PITUITARY TUMOR:trying Dexamethasone+Cabergoline, need help!

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A

AmazeLee

Active Member
Joined
Jan 26, 2013
Messages
37
Location
France
Hello ratties lovers,

For the past 10 days, I've had one of my girls, Pepper, who's 18 months old, beeing really sick.

She's just been diagnosed with pituitary tumor.
Thanks to the english ratty community (both US and UK), I've learned about some treatments to help pain relief and possibly shrink the size of the tumor, so the neurological effects of the tumor will revert back to "sort of normal", and give my girl a better quality of life for the time the meds would work and until it's time to put her to sleep :-/

My vet decided to inject her 1 unit of Dexamethanose, saying it would work for 5 days in her system.
Starting today, I have to give her 1 drop of Cabergoline (0,05mg/ml).

That's where my vet and I needs some piece of advice to start adjusting the correct dose.

First visit to the vet, was on Tuesday, 15th, Friday I came back with her cause some pus (not sure it's called like that in english), was coming out of her vagina.
She diagnosed an uterine infection and according to the state of Pepper at that time, she needed surgery so both ovaries and uterus would be removed. Vet said chances she wakes up from surgery are very thin, but she did wake up ;)

Since then, been to the vet at least twice a week.

We tried Metacam to help relieve the pain Pepper might be feeling as we still couldn't find what was going wrong with her, it didn't work (well I didn't see any improvment), and then realised that in case of hemorrhage it could kill her. She had it for the past 3 days (i didn't give her any today as I wanted the vet to give her some Dex)
On Wednesday, we started candilate, thinking she took the risk already if she had any bleeding inside with Metacam.
3 days, no effects (nor good or bad)

As of today, we're stopping Metacam and Candilate, and try the above meds.

Here's all the docs and infos I read so far:
http://www.jorats.com/forum/viewtopic.php?f=21&t=22656
viewtopic.php?f=26&t=2288
http://www.ncbi.nlm.nih.gov/pubmed/21879967
http://ratguide.com/meds/central_nervou ... goline.php
viewtopic.php?f=21&t=13851
http://www.goosemoose.com/rfc/index.php?topic=4095109.0
http://ratguide.com/health/neoplasia/pi ... _tumor.php
viewtopic.php?f=21&t=24452&hilit=bromo
viewtopic.php?f=21&t=28917&hilit=bromo
http://www.pfizer.ca/fr/our_products/pr ... ograph/159
viewtopic.php?f=21&t=29818
viewtopic.php?f=22&t=30054


If you have more links to bring to my attention, or advice, I'll welcome them arms wide open ;)
Thank you for your help :)
 
i cannot use cabergoline myself as its waaaay too expensive here but in the UK you are able to get it reasonably so that's fantastic. I have used bromocriptine with great success though :) I actually have a boy here on it and you would never know he had it. :thumbup:

When did she show signs of PT? Were they classic symptoms? Can you describe her symptoms? I just want to ensure you aren't dealing with inner ear infection or a stroke instead of PT, where the cabergoline won't help.

She had surgery/full spay on Jan. 15th, but she hadn't started treatment for PT then? Its been noticed that surgery/aneshesia can really get a PT growing fast (like having a sinus infection and flying with it, the bacteria multiplies like crazy and you are very sick, very quickly).

The dex usually only works for 3 days not 5...but it should kickstart the cabergoline. I usuaally noticed improvements with the bromocriptine in about 2 days.
 
I forgot to mention she's on Baytril since January, 15th.

First sign I saw, is when she was drinking at the drinking bottle, not having her paws balanced, she was shaking it.
That's a behavior I never saw in any of my rats (I had 8 total, lost 2, I have 6 left)
I think that was around Christmas time.
Then, a week or so later, I noticed she'd stay a very long time the head in the feeding bowl, but not trying to select her favorite food with her paws, just eating the head in the bowl. I thought maybe she was just too big and lazy.
Then another week later, I finally realized she no longer used her front paws to hold food, and was struggling trying to hold it. I weighted her and she lost 60gramms (she's a big mama, usually she weights 390g), so I didn't noticed till that day that she lost that much weight
Then the symptoms went worse, she totally lost the ability to hold food, she couldn't eat solid food even if I hold it for her (we tried apple, she couldn't bite in it, but yet as no problem swallowing, or using the back tooth), she's lost her balance, desperetly tries to groom herself but always end up rolling (I groom her every other day, and serynge feed her with baby food cereals and other stuff)
She's also a bit circling (but big circles), and i let her have a walk few times a day (3 to 5 minutes) so she can exercize (plus she wants to, everytime after I feed her, she wants to go down)
Got to watch for her very closely when I let her on the coach cause if there's an edge, you can be sure that's where Pepper wants to go and then risked to fall.
It seems she enjoys the walk, and walk pretty straight all around the place, just I noticed she has to be the nose on an item to realize something is blocking the way.
She losts smells, and have the tendancy to walk all over the food in the cage cause she doesn't even notice she's on food.

I think she has other symptoms, but those are the main ones.

Thanks for your time and help :)
 
lilspaz68 said:
Here is another one of my bromo/PT cases

viewtopic.php?f=21&t=29818&hilit=Shade+PT
Click to expand...

I read this thread (3 times at least), did I forgot to put that on my list? (I guess I did)
That's one of the thread that gave me motivation to discuss Bromo or Cabergoline with my vet.
I also used the pics shared on the thread, to show my vet what I meant with difficulty holding food with paws, how helpfull :)

It's all new to my vet, she never used such meds on rats, and I can't seem to find nowhere on french forums a person who tried this medication.

I choose from what I read here and there to go for Cabergoline, though it's more expensive than Bromo (but Pepper worth it, and even more), and less side effect (+ long term action, about 60 hours from what i read). I paid (I live near Paris, France), 25€ for 7ml.
You could think at a rate of 1 drops a day it'll last a long time so the medication isn't that expensive. Yes, but NO, once opened, you can only keep the Cabergoline for a week, yek!

On my way back to the vet today, I stopped by the pharmacy and asked if they could order some cabergoline preparation, like maybe 1ml. He couldn't help today with that request, grrrr it's saturday, have to wait till Monday. I'll also ask if it's possible to freeze Cabergoline, if it'll still be effective if frozen (I bet no, but have nothing to lose asking)
 
I would imagine freezing is not a good idea. I have only seen it used as a solution. Also people were giving it once every 3 days, not every day like bromocriptine.

You might want to consider switching to bromocriptine instead. We now know it is dosed at 3 mg/kg for rats. This is important for your vet to know.
 
That's indeed my point in posting for the first time on here (though I've been a reader for several years)

I forgot to mention this precious link:
http://www.shunamiterats.co.uk/blossompit.shtml

I know this person from reputation if I could say. I read her book about feeding rats which was very documented and interresting in many points.
And she's saying she was giving 4 drops per day,on the other hand from a research I remember they said 0,06ml for a 300g weight rat.

My logic (which is special :p) thinks if it takes 3 days for the Cabergoline to kick in the rattie system and last for about 60 to 72 hours, it doesn't sound logic to give it once every 3 day. Or maybe it's just the first time you take it, the system needs 3 days to assimilate it, and then the system is sort of used to and the Cabergoline works within a few hour?
I'll have to re-read again all the mentionned links above, to count how many owners used the every 3 day intake, so I can discuss this with the vet on Monday on the phone.

I can't seem to find what the equity (equivalence?) for a drop in milliliters, that would be such a precious help if anyone could help on that too ;)
 
My vet was spoke to a pharmaceutical company here and can get Cabergoline in individual dose (3 mg?) capsules. It would cost me $180-200 per month but it may be cheaper in your area. You may want to ask your vet if they can arrange something similar.
 
lilspaz68 said:
You might want to consider switching to bromocriptine instead. We now know it is dosed at 3 mg/kg for rats. This is important for your vet to know.
Click to expand...

I didn't noticed that bold note you wrote before I replied!
Do you have any trustfull link(s) to share about that, so I can share with my vet, and can "feed" me too with it?

Thanks again
 
victoria said:
My vet was spoke to a pharmaceutical company here and can get Cabergoline in individual dose (3 mg?) capsules. It would cost me $180-200 per month but it may be cheaper in your area. You may want to ask your vet if they can arrange something similar.
Click to expand...

Good point! Thanks
Not sure if it's an US or UK or maybe canadian forums I'm on (no kidding)

Got to check if Cabergoline is avalaible as pill form instead of fluid (why didn't think about such elementary thing to check ;-) )

Edit: I guess it's Canadian seeing your profiles locations ;)
 
Just found an answer to one of my own question, just by looking at the information sheet in the Galastop box.
3 drops are equal to 1ml (1 milliliter)
Packaging exists in a 3ml bottle, which would cost me logically 50% less a month a least, and brings the treatment on the reasonnable budget size.

So far here's what i found regarding Cabergoline in a solid (pill) form:
http://www.steroidology.com/forum/anabo ... iquid.html
Interresting, hun?!
I keep on digging infos.

Edit: It seems I can find 8 pills tablets dosed at 0,5mg per pill it's for human use not veterinary (costs about 35€), also concentration in the Galastop is 0,05mg/ml. I'm not good at math so I can't see by myself if that would be an otpion for me (anyhow I'll mention that to my vet)
 
AmazeLee said:
lilspaz68 said:
You might want to consider switching to bromocriptine instead. We now know it is dosed at 3 mg/kg for rats. This is important for your vet to know.
Click to expand...

I didn't noticed that bold note you wrote before I replied!
Do you have any trustfull link(s) to share about that, so I can share with my vet, and can "feed" me too with it?

Thanks again
Click to expand...


It's all on VIN, but he can phone or email my vet for the information.

http://www.drmunn.ca/Greenwood_Park_Ani ... CT_US.html

I also found this

viewtopic.php?f=26&t=2288#p427699

With the cabergoline, I believe it stays in the system for 3 days and that's why its every 72 hours
 
Will go read that right away lilspaz68, thanks for sharing.

I realized I misunderstood the time for the system to assimilate Cabergoline (the info sheet says between 4 to 8 hours for a dog), and the time to see (hopefully) improvment that's about 3 days. My vet went by the book, info sheet says each day X ml/kg for dogs and then did the math for a my Pepper. Can't blame her. But I wonder, how can I bring the fact that it may be better to only give it to her every 3 days to my vet? Why is it sunday tomorrow so obviously I can't call my vet :-(
Such tons (or pounds) of informations I read those last days, it's getting messy in my mind. Should take a break from researching (but time isn't on my side on this race)

What's VIN?

And thanks for your vet adress, didn't realised that's what you gave me in the first link.
Will give the infos to my vet, hopefully she speaks english ;)
 
VIN is the veterinary information network...its like a huge vet forum/information site. Here's the link

http://www.vin.com/

Your vet can also email the clinic, and try to get someone to type it out for her.

Get her to say something like this.

I am (insert Dr. name here)a vet in France.

I would really like the information on bromocriptine use and dosages emailed to me for use in rats with pituitary tumour.

I am keeping this brief as I do not speak or write english.

Thank you,
 
AmazeLee said:
Will go read that right away lilspaz68, thanks for sharing.

I realized I misunderstood the time for the system to assimilate Cabergoline (the info sheet says between 4 to 8 hours for a dog), and the time to see (hopefully) improvment that's about 3 days. My vet went by the book, info sheet says each day X ml/kg for dogs and then did the math for a my Pepper. Can't blame her. But I wonder, how can I bring the fact that it may be better to only give it to her every 3 days to my vet? Why is it sunday tomorrow so obviously I can't call my vet :-(
Such tons (or pounds) of informations I read those last days, it's getting messy in my mind. Should take a break from researching (but time isn't on my side on this race)

What's VIN?

And thanks for your vet adress, didn't realised that's what you gave me in the first link.
Will give the infos to my vet, hopefully she speaks english ;)
Click to expand...

Shelagh's (Lilspaz68) vet would be a better option because he has more experience but if your vet doesn't speak English, my vet speaks French and has looked into these medications for me. Let me know and I'll pass along his contact info.
 
lilspaz68 said:
i cannot use cabergoline myself as its waaaay too expensive here but in the UK you are able to get it reasonably so that's fantastic. I have used bromocriptine with great success though :) I actually have a boy here on it and you would never know he had it. :thumbup:

When did she show signs of PT? Were they classic symptoms? Can you describe her symptoms? I just want to ensure you aren't dealing with inner ear infection or a stroke instead of PT, where the cabergoline won't help.

She had surgery/full spay on Jan. 15th, but she hadn't started treatment for PT then? Its been noticed that surgery/aneshesia can really get a PT growing fast (like having a sinus infection and flying with it, the bacteria multiplies like crazy and you are very sick, very quickly).

The dex usually only works for 3 days not 5...but it should kickstart the cabergoline. I usuaally noticed improvements with the bromocriptine in about 2 days.
Click to expand...

Re-reading all that's been said to me, I realized you talked to me about one of your boys who has PT (boy? from what I read it's pretty rare), and didn't even ask you how he was? (forgot my manner sorry, it was a long day)
How were his symptoms? Did you notice the first sign quick enough and diagnosed PT in a timely manner? How long since he started Bromo? How old he's this little boy?
That's a lot of question LOL.
Maybe I read your thread where you mentionned your experience without noticing it was you, any magical link?
 

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