Newly Diagnosed Cushings Cat

Hi All -

Our darling Majic, an 8 - 10 year old domestic short hair rescue cat, was recently diagnosed with Cushings after Dex, ACTH and Ultrasound tests. It all began back in December when she started peeing outside her box and drinking excessively that we suspected something was wrong and took her in for tests. At first we all believed she was a diabetic and started her on Lantus and TR. However, once I began researching her symptoms more this led us to Cushings as well. She has a pot belly, folded over ears, fragile skin (not too bad), hair that won't grow back quickly, excessive thirst, etc. She had an Ultrasound which confirmed dual enlarged adrenal glands but not tumor. She is currently taking Lantus, 2u twice daily but her BGs consistently read in 220 range morning and evening. Once I got a reading of 90 at 1pm in the middle of the day at 1pm but that seemed to be an anomaly. We've done a curve and then slowly increased her insulin dose but nothing seems to help get her BG's under 200. She was given her first does of Vetoryl (10mg) yesterday once daily and we'll closely monitor her BG's to ensure we've not giving her too much insulin.

I know there aren't of us with a cat with Cushings but any help, comments, observations or guidance would be welcomed and appreciated.

She was also diagnosed with Cholangitis but has almost finished her meds for this and seems to be feeling better, moving around much more and generally looks healthier.

Clinically she seems okay. She eats well, isn't listless, but still pees outside her box from time to time. And, this morning she pooped on a floor in a bathroom.

I understand from reading the forum Acromegaly is more common and has all the similar symptoms of Cushings. Can anyone comment on this?

I have attached a log of her BG's just in case you want to see these. I have not noted every dose of insulin provided to her unless it was a change meaning an increase up to 2u from 1u or 1.25u

Thanks in advance for sharing anything you feel that would helpful for us.

 

Welcome to FDMB.
Some questions:
What are you feeding?
How fast did you do the Lantus dose increases?

 

Hi BJM -

Thanks for the quick response. She's on low carb wet food (FF and Blue Wilderness) less than 7% carbs. Lantus doses increased only after 4 - 5 days. We were following TR protocol but nothing seemed to work which I suspect was because of the underlying problem with Cushings. She may not be diabetic but shows high BG's because of Cushings.

 

Hello Rhea and Majic,
And a very warm welcome to FDMB

I don't have any personal experience of Cushings (or Acromegaly) so can't offer advice. But I did want to welcome you to FDMB and to say that Majic's blood glucose levels look pretty good to me, and you appear to be doing a good job. Well done for hometesting, and for being a proactive caregiver. Majic is very lucky to have you looking after her.

You may well get more responses to your questions if you also post them on the main health forum. The main forum gets more eyes than this forum does (although I see that the eagle-eyed - and very knowledgeable - BJ has already responded to you)

Very best wishes,

Eliz

 

Oh Okay Elizabeth. Thank for the suggestion. I'll post there too.

 

Hi Rhea, and welcome to you and sweet Majic. My Neko has two high dose conditions, acromegaly and IAA (insulin auto antibodies) so she's a type 3 diabetic like Majic. There are a handful of us around with acro-cats, and we've got one other member with a Cushing's cat who posts occasionally. We tend to hang out at the Lantus and Levemir forum and you'll get more answers there. This forum is more of a library for information with no active posters. The Cushing's info is limited, I've found another article that has a better description of Cushing's, specifically the second half of the article. It includes pictures and a description of the tests used to confirm Cushings. There are also tables showing the similarities and differences between Cushing's and acromegaly. Both acrocats and Cushing's kitties can get pot bellies and may need higher doses than type 2 diabetic cats.

Cushing's can be caused by one of three things; overuse of steroids, tumor on the pituitary or tumor on the adrenals. If there was no tumor on Majic's adrenals, does that mean your vet thought the Cushings was caused by a pituitary tumor? That's what causes acromegaly. There have been instances of a cat with both acromegaly and Cushings.

If you want help with dosing, it'd be great if you could put Majic's blood glucose values in the common spreadsheet format that we all use. The instructions are here. Majic's numbers are pretty decent for this early in the game, with most of her numbers under renal threshold. The other Cushing's kitty we have here was on around 10 units, but our favorite saying here is ECID - each cat is different, and that's even more so with the cats with high dose conditions.

 

Thanks Wendy and Niko. We are assuming her Cushings is caused by a pituitary tumor as there is no adrenal mass nor was she ever on steriods.

I think I'm all set with dosing just having a hard time getting the numbers down due to the Cushings. I was specifically looking for experience others had with treating cushings and what they had to do and what to watch out for in dosing insulin. I'm monitoring her very closely so should be fine.

By the way, I feed her EVO 95% and FF not Blue Wilderness.

Thanks again.

 

Pituitary induced Cushings is the more common.

You are still relatively new to the diabetes dance and with insulin on top of Cushing's that just makes things more complicated because it's two hormone systems. There are type two diabetic kitties that aren't doing as well as Majic is doing now. It just takes time to get to regulation. Another saying here is that it's a marathon, not a sprint. The Vetoryl will definitely help. If you do a spreadsheet we may be able to provide more suggestions on dosing.

 

Thanks for the offer. I'm all set with dosing. I was more looking for other cushings experiences.

Thanks again

 

Just based on the log book you posted, I noticed you haven't got many mid cycle tests during the day and I don't see any at night. Lantus is dosed based on the nadir or low point of the cycle. Many cats (including mine) go lower at night so you want to get some tests in then to see how low the dose is taking Majic.

You could try sending a message to @Jeannee and Nuggie whose cat Nuggie also has Cushings (pituitary caused). She just posts periodically. There is also a high dose cat facebook page, but I don't know if they have any Cushing's cats there at this time. It's not a common condition.

 

Hi Rhea - I'm Lu-Ann, and my boy Grayson was an insulin resistant (IAA) Acro kitty. He did very well over the nearly 3 years we treated him, and had all but gone OTJ when he was dx with a large abdominal mass and the equivalent of blood cancer. But that was unrelated to his Acromegaly.

There have been only a handful of Cushings kitties that I'm aware of... in fact, I once mentioned them to my vet, and she said she thought that Cushing's kitties were an anomaly! It appears you're doing a great job managing Majic. I will see if I can round up someone that had a Cushing's kitty to offer you some advice. In the meantime, keep up the good work!

Lu-Ann

 

Rhea, where are you located? US/Canada? Europe? Other?

The Royal Veterinary College (RVC) in London recently posted a follow up on Cedric, a Cushing's kitty there. If you're on Facebook, do a search for "Feline Diabetes Remission Clinic" and search for Cedric's story. They are pretty much the leader in treating ... but certainly worth inquiring regardless of where you are.

I've also PM'ed a friend that had a Cushing's kitty. Not sure if she's a member here, but hoping she'll have a chance to pop in & help.

 

Just checked my log... looks like about 15 kitties dx w/ Cushings I'm aware of.

• Cheryl's Witty (Whiskers) (2011) was on trilostan 10mg BID.
• Johanna & Matt's Loki had surgery at VCA in Los Angeles. OTJ after a month.
• Lisa's Miss Murphy had steroid inhaler induced (Iotrogenic) Cushing's (2009)
• Robin's Neko was also Iotrogenic Cushings. There was a lot of other things going on, healthwise that played a big role.
• Sarah B's Casey was on Vetoryl. (2011-2013)
• Pattie & Sophia (foster) 2014

The rest were just names, no further data. Not sure if you'll find them here in the early Acro/Cushings forum, or if they came from other groups. (I don't think Catacro message board was transferred over when FDMB updated... I think that data is probably lost). I've been around a little over 3 yrs; Pattie's short-term foster and Robin's were the only Cushing's kitty that I was familiar with, and briefly Sing Jai.
Here are the other names, in case someone is still in touch with them and can reach out:

• Winnie & Sing Jai 2010-2013
• Will & Shishi 2010
• Trish & Putter 2010-2011
• Tammy & Mika 2008
• Mari & Punky 2009
• Linda & Bear Man 2008
• Diana & Casey 2008
• Ashley & Tigger 2010
• Amy D & Pedro 2010

 

Hi all -

Just a short note to let you all know Magik died peacefully after a short run with us trying to manage her Cushings. She handled the Veteroyl well and I even managed to get her BG's under control at readings between 70 - 170 regularly. In the end, the skin on her back broke open and could not be sewn up because the remaining skin around the open wound was also too thin. The vet euthanized her right there rather than us bringing her home in a full back bandage that wrapped around her entire belly. She would have had to be sedated and we felt that was not a life we wanted her to live. She went to sleep peacefully being cradled in my arms and my son's arms in a quiet room at the vet hospital.

She was dearly loved and we miss her every day. However, I was very proud we were able to make the decision for her. We must be the voice for our animals at the end of their lives and avoid suffering and fear whenever possible.

Magik will always be in our hearts. Boo, her trusted companion, misses her very much too.

 

Rhea

Cushing's is such a terrible disease and I know that you did everything you could to fight the effects. I am very aware of what a heartbreaking disease this is.

You gave Magik love and a happy life; you gave her the best treatments to allow her to have a good quality and then you gave her the greatest gift of all...freedom from pain. The greatest act of love is for us to allow our furbaby to be free of pain and be able to leave with dignity.

I know the loss will never be forgotten but in time the happy memories help take the sharp edge off. Scritches to Boo and many to you and your family.

 

Mary Ann - you are a doll. Thank you for the kind words.

Hang in there.

 

I'm sorry I'm so late in seeing this Rhea. Sorry you had to make that difficult decision, but, just like with Grayson, it truly was the only decision at that time. Like Magik, Grayson started experiencing tearing at the end. Not sure if it was from the Prednisolone, the chemo drug Hydroxyurea, the combination, or something else. There's a condition that's called Fragile Skin Syndrome... my guess is that any one or more could've been the issue at the time. Understanding that is the point of no return, we can only make that one decision. So terribly sorry for your loss of Magik. Hugs to you and Boo. Peace. May you find comfort in knowing that Magik is in good company with all our special kitty friends from here, including my special boy Grayson. <3

 

Rhea, I'm so sorry to hear about Magik. We love our little ones so much, and some of them really got a bad deal with the health problems. Cushing's is a tough one.

I have no doubt that Magik knew you loved her and was glad you were there with her til the end. Fly free little one and land softly.

 

Requiem aeternum, Magik.
{{hugs}}

 

Hugs to you Rhea. I am so sorry it was Magik's time. You did a lot for her and I'm sure knew it.

Fly free little one.