Cat has had no appetite in weeks, newly diagnosed with hyperthyroidism

[IndyJones]

5mg is what kabuto gets total in a single day. Usualy the vet starts with the smallest dose possable and increases it from there as needed.

The higher the dose the more likely and intense a reaction can be. Also please wear gloves and wash your hands if you are using the gel. If it gets on you you can get secondary hypothyroidism.

 

[silent meowlook]

Hi. I’m sorry, but your cat needs to see a specialist in internal medicine or at the very least, a feline only veterinarian to get him situated.

 

[pearl99]

I agree with the two 5mg tabs being way too much. The pills are likely better absorbed better than the gel. And it has serious side effects.
Gracie's dose max was a quarter of a 5mg pill twice daily. Of course the T4 level has to be checked to determine the dose, and different cats require different doses, but 10mg/day without any T4 level is not good practice.
Don't mean to pile on! You have enough worries, but just adding to the statements.
I agree with at best halve the 5mg tablets until a blood test is done.

 

[IndyJones]

Kabuto actualuly gets two 1.25mg pills a day. I double checked his bottle. Just one of those 5mg doses is double what he gets per day. Granted, his t4 was tripple what it should have been at 150 nmol/l so ymmv depending on your cats t4 level.

The pills come in 3 different dose sizes 1.25mg 2.5mg and 5mg. So your cat is getting the maximum dose without bloodwork which is very concerning.

 

[elliebean]

I spoke with the clinic this morning, I couldn't speak to the vet directly as he wasn't in today, but someone in the office did and got back to me. He said to give him the high dose but made me an appointment for next week to recheck his T4.

And I agree that we would be better off with an internal medicine or feline specific vet, but I don't think there are any that aren't over an hour away from me. The time/distance isn't an issue for me, but my cat gets pretty stressed out in the car. I don't know what the best thing to do is. But anyway, I found some puree treats my cat will eat, and he's been having zoomies again for the first time in several weeks.

 

[FeebysOwner]

I went back and re-read this thread. It turns out your cat was on 5mg twice a day with the transdermal based on comments you have made twice now, and I kept reading over the 2 clicks twice a day part (sorry)!

I was given a Wedgewood methimazole 2.5mg/.05ml (1.5ml twist pen) with directions to give him 2 twists twice a day.

So, while I still don't agree with the vet about not checking his T4 level before changing the med from transdermal to oral, I guess I can kind of understand why he thought he didn't need to. But I am glad it will be checked after just one week on the oral version. I will say that after this next re-check, I still think you should have another done about two weeks later, just to be on the safe side. Me being a bit precautious and recommending yet another check is somewhat dependent on what his T4 reading is next week.

Most competent 'regular' vets can handle hyperthyroidism. But a lot of them like to put a cat on a high dose just to get their T4 down quickly. The problem with doing it that way is that some cats will have reactions to getting a high dose without letting their bodies gradually adapt to the meds first. If they do have a reaction, then the meds have to be stopped for a few weeks and re-started at a lower dose - kind of defeating the purpose in trying to rush to get a lower T4 reading. Other times, just lowering the dose can be sufficient in getting rid of side effects.

I am hard pressed to think that just one (or two) oral doses have made that much of a difference (re; his zoomies), but perhaps since he was on the meds, albeit transdermal, he is just now turning the corner in terms of responding to them with the 'extra' boost from the oral version. Just watch for lethargy and an even greater loss of appetite should the dose be too high. Too high of a dose can cause temporary HYPO-thyroidism.

I hope this move proves to be a good one for your cat! Keep us posted!

Btw, did I also manage to miss his name being posted by you??

 

[elliebean]

I went back and re-read this thread. It turns out your cat was on 5mg twice a day with the transdermal based on comments you have made twice now, and I kept reading over the 2 clicks twice a day part (sorry)!

Oh, no, sorry it's been so unclear, it takes 2 clicks/rotations of the pen for the 0.05ml/2.5mg (it reads "each 2 full pen rotations delivers 0.05ml of gel). I don't think I actually mentioned his name, or what he's like, sorry! His name is Gibbs (I was into NCIS when I was in school) but he goes by Gibby. He was already an adult when I saw him at a shelter, and he kept yelling and grabbing my legs through his kennel bars, so I had to take him home! He's a very sweet boy, he wants cuddles at bedtime and demands to be held throughout the day, and he gets very jealous of his sister who is a lap cat. It's been really hard to see him stop doing things he always used to do. Since I came back from out of town he hasn't gone up his cat tree or chased his sister around. I'm really hoping he can start to improve even though it took them so long to diagnose him.

 

[neely]

I agree that we would be better off with an internal medicine or feline specific vet, but I don't think there are any that aren't over an hour away from me. The time/distance isn't an issue for me, but my cat gets pretty stressed out in the car.

I'm just reading your thread and want to let you know how sorry I am that Gibby and you are going through this without what I would consider the proper vet care. I completely understand your predicament with living in a small town and another more knowledgeable vet being further away. However, since you mentioned he gets stressed out in the car there are several different meds you could give him before a car trip that would not sedate him but rather calm him and relieve the stress. As others have mentioned a feline only specialist or board certified veterinary internal medical specialist would be ideal. Here is a link to feline practitioners by state/country that might have some helpful information for you: You are being redirected...

Our cat was also diagnosed with H-T approx. two years ago so I can relate to Gibby's health issues. I switched to a feline only vet 10 years ago when our previous vet retired and I've been extremely happy. The knowledge and care our cat has received is remarkable. I do think it would be well worth your while to start looking into another vet and preferably a feline specialist. Gibby is a handsome boy and I can tell from reading your posts how much you are smitten with him. You're doing a wonderful job looking after him and wanting the best treatment for his H-T. Best of luck, please keep us posted and come here to ask questions or concerns anytime.

 

[FeebysOwner]

Oh, no, sorry it's been so unclear, it takes 2 clicks/rotations of the pen for the 0.05ml/2.5mg (it reads "each 2 full pen rotations delivers 0.05ml of gel). I don't think I actually mentioned his name, or what he's like, sorry! His name is Gibbs (I was into NCIS when I was in school) but he goes by Gibby.

Well, glad we finally got that cleared up - whew!!! So, me back to questioning your vet. Darn!

 

[elliebean]

Well, I have a small update today. Since he started the pills/higher dose, the appetite he was regaining disappeared again, and the last few days he's been vomiting several times a day. I don't remember if I said here, but I had pushed to get my cat another appointment to check his T4 levels which would have been Wednesday -- but come Tuesday, I just had a really bad feeling about the clinic we'd been seeing. I canceled that appointment and made one at a clinic closer to me for today, which is much smaller, but they were much more helpful. She was very nice and very sympathetic at the lack of treatment my boy's been getting. Unfortunately, she said his thyroid/tumor feels very large to the touch (none of the vets I saw at the other clinic even checked as far as I know), his T4 is still very high (their in-house testing would only read up to 10μg/dL), and that he may just not respond well enough to medication. The new vet gave him a cerenia injection and subcutaneous fluids and gave me a referral to a specialist in another city to find out what our options will be. She also had me halve the pills I was giving him (as y'all recommended). I know I likely won't be able to afford radioactive iodine treatment up front, but maybe the specialist can help us find a way to make my baby feel better.

 

[neely]

I know I likely won't be able to afford radioactive iodine treatment up front, but maybe the specialist can help us find a way to make my baby feel better.

So glad you got an appointment with a different vet and she took Gibby's H-T case seriously. Also glad she recommended seeing a specialist to discuss your options. Fingers crossed you will get a professional opinion with a knowledgeable specialty vet and go from there. Please keep us posted on his progress.

 

[FeebysOwner]

Sorry you didn't get better news - and sorry he's throwing up.

I hope this smaller clinic will also send his blood out to a larger lab so that you have a second opinion of the T4 results. Any clinic that does in house testing can have skewed results, especially when they can't get a more accurate reading. Vomiting and the timing of when he last took his meds can also skew the results - not in his favor. At this point, I am glad they reduced the meds anyway.

Do note that the Cerenia injection lasts no more than 24 hours, so I hope the clinic gave you some oral meds to follow up with in the coming days. You could also ask them about giving you injectable doses if needed. They are given subcutaneously, which I know, is much easier than one would think. I only suggest that if you can't get the pills down him.

How long before you can get in to see the specialist? I presume this is either an internal med vet or an endocrinologist?

 

[elliebean]

It is an internal medicine vet, the earliest I could get an appointment is for a month from now. He's still going through the motions of vomiting a few times a day, though he usually doesn't vomit anything up. Just seems to be dry heaving mostly. He's been able to keep food and water (and his pill) down, but if the vomiting/heaving doesn't improve I will ask the vet about meds I can give him at home, as they didn't give me anything at the appointment Friday.

 

[FeebysOwner]

Since you have to wait a month to see the internal med vet, call whatever vet you worked with (I guess at the clinic?), tell them about his heaving/gagging and occasional vomiting and ask for something you can give him at home. The sooner you can get him something to help settle the stomach convulsions that must be going on, the better.

 

[elliebean]

Sorry it's been a few weeks. After my last post I did get my cat some cerenia pills from the vet. They immediately stopped the vomiting completely, and he even regained his appetite and started eating all on his own. He was doing much better for 2 weeks. Unfortunately this weekend he started struggling with breathing, he has been breathing pretty fast and doesn't want to each much again (he's still nibbling at kibble and treats but doesn't want his pates anymore) and he's more lethargic than he's been the past few weeks. His specialist appointment is still 2.5 weeks away. I'll call the vet tomorrow but I'm really worried about what this could mean. Not sure if I should be preparing myself for the worst already or not.

 

[FeebysOwner]

This breathing issue - is it new? Was his T4 ever rechecked? Hyperthyroidism can cause heart issues - which can be treated, and in many cases reversed when done along with control of the hyper-T.

See what the vet says - perhaps they can help you in getting the specialist appt. moved up?

 

[silent meowlook]

Hi. How much Methimazole are you giving him now? Unfortunately hyperthyroidism and heart disease can go together. If he has or has developed heart disease, he could be in congestive heart failure. Of course I am only speculating what could be going on with him. But, if he was my cat, I would take him to the ER to make sure. You don’t want him suffering.
I am sorry he isn’t doing well. Please keep us updated.

 

[elliebean]

I took him in this morning and they did x-rays, the news wasn't good. His lungs were very speckled and the vet thinks it's either cancer or a type of fungal pneumonia he wouldn't recover from. He's already having a hard time breathing and can't get comfortable. The vet said if it was his cat he would consider euthanasia this week. I wish it was better news

 

[FeebysOwner]

I am sorry to hear this. How did the vet narrow it down to being fungal (vs. bacterial), if not cancer? Nonetheless, I suspect the vet suggested euthanasia because treatment probably would initially mean hospitalization so that your cat could receive oxygen and nebulizer treatments to reduce his breathing discomfort - along with anti-fungal and anti-inflammatory meds, which would likely be given on a more long-term basis.

Is your vet considering a second opinion?

 

[BeccaCat]

Is your vet by chance a cat-only vet? I know you mentioned there aren’t a lot of options where you are. I live in a highly populated area, and I found my sick kitty got much closer attention and more accurate diagnoses once we started seeing a cat only vet.