Hyperthyroid in cats

[mom2rtk]

Called with some questions for the vet today. He was out and his partner talked to us. Also had us run her up there for another look. He's a lot more pessimistic and says he thinks her issues are more about her liver than hyperthyroid. At this point I really fear that we're about to lose our 3rd (and final) cat in the past 7 months.

More fluids today. Said to let them know tomorrow how she's doing. I really can't imagine she's going to come out of this all of a sudden. And I doubt there's much treatment for liver disease anyway.

I'm just shocked. This is just too much.

 

[morgan98]

Called with some questions for the vet today. He was out and his partner talked to us. Also had us run her up there for another look. He's a lot more pessimistic and says he thinks her issues are more about her liver than hyperthyroid. At this point I really fear that we're about to lose our 3rd (and final) cat in the past 7 months.

More fluids today. Said to let them know tomorrow how she's doing. I really can't imagine she's going to come out of this all of a sudden. And I doubt there's much treatment for liver disease anyway.

I'm just shocked. This is just too much.

I am so sorry to read this update. My thoughts are with you, as cats can be fairly resilient and hopefully they can find some treatment that can work.

 

[Meriweather]

Yes, please feel free to ask questions. The radioactive iodine treatment felt like a big step when we did it, but she was just not getting any better. She recovered from it fairly quickly. The hardest part once we got her home was separating her from our other cat. Not because keeping her in another room was really hard, but because she did not understand why she couldn't roam around the house and see the other cat or us.

Also she hated taking the pills and then was causing us plenty of stress too.

Hopefully you did catch it relatively soon. It is so hard to see our pets sick.

Yes, that is my Morgan and she will always have a special place in my heart (like all pets do) I adopted her when I was still living in Indiana and when I was married the first time. She came with me after my divorce and a move to Michigan and Georgia and a new husband...lol! We went through a lot together.

Our cat also had the radioactive iodine treatment at age 9.
Hardest was him starting at the clinic for a week.
So worth it. He lived to be 20

 

[DisneyOma]

Called with some questions for the vet today. He was out and his partner talked to us. Also had us run her up there for another look. He's a lot more pessimistic and says he thinks her issues are more about her liver than hyperthyroid. At this point I really feathat we're about to lose our 3rd (and final) cat in the past 7 months.

More fluids today. Said to let them know tomorrow how she's doing. I really can't imagine she's going to come out of this all of a sudden. And I doubt there's much treatment for liver disease anyway.

I'm just shocked. This is just too much.

I hope they find an easy fix for Fritz! My 13 year old cat Pi has been on methimazole for 2 years now. It took about 6 months to get her dosage right, and she gets bloodwork done every 6-8 months to recheck her levels. She's on a compounded dose, in a liquid form, that I syringe into her stubborn mouth. She can't spit it out, as it is viscous, and she gets the entire dose because it is given straight into her mouth, not on a treat. That way we don't have to worry about her spitting it out and the other cat eating it. She's lost a little weight, but she's playful and not throwing up every day. She still pukes up hairballs, and sometimes just plain old bile, but only a few times a month. She's always been a puker though - one her nicknames is Pukey Pi.

 

[OneOftheB's]

So 3 days later, eating is still a problem. No idea if she's drinking. Took her back yesterday and she got fluids and a B12 shot. I'm highly invested in various cat foods and kitten food. I boiled chicken. And she's not having it. She does still love eating Temptations cat treats, probably the cat equivalent of eating potato chips. But at this point, I can only assume it's better than nothing for the short term.

Try meat flavored baby food (read the label to ensure there are no onions). That’s a food that even the sickest cats at the shelter will eat a few bites of (plus it’s pretty high calorie). Good luck, my old man has hyperthyroidism but he does eat.

 

[mom2rtk]

I thought I'd update my thread with some optimistic news.

Based on something someone posted here, I sought out some lay advice on a couple of hyperthyroid groups on Facebook. The prevailing opinion on at least one of the groups is that many vets are starting cats on too high a dose of the medication methamizole for treating the hyperthyroid. After a while of struggling with getting Fritz to eat, I went rogue and cut her dose in half. And soon after, she took a huge turn for the better. For the last 6 weeks or so she has been eating well and has put back on at least 2 pounds. Medicating her twice a day is a big commitment, but she's family so that's what we do.

The best news of all, I took her back in last week for a repeat full blood panel. And every single one of her values were within the normal range. Even the liver values were back to normal. She's looking great and acting like her old self.

We're in bonus time. I really thought we were going to lose her.

 

[DisneyHardin]

Thanks for the update. It makes me feel much better about the vet appointment we have tomorrow. My cat has been prescribed 1 cc of methamizole in the morning and another .5 cc in the evening. I just can't subject my sweet girl to medication 2x a day, so I just didn't do the evening dose. I'll be interested to see what her levels are tomorrow. In my opinion she is is doing well, her fur is much better and although her weight is down from a year ago, she seems to be maintaining.

 

[mom2rtk]

Thanks for the update. It makes me feel much better about the vet appointment we have tomorrow. My cat has been prescribed 1 cc of methamizole in the morning and another .5 cc in the evening. I just can't subject my sweet girl to medication 2x a day, so I just didn't do the evening dose. I'll be interested to see what her levels are tomorrow. In my opinion she is is doing well, her fur is much better and although her weight is down from a year ago, she seems to be maintaining.

Best of luck with your appointment tomorrow!

How many mg of methamizole does that translate into? 1 cc is a quantity, but doesn't say what strength. Is it liquid, pill or transdermal?

We started with liquid and that was just awful. Fought her each time. Twice a day. Actually 3 times a day since I was also giving her liquid milk thistle to help with her liver. It was just terrible to have that be my interaction with her each day. Eventually I found some videos on YouTube of pilling a cat and decided I wanted to try that instead. It wasn't terrible. Definitely better than restraining her and giving liquid. Of course it wasn't as easy as this guy makes it look, but it improved my technique a lot.

Eventually I settled on our current method. Our cat takes 2.5 mg twice a day. That's 1/4 of a 10 mg tablet. So it's pretty small. I had tried pill pockets, but she wasn't excited about those. But the pill pockets are made from a tacky doughy substance that can be useful. I decided to use part of a pill pocket to attach that 1/4 of a pill to the back of what she really does love, Temptations cat treats. Now I put that doctored treat with a few other Temptations on a plate and put it in front of her and she takes it willingly. It's been a huge life improvement for her and for me. We've settled into a livable routine. I'm even thinking of discontinuing the liquid milk thistle since her liver numbers are back in range again.

 

[DisneyHardin]

How many mg of methamizole does that translate into? 1 cc is a quantity, but doesn't say what strength. Is it liquid, pill or transdermal?

I had to go check the bottle - it is liquid and one dose using the little syringe they gave to give it to her with, is 5 mg. So she is supposed to be getting 7.5 mg/day, but I am just giving her the 5.

 

[mom2rtk]

I had to go check the bottle - it is liquid and one dose using the little syringe they gave to give it to her with, is 5 mg. So she is supposed to be getting 7.5 mg/day, but I am just giving her the 5.

What most of the lay "experts" in the hyperthyroid groups believe is that some vets start cats at too high a dose these days. That they are using outdated dosing protocols. 5 mg in one dose is a lot. We were started at 5 mg twice a day and now do 2.5 mg twice a day. Based on the info I'm seeing online, I worry that our dose might still be a little too high. Most are saying cats shouldn't be started over 1.25 mg twice a day, then adjusted up as needed. But I believe most say they should be dosed twice a day so take that for what it's worth.

If dosing twice a day is too much, have you considered trying a different form to make it easier?

 

[Mango7100]

What most of the lay "experts" in the hyperthyroid groups believe is that vets start cats at too high a dose these days. That they are using outdated dosing protocols. 5 mg in one dose is a lot. We were started at 5 mg twice a day and now do 2.5 mg twice a day. Based on the info I'm seeing online, I worry that our dose might still be a little too high. Most are saying cats shouldn't be started over 1.25 mg twice a day, then adjusted up as needed. But I believe most say they should be dosed twice a day so take that for what it's worth.

If dosing twice a day is too much, have you considered trying a different form to make it easier?

I would typically start at the 2.5 mg dose and recheck bloodwork in 4 weeks. methimazole can cause anorexia, vomiting, rarely blood count decreases, and rarely facial itching. You do have to watch their kidney values as well since long term hyperthyroidism has adverse effects on renal function, but in the short term can actually temporarily improve their kidney function. I agree pills are easier (I had a hyperthyroid cat for years that I gave methimazole to). Transdermal also works for those who can’t give oral meds. There is a prescription food called y/d which is iodine restricted (iodine is needed to make thyroid hormone). It has a great success rate in studies and in my experience but you must be very strict—no other treats, no mixing food, no eating birds, etc. Radioactive iodine is still the gold standard and is the treatment of choice for cats who can be in isolation until they are cleared from radioactivity. It is very effective (sometimes they actually become hypothyroid), and I would chose that for my cats in the future—but it is costly and isn’t available everywhere.
Glad your kitty is doing better! Super cute pic.

 

[SharonZ]

I highly reccomend getting the medication formulated into a transdermal gel. We do that for my cat's anti-anxiety medication, and we rub into his ear, he doesn't even notice.

 

[mom2rtk]

I would typically start at the 2.5 mg dose and recheck bloodwork in 4 weeks. methimazole can cause anorexia, vomiting, rarely blood count decreases, and rarely facial itching. You do have to watch their kidney values as well since long term hyperthyroidism has adverse effects on renal function, but in the short term can actually temporarily improve their kidney function. I agree pills are easier (I had a hyperthyroid cat for years that I gave methimazole to). Transdermal also works for those who can’t give oral meds. There is a prescription food called y/d which is iodine restricted (iodine is needed to make thyroid hormone). It has a great success rate in studies and in my experience but you must be very strict—no other treats, no mixing food, no eating birds, etc. Radioactive iodine is still the gold standard and is the treatment of choice for cats who can be in isolation until they are cleared from radioactivity. It is very effective (sometimes they actually become hypothyroid), and I would chose that for my cats in the future—but it is costly and isn’t available everywhere.
Glad your kitty is doing better! Super cute pic.

Thanks so much for chiming in! I've given the radioactive iodine treatment some thought, but right now we're pretty settled in with the pills. The cost is kind of offputting, as is the idea of driving 2 hours with her each way to do it. She's a talker and never shuts up on the 1 mile trip to the vet. LOL. I can't even imagine 2 hours. But if things take a turn, we'd give it more serious thought. Honestly, a couple months ago I didn't think she'd ever be strong enough to consider other options.

I have heard surgery is also an option? What are your thoughts on that?

 

[mom2rtk]

I highly reccomend getting the medication formulated into a transdermal gel. We do that for my cat's anti-anxiety medication, and we rub into his ear, he doesn't even notice.

That's certainly something we might consider. But the cost is much higher and she's doing well on the pills so far. Great answer for a lot of people though. Maybe @DisneyHardin might want to consider it.

 

[SharonZ]

You are absolutely correct, the price is much higher. It's great for cats that are hard to pill, or owner's that need to depend on other people to occasionally medicate in their absence.

 

[Mango7100]

Thanks so much for chiming in! I've given the radioactive iodine treatment some thought, but right now we're pretty settled in with the pills. The cost is kind of offputting, as is the idea of driving 2 hours with her each way to do it. She's a talker and never shuts up on the 1 mile trip to the vet. LOL. I can't even imagine 2 hours. But if things take a turn, we'd give it more serious thought. Honestly, a couple months ago I didn't think she'd ever be strong enough to consider other options.

I have heard surgery is also an option? What are your thoughts on that?

Surgery was done more routinely years ago, but honestly haven’t had a cat for surgery in over 10-15 years. Most vets don’t recommend surgery anymore since there are better, less invasive options.. If people want a cure I prefer radioactive iodine. But meds or diet are also valid long term options. If owners can medicate, they tolerate the meds, and owners are willing to do the monitoring bloodwork (which is essential) then meds are totally fine. I did meds on my own cat for years, and she died at the age of 18 unrelated to her hyperthyroidism.

 

[Mango7100]

And yes, the radioactive iodine is way more pricey up front. But it may not be as much as people think if you consider the cost of meds and bloodwork monitoring every couple months. Also, not every cat is a candidate for radioactive iodine since they have to be isolated with very minimal contact for several days. So a diabetic cat who needs insulin twice daily could not be in the isolation protocols that are needed after treating with radioactive iodine. In school one person would go into the isolation room to feed, check on every one, clean houses, etc. They only would stay in for a few minutes once daily.

 

[sarahann77]

My Molly didn't tolerate the meds so I'm taking her in for radioactive iodine treatment next week. Scared for the 1hr drive and her being away for the few days but it's best. Still considering the isolation needed afterwards and where she won't beat down the door when confined. She's done fine for the last 2 months being off the pills waiting for the treatment. She's lost a bit more weight but seemed to be holding at 14lbs (originally 17)

For me, the cost of the meds and the bloodwork routinely was costing just as much as the radioactive treatment, if not more in the long run so that was the best way to go for me. Especially after the pills made her liver numbers go up.

 

[mom2rtk]

My Molly didn't tolerate the meds so I'm taking her in for radioactive iodine treatment next week. Scared for the 1hr drive and her being away for the few days but it's best. Still considering the isolation needed afterwards and where she won't beat down the door when confined. She's done fine for the last 2 months being off the pills waiting for the treatment. She's lost a bit more weight but seemed to be holding at 14lbs (originally 17)

For me, the cost of the meds and the bloodwork routinely was costing just as much as the radioactive treatment, if not more in the long run so that was the best way to go for me. Especially after the pills made her liver numbers go up.

Best of luck to Molly! I hope you'll let us know how it goes. The drive would scare me too and is one of the reasons we're not currently considering the option. Of course our decision calculus would change if she stopped tolerating the pills or if her numbers started getting out of control again.