Acromegaly Diagnosis

at long last, the bloods were sent out and results received and vet met with Berkeley and me tonight.

This past week since Berk came home from the last stay at the vet, has been strange. Her Blood glucose readings have been the best (actually hit several yellows and today a 169 with a retest of 185 or vice versa). But she has started pudding to liquid stools again, and seemed to have some pain in the belly. I also perceived that there was less urine at one sitting and also less bolting of food. But she also started to get fussier about what she would eat.

End result tonight, she was dehydrated. lost a few ounces but otherwise alert. She is now on Fortiflora and what ever non-carb canned food (DM, EN or FF) that she will deign to ingest. She is also on amoxicillin for the pancreatitis.

Her lab works showed chronic pancreatitis, negative for insulin resistance and high positive for acro. Not that is meant that much to me, but vet was pointing out she was 350 value-way out of line.

Both Berk's vet and the others in the office were pretty amazed about the acro diagnosis, declaring it "unusual". I know they finally sent the bloods out to "humor" me and this is a new ball game for them. She is having a conference call, (whatever) with the Michigan Doc to learn about acro and hear what their recommendations are. She is not that comfortable with leaping ahead with higher dosages so I am to monitor and increase doses weekly, with checking in her with her every week before the dose increase.

Just to end the night on a lousy note, I was rushing to get home from vet, wait for Berk to relax (so no vomit),test and then give insulin and food , within 1/2 to be in schedule. So, not sure how, but as I withdrew needle I see a little bead of clear fluid roll down her coat and in addition, there was still some insulin in the needle. Thought a bit and rejabbed her with the remaining fluid but have no idea how much was lost. But she did eat well tonight and ate the fortiflora.

 

How is Berk's weight doing?
I would keep increasing the does and you said and see what happens.
My MurrFee is doing pretty good on 13 units Levemir 2X daily

 

Facebook Acromegaly pages

There appear to be about 4:
https://www.facebook.com/groups/acromegaly/
https://www.facebook.com/groups/68039236605/
https://www.facebook.com/pages/Feline-Acromegaly/182581725165745
https://www.facebook.com/groups/200919730033567/

 

Hi BJM-when I click on the facebook links I get told I need an account to enter?

About time to get new insulin bottle (have lantus)-advice as to levemir versus lantus for acro?

Has anyone had surgery to remove pituitary?

Read heer about Redbank NJ and Yonkers NY for the stereo xrays treatment (Well, that was last night, so I hope I am recalling the locations for the NE correctly)

 

I believe Neko of Wendy & Neko had the SRT done. I'll drop a link to this thread in the Lantus ISG. There are quite a few people who have or are dealing with acro cats.

 

Hello there - sorry to hear about the acromegaly diagnosis, but now that you have a diagnosis you can figure out how to proceed. Berkeley is still the same sweet kitty she was before the diagnosis. Make sure you give her a great big hug from us and some scritches. :YMHUG:

Alexis posted over on the Lantus TR forum - as that's where the people with acrocats tend to hang out on a day to day basis here. There is a Acro/IAA Forum here that has lots of information, but not much action. People have used the Tight Regulation protocol for acrocats before. You do want to be aggressive to get ahead of the resistance from the acro tumor. It's great you saw some blues yesterday - sorry about the bounce today. :roll: But the more time under renal threshold the better. She will feel better as you have noticed.

I took Neko to Fort Collins, Colorado and CSU for stereostatic radiation therapy (SRT) almost two years ago now. These same procedure is available at Yonkers and at RedBank. If you read the Acro/IAA Forum, someone there posted her experiences at RedBank recently, cat name of Lily. SRT radiates the tumor and neuters the tumor cells. Surgery was done in early days to remove the tumor, but in cat's it's such an itty bitty thing that the radiation therapy is the more current treatment. If you are up for more reading, read this post here. There are articles listed that describe treatment options and just to give you general information about acromegaly.

Acromegaly is more common that vets previously thought. One of the research papers in that post says that up to 30% of harder to regulate cats have acromegaly. My vet was like yours and humored me on the blood tests. One vet there (not my regular one), called them exotic tests. Since the positive results my vet has since diagnosed acromegaly in a second cat at her clinic. Neko's IGF-1 number was 440. There is no correlation between the number and the size of the tumor.

As for insulin, there are both Lantus and Levemir acrocats. I started out on Lantus and switched to Levemir last year, but not until her dose came back down to small doses again. Some people find that large doses of Lantus can sting and cats object to it, because of it's acid base. Neko was fine with Lantus. For some cats, Levemir smooths out the numbers and gives flatter cycles (it did for us). The only thing is that you have to deal with a later nadir. Neko's Lev nadir is typically +9 to +12.

We also have a good Primer on Pancreatitis. I know, more reading. :lol:

Please keep asking questions - there are a number of us around who know what you are going through. :YMHUG:

 

Hi! My punkin also had acromegaly - i'm sorry for the diagnosis, but want to reassure you that you aren't alone. Many of us have gone through this and will be glad to help you.

Punkin had the SRT done at Fort Collins, Colorado too. His IGF-1 was 281, so not quite as high as Berk's but high enough. Basically you want to give as much insulin as it takes to bring down her BGs into healthy numbers. Punkin got up to 15.5u before we had the SRT done, then he came down in dose but didn't go off of insulin. Punkin passed away a year ago, but not from the acromegaly or diabetes. We think he likely had cancer.

There are some complications that cats with acro can have - arthritis and enlarged organs are two that are common. Many of us give pain relievers to address the arthritis.

As you get into larger doses, larger dose increases can be appropriate - you'll want to watch Berk's responses and tailor what you do to what works for her. Just like any diabetic cat, you want to get enough spot checks in so that you know how low a particular dose is getting Berk.

Hang in there! Keep asking questions and we'll be happy to help you. I'd like to invite you to post on the Lantus/Lev Tight Regulation support group. Several of us there have been through the same thing you're going through and we'll be glad to help you figure out how to proceed. Most vets don't have much experience with high dose cats, but we can help steer you.

 

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Hi Barb,

My cat Lily is the one who had stereotactic radiation treatment at Red Bank Veterinary Hospital in New Jersey back in January of this year. At her highest dose Lily was getting 54u of Lantus twice a day and seeing blood glucose levels mostly in the 300-600 range, now five months later she is getting 15u of Lantus twice daily and seeing BG levels in the 100s.

Please do let me know if there is anything else I can tell you about my experience at Red Bank, if you are considering radiation. I have copies of Lily's paperwork from Red Bank uploaded on google docs and would be happy to share that information with you. We had a really positive experience all around-- even from before we had our in person consultation and our doctor, Dr. Dustin Lewis, spoke with us at length on the phone answering all of our questions and sharing all of his knowledge with us. I'm thankful each day that we found out about stereotactic radiation for treating feline acromegaly and our decision to pursue treatment at Red Bank. Dr. Lewis did his residency at Colorado State University (CSU) where some of the other folks went for treatment, so the fact that he came the east coast and brought his knowledge and experience from CSU really opens up the opportunity for those east coasters contemplating treatment. The Animal Specialty Center in Yonkers offers similar treatment too, which we also researched, but we chose to pursue Lily's stereotactic radiation treatment at Red Bank.

Also, based on what you were saying about dehydration and pancreatitis-- if you don't do so already, try adding water to Berk's wet food. Some cats will let you saturate their food until it's like soup, while others will make you be more conservative and sneak a couple of teaspoons of water into their food. I find myself doing this to be proactive. Of course for a pancreatitis flare up you would want to administer subq fluids, Pepcid AC, and possibly appetite stimulants and some of the other courses of treatment listed in the pancreatitis primer.

I hope Berk is doing well and please don't hesitate to contact me with any questions or just to talk. I was so scared and sick to my stomach when I found out that Lily had acromegaly back in November of 2013, but it can be managed and treated with quite a great deal of success.

Best,

Jessica