08/20 George AMPS 332; +5.5 188

[George’s Mom]

Yesterday

Depend on his heart and level of CKD. Places doing SRT will want to see an echo first. SRT consists of between 2 to 4 days with anaesthesia. Neko got to the point her heart could not take anaesthesia. You might want to read the paper outline I linked in this post: Paper on QOL and response to treatment for acros

Just read it. Two things: 1) Per the whitepaper, seems like Cabergoline worked as well as SRT? 2) Seems like it's going to be a while before we can get the echo. So maybe we should try cabergoline in the meanwhile?

I remember reading about someone who was considering SRT vs Cabergoline recently, and the advice that person was given was that they should not try cabergoline if they were going to do SRT.

FYI - All info vet provided to me is uploaded. George's MSU results, a diff view of the same labs from 8/3, and she also provided me with a few whitepapers she found as she was doing research, none of which mentioned cabergoline that I could see.

Last comment - George's #s have gone higher. Not sure why. I did not fur shot yesterday for sure. I did give him .25 of R this morning 30 mins prior to AMPS because he was at 366.

 

[George’s Mom]

Oh and 3) sounds like most likely he has around 2 years of life left. I know he's 17.5, but I had designs on him being the oldest cat alive (30something)... I know I know, but I can dream!

 

[tiffmaxee]

I’d ask your vet about possible proteinuria. You would want a second urinalysis in a CD month or do because it can be up and then down. There is an add on test depending upon how long it would be good with the current sample. Sorry about the diagnosis. Don’t let yourself think about longevity. Nothing has changed since diagnosis.

 

[Wendy&Neko]

The paper did not compare how well cabergoline did against SRT, but rather caregivers perceptions. Also, the paper lumped all types of radiation together, not just SRT and there is a wide range of radiation treatments. Neko got about 4.5 years after SRT, Pamela's Amethyst is still going after 5 years on cabergoline, but she was diagnosed young. We've also seen cats just on insulin go 4 years. And cases of all of those where cats lasted much less. It really ranges. All you can do is try and see what happens. Depending on size of tumour, and maybe other things, for some cats cabergoline doesn't do much. Worth an experiment.

As for trying cabergoline, there is no problem trying in now, either as an interim solution or as the solution. We did have one member whose cat was on cabergoline and it was recommended to him to stop it before SRT, and you need time to taper it off.

As for insulin dose, I'm not surprised he didn't hold that big a reduction. I think you'd be fine to increase to 4.5 units.

For the labs, I found it handy to enter the data on the labs tab of the spreadsheet. That way I could see trends over time much easier for individual values. I agree with Elise re asking about proteinuria. Not uncommon in acros, Neko had it. There are treatments. The add on test she's referring to is the urine protein/creatinine ratio (UPCR). Has George had his blood pressure taken recently?

 

[George’s Mom]

Have you noticed any of the typical acro side effects?

Truthfully I think SRT would be rough and not really extend his life by much. That said, if he's got side effects it may help alleviate those...so it's up to you to weigh risk, costs, and quality/length of life.

I personally would try cabergoline first. Every cat has a different response to it, but my cat has been on it for a year now and I've not seen any signs of progression (he cannot undergo anesthesia for imaging so can't speak to what's actually happening inside, but all physical exams have checked out, his skull changes stopped, etc).

George has always had such large feet, long tail, big ears, etc. a very long and just overall big cat (but slender). This is baby George:

That being said, more recent years he has had separation of his front jaw. He has a heart murmur, and high blood pressure. So I think he shows symptoms.

I’d ask your vet about possible proteinuria. You would want a second urinalysis in a CD month or do because it can be up and then down. There is an add on test depending upon how long it would be good with the current sample. Sorry about the diagnosis. Don’t let yourself think about longevity. Nothing has changed since diagnosis.

I will want to get some labs retested anyway after changing food and adding phosphorus binder. So I can prob just request this too.

As for trying cabergoline, there is no problem trying in now, either as an interim solution or as the solution.

As for insulin dose, I'm not surprised he didn't hold that big a reduction. I think you'd be fine to increase to 4.5 units.

For the labs, I found it handy to enter the data on the labs tab of the spreadsheet. That way I could see trends over time much easier for individual values. I agree with Elise re asking about proteinuria. Not uncommon in acros, Neko had it. There are treatments. The add on test she's referring to is the urine protein/creatinine ratio (UPCR). Has George had his blood pressure taken recently?

I will talk to vet about trying Cabergoline.

Reading this after PMPS, so will start 4.5 tomorrow @AMPS.

Will also ask vet about urine protein/creatinine ratio (UPCR) for proteinuria evaluation.

Labs: will add to SS when time permits. Agree trending would be good to see.

Blood pressure: yes, those are in SS to far right: BP Measurements and medication administration history. This is on same sheet as BG measurements.