Advice - 16 Yr Old Cat With Hyperthyroidism And Only Eating Gravy

[elizabeth k]

Hi everyone. I need some advice. My beautiful kitty, Leila is 16. She has had hyperthryoidism for several years. I tried the Methimazole gel in her ears and it did not work. She either would not sit still enough for me to administer it or she just flicked it away. So, she was prescribed the Methimazole pills. Trying to administer pills orally is like fighting an alligator - I tried everything. I finally figured out a way: scoop out the soft interior of Temptations Treats with a toothpick, insert pill and cover up the end with the soft part that I scooped out. Boy, was this time consuming, but it worked...for a while. She finally figured it out and I gave up. I bought Pet Well Being Thyroid Formula and also Kidney Formula. She seemed to be doing great. Fast forward to last week, she stopped eating all but the gravy part of canned food. I got on the floor and watched her try to pick up a hard treat and she couldn't do it. I have been mixing pate cat food in the blender with a little water and I also bought some Delectables Stew and Bisque. She can't even get the little morsels in the stew into her mouth. I took her to the vet today. She has several rotted teeth. The doc said her heart sounds good, but she has tachycardia due to her thyroid not being regulated by the medication. The doc said that tachycardia can lead to blood clots in the legs or the lungs and she wants her back on the medication. I don't know what to do. She seems so much happier now that I am not chasing her down 2x a day with a pill. I also think the Methimazole made her very restless. Does anyone have an opinion on this? Also we did blood work and if it comes back ok, the plan is to give her general anesthesia and have the rotted teeth removed. I have been reading all over the internet that many senior cats live with rotted teeth and eat only gravy or bisque-textured foods. I would imagine that those rotted teeth have to be painful, so I am leaning towards having them removed. Opinions? I have had her since she was 8 weeks old. She was laying in the street next to her mother's dead body - her mom was hit and killed by a car. She is my baby. I would appreciate any opinions. Thank you.

 

[FreedomKitty17]

I had a cat with hyperthyroidism, she was 18. She never had any teeth issues, but she couldn't walk and as it got worse, she couldn't even move. She died a few years ago. I do have an older cat now with teeth issues, and I would definitely suggest taking those teeth out, as you can't for sure know her pain level, and it's probably better all around for her health. It's a hard choice between having her live longer but less happy with pills, or her possibly live shorter but happier with no pills. You could crush up the pill and put it in a strong flavored bisque? Trust me, I know what it's like to have a cat from practically birth, I have had lots of cats (still do lol) and am currently fostering kittens. This is all my opinion and experience of course, you must do what feels right to you and what your vet says will be better for your baby. Let me know how it goes, and I'm willing to give any more info that I have.

 

[Antonio65]

Hi everyone. I need some advice. My beautiful kitty, Leila is 16. She has had hyperthryoidism for several years. I tried the Methimazole gel in her ears and it did not work. She either would not sit still enough for me to administer it or she just flicked it away.

Hi Elizabeth, can I ask you how your cat could flick the gel away?
I have been giving my cat ear gel for months and it never came off. Probably your gel was too runny and didn't absorb right away?
Have you considered the I-131 therapy for her?

 

[elizabeth k]

My cat would shake it off and rub it off with her paws. Maybe I did not rub it in well enough, but she is a handful to treat. Her labs always came back with high levels so she was switched to tablets. The vet and I discussed trying the gel again and I am going to do it. I have considered radioiodine therapy and it might be my best option because it is permanent. My vet does not provide this service, but there is one provider in my area who I will call. Cost may make this option tough for my family. Thank you for your response. I am grateful.

 

[Antonio65]

If your cat doesn't love to be handled it can be difficult...
It also depends on how much gel you have to rub in her ears. I asked the compounding pharmacy to prepare a gel with a very high concentration of methimazole so that I had to use a tiny amount of gel. It was easier to put a small drop of gel rather than a long strip of gel.
Yes, radioiodine therapy can be expensve, but you would have a healthy cat for life vs a few years of an unhealthy cat and the expenses of gel and monthly blood works to assess the therapy.

 

[elizabeth k]

I had a cat with hyperthyroidism, she was 18. She never had any teeth issues, but she couldn't walk and as it got worse, she couldn't even move. She died a few years ago. I do have an older cat now with teeth issues, and I would definitely suggest taking those teeth out, as you can't for sure know her pain level, and it's probably better all around for her health. It's a hard choice between having her live longer but less happy with pills, or her possibly live shorter but happier with no pills. You could crush up the pill and put it in a strong flavored bisque? Trust me, I know what it's like to have a cat from practically birth, I have had lots of cats (still do lol) and am currently fostering kittens. This is all my opinion and experience of course, you must do what feels right to you and what your vet says will be better for your baby. Let me know how it goes, and I'm willing to give any more info that I have.

I had a cat with hyperthyroidism, she was 18. She never had any teeth issues, but she couldn't walk and as it got worse, she couldn't even move. She died a few years ago. I do have an older cat now with teeth issues, and I would definitely suggest taking those teeth out, as you can't for sure know her pain level, and it's probably better all around for her health. It's a hard choice between having her live longer but less happy with pills, or her possibly live shorter but happier with no pills. You could crush up the pill and put it in a strong flavored bisque? Trust me, I know what it's like to have a cat from practically birth, I have had lots of cats (still do lol) and am currently fostering kittens. This is all my opinion and experience of course, you must do what feels right to you and what your vet says will be better for your baby. Let me know how it goes, and I'm willing to give any more info that I have.

Thanks Freedomkitty. Well, I just received the lab results. One of Leila's liver enzymes is a bit elevated, her white blood count is high and, as expected, her thyroid level is very high. We are going back in 10 days to re-test. I forgot to mention that Leila received an antibiotic injection yesterday and the vet feels her blood results will be better in 10 days. If all goes well, I will make an appt to have her teeth removed/cleaned. I tried your suggestion: I crushed 1/2 tablet of thyroid med and mixed it into puréed tuna. She wouldn't eat it. Then I offered her puréed tuna w/o medication and she would not eat it. I guess today is just not a tuna day. I will try this again with Delectables bisque and other gravyish cat foods. If I don't have success with the pills, I will purchase the transdermal gel at my 10 day appt. You are so right about the difficult choice between an unhappy cat on pills who may live a longer life and a happy cat who may not live as long. I will take it one step at a time for now. I have another 16 year-old kitty and the vet says he is very healthy for his age. I wish it could be like this for all cats. Then there is my 2-year old rescue who fortunately is also healthy (all are rescues). We are all here because our kitties are our babies and we love them so much and do our best to give them happy, healthy lives, but sooner or later we all face tough decisions. It's not easy.

 

[Antonio65]

I'm sure you know it already that the methimazole therapy cannot be discontinued once it has started. The best results come when you give her dose of methimazole twice a day, rather than a higher dose once a day.
It is important to never forget or skip a dose, set an alarm on your clock or phone to remind you of that duty. Also the times of the day should be the same daily.
It is a hard battle and it can only be won with a definitive therapy, unfortunately.
All the best!

 

[elizabeth k]

If your cat doesn't love to be handled it can be difficult...
It also depends on how much gel you have to rub in her ears. I asked the compounding pharmacy to prepare a gel with a very high concentration of methimazole so that I had to use a tiny amount of gel. It was easier to put a small drop of gel rather than a long strip of gel.
Yes, radioiodine therapy can be expensve, but you would have a healthy cat for life vs a few years of an unhealthy cat and the expenses of gel and monthly blood works to assess the therapy.

Thanks Antonio. She was getting 2 rotations of gel from the syringe. Good idea to have it compounded into a higher concentration. Very true about the cost of radioiodine vs monthly costs of blood work/ meds. My cousin lives in NJ and her methimazole is in liquid form. She just puts a few drops on her cat's preferred food. I am going to ask my vet about it.

 

[Antonio65]

Thanks Antonio. She was getting 2 rotations of gel from the syringe. Good idea to have it compounded into a higher concentration.

In my case the gel came into insuline syringes, 1 ml each.
I had to use a few IU (international units), about 4-5 units, that is 1/20 of 1 ml, as you can see it was a real tiny amount, absolutely easy and extremely precise (precision is essential) to administer.

 

[Antonio65]

This is what the syringes I used to use look like. It is an insuline syringe without its needle.
Just imagine it filled with a whitish gel as thick as mayonnaise
You see the numbers on the upper part of the syringe, 10 to 100. These are the IU (international units), 100 IU = 1 ml.
Then you see 50 small marks in the lower part of the syringe. Each mark is 2 IU.
I asked the compounding pharmacy to prepare a gel with 25 mg methimazole per 1 ml (25 mg/ml), so each small mark is 0.5 mg (1/50 of 25 mg) of methimazole. This is what I had to give my cat, 2 marks twice a day (1 mg + 1 mg) until she was treated with radioiodine one month ago.

 

[elizabeth k]

View attachment 197130
This is what the syringes I used to use look like. It is an insuline syringe without its needle.
Just imagine it filled with a whitish gel as thick as mayonnaise
You see the numbers on the upper part of the syringe, 10 to 100. These are the IU (international units), 100 IU = 1 ml.
Then you see 50 small marks in the lower part of the syringe. Each mark is 2 IU.
I asked the compounding pharmacy to prepare a gel with 25 mg methimazole per 1 ml (25 mg/ml), so each small mark is 0.5 mg (1/50 of 25 mg) of methimazole. This is what I had to give my cat, 2 marks twice a day (1 mg + 1 mg) until she was treated with radioiodine one month ago.

Antonio that is a small amount. Leila's medicine was in a syringe, but I had to make two full rotations on the upper half of the syringe. It was quite a bit. I also could not twist it until I was very close to her ear because it would drip off. Then I had to do it again in her other ear. It wasn't a good system. I have an update which I will post below and if I need to use the gel again, I am going to have it compounded like you did. Thank you.

 

[elizabeth k]

I thought I would update and it is fairly good news. It seems that the antibiotic is working - Leila has picked up and eaten a few treats. Even more good news: For the past few days, I have been feeding Leila some GNC Nourishcat Senior Cat Formula (along with thinned canned food). Since I know she needs the methimazole, I crushed 1/2 tablet (2.5mg) and whisked it into the Nourishcat. Much to my amazement, she lapped it up - every last drop. Either she cannot taste the med or likes the Nourishcat so much that she is willing to deal with the taste of the medication. I repeated this every 12 hours since Friday night and she has lapped it up every time. I have a call into my vet to let her know and see what she wants me to do. Leila was taking 7.5 mg twice a day prior stopping it, but I would not dare administer that amount until the vet gives me some instruction as to how she wants to proceed. I also don't know if Leila will still drink the Nourishcat with that amount of crushed methimazole in it. If she won't, I will be heading to a compounding pharmacy. I did call a radioiodine treatment center to get some information. I will put the radioiodine procedure on hold for now if I can successfully administer the methimazole. Leila is looking good and is pretty frisky, so hopefully we will be able to go ahead and deal with her teeth next week.

 

[Antonio65]

E elizabeth k ,
it seems a high amount of methimazole to me!
Many vets tend to give cats high doses of med just to be safe, but from what I have read on the web on specific websites, this amount is way too much and it can do more harm than good.
In order to have Leila treated with radioiodine you have to successfully control her hyperthyroidism.
What I have been told by vets at the radioiodine center and other people who have gone through the same experience, the sooner a cat is treated the better it is. Hyper-T and methimazole give damages to kidneys, liver and heart, that's why a quick approach is better for the cat.

I would suggest you to join this Yahoo! Group where all kind of info and support for hyper-T cats is given
Yahoo! Groups

 

[elizabeth k]

Thank you Antonio. I will join the group. I am waiting to hear back from the vet and I will ask her about that high dosage of methimazole. As of last blood work (9/20) her kidneys are fine - thank God. The radioiodine clinic that I called said that Leila should not take any methimazole for two weeks prior to the treatment. I told them that from everything I have read, the cat must be successfully treated prior to therapy. They said this was incorrect. I am very confused.

I do have another question: since Leila will be under general anesthesia to have a few teeth removed, what do you think about surgery to have her thyroid removed? I haven't done any research yet and I will of course. She is 16 and I am not sure how hard the procedure would be on Leila, how long she would be under, what the recovery entails and how hard/long the recovery would be for a cat her age. Thank you for your help.

 

[Antonio65]

E elizabeth k , in my post I had written that hyperthyroidism should be successfully controlled, not treated, I mean that the therapy that your cat is following should keep symptoms under control and fT4 and T4 levels within a certain range and possibly with constant levels. Every center has their protocol to assess whether a cat is a good candidate for the treatment. With no kidney issues you are a step forward.
It is correct that the therapy has to be suspended a few days prior to the treatment. In my case was 5 days prior to the admission.

There are three ways of treating hyperthyroidism, the metimazole, the surgical removal, the radio iodine.
The last one is the best, the middle one is the worst. It comes with several risks and neatly no vet goes for it.
And no vet will ever do a surgery of any kind in the same session of teeth cleaning removal. The mouth is rich in bacteria of every kind and they would spread around during any operation in the mouth. Any other open wound on the body will be attacked and infected by them.

 

[babiesmom5]

E elizabeth k ,
it seems a high amount of methimazole to me!
Many vets tend to give cats high doses of med just to be safe, but from what I have read on the web on specific websites, this amount is way too much and it can do more harm than good.
In order to have Leila treated with radioiodine you have to successfully control her hyperthyroidism.
What I have been told by vets at the radioiodine center and other people who have gone through the same experience, the sooner a cat is treated the better it is. Hyper-T and methimazole give damages to kidneys, liver and heart, that's why a quick approach is better for the cat.

I would suggest you to join this Yahoo! Group where all kind of info and support for hyper-T cats is given
Yahoo! Groups

I too had a hyperthyroid cat who was successfully treated with I-131. She was first put on a short therapy of methimazole just to get the thyroid hormone levels down sufficiently that she could undergo the I-131. I echo Antonio65 who stated that the sooner a cat is treated, the better it is. Even though a cat is on methimazole, the tumor keeps growing and the longer the cat is on it the greater the risk of side effect damage to heart, liver and kidneys.

Methimazole is also used for people with Hyperthyroidism, but only for a period long enough to get the thyroid hormone levels down sufficiently to do the Radioactive Iodine treatment for the same reason--risk of side effect damage, especially to liver.

 

[Antonio65]

There are three ways of treating hyperthyroidism, the metimazole, the surgical removal, the radio iodine.
The last one is the best, the middle one is the worst. It comes with several risks and neatly no vet goes for it.
And no vet will ever do a surgery of any kind in the same session of teeth cleaning removal.

I'm sorry, I would like to correct some words of my previous post.
It was methimazole, radioiodine, nearly and teeth cleaning and/or removal.
I shouldn't use my phone to reply message, and above all I shouldn't trust the android autocorrect feature [/user]

 

[elizabeth k]

Antonio, good info. Thank you very much. No worries about autocorrect. I know what you mean. I think the radioiodine clinic made the assumption that I was going to do the therapy shortly after Leila's teeth cleaning/removal. That is probably the reason they said she should not go back on methimazole since the r-i therapy would be soon. It was my particular situation they were talking about. I also misunderstood them about withholding methimazole during the period before the radioiodine therapy. I understand now. Thanks for helping me understand this.

 

[elizabeth k]

Just an update. Leila is doing well. We have been to the vet twice and have had blood work twice. She has received 2 antibiotic shots and it appears that her infection is gone and her mouth pain is gone or much better. She is eating well and not dropping particles of food into her water bowl. Her thyroid is under control also. The vet gave me a different variation of methimazole gel that is much easier to administer to her ears. So far, so good. The doctor wants to hold off on removing some of her teeth. She said as long as there is no infection Leila should be good. She is 16 and I know her very well. If she starts to not feel well, we will go back to the vet for a new plan. Now that I have this behind me, it's time to think about radio iodine therapy. Thanks for all the support.