Tom is fading away....

I adopted Tom in January. He was 12 years old and dumped by his family for what I think is a weak excuse. At the shelter they discovered he had hyperthyroidism but I could accept that. I have had many cats over my lifetime and I worshipped them all but Tom was the greatest.

He has had a lot of tests including blood work on numerous occasions. He was holding his own but the last few days he was a lot different. Was very independent and would not sleep on my feed or follow me around. He was always hungry and recently very thirsty. About two weeks ago he started howling about 4 in the morning looking for food. I would not get up until 6 to feed as he had to have meds at the same time. After he was fed he wailed again to go outside. I would not let him out alone so ended up going outdoors with him about 6:30.

This morning I took him for a pedicure and weigh-in. I was shocked to see he had lost weight. He was 6.1 kilos since I have owned him and today it dropped to 5.79 kilos. That is almost a pound.

At his last blood test they thought he had a renal disease but very slight and almost normal for his age. They prescribed Avanti KS supplement which I gave him twice daily. it seems to me he went downhill at that point. He had runny stool which was not the case previously. I researched the supplement and found the only side effect was a GI problem. On the advice of my vet and a tech rep from Avanti I stopped it for two weeks and reintroduced it gradually. While he was off it his stool was fine but again they are runny. I have stopped it altogether.

This big a weight drop in about 4 weeks is scary. Is he fading away? I do not know. My vet works in a big hospital but only 3 days a week. She will not be back for 5 days so I have made an arrangement for another vet to contact me in the morning to perhaps arrange another T4 test for his hyperthyroidism.

I am fortunate that I have the means to cover these expenses and will do anything o get Tom better. 

Wonder if he simply needs a higher dose of the methimazole?  That wouldn't necessarily account for him feeling bad, but howling at night and losing weight while still eating are classic symptoms of the hyperthyroidism we already know he has, so it seems like something that would be recommended to check again.  It could be that he's no longer well controlled on the current dose.  I remember some of your other posts but not sure when you last got the thyroid labs.

I'm sorry he's not doing that great and hope you are able to pinpoint the source.  As you know he should be able to live quite some time with the hyperthyroid if controlled well although every case is a little different.  Hang in there.

i'm so sorry that your Tom isn't feeling well. 

you might discuss with the vet you see tomorrow if it would be worthwhile to look at Tom's kidney values (bun and creatinine) if blood work is going to be done anyway. it might be that your boy's renal disease has progressed.

Thank you for the comments. Just a quick recap on the T4 numbers. When I got him his numbers were above 90. They could not say the exact number as the scale stops at 90. I started dosing him 5mg of Tapazole twice daily and the numbers went down to I think 57. The vet said the good range is 20-60 but for a cat his age somewhere around 30 would be ideal. Kept him on that dose and he dropped to 17 so we went with 7.5mg daily and his last T4 was 35. She was satisfied with that, kept him on the 7.5mg and said the next blood test should be in 6 months! With just one test showing 35 I do wonder if it is steady or gone either way. This is why I want another T4 test.

When his numbers were high he didn't show any great desire to drink, unlike now. he wasn't hyper but just a nice average cat.

The wailing is very loud and the only time I heard him wail like that was just before he threw up - on two occasions. I do not think it is pain but just a means of getting my attention. It only happens in the morning. My neighbour has a tom and he wails but not as loud as Tom but he is 18.

The last major blood work was about 6 weeks ago and his platelets were mildly elevated but she was not concerned. The BUN was a bit high and the Urine Specific Gravity was too low which she says is very typical in older cats. I do have the exact numbers in the file.

Going back to the Tapazole it was easier to ensure he had taken the full dose but with the dosage being cut it means having to slice a tablet in half. Even with a pill cutter I do not always get the whole thing I figure.

What bothers me is that Tom is at the mercy of a vet who although very good, is only there 3 days a week. He has tried a lot of medications for other ailments and most have had side effects that made me discontinue their use - with approval of course.

Is there a reason your vet is trying to control Tom's hyperthyroidism with meds, rather than curing it with surgery? I'm asking because I have had four cats over the years who each developed overactive thyroid. In all four cases, the vet removed the thyroid and that permanently cured the problem. Sometimes they will use radioactive iodine to destroy the overactive thyroid tissue, but my vet just removed it surgically. Sometimes cats may need thyroid supplements after the surgery, but none of mine did. Apparently, even though the gland was gone, there was enough thyroid tissue left to maintain an adequate T4 level. Before the surgery, a couple of my cats had symptoms such as rapid heart rate due to the high T4 level, and they had to take Tapazole until those symptoms were controlled well enough for surgery to be safe--but we went ahead with the thyroidectomy as soon as possible. So if you haven't discussed this with your vet already, you might want to consider it. Overactive thyroid can make them so sick--and,at least in my experience, removing it can take them right back to normal again.

Thank you. You are asking a valid question. No it was not discussed and I believe it may be because they were concerned about the danger of the anaesthetic in his case. He also needs a tooth extracted but for the same reason they held off.

There was discussion about the radioactive treatment which I investigated. The cost is $1800 plus tax plus any other required meds. The drawback for me is he would be admitted on a Wednesday and released the following Wednesday with no contact in between. I am not concerned about the cost but as Tom was let go by his former family after 12 years I thought it would be hard for him to be alone again for a week. Maybe I am being too sentimental but that is how I feel.

I told him - although I am sure he didn't understand - that I would always keep him and love him and never dump him.

I am supposed to be in touch with a second vet tomorrow (Tom's regular vet is off until Thursday) and will ask her opinion on the surgery. She knows Tom and his situation. What I find cute is that everyone knows Tom even when I went to the pound to adopt him they all knew Tom.

Its Tom the Cat said:

 
Thank you. You are asking a valid question. No it was not discussed and I believe it may be because they were concerned about the danger of the anaesthetic in his case. He also needs a tooth extracted but for the same reason they held off.

There was discussion about the radioactive treatment which I investigated. The cost is $1800 plus tax plus any other required meds. The drawback for me is he would be admitted on a Wednesday and released the following Wednesday with no contact in between. I am not concerned about the cost but as Tom was let go by his former family after 12 years I thought it would be hard for him to be alone again for a week. Maybe I am being too sentimental but that is how I feel.

I told him - although I am sure he didn't understand - that I would always keep him and love him and never dump him.

I am supposed to be in touch with a second vet tomorrow (Tom's regular vet is off until Thursday) and will ask her opinion on the surgery. She knows Tom and his situation. What I find cute is that everyone knows Tom even when I went to the pound to adopt him they all knew Tom.

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There is a third option (possibly).  Some cat's Hyperthyroid can be controlled by a prescription diet Hill's Y/D, it comes both in wet and dry.  As to the radiation treatment, despite the downside of cost and separation, it is a complete cure.

Thank you. I have looked into the Hill's diet and was told it has to the only food the cat can have. Not that Tom has eaten human hood but anything other than the Hill's would make the diet not as effective.

Your reluctance to be separated from Tom for a whole week doesn't sound sentimental to me! That's a long time for a little cat. He's already not feeling so good, and then the person he counts on for food and security disappears? And he probably wouldn't get much contact from the hospital staff, due to the radiation precautions involved. I would be afraid he might become depressed and stop eating.

Thank you. Tom is a very important member of my family. Not only would he perhaps miss me but I would miss him. It would be a long 7 days.

Its Tom the Cat said:

 
Thank you. I have looked into the Hill's diet and was told it has to the only food the cat can have. Not that Tom has eaten human hood but anything other than the Hill's would make the diet not as effective.

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True so if you are able to feed that as his only food then it would be an option.

I will look into it further. Thank you

Its Tom the Cat said:

 
I will look into it further. Thank you

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Happy to help.  Keep us updated.

Hi, how is Tom doing? I've been thinking about the two of you and hoping things are getting better for you.

I do not feel very positive about Tom's condition. He is very active in the early morning as he is hungry and wants to go outdoors. I won't let him out alone as he has an escape attitude. He has done so four times but has turned not long after. I am busy trying to find the loopholes he uses.

He is also alert in the evening again looking for food until bed time. As I have written before he must have been a real tomcat with his former owners, possibly outside all night.

He is eating well, taking his Tapazole without problem and drinking an awful lot. I do not know I he has lost anymore weight as I have not been to the clinic with him although it is nearby he does get car sick.

My concern now are his stool. He goes once, maybe twice daily and they are very runny, much like chocolate pudding.

Last Sunday night I captured a sample with what I thought was blood and Monday morning got another which was more formed. The lab tested the second sample only as it was the most recent and found no parasites, no ova and no blood. So anyone's guess is to what the runny stool problem is.

His regular vet works Thursday to Sunday and although other vets will look at him they do not have the same intimate knowledge, only what is on the file.

I am in the process of changing his food as he had two brands and am removing one to find out.

That is the latest and I thank you for your concern.

From what I've read, the tapazole could be causing his diarrhea--but I'm not a vet, so I can't give any good advice about that. I hope that your good vet will be able to help.

As far as tracking his weight--have you thought about getting a digital postal scale so you can weigh him at home? I got mine on Ebay for only about $16. I have spent the summer nursing a very thin old cat with chronic hepatitis, and it is really helpful to be able to weigh him every day.

It is really, really hard nursing a kitty with a serious, chronic illness, like your Tom (and my Jasper). You work so hard to help them get better, and it is terribly discouraging when they don't improve or even backslide. And sometimes it feels like you are doing this very hard thing all alone. FWIW, my thoughts and prayers are with both of you. You're not alone in this struggle!

You are really in a hard place. I read your posts carefully. Totally agree surgery/anesthesia would be way too risky. I understand your not wanting to be separated for a whole week. Does your vet do radiation treatments? My understanding is only special clinics or university clinics do that. Personally, I would sit down with whoever actually does the treatment and ask questions. Due to the circumstances and that it could cause him undue distress, if there was a way you could visit. There must be a way to be near him, somebody feeds, gives water and cleans the litter box. His condition is worrisome and the radiation sounds like his best bet. Tom is so very lucky to have you!

The vet suggested Tom go on a diet of Hill's I/D with some Fortaflora powder. He is not crazy about the food and would rather have his Fancy Feast. I believe that is what he had before he came to me and it works. The runny stools are what he passes primarily. I took a sample to the clinic and they found no parasites, ova or blood. They are interested but not concerned.

The stool condition plus his weight loss is what is bothering me. Last weighed he was 5.8 kgs down from 6.1. I am taking him this morning for another weighing and am worried about the results. That plus the fact he gets car sick even though the clinic is a mile away.

I have been looking for scales on Amazon but they are pricey.

Thanks for your compassion.

As expected Tom's weight is now down to 5.49 kgs. The vet tech was concerned and has me booked in with the vet for Thursday at 5. I have been re-reading all of my documents on hyperthyroidism and many of the traits he is exhibiting now are consistent with the symptoms. Excessive thirst and urination, diarrhea, hunger and in some cases a weight loss while consuming above normal amounts of food.

He had this condition when I got him and after numerous T4 blood tests his numbers went down to 60 and 57 then right down to 17 (hypothyroidism) so we changed his dose from 10 mg of tapazole to 7.5 mg and his number was 35 which is in good range given his age. So we were told to keep him at 7.5 mg and go back in 6 months for a further T4 check.

On hindsight I think we should have gotten another check a month later to make sure the 35 stayed constant but as noted above we were told it was not required because given the symptoms maybe that number has risen. I know its a very fine line between good and bad numbers and dosing accordingly.

Overall except for the obvious weight loss he seems normal. Being a tom cat and in previous homes he may have been allowed to wonder at night he hankers to go out when its dark. I don't let him. He sleeps a lot in daytime, is very affectionate and responsive. We will see what Thursday brings.

Hi, I was wondering if you had spoken to the vet about adding pure pumpkin into Tom's food? Its supposed to bulk up the stool. Please keep us updated. Sending happy thoughts your way.