hyperthyroidism - can i have your experiences (and sympathy)..?

[Rosella moggy]

Many thanks Andrew. I've had lots of extremely helpful replies 

[Andrew]

Just a quick note for Andrew if he's about. I've applied to join the group you suggested as took Tom ("borderline" HyperT last couple of tests) to different vet yesterday (same practice). 

I took him in due to sneezing which seems to have affected his eating and he has lost .5kg in last week.

Tom's heart rate was over 300 i.e. extremely fast but think that was coz vet dragged him awkwardly out of his carrier. Tom previously had adverse reaction to 10mg Vidalta so treatment was stopped completely and this vet has now prescribed 5mg felimazole twice a day without even reading Tom's notes properly (busy bank holiday Saturday) 

Did as prescribed yesterday but am now inclined to reduce to 1 tablet a day for next couple of days and speak to vet that treated him previously when surgery reopens on Tuesday.

Do you think that's a plan?  I see the suggestion is to start treatment on only 2.5mg once a day but don't know if it's OK to break up 5mg Felimazole tablet as was specifically told not to break up Vidalta tablet.

My apology. I happen to get online first time in about 10 days and I am in Italy for another few weeks.. I donàt have internet access and I can only go to use internet once a week or so..

The best thing to do is to join the hyperthyroidism group in yahoo and post the situation and questions.. Make sure to get the numbers -- T4, fT4 etc.. And read Alices and Helens replies..

If they dont reply, you just add my name in the subject line and tell them I say theyd help you :-)

I really hope it goes well..

Andrew

[Rosella moggy]

I keep changing my mind MM (I could win an Olymic Gold at dithering) but only gave Tom 1 tablet yesterday am and think that's what I'll do today and tomorrow when I hope to have a proper chat with young female vet that's been treating Tom's HyperT so far.

I can't see how you can split the tablets, they are so tiny!  Don't they just disintegrate?

I am going to buy a pill cutter. Never even heard of one before.

The HyperT Forum is very helpful. Someone has confirmed with manufacturers of Felimazole that the reasons they say not to split tablets is in case of uneven dosage (OK if use each half of same tablet on same day) and may be very slightly less effective if split. Almost everyone on that forum seems to split tablets and the general advice is just like Andrew says i.e. to start medication at 1.25 mg of Felimazole and same level of increase to determine correct level using regular blood testing.

Vidalta is different as it is a slow release tablet.  Our Tom also started vomiting and had diarrhoea Jorgon following a few weeks of Vidalta. Blood test showed up raised liver enzymes. It is a pity the lowest dose for a tablet is 10mg.

[Rosella moggy]

Really sorry to hear this Jorgon.

Check on the dosage used for Vidalta and has she been tried on Felimazole?  Again dosage so important. 

http://www.noahcompendium.co.uk/Dechra_Veterinary_Products/Felimazole_5_mg_Coated_Tablets/-37182.html
 
Vet yesterday said there is also another treatment we could try if Felimazole also causes problems with our Tom but only licensesd so far in humans and, as you can tell, I have little faith in yesterday's vet anyway.  I would urge you to join the forum suggested by Andrew much earlier in this thread which I have done today in the hope that it will teach me how to get the best from my vet.  It does however seem to be mainly a US site so medications different.

Are you insured by any chance?  I'm thinking maybe a referral to a specialist? 

[jorgon]

There is a new med licensed for hyperT in cats, its called Vidalta. Well its not exactly new - its the Carbimazole based medication and has been used before in the form of Neomercazole. It only needs to be given once a day, unlike Felimazole (which is Methimazole) which is usually twice a day.

Our cat reacted quite badly to Vidalta, as she had done to previous medications for Hyperthyroidism (severe vomiting and loss of appetite).  From previous medications she recovered quickly but this time it was an anxious 4 days before she started to eat again, despite an injection by the vet.  She now seems to be slowly returning to "normal".  We've been through various hoops with her - including a thyroidectomy, and seem to have reached a dead-end with the treatment.  She's a very anxious sensitive cat and at her age (17) we don't think we could put her through the radio isotope treatment.

[Millys Mum]

Working in pharmacy there were certain rules of thumb and things like hormones you didnt split, also if it applies to either of you, wear gloves if you crush them as it can cause problems in women of childbearing age. A teratgon <sp>
Also the coating may control how the drug is absorbed.

Twice daily is the best but if your talking until tuesday when you could get to the vet once is not so bad

[Rosella moggy]

Obviously every cat is different Helen but the Felimazole manufacturers website is really very clear that "in light of recent studies" the 5mg tablet is only suitable for cats requiring higher dose rates.

For long term treatment the starting dose should be 2.5mg twice daily and dose adjusted after 3 weeks according to the serum total T4 i.e. start low and increase.  Tom has already suffered side effects with raised liver enzymes on 10 mg Vidalta (and I am already suffering sleepless nights and indegestion from anxiety due to slap happy vet prescribing without referring to Tom's notes).

Cheers Jasmine. 22 is a fabulous age and really cheers me up.

[Jasmine]

My Martha (22) has been on Felimazole for 3 years now (ever since we've had her).  Her dosage has obviously varied over that time and she's currently stabilised on 5mg twice a day - once last year I had to give her 12.5 mg (2 x 5mg & 2.5mg) at 8 hour intervals for 10 days. 

Anyhow, what I wanted to say was, I have always crushed them and mixed the powder in her food, she simply wouldn't have taken them otherwise and wouldn't be alive today (the dear fossil she is!).

I can't see how you can split the tablets, they are so tiny!  Don't they just disintegrate?

[Tiggy's Mum]

Tiggy started on 5mg twice daily, the dose was adjusted after each blood test and we finally perfected 1 2 1 2 1 2 1 a week.  I would stick with the dose the vet has said, you can actually get 2.5mg tablets so once he's had a blood test it might be that he settles on a lower dose.

[Rosella moggy]

OK. I've decided.  The manufacturer's website says "tablets should not be split".  Goes on to say "if, for reasons of compliance, once daily dosing with a 5mg tablet is preferable, this is acceptable altho reduced efficacy can be expected compared to a twice daily regime"

[Rosella moggy]

butter!   

This is driving me a bit batty now.  Have done nothing today except sit at this computer trying to figure out what to do.  Even the website for the manufacturers of Felimazole say initial dosage is 2.5mg twice a day not the 5mg and "do not break or crush tablets".   

[Millys Mum]

I would have thought no to breaking up due to the nature of the drug 

[Desley (booktigger)]

Good, fingers crossed it works well for him.

[Rosella moggy]

Yes of course you're right Desley. Just rang Vets Now and got to speak to a helpful vet. 

He said that Felimazole should be given every 12 hours or so. No problem halving tablets and reducing dose
to 2.5mg each time (altho Tom may not like the taste) and get a blood test done asap.

[Desley (booktigger)]

R, you would be best ringing the out of hours vet rather than swap and change treatments.

[Rosella moggy]

Just a quick note for Andrew if he's about. I've applied to join the group you suggested as took Tom ("borderline" HyperT last couple of tests) to different vet yesterday (same practice). 

I took him in due to sneezing which seems to have affected his eating and he has lost .5kg in last week.

Tom's heart rate was over 300 i.e. extremely fast but think that was coz vet dragged him awkwardly out of his carrier. Tom previously had adverse reaction to 10mg Vidalta so treatment was stopped completely and this vet has now prescribed 5mg felimazole twice a day without even reading Tom's notes properly (busy bank holiday Saturday) 

Did as prescribed yesterday but am now inclined to reduce to 1 tablet a day for next couple of days and speak to vet that treated him previously when surgery reopens on Tuesday.

Do you think that's a plan?  I see the suggestion is to start treatment on only 2.5mg once a day but don't know if it's OK to break up 5mg Felimazole tablet as was specifically told not to break up Vidalta tablet.

[Desley (booktigger)]

Good luck with him, I have had a few that only came eating dry, and while I have had success, they have still swayed more towards dry than wet. She is, its ironic actually as I have had two cats younger than her this year wiht terminal conditions.

[Andrew]

She didn't eat any wet food before coming here, so I am pleased that I Get some into her twice a day. her bloods showed her liver and kidneys are fine though (she came to me wiht suspected liver issues), but I am a meany and restrict certain things cos she is a tad overweight - I always watch weight regardless of age, as i would rather them come down with something due to age, which I can't control, rather than weight, which I can.

Very very well said! Mine is only 10 and he has been addicted to JWB... I tried several times to switch him over to wet food only but it wasn't successfully.. Now he eats half dry food and half wet food! I hope this one can live until 18!!!

Yours sounds doing great with liver and kidney doing well!

A

[Desley (booktigger)]

She didn't eat any wet food before coming here, so I am pleased that I Get some into her twice a day. her bloods showed her liver and kidneys are fine though (she came to me wiht suspected liver issues), but I am a meany and restrict certain things cos she is a tad overweight - I always watch weight regardless of age, as i would rather them come down with something due to age, which I can't control, rather than weight, which I can.

[Andrew]

my philosophy is that, since he/she is 18, let him/her eat whatever he/she wants and just pleases him/her as much as we can 

[Desley (booktigger)]

Thanks for that - mine have their thyroid tested yearly, but fortunately no issues to date. I do feed them (or try to!!) mainly wet food and good quality, but the oldest (18) does prefer dry food, as do some of the fosters.

[Gillian Harvey]

Yes, I'd heard that soy isnt good for cats full stop! It isnt always easy to spot in foods either, sometimes it will say soy, but in some wet foods you will see 'vegetable protein extracts, or vegetable protein' - which is soy. There was a thought some while ago, that the increase in hyperthryoidism in cats was due to the metals used in tins of cat food (not just the pop tops) - but I don't know if thats been researched any further or if any real conclusions were made.

[Andrew]

Abstract
American Journal of Veterinary Research
May 2004, Vol. 65, No. 5, Pages 586-591
doi: 10.2460/ajvr.2004.65.586



Effect of dietary soy on serum thyroid hormone concentrations in healthy adult cats

Heidi L. White , DVM Lisa M. Freeman , DVM, PhD Orla Mahony , DVM Peter A. Graham, , BVMS, PhD Qin Hao , MS Michael H. Court , BVSc, PhD
Department of Clinical Sciences, School of Veterinary Medicine, Tufts University, North Grafton, MA 01536. (White, Freeman, Mahony); Veterinary Diagnostic Endocrinology, Diagnostic Center for Population and Animal Health (AHDL), Michigan State University, Lansing, MI 48909. (Graham,); Present address is NationWide Laboratories, 23 Mains Lane, Poulton-Le-Fylde, Lancashire FY6 7LJ, UK. (Graham,); Department of Pharmacology and Experimental Therapeutics, School of Medicine, Tufts University, Boston, MA 02111. (Hao, Court)
Objective—To compare effects of short-term administration of a soy diet with those of a soy-free diet on serum thyroid hormone concentrations in healthy adult cats.

Animals—18 healthy adult cats.

Procedure—Cats were randomly assigned to receive either a soy or soy-free diet for 3 months each in a crossover design. Assays included CBC, serum biochemical profile, thyroid hormone analysis, and measurement of urinary isoflavone concentrations.

Results—Genistein, a major soy isoflavone, was identified in the urine of 10 of 18 cats prior to dietary intervention. Compared with the soy-free diet, cats that received the soy diet had significantly higher total thyroxine (T4) and free T4 (fT4) concentrations, but unchanged total triiodothyronine (T3) concentrations. The T3/fT4 ratio was also significantly lower in cats that received the soy diet. Although the magnitudes of the increases were small (8% for T4 and 14% for fT4), these changes resulted in an increased proportion of cats (from 1/18 to 4/18) that had fT4 values greater than the upper limit of the laboratory reference range. There was no significant effect of diet on any other measured parameter.

Conclusions and Clinical Relevance—Short-term administration of dietary soy has a measurable although modest effect on thyroid hormone homeostasis in cats. Increase in T4 concentration relative to T3 concentration may result from inhibition of 5'-iodothyronine deiodinase or enhanced T3 clearance. Soy is a common dietary component that increases serum T4 concentration in cats. ( Am J Vet Res 2004; 65:586–591)

http://avmajournals.avma.org/doi/abs/10.2460/ajvr.2004.65.586?cookieSet=1&journalCode=ajvr


Cat litter/Sodium bentonite

http://yourcatcareguide.com/wordpress/?p=294

http://answers.google.com/answers/threadview?id=286497

[Andrew]

Andrew, could you just expand on your comments about food and litter please? What foods should be avoided? I dont have any hyper-t cats, but I do have a 15 and 18 yo, so always handy to know.

http://www.itsfortheanimals.com/DODDS-NUTRITION-THYROID.HTM

Jean Dodds is a leading animal endocrinologist... She has retired so she doesn't really care about pharmaceutical companies or big prescription diet companies... She has a charity lab Hemopet that I asked my vet to send Charlie's blood sample to for a full thyroid panel. My vet said he already knew of her because she published a lot of research. She interpreted the results. And it is much cheaper than the UK's labs... You vet should have this information and if not, you can send me a message. (I'm not saying you need to do it now but just for record that if anyone in the future needs a full thyroid panel because I won't be here forever..)

So in that article, there is implication of soy and hyperthyroidism.

Now, trying to find litter info for you...
Personally, I would dump all dry food if the cat accept wet food... Someone told me -- if you eat dry instant noodles with added supplements for 5 years (that'd be one year in cat's life), all balanced and complete, will you be healthy? .......cats are natural carnivore... dry food, in order to save money, uses some animal by products or waste (max 30%), then use soy or corn to bulk up the quantities and add supplements... That's what we call a complete diet for cats...

If your cat accepts it, I'd feed high quality we food..
A

[Andrew]

Desley,

sorry but I threw all my notes away because I was quite angry after Charlie's death.. So I can't really find any study but only my own memory. (although I can ask people in the hyperT groupt to find the study for me, they told me this.)

I try to state everything that I can quote from research and studies.. but now I can only use my memories..

I remember a well known feline specialist told me not to give the cat any food containing soy if Charlie has hyperT... She said soy makes hyperT worse and that soy might be the reason why cats develop hyperT... I'll ask again. But I'm trying not to go back to that memory..

Litter wise -- this is from megacolon group that we've noticed from out limited cats in the group -- about 50, that they all used clumping litter or clay based litter. So anything natural is really better for their GI. (they do lick off the powder after using the litter)

The senior lecturer at RVC, who operated Charlie, told me she uses garden soil for her own cats..

Andrew

[Desley (booktigger)]

Andrew, could you just expand on your comments about food and litter please? What foods should be avoided? I dont have any hyper-t cats, but I do have a 15 and 18 yo, so always handy to know.

[Andrew]

Sorry, I forgot to add.

Be very careful when doing a surgery.. Some abnormal thyroid can be in the chest or worse, in the stomach... If technetium scan is not performed but simply relied on the vets fingers, then the surgery could have done nothing... I met someone whose vet operated the cat's neck, cut one thyroid gland, then it did nothing -- it turns out the gland is in the chest. And if going for surgery, there is a high chance of recurring hyperthyroidism or risk of parathyroid damage, which can be dangerous (parathyroid damage is much less in the UK though, due to experiences = unsuccessfully cases in the 90s)

A

[Andrew]

You may wish to join http://pets.groups.yahoo.com/group/feline-hyperT/ the owner is british too.

If you join, tell the owner Penny I send you there so you'll be approved immediately -- there are too many spams around...

They really know a lot about feline hyperthyroidism..

Andrew

[Andrew]

What was his T4 number? Did the vet only do T4? To be honest, to determine if it is simple hyperthyroidism, I would request a complete thyroid panel including total T4, free T4, total T3, free T3, T3 and T4 autoanitbodies.

If starting Carbimazole, I would not go beyond 5mg per day. For Felimazole, 2.5mg per day. Also, you must test him at least once a month in the beginning to see if it is working. Most importantly, antithyroid medications can cause srious side effects -- low white blood counts, low blood count, liver damage etc. One most important thing is that once the thyroid is lower, it can sometimes unmask pre-existing kidney disease -- ask for a urinalaysis. antithyroid medication, be it methimazole or carbimazole, can have nasty gastrointestinal side effects too. Start low and let the cat get used to it.

This is an article I read last year because my cat also had hyperthyroidism. This is an excellent article. Don't depend on your vet -- veterinary endocrinology is a big joke, compared to human endocrinology.
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6658&Category=996&O=Generic Note that it is recommended to start 2.5mg methimazole, which is quivelent to 5mg Carbimazole. Most vets in the UK start at a crazy dose at 10mg Carbimazole... If your cat is doing well, then you're lucky... 10% dies from it... Start low please... Vets should really get up to date studies and publications on the dosage... But then again, it is only cats..

If you're going for a surgery, please request a technetium scan before the surgery to locate where the abnormal gland is -- a few vets use their fingers to feel it and 50% are wrong -- your vet may end up having the wrong thyroid gland removed... RVC and others may do a technetium scan. Ask for Dr Syme at RVC.

If a cat has hyperthyroidism, make sure to ask your vet to check the cat's blood pressure and if possible, a heart ultrasound. hypertension and cardiomyopathy are common concurrent illness with hyperthyroidism.

RVC, Barton in Cantebury, Bishopton in the north, Animal Health Trust, Bristol and Glasgow vet schools have roadioactive iodine therapy (I-131) which may take between 3 weeks - 8 weeks for quarantine. If your cat has rabies jab, go to Holland -- the quarantine is only one week. Old literature said success rate is 5%.

Hyperthyroidism is a very easy to treat. Get rid of all those crap cat food -- soy is extremely bad for hyperthyroidism cats.. There has been a study that fire retardant may link with feline hyperthyroidism in the US. So try not to use any heavy chemicals at home as well. Get her natural wood base or world best cat litter as well. Then, the hyperT will not advance.

You may wish to join http://pets.groups.yahoo.com/group/feline-hyperT/ the owner is british too.


A

[Rosella moggy]

I would be very careful kingbimbobs as HyperT can have an effect on major organs and you would need to ensure that the insurance would be worth the paper it's written on. I imagine your vet once again would be the one to speak to about this as it would be him/her that would be responsible for linking or not linking any future health problems. All ours are with Axa. It's good cover and so far they have paid out promptly.  Might be worth giving them a quick ring perhaps to see what they say but I would guess they would say depends on whether the vet links up a future condition with an existing one.

[kingbimbobs]

Would be a good idea to insure him before anything else crops up!

you know?!

i was wondering though, i take it that the insurance would not cover anything to do with the hyperthyroidism, since it will be a pre-existing condition, but can they also back out of payment on other diseases by saying that the hyperthyrodisim left him in danger of getting it..?

[Ela]

We have over the years has numerous cats with this problem, in fact my own Jeannie has it. Mt Jeannie is on tabs for life as she also has other problems, but many have the op and go on to leas a 'normal' life.

apparently cats have two thyroid glands so can quite happily survive with one.

A number of our cats have needed to have both out but go on to have a good quality life.

[Millys Mum]

Would be a good idea to insure him before anything else crops up!

[kingbimbobs]

A phone call to your vet wouldn;t hurt though.

i did call the vet and he said to give it 24 hrs. he wasn't happy about the puking, but since nimbus isn't being eratic today, he said hold off until tomorrow.

i did ask how much this was going to cost. london prices mean i am looking at £450-550. OUCH! 

he also said they don't do installment / payment plans.  *sigh* i realise now that if i am denied funding, i won't be starting my masters this september...  i hope king bimbobs knows how much he is loved. actually, he probably doesn't, the effing sod.   

[Rosella moggy]

It's very difficult to advise others when they need to bring puss to vet and when to leave it a while coz, when all's said and done, we all know our cats better than anyone else including the vet. A phone call to your vet wouldn;t hurt though.

You will of course be in the early worry wort days having only just found out he's hyperT and read all the horror stories  .  Only you will be able to remember how he usually is when it's hot but for what it's worth, one lot of sick doesn't amount to much in our house.  I spend a lot of time cleaning up after our 4.  It has been very hot today so him being lethargic seems normal.

Thunder has just arrived and it's getting quite dark. Yippee don't have to water the garden tonight 

[kingbimbobs]

urgh, so i've just got home from work and he seems off again. now he's really lethargic and soppy / clingy and has thrown up on my desk. yay! 

maybe it's just the heat. it's very humid today.

i am a terrible worry wort. 

[Gillian Harvey]

Vidalta is what Tom reacted adversely to Gillian. I wondered whether it might have been too high a dose (being only 1 tablet instead of the 2 felimazole) as Tom only borderline. Vet not inclined to give any more meds unless he deteriorates. He's been sick alot over weekend (bringing up clear liquid) but he does that if he's not eating and he's drinking too much so he's had to put up with salmon and chicken this morning. He leads a dog's life  

Interesting Rosella, years ago previous cats I've had with hyperthryoidism were put on Carbimazole (Neomercazole) and had bad reactions  - so maybe its the Carbimazole as opposed to the dosage - hard to know. My vet did say that she had many cats doing fine on Felimazole and wasnt inclined to change them to Vidalta for the sake of giving less tablets. Hope Tom is ok. 

so it seems by all of your stories that hyperthroidism isn't too deadly in terms of life-expectancy, so long as it is treated.

he's definitely levelled out on these meds. seems pretty much back to normal last night and so far this morning. much more calm, which is very good.

Glad he's doing better 

[swampmaxmum]

don't know anything about hyperthyroidism but I'm so glad that the wonderful cat lovers on this forum have helped you to feel calmer. Know how hard it is when our furries are unwell and hope that all goes as well as possible 

[Rosella moggy]

Vidalta is what Tom reacted adversely to Gillian. I wondered whether it might have been too high a dose (being only 1 tablet instead of the 2 felimazole) as Tom only borderline. Vet not inclined to give any more meds unless he deteriorates. He's been sick alot over weekend (bringing up clear liquid) but he does that if he's not eating and he's drinking too much so he's had to put up with salmon and chicken this morning. He leads a dog's life  

Anyway delighted that Nimbus is now doing well on his meds and so pleased to have been part of putting your mind at rest kingbimbobs 

[kingbimbobs]

nimbus' clingy-ness is probably just a cat-specific symptom. it's just the way he behaves when he is unwell - i know if from all the abscesses he has had. whenever there is one brewing, he becomes a lap-cat and wants to be near me all the time. well, i say "becomes a lap-cat" but my lap is too small, so he just sits next to me, touching me with his paw or side.

so it seems by all of your stories that hyperthroidism isn't too deadly in terms of life-expectancy, so long as it is treated. that's a joy!  for a while i was really worried about its implications.

sharon: i had thought about asking them if i could be put on a payment plan, but i wasn't sure if it was something a vet would offer. i'll ask them for sure now. thanks for suggesting it.

he's definitely levelled out on these meds. seems pretty much back to normal last night and so far this morning. much more calm, which is very good.

anyway, thanks so much for sharing with me. it's nice to read so many positive stories. when i googled the disease on saturday evening, i got some serious horror stories - i was scared!