Hyperthyroid and Not Tolerating Methimazole

Oberon is 15 years old and has hyperthyroidism and CRF.

Our vet put him on on 5mg of Tapazole per day (1/2 tab every twelve hours). He was showing improvement for ten days and was gaining a little weight. Then he started repeatedly throwing up foamy liquid and our vet said to take him off for five days and reintroduce at 1/4 tab twice a day (2.5 mg per day). Five days later, he was throwing up the same stuff, so she (the vet) said to lower it to 1/4 tab once per day (1.25 mg per day). This has worked for only a couple of days... Now he throws up every time, about two hours after I give him 1/4 tab (1.25 mg). Again, I have taken him off of it completely.

I will be calling our vet again on Monday, but was wondering if anyone has advice or can give options I can discuss with her. He is not a candidate for the radioactive iodine, due to his CRF.

Here's a pic of Oberon. Thanks in advance for any help.

I don't have any advice for you, but just wanted to let you know that I'll keep that beautiful boy in my thoughts and Prayers.

How advanced is the CRF? If it's still mild, he may still be a candidate. You may also want to ask the vet about giving him Pepcid AC, especially if he's still vomitting. Another option might be iopanoic acid--it replaced ipodate, which is no longer available. Iopanoic acid isn't very common and would likely need to be ordered from a special compounding pharmacy, like Island Pharmacy:

http://www.islandpharmacy.com/site/1...ge/769195/site

Also, you may want to ask whether a trandermal form of methimazole might be an option. Sometimes it works for cats who otherwise have gastrointestinal upset on the pill form of methimazole.

Thank you for all the great advice and well-wishes! I will ask my vet about all the possibilites suggested. I'm going to check out the site right now.

Originally Posted by cloud_shade

How advanced is the CRF?...

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He's at 25% kidney function.

Since CRF isn't usually diagnosed until they have 34% or less of the function remaining, 25% isn't terrible--it's still pretty early in the course of the disease. Is Oberon showing signs?

http://www.felinecrf.org/how_bad_is_it.htm

Originally Posted by cloud_shade

Since CRF isn't usually diagnosed until they have 34% or less of the function remaining, 25% isn't terrible--it's still pretty early in the course of the disease. Is Oberon showing signs?

http://www.felinecrf.org/how_bad_is_it.htm

Click to expand...

The only signs of CRF he was showing was blood in the urine, and after it persisted with antibiotics (he had a history of UTIs), we had blood and urine tests done - also because he had lost some weight. He hasn't crashed or anything. He can still jump up on the sofa and bed, and go up and down the stairs, but of course, not like he used to when he was younger. He's like a frail old grandpa now.

He loves water, and we've no problem getting him to drink. I've elevated two water bowls and keep one filled with cold water from the fridge. He likes that one a lot.

He was also put on Epakitin for the CRF which he ate on his food for about a week. He then decided he hated it. He refused to eat anything with Epakitin in it, and then quit eating entirely. We jumpstarted his appetite again (thanks to another phone call and advice from our vet) with two days of Fancy Feast, and since then he has been eating the best canned foods I can find here: Go! by Petcurean, Nutrience, Max Cat (Nutro), and Science Diet. He won't eat the same thing two days in a row and demands variety (weird cat).

I've tried sprinkling a tiny amount of Epakitin in his food a few times but he won't touch it, so I haven't tried that in a few weeks.

Oh, he also intensely dislikes the Pill Pockets, so I've had to hide his 1/4 tab of Tapazole in a Temptations Treat. I know they aren't good, but we decided the good outweighs the bad.

But right now, other than a decent diet, he isn't being treated at all.

Oberon thanks you, too.

I've heard that the aluminum hydroxide dry gel powder is tasteless and is tolerated better than many of the other phosphorus binders--it might be worth trying (this site has more information on places that sell it: http://mysite.verizon.net/~vze2r6qt/...ders.htm#aloh3).

As for the jumping, what was his potassium level? It should be kept in the mid-range (usually around 4.5 depending on the company that did the test)--I've heard the generic Target potassium gluconate tabs are good for that. Low potassium can cause weakness (though high phosphorus can too).

I'm glad to hear he's drinking enough--that's a good sign.