New Acro Kitty

Hi all,

I thought I'd introduce myself (Debbie) and my cat (Cindy). Cindy was diagnosed yesterday with acromegaly.

A bit about Cindy...

In 2008 she started having grand mal seizures. After a lot of testing, she was diagnosed with cryptogenic epilepsy. This means that the neurologist believed that there were changes in her brain but couldn't find a tumor. This is slightly different from idiopathic epilepsy where they don't see any changes in the brain.

April of this year she was diagnosed with diabetes. She was started on Lantus. In May she started having problems with her eyes. For some unknown reason, both eyes became entropian. The opthamlolgist had us try a variety of ointments all with no effect. Cindy was in a lot of pain. Eventually, our regular vet put her on prenisone eye drops to reduce the level of pain she was in. The opthamologist didn't want to do surgery until the diabetes was regulated. We eventually got her to change her mind and Cindy had the eye surgery in August.

Another problem Cindy has is that since her diabetes was diagnosed, and maybe a little before, every 28-32 days she has a bout of vomiting and inappetence. Since she was going under for the eye surgery, we opted to have an ultrasound done to see if anything else might be causing these bouts. During that procedure, they noticed possible thickening of the small intestine and a slight enlargement of her left ventrical.

After the eye surgery, and the stoppage of the prednisone, we were hoping to see a change in her blood glucose but no go. So after going up to 7 units of Lantus, the internal medicine vet recommended we change to ProZinc in the hopes that the change would make a difference. We are up to 4 units of ProZinc now with no noticable change in her numbers.

Cindy needed to have her heart re-checked for changes so a week ago Thursday, we brought her back to the specialists for an echocardiogram and ultrasound. The cardiologist diagnosed her with restrictive cardiomyopathy and she is now on asprin every three days and enalapril daily. Further, the internist diagnosed her with potential IBD as the more of the small intenstine appears thickened. The ultrasound also showed possible pancreatitis so she was tested and it was confirmed.

I also had her tested for acromegaly. Much to the vet's surprise, the results came back positive (369). So, based on what I've read in the various posts, Cindy will be starting on Levemir soon. The internist has not used it before so he wants to research it more before he gives me a prescription. He also mentioned something called CyberKnife as a potential option for removal of the pituitary. Has anyone had any experience with it?

Looking at everything that has happened to Cindy over the past few years, it seems that she may have had a tumor actually starting in her brain that caused the epilepsy. She clearly has a tumor on her pituitary now so they may or may not be the same. The acromegaly may be causing her skull to increase in size but not her eyes, so as the skull grew, the eyelashes turned inwards. The heart condition can also be caused by the acromegaly. I don't know that all of these are actually related but it kind of feels like they are...

Anyway, I'll be doing a lot of research over the next few days/weeks but if anyone has anything that I need to know asap, I'd be happy to hear of it.

Thanks in advance!

 

Hi Debbie.

I'm sorry about the diagnosis. It sounds like Cindy's acro is causing all sorts of problems for her.

Dr. Kathy Lunn @ Colorado State University appears to be doing the most acro research in the US. She, and the radiologist Dr. LaRue, do stereotactic radiation surgery, which is a very highly targeted radiation. It allows the kitty to receive massive, but pinpointed, amounts of radiation to the pituitary. The cost is very similar to regular radiation, but is significantly less stressful on the cat. CSU is the only vet hospital that has this machine. I don't know, but I suspect this is the "cyber knife" the vet is thinking of.

Dr. Lunn is also currently doing a drug trial. It's not a long-term solution, but it could very possibly help for the duration of the trial. Dr. Lunn is a very kind lady - I'm sure that either you or your vet could contact her and discuss options.

Recently, in California, someone had an actual surgery to remove the tumor.

The "What we Know" sticky has lots of good information, so you might want to start there.

 

Hi again Debbie,
Like Heather said, the current preferred surgery is Dr. Lunn's. I have not had that done for Leo, so I'll leave the details up to those who have had it done on their cats.

I hope your vet will find the information he is looking for on the VIN. Ultilmately this is your cat and if you want to try Levemir, I don't see why he wouldn't just write the prescription. It is very similar to Lantus as you know, but most of us with high dose cats find it vastly preferable with its gentler action and possible longer duration. As far as looking for that perfect dose, there's no way to predict what dose she needs to stabilize. We have had cats go as high as 62u BID, and other cats never top 10u. The important thing is to give her the insulin she needs until you see those numbers coming down. My Leo went all the way to 40u BID. He is now a happy 18.5u cat.

I have a cardio kitty as well, who is also on the enalapril/aspirin therapy. I find enalapril to possibly contribute to constipation issues with Leo. What I have done is incorporate Miralax into his diet. As time has gone by, I have found I have needed to increase that dose, as his constipation flareups have gotten more frequent. Miralax is a form of laxative that doesn't make them go, it just keeps things more hydrated in the colon to make it easier to go. I give Leo 1/2tsp BID, but the recommended starting dose for cats is 1/8tsp. You can work that dose up and down if the stool gets too loose or too firm. This is not something that builds up in the system, and as few as 2 missed doses in Leo can bring on the constipation again. Miralax is OTC, in the human pharmacy, and mixes quite neatly into food. I always water down his food anyway, but I make sure to do it when there's miralax present, as it carries water into the colon.

The vomiting and inappetance may also be pancreatitis, this is something to keep an eye on with any diabetic, even an acro. It's tough to diagnose, and requires bloodwork and sometimes an ultrasound to back it up. If it's suspected, you can try pain meds, pepcid ac (famotodine), and fluids (with Leo's HCM, I am restricted to 50cc per day) and see if they aid her at all.

Hope this helps somewhat! Welcome to our family
..Carolyn