Really Mad At Myself

Max is 17 and was diagnosed with IBD about a year ago. The vet treated him with prednisolone which seemed to help for a short while. We added mirtazapine and cerenia about 6 months into his treatment because he was losing weight but after a couple months he started periodically throwing up all the medication. The vet said to keep giving it to him but then he threw it all up every time and his weight was dropping more. Several blood tests were all normal but he went from 9.2 to 8.4 lbs in 6 months. He has other symptoms that are indicative of hyperthyroidism but the vet said his T4 was fine. I took him to a new vet for a second opinion and she did an ultrasound that showed moderate inflammation. She gave him a shot of depo medrol and did more blood work that was all normal. She did say however that some hyperthyroid cats don't have a high T4 so we will start methimazole transdermal gel on Monday (she had to order it). I am really hoping it helps; he has gotten so skinny that it frightens me.

I am so mad at myself because if it was hyperthyroidism all along then I let my Max suffer for a year without the proper treatment. I am so afraid that we are starting too late and he won't regain his weight.

I am so sorry for Max, and what you've all been through. You could not have possibly known what was going on for sure, it even stumped the first vet with the normal T4 count.

The good news is, as I understand it, typically when the T4 count is normal or close to it, it is common for this to be seen in the early stages.

Is there anything the vet can give along with the thyroid meds to help him get back to eating faster? And, how long did the vet expect it to take before you might start seeing some results?

Please keep us posted. And I have Feeby's paws crossed that the med starts working pronto!

Thyroid testing is tricky business and sometimes it takes a vet that really specializes in this type of thing to catch it. Even the best all around pet vet sometimes misses things because cats are just too darned good at hiding their pain and thyroid levels can vary. Sometimes a T4 doesn't catch it.
Don't be mad at yourself, be proud of yourself for doing all you can to make sure he's a happy guy. Sometimes this diagnostic stuff takes a lot of time to narrow down.
Furballsmom has a really nice list of tempting foods that cats that aren't eating good or need to put on some weight usually like. I'm sure she'll be along to share that list with you.
I think you're doing right by him and I bet Max things so, too. He's 17, that's pretty amazing..

FeebysOwner said:

I am so sorry for Max, and what you've all been through. You could not have possibly known what was going on for sure, it even stumped the first vet with the normal T4 count.

The good news is, as I understand it, typically when the T4 count is normal or close to it, it is common for this to be seen in the early stages.

Is there anything the vet can give along with the thyroid meds to help him get back to eating faster? And, how long did the vet expect it to take before you might start seeing some results?

Please keep us posted. And I have Feeby's paws crossed that the med starts working pronto!

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Thank you for the support. He is actually eating pretty well since the shot and the new vet didn't want to start another appetite stimulant yet since he has been throwing up all the other medications. He still has some vomiting but we are hopeful the thyroid med will help with that too. She said we should see some improvement in a couple of weeks after starting the new med.

If you highly suspect hyperthyroidism the best thing would be to get a scintigraphy for your cat. It will accurately measure the iodine levels in your cat. I say trust your gut and get it tested. If he does have hyperthyroidism he can get an accurate radioactive iodine treatment which is an actual cure.

1 bruce 1 said:

Thyroid testing is tricky business and sometimes it takes a vet that really specializes in this type of thing to catch it. Even the best all around pet vet sometimes misses things because cats are just too darned good at hiding their pain and thyroid levels can vary. Sometimes a T4 doesn't catch it.
Don't be mad at yourself, be proud of yourself for doing all you can to make sure he's a happy guy. Sometimes this diagnostic stuff takes a lot of time to narrow down.
Furballsmom has a really nice list of tempting foods that cats that aren't eating good or need to put on some weight usually like. I'm sure she'll be along to share that list with you.
I think you're doing right by him and I bet Max things so, too. He's 17, that's pretty amazing..

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Thank you! We have had Max since he was 7 weeks old. The new vet is an internal med cat specialist and she sounds confident that we are on the right track. I just wish I had taken Max to her sooner.

Kitty Mommy said:

Thank you! We have had Max since he was 7 weeks old. The new vet is an internal med cat specialist and she sounds confident that we are on the right track. I just wish I had taken Max to her sooner.

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Please don't play "could-a, would-a, should-a." There's no sense in driving yourself crazy with that. You're there now, that's what matters most. I bet in no time she'll have Max back on track

kittyluv387 said:

If you highly suspect hyperthyroidism the best thing would be to get a scintigraphy for your cat. It will accurately measure the iodine levels in your cat. I say trust your gut and get it tested. If he does have hyperthyroidism he can get an accurate radioactive iodine treatment which is an actual cure.

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Thank you. I haven't heard of a scintigraphy before so I will ask about it.

Our other cat is 19 and she has been on the methimazole for about 2 years. It was found during a senior blood panel at one of her regular check ups and she wasn't showing the typical symptoms.

1 bruce 1 said:

Please don't play "could-a, would-a, should-a." There's no sense in driving yourself crazy with that. You're there now, that's what matters most. I bet in no time she'll have Max back on track

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Thank you. It's hard not to feel guilty about missing this and you are right; we are taking care of it now.

Kitty Mommy said:

Thank you. It's hard not to feel guilty about missing this and you are right; we are taking care of it now.

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I know that feeling well my friend

I thought hyperthyroid was associated with a ravenous appetite, not needing appetite stimulants. I’m not sure it’s that. I’d suggest that the IBD meds aren’t working because they are trying to manage the injury without addressing the insults that are causing the injury.

What I didn’t see in all that is whether you ever addressed the cause of the IBD. The diet. Drugs alone won’t do it. I just posted about this in another thread this morning.

Ibd Kitty Trying New Things

It is possible to manage even heal IBD without medication.

Another thing I would suggest/insist is B-12 shots. If he’s lost weight and been vomiting, he is depleted. You will not get very far in the treatment without B-12. And a cat with compromised digestion that is also vomiting will not be able to get enough B-12 from food alone. The good news is that B-12 is cheap and easy to do the subcutaneous shots. You can buy the supplies from your vet and get a vet tech to show you how to do it. You can watch it on YouTube if you’re curious.

Don’t beat yourself up. There’s a lot of bad or incomplete information out there from the food we feed them to the doctors who take care of them. We all still have so much to learn from these creatures who don’t give up their mysteries very easily.

Hi!
Are you handfeeding/force-feeding him?
Tongue depressors or wooden model sticks (found at hobby stores) are useful to get food into the mouth of a cat

Just in case this is of any help, and check with your vet first to be sure there's no issues;

Try sitting with him some more and see if he'll lick other mushed up food off your finger or a spoon. The reddi whip helped another kitty recently but all of the things on the list have eaten by at least one cat.

18 Awesome Cat Feeding Tips By Thecatsite Staff Members

Also here is a compilation of things;

Try feeding in different locations - and utilize different heights. For example put a couple of books underneath the dish, next time use two thick phone books, or a small-ish box so the heights are varied....

Try some raw egg yolk. Egg white must always be cooked, and some people cook the white and make a slurry of sorts by adding in the raw yolk.

Try making these recipes - they're just as viable for an adult cat as for kittens;
Kitten-Rescue.com

These below can be used on their own or combined with food. Also, if you heat the food a little - stir it so there aren't any hot spots from the microwave.

Or you could heat some water, about a tablespoon, and add that to canned food. A small glass works to stir it all up.

• Chicken, beef or ham flavored (pureed) baby food such as Gerber Stage 2 - make sure there is no garlic or onions in the ingredients

• Tuna and/or the juice, a low mercury/low/no sodium brand is called SafeCatch

• Salmon, mackerel

• Sardines (make sure there are no bones)

• boiled cut up chicken or turkey with no seasonings

• canned kitten food any brand

• Try mixing in Kitten Milk Replacer - there are recipes on the internet or store bought

• Fish, tuna or BBQ flavored canned wet food (I personally have never seen BBQ flavors, but...)

• Lickable cat treats or pouch treat 'gravy' poured over the food

• kitten glop (recipes in website link above)
• Bonito flakes
• fortiflora
• fish oil
• green beans or asparagus mushed up, lettuce, applesauce, mashed chickpeas, black olives
• whipped topping such as reddiwhip
• dry pasta

• goat milk, or no lactose cow milk
• whole cooked eggs (the white must always be cooked) or raw egg yolk now and then
• broth with no salt and no garlic or onion or seasonings of any kind
• There are also commercial toppers, Applaws is a brand that can work well as a topper
  
• Some good treats would be freeze dried Purebites, Orijen, Meowtinis, Meowables, Only Natural Pet, Primal

• There are also Lickimats that you could spread types of soft food onto, even plain unflavored yogurt, and even freeze it. Licking something can help a cat to feel better emotionally The LickiMat - Food Puzzles for Cats
• shredded cheddar cheese, string cheese