Pot belly cat?

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Cleocatra, Mar 16, 2020.

  1. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Just came across LuvThisPig's thread about cats w/ "pot bellies" being a possible acromegaly indicator. My Cleo is a pot bellied cat too. She started showing a bulging belly when she was 4+ y.o. after being fixed after having 4 litters. We knew this cat when she was young and slender, but then we adopted her after p.o. had her fixed at 4 y.o.
    We are presently pursuing cabergoline w/ our IM vet Dr. Stiller at VCA Animal Diagnostic in Dallas. She still has to figure out dosing and then find a sourcing pharm. Rt now she's looking to Wedgewood Pharmacy. They are online. Cleo is very insulin stubborn. She maxes at 500 and I can only get her down to ~350 on a good day. This has been going on for 7 months. She shows hind leg neuropathy. She's on zobaline. The intense hunger is becoming a problem where she starts nipping on our ankles for food. She's pooping up a storm and I think her food is partially digested.
    Is LuvthisPig still with us here?
     
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  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Sarah (LuvthisPig) hasn't posted for a while. Pig was one of those acrocats that needed considerably higher doses. If you are interested, here is Pig's spreadsheet. And yes, pot belly is a common side effect of acromegaly.

    In this discussion post on cabergoline, most people start with the amount recommended by RVC, Chris from RVC said "10 microgram per kilo dose once daily
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Any chance of EPI? Exocrine Pancreatic Insufficiency?

    Thought I'd mention it, with the "pooping up a storm" comment.
    Normal colored dark poops, or another color?
     
  4. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    normal color, just soft and a lot since she's been binge eating. She was doing ok until a week ago when the hunger drive kicked up a notch. I could lock her in the laundry room to keep her out of the kitchen! Dr. just called us and said we can increase insulin from 8u 2x to 9U 2x.

    Cleo is 7 kg. So her cabergoline dose should be 70mcg. Wedgewood Pharmacy sells 75mcg doses. We ordered today $107 for 30 capsules. Here goes nothin'....
     
    Last edited: Mar 16, 2020
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  5. JeffJ

    JeffJ Well-Known Member

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    Best of luck with the Cabergoline. I hope it resolves the symptoms in your kitteh. Leo had an Acro pot belly. That gave us more of him to rub on and love. Even after the SRT it subsided a little, but it was with him until the end.
     
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  6. Olive & Paula

    Olive & Paula Well-Known Member

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    Good luck with the caber. Is Cleo easy to pill?

    Ollie had the pot belly.
     
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  7. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Cleo is easy to pill if she's not hungry. Lately she's been hungry and short tempered and I can't get ear blood until she's fed and calmed down. She's up to 8U 2x now. I need to test again in a few days and see if the #'s are down.
    How did Ollie respond when you put her on cabergoline? Did you get any BG# drops? What about GI issues?
     
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  8. Olive & Paula

    Olive & Paula Well-Known Member

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    No GI issues. But I started probiotic while waiting for it to arrive. And kept giving it for a week after starting to prevent any.

    Her glucose started to drop in about 10 days if I remember correctly but stalled just as quickly but in the yellows and some blues. Then started back up again. It certainly doesn't keep them down.

    Will need to monitor closely because caber will be unpredictable and all of a sudden causes glucoses to drop fast. The need for back to back reductions and skipped shots. Then can cause glucoses to rise back up just as fast.

    One thing to know. after you start it, if you decide not to give it anymore, it must be tapered off. Can not just stop it cold turkey.
     
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  9. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Are you able to upload a picture of what 'pot belly' looks like?
     
  10. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Here's a shot of Cleo walking. See how her midsection bulges outward? She's had that shape since we brought her home in '14 at age 4+.
     

    Attached Files:

  11. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Has she always been a bit bigger girl? (weight wise )
     
  12. Cleocatra

    Cleocatra Member

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    When we first met this cat at our friend's out in Lubbock Tx, she was kinda small. She had had 4 litters of kittens because she lived out in the garage and the local strays kept knocking her up. So when we decided to adopt her Sept 2014, after our friend had her fixed, she started getting this little pot belly. I thought it was because she free-fed on dry food. Our friend was the local cat lady that fed all the strays along w/ her 4 cats in the house. Cleo was a stray that decided she wanted to live in a house, not outside, but she terrorized the other cats so she stayed out in the garage. After we brought her back to Plano, we never could get her weight down. When we put her on a diet after the first few years, this cat cried and moaned and insisted on food. She is very demanding and manipulative. In the morning, she would jump up on the dresser and knock off all the pictures demanding to get her breakfast at 6am. So I think this acromegaly or whatever has been going on for awhile, fueling her hunger and stubbornness. But last summer she started slowing down, drinking and peeing a ton and we suspected DM.
     
  13. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Personally, I think some cats are just bossy like that. I have a couple of civvies who come and sit on me and stare at me while I'm still sleeping in the morning. Remember, we are THEIR servants!! :cat:
     
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  14. Ti-Mousse

    Ti-Mousse Well-Known Member

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    That's what Ti-Mousse looks like and probably a little larger.... I was very concerned about that, so first thing my vet did was taking x-rays : full of fat :( Ti-Mousse got that shape not long after we brought him home and had him neutered! Trying to have him lose weight but not easy... specially with acro!
     
  15. Cleocatra

    Cleocatra Member

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    wow, for him being acro, his BG#'s look pretty good. But his IGF-1 is only 114. Cleo is 460. I have trouble getting her #'s below 400 lately, up to 9U 2xday now but they're not budging. Very frustrated and she eats like a horse but doesn't do much anymore. Sad. Starting cabergoline to see if it will reduce the evil IGF-1 #.
     
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  16. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Your numbers probably look higher on the spreadsheet since you are using AlphaTrak glucometer. I switched to a human meter early on and Freckles' SS reflected the change.
     
  17. Ti-Mousse

    Ti-Mousse Well-Known Member

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    Are you considering at one point switching to a human meter? Some had very good results with Cabergoline; hope she'll do well on it!
     
  18. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    starting cabergoline today. Hope it doesn't backfire.

    3/25: Update: no issues to report after 1st day on cabergoline. She had pretty good behavior, except for biting her momma when she wanted supper.
     
    Last edited: Mar 25, 2020
    Reason for edit: update
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  19. Cleocatra

    Cleocatra Member

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    What percentage higher is the Alphatrak2?? I hadn't heard this before.
     
  20. Deb & Wink

    Deb & Wink Well-Known Member

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    Roughly 20%. Although there is no fixed and firm percentage, on how much higher the pet meters run. ECID.
     
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  21. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    There is no percentage higher for the Alphatrack vs human meters. In general, but not always, the AT runs higher in higher numbers, and much closer in lower/normal numbers - which is where it counts. Many people have done comparisons between the AT and a human meter and there hasn't been any obvious answer to the question on how to compare the two.
     
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  22. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    My CC is acro and definitly has the pot belly. She had skinny legs and a big round tummy.

    Your cat is probably stuck in glucose toxicity. If my cats numbers are high for a few days it's hard to get them down. Then it's time to raise the dose. A few weeks ago my cat was getting about 7.5, but the last few days she's up to 9-9.5. She just needs what she needs. The most she ever needed was 12.5.
     
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  23. JanetNJ

    JanetNJ Well-Known Member

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    Well one good thing about the quarantine and working from home is I can keep a good eye on her numbers. A good thing about her also having hyperthyroidism is I have a box of gloves home to give her her medicine. Lol
     
  24. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Do you up the dosage more than 1U when you see high #'s? Cleo is always high, so we're upping by 1U 2xday every week. I don't vary the dose unless our vet tells me. So far, she's told me to up it by 1U 2x the past 4 weeks. I don't just go up and down on my own. Now, if I would see her #'s drop, I will lower her dose, but you'll see by her SS that she never comes down close to the danger zone. But now that she's on cabergoline, I have to watch out. We're doing a curve today and then I report to vet tomorrow.

    Geez, she's at 565 this morning. I think it's because she's eating so much and I can't get a test until after I feed her, it's making her BG shoot up before I can get a true AMPS test

    ??- Do you just up the dose on your own? I'm afraid to do that, but at this point the gradual increase has not affected her #'s.
     
    Last edited: Mar 29, 2020
  25. JanetNJ

    JanetNJ Well-Known Member

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    I usually up it a half unit at a time or so, but if my cat was as high as yours I personally would raise a half unit ever few days until I saw the number come down. I raise and lower it myself but I've been at this almost 4 years now.
     
  26. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Looks like CC is getting Prozinc insulin and Cleocatra is getting Lantus. Since these are different insulins, I'm thinking there are different protocols for increasing the dosage for each?
     
  27. JanetNJ

    JanetNJ Well-Known Member

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    That's true. There are proticols on here for using Lantus... check those, or ask on the lantus forum. Although there may be dosing protocol differences for people treating ACRO. I was just sharing what I did since she asked, but yes, i should have mentioned that I use a different insulin.
     
  28. Cleocatra

    Cleocatra Member

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    I'm upping it from 9U to 10U starting tonight. Just tested- 546!! She's going higher as we go higher doses!! WTF???
     
  29. JanetNJ

    JanetNJ Well-Known Member

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    She needs what she needs. Like I said, cc had been as high as 12.5-13. Some acro cats need even much more than that. Even double that or more. I hope you find the breakthrough dose soon.
     
  30. Cleocatra

    Cleocatra Member

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    Thanks. I sent the curve data from today to Dr. Stiller. Here are todays #s: 1st and 3rd # is amps & pmps: 565 451 546 502.
    Could Cleo's immune system be fighting back the Lantus and not letting it form the depot and absorb in to the bloodstream? Are there other insulins that pack more of a "punch"??
     
  31. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Chris: I can't recall if you had IAA test done and if so what were the results?

    Freckles has IAA and acromegaly and with some cats switching insulin confuses the antibodies and a person can see lower numbers. This was not the case for Freckles though. Insulin resistance, as I understand it, is when the body views the insulin as an invader and throws antibodies at it to fight it until the insulin kind of overwhelms the antibodies and the resistance is broken. You've heard the saying, "Every cat is different"? Well, this is a perfect example. For some cats, a huge amount of insulin is needed before the resistance is broken while other cats a much smaller amount is needed. Finding the right dose is key. It can take 6 cycles for the depot to get filled with each new dose increase - that's why I believe the earliest recommended time to increase a dose with Lantus is after 6 cycles. If a person increases too quickly, they aren't really seeing the full effect of that dose because the depot isn't filled yet.

    Are there any other possible reasons for high numbers? infection? bad teeth, etc.?

    I wonder if a short acting insulin in conjunction with Lantus might be an option for Cleocatra?

    Thoughts @Wendy&Neko
    @Sandy and Black Kitty
     
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  32. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    No, not a good idea. Using R requires a lot more testing. R is a powerful insulin. It requires knowing Cleo's onset, nadir a duration on Lantus. You need a basic understanding of how the basal insulin is working before adding a bolus on top. Even now I have no idea if the Lantus dose is too much or too little.
    One of two scenarios explain this. Scenario 1 - more insulin is finally getting Cleo to some lower numbers than she is used to. We don't know whether this is happening or when because there are so many cycles without any data. The lower numbers are causing higher bounces. Over time the high bounces will come down as Cleo gets used to what to her are not normal numbers. Scenario 2 - the dose is too high.
     
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  33. Cleocatra

    Cleocatra Member

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    Nope, teeth are fine. No infections. At last vet visit, they did a full panel- no UTI's, she pees good.
     
  34. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Good point Wendy.

    Chris: you don't have enough data on your SS to really get a good idea what Cleo is during during the cycle. Take a look at Walter's SS on March 14, 2020 just for one example. Walter was in the 400s for both preshots but dropped to 119 in the AM cycle. If Zelda wasn't testing more than just at preshots, she would not have any idea what Walter is doing throughout the cycle. https://docs.google.com/spreadsheet...c5_vXAaYQ_grbn-TL_UB6H5tkQiqDxEq8nP2I/pubhtml

    With Freckles, it was getting frustrating. All I would see are higher numbers ... forever it seemed. Although I was thinking every time I tested her was "How high is the number going to be this time? Are we ever going to move down? What's the point of testing when she is high and flat?" Thanks to the encouragement of the members on this board, we continue on and continue following the protocol. The dosing and testing protocol is as much as a road map we are going to get with this Feline Diabetes journey - and it has helped many, many people.

    The other thing that help me feel better is I switched to a human meter. The data on this site is primarily geared to using a human meter - plus the testing strips are much, much cheaper which allowed me to test more. You can see on Freckles SS that we started with an Alphatrak in 2019 and Freckles was always in the pinks and reds and some blacks - very similar to Cleocatra - it was depressing for me. After we switched monitors, it was easier seeing yellows. With my spirits being lifted, so did Freckles I think.

    Now that you've started Cabergoline, being extra vigilant with testing will help keep Cleo safe as the drops can come out of nowhere. You are lucky your vet prescribed cabergoline as I'm having difficulty convincing my vet to give it a try.

    Anyway, just my two bits. I can totally relate if you are feeling frustrated. We all want to help our kitties and it's nice to be surrounded by like minded people if it's only virtually.
     
  35. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    Just talked to Dr. Stiller. Btw, she spanked me for upping the dose last night and today on my own, so I had to sit in the penalty box for 2 minutes and feel shame!
    I mentioned prozinc and she said "we can try it if you want.." and I said yes, why not. She also agreed that shooting a short acting insulin on top of Lantus is not a good idea.
    When I mentioned IAA, she didn't know of any labs that do that test. Where do y'all get that test?
    So I'm picking up the Prozinc tomorrow at their clinic. I think she said $139.

    Just tested: +5 hrs. 592 never been this high
     
    Last edited: Mar 30, 2020
  36. Judy and Freckles

    Judy and Freckles Well-Known Member

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    I got the IAA test done at the same time the acromegaly was diagnosed at Michigan State University. Insulin autoantibody

    https://vdl.msu.edu/Bin/Catalog/Catalog.exe

    How experienced is your vet with treating acrocats?
     
  37. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Chris: what is Cleo eating?
     
  38. Cleocatra

    Cleocatra Member

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    Feb 2, 2020
    I'm surprised they didn't run the IAA test. It's so cheap! I guess her blood sample is gone now. Honestly, I don't think this vet has much experience w/ acro. She's probably in her early 30's. She is easy to work with and she takes time to discuss everything. I base this on her never hearing about cabergoline, which means she's not on the cutting edge yet. Whatever, I can deal w/ that. That's what this forum is for, to challenge the vet community to expand their breadth of treatment.
    Cleo is eating Purina canned DM. She likes it and it isn't causing any problems. Remember, we got her off the crappy Purina DM dry food and her #'s dropped right away and her pee-ing went down like 40%.
    We gave her some canned FancyFeast and it didn't end well, so back to the DM- oh, and we supplement w/ Starkist tuna in water, well drained, as low-carb in-between snack.
     

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