Cleo on cabergoline

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Cleocatra, Mar 26, 2020.

  1. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Day 3 on cabergoline. I've only given her 2 doses (75mcg capsules) the last 2 mornings. It has seemed to slow her down, make her more irritable when messing around w/ her hind legs so I think she's hurting more today. I have not given her the dose of cabergoline for today yet. I gave her a dose of gabapentin this morning because I think she's hurting, so it will be easier to give the caber later on this morning.
    No apparent GI upset so far. She's still eating, pooping and peeing as usual but she's dragging her butt in the litter the last 2 days because of the neuropathy.
    Any thoughts on the initial effects of caber?
    --Gave her the caber 75mcg dose.
     
    Last edited: Mar 26, 2020
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  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Are you doing any blood sugar testing at all? I don't see anything on the spreadsheet. It can take 7-10 days for cebergoline to impact the numbers, but when it does, it can be significant.

    I have no personal experience with cabergoline, but if there are impacts, it seems to be on the appetite.
     
  3. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    I have to do a good curve this weekend and send to the Dr. So does the appetite reduce? I would think it would if it brings down the IGF #.
    I need to do some spot checks tonight and into the weekend.
    Thanks.
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    The appetite will reduce when her numbers come down. I don't know what I can do to stress the importance of testing, even more so with cabergoline in the picture. Take a look at Marvin's spreadsheet. Starting end of June 2017 is when cabergoline was started. Marvin was on 8 units, spreadsheet didn't look much different than Cleo's other than having more data. End of week 2 they were down to 6 units, down to 1.5 units the following week. If Nat hadn't been testing, Marvin would have been way overdosed and probably hypoed.

    Cabergoline does not reduce the IGF-1, it impacts the growth hormone, which IMHO is the worse of the two.

    How much experience does your vet have with acrocats on cabergoline?
     
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  5. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Just tested- 472 :( . they have a dr. that does the SRT,

    Ok- I thought the IGF-1 was the growth hormone.

    wow- 1 week and he came down, what, 50%+? That's pretty dramatic. I can only hope Cleo responds like this- she's just been so high for so long.
    Do you think the Alphatrak2 is showing inflated readings?
     
    Last edited: Apr 2, 2020 at 3:27 PM
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Glad you vet is easy to work with, but I wouldn't take dosing/testing advice from her.

    Growth hormone is produced in the pituitary - it triggers insulin growth factor -1 to be produced. So you've got both things going on.

    Yes, the Alphatrak will read higher than human meters, though they get closer to human meters as the numbers get lower. Since our dosing methods were written using human meters, and their test strips are cheaper, most people use human meters. Also easier to get the strips when you need them.

    Marvin's reaction was probably the strongest of any we've seen. Some take longer. Here is Tiffany's spreadsheet. They numbers are using the AT. She started cabergoline on 9/20. Marvin and Tiffany were of the lucky 2 that went off of insulin. Most of the others did see a good drop in dose.
     
  7. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Are you giving zobaline to help with the neuropathy?
     
  8. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    yes, she's getting 1 tablet of Zobaline every night. Her BG#'s are still too high. Today: 565 451 546 502. She's had 6 doses of cabergoline since last Tuesday.
     
  9. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Oct 20, 2019
    @Cleocatra

    Cleo is taking capsules of cabergoline? Is this how cabergoline is usually administered? Was the cabergoline specially compounded for Cleo?

    Just curious...
     
  10. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    yes capsules. 75 mcg compounded at Wedgewood Pharmacy in New Jersey. I think it comes in a liquid form too. $100 for 30 caps.
    So she's had 13 doses. On Friday, we noticed the ravenous hunger had subsided. She wasn't eating like she was starving first thing morning. Calmer and not always begging for food, and food intake has reduced a little.
    I pill her after she eats at 7am. I haven't noticed any stomach upset...until this morning- I pushed the pill toward the back of her tongue and hold her mouth shut until she swallows...only she must've bit it open, but I let her chase it w/ more food. 5 minutes later she threw it all up!!! This is the first time she's done that. So I need to get it to more to the back of her mouth otherwise if she bites it open, it will upset the the tumtum. Just a word to the wise.
    We are also on 2U 2xday of Prozinc. Vet told me not to test until next weekend. She doesn't think daily testing is necessary. But on the lower dose of Pz, I think we'll be ok if all of a sudden her BG#s drop from the cabergoline taking affect.
    -Freckles' #'s look pretty good. I wish Cleo would hit some yellows and blues.
     
  11. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Ok. Good to know about the cabergoline. I'm still trying to connect with an IM vet to see about giving it to Freckles. I read something on this site about dry pilling a cat could do damage to them. I'm glad to see that you are giving food/water with the pill.

    I would be scared shitless shooting insulin blind even though Freckles has only had 1 low PS number.... it only takes once. There was a CG that just posted a couple of days ago that the new owner of the cat gave a dose that was higher than what the cat actually required. It's too bad the new owner didn't connect to people on this site. The kitty didn't make it. cat_wings>o

    Even with Freckles having higher numbers, I always feel that I'm gathering good data to see some trends. My vet initially told me that I don't need to test regularly but only once/month. In my head I thought "Are you out of your mind? Would you give a child an insulin shot without testing first?" Looking at some other SS on this forum, I'm so glad that people test.

    We are using a different glucometer than you though too. When we used the Alphatrak, we had pinks and reds (See 2019 top of SS). Since the numbers on this forum are calibrated to human glucometer, plus the Alphatrak strips were way too expensive to test frequently, we switched to Freestyle Lite glucometer.
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Because of the possible narrowing of the pharynx in an acrocat, I think liquid formulation is better that capsules, if you have that option.
    Your vet is just wrong. She has no experience with cabergoline and what it can do. Two weeks after starting is often when it can make a significant difference in the dose. Judy gave you one example, but we've had countless numbers of caregivers come here, we convince them to test, and they find their cat in dangerously low numbers.

    Cleo could hit yellows and blues, if you tested enough to increase to a good dose.
     
  13. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    No, I hear you loud and clear. I understand pretty much everything about the cause/effects here. I think I'll take a couple of tests in the next couple days since she's showing a change in appetite and behavior. I don't need to tell the vet I'm doing it, right?!! thks
     
  14. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Chris, you can get suspension cabergoline from Wedgewood. Many flavors to choose from. Ollie loves the bacon/marshmallow flavor.

    I guess I missed quite a few posts. When you changed to Prozinc why such a lower dose?
     
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  15. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    I might look at going w/ the liquid caber. The pill is a real challenge every morning. I don't like getting clawed, either. I talked to Dr. Stiller about maybe switching insulins and she thought PZ was worth a try. It is also a slow acting insulin. She didn't tell me why she went down to 2U, maybe to not to start too high w/ an insulin that might have a stronger effect?? IDK.... But she didn't want me to test for a week and I think that's not safe. So I will do a few random tests until I do a full day curve. Something's happening tho, cuz kitty is behaving differently. Less aggressive appetites, wants to go outside w/ me for coffee on patio in the morning, wants lap time on the couch at night, is very alert and happy (as long as I don't mess w/ her back side too much) and just not as edgy. She still has the neuropathy which I feel bad for her, especially when I have to do a butt bath.
     
  16. Olive & Paula

    Olive & Paula Well-Known Member

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    Are you giving Zobaline for neuropathy? It helps with the nerve pain. I used it in the beginning and it helped Ollie's legs. Then when she went on gabapentin I stopped it, then the bupre thinking those would help more. Couldn't brush or touch her back. Lately the legs appear shakey. I started the zobaline back up and I can brush her and legs less shakey. She doesn't seem to have as much nerve pain now.
     
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  17. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Yes I'm giving her the zobaline every night. We need to get that BG# down that's causing the neurop.
     
  18. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Oct 20, 2019
    Good for you Chris. Testing is soooo important. It just boggles my mind why a vet would tell the client not to test... It's up to you if you tell your vet.

    When I had the frank discussion with my vet I asked if I didn't test, what if Freckles went low? His reply was, "You'll notice because she'll start wobbling around and look all spaced out." I'm sure my jaw hit the floor because after my reaction, my vet said that I could test if I wanted. Why would a CG allow their cat to get to the "wobbly/spaced out" state when a simple glucose test could catch a dropping number much earlier and keep the cat out of harm's way.

    I blatantly told my vet that I was testing... end of story.
     
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  19. Olive & Paula

    Olive & Paula Well-Known Member

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    With my first cat I was told if he has a seizure bring him in. I asked what if it's after hours or a weekend, I was told go to ER. I asked don't we want to prevent seizures? Why can't I test at home like my mother tests her own sugar? He said if you go that far, its okay. I didn't know of this place at that time.
     
  20. Judy and Freckles

    Judy and Freckles Well-Known Member

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    :eek::eek:
     
  21. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Prozinc does not have a stronger effect. Typically when people switch from Prozinc to Lantus or Levemir (hardly anyone goes the other way), we suggest the same dose to start.

    Good to hear Cleo seems to feel better. I wonder if the Lantus sting was bothering her. The acid base of Lantus can impact cats at higher doses and we often hear of cats changing behaviours with an insulin change.
     
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  22. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    yes her behavior is better, not so hungry, but she still gets pissed off when I'm trying to test and she still wants to eat. I still think she needs a higher dosage NOW. Last 2 tests were around the 500 mark. I don't like seeing the neuropathy and I think the hi BG is a direct driver to that. Why do I have to wait so long to ramp up if her BG#s are already so high?
     

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