Hyperthyroid Cat with Kidney Disease and IBD

My cat was going through a bunch of health problems over the summer, and was finally diagnosed with having hyperthyroidism and food intolerances/inflammatory bowel disease (IBD).  For the food intolerances, she is now on a duck and green pea canned food which has completely cleared up her problems with gas and loose stools that she had been having for over a year.  For the hyperthyroidism, she was put on methimazole, 5 mg twice daily.  Her thyroid levels went down too low after that, and we also discovered she had kidney disease.  Her medication dosage was decreased twice, finally down to 1/2 tablet twice daily.  Her latest blood worked showed her thyroid level at the lowest it has been, and also her kidneys are even worse.  The doc told me to take her off the pills completely and then we will recheck her kidneys.  He said we may want to try a kidney disease food.  I am worried that she will not be able to tolerate the kidney disease food because of her IBD, and I am also thinking it is pointless to recheck her kidneys after taking her off the methimazole.  Does anyone have input?

I'm sorry to hear your cat has all of these issues. Each one is difficult to deal with on its own, so a combination must be so stressful for you guys. How old is your cat?

Honestly I am not sure how old she is. According to the shelter I got her from she should be between 6 and 8. I think the vet thinks she is probably older because her health problems are common only in older cats.

http://www.felinecrf.org/diagnosis_calcium_phosphorus_pth.htm   This is a very good website about CRF, lots of good info.  The link is to an article about a condition called secondary hyperparathyroidism which happens with CRF.  I wonder if that is what is actually going on with your kitty.

I have been fortunate so far I have only dealt with IBD.  Hopefully someone who has had a CRF kitty will chime in.

Hyperthyroidism can actually mask the true status of the kidneys.  The hyper-thyroid condition causes more blood to pump through the kidneys, making them work a little harder. You should actually have a better understanding of the true kidney condition when taking Methimazole than without it. 

My cat had hyper-t and kidney failure, along with cancer.  The vet discussed the concept of reducing the Methimazole to keep the kidneys working "better", but ultimately she said it's better to treat the hyper-t and then provide appropriate care for the cat with renal failure.  There is a lot of wear on the body (heart function) when the cat is in a hyper-t state (a treatable condition).  You don't list your cat's kidney stats to determine the severity of the kidneys, but good food and sub-q fluids can markedly help the cat when in CRF. 

Denise directed you to a great website for CRF.  Dr. Mark Peterson is the premier vet for hyperthyroidism.  He has several articles that discuss nutrition for the hyper-t cat and kidney cat.  http://endocrinevet.blogspot.com/2011/09/best-diet-to-feed-hyperthyroid-cats.html    http://www.animalendocrine.com/wp-c...-Hyperthyroidism-Concurrent-Renal-Disease.pdf

I never fed my cat the commercial kidney food.  IMO, the food has way too many carbs for a cat with cancer and not enough protein in general.  That's not to say that it hasn't helped a lot of cats.  The point of the food is to lower the phosphorus level the cat eats.  I tried to do the same by choosing lower phosphorus commercial food and making a homemade diet.  This was done with my vet's blessing. 

I am sorry you are having to deal with this, I know it is stressful for both of you!  I would do some reading of the CRF and Dr. Peterson websites, and then have another conversation with your vet. 

I too have read that often vets like to treat the hyperthyroidism first and then the kidney disease.  Seems likes it is a bit a of a balancing act.  The hyper-T is masking the kidney disease but to allow the hyper-T to continue will wear out or starve the cat.  At least that is how I understand it.

I think IBD, hyper-T, and kidney disease in one cat poses a difficult quandry regarding food.  I have two cats - one has IBD and Kidney issues, the other hyper-T.  With Hyper-T and IBD - a high protein diet is often suggested.  But with kidney disease, a low protein diet is often suggested.  I was just reading about diet for kidney disease and one source emphasized high quality protein but I don't know how to distinguish high quality from low quality.  I wish I had a suggestion for you.  I'm going to try my IBD kitty with kidney issues on a food with lower phosphorus levels,  We are currently trying to manage his IBD with prednisolone.  I have not been able to manage it with a change in diet.  I may eventually try the prescription food for kitties with kidney issues.