Hi everyone, Results are in for Shmee's IGF-1 test. I just posted in the Lantus forum but I figured I should post here too. I am heartbroken. I have read over the Acro stickies and I do not see remission mentioned anywhere..... are his odds completely zero now? I feel numb. And my poor Shmee.... I think this is the worst feeling I have ever felt. Email from vet (I am taking her words with a grain of salt. I would love to hear from the acro experts here): "I have full results back from MSU, they are attached. The IGF-1 value is very elevated, so Shmee does have acromegaly. Acromegaly is caused by a (normally benign) tumor on the pituitary gland that causes the pituitary to secrete excessive growth hormone. From what I have researched, diabetic cats with acromegaly cannot go into remission unless the acromegaly is treated. That being said, most cats with acromegaly do not respond to insulin and Shmee is, although at a fairly high dose, so it's possible that the acromegaly is not making him insulin resistant (the endocrinologist said not all acromegaly cats are insulin resistant). The only real treatment for acromegaly is to have the pituitary tumor surgically removed. This procedure is not offered many places. The Royal Veterinary College in London is the hospital that perfected the surgery. From what I can find, Washington State's Veterinary School is also doing the procedure with good success. There is a medication, Pasireotide, that can be used to suppress the pituitary tumor's secretion of growth hormone. It is not always successful, it has side effects (mainly stomach upset) and there seems to be issues getting it in the US. It is also very expensive. I couldn't find costs for US but I found someone who said it's about $2000 GBP (which is ~$2600 US) a year. Cats on the medication don't normally go into remission, it just makes it more likely they will respond to insulin. So for Shmee, since he is responding to insulin, you are most likely looking at keeping him regulated vs achieving remission, although since he's responding to insulin there is a chance the acromegaly isn't affecting his sensitivity to insulin. Based on his BG chart I'm guessing he will need 5.5 - 6 units twice a day to maintain a good regulation." MSU results attached.