? 9/28 Dak Follow-Up Vet Results

Jeremy & Kate

Jeremy & Kate

Member
Previous thread: https://www.felinediabetes.com/FDMB...s-390-6-381-pmps-389-402.293965/#post-3206159

Based on Dak's values not improving, despite getting up to 17 units of Lantus twice a day, we had a follow-up appointment with the internal medicine specialist on 9/20. They did the typical blood panels and urine cultures, and sent off a blood sample (to Michigan State University) for the IGF-1 test. Based on some of his values on the regular blood panels, there was strong evidence that he has acromegaly (we had a suspicion that he may have acromegaly based on his values and insulin not working, plus folks comments on our threads, thank you @Wendy&Neko ). Drum roll please (results came back on 9/27).... Dak has acromegaly. His values on the test exceeded 1200. So our next steps, after talking with the internal medicine specialist (they told us the recommended options for acromegaly and based on our own research for treatments), will be to pursue radiation (SRS). We should be getting a call back early next week with options where we can get the treatment, since it is not available near us. The internal medicine specialist does want us to keep Dak on 17 units (twice a day), hence why we have been keeping that dosage amount since the 9/20 appointment.

With folks who have experience with acromegaly, are there places in the US that you would recommend pursuing treatment at, primarily SRS treatment? In case it helps with any recommendations, we live in Mississippi, and expect that we will have to travel/fly with Dak for treatment.
 
Jeremy & Kate said:
Previous thread: https://www.felinediabetes.com/FDMB...s-390-6-381-pmps-389-402.293965/#post-3206159

Based on Dak's values not improving, despite getting up to 17 units of Lantus twice a day, we had a follow-up appointment with the internal medicine specialist on 9/20. They did the typical blood panels and urine cultures, and sent off a blood sample (to Michigan State University) for the IGF-1 test. Based on some of his values on the regular blood panels, there was strong evidence that he has acromegaly (we had a suspicion that he may have acromegaly based on his values and insulin not working, plus folks comments on our threads, thank you @Wendy&Neko ). Drum roll please (results came back on 9/27).... Dak has acromegaly. His values on the test exceeded 1200. So our next steps, after talking with the internal medicine specialist (they told us the recommended options for acromegaly and based on our own research for treatments), will be to pursue radiation (SRS). We should be getting a call back early next week with options where we can get the treatment, since it is not available near us. The internal medicine specialist does want us to keep Dak on 17 units (twice a day), hence why we have been keeping that dosage amount since the 9/20 appointment.

With folks who have experience with acromegaly, are there places in the US that you would recommend pursuing treatment at, primarily SRS treatment? In case it helps with any recommendations, we live in Mississippi, and expect that we will have to travel/fly with Dak for treatment.
Click to expand...
@Wendy&Neko
 
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I don't have any experience with this, but just wanted to say I'm very sorry about the diagnosis, even if you did suspect it. I have so much respect for those here that treat cats with acromegaly. Sending lots of good vibes to Dak and you :bighug::bighug:
 
Sorry to hear about the acro diagnosis. :bighug::bighug::bighug: But now you have answers you can move forward with treatments. And most important thing someone told me at this point - Dak doesn't know he has acromegaly, he's the same sweet cat he was before hand.

Did the vet do the test for IAA (insulin auto antibodies) as well? As you can see by my signature, it's not an uncommon combination and can impact dosing strategies.

Neko had SRS at Colorado State University. At the time, they were the most experienced in it. We drove 3 days each way from Vancouver. Three years later her tumour came back, and I flew the second time (plus drove from Denver to Fort Collins).

As far as locations go, North Carolina State U also has a good program. One of our members had SRT done in Austin. I see the U of Georgia also does SRT. This post, though dated, describes some things to consider and questions to ask. If you post the list from the IM when you get it, I can comment. SRT is not as common now here as it used to be so harder to get current stories. Primarily due to cost and the availability of cabergoline now. We did have one member recently go to Yonkers for Cyberknife.

I disagree with the IM vet about dosing. It's better for Dak's body if you can get him to a dose that provides some relief from all those high numbers above renal threshold. Did the IM vet say why not to increase? Glucose toxicity is well set in by now. It's likely his numbers will get worse on this dose if you stay with it.
 
Just want to send you all love and support for all you are doing to help your sweet Dak. ❤️
Hugs to you, Jeremy and Kate. Wishing you all the best with the treatment options :bighug::bighug::bighug:
 
We want to say thank you to everyone for the love and support, as we continue on our journey with our super sweet cat Dak. As for the IAA test, we will check in with the vet and see if they ask MSU (Michigan State University) to perform that test as well. I believe we asked for them to send off samples for the IGF-1 and IAA test, but we will double check and confirm. We will definitely post the list of locations, once we get them from the IM that has been handling Dak's case.

Yeah, we have similar feelings on holding the dose for this long with Dak. The IM vet mentioned that they wanted us to hold his current dose for a week to two weeks so that it can get to full strength in his system, due to glargine insulin (Lantus) being a slow acting insulin. When the IM vet called us yesterday and gave us the news about Dak's IGF-1 test results, we did ask them if we can increase Dak's insulin dose, but they recommended keeping it at 17 units twice a day. They (IM vet and vet school student) were surprised when we scheduled the follow up appointment and informed them that Dak was at 17 units twice a day, as that was not the protocol they told us to follow when he was last seen by them in late June/early July.
 
Jeremy & Kate said:
We want to say thank you to everyone for the love and support, as we continue on our journey with our super sweet cat Dak. As for the IAA test, we will check in with the vet and see if they ask MSU (Michigan State University) to perform that test as well. I believe we asked for them to send off samples for the IGF-1 and IAA test, but we will double check and confirm. We will definitely post the list of locations, once we get them from the IM that has been handling Dak's case.

Yeah, we have similar feelings on holding the dose for this long with Dak. The IM vet mentioned that they wanted us to hold his current dose for a week to two weeks so that it can get to full strength in his system, due to glargine insulin (Lantus) being a slow acting insulin. When the IM vet called us yesterday and gave us the news about Dak's IGF-1 test results, we did ask them if we can increase Dak's insulin dose, but they recommended keeping it at 17 units twice a day. They (IM vet and vet school student) were surprised when we scheduled the follow up appointment and informed them that Dak was at 17 units twice a day, as that was not the protocol they told us to follow when he was last seen by them in late June/early July.
Click to expand...
@Wendy&Neko
 
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