Hyperthyroidism/Hypothyroidism

[its tom the cat]

When we got Tom he was 12 years old and a special needs cat. He had hyperthyroidism and we treated him with Tapazole (2 x 5 mg a day). His T4 numbers were above 90 and came down to 57 and then 50. We took him for another scheduled blood test yesterday and his numbers have dropped to 17. The vet says he is now hypothyroid.

Have been told the normal T4 range is between 20 and 60 with 30 being the ideal for a cat. The vet decreased the Tapazole from 10 mg per day to 7.5 mg per day. I did not think to ask why he would still be on the Tapazole if his numbers have dropped. I am awaiting a call back.

I understand hypo is rare in cats and of course we want to make sure he gets the best possible care.

Incidentally rescued old cats are great.

Thanks.

 

[2bcat]

Trying to dial in the right dose of methimazole is pretty common with hyperthyroid. The idea would be easing off the dose a bit will bring the level back up into normal range. You don't typically stop altogether because that will let the level go back up too high. To me, your scenario sounds quite normal for hyperthyroid.

He will need to be on the med at some dose for the rest of his life, unless you want to do the radioiodine treatment. That treatment is on the expensive side but does typically mean a full cure. If I had it to do over again with my cat who had this, I would have sprung for the treatment rather than have her take the med for nearly 4 years. But either is a valid choice.

 

[its tom the cat]

Thank you for the reply. As mentioned I did hear from the vet and she basically echoed what you had written. Being new to this malady makes me somewhat apprehensive. She also mentioned the radioiodine treatment of which I am aware but did not know it could be done locally. My only concern is his age. She figured 13 would be a cut-off year.

As to medicating him daily I have no concerns as I have the time and he accepts the meds readily The last rescue cat which I lost in December needed to have his food blended and fed by hand twice a day. This lasted almost 5 years and although it was somewhat of a burden I missed doing it after he passed away.

I am finding now that Tom I drinking more and urinating more than he has and am hoping it has to do with the malady. 

 

[pharber-murphy]

I hadn't heard an upper age limit for the radioactive iodine injection before. When  my Mr. Grimsby (a mature rescue) was diagnosed, I phoned a vet college to discuss my treatment options. They recommended euthanasia because he was somewhere between 10-13 years old. The vet I spoke with said he wouldn't survive another two years and I'd be wasting my money. I decided not to listen to him and I'm so glad I did!

Well, I did have to euthanize Mr. Grismby on March 20th this year - nearly six years after his radioactive iodine injection - for a different problem. So, don't let the vet tell you what you should or shouldnn't do - they can't predict the future any better than the rest of us. If you can afford it, I strongly recommend you opt for the injection. Tom could have many years of life left in him!

Best regards.

 

[2bcat]

Eh, from what I can tell the radioiodine is more of a choice and sometimes a cost issue than anything. I've heard of people doing it for 18-year-old cats. Mine was 13 when diagnosed and by the end of her life at 17 I probably spent as much money in meds and pill pockets, and then later in stress when she went off pill pockets, to make the treatment well worth it.

I don't think you said how old he is now (still 12? Or now older?) but I don't think age is an issue alone. It does become a bit of a "is it really worth it" issue, I guess, as in the older the cat is the more likely he will succumb to something else in a shorter amount of time. After about 4 or so years of survival the radioiodine might turn out to have been the cheaper option though, depending upon how much is spent on meds, recheck labs and so forth. My vet never brought up the radioiodine I don't think but in the end I thought my decision to dismiss it as too expensive was wrong. Part of it was also that Amber had and died of a heart condition and high thyroid levels can contribute to heart issues. It's possible that fluctuations over the years made that worse, whereas the radioiodine would have ended the problem once and for all.

Just my experience and conclusions, have no need to convince, just don't want that arbitrary age to dissuade you if Tom happens to be age 14+ already.

 

[its tom the cat]

Tom is just over 12 years of age. I know the pros and cons of having the treatment versus costs but as I had only found out today that the procedure was available nearby I had previously dismissed it because I did not want to travel a great distance and leave him alone for x number of days. He was dumped don't forget and I just wanted him to know he now has a safe and permanent home here.There is one question which I have not had a concrete answer on is how long would the animal be kept away if I decide on this procedure?

Thanks for all the input. My animals are my priority.

 

[2bcat]

I hear you. It's tough, the quarantine after is maybe around 5 days although I've heard as low as 3 days recently. I've also heard longer at times which would be harder but it really shouldn't have to be that long anymore. Best to talk with the local place you are considering using to see what their current standard is for the holding period. Radiocat quotes 3 days: http://radiocat.com/faq.html

It's really great what you're doing for Tom and taking into consideration all those factors so that he feels safe. Lucky cat. :-). I feel much the same about our current two, who had been returned to the shelter twice and had been in there for months before coming home with us, and they had a few supposed health/behavior issues. They are only 6 years old now but after a year and a half they seem to be settled in here very well.

 

[its tom the cat]

Tom has had a few small problems and the latest are an infected claw plus some sort of skin issue. Took him for a pedicure and that is when they found the claw problem. Gave him an antibiotic injection and told me to soak the paw daily in Epsom salts and to bring him back in two weeks. Everything was fine as far as I thought so did not go back. This time when I took him for his blood work they took it upon themselves to recheck the claw and of course it was still infected. More antibiotic and medicinal soap. So along with the Tapazole he is getting further medicated  plus enjoying a wet paw for 5 minutes twice a day. I am hoping that once the claw is okay we will only have the Tapazole concern which is easy. However I will be in touch with the local clinic that does the radioiodine treatment.

I have a funny feeling about vets. That is there is never just one visit. When I was a child many years ago we had cats and dogs. Apart from rabies injections and neutering they never saw a vet. Dental work was almost unheard of.

 

[pharber-murphy]

It was many years ago, but Mr. Grimsby was hospitalized for five days, including the day I took him in for the injection. I understand that humans are quarantined for only three days. That doesn't make sense, I know, but that's what I've been told.

They did caution me when I brought him home to stay away from him for a while - no cuddling because he could transmit radioactive material to me. Of course, once I got my boy home again, it was nothing but cuddles - I probably glow in the dark!

So, it's safe to say you and Tom will be separated at least three and up to five days.

BTW, I wanted to add that I was warned it may not be one injection, and it's all done. There are two thyroid glands and the other could go haywire later. That didn't happen, so far as I knew, but it is a possibility. You may want to schedule an appointment with the vet who will be doing the injection for more up-to-date information.

Good luck to you and Tom. Keep us posted!

Best regards.

 

[its tom the cat]

Thank you for your input. I have requested a session with the vet to answer any questions. I have also been on-line and the info is as you said. Now that Tom is hypo and not hyper I wonder if it is still the same procedure.  I have noticed that he is drinking much more now then when he was hyper.

 

[2bcat]

I wouldn't worry too much about the current at the moment hypo. That is artificial and temporary, from the med dose being too high. Should completely stabilize with the right med dose. If you stopped the methimazole completely, he would be back at hyperthyroid in a few days or so. That is what the radioiodine would cure.

After adjusting the med dose you'll be testing again in a few weeks i would think to make sure it is at the correct level now. I'm not sure what the standard is for thyroid level being lower than normal before going for the radioiodine treatment. I know they like it to be controlled to a certain degree before the procedure.

If you want to bring up a concern, it would be a worry that the radioiodine would leave him permanently hypo. That's something you should bring up with the treatment center vet. Prrhaps they may be able to adjust the treatment dosing based on his known strong response to the methimazole.

 

[its tom the cat]

I have not yet decided on the procedure although from what I have read it seems to be a miracle cure. Tom is quite dependant on me and it would hurt me and him to see him confined to a small hutch like he was at the rescue. They say cats only think of the moment but I wonder if that is true.

My last cat was rescued from a neighbour who had got him as a toy for the kids. Didn't take long for them to "forget" he was there and forgot to feed him. I saw an opened can of cat food under their hedge and realized what was happening. He became a very aggressive cat because of the way they abused him. I coaxed him to my place and he would not leave. After two weeks they came looking for him and I asked them point blank if I could keep him. Took them less than a second to say yes. A few minutes later they brought over his toys and bed and that was it. I felt bad for him and for them but was determined to make him know love. Anyway that is another story.

Tom is urinating a lot and drinking a lot more than he was when hyper. He is also taking antibiotics for his infected claw. That could be the cause.

As to numbers I was told 20-60 is normal thyroid levels. When I got Tom it was over 90 and the scale does not read above 90 in their hospital. After a month and Tapazole it was down to 57 and then 50 and his last reading was 17. The vet is aiming for 30. He was on two 5 mg pills a day and now its 1.5 mg pills a day.

Heck the way I talk about cats you would think I like them! Actually I do, especially old special needs guys, but my first love is rabbits.

 

[2bcat]

Well, certainly he would feel probably scared going to the place and staying there for a few days.  When a cat is uncomfortable in surroundings, a small space is actually better anyway.  It won't be the most comfortable thing in the world, but he'll get through it if you choose to do it.  Cats live in the moment but it isn't like he'll forget you either.  What you really can't attribute to them is human emotions like resentment or such.  In other words, he will be uncomfortable perhaps for the few days but he won't have weeks or months back at home of thinking "Why did you do that to me?" because they don't really form that kind of association with a single event.  At least, that's how I would understand it.

You on the other hand will probably be a wreck for the few days. ;-)  It'll be harder on you than him, quite probably, that's what they always say I know but I think there's a fair amount of truth to it.

So do you actually have both rabbits and cats in the house?  I always wonder how that works, rabbits and cats or birds and cats, given that cats would probably chase and eat them by nature....

 

[its tom the cat]

There is little doubt that  I would be a wreck. Even leaving him for 10 minutes while they draw blood is a lifetime! Anyway no decisions are forthcoming as he is on antibiotics and I want to get that taken care of. 

Tom lives indoors although I think in the past he was a night prowler and now only goes out if I m with him in the fenced yard. The rabbits live in a bunny barn and go out to lay in large outdoor pens in the daytime only if I am there. I keep Tom away although he is curious. I was told that if a cat scratched a rabbit the rabbit would die within 24 hours because of something in the claw. Having said that I know of many people who let their cat mingle with their rabbit.

 

[its tom the cat]

I have heard from the radio iodine clinic with the the following info.

The cat is admitted on noon Wednesday and released the following Wednesday at noon. The cost is $1750 plus 5% tax plus any other needed meds or treatments. Looking at about $2000.

They also said it is a treatment for hyperthyroid cats but not hypothyroid cats which is a rare condition.

 

[azjeni]

My Winston will undergo radio iodine treatment at VCA Animal Referral and Emergency Cetner of Arizona in Mesa on Monday.  $980 for a Monday start.  He'll be in isolation until Thursday afternoon when he'll be in the radio cat general population.  Release set for Saturday pending good radioactivity levels. Wishing all of our fur-babies the love and happiness that they bring to us! ~

J

 

[its tom the cat]

That is excellent. I am sure it will be worth every penny. Up here it is $1800 plus 12% tax (yep tax) plus any extras needed (plus tax). He would go in on a Wednesday and only come out the following Wednesday.

I have difficulty doing this as Tom was basically dropped off at the SPCA as his family did not want him any longer. He was 12 at the time. I feel that Tom would get very lonely after a week and probably think we had dumped him too. Maybe its my imagination but he very much a part of me and giving him the daily meds is not a problem. Good luck and looking forward to hearing how it worked out.