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Question about hyperthyroid

post #1 of 16
Thread Starter 
Spot is my first cat to be diagnosed with this condition although I have a friend whose kitty has been successfully on methimazole for a year or two.

Spot is one of my ferals, so I seldom get my hands on her. Last Thursday I noticed her having trouble jumping up onto the bottom rung of a cat tree so I caught her (took about 15 minutes, usually takes 30) and took her in. The bloodwork came back hyperthyroid. I started the methimazole on Friday, once a day because she's hard to catch. The vet said if she stopped eating to cut the dose in half and start giving it twice a day. I did this on Monday, in addition to syringe feeding a couple times a day. On Wednesday I took her back in and left her at the clinic for the day. They gave her fluids and said to take her off the methimazole. The vet prescribed an appetite stimulant and said to call on Monday. He mentioned that her heart is racing and I can actually hear her breathing.

On Friday she started eating on her own a bit although she is either so weak or fatigued that she won't even stand. I've been warming food and offering it 5-6 times daily. I have to position the plate so she can eat. She is as close to death as I've seen an animal. I've read that in a small percentage of hyperthyroid cats that the methimazole causes anorexia, which appears to be what happened here. The vet mentioned trying her on a lower dose after we get her eating. I don't think surgery is an option. I don't think she'd survive it. And while the kidneys looked okay on the bloodwork, I have to suspect they might come in to play before all is said and done.

She's probably 12 years old and has never tamed, even though I've had her indoors for the past 8 years. Hard to know what made an animal that afraid of people. Anyway, I have a feeling that I may have to make a decision whether or not to let her go. YES...there was a question in all of this. Has anyone had a cat with this same reaction to methimazole and what was the outcome? Is anyone aware of any treatment options other than the methimazole, surgery or radiation?
post #2 of 16
Oh honey, I am so sorry. You must be in anguish. I've not heard of this condition before, I guess I need to do some research.

Do what your heart tells you. If she is so weak and can not eat or drink, what kind of a life is that for a free spirit? She knows you love her. She trusts you up to a point (for a feral, that's a miracle in itself).

We are here for you. Sorry headbuts and sooooothing licks from KittenKiya's Clan.

PS: There are two medications, Propylthiouracil (PTU) and Methimazole. They said that more side effects are with the PTU so that sounds like it's out. They mentioned radioactive iodine, but there are concerns about using this if there is kidney trouble.

They did mention another new drug, Ipodate, but again, kidney concerns are here too. Surgery was mentioned but that would depend on the overall health of the animal and by the sounds of it, she is NOT well. The report also said that 3/4 of the kidneys have to be compromised before the problem shows up in testing.

Oh honey, all I can offer is hugs. I am so sorry.
post #3 of 16
I actually had two cats with this condition, one lived to be 19 years of age the other 17 before they passed on. There are pills to help but we never put them on it. Its just a matter of making sure they get plenty of fluids and food in their systems. As for putting them down, that is your call as to when. Neither of our girls ever seemed in pain. The 19 year old died peacefully in her sleep one night and the 17 year old the day she died curled up in my lap and as i pet her watching tv drifted off. They lived fully happy lives, just skinny. The 17 year old was 17lbs when diagnosed, she dropped to 10lbs before she passed on. The 19 yer old was always a frail thing, never weighing more than 8lbs.

I am sorry to hear your baby has this but as for meds i cant offer you advise on that as we opted not to use the meds, to many side effects from what i remember.

yawl are in my thoughts.
post #4 of 16
Thread Starter 
Thanks KittenKiya and MaliKitty

From what I know of this condition, both in people and animals, Spot is probably not in pain, but is just so fatigued she can't bring herself to move. I'm not talking just being a bit lethargic...she simply doesn't move more than a couple of times a day to use the litterbox.

I'm not sure how I could keep enough food in her without benefit of medication. One of the symptoms is a ravenous appetite while continuing to lose weight. This is pretty much what happened. Up until a week before she was diagnosed I can remember seeing her scarfing it down at the dinner plate.

I have a friend (human) with this condition. She told me that the fatigue she felt before being diagnosed was beyond belief. She would come home, sit on the sofa for three hours trying to summon the strength to get up and go to bed. I see this in Spot, and while she is still eating on her own I think there is still a will to survive. I'm just not sure how to help her.
post #5 of 16
I'm so sorry that Spot is doing poorly. My Sophie was diagnosed with hyperT at 15 (we lost her to cancer last month, at 17). I remember her being so ravenous-- it seemed as if she just couldn't get enough to eat--but going from an all time high of 20 lbs down to 10. I never noticed her being particularly lethargic. She was on methimazole, too. Her dosage was pretty much "try this much & see how she reacts." I had to constantly play with the dosage, trying to find a happy medium. There were times she would go off her feed for a couple of days at a time; then I'd with-hold her meds for a few days & she'd perk up.
Did Spot's other tests come back ok? (I'm assuming the vet checked her heart & you mentioned her kidney functions were ok) I wish I had some incredible bit of knowledge to pass along. My first thought is that the meds somehow shocked Spot's system big-time (did the vet start her on a large dose?), and that it may take awhile for her to recover. It sounds as if you're doing all you can for her. If she were mine, I don't think I'd start the methimazole again until I was satisfied that she was actually in need of it. As my vet told me, you're the best judge of how your cat is doing. I do hope she starts eating again. I'm really sorry you & she are going thru this.
Sending loads of (((healing vibes))) to your sweet Spot.
post #6 of 16
My Molly was on methimazole for a few years with no problems. She also ate quite a bit, but would never gain weight. I never saw any of the fatigue you are currently seeing.

Sending lots of good thoughts to the two of you
post #7 of 16
You can see my Spot in my signature--he was a stray that I found in his final years, and he was also hyperthyroid. He was diagnosed almost as soon as I found him, so I don't know whether he was eating tons or not. Throughout his time with me, he went through a couple of periods where he wouldn't eat. I was afraid I would lose him. I syringe fed him and gave him the appetite stimulant, and his true spirit came back. The close-to-death appearance may be more related to her not eating than the methimazole. What dose did you start her on? I would suggest 1/2 of a 5 mg tablet twice per day, and repeat blood work in a couple of weeks to see if that brings the thyroid level down. Get copies of the bloodwork, as it makes it easier for you to track her progress. If it is hard to give her pills, ask the vet about transdermal methimazole that can be rubbed on the ears.

Hyperthyroidism itself is hard on the heart and other organs and may be causing the rapid heart rate and heavy breathing. It is important to get the thyroid levels down while getting food into her--assist feeding is not fun but often necessary to get the cat feeling back to normal.
post #8 of 16
Thread Starter 
The methimazole was compounded at 20mg in a 10ml solution, which comes out 2mg per ml. Her initial dose was .25ml, which would be .5mg. After three days I split the dose, so it would be equivalent to the .25mg twice daily. A friend told me that initially they used half that dose for 2 weeks on her cat, to make sure her system could tolerate it. I really wonder if those three .5mg doses to begin with weren't a huge mistake.

Spot was still running from me 9 days ago when I first took her in, growling, hissing, the works. She hasn't moved in three days. Today as I helped her stand to eat I found a small hard piece of stool in the bed. So far it looks like she's making to the box to urinate. Her eyes are sunken. It doesn't look good. I'll call first thing to find out if they're going to prescribe starting her back on a smaller dose of methimazole.

I've been alternating cat milk and soft food every couple hours, and she's still trying to eat. Takes her five minutes or better to lap up a tablespoon of food. I felt that cumulatively she did okay yesterday, but I may supplement some AD later today. I couldn't interest her in water, but she seemed to like the warmed cat milk. She made a pretty good dent in a 200ml box yesterday, and it has a few nutrients in it, so I figure that's good. I have a dripset and fluids, but I noticed the ringers had an 06/2006 expiration on it. I forgot to ask the vet...does anyone know if it would still be okay to use? It's unopened.

cloud shade...what part of Oregon? I'm east of Salem.
post #9 of 16
Have you tried force-feeding Spot? ( I know some people like to use the term assisted-feeding, but at my house it's always been forced) It does sound as if she's hungry, just too weak to bring herself to eat. I would imagine the more food you can get into her the better. It may take a while for the meds to work out of her system.
As for the fluids, I had a bag that was out-dated by several months. The vet's ass't. told me that if the fluid wasn't cloudy it should be ok, altho' I'd probably double-check with your vet to make sure. I don't know that I would give sub-q fluids at this point; if she's drinking the cat milk, I'd hold off (just my opinion).
post #10 of 16
Thread Starter 
I agree on the fluids as long as she's drinking the cat milk, I was mainly curious whether they were still usuable or not. So many things are still good long after the expiration and in case I do need them for her, I want to make sure I'm not doing more harm than good. The clinic reopens tomorrow after a loooong weekend, so I'll see what they say. Worst case, I've always found the emergency clinic willing to answer questions like that.

I did force feed her on Monday and Tuesday. It's not much of a stuggle since she's almost limp. I want to give her the opportunity to eat on her own if she can, or will. I usually will force feed when I think they just need a temporary assist. It pains me to force food down a dying animal though...and she looks so rough. There's something about the look of a dying animal that just sticks with me from my time at the clinic. I hope I'm wrong though.

This has taken such a bad turn. When the vet gave me her meds last Friday she said..."see ya in a month!" like it was no big deal. ***sigh***
post #11 of 16
I feel so badly for you & Spot; it sounds as if you're doing everything you can for her and she's just not responding. Will you be taking her back to the vet on Monday? It sounds as if she went down-hill incredibly fast; makes me wonder if the meds are the only thing at fault.
Sending you loads of prayers, hoping your girl improves.
post #12 of 16
I'm near Portland--when I found my Spot, he was at Clackamas Community College. Can you call an emergency vet and see if they think giving her the fluids is a good idea? Sunken eyes often go along with dehydration. Try to keep up the assist-feeding. Sometimes it takes a while to get them eating on their own again. On the Yahoo! Senior Cat group that I'm on, we had someone who's cat took several days of assist feeding before eating on its own again.

When you talk to the vet, you might also ask about liquid diets like Rebound. They have more nutrients than Catsip.
post #13 of 16
Thread Starter 
Thank you for trying to help and the good thoughts. She's gone now.

Her condition just continued to go down. This morning the vet examined her and said he felt there was more going on than the hyperthyroid, possibly her liver and heart. It wasn't right to make her go on. Knowing now what I do, I would have let her go last Wednesday. But I tried and I got to say goodbye. I wish she could have trusted me enough to let me hold her before she was too sick to care, but it doesn't always work that way.
post #14 of 16
Heartbroken headbuts and tearful, sorry licks from KittenKiya's Clan.
post #15 of 16
i am so very sorry to hear this, RIP little one.
post #16 of 16
Oh, sweetie, I'm so sorry. You did the best you could for your girl, and I'm sure she knew it. You have my very deepest sympathies.
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