Recently, while I was scrolling through one of my favorite cat groups on Facebook “Cole & Marmelade – I love my cats”, I saw a post from Sarah about her cat Pig who has a health issue called Feline Acromegaly or Gigantism. Sarah spent A LOT of time researching and studying about her cat’s condition and has a lot of experience dealing with it. I asked her if she can answer a few questions about Feline Acromegaly to help other cat owners whose cats have the same health issue. She was so nice and answered all my questions in detail, so continue reading to learn about her own experience with Feline Acromegaly.
I also want to highlight that she launched a fundraising campaign at Gofundme.com to gather the funds for the Radiation therapy that Pig needs to survive. So please, go check it out and donate if you can. Share it with your friends too so we can all help Pig get the treatment he so desperately needs!
Disclaimer: Before we get to the medical stuff, I want to say that this post should not be taken as a medical advice for your particular cat. Each cat is different and might require different approach. If you are worried about your cat or your cat is already diagnosed with Feline Acromegaly, make sure to consult with your vet before you make any decisions.
Interview with Sarah about her experience with Feline Acromegaly
Question no. 1: What were the first symptoms you noticed in Pig?
From the moment I laid eyes on him, I was in love. I mean, so deeply in love that I knew from that moment that I had pledged my life to his and he to mine. I made a promise that day to always love and care for this scrawny little black kitten monster. A promise I have not ever taken lightly.
Pig has always been a very special cat. Of course, I think all cat owners will tell you this. His personality is larger than anything in the world and his love is just as strong. He has always been full of energy and rambunctious antics. I mean, one day he tried to fight a cow that had wandered onto my front porch because, well, that cow was too close to his home. He is a feisty one, a brave one! So, when he started to isolate himself in the house I knew something was wrong. He went from being an adventurous and open boy to a couch recluse in only a very short time. I first noticed the changes in his behavior.
You see, cats are masters at hiding illness and pain, it is in their biological make up to do so. It is because of this that most illnesses first show in behavioral issues such as peeing somewhere other than the litter box or hiding. Pig was hiding. A lot.
He was also very lethargic and just a little puny. I kept saying that there was something wrong with him, that he just did not seem like Pig. He seemed depressed, in fact, and nothing I did could bring him out of it. He did not want to play anymore and he barely ever wanted to snuggle or be petted. Actually, about the only thing he showed any interest in was food, sleep, and water. In fact, he seemed to be obsessed with food and water. He started begging for food all the time and the water? Oh, he drank a LOT of water. I immediately knew something was wrong.
We thought maybe it was arthritis or constipation, but nothing really seemed to fit the bill. I kept telling people I thought he had a bladder infection and no one would listen. Well, one night my fears were realized and he started peeing blood. After rushing him to the Emergency Vet Clinic, I found out that he was a diabetic. This explained a lot.
You see, the number one indicating factor for Acromegaly is a diabetic cat that is difficult, if not impossible, to regulate. All the symptoms I noticed were symptoms of diabetes. In fact, so many of the typical Acromegalic symptoms do not even show until much later on in the progression of the disease. Actually, it took a few months to get the diagnosis and it was not until after Pig reached about 10 units of insulin twice a day that my vet finally relented and ran the tests.
The problem is, that many vets do not even check or believe that a cat can be Acromegalic as it was once very rare, so many of them will not test for it until it is way late in the disease. This is what happened to Pig and I. My vet was very open about the fact that she did not believe he was Acromegalic and even went as far as saying he was not, but we ran the test anyways. When she called to give me the results she was genuinely surprised that he tested positive, so much so that she called a leading endocrinologist to verify the diagnosis. It is scary to realize that if it was not for my own, personal research and support groups, I may never have known.
Question no. 2: What kind of treatments are available to your knowledge and what did your vet suggest for Pig?
You see, this is where a lot of the issues begin. My vet, as so many others, had not ever had to deal with an Acromegalic cat, so the only suggestion I got was to see an Oncologist. However, Acromegaly is not cancer even though it is caused by a functional, but benign, tumor on the pituitary gland. Quite literally, everything that I know about the disease I learned through personal research and through forums such as the Feline Diabetes Message Board. What all of this means is, that since this journey began, I became Pig’s vet and best advocate. While some vets do have experience with this, mine does not. This has made getting the appropriate medications very difficult.
There are several treatment options out there, but sadly, many are costly or in medical trials. Owing to the once thought rarity, much of the research on this condition is very new and many of it is a cross over from human treatment. This causes the cost to skyrocket. With that being said, there are options out there. The ‘gold’ standard being hypophysectomy or the surgical removal of the tumor. However, success rates of this depend on how skilled the surgeon is and the funds for good, post-operative care. Availability of this procedure, as with most treatments for Acromegaly, are limited as well.
Another avenue of treatment would be radiation therapies such as SRT (Stereotactic Radiotherapy) which uses a highly targeted beam of radiation to neutralize the tumor. Intensive-Modulated Radiation Therapy or IMRT is another type, but is not as targeted and takes many more trips under anesthesia. Even as radiation therapies such as these show very good results, and even improvement in tumor size, neurological issues, and insulin need, the price can be quite scary.
There are other options as well, such as drugs like Pasireotide that target on decreasing the production of the growth hormone, but if radiation and surgery are not expensive enough for you, this is even worse. Cabergoline is another drug similar to Pasireotide, but is only in the initial stages of testing with highly varied results. Some kitties have shown wonderful improvements on the drug, while others none at all. Cabergoline is not as pricey as Pasireotide, but has very unpredictable results. Of course, you can always just opt for meeting the insulin need.
In fact, an Acromegalic cat has a tremendous amount of Insulin-Like Growth Factor or IGF-1 in their little bodies as a result of this pituitary tumor. This IGF-1 blocks the doors to the cells and prohibits the body’s natural insulin to open those cells and admit the glucose. This is why we see Acromegalic cats as diabetic and it is also why they are very difficult to regulate. Most diabetic felines can be regulated on anywhere from 1-5 units of insulin 2 times a day depending on the type of insulin. However, an Acromegalic cat is what we call a “Big Gulp” cat. Just look at Pig, he is up to 30 units of Lantus (a slow acting insulin) twice a day in conjunction with a fast acting Novolin R type insulin. These insulin dose levels would kill a normal cat, but for Pig, they barely bring his glucose numbers below 300.
The problem with opting to treat this way is the fact that insulin is expensive, so you are spending a tremendous amount on it. I spend upwards of $500 a month just on insulin, not to mention the other medications that he needs to be comfortable. Treating with just insulin does not stop the growth hormone and you are still faced with all the nasty side effects of the disease such as bone and tissue growth. As such, there needs to be some level of pain management as these poor guys experience a lot of growing pains. All in all, it costs me roughly a conservative $700 a month for all of this treatment and special food. This is why treatments such as SRT and IMRT are so very important. They will save a load of money in the long run and, not to mention, the life of your best friend. In the end, it all depends on what is best for you and your kitty.
Question no. 3: How does Pig’s medical treatment work? Did you already notice any positive results?
At the moment, I am treating Pig with insulin only. This is not my choice, but a necessity of finances. His diagnosis was rather sudden, considering everything, and the previous vet bills drained my savings account. However, we are working very hard to save and raise the money for his SRT treatment. I find this options to be the most viable.
Every day is broken down in 12 hour cycles for Pig. Every day at 11:00am and 11:00pm, I prepare his morning and evening meals along with his meds. Every 12 hours Pig receives 30 units of a glargine, a slow acting insulin that builds a ‘depot’ of sorts in his body. This insulin is good at maintaining his sugar levels for long periods of time and helps me to control them throughout the day. However, it is not strong enough to conquer the insulin-resistance on its own. It is for this reason that I use a Novolin R type insulin. R is a pretty harsh and incredibly strong insulin and it is also very fast acting compared to the glargine base. The R has the power to quickly pull down his sugar levels in order to allow the slower acting insulin to take hold and keep those numbers down. It is important to note, R is a very potent insulin and not recommended for use in novice situations unless directed by a veterinarian. It took weeks of research and testing to appropriate the right dose for Pig. This insulin really should only be used in clinical and emergency situations.
I would also like to note, any time you choose to use insulin for your kitty you should be monitoring blood glucose levels at home on a regular basis. I test Pig before every shot and a minimum of 4 other times in the day. When adjusting his dose, I test him every hour for five hours after the change. It is also very important to log every number in a spread sheet as this will help your vet to know how your kitty is reacting to the insulin in the home environment. Trust me on this one. It is important!
Sadly, at this time, I have yet to be able to get Pig to come under regulation and we continue to struggle with his sugar levels. This is why I feel so very adamant about SRT and why raising the funds to do so is so very important. As a result of Pig not being regulated, he receives a handful of other medications to manage Acromegalic symptoms and improve his quality of life. Along with his insulin, Pig also receives 50mg of Gabapentin every 12 hours to help with the aches and pains of Acromegaly. He also receives 25ml of Cisapride to stimulate his colon walls to produce a bowel movement as many Acro cats will suffer from mega-colon and organomegaly, meaning they become incredibly constipated as some internal organs have grown larger than they should. He also receives ¼ tsp. of Miralax in almost every meal. Every week he receives a .25ml injection of cyanocobalamin or b12 supplement alongside a .30ml injection of Adequan to help support his joints.
One thing to remember, that as long as an Acromegalic cat, or diabetic cat for that matter, remains unregulated in regards to sugar levels, they do not gain the proper nutrition from their food. As a result, they need to eat a tremendous amount of food, spread out in small meals throughout the day. A timed auto-feeder is the saving grace here!
Also, owing to the extended duration of unregulated sugar levels, kidney problems can become a very big issue for Acromegalic cats. As such, I highly recommend a good, complete raw diet. I currently feed Pig RadCat Raw and he just loves it!!
We have actually seen tremendous success in treating this way alone. Pig’s quality of life has greatly improved. However, his sugar remains a problem. One that can cause problems all its own. Again, this is why I fight every day and save every penny so that we can soon afford SRT therapy for him. Pig is a fighter. Pig is a hero. He saved me and now, I fight to save him.
Question no. 4: What kind of care does a cat with Feline Acromegaly require?
Love. All that these kitties require is love. Yes, there is a tremendous medical responsibility, but at the end of the day, these guys are still the best friends that they ever were. It can become intensive. It can become very frustrating and, trust me, you will lose sleep. However, in the end, all you really have to do is love. You will find, if you ever have the privilege to be in the life of an Acro cat, that they are the most tolerant and personable guys. Maybe it is because they realize that all you do for them, you do for love. Even as this is a hard struggle with an intense learning curve, it will be one of the most rewarding things you have ever done in your life. I would not change it for anything. Just when I think that I know it all, Pig comes in and teaches me just that much more.
One more thing. Please, I beg you, take the time to stop by Pig’s fundraiser and read his story at https://www.gofundme.com/FortheloveofPig as we fight for the funds to provide him with the Radiation therapy that he needs to survive. All donations are greatly appreciated and any excess over the cost of treatment will be donated directly to the FDMB, other support groups, and victims of this condition. I thank you in advance for your time and attention to this debilitating monster and hope that one day we can see this thing to light.
For more information regarding Feline Acromegaly and other Insulin-Resistant conditions as well as Feline Diabetes in general, please visit the Feline Diabetes Message Board.
Also, for a more comprehensive understanding of this condition please read the articles found at the following links:
- Feline acromegaly: an essential differential diagnosis for the difficult diabetic
- Feline Acromegaly Treatment by Diabetic Cat International
- Feline acromegaly: The keys to diagnosis
- Research shows why vets are often missing the cause of feline diabetes
- Questions by acromoms and Answers by Dr Lunn about Stereotactic Radiosurgery at Colorado State University
- Feline Acromegaly Treatment
- Feline Acromegaly- Treatments by CatsDiabetes.blogspot.com
- Diabetic Remission Clinic on Facebook
The end of the interview.
Back to me
If you want to read more about Pig and his condition, take a look at Sarah’s article The Silent Giant: Under the World with Feline Acromegaly.
I want to thank Sarah for taking the time to write these comprehensive answers and giving us an insight into a life of a cat with Feline Acromegaly. I am sure these answers will be of great help to cat owners whose cat is dealing with the same health issue.
Don’t forget to share the fundraising campaign, and if you can, donate too! Pig will be thankful!
What’s your experience with Feline Acromegaly? Let us know in the comments!