frustrated-hyperthyroid cat-looking for support

Hi
I am so frustrated! My Chester (see above picture) was diagnosed with a high level heart murmur when he was 2. I was told he wouldn't live till 3...7 years later he's still kicking at the age of 9.
He has always been obsessed with food so I didn't think much of his demanding nature until my dad suggested it could be hyperthyroidism. I had him tested and sure enough, he's sick.
The vet went through all of the options with me...he can't have surgery because of his heart, and I can't afford the radiation (plus I've read enough stories of kidney failure post procedure to scare me and he would have to deal with the stress of the car ride/not being at home). Medication seemed like a perfect option. Last week, after being on the meds for 2.5 weeks, he suddenly started vomiting uncontrollably, scratching his ears till they bled, and eventually developed diarrhea. After another vet visit, being taken off the pills, and some anti-nauseant and anti histamine injections hes back to himself 4 days later.
The vet and I have reluctantly decided to go with the food option. Unfortunately I made the choice to look on here for opinions, which seem negative at best.
I hate feeling like I could be doing something wrong, but am feeling backed into a corner here.
Just was hoping for some encouragement. I really had high hopes for those meds but I'm also not ready to put my guy down while he still has a quality of life.

He sounds like a great cat and he's super cute. I'm sorry your frustrated,and I wish we could help more. I'm Not sure where you've posted before but this is the first I've read of your cats troubles. I've never heard of a cat who reacted badly to medication for hyperthyroidism, is there no way to get him back on Meds?

On the hyperthyroidism subject I haven't posted. Just realized it was a possibility, did some research, brought him in for testing and went from there. I used to be a lot more active on the site...now I mostly search old topics when I need advice.
Anyway, yeah...side effects are rare 5-10% and usually it's vomiting which you can get through with titration on a second try. An increadibly small number- the vet says its around .5% get this scratching of the face. Unfortunately once a cat gets this kind of reaction you can't even go with the gel because the itching will come back every time. Hypothetically the vet says he could put him on a antihistamine in addition to the meds but would be on top of his 2 heart meds and he says that there is more potential for interaction issues the more meds we add.
Wish there was an alternative meditation I could offer, or enough doubt that it was the cause of his symptoms to try it a second time. He fits the profile of the 1/200 cats though and the symptoms are gone now that we've stopped the meds.

Hi Sylorna !

The very best advice is sure to come from a group of people who have been successfully managing their Hyper-T kitties' health for years and years....like, 14 years !

Here they are: https://groups.yahoo.com/neo/groups/feline-hyperT/info

Just click on the purple  +Join Group   button.

That's where I'd be looking for a solution.

Keep us posted.

I understand your frustration. While I would never recommend y/d as the treatment of choice, you have exhausted the other options. At this point, you need to keep him eating and as stable as possible. The only "cures" for hyperthyroidism are the radiation therapy and surgery. The other treatments do nothing to stop disease progression unfortunately. Many vibes for Chester.

Thanks guys. Ill check out that yahoo groups page. Spoke at length with the tech this morning and she says she has seen good results in the past. Its not ideal. I also consulted a place that does the radiation and I would be looking at about $2000. The food should help a bit and at least keep him comfortable for now. We'll go from there.

I won't begin to pretend to know more than the yahoo group on Hyperthyroidism, but I have two cats that have the condition, one treated by radiation, the other managed via Methimazole.  Although an actual allergy to the drug is a possibility, often a reaction to the drug is caused by starting the medication at too high of a dose.  You didn't mention what dose your cat was prescribed.  I believe the "normal" starting dose, recommended by the drug manufacturer, is 5 mg per day.  From everything I've read, and in discussions with my regular vet and a vet internist, it is much better to start at a lower dose, test for effectiveness, then go up in dosage if necessary.  This not only allows the body to get used to the medication, it also prevents over medication.  It is also best to split the dose into twice a day offerings, as its treatment effectiveness is about 12 hours.  Each cat is different, but my cat is managed at 1.25mg, twice a day.  His latest T4 reading was 1.4. 

If in fact your cat's reaction was because of a higher dosage to start, I wouldn't think the reaction would be permanent if you try again at a lower dose.  Obviously you need to discuss this with your vet, and I know you don't want to cause your cat undo discomfort, but IMO trying again would be a better next option than keeping your cat on the Y/D food for the rest of his life.

I also want to clarify something you said about the radiation treatment.  It does not cause kidney failure.  The hyper-t condition often masks an existing kidney condition because hyper-t causes an increase in blood to flow through the kidney, which makes the kidney work harder than it might otherwise.  Once the thyroid is controlled, the blood flow returns to normal and the true condition of the kidney is seen via blood work.  The resulting decrease in blood flow will happen regardless of how you treat the hyper-t.  The point of not doing radiation (with complete cure), if in fact there is a kidney problem, is it may be better to keep the blood flowing at a higher level to help the kidney along. 

Rather than pills, my cat gets his medication in a liver treat compounded by a vet pharmacy.  It's been a great option because he looks forward to his medicine.

It sounds like you've done a lot of reading on this subject.  Have you read through Dr. Mark Peterson's site regarding hyper-t treatment? That was a great source for me.  Positive vibes to you and your kitty!

Hi Sylorna,

   I went through this with my Cotton   several years ago. Surgery and radiation weren't options for him due to age and other health issues. At the point you're at, anything he'll eat that will help him keep weight on is a good option. Prescription foods are exactly that - food meant for a specific issue. While overall, they may not have much going for them, when you have a sick kitty, any food they'll eat that keeps them stable is good food.

I'll second what LCat4 said about finding a compounding pharmacy. Many cats have difficulty with oral hyper-t medication (Cotton did...it took us a long time to get him on the right dose) but a compounding pharmacy can often make it into a topical gel that gets rubbed on the ears instead of ingested. If that's an option for you, quite a few people have better luck with it.

Lots of  for you and Chester. Hyper-t can be a rough disease to deal with, but it can often be controlled, even if full treatments aren't an option. 

Hi guys
Thanks for the thoughtful responses. I checked the meds bottle when I got home. He was on 2.5mg twice a day. When I asked my vet about a lower dose he said because the pills are so small and round they're almost impossible to cut, which after many years of cutting heart meds, makes sense to me. Also from everything I've read the committing can be dealt with with a slow titrationor the gel but the scratching of the head always comes back. I'll look into it further though.
I always thought he'd die of a heart attack...this certainly is a surprise. I have an appointment with the vet tech tomorrow and more reading to do. Thanks again to everyone, it helps with the panic.

Sylorna, for your consideration, the vet compounding pharmacy I use is BCP Vet Pharmacy in Houston, TX. You can google them. They can put lots of different meds in the treat chews I mentioned before. They have different flavors, I chose liver. I have them made with 2.5 mg of Methimazole, I then slice them in half (they're soft) to give AM and PM. My vet calls in the prescription, I give my credit card, and it's shipped to my door in 3 days (I'm in CA). Two month supply is $40, including shipping. If your vet wants to try a lower dose, I heartily recommend you look into this.

Something else I wanted to mention...I know you said that cost was an issue against the iodine treatment. I know it's expensive, but if you get to a point where it is possible, I recommend you go that route. We made that choice for the one cat, it's wonderful to have it resolved. When my other cat was diagnosed with hyper-t, he was also diagnosed with bladder cancer. No one thought he would live long, so we opted to manage the thyroid with medication. A year and a half later, I wish we had done the iodine treatment. It would have made his current health better, and we'd be dealing with fewer health considerations at one time. With your cat's heart condition, I can see that being an issue as well.

Anyway, good luck with your decisions.

Y/D food is like your kitties "get out of jail thyroid card". It can take a stressful situation for many people and cat's alike quickly nullify those effects. Let the food do it's thing, for atleast a few months. They usually regulate quite quickly on the food. No pills, no gel, no stress. Forget about surgery, radioactive iodine and the rest. Don't rush into anything. He's gotta eat right? So the food integrates and becomes his "cure". One you're happy he's doing well, and he's happy he's doing well, squirrel away 100 bucks a month for him. If you can. For his radio iodine therapy you get done in 2 years time (which is nothing in the extended life of a cat).  You should know that ANY hyperthroid treatment can reveal renal insufficiency, but wont be the cause of it. You vet will have/ should have gone over that one, but if it went over your head it tells me there is too much stress going on. The number one thing I tell people is that hyperthyoidism is a "life gets back to normal" problem. Let your cat prove that to you first, then figure out your next steps!

k

Ok, current plan:

I'm starting the food tonight after a meeting with the vet tech, and will be considering a proceedure in the future.  I did catch that the kidney problems were due to prexisting conditions being revealed...my point was that spending the money immediately to find out that he is in renal failure right after is not worth it.

I like the idea of testing out the waters with the food for now and if things go well with his kidneys and the food is not an option for long term care due to his love of food or it not being good enough quality I can sign him up for a proceedure.  I managed to find a place around 3 hours away that will do the proceedure for $1300, which is much more doable.  Also going to have the vet call the vet school in Guelph, which may be cheaper.

I am stressed about this, mostly because I want to make sure I'm doing what's best for him within my means....but I'm starting to calm down with a plan.

I'll let you guys know how it goes   Thanks again

Lots of vibes for Chester.  I think the consultation with Guelph is great.  I see you are N Bay.  Sault Ste Marie Michigan also has a phenomenal vet college which some of our vets on the Ont side of the border use.  I definitely understand the concern especially with the heart situation.  My big guy has a heart murmur also and I know it is always an issue.  Please let us know how you make out.  You and Chester are in my thoughts and prayers. 

Oh!  I need to update that!  We moved to Brampton in the Toronto region recently...it makes Guelph really nice and close.

Consulted with the tech tonight...she's consulting with the doc about increasing the amounts from very tiny and maybe adding an antihistamine.  We agreed that the food was the last option for my guy.  The doc has asked me to email him a list of things to research and consult over for the weekend...I have to admire a vet that is willing to go the extra mile.

That yahoo group may indeed save Chester's life, they've already been so helpful!

In the meantime he's eating a ridiculous amount of wet food and has dry available at all times, which has caused my girl to get considerably fat, but we'll deal with that later.  He's in heaven over the wet...if he could, that's all he'd eat.

Keep sending those vibes, I have seen them work miracles on this site before  

You are nice and close to Guelph.  They should hopefully have some answers for you.  There are new medications and foods cropping up all the time so hopefully one of them will click.   It is nice to see a vet go the extra mile.  Big hug for Chester and you know we are thinking of you.

Sylorna said:

 
...he's eating a ridiculous amount of wet food and has dry available at all times, which has caused my girl to get considerably fat...

Click to expand...

I don't understand the italicized part........who is getting fat.......and, why?

If you're speaking of a second cat.....and, if that cat is not hyperthyroid, she should not be eating this "food".

the food is not the perscription food...she is eating her normal taste of the wild.  I didn't purchase the vet food in the end, and am exploring smaller dosages and antihistamines.  I used to measure their food out and not free feed, but with Chester's weightloss over the last year I've been leaving the kibble for free feeding so he doesn't die of starvation.

We have 3 cats total, but Dynah has become quite obese in the last year or two (about 15lbs).  She is otherwise healthy, and I will tackle the weight gain once we start seeing Chester's weight go up again and I can start to measure the amounts again.  In the meantime I've been playing with her more and she does not get treats.

Sylorna said:

 
the food is not the perscription food...

Click to expand...

Ah, OK, then.....

I had only picked up on this:

 I'm starting the food tonight after a meeting with the vet tech...

Click to expand...

and, apparently I missed the meaning of this part:

 ...she's consulting with the doc about increasing the amounts from very tiny...

Click to expand...

Personally, I'm relieved that you're going that route. I suspected from the start that it might be all about too high a starting dose. So, was it the Yahoo group that recommended reducing the dosing ?

Frankly, (IMO) that "food" is crap - garbage - unfit for any cat.

I was previously going to post to you about this, but got sidetracked.

Part of what I would have posted was this: The Veterinary Endocrinologist who 'discovered' Feline Hyper-T in 1979, has written extensively about this "y/d" "food"........and, none of that is complimentary.

First, here is his professional background: http://www.drmarkepeterson.com/biography/     Click the "home" button there for his personal site.

Now, for his evaluations of this "food".....there are a series of blog entries starting in December 2011, the most recent in September 2012 (the most recent at the top of the page) right here: http://endocrinevet.blogspot.ca/search/label/y/d diet

For the most part, I found his pieces easily understood, in plain language. Some is more technical - those pieces can be skimmed through, though, and with a little patience I'm sure the picture will come together for you.

For my money, that is someone I trust........

So its time for an update. I have decided to bring my boy in for radiation. This partial dosing and allergy thing is just not worth the money. He's going in in June and I'll let you know how it goes.

Good luck!