My Uncle's Hyper-T Saga (long)

Does anyone know of a link between hyperthyroidism and cancer? My Uncle has an 8 y/o tabby that I think is rail-thin (compared to my cats, anyway). She was finally diagnosed withy hyper-t about 9 months ago. His vet is doing bloodwork at the rate of every couple of weeks, which seems excessive to me. Three weeks ago, one vet at the clinic told my Uncle that Puddy-Tat's numbers had improved and maybe he could switch her meds to every other day. A couple of days ago, a different vet at the same clinic said her numbers were higher and they'd have to switch her meds to twice daily!

Uncle Joe is in his late 70s and very recently lost his wife, my beloved Aunt Mary, who made 99% of the decisions in the household. He seems at a loss as to how to handle all the conflicting info he's getting at the vets, and is constantly turning to me for help. I believe he's come to the conclusion that a) the different vets don't know what they're talking about or b) they're running lots of labs on Puddy that don't need to be done and taking his money. The last vet he spoke to a couple of days ago mentioned that with the hyper-t Puddy would probably develop cancer, too. Last month, a different vet said Puddy might have a parasite and to bring in a fecal sample (they didn't find a thing in it). It seems as if there's always some new problem going on with the kitty, but then the tests show everything is actually ok.

(boy, I'm getting carried away here!) Puddy is getting the transdermal gel in her ear, except when I 'cat sit' while Uncle Joe is out of town; I insisted he get the tablets, as it's just easier for me to dose her that way. Could giving the tablets versus using the gel make a difference in Puddy's numbers? I know the gel is measured in individual doses, so it makes me wonder if one is actually more effective than the other. (I don't know why Uncle Joe insists on doing the gel over the tabs, as he's told me he has a hard time getting it in her ear anyway) I'm confused as to how her numbers could go so completely goofy in a 2 weeks time frame (from meds every other day to meds 2x a day); I know Uncle Joe is dosing her like he's supposed to (at least, he says he is). I've tried to tell him nicely several times that maybe he should get a second opinion (I don't use the vet he does, and I trust mine completely). He's one of those people that can't make a decision without asking 14 other folks what they would do, which can be a little irritating after a while.

He says Puddy has had a better appetite lately, and has actually gained a pound in the last 6 weeks or so. I'll be cat-sitting again for 5 days next week, and his girl will be getting the tabs while I take care of her. I've asked him to get copies of her bloodwork for me; if nothing else, I can post them here and see if anyone can make any sense out of them.

So, after all this, does it seem as if his vet clinic is doing the right thing or just taking advantage of hiim? And, any input on giving the gel versus the tabs would be greatly appreciated. Also, is there really a link between hyper-t and cancer? Sorry about being so long-winded, but I'm totally confused.

Hi Libby,
My tabby (11 yo) was recently diagnosed with hyper-t too, but I think at a pretty early stage so she hasn't had the other health problems you describe. She is taking a compounded oral version of methimazole that I have to give to her twice a day. She eats it just like a treat (it's liver flavored). I have heard that the transdermal stuff maybe isn't as effective and has different side effects from the oral version. It wouldn't surprise me if the effectiveness was different. It seems strange that they would give him both - I would think a consistent dosage and method would give the best results. I have also never heard of a treatment that was every two days (if that's out there, sign me up!). I've heard usually twice a day and sometimes three times a day, I think depending on the dosage needed. Have you considered radioactive iodine treatment? It's very expensive, but is considered the best treatment (actually it's a cure). If the cat is only 8 and otherwise healthy, that would save the hassle of daily medication for many years.

As for the frequency of the tests, after a cat goes on the medication, they do need bloodwork after a period of time to see if its working and if the dosage is right. I think the initial checkup is somewhere between two weeks and 30 days (my vet wants to see mine at 30 days). After that there are some additional checkups, but I wouldn't think they would need to be so often unless there were complications or other problems present.

I'm not sure about the link between hyper-t and cancer, but I know if it's left untreated for a long time it can cause organ damage and heart problems. If you google "hyperthyroidism in cats" you'll get a ton of information to look through.

Good luck!

It seems strange that they would give him both - I would think a consistent dosage and method would give the best results.

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The tablets were my idea; I didn't think I could do the gel when I'm cat-sitting, but I can pill Puddy with very little effort. For some reason, my Uncle Joe didn't want to go the tablet route, altho I've been trying to convince him that it would be a more consistent dosage.

I've had a hyper-t kitty myself; Sophie was diagnosed when she was 13, and we lost her to cancer at 17. I seem to remember her being on her meds 2x daily, then cut to 1x daily, then 2 days on, 1 day off. I also remember the first sign that something was wrong with her was her voracious appetite---she was literally eating anything that wasn't nailed down and begging for more! My Uncle's cat, on the other hand, never experienced that symptom. I know the blood work has to be done on a regular basis, but every 2 weeks sounds like over-kill. I'm just really suspicious of the fact that his vets repearedly discover an additional problem with her, they run more tests, then decide they were wrong after all.

Apparently, the vet has talked to Uncle Joe about the different treatment methods--including the radioactive iodine and removal of the thyroid. He doesn't really know much about either procedure, and he just doesn't seem to know what to ask his vet. He actually seemed to think the iodine might be the best idea----until his vet mentioned that Puddy would probably develop cancer soon! What the hey!?

I don't imagine I'm going to find a lot of answers to this problem, as I'm only getting what Uncle Joe is telling me. I think I just needed to vent because I'm so frustrated!

I don't know where the vet got the idea that hyperthyroidism leads to cancern. There is a very, very small percentage of cats who have thyroid cancer (about 2%) but most have thyroid tumors. I have known of lots of cats with hyperthyroidism, and I have never heard of a connection between that condition and cancer. I think that vet should either provide some proof or lose a client.

As for the medication, it should nearly always be given twice per day. If the values are too low, reduce the amount that is given but continue giving it twice per day. The medication does not have a very long half life, so it is not doing anything to control the T4 levels much of the time if it is only given every other day. I would also suggest sticking to one form of the medication to ensure that the blood levels stay as consistent as possible. Is your uncle cleaning the kitty's ears between doses? That is a critical part of using the transdermal gel. If the ears aren't cleaned, the medication will not be absorbed.

With the blood tests, it is typical to run bloodwork two weeks after a dosage change to ensure that the change was adequate and that the levels are remaining within the normal range. After that, bloodwork can be done every 3 to 6 months or as symptoms appear again.

In an 8 year old cat, I would strongly recommend looking into the radioiodine option. It is cheaper in the long run, though more expensive upfront, and it is better for the cat overall since the thyroid levels remain in the normal range all the time--fluctuations can lead to heart, liver, and kidney damage over time.

Is your uncle cleaning the kitty's ears between doses? That is a critical part of using the transdermal gel. If the ears aren't cleaned, the medication will not be absorbed.

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That's it! Uncle Joe has never mentioned cleaning Puddy's ears, so I called him and asked if his vet had told him that needed to be done. Well, of course they hadn't told him.
I think I've convinced hiim to switch to the tablets for now; that way his kitty will get the proper dose each and every time, and he won't have to clean her ears. (he really didn't like the sound of that ) I took care of her a month ago while he was out of town for 5 days and I gave her tablets. He's told me several times that he doesn't know what I did to her, but she just seemed so much better. Apparently, she was getting the meds she was supposed to be getting and it made a noticable difference. He's leaving again this Sunday for 5 days and I'll be taking care of her and his other kitty, Thomas.
For some reason, Uncle Joe seems almost timid about giving Puddy a pill. I did it, and she doesn't really know me very well. I think I'll have to give him a lesson in pilling a cat. Hopefully, his little girl will get on a regimented dose and feel better again. I think he's seriously considering the iodine treatment for her, as well.
Thanks, cloude_shade!