Hyperthyroidism operation - anyone have experience of this?

[jezebel]

I got the dose wrong, she's on 10mg, not 15.

Liz, I feel the same - just the thought of her being miles away from home for several weeks with no contact horrifies me. She has history of not coping well with change - she hid for the first three months she was with us, and cried and was scared of everything. It's why her nickname is Boo. Plus, she's 16 now, and I think she might be just a bit too old to cope.

But I'll talk over everything with the vet when I take her back in a month.

[Liz]

The Vitalda does start high and having had 4 Hyper T's started on it can say with no issues and to help with kidney issues there are phosphate binders which can be added to the food to help negate the side effects as well.

My main consideration was always the cat and my 4 just couldn't have done the away from home or the isolation with no handling at all due to the radio iodine and my biggest fear was if they for any reason took a turn for the worst they would never come home and would have to be disposed of as radio active waste, so we went with the tablets for 3 and the operation for one and managed to get all levels stable and happy in fact Max was Hyper T for 10 years before he died last April so we did something right

Iodine is not for everyone's cat or their owners especially if you can tablet the cat and have faith in your vets and yourself to be able to medicate the cat then sometimes tableting is the way to go

[heather sullivan]

My vet discussed surgery with me for Silvie and she recommended the RI therapy as it has the greatest success rate, around 97-98%. Surgery can work, but she did tell me they don't always get all the thyroid tissue and it can grow back which means further surgery. She said it is very tricky surgery and a lot of vets do not like doing it.  ALso there is always a slight risk of going under anaesthetic, especially in an older cat. The RI is jus slight sedation and an injection under the skin at back of neck. THe only downside is meds first to stablise the T4 and then them having to stay away from home until no longer radio active.  I would def recommend the RI - its much safer and a better chance of cure. If after the 1st injection, I was told a very small percent of cats need a further injection, but its very rare. My older cat Tabby who is 21 has been hyperthyroid for a good few years but she is on pills, although the little madam is refusing them at the moment as she has been ill with some sort of infection.  She is not insured any more but I wouldnt put her thru leaving home at her age and I couldnt afford it anyway     You could always ring one of the veterinary centres that do this treatment, I rang quite a few to get more advice about it and they were all really really helpful

[Gill (sneakiefeline)]

PLEASE BE AWARE THATTHE DRUG SHE IS ON IS KNOW TO MAKE CATS VERY ILL AND THE DOSEAGE IS TOO HIGH.

THE FACT THAT ITS BEEN CAUGHT VERY EARLY IS BETTER FOR RADIO IODINE TREATMENT AND SADLY IT IS LIKELY SHE WILL GO DOWN HILL FROM HOW SHE IS NOW.

MOST VETS DO NOT HAVE A CLUE ABOUT THE BEST TREATMENT START THEM ON THIS DRUG OR THE OTHER ONE WITH TOO HIGH DOSEAGE .....MY VET WAS THE SAME COS THEYARE FOLLOWING WHAT BTHEY KNOW TO BE THE GUIDANCE DOSE ON THE MEDS.

MISA WAS ON A LIQUID FORM OF THE OTHER DRUG AND I SPOKE TO THE VET WHO WORKS AT THE COMPANY AND ALTHOUGH THEIR GUIDANCE WITH THE MEDS IS DOUBLE THE DOSE THAT MISA STARTED ON SHE SAID YES THAT IS TOO HIGH REALLY!!

OK WE THEN HADN TO INCREASE IT FOR MISA AND ALSO AGAIN BUT STILL NO GOOD.

SADLY I DIDNT REALIZE THE SHOUTING FOR WATER AND FOOD DURING THE SUMMER WAS AN INDICATION OF ANYTHING BUT ITS WHEN HIS JELLY BELLY WENT THAT BELLS STARTED TO RING. I SO WISH I HAD PICKED IT UP EARLIER.

I JOINED AN AMERICAN HYPER T GROUP BUT HAD A SERIOUS ISSUE WITH ONE OF THEM ON NEW YEARS DAY AND THINK THAT WAS THE LAST STRAW WHICH DAMAGED MY HEALTH SO BAD.

PROTOCALS ON RADIO IODINE TREATMENT BARE VERY DIFFERENTHERE TO IN THE STATES AND WE ARE NOT SO CAREFREE ABOUT THE RADIOACTIVITY AND AS WE LIVE IN THE UK , UK RULES APPLY.

IF YOU HAVE INSURANCE SEE IF THE WILL PAY FOR RADIOIODINE ITS ABOYT £2,200 AT LNGFORD AND IF HER LEVELS ARE STILL VERY LOW IT SHOULD BE A ONE OFF AND THEN COMPLETE CURE.

DIFFERING LEVELS OF IT ARE GIVEN AND MISAS WILL BE INTERMEDIATE AND THEY SAID IF HE NEEDS FURTHER TREATMENT IT WILL BE ABOUT 20% OF THAT.

WONT GO INTO DETAILS OF WHY HE COULD NEED MORE YET BUT ITS HOPED IT WILL FULLY WORK FIRST TIME.

[Kay and Penny]

 your description of her symptoms sound just like Trigger was - he doubled his food intake without putting on weight, but showed no other signs of the disease - as he was only 11 the radioactive iodine treatment was best for him, because with medication the tumour goes on growing, and so is not a good option for a cat with a good few years ahead of him/her

his T4 level started off at around 60 when he was referred for treatment, and he was basically a healthy cat, so don't understand the comment that Bass isn't ill enough for I-131. I'm afraid it sounds as if your vet is not well up on this condition, and its treatment, and only knows to chuck medication, at too high a level, at it

[jezebel]

Thank you Gill.


Fortunately, I think we caught it early. Bass had been eating a lot and not gaining weight (she hasn't lost any either but has always been a slinky little thing anyway!). She'd been howling a lot (which is what made me take her to the vet) but had no other signs - her coat is lovely and glossy, and she's not restless or aggressive.


She's had blood and urine tests, both came back fine apart from the Hyper T. She's on Vitalda - I think it's 15mg - and will have another blood test in four weeks.


TBH, I'm in two minds about radiotherapy treatment. I'm not too worried about the expense - she's insured (at least for the first 12 months of treatment) but I can't bear the thought of her in a cage by herself for four weeks.

[Gill (sneakiefeline)]

I AM VERY SORRY JEZEBEL 

OK , NO CAT WITH HYPER T IS NOT SICK ENOUGH FOR RADIO IODINE, BUT ITS VERY COSTLY.

IF YOUR CATS T4 LEVELS ARE STILL LOW AND SHE DOES NOT HAVE KIDNEY DISEASE ITS THE BEST OPTION.

DONT KNOW WHERE YOU LIVE BUT LANGFORD BRISTOL IS THE BEES NEES.

HOWEVER I HAVE HAD A CAT THAT HAD THE OP TOO BUT MANY MANY YEARS AGO AND MAY BE NOT AS MUCH WAS KNOW ABOUT HOW TO TREAT HYPER T THEN AS NOW AND FOR CERTAIN THEIR WAS NO MENTION OF THE KIDNEY PROBS THAT COULD BE THERE.

I DO NOT RECALL A BLOOD TEST EVEN!

THE OP DID NOT HELP AND MY SUSPICION IS THAT SHE ALREADY HAD KIDNEY PROBLEMS BECAUSE WITHIN A MONTH SHE DID.

HAVE YOU HAD A BLOOD TEST AND WHAT MEDS AND HOW MUCH IS SHE ON?

THE BEST WAY TO START MEDS IS A VERY LOW DOSE ABOUT 1.25 TWICE A DAY AND NOT VIDALTDA SP?

THEN DO BLOOD TEST AFTER A MONTH WHICH WILL SHOW IF T4 LEVELS HAVE DROPPED AND WHAT HAS HAPPENED TO KIDNEY LEVELS........WHAT ARE THE TV AND CREATININE LEVELS NOW?

I TOLD MY VET ON DAY ONE THAT IF POSSIBLE I WANTED MISA TO GET RADIO IODINE TREATMENT AND HE GOT IN TOUCH WITH LANGFORD, THAT WAS BEGINNING OF OCT AND IN A MONTH.NOV...........LANGFORD HAD RUNG ME AND MADE THE APPT. MISA WENT THERE ON TUES AND WILL BE TREATED NEXT WEEK.

THEY DO MASSIVE AMOUNTS OF TESTS FIRST WHICH HAPPENED TUE AND YESTERDAY AND ALTHOUGH HE IS VERY PRERENAL THE RESULTS ARE GOOD ENOUGH FOR HIM TO BE TREATED.

THE KIDNEYS DO BETTER WITH INCREASED BLOOD SUPPLY WHICH HAVING HYPER T CAUSES, SO BRINGING THE HYPER T BACK TO NORMAL TAKES AWAY ANY AID FOR KIDNEY DISEASE.....THATS THE LINK.

MISAS T4 LEVELS WERE TESTED ON TUE AND HAD INCREASED MASSIVELY SINCE HE WAS DIAGNOSED AND RUNNING AT 500.


ON MY MISA ILL I NEED HELP THREAD NICOLA AND HEATHER HAVE ALSO WRITTEN LOADS OF GOOD INFO AND THINK I ALSO HAVE A PM FROM NICOLA WITH LOADS MORE INFO.

SADLY NICOLA HAD 2 CATS AT SAME TIME WITH THIS AND NEITHER WERE CANDIDATES FOR RADIO IODINE BUT HEATHERS CAT SYLVIE WAS TREATED AND HER T4 LEVELS WERE HIGHER THAN MISAS AND SHE IS NOW CURED AND A TUBBY LITTLE CAT AGAIN.

MISA HAS LOST ABOUT HALF OF HIS BODY WEIGHT RIGHT NOW AND THEY HAVE PUT HIM BACK ON MEDS COS HIS LEVELS SO HIGH BUT HE WILL BE TAKEN OFF 2 DAYS BEFORE TREATMENT........THEY HAVE JUST RUNG ME TO GIVE ME AN UPDATE.

IF I CAN HELP AT ALL PLEASE LET ME KNOW COS I FOUND IT SUCH A STRAIN I HAVE BECOME VERY ILL BUT EVERYONE ON PURRS HAS HELPED ME SO MUCH.

 

[jezebel]

Sue: thanks very much for posting that. Crikey, it's complicated!

Liz: Bass is on Vitalda but I think it's 15mg - but thanks for the offer, I'll  bear it in mind if the dose is adjusted down.

Kay: I can see why your vet hated doing the op - it sounds horrendous, and not even particularly successful.

[Kay and Penny]

when my Trigger was hyperthyroid and the vet was discussing various options, she admitted she hated doing the operation as it is a tricky one - and she was considered an experienced surgeon - so I wonder if some vets put owners off this option because they don't want to do it

[Liz]

Are they on felimezole or vitalda as I have some 5mg vitalda s we have no Hyper T's anymore if you want them

Our max had the op and was fine but we waited for bout a year to get the most of the thyroid away and it worked well for a couple of years till the missed bit took over and he went back on tablets

[Sue P (Paddysmum)]

And sending very gentle snoozles for Drum and Bass.  And you too.   

[Sue P (Paddysmum)]

That's really bad luck, Jezebel.  I haven't had experience of either the op or the radiotherapy option, as Paddy was not a suitable candidate for either.

Gill's just going through the radio iodine option with Misa now, and he's away at Langford for around a month.


I found this, if it's any help?

http://www.yourcat.co.uk/Indepth-cat-articles/hyperthyroidism-in-cats.html


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"Surgical removal of the affected thyroid tissue (thyroidectomy) can produce a permanent cure and is a common treatment for many cats with hyperthyroidism. In general, this is a very successful procedure and is likely to produce a long-term cure or permanent cure in most cats. However, surgery will not be successful if 'ectopic' thyroid tissue is present and even after successful surgery, occasionally signs of hyperthyroidism develop again at a later time if previously unaffected thyroid tissue becomes diseased.

To reduce anaesthetic and surgical complications, where possible it is always recommended that hyperthyroid patients are initially stabilised with anti-thyroid drugs for three to four weeks before surgery. Any associated heart disease must also be treated where necessary. Good success and avoidance of post-operative complications depend on good surgical skills, and experience is necessary to achieve good results.

The major risk associated with surgery itself is inadvertent damage to the parathyroid glands - these are small glands that lie close to, or within, the thyroid glands themselves, and have a crucial role in maintaining stable blood calcium levels. Damage to these glands can result in a life-threatening fall in blood calcium concentrations (hypocalcaemia). This is most likely to occur when both thyroid glands are removed at the same time, since this can result in damage to both parathyroid glands. To minimise the risk of this complication in those cats that require removal of both thyroid glands, it may be appropriate to perform the procedure in two stages, removing the most affected gland first and allowing six to eight weeks for recovery of parathyroid hormone production before removing the second thyroid gland.

It is usually recommended that cats remain hospitalised for a few days after surgery so that blood calcium concentrations can be monitored and any treatment given, if required. Clinical signs of low blood calcium include muscle twitches and weakness, which can progress rapidly to convulsive seizures. Treatment is with supplemental calcium by injection and then by mouth. Additional treatment with vitamin D3 is also needed to allow the calcium given by mouth to be used effectively. Once stable, continued treatment can be given at home, but in most cats the damage to the parathyroid glands is only temporary and treatment may only be needed for a few days or weeks."

[jezebel]

Oh, the joy of elderly cats - Drum has Chronic Kidney Disease and now Bass is hyperthyroid!


Has anyone's cat had the operation for this? My vet says she's not keen on it but I'm not sure why (I should have asked but she was going through all the options so there was a lot to take in).


Apparently Bass isn't ill enough to be considered for radioactive iodine therapy, so she's been put on tablets for now (I couldn't believe the price: £45 for 30 days' supply. )