Update on Willow: life is good with cabergoline

Discussion in 'Acromegaly / IAA / Cushings Cats' started by cabreu, Dec 6, 2021.

  1. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    It's been a while since I've logged in, and also since I've stopped recording Willow's BG. It's so stable! Since returning to work, I've only been checking it before each shot, and it's always in the 100-130 range. I had slowly reduced to 2 units (down from around 8 at the start of cabergoline).

    We had to go out of town and couldn't find a sitter who could do shots, so for 3 days, Willow only got cabergoline, but no insulin. I figured her BG would spike to at least >200. But when I got home it was 112! Checked again with a bigger drop of blood and got 127. That was last night, and I didn't give her insulin, and this morning she was at 130. Checked this evening, and she was at 115. I am going to see how far this goes, but I think we're past the depot stage, right?

    Other than that, Willow seems good. Vet said she has a slightly enlarged heart, but I never did the echocardiogram. She hates going to the vet so much! But her teeth are in bad shape, and I am not sure whether to risk putting her under for a cleaning/extraction. Is the echocardiogram going to tell me anything useful? I assume they'll have to put her under for that too, and even if it's not as bad as the dental anesthetics, I don't want to put her through anything unnecessary. I'm a little worried that if we do the teeth cleaning, she won't wake up. Any advice appreciated, and thanks to everyone (especially Wendy) for getting Willow here!
     
    Dasha and Kabosu likes this.
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Awesome news on Willow's insulin needs, or lack thereof!! :) The depot lasts 4-6 cycles, so should be mostly gone. At the end of 14 days without insulin, she'd be officially in remission. Keep us posted how that goes.

    Before any dental, you will need to get blood work done at a minimum. Neko had a "slightly enlarged heart" for a couple years before it became something more. But once it became worse, it was no longer safe for her to have anaesthesia. Cats don't have to go under anaesthesia for an echo, though depending on how fractious, may have to have mild sedation. A echo can give you a baseline on the heart, can let you know if there other heart changes, and more importantly, in Willow's case, whether it's safe to have anaesthesia. Sounds like you might want to engage a dental vet specialist. They generally do more monitoring under anaesthesia, and are used to doing dentals on complicated kitties.
     
    Suzanne & Darcy likes this.
  3. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    My cats have never needed sedation or general anesthesia for any kind of ultrasound, including an echocardiogram. However, they’ve been “cooperative” cats. Some of the cats who hate going to the vet are so scared that they actually just hold still … so that works too (poor babies.).

    I would definitely pursue getting her heart checked out to see if it is safe for her to undergo general anesthesia- as well as bloodwork, of course (which I am sure would be required by the vet anyway before anesthesia.). The reason is that you want to get the teeth taken care of while it is still safe for her. Bad teeth can cause soooo many health problems for cats - for other organs, including the heart, and obviously can be very painful and cause them to stop eating. Many people get into the situation where their cats cannot safely be anesthetized and then not much can be done about the teeth. I have been in that situation myself where nothing could be done except to pulse antibiotics. But that wasn’t a diabetic cat where I had the added complication of dealing with increased BG resulting from a tooth infection.

    Anyway, I am really happy to hear about how well Willow is doing on Cabergoline! That is just such great news.
     
  4. cabreu

    cabreu Member

    Joined:
    Jul 30, 2020
    Thank you both for the replies! It is a good point about not letting her condition worsen before taking care of her teeth, and I appreciate being able to learn from your experience on that. I'm not looking forward to spending thousands on all of this, but I think it's the best thing to do. Are the dental vet specialists even more expensive than regular teeth cleaning/extractions?

    Meanwhile though, Willow is doing great! Before we stopped the insulin, she had been throwing up more often, and it had gotten to ~3 times per week. Since I wrote that last post a month ago, she only threw up once a couple of weeks ago, and it wasn't very much! It seems that handling both insulin and cabergoline was difficult on her body. Now she is in the 120s usually when I check her BG, or at the most, the 140s. We are increasing the cabergoline dose, since she gained a pound from when she first started the prescription. But the biggest sign that she is feeling better is that she is back to her complaining, can-I-talk-to-the-manager self! Lots of meowing and running around!
     
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I found a dental specialist a bit more cost, but not a lot more. But they also had a dedicated person there monitoring Neko's vitals during the procedure. Which made me feel better because of her heart and kidney issues at the time. A dental specialist also saved Neko's tooth. She had some red on a gum line, regular vet thought the tooth needed extraction, but I asked for a referral to the dental vet for it. Turns out the red was due to soft tissue growth on the gum below the tooth above rubbing it and some tooth shaving was all she needed. Not all vets do full xrays before dentals, and that's an extra cost item, but well worth it.
     
  6. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    Yes. I am afraid they are usually more expensive, but you can perhaps get an estimate. I've seen a great deal of variation in the prices that people here have quoted for the dental specialists.
     
  7. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    What great news about how Willow seems to be feeling much better! And weight gain is excellent! A very good sign (unless she was overweight, of course!) Thanks for the update! Keep us posted on your sweet Willow!
     
  8. Elisha and Charlie

    Elisha and Charlie Member

    Joined:
    Dec 7, 2021
    Charlie had the same problem with teeth. We are brushing them every morning and night (well my daughter is) at first it was just water and a tooth brush, my vet gave me some solution to use as he had early signs of gingivitis. She didn't want to put him under to clean with everything he has. She is so impressed with how they are looking. We also have strips of meat, where possible, rather than mince.
     
  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    This product has very good results You cut open the capsule and put the contents on their gums. I have used it with very good results and I have a friend who has used it with very good results Of course, the cat I am using it on lets me do this with no fighting upload_2022-1-23_8-3-28.jpeg upload_2022-1-23_8-3-28.jpeg
     
  10. MollyG

    MollyG Member

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    Mar 3, 2021
    Can I ask what dose of cabergoline you're using? I have been using it since last year and it slowed Allie's lantus dose increase, but hasn't lowered it by much (22-18 units). My vet told me today that her cab dose was too low (25mcg/kg) and she doubled it.
     
  11. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Are you saying your new dose will be 50 mcg per kg?
     
  12. MollyG

    MollyG Member

    Joined:
    Mar 3, 2021
    Just saw the vet today, haven’t rec’d the script yet so not really sure. Her weight changed and her dose changed when we changed the concentration of Cabergoline so I don’t know the exact dose she was getting. Let you know when I know.
     

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