Tom is fading away....

Actually I have a can in the fridge which was used at a previous time but he was not fond of it. I do have a bunch of questions besides that, namely why when he read 35 after one T4 test she thought he was stable. I think and hope I am right that another T4 test may show the numbers differently.

I tried to get him to eat a limited amount of food, but more than previous, but now I will feed him as much as he wants. He eats the Hill's I/D but much prefers his FF. The Hill's is a bit more difficult for him to eat, even when heated.

Interestingly it is now 6 pm Pacific time and he has not had a bowel movement since last night. I do not feel he is impacted but maybe the Hill's is helping. I must confess as he likes FF so much I am mixing the two.

On the topic of the scale (sorry if I seem obsessed, it just seems like that would be so much easier on both of you)--my scale is a DigiWeigh. You can get one like it on Amazon for $17.99+free shipping: DigiWeigh Shipping Scale (DW-56BPB) I have had great results with mine. It has "tare" and "hold" buttons, which make it easier to weigh the cat.

Good luck with transitioning Tom to the I/D. It'll probably be easier on his system if you gradually switch over from the FF to the I/D, anyway. Maybe, over time, Tom will let you cut down on the FF and increase the I/D. (Our dog didn't much like the canine I/D, either, but he did finally accept it.)

Hope Tom's new bloodwork will give you some answers!

Have you tried Methimazole? That's what my hyper-T boy is taking, it works great for Mr Man.

My do I feel silly. Finally looked it up, they are the same thing.

I'm still hoping you can work out some kind of visitation and get to do the radiation.

If he's eating plenty as you say and losing weight, and we know he's hyperthyroid, then presumably the methimazole dose is not in fact high enough. There's no reason to think that the ongoing weight loss is from anything else unless you have confirmed that the T4 is normal. The runny stool may be from food issues.

Normally it is ok to go back and test only at 6 months once levels are stable, but when the symptoms have come back as you describe, it sure makes sense to check it again. It may be that it's going to be tough to manage his levels with the methimazole and you might want to think again about the radioiodine treatment. Tough as the separation may be, if it gives him extended time without the meds and recurring symptoms, he will get over the few days of quarantine. It'll probably be harder on you than him! That is what i would be looking at, anyway, as I have mentioned before.

Hope you get some confirmation of the issues soon.

I am angry and frustrated and worried. But mostly angry. Took Tom to the vet with my concern about the runny stool and the weight loss and apart from taking blood for the T4 test nothing has been resolved or even suggested. Its a classic case of take two Aspirins and call me in the morning but this cost me $140.00. Its not about the money but what seems to be a very cavalier attitude by the vet.

I am considering another vet but this clinic is a mile away and full service. Nevertheless and maybe I am saying this in anger but most vets I have encountered are in it for the money. Although I do know one or two who are not.

Tom is fading away, I can see it. He has lost one pound in a month. The vet said that it might be his hyperthyroidism or kidneys but his last blood work showed a slight elevation in those (kidney) numbers which she said was expected in a 12 year old cat. At the time she prescribed Aventi a powder for kidney ailments and I am certain that is when the runny stool started. I had stopped it right after.

I am expecting his T4 results today and am hoping that it will be the problem solver.

The newest T4 results are 72 which makes him again hyperthyroid. This angers me because he was at that high number and with two 5 mg tabs of Tapazole it was reduced to 17 or 19 which is now hypothyroidism. The range should be between 20 and 60 with the 30s a good number for older cats. After testing at 17/19 I was advised to reduce the dosage to 7.5 mg per day and this hit 35 which was perfect.

The vet said she was not needing to see him for 6 months which I found strange because how stable was that number at 35. Now being at 72 she wants him back on two 5 mg tabs a day. This is really yo-yoing which I understand.

She also tells me he is anaemic and his rate is below the norm. Reason may be a kidney condition although at the last blood panel 2 months back his numbers were very slightly elevated which she considered normal for his age.

She has sent blood out for more renal testing. May have results later today.

I am very angry, frustrated and obviously very upset. This poor cat was dumped by a family at 12 years (for a reason I thought was feeble) left in a shelter for (fortunately) a week until I found him. It was love at first sight and he and I bonded more than any other animal I have ever had. He is a great cat and I am just so angry that he has to go through this.

Sorry to hear you and Tom are having such a rough ride with the hyperthyroid.  With some cats they are stabilized fairly easily with the med, and with others the levels are more variable as you have found.  Also, it is common to uncover kidney issues with hyperthyroid, although how far along is quite variable.  With Amber, it was just over 3 years of treatment on the Tapazole before we saw kidney levels that were at a point where treatment was started for that.  But many cats end up needing kidney treatment sooner after hyperthyroid treatment starts.

I looked up the Aventi which I haven't heard of.  It seems like it shouldn't hurt (not sure how much it helps anything) but if you're sure it corresponds to the timing of the runny stool, it makes sense to me to stop using it to see if the runny stool clears up.

If you are not feeling happy with the current vet it may help your peace of mind a lot to get a second opinion and possibly switch if you find the second vet more to your liking.  Happens maybe less often than it really should.  Just like in human medicine we should really feel comfortable with the vets and if it doesn't feel right, we should probably look for another vet.  I don't believe most vets are in it for the money; rather it is the opposite.  Vet school is about like med school in time and cost and for most vets pays off a LOT less in salary than for doctors working on humans.  Maybe it is less dramatic in Canada but probably not by much.  BUT, there certainly are SOME vets who run practices that really like to run up the tab.  Also a vet practice that has a lot of modern machines will necessarily have to have enough income to pay for all that stuff.  My particular vet is a solo practitioner (only one veterinarian, and a couple techs) and if my cats needed the latest in imaging or some other things he'd have to refer me elsewhere.  He's not getting rich for sure!  But for routine checkups and even for senior cat care such as this, he was capable, available on the phone and reasonable in cost.  I have still had reservations about him on certain issues but in the end the good outweighs the bad for now.

Thank you for reading and answering my post. It is possible I was a bit harsh with my views about the vet and it possibly stems from my frustration and feelings about Tom. I started going to this clinic because two of the vets have rabbits and me being a rabbit owner needed a vet who deals in "exotics" as they are called.

My previous vet was a one person show and as in your case delegated the testing etc. to the hospital. When you mention the hospital to anyone in this town they all have the same negative comments. We do not like it. So having a clinic/hospital within a mile of my house was ideal.

I have two friends who are vet techs and both have quit their jobs over up-selling by the vet. I won't say my vet does that and maybe its because having 5 rabbits and a cat I have a good knowledge of animal health - albeit not like a vet - especially with rabbit health.

The latest news I received was the lab tests done today were not ready and the vet has left until next Thursday. In her phone message to me she said the tech would email the results to her and then we can consult. So I am presuming she will phone me.

At the moment I am in limbo. Tom and I had a sit down on the sofa earlier and he is very affectionate. He fell asleep curled up in a ball and when I patted him his front legs stretched out as they always do and was purring the whole time.

My life is dedicated to my animals and even though I have the means to take care of them it doesn't mean much if they are terminal. My last rescue cat became special needs and in the end he told me he was ready. But he was really ill and when the time came I accepted it very well. With Tom it will be a lot different, just like it was when I lost my rabbit after 13 years.

You do have a car? My vet is 18 miles away and to do radiation or any specialized work I will take them to Kansas State U, 163 miles away. At this point I would recommend a University Vet clinic or, at least, a clinic that specializes, preferably feline only.

It's great that you have rabbits, and they get along with Tom I suppose, or do you not still have rabbits at this time?  I didn't know that they lived 13 years, that's pretty long I think for a rabbit, seems like.  The shelter where our cats came from also has rabbits, but I chose my vet because he only sees cats (not that I would mind rabbits being involved, but I was trying to avoid vets who are too focused on dogs as so many things in small animal veterinary health seem to shortchange animals other than dogs).  Plus he's only 5 miles from house, probably both the closest vet to my house AND he only sees cats!  So it was kind of a no-brainer.

Anyway, my vet sends the blood out for lab and gets results the following day, fine for anything but an emergency I think.  Where I wonder if I might miss out sometime is if he doesn't have an ultrasound.  I don't know if he has one or not.  He does take his own x-ray and get that back immediately in house, and he apparently can do some things with urine in house and probably a few other items.  One of my prior cats got an x-ray.  It would only be serious emergency or some kind of really high tech imaging or something (CT or MRI) that he couldn't do I think.  Most other things he should still be able to do in house.  He doesn't have a fancy building either (I'm sure that helps the cost) but it's adequate.  Now if the cats needed overnight type hospitalization but because of an event that isn't really an emergency, that is probably another area where he couldn't do it perhaps.  I'm not sure.  I don't know if they keep any cats overnight or not.

Around here there are some vet practices that may have a bit more things they can do in-house and have an overnight hospital of sorts, but all emergencies at night would still likely be referred to an emergency vet center.  And yes, the closest one of those, I would not go to again after a bad experience several years ago.  It was the worst kind of money grab, without even any soothing staff or other good service to go with it.  Ugh!  Luckily, there is another choice for emergency that's only a few miles more out of the way.  It might not be any better but can't be worse, so my plan is to go to the other place if there's ever a need.  If something not-quite-emergency comes up that my vet can't do, I'll have to cross that bridge then I guess.  I haven't thought about it but I should ask him I suppose.

As always I hope you can help Tom's health become a little more stable, and I think it is possible still.  I do not think you are running out of options yet at all; you are actually still early in your treatment of hyperthyroid.  But in narrowing things down to an ideal treatment you want either this vet to be working well with you or maybe another vet would be better for him, not sure.  But I'm sure you'll figure out what is best for both of you.

For KSKATT - yes I do have a car but Tom gets violently sick even on a short journey. He throws up and urinates, thankfully its in his carrier. He could never drive 18 miles to a vet, especially now with up to 3 trips a week. If I knew I could find a cure-all then I would consider taking him a very long distance. In fact I would rent a plane and do it.

There are no veterinary colleges anywhere near here. I did have a feline vet with my previous two cats but in the end she was not interested in their condition. It seemed she was resigned to the fact they were terminal when in reality they weren't.

For 2bcat - yes I do have 4 rabbits who are all rescues and I think about 5 years old. I do a lot of rabbit rescue work and we have just built a small barn in the country where we are housing 30 rescued bunnies. All spayed and neutered of course.

Tom is curious about the rabbits but they do not mingle. I have two 64 square foot outdoor pens for the bunnies - two per. At night or if I am not home they sleep in a small bunny barn in very large hutches.

Sadly people do not understand rabbits but they are amazing creatures. My Sedgewick was 13 years three months when we put him to sleep. took me 3 years to stop mourning.

The supplement I mentioned earlier is Aventi KS. I think I misspelled it.

It is now almost 6:30 at night and I never heard from the vet regarding today's test results although she said she would consult with me. And she is going away until next Thursday! All part of the frustration.

Tom was outdoors most of the afternoon (supervised always) and usually when I feed the bunnies supper he wants his. He did well with it then slept on the sofa until I asked him if he wanted to go back out. Which he did.

Finally just in case people have not read the whole post Tom is 12 and a half and I have owned him since December. I knew he had hyperthyroidism but did not realize the other problems. That's fine. He is my cat now and always will be - problems or not.

Its Tom the Cat said:

 

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Hi,

A couple of thoughts.  I researched side effects to Tapazole and while there are many  the ONE side effect that isn't listed is loose stool/diarrhea.  See http://www.1800petmeds.com/Tapazole-prod10191.html

Another site pointed out that hyperthyroid cats are at risk of IBD which causes loose stool or vomiting and in serious cases weight loss so i'm wondering if there has been discussion about possible IBD as a secondary illness?  See http://www.allfelinehospital.com/hyperthyroidism.pml

Also, while expensive, the radioactive (one time) treatment is a complete cure.  http://www.vet.cornell.edu/hospital/services/Companion/Internal/conditions/felinehyperthyroidism.cfm 

and http://www.radiocat.com/

When I read here, I think about Mr Man, my hyper-T boy, as a way to "put myself in your shoes". Mr is in much better shape than Tom, but I have researched quite a bit, just for my own education. I'm not trying to say my situation is like yours, yours is my fear. Surgery, radiation, lifelong medication such a wonderful selection of choices. If it comes down to it, I think radiation is the top choice, for me anyway.

Is there a mild sedative, perhaps one of those calming collars, that would get Tom through the trip? I'm probably getting ahead of myself. A very serious consult with vet, specialty vet, and you. Taking that in depth look at Tom and determine his chance of complete cure. The shape he's in, just areal reduction of symptoms would sound pretty darn good to me.

By the title of this thread, and much of what you have shared,  whatever gives him the best chance of quality life for the longest period of time, is where you are at. Tom is so very lucky to have you!

For StephenQ

Thank you for the links I will be sure to go through them. The runny stool has only been a recent (two months about) problem.

I have looked into the radioactive treatment and here it is about $1800 plus 12% tax and any extras. The money is not a problem. What bothers me is he will be gone from Wednesday to Wednesday with no chance of me seeing him at all. I do not think he nor I could do that as he was a dumped cat and he may feel abandoned again. He also has kidney problems.

I did just receive the test results and will comment on them below.

Thank you.

For KSKatt

Thank you for your continued interest in Tom. I have just had an email from the vet an his kidney numbers have increased. She wants him back on the Aventi KS and also asked if I was willing to administer Sub-Q fluids twice a week for his anemia. Of course I will do whatever it takes but have not done that for years and it was for a rabbit. I contacted the clinic and Monday they will give me a demo and a take home kit. If I feel squeamish about doing it they will do it at the clinic for $20 per time. I also have a cat groomer who does it on a regular basis an will talk to her.

You ended by saying Tom is lucky to have me. I have hard that a few times but I feel I am lucky to have Tom. He is a gem.

For what it's worth, I felt squeamish about doing the sub-q fluids, but after watching the vet do it once we plunged in and did fine.  When I understood better that I was just trying to jab under the skin and wasn't likely to hit anything that would bleed, etc, then it was fine.  I ended up doing most of the sticks.  In Amber's case it was better to use a thicker needle (18 gauge we used) and get the fluid in quicker.  The stick is momentary, but the fluid flow might be a whole minute or more shorter vs a thinner needle.  With the fluid warmed and using lactated ringer solution, she was not uncomfortable at all with this, got very used to it.  Watching the cat just not feel that great and not eat was much harder than the sub-q, as was pilling!

If you want to delve into lots of info about the kidney disease, what to look for and what to try, this is the best resource:  http://www.felinecrf.org

You are lucky to have each other, that's what it comes down to.  As you have often noted, his prior family apparently unceremoniously dumped him.  I'm just afraid that your time with him is going to be marked nearly entirely by these medical issues.  Hang in there.

Well a new day. Tom was up early (4 am) because I awoke at that time. I had made arrangements with my clinic to demonstrate administering sub-q fluids. Tom and I were there at 9 and the vet tech was amazing. I know most because they trim  my bunnies nails but Lucy did not know Tom.

What was explained was different to the YouTube videos I had watched. she ran through the procedure and asked if I wanted to do it. I did! Tom didn't say a word which is typical of his attitude towards medication.

I expected a fluid bag held up by a stand but what she did was fill two 60cc syringes from the bag and put a short tube/hose on the first. She said to change needles each time and to make certain the fluid was warm. The fluid bag was put aside. I bled the air from the tube/hose and tented Tom's skin and with the bevel edge of the needle facing upward stuck it in. He did not flinch. I used my left hand to hold him and the needle and my right hand to push down on the syringe as it was standing on its end. Rather than using the plunger with my thumb I pushed on the body and the plunger being flat on the table went in.

The more difficult part because I would have needed 3 hands was to change the tube/hose from the first syringe to the second. She said to practise that and it would be easy.

I don't know how long it took but it may have been 10 minutes to administer 120cc. Tom did get a bit impatient but never fought. He rolled onto his right side and that was still okay as far as the drip was concerned.

I now have a bag of saline solution (I thought it would be Ringers) a dozen #20 needles, two syringes and a hose. The bags sell for $6 and the needles I can get from my local pharmacist.

It was a successful experiment  and now I have to try it at home which might be in 2 days. Lucy said the fluid could be administered daily if need be and would not hurt the cat. After having done it I am anxious to give it a go. Hopefully it will be as easy and even more importantly that it helps Tom.