Yoshi update

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Stressedcatmom, Jan 1, 2020.

  1. Stressedcatmom

    Stressedcatmom Well-Known Member

    Mar 16, 2017
    My best friend, Yoshi was just diagnosed yesterday.

    I am devastated beyond words. I can’t stop crying.

    Brief history: He was diagnosed with diabetes about three years ago. 2u of prozinc and a diet change and he was in remission for 2.5 years.

    This August I noticed diabetes symptoms and he came out of remission. New vet prescribed Lantus. He had a UTI and bad teeth (5 extractions). I prayed this was what caused coming out of remission, but the dose kept increasing. Tested for acro and here we are.

    I’ve read a lot on this forum and it makes me cry harder. I can’t take him for the removal and I’m not sure I can swing radiation. The vet is back on Saturday and I plan to discuss it, but to be honest, I don’t think I can swing that cost either, and I just don’t want to impose any more risks on my babe.

    Prior to the Acro dx, my vet and I thought he just wasn’t responding to lantus and we were going to go bk to Prozinc (I purchased a vial), but I wanted to wait to get the test results back before I switched.

    I have to update his spreadsheet, but he’s been in blues a lot on 7.5u.

    I don’t even know what I want to ask everyone. My head is spinning.

    How do they get this? How long can he live without removal or radiation? He’s healthy for the most part except when he bounces in the morning, he sleeps. After reading symptoms, I realized he has some. He has a belly, his paws grew a bit, his jaw is slightly pronounced and he makes a clicking noise when he eats which I thought was a result of the dental. And he snores.

    I’m probably all over the place with this post, but I just wanted to reach out. I need some support and some sort of light at the end of this really devastating tunnel.

    @Wendy&Neko, here we are.

    Thank you.

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  2. JeffJ

    JeffJ Well-Known Member

    Jul 7, 2016
    I'm sorry to hear about Yoshi kitteh. Leo had those same external symptoms.

    Acro can be a challenging disease, but it is not an immediate death sentence. Besides SRT and hypophysectomy, some have found cabergoline to be successful. You probably already saw that in some of the threads. And there are some folks who provide insulin-only. Some Acro cats live a long time. It just depends on the tumor size and output, plus the remedy.

    To repeat myself, you should consider Cabergoline. There are not many definitive studies on cats. However the studies on humans showed a good percent responding successfully. I don't recall Cabergoline having bad side effects from the cats on the forum here. Finally, the costs for cabergoline are affordable for most. Recent prices from Teresa (for Cricket) were:
    $84 - $100 / month
    in this thread here <<<----- link

    You asked how cats get Acro. There is no answer. Why do cats or humans get cancer? In many cases, it just happens. Leo ended up with small cell lymphoma (SCL) during the year after his SRT. We successfully treated for that for 2 years. Our kittehs don't live forever. But there are different treatment regimes we can provide to extend their lives. I hope Yoshi has a long life. From his chart - I would keep doing safe dose raises until you get some more blues on the chart. Neuropathy happens from the consistent high BG numbers, and it makes for a more complicated health situation.
  3. Karen&Rocket

    Karen&Rocket Member

    Feb 4, 2019
    I'm so very sorry to hear about Yoshi's diagnosis, especially after being in remission from diabetes. I understand... Rocket was diagnosed in July of 2019. I have never cried harder than I did on that day.

    We opted for radiation (SRT) for Rocket -- we weren't sure we could swing the cost either, but we found a great vet near us who came highly recommended, and we got a little financial help from family. Care Credit was offered to us at the office, so that might be an option too. I don't have any experience with cabergoline, unfortunately, but like Jeff said, I would recommend looking into it too.

    Rocket is doing pretty well after SRT. Before and immediately after treatment, he was on 12-13 units of Levemir. He's now down to approx. 3.5 units, which is amazing. Going down the dosing scale can be challenging, and Rocket tends to be on the bouncy side anyway. I've also had to be somewhat conservative with his dosing on occasion, since I work odd hours some weeks, and his spreadsheet reflects that unfortunately. I'm hoping that his acro symptoms will be lessened/delayed by treatment, but there are no guarantees as far as that is concerned. I do notice that his snoring is much quieter now, and he's generally a much happier kitty. :)

    Anyway I'm kind of rambling, but I just wanted to give you some background on a fellow acro kitty. Feel free to ask any questions, or just vent if you need to. It's a very sad diagnosis but not without hope. I've gotten some amazing help from others here who have gone through this too, so I'm happy to offer what advice and support I can.

    Hugs to you. Please give Yoshi a hug for me too. :bighug::cat::bighug:
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Feb 28, 2012
    Sorry you are here Jennifer. :bighug::bighug::bighug: Those of us here know how devastating this diagnosis can feel. The most important thing to remember is that Yoshi doesn't feel any different now that you have a diagnosis. He doesn't know he's an acrocat, though I can tell you there have been some great cats with acromegaly. Give him a cuddle from me.

    We can help you to help Yoshi feel better and still have good quality of life. The length of time that cats live with acromegaly varies a lot. A lot of these cats are older, and get other conditions too. Sometimes it's not acromegaly that finally takes them. We've seen cats live from 1.5 years to 5 years and over with acromegaly, some of the latter without any treatment other than giving enough insulin to keep their kitty under renal threshold as much as possible and managing any side effects as they occur. Neko had 4+ years after SRT, but when I asked the researchers at CSU who did the treatment, they said the average length of time cats survived after SRT was 2 year, not because of acromegaly, but because of those other conditions. I also asked researchers at the Royal Veterinary Clinic, who did the "1 in 4 diabetic cats has acromegaly" study, and they said they were seeing similar numbers with cats who had hypophysectomy, the surgical removal of the pituitary. I think treatment can make a difference for some kitties so I'm not putting it down, just saying it's not a guarantee of long life. One thing treatment will do though, is give better quality of life for the time they do have. Cats getting the surgery generally go off of insulin, as do a number undergoing radiation. Karen brings up a good point with Care Credit, there have been a few kitties get SRT with it. Even had one or two lucky enough to get it covered by pet insurance.

    You also are not the first caregiver with a cat coming out of remission to find a diagnosis of acromegaly. Just caused you asked, a link to possible reasons a cat gets acromegaly - and no, it wasn't anything any of us did. Neko's only symptom on diagnosis was her dose and ravenous hunger, and I later found her tearing eye was due to soft tissue growth in her tear duct. The majority of cats have no acro symptoms on diagnosis. How old is Yoshi now?

    Did you get IAA results too? I was kind of surprised to see your vet refer to the European reference numbers. It's sort of like the US vs. World BG numbers. MSU reports in the US values and we are used to both measurement systems.

    Jeff has mentioned it (and your vet did not), but cabergoline is the cheapest treatment currently available. I rather suspect your vet has been doing some recent reading on acromegaly (a good thing) and most of the current info comes from England. The folks at Royal Veterinary College did a study on cabergoline, but we have had more success here, and probably now more long term data than any where else. Here is a post I started on cabergoline, where a number of the people using it jumped in. FYI, we have had three kitties got OTJ on cabergoline, and a couple others on it over a year, reporting some reduction in insulin needs and most important, reduction of some of the acro symptoms. Two active current users @Olive & Paula and @Pamela & Amethyst are longer term on cabergoline. Some cats report some mild GI symptoms to start, but that's it.

    I will stop now, could write lots more.:oops: Take your time. Read a ton - at least I did. Ask questions. We are here for you and Yoshi. :bighug::bighug:
    Last edited: Jan 2, 2020
  5. Stressedcatmom

    Stressedcatmom Well-Known Member

    Mar 16, 2017
    Thank you for all of this info. I’ve been reading and reading. I forgot to answer your question. Yoshi will be 14 this year
    JeffJ likes this.
  6. Stressedcatmom

    Stressedcatmom Well-Known Member

    Mar 16, 2017
    Hi everyone, I posted over in Lantus in more detail: http://www.felinediabetes.com/FDMB/threads/yoshi-update-test-result.223706/

    I looked at the study she sent me and while one cat responded better to insulin with cab, none saw a decrease in the IGF concentration. It virtually has no effect on the tumor, apparently. I am wondering if any other acros tried cab, and then retested the IGF?
    Last edited: Jan 10, 2020
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Feb 28, 2012
    I believe only @Olive & Paula had the IGF-1 retested. Cabergoline does have an impact on the tumour. The tumour outputs growth hormone, which causes an increase in IGF-1 to be output. What cabergoline seems to do is reduce the growth hormone output. That in turn means a reduced dose and some of the other side effects caused by excess growth hormone. That is a good thing. There is no way to test feline growth hormone output, and even if there was a test, it varies throughout the day, so you can say what is excess.

    To tell you the truth, SRT also does not have much impact on IGF-1. I was told not to bother retesting afterwards. I know a couple people did, with not much change, or the number even going up. But it was clear that growth hormone output was reduced and their was benefit to the treatment.
  8. Stressedcatmom

    Stressedcatmom Well-Known Member

    Mar 16, 2017
    @Wendy&Neko you need to be a vet. You are so good. I read the South American study and I felt better, but I didn’t know why because of all the jargon. You totally translated it. You really are invaluable to this board and I can’t thank you enough for all your help.
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Feb 28, 2012
    No where need good enough to be a vet. I know a lot about just one or two topics. Vets need a very broad knowledge about multiple species. I am just helping as I can. So many vets no so little about acromegaly. They used to be taught "this is acromegaly, you will never see it".
    Karen&Rocket likes this.

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