Acromegaly in a cat

Re: Acromegaly in a cat

Holly Norman — Wed, 10 Dec 2014 11:36:03 GMT

Sorry! My mistake- must have been AHT I was thinking about- those are the two I tend to use most frequently!

Re: Acromegaly in a cat

Andrew Kent — Wed, 10 Dec 2014 09:51:55 GMT

[quote user="Holly Dale"]I spoke to Rob Foale at Dick White Referrals and I believe these guys are also offering radiotherapy for pituitary tumours[/quote]

Dick White's don't have a radiotherapy facility - in the South East it is Cambridge University, AHT or VRCC. Elsewhere Liverpool, Edinburgh or Glasgow (Don't think I've missed anybody out!). There can be big price differences between the different places so depending on the financial situation may be worth looking into this first.

RVC and Bristol are both offering surgical management now I believe.

Andy

Re: Acromegaly in a cat

Holly Norman — Wed, 10 Dec 2014 09:44:11 GMT

I spoke to Rob Foale at Dick White Referrals and I believe these guys are also offering radiotherapy for pituitary tumours

Re: Acromegaly in a cat

SAB — Wed, 10 Dec 2014 09:41:29 GMT

Thanks everyone for your advice. Looks like RVC are the best people to get in contact with.

Re: Acromegaly in a cat

Claire Fisher — Tue, 09 Dec 2014 19:17:00 GMT

I have diagnosed a few acromegalics - only 1 opted for radiotherapy (too far from London for surgery to be considered). She went to Liverpool uni, I think she had 12 treatments over 4 weeks which were well tolerated. After a few months (4 I think) her insulin requirements stabilised though they have never decreased.

Re: Acromegaly in a cat

Andrew Kent — Tue, 09 Dec 2014 18:05:20 GMT

The main options would be surgery (at the RVC) or radiotherapy (at your nearest centre!). With an IGF-1 that high it is likely that that is significant, the elevated fPLI may well just be incidental (does the cat have any other signs of pancreatitis?).

Only smaller masses are amenable to surgical resection (<1cm), and so MRI would be the first step to decide whether surgery is even an option. We have, over the years, irradiated a reasonable number of cats with acromegaly, most of them receive 10 fractions of RT over 4 weeks. Most cats will show an improved glycaemic control (ranging from some improvement to complete remission) but it can take up to 4 months after RT to see the effect.

The RVC is also investigating a potential third option of medical therapy for cats who do not fit the criteria for surgery/RT.

Andy

Re: Acromegaly in a cat

Nicola Lawlor — Tue, 09 Dec 2014 17:58:07 GMT

My own old cat had acromegaly and diabetes, he also had a lot of other concurrent problems and in his case I decided not to go down the acromegaly treatment route due to these. He was a complete nightmare to treat with his diabetes and was was on over 20iu caninsulin bid for a hint of control some of the time. If he had been younger and/or healthier in other aspects of his life we would have looked a lot more into the treatment of the acromegaly is it clearly caused a great deal of difficulty with his diabetes. We managed about 6 months with him before his ongoing renal failure became too far gone to be fair.

Re: Acromegaly in a cat

Thomas Johnson — Tue, 09 Dec 2014 17:50:10 GMT

[quote user="SAB"]

Has anyone referred clients for surgery/radiotherapy for pituitary tumour? If so how successful was it? Where were they referred to? How did the cases turn out long term?

Any information regarding risks/benefits, long term prognosis would be gratefully received!

[/quote]

I haven't referred a cat for surgical removal of a pituitary tumour, but it was mentioned by one of the lecturers at the London Vet Show that the RCV are doing them, and the outcomes have generally been good, so it might be worth getting in touch with them.

Re: Acromegaly in a cat

Martin Atkinson — Tue, 09 Dec 2014 17:34:58 GMT

[quote user="SAB"]Has anyone referred clients for surgery/radiotherapy for pituitary tumour?[/quote] I don't think this is a viable or practical possibility. You should concentrate on controlling the pancreatitis with diet and monitoring the blood glucose levels with regular insulin response curves. You haven't told us what doses of insulin you are giving but they can be considerable if it truly is acromegalic. But be careful of just whacking them up as you risk an over-swing. You may also consider a switch to insulin glargine (Lantus).