EMERGENCY: Methamizole for T4 Killing 17 yr Old Cat?

My cat is a 17 year old male never sick all his life a few months ago he started begging for food, drink more often. Otherwise fine, lost a lb from 3 yrs ago, and sneezing alot.

Brought him for his annual checkup and the Vet did a Gediatric Blood Panel and found all his blood work good except for his T4 was high. Vet also did a sample of his bladder and found the urine to be all blood. She didnt know why. So we put him on Felimazole (Methimazole) 2.5mg for the past month to bring the T4 down. He seemed to still be very hungry and thirsty all the time, and the only thing we noticed different was he seemed slightly more lethargic. 

A re-check last week (month later) found the T4 still high and blood still in urine (bladder aspirate again). So she upped his dose to Tapozole (Methimazole) 5mg - why is the first name different? - and we gave him his first 5mg dose today. Hours later he went into a seizure type fit (out of nowhere) and ran to hide under the bed with mouth wide open and tongue out. He then calmed down after 5 mins and everything seemed fine. Now tonight he had another episode he fell sideways and flipped on his back mouth open even worse again and his eyes look watery and his breathing heavier. He then jetted for under the bed again to hide. Then again he seemed to get slightly better 1/2 hr later.

We dont know if the cause is the medicine or another underlying disease. We are afraid to get him in the carrier to the vet because we think he will die on the way. What do you think? What would you do?

Call the ASPCA poison hotline if you are in the united states and you feel your cat needs urgent treatment.  Is there an ER vet nearby.  The ASPCA should be able to advise you if you can skip the next dose until you contact your regular vet or go to an ER. They charged me 65 dollars but there was a treatment plan in place when we got to the ER. Or you can try and contact your regular vet.

http://www.aspca.org/pet-care/animal-poison-control

Agreed - please call your vet, a vet ER, or the ASPCA Poison Control (if you're in the US) for advice. Please don't give any more of the tapozole until you have talked with your vet. Tapazole is the brand name for the medicine, similar to how Tylenol is a brand name for acetaminophen.

The after hours voice mail message for your vet should have a phone number to call for emergencies. Please give that number a call for advice if you vet's office us currently closed. You may also find a local vet ER here http://www.veccs.org/facility-directory/

My cat survived he seems better today but were not sure if it was the meds or something else. We are withholding meds until further investigation.

AlienzYoungTwo said:

My cat survived he seems better today but were not sure if it was the meds or something else. We are withholding meds until further investigation.

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Have you called the vet yet to inform her of what happened on the new dose of Tapozole and discuss what changes to the hyperthyroid treatment may be needed?

Yes I called the Vet during the incidents. It's very strange. The vet seems to think it has NO relation to the meds. But if you read my post, it started hours after we dosed him. Eyes watery glazed over, 2 seizure like incidents. Mouth wide open, 17 years not a thing ever like this before.

Today no eyes glazed, no seizures yet (hopefully no more/dont know yet).....and no meds given (24 hrs later hoping they are waning from system).

My wife says no, not the meds. I say yes and I think maybe he went too Hypo and was going into a seizure/shock? What if his heart rate went too low? Wouldn't that cause respiratory and seizure like symptoms? No vomiting so doubtfully some other coincidental poisoning.

I'm curious on gut opinions and next step is to get him to a vet but quite honestly if the seizures are not from the meds and some kind of mini-strokes then taking him in a carrier is almost guaranteed to get his BP and all up - he's typically a very skittish cat and will freak. Were watching, waiting and taking it slow atm because he is currently asymptomatic.

You can look in your area for a vet that makes house calls.

Is your cat diabetic? That would be the ony way for hypoglycemia to occur and only if too much insulin was given. Excessive hunger and thirst can indicate diabetes but undiagnosed cats not on insulin or other diabetic medication would just have really high blood gluocse levels, not very low ones. Seizures are a really serious hypoglycemic symptom and cats don't come out of it after a few minutes and act just fine. I'm guessing that your cat iether has another medical issue going on and / or the Tapozole dose somehow induced the seizure (allergic reaction?). I'm surprised your vet doesn't seem concerned about the seizure-like episode. I suggest seeking a second opinion from another vet. Bring copies of your cat's medical records with you to the appointment. Or look into a mobile vet if you are concerned about stressing out the cat.

Im sorry LTS3 by hypo i meant hypothyroidism not hypoglycemia. His blood sugar is fine according to lab work.

Youre right about allergic reaction possibly and also about talking to another vet. I also appreciate the mobile vet tips from all - thats a good idea and we found one locally.

You are also right about kidney issues and also pancreatic diseases causing the extreme thirst and hunger, but we ruled out kidney with lab work and ultrasound. And with the high T4 and his age, all points to hyperthyroidism.

So the meds, my point was the implications of the meds sending him too hypo (out of hyper state). Thats actually the objective of the meds but blood must be monitored to ensure the balance is kept. So if a cat goes too hypo, like a human, there are severe complications.

However this again looked to be acute and not chronic it came out of nowhere so my hunch is allergic (if cats can have allergic reactions?), could be a bad lot of meds too (poison) or purely cooincidental (unlikely).

Anyone who loves a mystery come give your ideas. We will be following up with a second vet soon.

Sorry! I'm more familiar with diabetes than hyperthyroid so when I see "hypo" I automatically think hypoglycemia.

I found some threads on treating hyperthyroid in cats:

http://www.thecatsite.com/t/300735/anyone-with-a-hyperthyroid-cat-on-methimazole

http://www.thecatsite.com/t/311938/newly-diagnose-hyperthyroid-cat

http://www.thecatsite.com/t/83456/hyperthyroid-and-methimazole-transdermal-gel

http://www.thecatsite.com/t/313559/radioactive-iodine-treatment-and-early-stage-hyperthyroidism

Is radioactive treatment not an option for your cat? There is prescription food for hyperthyroid (Hills Y/D, I think). The ingredients aren't the greatest but some people feel that it does help their cat.

Here is my 6 years experience with  hyperthyroidism in chronological order. My 17yo Female  cat died this morning from complications of. My writing skills are not great. When you see an age of my cat, it may not be exact.

 

2010, Brought my 11 year old female cat to the Vet who had had dropped from 22 pounds to 17 pounds in quick time. Hyperthyroidism was determined..

began daily treatment of tapezole. 2 pills 2.5mg?  a day.

We declined the $1200something operation as we thought the pill treatment was more affordable than the operation. Note here, In retrospect, In the long run the operation would have been less expensive than the $20-30 a month daily pill treatment for 6 years

2012 Trip to the Vet. My now 13 year old hyperthyriodism  passed all the blood tests. was now at 15 pounds. The weight loss slowed .Her thyroid T4? was off the scale high. New Tapezold treatment was now 3 5mg pills a day

2014,September. my now 15 yo female about 12 pounds. Could not afford thyroid test, continued with 3 pills a day[5mg each[

2015 Oct 'wellness exam'  heart-lungs- passed, very good.  weight was 8 pounds  She was emaciated which would get more worse in the months to come

2015 Oct-DEC  Continued with 2 times a day but now i am missing many days as pill swallowing is getting hard for her.

2016 Jan - Feb. No longer giving her tapezole. went to Y/D CAT food, seemed to do some good but not enough

2016 March 4, 2016 [yesterday]  Thyroid exam. T4 off the scale high. My 17 yo female weighed 6 pounds.

2016 March 5, 2016, [i have a thread on this] Rush to the vet, had to put her to sleep. I stayed with her during the process.

My thoughts?

In 2010 when i noticed she was losing alot of weight despite eating 24/7,  Without intervention she did not have long.

I think the tapezole slowed down her weigh loss and provided her 5 more years of life.

When you say your cat was on 2.5mg and then on 5mg, are you talking just once or twice a day? 5mg twice a day is pretty typical. I wouldn't say the cat overdosed on it at 5mg a day, or even twice a day. Were the kidney values in the blood work normal a week ago as well? Treating hyper-t can unmask existing kidney problems (the two kinda go hand in hand unfortunately). Allergy is entirely possible, although I don't believe it's common, and odd that it only showed on the 5mg. Possible there is some other non-active ingredient that is in that pill. So many possibilities there.

But you definitely need to talk to a vet, regardless. You need to both find out what is causing the seizures, but also need to find a way to treat the hyper-t. Untreated hyper-t will just cause more and more problems over time.

Good points we are proceeding back with the brand that did not cause issues. That would be 2.5 x 1 a day over next week then upped to 2.5 x 2 a day a week later. Only with the brand that did not cause issues @ the 2.5 dose. The 5mg was 1 x a day was under another brand and the one that we noticed issues coinciding. 

We also will do a EKG and Echocardio to rule out secondary cardio issue from the hyper state. Thanks for advice.

Sorry to hear of your recent loss . Sounds like you did everything that you could for your pet. Glad to hear she got 5 extra years. Our cat is male, he is 17 and is 7 lbs. He was only 9 -10 lbs in his prime. He does appear to be getting thinner lately so we need to continue the meds that caused no effect and avoid the brand that caused issues - which this latter one happens to be the brand that was successful for you.

We had a bad experience with a female cat not getting enough hydration with the Hills W/D dry food diet. I will stay away from this. Thanks for the links. I don't think we like the radioactive option at this time.

AlienzYoungTwo said:

 
Sorry to hear of your recent loss . Sounds like you did everything that you could for your pet. Glad to hear she got 5 extra years. Our cat is male, he is 17 and is 7 lbs. He was only 9 -10 lbs in his prime. He does appear to be getting thinner lately so we need to continue the meds that caused no effect and avoid the brand that caused issues - which this latter one happens to be the brand that was successful for you.

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Thanks AlienzYoungTwo. At 6 pounds, her ribs and other internal bones were protruding, had little muscle, no fat. At the same she was liking her 5 minute walk outside. Just Yesterday she was doing her typical wet nosing nudging my ankles for food.

A adage i heard about cats when they get near the end: its better to put them to sleep too early than too late. I think that means even though your cat still shows some life, if they   are allowed to pass naturally, it  could have be a rough passing away for them.

[ just a reminder especially to myself, this thread is about AlienzYoungTwo's cat ]

AlienzYoungTwo said:

 
We had a bad experience with a female cat not getting enough hydration with the Hills W/D dry food diet. I will stay away from this. Thanks for the links. I don't think we like the radioactive option at this time.

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All of the Hills prescription products are available in canned formulas. Most vets recommend dry food in general. Dry food contributes to dehydration because, well, there's no water in dry food and most cats just don't drink enough water from a bowl to meet their needs. When possible, it's best to feed canned food. It's an easy way to keep a cat wll hydrated.

I just saw your other thread. I'm sorry that your hyperthyroid cat had to be PTS