Pumpkin- Acro DX and Lantus/Cabergoline

Discussion in 'Acromegaly / IAA / Cushings Cats' started by KAC, Nov 30, 2020.

  1. KAC

    KAC Member

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    Jul 31, 2020
    Also posted this in Lantus forum...........

    Pumpkin has been diagnosed with Acro. Had test from MSU. His neuropathy has gotten pretty bad because he is staying in the 400/500 range with 13 units Am/Pm of Lantus. I really need to find some relief for his wonky up and down numbers so neuropathy can improve............he is such a sweetheart.

    Looking for info on cabergoline or other medicines that can help counteract the hormone storm from the tumor. Would love info on dosing for cabergoline, etc. Also, I read somewhere on a message (can't find it now) that B12 shots help with neuropathy and the muscles.

    Any help anyone can give me on any of these topics is very much appreciated. :cat:
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
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  3. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    See https://felinediabetes.com/FDMB/threads/cabergoline-acro-iaa-information.237336/
    The dose seems to be 10mcg/kg

    My vet is considering Cabergoline for my Snuffles who was Dx'd last week. The radiation treatment or gold standard drug
    Medical Treatment Using Pituitary Inhibitors

    Using somatostatins to inhibit GH secretion by the pituitary tumour has proven very effective in humans suffering from acromegaly, but has previously proven ineffective in cats. Previously tested dopamine agonists and somatostatin analogues, including long-acting formulations such as lanreotide, have not resulted in detectable clinical improvement. Nevertheless, a novel somatostatin analogue Pasireotide (Novartis, Basel) has been tested in the author's Acromegalic Cat Clinic and found to be effective, leading to insulin dose reduction in all cats, decreases in IGF-1 and even diabetic remission in 25% of cases when using a once monthly preparation. However, somatostatin treatment was also associated with gastrointestinal side effects in a significant number of cats, including diarrhoea, rendering this not a miracle solution, especially considering its considerable expense and the fact that the pituitary tumour is left in place.
    https://www.vin.com/apputil/content/defaultadv1.aspx?pId=12886&catId=57097&id=7054862

    the yearly cost of Pasireotide for human is about $62K/year
    https://www.ncbi.nlm.nih.gov/books/NBK349163/table/T30/
     
  4. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Leo had bad neuropathy before I got him regulated. It is really disheartening, so I know how challenging this is.

    As Janet said, mid-cycle numbers are critical to determining dose effectiveness. Zobaline (B12) is a B12 that is often given. These are frequent topics. You might consider searching the general forum for past discussions. Just giving B12 will not resolve the issue. Your kitteh has to get regulated.
     
  5. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    I used cabergoline for Ollie. GI upset is most common and resolves on its own in a few days. I used probiotic while waiting for it to arrive (compounded into suspension) and continued probiotic the 1st week she was on it. Ollie never had any gi upset.

    It really depends on what yours and vets goal are for using it. For me it was to lessen her symptoms which were really awful. It worked for that very well once we reached a good dose. She even had a few good months of being "normal" walking properly, playing, enjoying life. Her insulin dose did go down by half. Ollie had other issues that caused her insulin to go up and down. But her acro symptoms remained gone.

    Pamela and Amethyst are on it a few years now. Her insulin dose is quite high. Erin and Moe are on it, Moe's dose has gone down some.

    The cabergoline (which is different than pasireotide) to me was affordable it was $125/month. Using both together has much better results. Then there is one that's starts with "o" don't know the spelling that has promise when added to cabergoline. My vet was afraid to add a new med she wasn't familiar with.
     
    Last edited: Nov 30, 2020
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  6. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    My cat's dose has gone down significantly this year. Makes me wonder if the hyperthyroidism meds that she started a year ago effected it in some way... or it could be a coincidence. Either way, CC only needed 5 units today, so i'm a happy camper.
     
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  7. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Probably will never know.........
     
  8. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    The "o" is likely "octreotide "

    The somatostatin analogue octreotide has been evaluated in a few cats with acromegaly with limited success. In a study of four cats with acromegaly, no change in serum growth hormone concentration was noted after treatment with octreotide.2 Another study, which measured the short-term effects of octreotide in five cats with acromegaly, found a decrease in growth hormone concentrations for up to 90 minutes after octreotide administration.3 However, a recent study evaluating a long-acting somatostatin analogue (Sandostatin LAR Depot—Novartis) showed no benefit in cats treated for three to six months.4
    https://www.dvm360.com/view/feline-acromegaly-treatment-options
     
  9. KAC

    KAC Member

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    Jul 31, 2020
    Thank you so much!!
     
  10. Olive & Paula

    Olive & Paula Well-Known Member

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    Even when given with cabergoline?
     
  11. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    I could not find anything about trials of cabergoline AND octreotide together.
     
  12. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    I will have look for it on my pc.
     
  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    It came in private correspondence between one of our members and a researcher at Royal Veterinary College. In this post and that one. Octreotide is NOT cheap either.

    The price Larry quoted above for pasireotide is a bit high, as that is a human dose. Cats need less. Plus the quote was for the daily version and the Signifor LAR (long acting, once a month shot), got better results in trials. When I got a quote for Canadian prices several years ago it was "only" about $5000 for 3-4 months worth. :eek: Cheaper to save your money and get surgery if you have that kind of money.
     
  14. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    No wonder I couldn't find it.

    When I checked price for octreotide a couple of years ago, it was quite reasonable.
     
  15. Larry and Kitties

    Larry and Kitties Well-Known Member

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  16. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015

    It is still reasonable. I checked last night. Wal-Mart was cheapest at $32 but they don't have it. I was considering it for Ollie but vet wouldn't.

    You would have to figure out how much you give and how long vial would last. If it's 1 vial a day, that could be cost prohibitive.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    In the study described in this old post they were just starting to trial octreotide at CSU. They were using the long acting, once a month shot version. The trial of octreotide by itself did not work. They had finished the trial when I was there. At some point, it would be interesting to contact RVC and see if they also used the long acting version, what the dose was, and how many cats they tried it on.
     

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