Newly Diagnosed Hyperthyroid

[mommytobuck]

We seem to have found the problem. The second test came back, Free T4, and according to the vet it is "high" - So I will check the records to be sure but the doctor says that means he has hyperthyroidism.

They are giving me medication and I will have to go back in 30 days to get a follow up blood test.

The doctor also said that hyperthyroid can mask kidney problems. So he said that could be worse than it would appear.

He said something about an iodine treatment that would require my cat to stay overnight somplace not sure that would be reasonable at the age of 16, but.

I am happy because I really did think it was unusual for him to lose so much weight after years of him being a fatty that I couldn't get to lose weight.

 

[FeebysOwner]

That is good news and bad. First off, please let us know what his numbers are relative to the T4 and free T4 (including the 'ranges'). Secondly, let us know what the med dosage is that the vet is recommending - very, very important to know as many vets prescribe a too high dose which can cause problems of their own. Thirdly, you need to educate yourself on hyperthyroidism - this is a highly technical and somewhat cumbersome web site that addresses all of it, but you need to do that for you and Bucky. Trust me, it is well worth navigating around the site to gain more information.
Endocrine Clinic | Animal Endocrine Clinic

There is also a hyperthyroid forum that you might want to join (for free) to ask questions when you come up with a list. I will give you the link, if and when you think you are in need.

 

[mommytobuck]

My cat is 16 years old. He was just diagnosed hyperthyroid. I am trying to get a handle on the actual results (don't have all the files yet). Last week we got a blood test done and his T4 came back at 2.7. (below is the quote from the records)

Test Results
T4 2.7 μg/dL 0.8 (lowest value) 4.0 highest value.
The Total T4 result is greater than 2.5 mcg/dl and less than or equal to 4.0 mcg/dl. A Free-T4 by equilibrium dialysis may aid the diagnosis of hyperthyroidism in cats with clinical signs of
hyperthyroidism.

So we did the requested "Free T4" test and I got the call today that said it was "high" (still trying to get the records). I asked the vet what that means and he was kind of vague. He said he has seen higher. Has anyone else had a Free T4 test?

I am a little confused as to how the total T4 can be so low when he has hyperthyroid.

In any event though, I do think he might he hyperthyroid -ish - because of his symptoms.
- He lost weight.
- He is hungry a lot
- He has been throwing up.

The vet gave me Felimazole - 2.5 mg for 14 days... and 5mg after that. And shockingly my cat took it in a pill pocket.

The vet also think his kidney issues could be worse than they appear right now due to the hyperthyroidism masking it. But I am not sure because 2 years ago he had labs and his kidney values were good.

I am happy on the one hand as we have a diagnosis but I am bummed about all of this coming at me and honestly have never trusted this particular vet completely after they misdiganosed my cat several years ago.

The vet suggested the iodine treatment... but I don't see how I could do that. My cat has to be heavily medicated to have a vet visit. How could be be at a vet hospital for days on end. Plus there is also the cost.

 

[mommytobuck]

That is good news and bad. First off, please let us know what his numbers are relative to the T4 and free T4 (including the 'ranges'). Secondly, let us know what the med dosage is that the vet is recommending - very, very important to know as many vets prescribe a too high dose which can cause problems of their own. Thirdly, you need to educate yourself on hyperthyroidism - this is a highly technical and somewhat cumbersome web site that addresses all of it, but you need to do that for you and Bucky. Trust me, it is well worth navigating around the site to gain more information.
Endocrine Clinic | Animal Endocrine ClinicThere is also a hyperthyroid forum that you might want to join (for free) to ask questions when you come up with a list. I will give you the link, if and when you think you are in need.

2.5 mg Felimazole (every 12 hours) for 14 days and 5 mg after that.

So for this is all I have.. waiting on the Free T4 results.

Test Results
T4 2.7 μg/dL 0.8 (lowest value) 4.0 highest value.
The Total T4 result is greater than 2.5 mcg/dl and less than or equal to 4.0 mcg/dl. A Free-T4 by equilibrium dialysis may aid the diagnosis of hyperthyroidism in cats with clinical signs of
hyperthyroidism.

 

[FeebysOwner]

2.5 mg Felimazole (every 12 hours) for 14 days and 5 mg after that.
So for this is all I have.. waiting on the Free T4 results. T4 2.7 μg/dL 0.8 (lowest value) 4.0 highest value.

Nope. Too high. Too much to start off with at that level of T4. Even my cat who has a 3.4 T4 doesn't get that much. IMO, start off with 1.25mg twice a day, no more.

 

[mommytobuck]

Nope. Too high. Too much to start off with at that level of T4. Even my cat who has a 3.4 T4 doesn't get that much. IMO, start off with 1.25mg twice a day, no more.

So should I just cut the pill in half? I can't see telling the vet what to do.

 

[pearl99]

I just stumbled on this thread.
I have a hyperthyroid and CKD (stage 3) kitty- Gracie in my signature. She's 14 years, diagnosed last September after vomiting and weight loss symptoms. Her hyperthyroidism was indeed covering up the kidney disease.
This is my only experience with either of these and I also thought "wow" at the dosage of felimazole your vet said.
I have felimazole tablets ordered from Chewy, Gracie is on 1.25mg twice daily (they are 5mg tablets.) This is what Gracie was started on.
I do cut them in half with a pill cutter. Mine are scored, a score at the middle. I then cut them to 1/4 with the pill cutter.

I'm not saying what you should do because I just don't have experience with this, just what I'm doing.
They don't come out exactly equal so I give a larger quarter in the morning and a smaller quarter at bedtime, to be as even as possible.

I wonder about 30 days for a blood test, I had one at 14 days to check the T4 level.
Maybe Buck doesn't also have kidney disease- but just info I'm doing the Royal Canin kidney food, I've read about the debate of kidney diet vs. not a kidney diet, and so far sticking with kidney diet.

She's done very well on this, but I do have to give her Mirataz for appetite stimulant. She stopped eating without it.
Here's hoping Buck does well also!!!
You've both been through so much!!!

 

[FeebysOwner]

So should I just cut the pill in half? I can't see telling the vet what to do.

I talked to my vet when we first started Felimazole and told him what I had learned through research - things like an over-reaction to too much of the meds possibly making a cat have adverse reactions to it that makes it so that you have to stop the meds for a while and then start over at a lower dose - why in the h*** do that? Consult your vet - you should always tell them if you want to change the dosage.

The typical re-check happens at 3 weeks, dosage adjusted if needed, and then again 4 weeks later. If you wait 30 days, then I would certainly go with the lower dose.

 

[neely]

Your vet is correct about Hyperthyroidism masking kidney issues, this is not uncommon. A lot can change in two years since his last labs especially given his age of 16 yrs. old. Our cat was also diagnosed with H-T last year and we started off with Methimazole in the transdermal gel form. It had to be compounded at a specialty pharmacy. It did help bring his T-4 levels down but it is not a cure. In order to be a good candidate for the I-131 Radioactive Iodine the cat's other medical issues have to be taken into consideration by the Radiology Diagnostics & Imaging Specialist who performs this treatment. Because our cat had no other existing medical issues we did go ahead with the I-131 but we saved up for it first. Not many facilities perform this treatment and it is very important to make sure the specialty hospital you choose does a scintigraphy procedure prior to the I-131. I could tell you more about the Radioactive Iodine but that would be getting ahead of yourself. First, try the Felimazole. However, double check if that is the best dosage for him to start with since it seems a bit high. Then see what his T-4 results are after a month and go from there.

 

[mommytobuck]

I talked to my vet when we first started Felimazole and told him what I had learned through research - things like an over-reaction to too much of the meds possibly making a cat have adverse reactions to it that makes it so that you have to stop the meds for a while and then start over at a lower dose - why in the h*** do that? Consult your vet - you should always tell them if you want to change the dosage.

Ok I will give him a call. Thanks. I also want to talk to him about getting the pills at chewy since this supply from the vet was crazy expensive. I was worried I wouldn't be able to give him the pill but he is taking it with a pill pocket so -- so far -- so good.

After 1 pill today Buckwheat is very sleepy and a bit "off".

I can't cut the pill that he gave me in half. It has a hard outer covering (like an M&M) ... but I also found out last night -- and I am not sure if this is correct... does this pill have to be carefully handled? It can effect your thyroid status by touching it? So that is another reason I don't want to cut it in half.

Maybe Buck doesn't also have kidney disease- but just info I'm doing the Royal Canin kidney food, I've read about the debate of kidney diet vs. not a kidney diet, and so far sticking with kidney diet.

Now that I found out about how hyperthyroid masks kidney disease I would not be surprised if it was worse than we thought, but, still, I am hopeful. If the numbers come back much worse I will go 100% kidney diet.

 

[FeebysOwner]

I can't cut the pill that he gave me in half. It has a hard outer covering (like an M&M) ... but I also found out last night -- and I am not sure if this is correct... does this pill have to be carefully handled? It can effect your thyroid status by touching it? So that is another reason I don't want to cut it in half.

Use gloves if you are worried. However, I have been handling these pills since 10/2020 with no issue. After all, they are coated; even if you cut them in half the odds of getting enough, if any at all, absorbed into your skin is next to none.

As far as cutting the Felimazole in half - very easy to do with a pill cutter. You can buy one most any place, normally located near the pharmacies in stores. I even have to cut them into quarters in order to ensure I am not giving Feeby too much. The quarter sections are harder to get totally even, but not so bad as to worry about the dosing. It is doable.

 

[mommytobuck]

Use gloves if you are worried. However, I have been handling these pills since 10/2020 with no issue. After all, they are coated; even if you cut them in half the odds of getting enough, if any at all, absorbed into your skin is next to none.

As far as cutting the Felimazole in half - very easy to do with a pill cutter. You can buy one most any place, normally located near the pharmacies in stores. I even have to cut them into quarters in order to ensure I am not giving Feeby too much. The quarter sections are harder to get totally even, but not so bad as to worry about the dosing. It is doable.

Thanks. The vet is out for a few days. I am going to stop the meds and wait for him.

 

[pearl99]

Thanks. The vet is out for a few days. I am going to stop the meds and wait for him.

Mine are not coated, so they cut easily, and I use a pill cutter to quarter them also. I don’t wear gloves, but I do wash hands after- I don’t think I’m getting anything on my hands but wash anyway. Could also use tweezers.

 

[mommytobuck]

Getting irritated with the vet. They didn't send me the records and when I called no one answered all afternoon. I had to leave a message. And no one called me back. I want to go to another vet but I don't think anyone else would be better / different.

My cat threw up again today. That makes 1x every 72 hours. It was green and smelly. I think bile.

I joined a facebook board and that adminstrator told me she thought he should be on .6 Felimazole.

I hate playing phone tag with the vet. The old vet (who managed to get rid of me) had e-mail so I could send a message that way, not this one.

 

[FeebysOwner]

My cat threw up again today. That makes 1x every 72 hours. It was green and smelly. I think bile....I joined a facebook board and that adminstrator told me she thought he should be on .6 Felimazole.

Bile sounds like an empty stomach...
What the heck is .6 Felimazole????
Did you ever join the free H-T forum? [email protected] | Home

 

[ObeseChess]

Sassy was recently diagnosed with very mild hyperthyroid too and we are also doing .625mg felimazole (1/4 of a 2.5mg pill, presumably what was meant by ".6 felimazole") every twelve hours. Any more than that and she got very itchy and she hated the transdermal stuff. I realize that the iodine is of course a "cure" but I too would be wary of such a thing with a cat that age. 2.5mg seems much too high to me as well.

 

[mommytobuck]

Sassy was recently diagnosed with very mild hyperthyroid too and we are also doing .625mg felimazole (1/4 of a 2.5mg pill, presumably what was meant by ".6 felimazole") every twelve hours. Any more than that and she got very itchy and she hated the transdermal stuff. I realize that the iodine is of course a "cure" but I too would be wary of such a thing with a cat that age. 2.5mg seems much too high to me as well.

Thank you, that is what I meant.

And thanks to the link for the group... I have joined.

 

[FeebysOwner]

625mg felimazole (1/4 of a 2.5mg pill, presumably what was meant by ".6 felimazole")

Now, that makes sense. Thanks for clarifying. I should know better given Feeby gets 1.875mg in the AM (3/4 of a pill) and 1.25mg in the PM (1/2 of a pill) - DUH!!!

 

[mommytobuck]

I am starting to think I am going to have to find another vet. I called this morning to get the records of the free T4 and they told me again, that they needed the vet's approval to give it to me. I asked the girl to tell me the result and she said she couldn't without talking to the vet. I said, those records are mine. I paid for the test.. that result is legally mine.

She said it was "policy" I asked to speak with a manager -- she said the manager wasn't in.

I told her I didn't want her to get in trouble but the reason I wanted the results is so I could be prepared when I talk to the vet. So it makes no sense for him to give the results when he calls. I also mentioned that my pet insurance will not pay without knowing what the test was for and they will take the records to prove that..

Not to mention that I am tired of this "vet calls" thing. I can't and won't be around all day for his phone call. I have a job myself.

Finally, I am growing suspicious that they won't give me this test. Especially after the incident I had with them years ago where they diagnosed him with CKD at 3 years old and when I got the records and checked on the internet - thought they were wrong and, since he is 16 now, I think I was right.

God I have gone around to soooo many vets over the years.

 

[FeebysOwner]

I called this morning to get the records of the free T4 and they told me again, that they needed the vet's approval to give it to me.

This 'procedure' is actually pretty common. I would call them back and ask to leave a message for the vet that if you miss his call and he leaves the results on a VM (which he most likely will), would he then please authorize release of the test results to you. If you have email access, you can also send him a message requesting the same.

You don't have a cell phone that you have with you at work? I now ask for the vet to call me on my cell phone - which I most always have with me - for this very reason.