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Author Topic: Isis is hyperthyroid  (Read 160944 times)
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catbird
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« on: November 10, 2011, 07:25:51 PM »

Well, we got Isis' lab work back today, and as I suspected, she is hyperthyroid, pretty seriously so.  She'd been losing weight, and acting even more nervous and edgy than usual (she's always been a high-strung cat) as well as having other symptoms.  She is 14 1/2, half Burmese and half "unknown".  She was affected by melamine in 2007.

Normals in T4 at this lab go up to 4.8.  Isis has a level over 20!  (I think the vet said 23-something, but I was in such a state of shock that I didn't quite hear what she said.)  I'll get the lab printout tomorrow.  Her T4 was 1.9 three and a half years ago.  The problem seems to have come on in about the last 6-8 months.

We are talking about treatment options.  At this point, it looks as though the ear gel might be the best way to go.  Unfortunately, Isis has heart problems, including arrhythmia and a pretty strong murmur, and all vet visits are kind of risky for her due to the stress; she completely freaks out.  Unfortunately, I guess there are a lot of vet visits in her future now.  I hope she'll tolerate the ear gel without bad side effects.  It's such a balancing act.

More later.
« Last Edit: November 21, 2011, 06:46:36 PM by catbird » Logged

The problem with cats is that they get the exact same look on their face whether they see a moth or an axe-murderer--Paula Poundstone
Fizzy1
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« Reply #1 on: November 10, 2011, 09:05:20 PM »

Oh gosh I'm sorry to hear this.  Treating hyperT is a balancing act even without other health issues.  I hope the gel is the perfect fix.  I don't have any experience with the gel but I know others here have used it.  I know that even though hyperT is a treatable disease, it's still a struggle.   Good luck to you and Isis on your journey.
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catwoods
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« Reply #2 on: November 10, 2011, 11:28:03 PM »

I too am really sorry to hear about Isis being hyperthyroid. Many hopes and wishes going out for the ear gel to bring the numbers back to normal, without side effects.
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caylee
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« Reply #3 on: November 11, 2011, 12:21:14 AM »

Sending many good vibes for improvement in the bad numbers for Isis.

Hugs
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Meowli
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« Reply #4 on: November 11, 2011, 03:49:37 AM »

Sending a prayer for Isis, I hope the gel treatment works well and that she also gets calmer about the vet visits.
{{hugs}}
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catbird
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« Reply #5 on: November 11, 2011, 06:27:50 AM »

According to the vet, there is the possibility that Isis' heart troubles might be reduced if the thyroid is brought under control, although that pre-dates the elevated T4 (and I concluded long ago that it was probably related to her melamine encounter, since that is when the heart problems started.  As I have posted before, rat studies with melamine showed that heart damage is also one of the effects, although it doesn't get discussed often.)

There is also the possibility that her arthritic hips may be less painful if she can re-build muscle mass to support the area.

Since her blood pressure was elevated at the visit this week, the vet wants to re-check it again next week, and if it's still up, start a BP med, at least until the thyroid gets down lower.  Isis has a life-long history of severe stress at the vet clinic, plus this visit was actually precipitated by a painful paw (claw problem that was easily taken care of).  But she's not had elevated BP before despite her stress.

The worst part is, this is a cat who is completely impossible to medicate.  Some of you who have been around for awhile may remember my struggles just to give her a course of Clavamox for a bite wound a few years back.

Oy.  I don't know how I would ever get a BP med into her.  Trying to take it one step at a time to stop my head from spinning.  Of all cats to develop a need for daily medication!
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lesliek
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« Reply #6 on: November 11, 2011, 06:59:44 AM »

I'm sorry to hear Isis is hypert and that her heart problems are worse. Here's the link for the feline hyperT group that mandycat posted for me http://pets.groups.yahoo.com/group/feline-hyperT/. Here is the blog Dr Peterson writes [he's a specialist with a NY clinic & you can sign up for email updates] http://endocrinevet.blogspot.com.
  Punkin's T4 was also very high ,20.4 & came down to 15.6 with 3 weeks of twice daily 1.25 mg methimazole. Unfortunately as soon as the dosage was raised he had side effects. He's been using the transdermal now for a week & so far only a little gum bleeding twice. He isn't easy to pill or treat either, but I am managing to get the gel on his ear without too many bites & scratches. Did you ask about a liquid compound for his bp drug ? Its usually easier to get the syringe of liquid in than a pill.
 I found with Remy that anything else being wrong made his heart worse & the high T4 puts Isis in constant overdrive, so that may be causing the higher bp. Pm me if you need a good compounding pharmacy, Stokes has done Punkin's & Remy's & has a very good reputation.
 I have been reading only on the yahoo group, but you can be more active. I wouldn't pick the option for all replies to come to your email though because you will at times get hundreds. mandycat recommended just getting a daily notice or going to the group to read & that works much better.
 Hopefully the rechecks will be easier on Isis, its just a bloodtest & possibly a urinalysis. Not a full exam. You should see a big difference in how she feels after a few days of meds , but remember don't let them start her high. Stick with 1.25 mg for now so that the drop in T4 isn't drastic. That has caused a lot of problems for members of the group, unfortunately some were fatal.
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Spartycats
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« Reply #7 on: November 11, 2011, 09:21:09 AM »

Catbird,

I'm sorry to read this news about Isis.  I will send calming thoughts to you both, that you can find a medication regime that is doable. 
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merrihart
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« Reply #8 on: November 11, 2011, 10:07:51 AM »

Poor Isis.  I hope you find the right meds and dosages for her and it doesn't cause undue stress on either of you.
+++++++++++++++++++++++++++++++








.(beau was wishing her well too!)

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catwoods
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« Reply #9 on: November 11, 2011, 02:19:13 PM »

Sorry to hear about the increasing complexity of keeping Isis medicated but happy about it, too. I hope that ways to do this will arise as you go along, making it a peaceful path for everyone.
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Mandycat
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« Reply #10 on: November 11, 2011, 09:45:46 PM »

catbird,
I am so sorry that Isis has been diagnosed with hyper-T.  You can read what I wrote to Leslie on Punkin's thread for some basic information.  Leslie gave you the link for the hyper-T forum if you are interested, and Dr. Peterson's blog. Actually he has 2 blogs, and you can reach one from the other by clicking on the link that you will see on the upper right of the page.  One is for vets and vet techs, but actually is very helpful to owners as well, and the other is more for owners. Below is the link to the one for owners.  At this blog, scroll down to the October 23 blog for information about treatment with methimazole.  To get to the beginning of the series of blogs that detail all general information and information about testing, etc. for hyper-T in cats, go to the bottom of the page and click on "Older Posts".  On that page, scroll down to the September 16 blog for the Table of Contents and click on the red links.  There are also some other blog entries on diet, water requirement, etc. for hyper-T cats. I think you will be able to find them.

       http://animalendocrine.blogspot.com/

The transdermal form of the methimazole will most likely work well for Isis and avoid some of the GI side effects that happen with the pill.  Start with just 1.25 mg twice a day.  When the vet orders the gel, ask him to order it as 2.5 mg per 0.1 ml.  It will be in a 1 ml syringe that contains a total of 25 mg. Each dose will be 0.05 ml, so you will have 10 days of doses in one syringe. This concentration gives you a very small amount of gel that you have to rub in and is not messy.  You can get a prescription from your vet and order the gel from a compounding pharmacy in your area, or on-line.  It could be less expensive for you that way.  Vets seem to charge more for most medications that you can get on your own, especially maintenance type medications.  A few tips about the gel.  It is rubbed into the hairless part of the ear flap. Rub gently until it disappears.  Keep other kitties away from her for maybe 1/2 hour to be sure it is absorbed, and try to not let the other cats groom her ears during that time.  Use alternate ears for doses each day.  Wipe the ears with some warm water before applying the gel to avoid build-up. Some people use a little witch hazel every 3 days or so to do a more thorough cleaning. Residue that builds up can keep the gel from absorbing properly.  Vets seem to forget to mention this to owners.  This amount of gel will most likely not decrease the T4 to what it needs to be, although we are sometimes surprised at individual responses to the medication.  But, it is still better to go low and slow with the medication to avoid nasty side effects.  Retest T4 in 3 weeks, and the medication is then adjusted according to the test results. The increases are also slow, with retesting every 3-4 weeks until the optimal dose is reached.  Once the thyroid is controlled, you will only have to test every 3-6 months, unless you see some symptoms that are concerning.   The heart problems and BP could very well be caused by the hyper-T and may improve as the thyroid is controlled.  Even though the problems pre-date this hyper-T diagnosis, there is a subclinical phase to hyper-T and those problems may have been present in that phase.  Hard to tell because of her food troubles in the past.  With a T4 of 20 something, it is quite possible that she has had the hyper-T for longer than you suspect.  With some cats, the first signs are so subtle that they are missed. 

I know you are concerned about her daily medication, but for those using the gel, it seems that the cat actually come to like their ears being massaged.  I hope that is the case for Isis.  Certainly the oral medications present a different challenge.  If you do have to give her pills, you might want to try Pill Pockets that you can hide the pill in and give like a treat, or use some other food she likes, like cheese, to hide the pill.  There is always the pill popper as well.  The Pill Pockets are great, though, if she will eat them. 

Hope that all goes well and that Isis will soon be feeling better.  If you want, you can post all of her labs here and I will try to give you some guidance if you have any questions about any of the results.  Dr. Peterson does a good job of explaining what some of the common abnormal tests results mean, and most of the abnormalities are not significant in hyper-T kitties.  They are just part of the disease and resolve with the normalization of the thyroid.  I'm not a vet, and not an expert, but, with having had a previous kitty with hyper-T that was maintained on methimazole for 5 years, having experienced Mandy's hyper-T for which we did the I131 treatment, and being a member of the hyper-T forum, as well as the research I've done over the years, I have gained some knowledge that I can share and at least try to be helpful.   
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JoMax
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« Reply #11 on: November 12, 2011, 11:16:39 AM »

Sorry to hear about Isis.  I cant offer any thoughts about the condition, but do send my love & healing thoughts for you and hope you can come up with the least traumatic stategies for pilling/vet visits.
{{{hugs}}}
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Sandi K
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« Reply #12 on: November 13, 2011, 12:06:22 PM »

catbird, Ive always wondered, how do they take into account the cat is stressed when they are taking a BP reading?  I guess maybe they have some sort of acceptable level it should be even if they are stressed?  But I know I get whitecoat at the Drs office so my BP readings are always off but at home they are perfect.  The other thing I would be afraid of is having to start too many new meds at once although if Isis really has high BP I guess it needs to be treated.  But if she has side effects, how do they know which one is causing it.  Would it be possible for them to start her on the ear gel for the T4 first and see if that helps the blood pressure or maybe its so high they want to treat her now.  But I would guess the stress of the vet visit on a cat that is easily stressed as well as just being hyper-t by itself could raise her BP.  

But anyhow ugh.  I know its a complicated issue with Isis and her other health problems.  I keep hoping  maybe the ear gel will work good for Isis.  And if you can get the T4 down with the ear gel and no side effect problems, you will be able to see what the whole picture looks like with the T4 controlled (BP, heart, kidneys) and be able to come up with a plan that works for her.  I think its always important to remember not every cat is the same, some do well with the pills, some dont, some cant tolerate the gel, others do, etc.  And each cat has its own make-up even without the thyroid issues.  Anyhow keep us posted on how Isis is doing.  I know how upsetting this must be.  
« Last Edit: November 13, 2011, 12:07:59 PM by Sandi K » Logged
catbird
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« Reply #13 on: November 13, 2011, 05:59:24 PM »

After my most recent conversation with the vet on Friday, the plan is to begin the starter dose of the methimazole first, then take Isis' BP again when she comes in for the first lab work 3 weeks later.  (The filled syringes of the ear gel should arrive in my mail some time in the coming week; they are coming from the compounding pharmacy.)  That may be too soon to tell, because Isis has a whopping high T4 level, and it's doubtful that the starter dose of the med will bring it down anywhere near what it needs to be, but we can hope it will give an indicator as to whether treating the thyroid will correct the BP.

I think the vet is basing the BP concerns on the fact that despite her stress level at previous vet visits, Isis has never displayed elevated blood pressure before. Undecided  But, she never had high T4 levels before, either.  Of course, we are hoping that the BP will come down once the thyroid is controlled, and hopefully Isis will not need blood pressure medication.
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petslave
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« Reply #14 on: November 13, 2011, 07:28:06 PM »

Oh no catbird, I'm sorry to hear about Isis' hyperT diagnosis and other health problems.  I hope she will do OK with her ear gel, and it will help not only her hyperT but also that worrisome high BP.  It is scary to have to take them in when they are on the edge with heart problems and extreme stress.  I have to wonder if the contaminated food might not also have caused thyroid problems in pets too.
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