Hi I’m new - Jack’s treatment questions

hi everyone! I’m new so I’ll be spending a lot of time reading through all these posts but I wanted to reach out here as well.

Jack has been having signs of something wrong in terms of the diabetes since September. He seemed to be getting worse as his neuropathy progresses in spite of higher insulin dosages (we got up to 7 and then changed his diet and now he is at 1.5 but probably should be between 2 and 3) of Lantus. He got his Igf1 results in January and confirmed acro.

I see Jeff is from Austin Texas too so I would love to connect as I need help finding a dr I like.

I took Jack to Texas a&m this week for a meeting with the Oncologist there and we are discussing Srt. Jack is going to have a scan on Tuesday and we will make a decision. I will share more about that but I am so tired now!

 

Hi Andrea, and welcome. My Neko had SRT as well, but at Colorado State University. Twice actually since the tumour came back after three years. At the first time, there weren't many places that did SRT. Thankfully it's an option open to more now. CSU was three days drive each way for me, I think Jeff did it in two.

What questions do you have?

I have a few for you too. What insulin is Jack on? What was his IGF-1 number? Are you home testing his blood sugar? If you want any help with dosing, we can help you with that too. Most of us end of making our own dosing decisions, with the help of people here. If you do happen to undergo SRT, there can be times when the dose changes quickly, faster than you can get an answer back from the vet. And lastly, is that Jack's tail hanging off the bed? It looks just gorgeous! Kind of a fan of the floofy tails myself.

 

hi! Jacks IGF 1 was 291. I will see if I can link my spreadsheet and I am home testing. i had a crazy thing happen when we finally switched him from Hills CD to Purina Dm (jack eats that and FF Pate) and he dropped from 7 units to 5 and then i noticed after 5 days at 5 units he was lethargic in the afternoons and had low numbers. so i called the vet who chastised me for home testing and told me my numbers didn’t indicate anything and to give the insulin anyway until I could conduct a curve to tell us otherwise. So i didn’t listen to that and cut his dose in half. I thought it was still high so I went down to 1 unit and am working my way back up every 6 cycles by half a unit.

 

I am glad you stuck with your instincts and ignored the vet! C/D is crazy high in carbs so of course Jack would need less insulin. I had another cat on it for crystals when Neko was diagnosed. With her crazy hunger she pushed him away from his food so I had to police them eating. I asked the vet what would be good for both of them, and I ended up feeding a raw diet which worked well. If Jack has urinary issues, the low carb with lower phosphorus is the way to go. Fancy Feast is a higher than ideal in phosphorus, but there are lots of commercially available options. You don't need to feed DM either - it's not the best quality food.

Partway down the spreadsheet instructions is a section telling you how to include the link in your signature. Depending on what nadirs a cat is seeing, increases by 0.25 units may be better than 0.5.

 

Yeah, diabetic (and other kittehs) just love carb food. Gives them a sugar high.

Your experience with the vet - we have heard that story before from others. I just don't get it, why some vets would discourage home testing. Or why the vet would insist on doing the curve. All that testing is easier done at home for a tiny fraction of the cost.

 

And way more accurate. Some kitties show really high numbers due to stress at the vet. Had a non diabetic test over 220 at the vet - not the usual clinic, it was the weekend. Vet called me the next day all worried about diabetes. I tested at home - 53. It's quite common to hear of cats testing higher at the vet clinic.

 

Ditto that. I had a non-diabetic test 386 on the vet’s lab work, which is pretty crazy high. Even I had second thoughts about diabetes. But of course she had freaked out in the exam room, slipped out of the tech’s arms, and run multiple laps around the room (climbing walls in the process), just before they pulled blood. She was in the 60s and 70s at home after she settled down.

 

Thanks for the welcome everyone! I was MIA this last week because I was just so busy. We took Jack last Tuesday to Texas A&M for a MRI because I was curious how large the tumor was since the vet suspected a macro adenoma as opposed to a micro adenoma due to the way he responded ti being pestered by the vet. The results of the MRI showed that it wasnt as big as he was expecting, and there was some debate over what the distinction was between macro and micro adenomas. Radiology looked at it and confirmed it is macro adenoma. The Dr said the only way to tell how fast it may be progressing is by rechecking with another MRI over time to look for growth, but feels that it isn't big enough to cause any space occupying discomfort at this time.

My husband and I decided we are going to pursue the treatment and Jack goes in Thursday for his planning. The vet said he can keep the cost on the lower end of the 3-5 grand quote unless something unforeseen occurs.

I need some help with my spreadsheet. I'll start a new convo for that.

 

Awesome news on the treatment! How many days of radiation is that? What type of radiation? SRT? Just trying to gather data on what types of treatment are available where. That price is much more reasonable that what I've seen elsewhere lately. You will definitely have to keep us posted.

 

Yes the Dr said conventional radiation (20 sessions) would range in the 8-10k area. I had no interest in doing that many treatments tho! But the HSRT which is 3-5 treatments runs in that range. The Dr knows we are budget conscious and respects that as well. SRT would be one treatment but he didnt recommend that because he said if they are off by a tiny bit it wouldnt be good.

 

Planning the radiation beams in any type of radiation is important. The pituitary is near the brain and the optic chiasm, so accuracy is key. The nice thing about SRT is it's a smaller intensity beam, coming from 7 different directions, and it's only where the beams meets that there is significant radiation. SRT does a CT scan each time before the radiation is turned on to make sure things are where they should be. Radiation along the same path each time (more conventional radiation) means more radiation along that same path. And has the same problem of having to be accurate. Not sure why the doctor didn't like SRT, unless he doesn't have an experienced radiation oncologist.

Fewer treatments is better. Each session requires anaesthesia, and multiple sessions are harder on them.

 

I hope it all goes well. A&M didn't advertise this, or didn't have it in 2016 when I had Leo treated. If this had been available, I would have checked it out since it is only 2 hours east of Austin (and that is where I completed my PhD in computer science).

It would be interesting to see any pictures of the facility or collateral they have. Interesting to us, and to potential future acro patients on fdmb as well.

 

Ill definitely try and get more info!

 

Hey wendy can you please have a look at my sheet? Jacks numbers have never been this good and Im worried hes trending downward. ?

 

Lovely cycle today! Can you get another test in tonight in a couple hours or more? If you can, I would stick with 2.5 units. He is on his way up now. We tell brand new people to go ahead and shoot the regular dose as long as they are over 200.

 

THANK YOU. Yes I will be up for a while. Ill give his shot. I am in shock at his numbers right now. WOW.

 

This is what you want to see.

 

Wow, Jacks BG#s are all over the place. Some nice low days and other super high days. Cleo is more consistently high than Jack. Why is that?

 

Cleo hasn’t reached a good dose yet, or I am guessing because there is little testing. Jack recently was changed from high carb food to lower carb, and his dose needed to be reduced a lot. Acromegalic cats are all different in how much insulin they need.