you please re-summarize the expected costs at the Orange County center?
What is the name and website of that center?

Some of the symptoms you described are common. Leo's paws grew, and his nails were super thick (even until the end). And neuropathy is just no fun - resolvable with lower BG nadirs and Zobaline in many cases.

I think that closer SRT center will work out great for you. Rocket will have a much better prognosis after SRT.

Best of luck with the surgery this Friday. We are lucky. We live in an age of modern medicine, and reap the benefits from it.:bighug::bighug::bighug::bighug:
 
Wendy&Neko said:
I am so glad to hear you have SRT near you. When we made the decision, I had two choices, one three days drive (CSU) and one 13 hours drive, but a lot more expensive with no acro experience. Sounds like Rocket will be in very experienced hands.
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Thank you. :bighug::bighug::bighug:

JeffJ said:
Good for you guys! It is never an easy decision for SRT, especially because of the costs. Pricing is useful to others too.
Can you please re-summarize the expected costs at the Orange County center?
What is the name and website of that center?

Some of the symptoms you described are common. Leo's paws grew, and his nails were super thick (even until the end). And neuropathy is just no fun - resolvable with lower BG nadirs and Zobaline in many cases.

I think that closer SRT center will work out great for you. Rocket will have a much better prognosis after SRT.

Best of luck with the surgery this Friday. We are lucky. We live in an age of modern medicine, and reap the benefits from it.:bighug::bighug::bighug::bighug:
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Sure - costs for CT scan and five treatments (MRI, if needed, is extra): approx. $8300. Not quite as bad as I'd thought (they had originally given us an estimate of around 9700, but that was a clerical error!). Tagging @Deena and Malby about this - she's in CA too, and we had talked about costs.

http://vetcancergroup.com/contact-us.html (we're going to the Orange County location, in Tustin CA)
http://vetcancergroup.com/services/radiation-therapy/stereotactic-radiation-therapy.html

I've thought about trying Zobaline too; we'll buy it after his treatments if needed.

I'll be off and on the website today; getting ready for Friday. But I'll be around if anyone has more questions. Thanks again :) :bighug::bighug::bighug:
 
That is a pretty price for the overall treatment plan. I'm glad it is working out for you. Thanks for posting that info and the website.

For Zobaline, really you should start it now. It won't hurt. You just mortar-and-pestle crush the pill and sprinkle it on the food. It is tasteless. Rocket will need supplemental B12 to get over the neuropathy, and Zobaline is easy to give.
 
Has Rocket ever been checked for arthritis? It is very common in acros. Not all acros get neuropathy, Neko did not. No need to give something if it is not needed.

Sorry the vets didn’t see the signs earlier, but neither did mine. Neko’s only symptom was one teary eye from soft tissue growth I found out later and the vet dismissed, and a savage hunger. Thick claws are common in acros. And if it helps any, many acros show symptoms before becoming diabetic. Neko’s teary eye started months before the peeing increased.

Let us know if you get a list of what to expect after SRT. If not, I can list some things. Resulting insulin needs post SRT are variable by cat, so no harm in safe dosing now. Neko needed her first reduction on the way home from Colorado, some kitties need a few months of increases before coming down. I was told it takes a couple weeks at least, my girl was a rule breaker. :p It all depends where the tumour cells are in their life cycle when radiated. Radiation in effect neuters them so they don’t reproduce.

Great news the costs seem to have stabilized for SRT, guess it helps it is getting more available now.
 
JeffJ said:
For Zobaline, really you should start it now. It won't hurt. You just mortar-and-pestle crush the pill and sprinkle it on the food. It is tasteless. Rocket will need supplemental B12 to get over the neuropathy, and Zobaline is easy to give.
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Ok, I'll order it so it will arrive when I'm back home.

Wendy&Neko said:
Has Rocket ever been checked for arthritis? It is very common in acros. Not all acros get neuropathy, Neko did not. No need to give something if it is not needed.
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He hasn't been checked for arthritis, but I can hear creaking in his shoulders sometimes. :( And he definitely has neuropathy in his back legs, though at this point some days are worse than others. I'm hoping it will reverse or at least get better with better numbers and Zobaline.

Wendy&Neko said:
Let us know if you get a list of what to expect after SRT. If not, I can list some things. Resulting insulin needs post SRT are variable by cat, so no harm in safe dosing now. Neko needed her first reduction on the way home from Colorado, some kitties need a few months of increases before coming down. I was told it takes a couple weeks at least, my girl was a rule breaker. :p It all depends where the tumour cells are in their life cycle when radiated. Radiation in effect neuters them so they don’t reproduce.
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We haven't gotten a list yet, so any info is appreciated! I do know that we'll need to really monitor his numbers after the treatments. Nice that Neko responded so quickly! Thank you. :)
 
Glad to hear you’re able to swing the SRT! Great that it is available so close to home, that should make it easier.

Hope all goes well Friday and you have a quick recovery
 
/Good to hear you are getting SRT.

I definitely would've done that or surgery if I had gotten Cricket's diagnosis before she had Congestive Heart Failure.
Keep us posted and good luck!
 
Thank you all so much -- I was back from surgery the same night (Friday), but it was a longer/more complicated surgery than expected so my energy levels are pretty low. BUT! I'm so happy to be home and focusing on just two things -- getting some good rest/recovery time in, and taking care of Rocket! :) Unfortunately we had to move his appointments back a bit (his CT scan is now scheduled for Aug. 7, with SRT the week of Aug. 12), but this means that I might actually get to go with him now too.

My only other wish is that he was more regulated before we start all this. We have him on 6U of Levemir now, which he seems to like much better than Prozinc, and even though his numbers have come down a bit they're still not good. At least they're much flatter now. But it's frustrating. I just hope we're doing the right thing.

Sorry if I sound a little scattered - I'm not quite myself yet. :)
 
Glad to hear your surgery is over and I hope you can be with Rocket for his SRT. For you it'll be a whole lot of waiting around, so it's not that important if you can't go, though it is nice to be there for the first meetings to hear what will happen. If only your DH can go, see if he has a recording app for his phone. I had to use that when I talked to the radiation oncologist, it was miles above my head and I needed to review it. Make sure you have a list of questions prepared before hand to. I found that really helped me organize my conversation.
Keskat&Rocket said:
My only other wish is that he was more regulated before we start all this. We have him on 6U of Levemir now, which he seems to like much better than Prozinc, and even though his numbers have come down a bit they're still not good. At least they're much flatter now. But it's frustrating. I just hope we're doing the right thing.
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Slow and steady is the way to go. The L insulins teach you patience. I would hold each dose at least six cycles (three days) at this point, and increase by 0.5 units if you don't see low blues. With low blues, you would hold the dose a bit longer. You did zip by the 5.5 unit dose, but that was probably OK. It does take the depot 4-6 cycles to stabilize, hence the need to hold the dose 6 cycles. It's great to see Rocket out of those blacks and reds now.
 
Just a quick update - Rocket is home from his CT scan this afternoon. He's a little wobbly, but is up and eating :cat: Good news is, his tumor was visible in the scan, and we'll be going ahead with treatments starting this Monday. I don't know if this is the best photo to see what is going on, but we saw a few different views while we were there. Now for some rest. :)
 

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It's great news that the tumour was visible. I know I was glad to know there was a positive ID on the acromegaly when I saw Neko's CT scan. The tumour also looks fairly regular in shape which should be easier for planning the radiation.

Rest and recover, it's a long week next week. :bighug: The CT scan day is usually the longest one.
 
Just catching up on this forum, glad you decided on SRT Karen. I am very happy I made that decision, Bronx would probably not be here right now if I didn't. Yes, it wasn't cheap but down from 37u to 3u is a money saver if you look at it that way. But more importantly, Bronx is here and happy and finally regulated w/o a pulsing tumor, you can't put a price tag on that!
 
Bronx's dad said:
Just catching up on this forum, glad you decided on SRT Karen. I am very happy I made that decision, Bronx would probably not be here right now if I didn't. Yes, it wasn't cheap but down from 37u to 3u is a money saver if you look at it that way. But more importantly, Bronx is here and happy and finally regulated w/o a pulsing tumor, you can't put a price tag on that!
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Thank you so much... I’m so glad to hear Bronx is doing so well! I love hearing the success stories. That’s all we want, a healthier and happier Rocket. He used to be such an active kitty; he always had to be a part of everything. Hoping he’ll get back some of his old self. :cat:
 
Ok we're a couple days away from Rocket's actual SRT. I just wanted to put this out there because it keeps rolling around in my head - we've been increasing his Levemir dose, with mixed results. Some days are better than others, but his numbers are all still too high. This morning was his 3rd shot at 8U of Levemir - if we keep going with increases, we would be going to 8.5 on Sunday morning (the day before his 1st SRT). Should we go ahead with the scheduled increase, or just stay at 8.0 since he'll be having radiation all this week? And what about during the week of treatment? Continue on to 9.0 on Wednesday?

I'm also starting to wonder how it will be after treatment, and how those of you who have gone through this have handled changing numbers, especially with a depot insulin like Levemir. I realize change (most likely) won't happen immediately, but would like some ideas so I can be somewhat prepared. :)
 
If you had been seeing greens or lower blues, I might be more cautious, but not where Rocket is at this point. Downward dose changes dues to SRT typically take at least two weeks, and many cats go up in dose for a while, maybe months, before SRT takes effect. I think I would go to 8,5, then hold it there.
 
Well, SRT pt. 1 went very smoothly! We're back home already, Rocket is just a little wobbly, but getting better by the minute. He's had a little bit to eat and is drinking water. Not much else to say except that everyone at the office was super friendly and kept us informed as to exactly what was going on, and how Rocket was doing. I'm feeling much better about the whole thing. Hopefully the rest of the week will go well too. :bighug::cat::bighug:
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Hmm... we just now hit our first blue (146) since switching to Levemir. I'm assuming this is from the long day, little food, anesthesia, etc.? Gotta keep a good eye on him this week.
 
Great pic of Rocket. I'm glad to hear all went well. I wouldn't sweat that blue - like you said, probably not enough food. Heck, it's probably good he got a break below the 200's! Go Rocket!:bighug:
 
Thank you! :bighug: Day 2 went well; we were home by 5:30 or so, Rocket ate, and a little later we went out for his usual sunset "walk" (he's harness trained). His numbers are still the same (of course, I don't expect anything to change this early), but interestingly he seems to feel better. Coincidence? He woke me up early this morning and seemed almost his old self. Even got snuggly. :) Unfortunately, he now knows something is up, and seems to have disappeared under the couch. We're not leaving for a few hours yet so it's all good.
 
I'm glad to hear the SRT sessions are going well for Rocket. They were harder on Leo because of the travel and the hotel room - he was toast that week.

Rocket's numbers can get adjusted after SRT. Rocket is pretty stable in general with his numbers. At least he got a couple of blue nadirs this week!:bighug:
 
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Ok! Day 3 update. Yesterday was tougher. We got there a little early like the previous days, but the office was busier and had an emergency critical case that came in (a beautiful Australian Shepherd - we saw him leave, and it looked like he was going to be ok). So, Rocket had to wait almost an hour before they took him in. Which was fine, but that meant going longer without eating, and we hit much worse traffic going home. Plus, I guess since it was his third day of anesthesia, etc., he had a harder time waking up than the day before. His blood sugar was low again (by Rocket's standards anyway) when we got home, but it shot up again like "normal." His appetite was good, and was this morning too, for the most part. He just seems more tired than usual.

For what it's worth, I'm pretty pooped too. I have to keep reminding myself that I'm still recovering from surgery. I know I haven't been getting enough sleep, and I had some pain yesterday that is reminding me that I have to take care of myself too. =/ Luckily I'm feeling a little better today, and I have a great hubby who is doing the driving for us, and who loves to cook! Woohoo. Pretty soon this week will be over, hopefully evertying will have gone well, and we can do some serious relaxing this weekend! :)
 
Karen, I've been reading along and tracking charming Rocket's new adventures. Please do rest some more and take good care of yourself. You are a lucky lady that DH is doing the driving and the cooking, a big thanks to him for being such a great guy.

Best of luck and good fortune going forward. Soft head bumps and chin scritches to Rocket, healing energies and calming vibes for you and gratitude to hubby for loving and caring for you both.
 
Idjit's mom said:
Karen, I've been reading along and tracking charming Rocket's new adventures. Please do rest some more and take good care of yourself. You are a lucky lady that DH is doing the driving and the cooking, a big thanks to him for being such a great guy.

Best of luck and good fortune going forward. Soft head bumps and chin scritches to Rocket, healing energies and calming vibes for you and gratitude to hubby for loving and caring for you both.
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Thank you so much, Lou. I read what you wrote to the DH and he really appreciated it too. I'll give Rocket some head bumps for you as soon as we get him out from under the couch - after three days of this he knows we're leaving in half an hour! :D
 
Rocket is almost done with SRT. YAY!

The whole process is pretty taxing, but you guys are almost done now. The anesthesia was tough on Leo too. And the lack of sleep is challenging. I bet your household will be nice and quiet this weekend with everyone sleeping. :bighug::bighug::bighug:
 
JeffJ said:
Rocket is almost done with SRT. YAY!

The whole process is pretty taxing, but you guys are almost done now. The anesthesia was tough on Leo too. And the lack of sleep is challenging. I bet your household will be nice and quiet this weekend with everyone sleeping. :bighug::bighug::bighug:
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Man... I was not prepared for how mentally taxing this would be for me and my husband, as well as Rocket of course. It's hard to see Rocket so worn out. Today they gave him gas anesthesia instead of intravenous, which he recovered more quickly from, but his appetite was less tonight. Maybe it's just the whole week getting to him. I finally got him to eat enough so I was comfortable giving him his shot. Just one more, buddy, and we're done for now. Hang in there. We love you, little Rocket.
 
You got this Rocket. One and done.

Once you both get over this Karen, we will talk about testing, and when you can ease off a bit so you get more sleep. You are a super cat mom, but you need to care for you so you can care for Rocket.

Total aside, cooking lessons were the best present I ever got my husband.:)
 
Wendy&Neko said:
You got this Rocket. One and done.

Once you both get over this Karen, we will talk about testing, and when you can ease off a bit so you get more sleep. You are a super cat mom, but you need to care for you so you can care for Rocket.

Total aside, cooking lessons were the best present I ever got my husband.:)
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Thank you Wendy :) That would be great; the next few weeks/months will be "interesting," and we'll definitely welcome advice if/when Rocket's insulin needs start changing. And yes, having to test a bit less often would be fantastic.

I'm very much looking forward to tomorrow when things are a bit calmer. Rocket will be so much happier once he realizes we're not going to the Dr. AGAIN.

I agree - husbands who like cooking are the best. Mine came that way (lol) but has only gotten better over the years!
 
JeffJ said:
Rocket is almost done with SRT. YAY!

The whole process is pretty taxing, but you guys are almost done now. The anesthesia was tough on Leo too. And the lack of sleep is challenging. I bet your household will be nice and quiet this weekend with everyone sleeping. :bighug::bighug::bighug:
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Agreed - YAY! Rocket was feeling a lot better this morning, and his appetite was good. But, he's under the couch again right now - he's no dummy. :cat: Tomorrow will be a much better day, and hopefully much more relaxing. I can't wait!
:bighug::bighug::bighug:

edit: hehe, Jeff, I just realized I replied to your post twice. Did I mention I was a bit worn out? :D
 
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Leo was toast after his SRT sessions. On the final Friday session I drove until midnite to get the first half of the drive back to Austin. You are basically doing a partial drive of that everyday because of the L.A. SRT location.

Well, it is 5pm Friday. So this is the last SRT day for Rocket. I forecast sleep in your near future, and healing SRT vibes in the next months for Rocket. With luck, he will have a nice steep "down-slope" of insulin usage over the next few months.:bighug::bighug::bighug:
 
JeffJ said:
Leo was toast after his SRT sessions. On the final Friday session I drove until midnite to get the first half of the drive back to Austin. You are basically doing a partial drive of that everyday because of the L.A. SRT location.

Well, it is 5pm Friday. So this is the last SRT day for Rocket. I forecast sleep in your near future, and healing SRT vibes in the next months for Rocket. With luck, he will have a nice steep "down-slope" of insulin usage over the next few months.:bighug::bighug::bighug:
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Well, it’s almost 7 pm here in CA, and we’re home. :) Rocket has pretty much gotten over the anesthesia already, since the last two days they recommended we not give him Gabapentin. So, we’re outside, he’s on his harness, enjoying the sunset and watching some bugs.

Thank you, Jeff. I hope Rocket has a nice (not toooo steep) slope down too. Just steep enough that it’s not too difficult to adjust his dose to changing numbers. I just hope this treatment helps him, that he feels more like his old self, and that we get to spend some good time with him in the months and hopefully years ahead.

I’ll definitely keep this thread updated with news on how Rocket is doing. Thank you to all of you who have gone on this short, but emotional journey with us. :bighug::cat::bighug:
 

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