Abstract
An affordable and effective treatment is needed to manage feline hypersomatotropism. The aim of this study was to assess whether treatment with oral cabergoline for 90 days in cats with hypersomatotropism and diabetes mellitus improved diabetic and insulin-like growth factor 1 (IGF-1) control. This was a prospective cohort non-blinded pilot study enrolling client-owned cats with spontaneously occurring diabetes mellitus and hypersomatotropism. Cats received oral cabergoline (5-10 µg/kg q24h) for 90 consecutive days. Serum IGF-1 and fructosamine concentrations were measured on days 1, 30 and 90. Quality of life was determined using the DIAQoL-pet questionnaire on days 1 and 90. Nine cats were enrolled and eight completed the study. There was no significant change in the following: IGF-1 (day 1 median 2001 ng/ml [range 890-2001 ng/ml]; day 30 median 2001 ng/ml [range 929-2001 ng/ml]; day 90 median 1828 ng/ml [range 1035-2001 ng/ml]; χ2(2) = 0.667, P = 0.805); fructosamine (day 1 median 499 µmol/l [range 330-887 µmol/l], day 30 median 551 µmol/l [range 288-722 µmol/l], day 90 median 503 [range 315-851 µmol/l]; χ2(2) = 0.581, P = 0.764); or DIAQoL-pet score (median on day 1 -2.79 [range -4.62 to -0.28], median on day 90 -3.24 [range -4.41 to -0.28]; P = 0.715). There was a significant change of insulin dose (χ2(2) = 8.667, P = 0.008) with cats receiving higher insulin doses at day 90 compared with day 1 (median on day 1 was 0.98 [range 0.63-1.49] and median on day 90 was 1.56 [range 0.49-2.55] units/kg q12h; P = 0.026). Cabergoline did not improve diabetic control or normalise insulin-like growth factor concentration, or improve patient quality of life.
Highlights
Hypersomatotropism (HST) in cats is a condition caused by chronic excessive growth hormone (GH)
There was a significant change of insulin dose (X2(2) = 8.667, P = 0.008)
With cats receiving higher insulin doses at day 90 compared to day 1
Summary
Hypersomatotropism (HST) in cats is a condition caused by chronic excessive growth hormone (GH). Medical management using pasireotide or surgical management via hypophysectomy has improved GH and diabetic control in cats with HST.[1,2,3]. These treatments are often too costly for owners and effective alternative modalities are needed. Recommendations suggest the primary medical treatment of patients who have moderate-to-severe disease should be SRAs and patients who have mild disease (serum insulin-like growth factor 1 [IGF1] < 2 times the upper limit of the age adjusted range) can be treated using a DRA.[4,5] The direct mechanism of action of GH-secretion inhibition by DRAs is thought to be via somatotrope dopamine 2 receptors (D2Rs) within the pituitary.[6] As cats with HST have pituitary expression of
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