Cat Thyroid Medicine

I have a 14 year old cat just started on thyroid medication. 2.5 mg. 2 times a day. He acts like he is a zombie after medication for hours! Stares at the walls like he's stoned. When will this go away? My vet does not seem at all worried.

Did you ask your Vet specifically if the zombie like symptoms should fade? I have no experience with Thyroid issues, so cannot answer your question. If you tell us the exact medication, maybe we can better help you.

My cat seemed lethargic during his first week on methimazole. He now, however, is moving around more and eating/drinking well. It could be that your cat's symptoms will disappear in a week or two. I read an article saying side effects usually resolve on their own within a few weeks. Is your cat still eating?

Okay, this topic is now of interest to me, too. My 13 yr old was just diagnosed with hyperthyroidism-labs are showing 8 with the high range as 4-so lab is showing double of the high range acceptable.
I’ve directed the doctor to my compound pharmacy because I don’t like the idea of pilling.
The idea of how this med will affect him makes me concerned, sometimes the cure is worse than the illness, ... so any resource you can point me to will be greatly appreciated!

Our cat has been on the methimazole ear gel for about 8 months now. I haven't seen her act like a zombie. She was sleeping more at first and had some ear irritation. Are you using pills or the gel?

Ear gel? I wasn’t given the option-the vet talked pills and when he did I nixed pills, and then he talked about compounding - I assume it’s in a syrup form because he asked about flavor.
But, I realize the question wasn’t for me-but for Charleeblu

Simone has been on the ear gel from the start due to her resistance to pilling and don't want to stress her out 2x a day.

Her initial dosage was too much, so I adjusted it myself but told my vet I had, and she was fine with this.
I could see in her behavior that it was just about right, she lost that zombie behavior and turned in to the normal cat I was used to.
Had her blood checked 2 months later and it was on the lower end where vet wanted it to be.

Not recommending this but I have heard that this med should be started at a lower dose and gradually increased as needed due to the side effects at first while their bodies adjust.

I get my transdermal gel online, cheap too.

Probably the dosage is too high. You'd better ask your vet if it's possible to start with 1.25 mg twice a day.
In my opinion this is a better approach.
Methimazole make cats slower and sleepy, furthermore it's heavy on kidneys and liver. That's why a 2.5 mg dosage is given only if necessary.

My cat started with 1.25 mg twice a day and then, every 5-6 weeks, she had a blood test to see how the med was working, so that we were able to make adjustments. There were moments when I gave her 0.625 mg twice a day, up to the last weeks when I gave her 1 mg twice a day.
At first they were pills, fractoined at the pharmacy, but after a few weeks I switched to transdermal gel which was much easier to administer.
Eventually she was treated with radio iodine and no more meds were needed since.

EDIT: Sorry, didn't realize the first post was that old!

gloriajh said:

Ear gel? I wasn’t given the option-the vet talked pills and when he did I nixed pills, and then he talked about compounding - I assume it’s in a syrup form because he asked about flavor.
But, I realize the question wasn’t for me-but for Charleeblu

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It comes in what looks like a thin glue pen that you twist and it dispenses the medication out the tip of a small sponge and you rub it on the inside flap of the ear. It is much easier than pills but you have to be very careful not to get any on you otherwise you medicate yourself as well. One pen lasts us a month with two applications per day.

In my research one person didnt like the twist pen ??
What I believe the compound pharmacy is preparing is a liquid- because there was talk of flavor.
There was a warning about wearing gloves.
One other concern I have is I have a multi cat(15) household-one article said to keep the other cats from coming into contact with the “deposits”- ha! Now we’re getting into crazy land-

I just received the prescription from the compound pharmacy - $50.00 for a 30 day supply - liquid form - chicken flavor.
The amount is .25ml 2 times a day. There weren't any precautions provided - I'll be calling the Dr. before I administer the first dose.
This is my boy (KiKi) with a 14th birthday in April, 2018 (+/- he was found in my daughter's garden crying for food about ?3 or 4 weeks old)

gloriajh said:

There was a warning about wearing gloves.
One other concern I have is I have a multi cat(15) household-one article said to keep the other cats from coming into contact with the “deposits”- ha! Now we’re getting into crazy land-

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The gloves were adviced when you administer the ear gel, because your finger would absorb half of the med you're trying to spread in the cat's ears.
If the liquid is given orally, and the cat doesn't spit or drool, well, I think no special precautions should be needed, but using a glove wouldn't be wrong anyway

gloriajh said:

I just received the prescription from the compound pharmacy - $50.00 for a 30 day supply - liquid form - chicken flavor.
The amount is .25ml 2 times a day. There weren't any precautions provided - I'll be calling the Dr. before I administer the first dose.

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I hope the syringe is small enough you can discriminate 0.25 ml.

Your kitty is a real beauty!!!

The syringe is really small, the pharmacist marked the measure on it for me.
Would you know if this dose size is usual?
I gave him his first dose this morning-hope he doesn’t have a bad reaction & trusting all will go well.
Thanks for your interest and input-much appreciated!!

Great thread!
I have a little guy that was diagnosed a couple weeks ago. We tried the pills but he had an adverse reaction. Vomiting and nausea/lethargic. He too was just staring at the walls, but it would go on for a couple days. We finally got him off of that last night and put him on compounded transdermal. Let's hope it brings down his levels and he snaps back to his normal self.

My dear Mr. Grimsby, pictured here, was diagnosed back in 2011 or 2012. He couldn't tolerate the meds at all - either pill or gel on the ear. He barfed up his toenails - it was painful to see and a real mess to clean up. He ended up getting the radioactive iodine injection, too. He went on to live another four years and we had to euthanize him at the ripe old age of 17 due to an unrelated illness - or maybe it was just old age. The injection was seriously expensive, but it really worked. If either of my two cats were diagnosed with it again, I'd go that route. But, maybe that's no help to you...

The normal range for a cat's thyroid is 0.8-4.0, which is different than the normal range for humans.

There is no 'typical' dose for methimazole that I can tell, as I've seen so many cats on different dosing regimens. Anything from 1/4 tablet once daily, 1/4 tablet twice daily, 1/2 tablet in the morning 1/4 tablet in the evening, 1/2 tablet twice daily, and some people give one dose for 3-5 days per week and slightly different dose on the other days.

It all depends on the level on the bloodwork. A cat with a slight elevation, say 4.6, is going to start on a lower dose than a cat with a level of 17 or 23. The cat's body weight is also taken into account.

And the dose can change when you bring them back for rechecks, sometimes you need to increase it and sometimes you need to decrease it. Sometimes it can stay the same. Sometimes you bring them in 1 month, or 2-3 months after the last recheck, sometimes not for 4-6 months or a year. It is all very individual! We are dealing with hormones and glands, after all. I didn't quite fully understand the endocrine system after college but I think I finally got it now. Takes time.

I mentioned this on a different thread, but at my clinic 75% or more of our hyperthyroid patients are also taking a low daily dose of prednisolone (NOT prednisone- they are different) to help them handle the possible side effects of the methimazole. If your cat can't handle the methimazole, it is worth asking your vet about.

As far as types of meds, what you can effectively and consistently give your cat is what is going to be best. The vets I work for "do not believe" in the transdermal gel and will never prescribe it because they say you can't know exactly how much of it gets properly absorbed.

Dilutetortislave said:

I mentioned this on a different thread, but at my clinic 75% or more of our hyperthyroid patients are also taking a low daily dose of prednisolone (NOT prednisone- they are different) to help them handle the possible side effects of the methimazole. If your cat can't handle the methimazole, it is worth asking your vet about.

As far as types of meds, what you can effectively and consistently give your cat is what is going to be best. The vets I work for "do not believe" in the transdermal gel and will never prescribe it because they say you can't know exactly how much of it gets properly absorbed.

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Thank you for the info. So the reason we went with transdermal is because my cat wasn't handling the side effects very well. So a dose of Prednisolone is given to cats taking the pill form? Interesting, I will bring this up with my Vet.

Dilutetortislave said:

The normal range for a cat's thyroid is 0.8-4.0, which is different than the normal range for humans.

There is no 'typical' dose for methimazole that I can tell, as I've seen so many cats on different dosing regimens. Anything from 1/4 tablet once daily, 1/4 tablet twice daily, 1/2 tablet in the morning 1/4 tablet in the evening, 1/2 tablet twice daily, and some people give one dose for 3-5 days per week and slightly different dose on the other days.

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KiKi tested at an 8
Vet prescribed liquid form- compounded- the amount prescribed is .25 - 2 times a day. I insert it directly into his mouth and after only 3 doses he seems to be doing okay.
.
I am interested in determining how this fluid amount measures up against the tablet -and- if the dose amount is typically the amount prescribed for the T score he had? Is it an aggressive amount or moderate?
I’ll be asking the vet, but till then, inquiring minds want to know.

Another question-is this condition because of a thyroid tumor?

gloriajh said:

Another question-is this condition because of a thyroid tumor?

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A hyperthyroid IS a tumor, though benign in the high majority of cases. The cat's thyroid is increased in volume and produces more hormone than it should be, and this causes all the symptoms you see.
The methimazole is NOT curing the tumor, it's only addressing the symptoms, but the thyroid will keep growing. This is the reason why a cat needs to be visited and assessed often through blood test, to see if the med needs to be re-dosed.
Both thyroid and methimazole causes different issues in the cats body, liver, kidneys, heart are heavily affected.
The treatment of first choice is the radioactive therapy with I-131. This radioactive therapy destroys the bad cells in the cats thyroid. There wiil be no more need of blood tests and meds for the rest of the cat's life.

The dosage of methimazole depends on the severity of the problem. The gel may be dosed in different concentrations, in my case also on customer's request.
I had my gel prepared at 25mg/ml. I had to give my cat 1.0 or 1.25 mg of methimazole twice a day, so I would rub 0.04 or 0.05 ml of gel each time.