The Choice

On Friday Betty underwent her day of tests. A day to ascertain if she is truly an acrocat and to expose the options for treatment. It started with the detection of a slight heart murmer, typical of these special cats. Ranked 2 out of 6 on the murmer scale, but potentially a blocker to sedation.

Decision number one, following the heart scan: 'we do not consider her to be any more at risk than a healthy cat, do you want us to go ahead with the sedation and the CT scan?'

Yes.

Betty had her CT scan, an ultra sound of her abdomen, blood tests and lots of hair shaved. The tumour is relatively large and confirms that Betty has acromegaly. She is accepted as a candidate for the drug trial that the RVC are running but it is one of four options.

Option one is radiotherapy, a risky invasive treatment involving multiple anesthesia, performed elsewhere with no real evidence of a long term success rate.

Option two is surgery. The 'gold standard' treatment. If successful then complete cure is achieved. But the risk of death during and post surgery is high.

Option three is the drug trial. It starts with five days of small doses. If responsive then six months of free treatment are offered - one injection per month. It works by eliminating the growth hormone produced by the pituitary gland tumour. This stops the progresive acromegaly disease and reduces/eliminates the need for insulin. It does nothing to act on the tumour and if successful, would need to be administered long term to maintain the effect.The brain tumour could still cause neurologcical problems. In addition, insulin dependancy can really wane through the month. The best way to keep her stable would be to learn to home test.

Betty is cat number 9 in a trial that has space for 12 cats. One cat is in remission, one has been put to sleep, most are still within the six month trial period and some have developed diarrhea.

Option four is to continue with the massive insulin dose. Betty is controlled at the moment but this could change at any time. Her qualitive of life is seriously undermined by her ravenous hunger.

Hobsons choice. The drug trial seems to be the safest option in my frazzled brain. But if it works I need to find a way to fund it after the free trial.

So my fingers and toes are crossed. I'm missing her like mad and visiting nightly. You can never rewind time and try another route, so I will never know if my choice is the best one. All I can hope is that it is as educated and as full of love as possible.

My home is not home without her.