Yesterday Sure would be nice to get the acro results I don't expect much today, but starting this thread just in case he decides to get a little crazy on the Levemir
Mr. Kitty and Fred will be Levemir buddies! We started on Lev this morning as well. Fingers crossed it helps both our guys! And I do hope you hear on the Acro soon. The waiting is torture. My sample was delayed in getting to MUS, so I missed the first Wednesday testing day. All said and done, I had to wait 2 1/2 weeks for the restuls. It is definitely no fun! Good luck!
Thanks! No funny business so far... I called the vet just to double check, they don't have results yet.
I just checked Fred, and he's down 41 pts at +2.5. I wasn't expecting that at all, as a) he was in good numbers overnight, which usually means a bounce, and b) the slower onset of Lev. But he also had a mighty poo right after his AMPS, so that might have something to do with it. Also, they say that cats can have an initial strong reaction to a change in insulin, and then level off again. We'll see! Xfingers for your results!
You probably don't need to test hourly the first day. The Lantus depot is depleting, the Levemir one is building.
Well a bit of a disappointing day, but I'd rather him be high and flat vs potentially fighting a hypo all day. We'll see how he does tonight and tomorrow; I will say if Levemir acts like this in green numbers I'll love it.
Vet just called, IGF-1 was significantly elevated Did not give me a number. He said he's still waiting on the interpretation of the results, not quite sure what that means. Wants me to give.him a call this weekend to discuss potential treatment options.
I am sorry too. I know how this feels. But I have a feeling that you really expected the positive acro result. I did. But I still was very saddened. Big hug!
Melissa, I am so sorry to hear this result. I too got the IAA result first and was somewhat hopeful that was it, and know how hard it is to hear the second result too. One thing that helped me was when someone said, your kitty is the same sweet kitty he was before he diagnosis, he doesn't know that he has acromegaly. With a diagnosis you can now plan next steps. You probably have a ton of questions. Fire away. We are here for you.
I did...I actually didn't even answer the call because I'd rather hear it on the voicemail and have time to process. And Ive been stalking the acro forum for awhile now just reading and reading and reading. Sigh. Tomorrow is a new day, and like Wendy says below he has no idea!
For a bit of inspiration, look at Chickamonkey's SS. She is IAA and acro, currently no treatment but Levemir. Not common, but does happen.
You're right - I went downstairs and he just looked at me like "you got any more of those PureBites?" I only have a few questions, if they're better suited for acro forum let me know. I found Dashas comparison of the treatments, really helpful (though she mistakenly cited source 11 in the cons for cabergoline, should be source 12, it confused me for a minute - but I'll mention that in the thread).Though I maybe wish I hadn't seen the life expectancy info... There two cab papers she cited appear contradictory - one out of Argentina saying it does reduce IGF-1 [16 in her sources], the other saying it does not [12]. And I don't have the spoons right now to really go in and analyze why they're different conclusions. Do you happen to know why? As I'm sure you know all too well, it's balancing finances and quality of life. I'm not satisfied treating only the DM while everything else progresses. Surgery is out for us. Radiation I'm thinking about but will need quote. I rather suspect he will be among the first, if not the first, IAA and/or acro cat my vet has had, but I do trust him to work with me. I'm pretty sure the reason he keeps calling at 9pm is because he gets off work and just researches. What changes with "preventive medicine" (it's late and my brain isn't giving me the right phrase)? Whereas before I'd take him in once a year for a physical exam and maybe bloodwork, what else is there to consider now? I'm very much a "head down, do what needs to be done, get it done, keep emotions aside" sort of person...but I admit tonight I feel overwhelmed. Two kids under two, a pandemic, a diabetic/IAA/acro cat, and a senior dog with her own challenges. So I'll take the hour that's left today and feel sorry for myself, and pick myself back up tomorrow! Edit - I guess one more question. For IAA goal is to keep them green as much as possible, yet for acro it seems the goal is to leave some wiggle room (because the growth hormone secretion isn't consistent?). How do I balance the two? Nadirs around 70 ish? Reductions below that? Is that even still considered TR?
Both studies were of very small numbers of cats, the English study was just 90 days. Not enough time or subjects. The RVC study was a pilot study, and I think concludes more research needs to be done. There have been way more cabergoline cats here than the RVC study. SRT doesn't reduce IGF-1 either, but it reduced growth hormone effects and dose too. In my mind that made it worth while, and was the only treatment option available at the time. The South American group has now studied I seem to recall closer to 50 cats and recommend it as treatment. Of course, they don't have surgery options there, not sure if they have radiation. My vet got off shift at 8:00pm and did follow up calls after that too. Neko was her first diagnosed acro cat, though she realized shortly thereafter there was another in her practice. I'd bump visits and blood work/urinalysis to every 6 months. There can be changes in organs, specifically heart and kidneys, due to acro, which can be managed if diagnosed in time. Most people here stick to TR. You don't really need a lot of wiggle room for growth hormone secretion - changes don't happen that dramatically unless you have treatment. For Neko I liked nadirs around 70 because that meant she was generally under renal threshold most of the time. I only changed the reduction point after SRT and her dose was dropping dramatically. When the IAA breaks, the rules may change including the reduction point. But you also end up doing BCS, skips, or maybe even back to back reductions. Take a look at Oberon's spreadsheet as an IAA kitty on a mission. Definitely take time for you!
Melissa...I'm so sorry to hear about the diagnosis. It does sound like you have a lot on your plate, so take all the time you need to process. I wish I were more knowledgeable about any of it, but there are so many wonderful people on the board who I know will be amazing resources. And, sometimes, it just helps to share with people who understand. "A worry shared is a worried halved". So sorry!!
Melissa I too am sorry about the news, I know nothing about this but you have a lot of experienced members here to help you. Take all the time you need to process this. Big hugs for you and kisses for Mr Kitty ♥♥
You know I have been thinking about you and Mr. Kitty waiting for the Acro results. I am so sorry to hear this but I also know how smart you are with taking care of your kitty. You will also find a way to deal with this. There are lots of folks on this site that are dealing with the same issue and you are in really good hands with them. My prayers for you and Mr. Kitty.
