SRT to treat Acromegaly - Punkin 9/2011 & CSU presentation

Punkin's on his way to Colorado State University for SRT

Punkin's 1st Day at CSU, CT scan, MRI, Anesthesia Plan

Punkin's 2nd Day at CSU, Echocardiogram, radiation

Punkin's 3rd Day at CSU, Radiation

Punkin's 4th/Last Day at CSU, Radiation

Comments from CSU, Google Doc with photos

SRT comments

We stayed at the Marriott on Horsetooth Rd - nice and close to the Veterinary Hospital, maybe a 10-15min drive. They gave us a CSU discounted rate of $84/night and we were in a "pet-friendly" room on the ground floor with a sliding door and grass/trees outside. Refrigerator & free wired internet (so only 1 computer at a time) was included. Staff couldn't have been better.

I'll post some more pictures, although there are punkin-specific ones in his condos.

i'd be glad to answer questions if anyone has them.

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

for others considering the treatment at CSU - our final cost ended up being $3,540. Not sure why it was less than the estimate of $4,000-5,000, unless it was because we did $600 worth of blood & urine tests before we left home to make sure punkin's kidneys and the rest of him were in good enough shape to be "worth" doing.

we did find his left ventricle was slightly enlarged, enough to say he doesn't have 100% heart functioning, but not enough to be a problem. he has some enlargement to the density of his skull, also not a problem. the visible signs we could see included enlarged tongue, feet, stools, and he has respiratory stridor (rattling while he breathes from excess tissue in his esophagus.)

the echocardiogram and MRI were covered by CSU as part of another study they are doing on acro kitties. the SRT was no longer being done as a study, it was now considered a treatment and charged at full cost.

our costs at home that i used as a comparison
...terumo syringes 100 syringes @$20.48 http://www.medi-vet.com
........+ 7.99 shipping = $28.47 (2/day =50 days =$0.57 per day cost
...Freestyle Lite Test Strips 4 boxes of 50 @ 30.79 http://www.americandiabeteswholesale.com
...Freestyle Lancets 2 boxes of 100 @ $9.95
.......$143.06 for 200 tests, mrrebates.com gives 8% rebate on ADW purchases so net cost = $131.61
........ i test 5 times a day minimum so this is a 40 day supply = $3.29 per day for strips & lancets
...Lantus bought locally from drug store, $114 for vial which currently lasts 30 days = $3.80 per day

total = $7.66 per day for treatment at 15.5 units
```syringes $.57
```test strips & lancets $3.29
```Lantus $3.80

it would take 462.14 days, or 15 months, at $7.66 to be equivalent to the $3540 cost of SRT at CSU. of course, if untreated, one would expect the dose would likely increase, which would shorten the number of days to become equivalent. there would also be additional tests to check on health during those 462 days.

for example, if the lantus dose was at 31 units and all other factors remained the same, the per day cost would be $11.46, making an equalization of costs at 308 days, or 10 months.

there are costs that continue after the SRT, just at a lesser rate - that is very individual so hard to predict for a particular cat. if they go off of insulin, the costs is eliminated. if they continue at a lesser dose, some costs continue, some decrease.

Dr. Lunn at CSU told me the expected lifespan of an acromegalic cat is 18 months - 3 years after diagnosis if the tumor isn't treated.

To reach the College of Veterinary Medicine Teaching Hospital:
300 West Drake Road
Fort Collins, CO 80523
970-297-5000

Drs Lunn & Timian are experts on acromegaly
Drs. LaRue & Griffin are experts on radiation oncology

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

How exciting! I sometimes wish it was something I could do for Charlie. I truly hope that you and Punkin see the same great results that most of the other srt kitties have seen! Scritches to Punkin!

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

thanks claudia! i know it's not right for everyone, but i hope it will help punkin - i sure went back and forth on it. time will tell.

i appreciate your encouragement!

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

Julie, I haven't been on the board in months, so I had no idea you were doing this for Punkin. How fantastic. Thank you so much for the detailed posts about how it all went and how you finally came to the decision monetarily to do it. It's been good reading while I've been up trying to get Guinness off of the floor with his 43 at +5.5. It's the first time he's gone so low since being diagnosed as an Acro Kitty.

I'm so happy for you and Punkin. Sending all sorts of good wishes your way!

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

hi linda! i included all the costs because it is expensive - the cost was the main reason i initially ruled out doing SRT. didn't really even consider it. but when you compare it to the overall daily cost, well it changed the picture for me. pay for it all up front or pay over time . . . it becomes 6 of one and a half dozen of the other.

you might add some karo to an entire can of the high carb food - the shed that our acro cats have from such high doses is a mighty force to try to counteract.

 

Re: Another SRT Story to treat Acromegaly - Punkin 9/2011

The 4th year vet student that worked with punkin did a presentation last week about feline acromegaly to the CSU veterinary school. They weren't able to get it taped, but he did send me the powerpoint slides to post here. At least one class of veterinary students from there is being trained about acromegaly!

Here is the presentation. We had to break it into 3 pdfs to be able to upload it here.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=54035

 

Re: SRT to treat Acromegaly - Punkin 9/2011 & CSU presentat

we're at 6 weeks post-SRT now and punkin's showing some signs of responding to the SRT treatment.

Thoughts about dose reductions in acro or high dose cat

i know every cat's situation is going to be different, but on the off chance that this will be helpful to someone else post-SRT, the post above describes the tactic that i'm using in reducing his dose.

 

Re: SRT to treat Acromegaly - Punkin 9/2011 & CSU presentat

thanks for sharing all of this great information, Julie. You are so detailed in your descriptions, and I know it will help someone in the future.

 

Re: SRT to treat Acromegaly - Punkin 9/2011 & CSU presentat

*tagging this so i can get back to it easier* (sorry lolz)

I really wish Coco could go through this. Id do it in a heart beat. So happy for Punkin :3

 

Re: SRT to treat Acromegaly - Punkin 9/2011 & CSU presentat

JUlie for some reason, my PM in response to your PM to me won't go through. Gee, I wonder why.
Here it is:

HI JUlie- sorry I rarely check these boards so I didn'tmean to seem like I was ignoring you!!! And I'm even worse at updating my SS!! Sorry!!

Snuggles is doing pretty good, he was at 11u Lantus BID & 4u Regular Insulin BID w/ numbers still in the high 400-500's. On October 4th, 2 months to the day after the last radiation session he dropped to 4u BID overnight. He held steady there for 3 months now then all of the sudden on Jan 1st we dropped to 2.5 & now we are at 2.0 BID with BG's ranging 90-130, but mostly flatlining in the 90's.

However ever since the BG's went within normal range the past 2 weeks he has been kinda blah, not eating much. I took him in for bloodwork last week & he has a low thyroid at .6 however, preSRT he was below .4 so Dr Lunn has suggested putting him on Thyroid supplement. Low thyroid is a possible side effect of SRT as Im sure you know, but it seems Snuggles was low to begin with.

His kidneys seem a bit better too. Creatinine was 2.8 when I went in now it's 2.4 It's possible the thyroid medicine will help that too.
Very interesting to me too is that Snuggles CK levels -muscle enzymes were super high at 1600 pre SRT now they are at 273, well within normal range. That would fit in with the active Acro growth.

Besides the last 2 weeks he has been so much perkier & happier overall, even my husband said the old Snuggles is back! He really shrunk alot. And most of all his Breathing is like 90% better, we can actually see how much the soft tissue has deflated in his throat with our own eyes and his breathing doesn't keep me up at night like it was. Plus I actualIy hear a slight grunty purr now, it seems he had lost the ability to purr and his high pitched meow is back, it was raspy for a while there, probably from constriction.

I am so glad I did the SRT. His IGF was 162 when I went in. I just sent the latest IGF sample to Dr Lunn for testing so I'll let you know what that shows. I have some pictures of the actual procedure being done that Dr Lunn took, plus MRI pics etc.

I'm glad your Punkin is improving & I'm sure you will have a sudden insulin drop coming soon!! I was testing 10x a day for a while there.. I'm debating at whether I should be a bit more aggressive w/ my dosing to keep him well under 100 but he's stable now and I'm happy with that, plus it is less stress on me!!

 

Thanks for sharing all these information. Its a great help.

 

It already has helped, Libby! I can't tell you how many of us took our kitties for SRT because (in part) of Julie & Pumpkin's experience!

 

Hi Julie! Has anyone else confirmed this as well? Makes me a bit anxious to read this, however everyone over at L&LL seem to be pretty confident that there is no rush with Miss Meows. Just wondering if there is any new news on the matter.

 

Hi Gabrielle, I'm sure this is going to vary cat by cat, depending on everything else going on with the kitty. Punkin and Tommy were diagnosed within a month of each other. Punkin was 12 at diagnosis (IGF-1 281), Tommy was 16 (IGF-1 300+ - I don't remember exactly).

Punkin was treated by SRT 9 months after becoming diabetic and passed away after being diabetic for 2.5 years - not from acromegaly, but most likely from cancer accelerated by use of cold laser for his arthritis (that would've been caused by the acromegaly.)

Tommy lived 4 years after his diabetes diagnosis and Lauren treated him only with insulin - she kept him Tightly Regulated, which probably minimized some of the damage that comes from high blood sugar. He died at age 20, which is amazing no matter how you look at it!

For Miss Meows, I would say there's no rush, meaning that you don't have to decide this week what you're going to do. But if you think you may want to have her treated, sooner is better than later, in my opinion.

The latest research is being added to this thread - which is located in Lantus/Lev Land in the New to the Group?" sticky. Near the bottom there is a collection of single topic posts.

 

Thank you, Julie! The pieces are slowly staring to fit together now I'll be sure to check out that link you recommended and try to get a decision sooner rather than later like you suggested. Thanks so much!

 

You're super welcome! The good news is that there is a wealth of experience - both people who chose to treat and those who only used insulin - that you can consider as you move ahead.