Topic: Flash being very sick with Felimazole - any advice please (Read 11784 times)

babsiec · « **Reply #25 on:** November 14, 2013, 19:29:51 PM »

Thanks all of you

to you all. Candy had a cancer on her paw also about 2 years ago, we had it removed but she hated the whole process, especially wearing the lampshade afterwards! as she was constantly trying to chew and wash the wound. It was a very traumatic time for all of us!! So that is partly why we decided against the nose operation. However it's good to know of some one who had it successfully.

We got our kittens from the farm down the lane, the mother had just three kittens (she was old) and we had them all, handled them when a day old and blind, so they always known us and have been such a lovely nature, NEVER bite or scratch us. However they also have the farm cat gene and have been amazing hunters (unfortunately). Many a time I've rescued some poor thing from them, much to their disgust. We lost Rosie (tortoiseshell) 2 years ago, to thyroid cancer. I had hoped they would live to at least 20, but sadly seems that's not to be.

Thanks for telling me about Cystophen. May ask vet for that next time, if needed.

heather sullivan · « **Reply #24 on:** November 14, 2013, 11:11:37 AM »

My cat had squamous cell cancer on the end of his nose, and went to Cambridge Vet Hospital and had his nose removed. (Nosectomy). He was about 11 or 12 at the time. The op was fine, he just had his nostrils refashioned and a smallish hole in his face, it looked a bit nasty at first, but he adapted ever so quickly. Sadly though he then tested positive for FIV and then developed stomach cancer and RIP. The nose op is not as bad as you may think

.

Nicola (RockysMum) · « **Reply #23 on:** November 14, 2013, 11:06:32 AM »

So sorry to hear that about Candy.

Rosella moggy · « **Reply #22 on:** November 14, 2013, 09:51:59 AM »

So sorry to hear about Candy

I thought I'd just mention Cystophen. Does same job as cystease but has a calming agent in it too. Just for info

babsiec · « **Reply #21 on:** November 13, 2013, 20:10:17 PM »

Hi Nicola and thanks again for sharing your experience - it is good to know the success stories.

The vet listened to his heart and said it was fast, and that was to be expected as it's part of the disease. He didn't offer any heart tablets. Next time I go I'll ask if its improved at all, and also keep checking kidney levels.

Flash did have a bit of blood in his urine before original treatment and vet said it was cystitis, which is often a side effect of HT. He gave him penicillin shot and cystaid.,which sorted it I thought. Now a bit of blood is back, so he's given him more cystaid. I'm hoping it will clear up as the HT becomes more controlled.

My other poorly cat Candy is sister of Flash, and unfortunately has skin cancer which is on her nose. We didn't want the extreme operation of removing her nose, so we're just giving her as much fuss as possible, as soon we'll have to make that hard decision, as we don't want her to suffer . They have been the most wonderful cats for 16 years, and it's hard when they get old and ill.

Glad for you that Bailey is doing well now and enjoying life again. Thanks again, Babs x

Nicola (RockysMum) · « **Reply #20 on:** November 12, 2013, 21:50:56 PM »

Glad to help. I know how worrying it is.

The most important thing is that you’re getting meds into him and responding to how he’s doing. Try not to panic too much as this condition is very treatable, it’s just a matter of finding medication that Flash can tolerate and then getting the dosage right. If he seems ok after a week I definitely think you should increase the dose as 1.25mg is a very low dose. But if he has problems again with being sick, or you’re at all worried, speak to your vet again about the gel.
I got it here no problem and if you have problems I’d be happy to ask my vet where they sourced it from for you. As I said, my vet didn’t know it existed until I told him about it, so I don’t think it’s often used in the UK.

It can take time to treat this illness, and there’s a lot of blood testing and stress involved at the start but it does get better, I promise! For you and for Flash.

Bailey is a big boy and his thyroid level was 129 when he was 1st tested and his heart rate was through the roof so he was on 5mg twice a day for a while. His thyroid numbers were perfect on that dose but he kept gaining weight – rapidly - and he became overweight and very lethargic. My vet was initially convinced I was feeding him too much but I knew it was the medication – apart from anything else he was eating less than ever! But he listened to me and we altered the dose to 2.5mg in the morning and 5mg at night, even though the vet was worried it could cause his levels to rise. His levels rose a bit at first then settled again. He’s been very stable for the past few months and is back to his usual lively, demanding self! It’s a case of treat the cat, not just the numbers.

You know your cat better than anyone, so your vet needs to work with you to tackle this. Trust your instincts and find out as much as you can online. It really helped me to get to know what the numbers meant and keep track of them.

What did your vet say about his heart rate? That’s one of the concerns with HT, Baileys was so high he was on atenolol for 2 weeks until we got his thyroid down. That kept his heart at a healthy rate. But Flash doesn’t have as high a thyroid level as Bailey did so there may be no concern there.
One other thing which is really important, as you treat the HT the vet will regularly test his bloods for thyroid levels and they should run renal tests on his blood to monitor his kidneys as well. It’s really important because, I know his kidney results were fine, but hyperthyroidism can mask kidney problems which only show up when the thyroid levels start to lower. Chances are he’s fine like Bailey was, your vet should have an idea from where his numbers are currently with his kidneys, but it needs to be checked. It’s common practice as you only get a true picture of renal function once the thyroid level starts to normalise.

Hope I haven’t bombarded you with too much info

but I know it helped me when my boys were first diagnosed. If you ever have any questions feel free to PM me.

babsiec · « **Reply #19 on:** November 12, 2013, 20:24:46 PM »

Thanks so much Nicola for your help (and everyone else). Re the gel, I was told by Dechra marketing manager who market the Felimazole in UK that they do not offer the ear gel in the UK - so interesting to know you managed to source it here!?. If the tablets cause more problems I will ask vet to source the the gel.. I have found that Flash's throid level is 90, so he does need some help.

I am now cutting the 2.5 tablet in half easily and he takes just 1.25 per day in food no problem. I give it at night only. In a week, I will alter to 1.25 morning and night. Hopefully this will get it in his system more gradually. Then after a few weeks, will have to have him tested and probably will need to increase to 5 a day, but I will give it spread over 2 doses. The vets don't really know too much about it, it seems, telling me once a day is fine.

I agree from what I've read it is best to be given every 12 hours, as it is not a slow release like Vitalda. I think the manufacturers now say it can be taken once a day as many people have trouble giving tablets, and once a day compares well with Vidalta from a marketing point.

I feel I'm having to get all this info myself when the vet should know it. I moved from a more local vet to the current one as they are better generally, but not in this case.

Glad that Bailey is now doing well on his tablets - gives me hope.

Flash is 16 and I don't want to put him thro an op if talets will work. The vet says they do one side only in operation (to avoid damage to the parathyn gland) and then about 18 months later may need to do other side. Very expensive and I don't want to put him through that at his age.

Nicola (RockysMum) · « **Reply #18 on:** November 12, 2013, 10:00:32 AM »

Hi,

My cat Bailey is hyperthyroid and my other cat Jake was too until he passed away recently.
Both of mine were on felimazole, Baileys now been on it for a year, it’s taken us that long to get his dosage perfect but he’s doing really well.
I’m very surprised by your vet prescribing it once a day as my understanding from my vet, and all the research I’ve done is that it should be given twice daily as each dose is effective for 12 hours.

First thing I would say is that Jake started out on vidalta (he was hard to get pills into so one a day seemed more feasible!) and had no problems with it at all, so don’t rule it out. We changed because although it was working, it seemed to be slower progress than felimazole was with Bailey. But Jake did do well on it for months.

The normal dose for vidalta is 10mg and although that seems high, the amount of the active drug methimazole is less in vidalta so it works out the same.

But the one thing that might really help is if you speak to your vet about the felimazole transdermal gel. It’s the same drug, compounded into a gel and you just rub a tiny amount on the inside of their ear twice a day.

It’s very easy to use and because it isn’t taken orally it stops the vomiting and other stomach problems that some cats encounter. We put Jake on it because we had major problems getting him to take his pills.

Definitely mention it to your vet. Mine didn’t even know it existed until I found out about it online, but they sourced it for me no problem. There are now 2 other cats in my vets practice using the gel and I know one of them was because the tablets were making him sick.

It sounds like it could work for you and Flash

I hope you get something sorted soon x

Rosella moggy · « **Reply #17 on:** November 09, 2013, 11:20:22 AM »

Quote from: babsiec on November 08, 2013, 21:51:14 PM

Went to the vet and he gave me the 2.5 Felimzole for Flash to have once a day - when I said I wanted to cut it in half, he really tried to persuade me not to do this, as the tablet wouldn't work as well, as the coating needs to stay on it until in the stomach. Asked about the 1.25 and he sort of glossed over that, and said the 2.5 was fine once a day.

For what it's worth and I'm no vet, depending on Flash's thyroid level and any kidney results you may have, I think I might be inclined to go with your vet's advice tbh

That was the dose my mom's cat Susan was on for her last 6 months. She was a very small girl. She passed away this summer but from kidney related probs

It's a difficult one to call as the advice on dosage is "Wherever possible, the total daily dose should be divided into two and administered morning and evening. Tablets should not be split"

Ideally it would be best to get 1.25mg tablets of course

Liz · « **Reply #16 on:** November 08, 2013, 22:09:12 PM »

You can buy a thing called a pill cutter - our vets sell them and they cut up tablets very well

babsiec · « **Reply #15 on:** November 08, 2013, 21:51:14 PM »

Went to the vet and he gave me the 2.5 Felimzole for Flash to have once a day - when I said I wanted to cut it in half, he really tried to persuade me not to do this, as the tablet wouldn't work as well, as the coating needs to stay on it until in the stomach. Asked about the 1.25 and he sort of glossed over that, and said the 2.5 was fine once a day.

I have cut it in half with difficulty tonight.

I am still uncertain whether to just give him 1.25 just once a day for 2 weeks, until I see if he can tolerate it without more sickness. I REALLY don't want to put him through that again, he was so ill, I don't think he'd have survived if I hadn't taken him off it.

I have heard from the manufacturers and they confirm the do a 1.25 tablet in UK now but didn't give me any stockits - just told me to get the vet to ring them. ! I may ring vet and ask him to et some in, as much easier than cutting them up.

Flash is not looking great at moment, so I really hope this works for him.

babsiec · « **Reply #14 on:** November 08, 2013, 08:21:57 AM »

Just had another thought - it's a shame we can't use the human version Methimazole - as it might be easier to cut into smaller pieces, as it wouldn't have the coating on.

babsiec · « **Reply #13 on:** November 08, 2013, 08:08:29 AM »

Thanks so much for all your help and advice - I can't believe the terrible situation we have in the UK regarding throid treatment, in that many GPs and now I find many vets, are so ignorant of how to medicate. A friend of mine had to do her own research to get her thyroid treatment under control. Yet it affects so many people/cats. Anyway, rant over - I wanted to give an update on poor Flash. I don't know his Thyroid level, but will ask today.

After we stopped the 5mg (in one dose!!) of Felimazole, he stopped constantly vomiting, and has now gone back to being constantly hungry. I am going to vets this morning. I WAS going to ask to change to Vidalta, but as I've read more, I see the minimum dose is 10mg, which I think is too high for him at first. I don't want to risk more vomiting.

Now I think I will try Felimazole again but in a much smaller dose to be gradually increased. I have been trying to buy the 1.25 tablet but can't find it anywhere in UK. I will ring manufacturer later (Dechra Stoke on Trent) It's a shame they don't offer the ear gel in the UK.

I would like to start him on what you said Maria - quarter of a 2.5 taken twice a day - but it must be so hard to cut them. I will suggest this to vet.
Thanks again for all your advice. I'll keep you updated.

Marla · « **Reply #12 on:** October 14, 2013, 14:42:46 PM »

Babsiec, I'm really sorry to hear that Flash is poorly. I'm glad that your vet has taken him off Felimazole for the time being. Lethargy is a sign that the dose was too high for him. I don't agree with the starting doses recommended by either vet.

We have two hyperthyroid cats (both 16 years old) that are stabilised on less than the normal starting dose of Felimazole. Both had very high T4 readings, but we started them on only 0.65 mg (¼ of a 2.5 mg tablet) twice a day and worked up gradually with blood tests between each increase. Flo is on only 1.87 mg (¾ of a 2.5 mg tablet) twice day. Rosie is on only 1.25 mg (½ of a 2.5 mg tablet) twice a day. Both are now within the normal range and are having no side effects or sickness. They will stay on these doses unless a future blood test indicates that it needs to be increased slightly.

With a sharp knife, it's possible to cut a tablet into 2 or 4 equal pieces. We tried a pill cutter but weren't able to get equal pieces. You should wear gloves to cut and handle partial tablets.

I wouldn't restart Flash on hyperthyroid medication until he's fully recovered, and then only start him on a very low dose.

I hope he's feeling better very soon.

Liz · « **Reply #11 on:** October 12, 2013, 12:27:46 PM »

I have 2 on Vitalda one on 15mg a day and one on 20mg a day - this has worked for my two Max had his thyroid removed and sadly a bit left Clio is feral so not an option

Good luck, I have great vets and trust them implicitly but do research as well

babsiec · « **Reply #10 on:** October 12, 2013, 11:27:35 AM »

Hi Kay and Rosella thanks for your helpful advice, appreciate all you help

. I have talked to another vet (recommended, at another practice further away) this morning, she said that because Vidalta is sold as a one dose a day, Felimazole have also now started saying their drug can be taken once a day also to compete!!! My dose is definitely 5mg once a day, says it on the bottle and they told us so. In future if I go back there, i will see the second vet I talked to, as he had mentioned having it twice a day. Surely the end result would be the same re vomiting?

The other vet suggested giving Flash a few days to recover - she said take him to the vets Monday if he is still being so sick. She then suggested trying Vidalta. depending on his levels, to start him at 10 or 15 once a day. She said Vidalta can also cause vomiting but each cat is different.

I will ring my vet this am and ask for the blood results to be emailed to me. It won't mean anything to me, but will to some of you I'm sure. Flash has gone out in the sun but I will get him in soon to watch him. He has vomited a lot overnight again (good job we have a tiled floor!)

Thanks again x

PS just seen the fact sheet thanks so much

Rosella moggy · « **Reply #9 on:** October 12, 2013, 10:55:40 AM »

Hi again. You may want to read this factsheet on felimazole? I always seem to be posting links to NOAH factsheets

I find them very helpful. Use the previous and next arrows to read full factsheet.

It looks like 1.25mg tablets are now available.

http://www.noahcompendium.co.uk/Dechra_Veterinary_Products_Ltd/Felimazole_ACY-reg_ADs-_Coated_Tablets_for_Cats/-40419.html

Rosella moggy · « **Reply #8 on:** October 12, 2013, 10:23:28 AM »

Hi. Good advice from Kay.

I would just add a couple of things. Firstly another blood test would be a good idea to see how the treatment to date has affected Flash. This will give you a better idea about the required continuing dosage. They should show how the results compare to "normal" range. Request a copy of both blood tests so you can compare for yourself. Be prepared for the kidney results to possibly change as HyperT can hide underlying kidney problems. I don't say this to alarm you further. It's just better to be prepared so that you can better discuss things with the vet.

I wonder whether the blood results may show raised liver enzymes (from the retching and yellow bile that you describe) which may suggest stopping felimazole.

Secondly when splitting tablets, only split one at a time. It is very difficult to split a tablet 50/50 so only doing one at a time will ensure you do not exceed the dose over a 24 hour period.

HyperT can be easy to treat but can also be tricky to get the initial dosage correct. A vet giving incorrect dosage instructions is not good at all. Please don't be offended but have you rechecked the written dosage instructions on the bottle label say only one 5mg tablet a day?

I would also ask to see the head vet at the practice if you do not have faith in the vet you have seen so far.

Sending every good wish to Flash

Kay and Penny · « **Reply #7 on:** October 11, 2013, 22:19:07 PM »

I would suggest you ring your vet asap and ask what his thyroid level was - if it is very high, I don't think you should stop treatment for more than a few days, and then either start him on two daily doses of 2.5mg of Felimazole, or cut in half the remaining 5mg tablets - it is important not to put too much strain on his heart

if he is not too high - say around 60 to 80 on the scale, then by all means try 2.5mg cut into two doses - and bear in mind people will tell you you can't cut the tablets, but if you handle them carefully there is no reason not to, and many - including me - have done for weeks and longer

the usual side effect some cats suffer from with Felimazole is intense skin irritation rather than gut problems, so it is just possible the symptoms are coincidental to the drug - resuming it to a lower, twice daily, dose will soon show one way or another

my HT cat had the radioactive iodine treatment, but everything I know about the condition I learnt from joining the Yahoo group http://pets.groups.yahoo.com/group/feline-hyperT/

babsiec · « **Reply #6 on:** October 11, 2013, 19:56:59 PM »

Quote from: Kay&3Ts on October 11, 2013, 19:19:26 PM

I'm afraid your vet seems to be very ill-informed about Hyperthyroidism, and its treatment

Thanks everyone. I chose this vet as the group seems to have more better qualified experienced people than the more local vet, and I saw the Surger Manager BVSc MRCVS. Am now very disappointed, and feel I have let Flash down by taking him and letting him have that treatment. In fact when I rang the vets today, I talked to another vet (BVCs PGCSE CBiol MIBiol MRCVS) who said it's usual to give it twice a day, which I've since found is correct. I don't have blood results but they did confirm he did not have kidney disease as they checked for this.

The tablets I have are 5mg, which would be hard to cut in 4 (tiny orange hard coated). I'm wondering whether to ask vets for some 2.5 tablets, then cut them in half, and give hom 1.25 night and morning, to see if he can tolerate that.

I am now worried in case he gets dehydrated, as he's been sick every time he has anything. Not eating at all. So hard to see him retching.

Shall I give him a break to get over this, then start on lower dose?

Thanks so much all of you. I think vets are like doctors, you have to do your own research too. Terrible really, when you think what they charge, you should be able to be confident they know what they're talking about..

Kay and Penny · « **Reply #5 on:** October 11, 2013, 19:19:26 PM »

I'm afraid your vet seems to be very ill-informed about Hyperthyroidism, and its treatment

for a start, Felimazole is designed to be given twice a day, as it is active for 12 hours only - I am astonished a vet does not know this - poor Flash has been alternating between being overdosed for half a day, and then going without treatment, so no wonder his system is thoroughly upset

as for surgery, as HT causes a rapid heart beat, that in itself is not counterindicative - I would not be letting this vet near any cat of mine with a scalpel though

I would suggest you get a pill cutter and try Flash on half a Felimazole twice a day (handle the cut halves with tweezers, and don't handle them with bare hands) and see how he goes - the aim is to bring down his thyroid level, but it doesn't have to be rushed - did your vet give you the resulsts of his blood test, as it's always useful to have the figures for yourself, so you can do your own research

Gill (sneakiefeline) · « **Reply #4 on:** October 11, 2013, 18:29:50 PM »

Poor boy and he needs ttp get stabalized asap....there are quite few threads on here but mostly about Vidalta causing probs.

Sending loads of good wishes

Dawn F · « **Reply #3 on:** October 11, 2013, 15:32:39 PM »

I don't have any experience but there are lots of people who do, I'm sure someone who can offer advice will be along soon

babsiec · « **Reply #2 on:** October 11, 2013, 15:29:43 PM »

Hello again I have since been reading a recent post about problems with Vidalta too! Maybe I would be best waiting till after our hols, (about12 days, then trying felmazole again but just 2.5 a day first?

babsiec · « **Reply #1 on:** October 11, 2013, 15:00:48 PM »

Hi there I do hope some of you fellow cat lovers may have some advice for me please. My lovely ginger boy Flash, 16, has been diagnosed with over active thyroid about 3 weeks ago. For some months he has been poorly, starving hungry and losing weight. He also then had blood in his urine, so we got a urine sample.

The vet said he suspected over active thyroid - he said he also has cystitis (possibly caused by stress). He had an antibiotic jab and a 7 day course, which seemed to make him happier short term. About 6 days after visit, vet had blood results back confirming over active thyroid, but saying they checked his kidneys and he did not have kidney disease. Started him on Felimazole 5mg one tablet a day, hidden in food.

After about 10 days he was looking worse - last 2 days has been vomiting, really retching, no food in his tummy so bringing up yellow bile. Looking very ill, eyes dark, lethargy, not himself at all. I do not want him having such a poor quality of life.

Rang vet today (didn't want to subject Flash to 20 mile round trip) and he advised take him off it for a few days. Then consider 2 tablets, 2.5 morning and night. I said surely that would have same results, sickness? He then said I could consider an operation if they can get him stabilised, but I am not wanting to put him though such a thing at his age, unless I could be sure he's have several good years after. He may have a heart problem from this, so felt an op was risky.

I then asked vet, what about other drug - Vidalta? He said they don't usually have this at their surgery but he could probably get it.I said I'd heard it may not have the vomiting problem side effect. As we are booked on a 5 day break in a week, he suggested we stop all treatment until I return, then may be try Vidalta.

I would carry on with Felimazole if I felt the vomiting was just a very temporary thing, but haven't been assured of that. At moment Flash is having a horrible time, and no doubt will lose more weight as he can't keep anything down, and possibly get dehydrated. What do you all feel? Any advice very welcome, thanks.

Author Topic: Flash being very sick with Felimazole - any advice please (Read 11784 times)