Newly Diagnosed Hyperthyroid

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mommytobuck

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And I thought for sure that I would see something after a full day of work, but nothing... what is happening here? If I cancel the ultrasound you just know he will immediately throw up
 

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And I thought for sure that I would see something after a full day of work, but nothing... what is happening here? If I cancel the ultrasound you just know he will immediately throw up
Better to follow through with the ultrasound than to cancel it and his symptoms reappear for you to just have to re-schedule it again. I know, I realize, it is very tempting to cancel, but... Even if for now the symptoms are 'gone', that doesn't mean than an ultrasound won't be of value. If there is something going on involving his digestive system and/or other organs, it will show up whether or not there are symptoms currently going on.
 
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12 more hours - no throw up. This is an amazing streak of 5 days.

I may have a problem with today's visit. Gabapentin makes him extra sleepy, when he has had food. I am not allowed to give him food for 12 hours ( just a tiny bit to give him the Gabapetin) and that makes him restless and awake. He is pacing around now asking for food... this extra energy could be a problem getting him to relax for the ultrasound or even getting him into the carrier.
 
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Well, he threw up. But to be fair he hasn't had any food for 10 hours (and that was just a small amount to give him Gabapentin) I was able to see that without food in his belly his throw up was clear - not green / brown -- it had some hair but I would say it wasn't a fur ball more like throw up with fur in it.

Still that was a long period without throwing up.

My hopeful theory is that it was the Meloxicam that irritated the GI and now that I have stopped that cold turkey he is healing a little.

He is very restless -- I can't get him to settle. I don't know if this is going to work today.
 
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mommytobuck

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So the ultrasound is complete. Buckwheat is home and appears ok. They said they would be in touch with the results... should I take that to mean there wasn't anything massive staring them in the face? Like a tumor?
Poor guy, he is all shaved on his abdomen.
Good to know that the Gabapentin worked for this purpose but he is very unsteady on his feet.
I gave him a big plate of food and I hope he will retire to bed.
 

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That all depends on the institution you used to have the ultrasound done. On Feeby's first ultrasound, I met with a specialist when I went to pick her up who verbally went over the results, and later sent me the report results. The second time, I received a phone call the same day going over the results, as I wanted to take her home as opposed to making her wait for me to see the specialist. Then, too, I was sent results via email.

Glad you got him through this! The belly hair grew back fairly quickly for Feeby - as she had to have another complete shave for her second ultrasound which was done 4 months later.

Keep us posted!
 
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Glad you got him through this! The belly hair grew back fairly quickly for Feeby - as she had to have another complete shave for her second ultrasound which was done 4 months later.
Well I got the ultrasound results back but I can't figure out what the vet is trying to say or if I need to do anything. The vet called me but I thought her explanation was very lawyer like and I couldn't get out of her what the import was of what she was trying to say. Ultimately everything was "normal" but for the fact that she said the lymphnodes were enlarged

Ileo-colic nodes are mildly enlarged and mottled with hyperechoic omentum adjacent
It also said
Abdominal Assessment:
- Kidneys: r/o chronic degenerative disease vs acute on chronic. Infiltrate possible though not classic for lymphoma
- Nodes: r/o marked inflammatory vs early infiltrated
Plan - Abdominal:
- GI and node biopsies would likely be needed for definitive diagnosis
- Monitor renal values over time
- If aggressive lymphoma suspected clinically, could attempt FNA of nodes and kidneys under anesthesia but cytology is less useful for small cell lymphoma/inflammatory disease
I asked her what that meant and she really was vague.. she said it could be cancer but it also could be inflammation etc. Only a biopsy could tell about cancer. But honestly I don't know about doing that.. when ultimately I think it could end in putting the cat down. I also don't want to something that might not really even tell me anything more.
 
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So my 16 year old cat has, for about 6 months, been sick. He has lost weight and is throwing up about every 72 hours. Usually clear liquid. I took him to the vet. All basic blood tests and urine was ok.

I asked for an ultrasound. The results largely were normal. But the lymphnodes were enlarged. My vet said we could do a biopsy to check for lymphoma. I am not sure I want to do that. First for the misery it would bring to my cat and also frankly the cost. Also, if he was diagnosed with Lymphoma I would not treat it. My cat has a number of other issues - CRD, gray area hyperthyroidism, asthma, arthritis

I feel my vet does not want to say it is lymphoma without a biopsy but I feel like it is. Anyone have an idea of the cost of the biopsy / how involved it is? My vet said even that could be inconclusive.
 

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An ultrasound without at least an FNA will almost always be inconclusive. I find it ridiculous that they did not go ahead and do an FNA when they saw enlarged lymph nodes. Did you ask about the FNA ahead of time?

The enlarged lymph nodes do NOT HAVE to mean lymphoma. Feeby's last ultrasound is when they saw some enlarged intestinal lymph nodes - and, at least they had the brains to do an FNA at that time. The FNA results were labeled 'inconclusive' because there weren't any obvious signs of cancer cells in the tissue they analyzed. They did indicate inflammation as well in the report I got, but because the FNA was inconclusive they would not rule out lymphoma.

In order to have a better understanding of the report results, you have two options: 1.) look up some of the terms yourself so you know what they mean. and/or 2.) ask this vet to send you a report in layperson's terms. It shouldn't be that difficult, and tbh should be done without you having to ask, IMO. I received a similar complex report from the specialist but there was also a layperson's report created as well.

If this was a specialty group you went to for the ultrasound, they should also be sending report data to your regular vet. Perhaps, you can ask them about getting a copy of what they received.

EDIT: I also have to say, I hope there is more to the report that what you shared. If that is all there is, it is pretty pathetic overall.
 
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mommytobuck

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An ultrasound without at least an FNA will almost always be inconclusive. I find it ridiculous that they did not go ahead and do an FNA when they saw enlarged lymph nodes. Did you ask about the FNA ahead of time?
That could have been my fault. On the forms I selected I wanted a call before they did anything but the ultrasound.... they didn't call but perhaps they took that to mean nothing else was authorized. I mentioned my cat can be a handful and he was a little more animated on Tuesday due to lack of food so perhaps that was an issue. As usual I found them utterly unhelpful. They told me my cat would be ready at 2... no one called. I drove there at 3 and said, where is my cat ? And they were like oh he is ready. I had to drive there because I had a work related thing at 4 and it is a 1/2 hour drive. I am really not sure what happened. As usual the vet wanted to talk on the phone and I listened but then said, can I have the records and she sent them after we got off the phone and we haven't talked since. As you know, I have to get the records before I talk to these people because the records always seem to be very different than what they are talking about on the phone.

The report went by each organ. Every organ but for the kidneys was reported as fine. The kidneys had some mineralization but I already knew that.

I will see if I can ask her for a clearer explanation of the results and also if Lymphoma is suspected.

I don't think i want a biopsy. Even and FNA. She said that could be inconclusive as well. I have now spent about 2K and I have no further information than a few months ago. My gut is telling me it is the Meloxicam... things just went down the hill then.

I do think the ultrasound helped. I was worried about a mass, a friend had a cat with similar symptoms and an ultrasound showed up a big tumor. There was nothing like that here.
 

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There might be an issue with the call to authorize another procedure - not that I am saying that they shouldn't have called, but what I was told is that it delays the entire process to have to stop the procedure, wait to place a call to the owner and then possibly wait to get authorization if the owner isn't immediately available. Like it or not, ultrasounds - at least where I went to - are performed by a team that does nothing but those all day long, so it is a bit of a production line, so to speak. Nature of the beast (job). It also causes the cat to stay on the table longer while they make contact with the owner. Chances are they didn't see anything to justify doing that to Buckwheat. If they had, I expect they would have called you.

Thankfully, the specialist I went to asked to receive an advanced authorization for the FNA, so no call to me was needed. It might be since this was Buckwheat's first ultrasound, they don't generally ask about an FNA. The specialists I went to did not ask when Feeby had the first ultrasound, just on the second one.

The FNA would probably be less 'annoying' to a cat than the ultrasound itself. The FNA is not much different than a blood draw - and doesn't really take any more time either.

Good to hear there was more content to the overall report and that nothing else was found.
 
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There might be an issue with the call to authorize another procedure - not that I am saying that they shouldn't have called, but what I was told is that it delays the entire process to have to stop the procedure, wait to place a call to the owner and then possibly wait to get authorization if the owner isn't immediately available.
It only dawned on me later that I did that to myself. The forms where not clear that was what I was doing. I was basically concerned they were going to get fed up with my cat being fractious and sedate him and that would be difficult. The ultrasound person was lined up with several patients so it was a conveyor belt situation.

If the FNA test is not too expensive I will consider it. My big concern is that it also comes back inconclusive.
 

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It only dawned on me later that I did that to myself. The forms where not clear that was what I was doing. I was basically concerned they were going to get fed up with my cat being fractious and sedate him and that would be difficult. The ultrasound person was lined up with several patients so it was a conveyor belt situation. If the FNA test is not too expensive I will consider it. My big concern is that it also comes back inconclusive.
Sedation, had it been needed, probably would have been something 'harmless' like butorphanol (they gave that to Feeby with her first ultrasound - nothing was needed for the second one when they did the FNA).

As far as I know another ultrasound would be needed to do an FNA. The ultrasound allows them to guide the needle to where they want the tissue from. The FNA isn't cheap, but not as expensive as the ultrasound.

It isn't the end-all answer, but I would prefer to see an inconclusive result on Feeby as opposed to a conclusive one!!! I don't think there is a test that can be run to give an entirely conclusive no-cancer result.
 
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As far as I know another ultrasound would be needed to do an FNA. The ultrasound allows them to guide the needle to where they want the tissue from. The FNA isn't cheap, but not as expensive as the ultrasound.
See now, that is my concern. I just can't keep spending money like this. I think I am done for the moment. I will see what happens over the next few months.
 

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See now, that is my concern. I just can't keep spending money like this. I think I am done for the moment. I will see what happens over the next few months.
Don't blame you. Feeby's first ultrasound was in August of last year. I wanted until December for the second one. And, yes I will have her go through another, looking for any new changes, in another month or so. Once that is completed and we don't have an answer, I will be done. Not so much the money, but the fact that currently everything else going on with her doesn't really point to lymphoma.

Just do try to get a better explanation from the vet on the ultrasound results!
 
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Just do try to get a better explanation from the vet on the ultrasound results!
Got it.. she basically said what I expected. Enlarged nodes could mean localized inflammation or cancer (doesn't necessarily mean Lymphoma). There is just no way to know without testing the cells.

She is going to get me an estimate for the FNA but I told her I am not inclined to do it.

She said vomiting and weight loss are symptoms of Lymphoma / cancer but they are also symptoms of a lot of other things.

Someone suggested to me that we just treat with steroids (and see if my cat improved) but the vet didn't think that was wise if we didn't know for sure.

One thing that makes me question a cancer diangosis is that my cat is hungry a lot. I mean very hungry. Though they say some cats can be more hungry I just don't get that vibe from looking at groups with cats that have cancer.
 
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She is going to get me an estimate for the FNA but I told her I am not inclined to do it.
It has been almost a week and no estimate. Humn...

Here is the good news, and I realize I am jinxing myself here. It has been 6 days since he threw up. The space in time between throw ups has been increasing. So far in March he has only done 4 throw ups. (I am keeping it on a calendar). For about 17 days. At two of them were a direct result of my having to fast him for the ultrasound.

I think that it has to do with removing the Meloxicam from his diet completely and I got him new dry food that he does really like at the moment. Thus I am wondering if he wasn't eating at night before and that was allowing him stomach to get sour.

What ever is going on not eating frequently enough directly leads to throw up. Eating about every 4 hours stops it. Why that is the case? I do not know... but if I do have a mechanism to stop it... that is a good thing.
 

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What ever is going on not eating frequently enough directly leads to throw up. Eating about every 4 hours stops it. Why that is the case? I do not know... but if I do have a mechanism to stop it... that is a good thing.
A lot of cats, particularly older ones seem to want to eat frequently, not sure why. Feeby 'munches' all the time - but, it might only be a bite or two each time.

The frequent eating is a good thing if it is keeping acid build up at bay for Buckwheat - that will certainly reduce vomiting!
 
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The frequent eating is a good thing if it is keeping acid build up at bay for Buckwheat - that will certainly reduce vomiting!
Well he got me up from bed and gave out a cry like he usually does before vomiting. But I gave him some dry food and that seemed to hold it off. If I can hold him off from throwing up for a week that will be major progress.
 
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Though he meowed violently this afternoon, with a yowwwwlllll.... I gave him some food and he went back to sleep.
This is a record.. we are coming up on 8 days today since a throw up.

Since he Pepcid AC didn't seem to work... could it be gas? Wondering if there is anything for gas.

I am starting to wonder if food contributes but it can't be that. I was giving him a lot of food before. I am really hoping it was the Meloxicam.
 
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