Some SRT Q and A

A member PM'ed these questions to me. I think they are beneficial if shared. The member didn't want to post here as it is a challenging time for them. I welcome additions from other SRT kitteh owners, many of whom helped me.

Q1) How did you educate yourself with all the different radiation types that are out there?
A1) Almost all the info I have, was from this forum and the links from this subforum. Many previous SRT patient parents helped me gain info. Previous threads on SRT were also very useful.

Q2) How did/do you keep functioning?
A2) There is Theresa and myself. It helps to have another person. Especially with wild insulin variations. It is scary to find your cat has significant Acromegaly. It is a devastating disease. I sleep at night because I know I am doing the most I can do to keep Leo alive.

Q3) Did you look at any of the private locations for radiation?
A3) I looked at the Acro subforum. There are not many SRT places for pets in the US. And Colorado State came up as a very good option.

Q4) Did Colorado State say what side effects might be caused by the radiation? So far, I've been given a mixed bag of information and none of it really matches.
A4) There are the potential for many side effects. Mostly I remember the potential for neurological issues since the radiation may hit surrounding areas. To my knowledge, Leo did not have any side effects except for getting healthier. I think there is a CSU blurb about side effects.

Q5) I've never been to Fort. Collins, do you feel the location and places to stay would be safe for a single female?
A5) I felt very safe there. It is a major college town. And Hewlett Packard is also there. The facility was well staffed, very clean, and very safe. I saw many single men and women bring in their pets during the week I was there - both young and old. This is not an issue with CSU.

Q6) I really don't know what to ask you....what questions did you ask your vet or the people at CO?
A6) I read a lot about Acro and SRT in this forum. I didn't have many questions. Frankly I knew more about Acro and SRT than my vet and the very specialized internist we visited here. And at CSU, they will answer any question you have. The full time vets and internists are excellent. To me they were Leo's Dream Team.

Q7) Is Leo an easy to handle pet?
A7) Fortunately yes. Hardly a complaint during blood ear testing or injections. He doesn't like pills much, but neither do I In this respect I am lucky.

Q8) My cat's team is pushing for 21 days of radiation - I don't understand all the details to speak eloquently on the topic, but the radiation is different than Colorado's short radiation. I like the idea of few times under anesthesia, but worry about the higher dose of radiation vs- leaving my cat someplace for 21+ days. (21 work days, so he'd been there for over a month)
A8) That is Linear Radiation, and they have it closer to me (Austin -> San Antonio). I don't like the protocol. It is not as precise. And the 10-20 days of anesthesia is very tough on any animal. That is why I went for SRT. Plus SRT is very precise - in that the collimated beams hit the specific areas in the target zone, and very little else.

Q9) Did you work with the neurologist at CO since it was the brain that received radiation? Did you like them?
A9) Yes. But there is no real followup unless you pay for it. Once you leave CSU, the treatment is complete. See Leo's thread - there were the following very nice and very competent people:
- 1 intern (go-fer)
- 1 assigned regular vet, just completed degree, this was his internship
- 1 senior DVM oncology overseer, a complete specialist
- 3 internist DVMs, specializing in oncology, with one assigned to Leo
- 2 or 3 people doing machine and pet setup
- plus front office staff, including volunteer staff who took an active interest in all incoming patients

Q10) How did they treat you and your pet? I know it seems like you liked them when you wrote your posts.
A10) I felt like I was at home. They were stellar. And they were competent. I had zero doubts. Leo received the best possible SRT that was possible. Once a clinic reaches a level of service, they are in the 95-100% region. CSU is one of those. There are other clinics which are probably at this level, and competent as well.

Q11) Can you give me any ideas what to look for or what to ask?
A11) Not sure. They will evaluate your kitteh. See my thread for history of the visit. The one variable is the CRT. They do a scan, and if it is not sufficient, they do a more precise scan (at additional cost) to achieve resolution of the tumor.

Q12) Did Leo's personality/happiness change during/after the radiation?
A12) Leo seems pretty much the same. His insulin demand slowly went from 18 units/dose to 4-6 units/dose. His eating went down a bit. He still peed about the same. Directly after the 5 days of anesthesia he was out of it for another couple of days. Probably some effects on his brain too. But he is as smart and agile now, as pre-SRT.

Q13) Did you board Leo at one of the CO partner facilities or did you keep him with you most of the time?
A13) I stayed up there in a pet-friendly hotel. I was with him nearly 24/7, except during treatment and visits to the grocery store. I even skipped visiting long-ago friends and skipped all sight seeing.

Q14) I feel like I have to give myself a huge education in radiation and I don't know where to start. Did you find any websites helpful?
A14) This is the place. People are friendly and helpful on this forum. There are at least 3 or 4 previous SRT owners here. They helped me tremendously.

Q15) I'm sorry to read about Leo needing chemo. I hope he does well with it. I admire the enthusiasm that you have when dealing with your cats and their ailments.
A15) Thanks. Leo is a trooper. We lost 2 cats and also 2 people last year, including my Mom. I was determined to give Leo more time. I do not regret it a bit. However, this commitment pretty much means we can't go on vacation. Who cares. Leo and our cats are better than Disneyworld any day.

Q16) I'm open to ideas, information and suggestions. It's a new road and I don't know anything about it.
A16) I would NOT wait. Acromegaly can grow aggressively. Every day with those extra growth hormones, is a day they are adversely affecting you kitteh. Excessive bone growth, restricted throat tissue growth, thickened organs, and eventually neurological problems. The extra insulin you give, is displacing the excessive IGH, and generally the best treatment is SRT, or a hypophysectomy (removal of pituitary).

I hope this is helpful. And of course....the required daily pic of Leo and Little Dude. A little out of focus. Leo is licking LD, and you can see Leo's e-tube.

JeffJ

 

The stickies at the top of this sub-forum contain some darned good info.

 

There are almost 200 members in the Facebook group for Feline Acromegaly, so there are plenty of current data available.... I am posting only to comment on the 21 sessions..... I know that IMRT is 20 sessions and worked wonders on one member's acro, but 21 sessions SRT?
Not sure about that amount.
https://www.facebook.com/groups/acromegaly/
You can ask all the others who have gone for SRT and IMRT.

 

Piling on my answers, where they differ from Jeff's.

I learned as much as I could about Neko's insulin behaviour - onset, nadir and duration. This made things more predictable and I also had an autofeeder I could fill with food if I thought she was going to go low. This gave me more freedom to get out. As far as coping with acromegaly, I dove into research. Knowledge is power.

Yes, I am in Canada and there is one facility closer than CSU. At the time, it cost over twice as much for treatment. I know a vet who has sent clients there and says good things about them, but the price made the argument for me.

Yes. One thing Jeff didn't mention is the potential for a cat to go hypothyroid after treatment. It's not common, but I know of a few who went hypoT after treatment. Fortunately it's handled easily with daily medication.

I went there once by myself with Neko. It felt like a very safe small town. Very friendly people when you mention you are there for treatment for your pet.

I can't stress enough how much safer fewer anesthesia is. Many acros have heart issues or kidney issues. Anesthesia is hard on kidneys and Neko had a heart block during an anesthesia. My thoughts, the less times out, the better. SRT is also much more focussed and the tissue surrounding the tumour that is hit is much less than in non SRT. I also liked Neko coming home to the hotel every night with me.

Keep reading and asking questions. There are more options than SRT now. The Royal Veterinary Clinic in England is researching some exciting medical treatments that can be done at home.