Congestive Heart Failure and Hyperthyroidism... Diet help??

Hi guys,

First of all, I wanted to say that I posted about 4 months ago for diet suggestions when my 20 year old childhood cat Bella was first diagnosed with CHF, and I received not only some great advice, but some wonderful support from people who have experienced the same, and I wanted to truly say thank you for that.

Since taking Bella in for CHF, I had to go out of town for a work conference in Boston for a whole week.  Unfortunately, I had to have friends come by and give her her medication and feed her.  She unfortunately stopped eating while I was gone and taking her meds altogether.  When I got back, she was in pretty rough shape and was dehydrated and not eating anything.  I took her in to get some fluids, and they performed a blood test.  As it turns out, not only does she have CHF, but she also has Feline Leukemia and Hyperthyroidism (which, after researching, I'm pretty sure led to the CHF).

She's now seemingly doing 100% better, and is eating to her hearts content when I feed her.  However, now I'm a bit lost on what I should be feeding her to meet her unique needs.  I know low sodium is important for the CHF, and I've been feeding her only food that measures less than .30% sodium content, which I was recommended in the past.  Does anyone have any other suggestions for how to properly balance her diet to address the hyperthyroidism as well?  She is constantly crying for food, so I've been trying to feed her a little more.  She is about 5 1/2 lbs..  Is feeding her more food for calories more important than worrying about limiting the food for the sake of sodium intake?  She is currently on a diuretic (furesomide), an ACE inhibitor (enalapril), and VetMedin.

Thanks in advance.

-Mark

I forgot to also add that she was just put on Methimazole for the hyperthyroidism.  This is a little concerning to me as well.  Some articles I've researched have warned against methimazole if there is a weakened immune system. Although, I guess that's the less of two evils considering she could wither away otherwise.

It's tough when you go away and your kitty has a setback, but it sounds like she is remarkably resilient.

I don't have exactly the right info because although my cat was hyperthyroid with CHF, she had kidney disease going by that time. So all my feeding stuff was based on kidney disease and not CHF.

I will say that she lived a few years taking methimazole with no trouble, but I figure variations in thyroid was responsible for the CHF in the first place and maybe is also interrelated with the later development of kidney disease. Although in some ways it's kind of surprising that 20-year-old Bella doesn't show signs of kidney issues since that is the most common old age cat disease.

The treatment with methimazole should help stabilize her weight and appetite eventually. It needs a few weeks to get going. I would feed her as much as she'll eat now since she has appetite. So many things that could go on later (hopefully they won't) can adversely affect appetite, including complications of the CHF. I don't know how close 5.5 lbs is to her normal or ideal weight, but it sounds pretty low. (I have a 6lb cat though so some are very small.) She really will need to be on the methimazole indefinitely unless you want to consider the radioiodine treatment. There are people with cats that old who opt for it, but if she tolerates the methimazole ok that should keep levels stable enough, though you have to recheck them regularly.

Hill's now markets a prescription diet that is purported to treat hyperthyroid, but it is not something I would ever consider. I think having her eat quality protein and take the methimazole would be a better choice.

Hope that is of some use. I'd be inclined to feed her as much as she'll eat. Sure you can watch the sodium a bit if possible. It's not a bad question to ask your own vet as well, but I doubt there's a 100% absolute right answer to it.

Thanks for your thoughtful reply.  She really is a resilient cat-- every vet I take her to is amazed to hear how old she is.  If you saw her in person you would think with her appearance, energy level, and intact senses that she is a much younger cat.  This is even more surprising considering the fact that she spent all of her life up until 4 months ago being an outside cat, having never been to the vet other than to be spayed (she lived with my parents before). 

From what I've researched, most people seem to agree with you on the idea of feeding her as much as she will eat.  At the moment I am researching raw high-protein cat foods that may benefit her most.  I've read that muscle atrophy is a big hyperthroid issue due to protein loss, so I'm thinking this would be the best diet for her.  They have some lower sodium options as well.
 

As far as her size-- we never weighed her before we were aware of her health issues, but as far as I can tell she is relatively close to the same size she has always been.  She has a smaller frame than most cats.

Last time I took her to the vet for her not eating, they gave me this dietary supplement called Suplical.  It is packed with concentratwed calories, protein, vitamins, minerals, omegas, etc.  Even though her appetite is back in full force, I'm considering adding this to her food to help her pack on some weight in case she goes through a spell again later.  Do you think that would be a bad idea?