Is there a "clearing house" of symptoms for acro/cushings?

I have read all I can find here and on line about both diseases, but the "clinical findings" and symptoms are not what I suspect a person living with an acro or cushings cat would list out. Also, I am guessing there is a period of developing symptoms where the cat seems "different" in subtle ways that vets dismiss because it can't be measured in any way useful to them.

I am asking because I have suspicions about Cami, always have ("always" means since Oct of last year). She has had a lot of vet visits with a Board Certified internist over the past 10 months and that vet says she doesn't see any of the classic symptoms of acro/cushings. But Cami is not responding the way either Beau or Jeddie did. Her dose is not high but she goes in and out of regulation all the time. I increase the dose then suddenly she needs a series of decreases, then it is back up again.

Anyway, just wondering if there is a more detailed list of signs/symptoms somewhere? Thanks.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

I had a heck of a time trying to regulate Spitzer with IBD and possible GI lymphoma.

All kinds of metabolic derangements can occur - liver, GI, pancreas, thyroid, pituitary, hypothalamus, gonadal (if present) - there are some even more obscure things at the mitochondrial level.

It may be that the vets do as medical doctors do - look for the horses first, then the zebras, and finally, after ruling more common stuff out, look to identify Pegasus.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

I presume you've read the posting on acromegaly basics. My favorite article is this one as there are color pictures and table 1 has quite a list of acromegaly symptoms. My Neko didn't originally show any symptoms other than hard to regulate and higher dose (got to 8.75U) and extreme polyphagia. And my vet was surprised when I got the positive IGF-1 result, she thought I was wasting my money on the test. She has since identified a second acrocat in her practice.

There is also a list comparing acromegaly/cushings symptoms in this article on insulin resistance.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

Well, Cami sure has her share of GI issues and maybe she is just an extreme version of ECID. However....

When she reached crisis state last Feb and had an US, the vet reported that all of her abdominal organs (kidneys, live, pancreas and intestines - don't know about spleen) were enlarged and she had a lot of fluid in her abdomen. She thought it was from extreme, diffuse inflammation. Cami was put on ABs and pred. A follow up US showed no fluid, but still enlarged organs. Shortly after that was the beginning of Cami's constipation issues and a dx of mega colon.

Now that her GI are under control and her GI tract is somewhat healed she has gained a lot of weight (6 lbs in May to ~12 lbs now). I know that alone could cause BG regulation issues. I have noted that each time she goes up the dosing scale she gets to a bit higher dose and each time she goes down it doesn't seem to be as low. These are just the things I am noting.

Wendy, thank you for the articles. I downloaded them and will read this week. I could not find anything like that when I did an on line search.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

If you are wondering about Cami having acromegaly, and you are not at any high dose, but show enlarged organs, and having megacolon issues as well, why don't you have the vet do a blood draw and have the 2 tests run?

If you think about it, a cat can be acromegalic but not need insulin at all if there is no excess hormone secretion.
There have been a handful of known acros who have just suddenly went right off insulin, so it's logical to figure that there may be a tumor but with no activity at the moment, or only a trickle that is being managed by a cat's pancreas.
There is no problem with the acro cat's pancreas, so if there is just a trickle, it's not a big problem.

Have the 2 tests done, for IGF-1 and IAA, and you will know for sure.

Gayle

 

Re: Is there a "clearing house" of symptoms for acro/cushing

Gayle, I know you are right. It's just that her vet disagreed that she could have either for lack of symptoms, so I wanted to have more "evidence" to justify it.

I want to do my homework before Cami's next check up at the end of Feb and be ready if I still think its warranted.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

Well, it's your call.... if you want the tests done, just tell your vet that it's your dime.
What about if you have your vet give you an estimate of the cost for the draw, the shipping and the tests, then you can decide.
I had the same issue with my vet yrs ago with Shadoe. She was a petite girl with no signs of acro yet her dose did keep rising. I finally had to give my vet the test info and I made the appt for the draw, saying I wanted the tests done and that's that.
Her result was 120, and her signs showed up later, over time.

Cushings tests are said to be not 100% conclusive, but they do exist. It seems there is a bit of a variety of cushings types: pituitary dependent, adrenal dependent, and steroid related.

If your vet does not think organomegaly is related to Acromegaly, then what would be the cause?

If you want the tests done, it's your dime.

Gayle

 

Re: Is there a "clearing house" of symptoms for acro/cushing

She felt the organomegaly was from severe inflammation. Cami was not absorbing food, her kidney values were bad, she had increased lymphocytes, decreased potassium, abnormal red blood cells and without looking at her blood work I can't remember what all else. Fairly normal liver function, although it was also enlarged. We have not done another abdominal US since May, I think, because I could not afford it and it didn't seem necessary for treatment assessment at the time.

She has been on a low dose of steroid for almost a year and that could explain some of the weight gain, but I don't think all of it.

My original post was so I could provide a "laundry list" of signs to support wanting the test.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

Maybe this will help.
From the Merck Veterinary Manual: Acromegaly

 

Re: Is there a "clearing house" of symptoms for acro/cushing

There are some cats who may have almost NO signs, but I would think enlarged organs is a pretty good sign, and I can't believe that inflammation is realistic for ALL the organs? Really? Nope.

I think it may be cheaper to test for acro and IAA, leaving the cushings and u/s for a later time....
The u/s will not tell you much more than you know now, but the 2 tests which are something like $50 and $15 can confirm or rule out 2 conditions.

Because of costs, ask your vet for an quote, the draw, shipping, and 2 tests. Then you can budget the amount.
i think I would talk over the kidney issues with your vet now because you may want to think of looking at Tanya's site and taking any action you need to slow down progress in that area.

Acro and IAA tell you alot about what to expect with your cat but ultimately, the treatment will not change.
You will home test and give insulin as needed. About the only differences in treatment I can think of right now would be B12 shots weekly for inflammation and also think of starting a maint dose of a pain med, like gabapentin, because growth does cause some aches in the cats, and you will see a diff in the cat after the pain med is started.

Best wishes in finding what you need for Cami.

Gayle

 

Re: Is there a "clearing house" of symptoms for acro/cushing

like Shadoe, Jazzy's physical appearance didn't change until later. Her insulin dose was higher than normal, and the dose had gone up and down quite a bit, but she didn't "look" acro. Over the next year or so until she died, she developed more of the physical signs.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

like Shadoe, Jazzy's physical appearance didn't change until later. Her insulin dose was higher than normal, and the dose had gone up and down quite a bit, but she didn't "look" acro. Over the next year or so until she died, she developed more of the physical signs.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

I should add that Shadoe's dose dropped from around 14u to 2.75u after a dental with 1 extraction.
Yes, her dose built up later, and like Jazzy, signs showed up much later when she turned into a bowling ball on little legs.

In general, she was a lower dose acro, and her highest reached only 21u BID.

Gayle

 

Re: Is there a "clearing house" of symptoms for acro/cushing

Cami's kidney values finally returned to normal in October. The vet's thinking was that whatever bacterial infection had taken hold there was cleared up (after 3 months of Baytril) and the kidneys were able to return to normal function. Prior to that she had extreme PU/PD that did not change when her BG was regulated, or during the months she was OTJ. This was since I got her. She was drinking 12-15 ozs a day. When she was put on SQ fluids that dropped to about 8 ozs a day. In Sept I started her on krill oil and spirulina and her PU/PD resolved within a week so I stopped SQ's. 6 weeks later her kidney values were good. So, for now, I am not concerned with her kidney function although it will be monitored at least every 6 months.

She is already a bowling ball with legs. In fact, her nick name is Cannonball (or Camiball). Her wt gain is a concern and it is what is making me revisit the possibility of some endocrine issue. She was 6 lbs for the longest time with a ravenous appetite that seemed to only produce copious amounts of thick stool. She started gaining wt over the summer and she's 13.5 lbs now. Her appetite is down somewhat, but she still is gaining wt.

Anyway, yes, I will get an estimate for the tests for next month during her check up.

 

Re: Is there a "clearing house" of symptoms for acro/cushing

My cat Lily showed physical manifestations of acromegaly prior to actually becoming diabetic. Lily's head became enlarged which included her jaw and interdental spacing with her teeth, as well as her paws getting larger. It wasn't until at least a year later that Lily's blood work showed diabetes. Along the way she got the "potbelly" appearance due to her enlarged organs, but I'm not quite sure when this came along. After her diabetes diagnosis we tested her for acro (IGF-1) which was 533, a CT scan later on further confirmed this diagnosis. After her diabetes diagnosis no low dose of insulin was working and we had to keep climbing up the ladder (currently at 18u twice a day), so it's good that your Cami is responding to a low dose.

I know how you feel especially with the organs being enlarged, and it can't hurt to get the test done for peace of mind of knowing whether you're dealing with just diabetes or diabetes and acromegaly. With Lily I always felt like something wasn't right, so sometimes your gut is a good enough reason to inquire further.