Testing for acromegaly et al

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Sean & Rufus, Feb 4, 2018.

  1. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Hello-

    Just curious at what length of time after diagnosis and/or what insulin dosage when things aren't "normal/working" do you start ordering tests for the diseases?

    thanks!
     
  2. Chubba (GA)

    Chubba (GA) Well-Known Member

    Joined:
    Apr 30, 2017
    I believe the tests are recommended when a cat’s dose reaches 5 units.
     
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  3. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Typically we suggest getting testing done for acromegaly (IGF-1 test) and insulin auto antibodies (IAA) when kitty gets to 6 units, if they are on low carb food. The links to the tests are in the Sticky Note on What We Know. Blood is drawn by your vet and sent to Michigan State University.
     
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  4. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Thanks for the info. Rufus is low carb food, but he was eating about 10(ish) temptations treats a day. So not sure if that was or would keep his numbers higher. I'll talk with vet about these tests. I don't think she has considered them.
     
  5. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Getting rid of the Temptations treats - very higb carb - will help get his numbers down.

    A lot of vets need convincing to test for those conditions. Vets over a certain age were taught that acromegaly is very rare. More recent studies have shown it's one in four diabetic cats that has it.
     
  6. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks Wendy. I know you've said I need more data, and I am working on it. But do you have any opinion on my guy Rufus? We were at 5u & 5u, started 5.5 today. His numbers without insulin are 600's. Yesterday was better, and he was an gabapentin so not sure if that helped lower numbers. But do you think he has some of traits of acro? Going on 11 weeks I think, and numbers are too much improved (or are they)?

    Thanks for any additional input you'd have :)
     
  7. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Large, long kitties can be a sign of acromegaly. Or they can be a sign of a big breed cat. The majority of cats diagnosed with acromegaly do not have any physical signs of the condition at the time of the acromegaly diagnosis. It's mostly the unrelenting high blood sugars and higher dose that are the clues to start.

    Dealing with inflammation/pain can definitely help the BG numbers.
     
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  8. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks. I guess we'll get to 6 and 6 units and then see if she'll o.k. the tests. She's not always receptive to my suggestions. Plus I'm not sure she's heard of it.
     
  9. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    My vet thought we had to get to 10 units before testing - never did get that high and tested positive for both acromegaly and IAA. I had to ask her to humour me to do the tests. The owner of the clinic called them my "exotic" tests. He later admitted I knew more than he did about acromegaly.
     
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  10. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    I'm not sure my vet would admit to not knowing something...
     
  11. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    "I'm not sure my vet would admit to not knowing something"
    Then your vet has problems. I am a computer security expert. Yet with co-employees and managers, I will readily admit when I don't know something. Then I'll read about it, if it is pertinent.

    Acro is not well taught at vet schools. Heck, diabetes information seems to be missing from many of the vets we have heard about on this forum. Anyhow.

    You are doing good. However we recommend daily tests for pre-shots. That is the only way you will be able to tame the Acro beast. Nadir testing (6hr to 8hr) testing is also very instrumental to show how effective the dose is. Your kitteh may get back to 400 or 500 at that AMPS or PMPS times but only the nadir test will show if the insulin drove the BG down.

    Since Rufus is at 5.0, you can raise in 10% increments every 7th dose until you see effective nadirs. Rufus really needs to get out of the high numbers. Otherwise neuropathy will occur very soon.
     
  12. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks Jeff. I know I need to do better with the testing pre-shot, but it's so high I never think it would low enough for problems. I'm 99% sure Rufus has dental issues, but dental specialist won't do xrays until his fructosamine test comes back "fair". This was a month ago. Regular vet wouldn't do a fruc test because she said numbers haven't changed. It's kind of a back and forth battle. Might be time for a new vet. Anyways, not sure if the numbers aren't getting better because of the teeth, or a different issue. He's got a couple things going on. Regular vet wants to keep increasing dose til we get to a good place, dental specialst office thinks we need to fix issues first and that the high numbers will come down. Now regular vet says I have to pick her or them, which is understandable I guess, but I was hoping they could work together. Not sure what to do....
     
  13. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    It's very strange, at least I think. Before and for a few weeks after fd diagnosis, he was showing signs of neuropathy, but he's on zobaline and doing much better. Also peeing and drinking almost back to normal. Better attitude. Hanging out more. Hiding less. No accidents. Showing daily signs of improvement. But the fricken numbers don't want to really budge. :(
     
  14. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Good. Like I said, you are on a good regimen. To help us help you, we really need preshot and nadir numbers. Also they are for you.

    At some point the doses will be effective. I do not dose Leo when he gets under 200. (Well, 185-210 is the iffy range). Some kittehs like Leo are sensitive in the lower range. And for him, he hypos easily if he gets dosed in the low preshot range.

    Zobaline is to repair the neural sheaths. But high BG is the root cause, since high BG effectively causes glucose toxicity. Without effective BG regulation, then Rufus will probably get some neuropathy. However, it is great that he is on a course of Zobaline!

    We've been there on big numbers too. Just stick with it. Let's see if you can get him in the 120-150 range on a nadir in the next few weeks.
     
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  15. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Thanks Jeff. Another reason I haven't been as vigilant about testing is because his ears look so bad! Don't want to gutter him, they look tender.
     
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  16. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    I can sympathize. But I am lucky. Leo's ears are fine. It is possible Rufus has bad ears from high BG. Lack of regulation causes issues with healing.

    You may try other areas. Some people test on paw pads. Kinda like a finger tip test on humans.
     
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