Ckd/hyperthyroid cat only will eat tuna...

Honehh

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Hi,
I believe this is my first post here. My 17 yr old male cat was diagnosed with hyperthyroidism and ckd last month. I immediately started researching everything about it, and realized that his diet was probably mostly to be blamed. I rescued him when he was 2 years old, and he refused to eat any type of meat or poultry foods, but he would eat tuna/seafood. So for the past 15 years, he's always been on a seafood diet.

My question is this, how do you get a cat who hates meat and poultry to eat it? I have removed foods from my house that were seafood based because of their iodine content. I have spent, not kidding, probably close to $200 in just 2 weeks trying different wet and dry foods that he might like (and that don't have grains, are non GMO, no soy, eggs, etc). I have found 0 that he likes. Sometimes he will lick the broth..but I know that's not enough nutrition for him. Because of the fact he's burning 30% more calories from his hyperthyroidism, I'm scared that he's not eating enough. I caved Last night and gave a bit of tuna, and he ate it all up. So it's not a loss of appetite, he just only likes seafood.

I have tried bonito flakes, catnip, putting chicken treats in the food..nothing. I've tried pates to soups to broths to chunks, everything. I'm at a loss. I want to switch to raw foods but I don't want to put the money out there for it, because I doubt he will eat it.

I have been partially successful with feeding the dry food (I know, he needs to be on an all wet..but he needs to eat something) Only natural pet power fusion poultry dinner. Because my cat has both hyperthyroidism and ckd..I'm in a juggle between low and high protein diets, this one being high protein. But he 50 percent of the time will eat it, and he needs to eat.

Any suggestions? I'm desperate at this rate. Do I need to start feeding him some tubes that just have calories in it since I assume he's not getting enough?

Also, in case interested.. last month my cats labs showed:
- creatinine at 2.3 (my boy is a big cat, is there a possibility that is the reason he's a .1 over?)
- BUN 53
- T4 10.8
His phosphorus is 4.6 which is in normal range, Tanya's site says it should be around 4 for a cat with kidney disfunction? His potassium level is normal as well it says at 3.7, but that's the lowest it can be. His sodium is 152 which is on the higher end, but in range... Which I found strange that one would be on the lower and the other be on the higher range.

Anyway, if you made it this far, thank you. My cat Max has been with me through everything, I want the best for him and I would appreciate anything you can add. Money is not an issue here, so if what you suggest is pricey, that's okay. I will do anything for my Max.

Thanks.
 

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Hi. I have a whole ton of questions and suggestions, tbh. Is he losing weight? How is his appetite if you feed him what he likes?

First off, forget the seafood diet having anything to do with hyperthyroidism - Feeby (17+ yo) has never like seafood other than human fish, and yet nearly 2 years ago was diagnosed with H-T. So, essentially, it just 'happens'.

Secondly, Max's T4 needs to be taken care of before you even know where the actual creatinine level might be - which is hardly worth mentioning - right now - until you get the T4 in better range. How are you treating his thyroid?

The rest of the numbers you have posted above are not really alarming at all at this point. BUN is impacted by many factors, so at this point, put that number aside.

Focus first on treating the T4 and go from there. That means, for right now, feed him what he wants and will eat. Get that under control, and that will give you a better idea on how to move forward.
 

neely

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Max's T4 needs to be taken care of before you even know where the actual creatinine level might be - which is hardly worth mentioning - right now - until you get the T4 in better range. How are you treating his thyroid?
I completely agree! :agree: A T-4 of 10.8 is very high and can affect other organs. Our 11-12 yr. old cat was also diagnosed with H-T and started treatment for it as soon as he was diagnosed. To reiterate what FeebysOwner FeebysOwner asked, what treatment did your vet recommend?

BTW, welcome to TCS! 😊 I'm glad you joined the site and came here for advice. There are many members who have or had cats with Hyperthyroidism and I'm sure can share their experience.
 
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Honehh

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Hi. I have a whole ton of questions and suggestions, tbh. Is he losing weight? How is his appetite if you feed him what he likes?

First off, forget the seafood diet having anything to do with hyperthyroidism - Feeby (17+ yo) has never like seafood other than human fish, and yet nearly 2 years ago was diagnosed with H-T. So, essentially, it just 'happens'.

Secondly, Max's T4 needs to be taken care of before you even know where the actual creatinine level might be - which is hardly worth mentioning - right now - until you get the T4 in better range. How are you treating his thyroid?

The rest of the numbers you have posted above are not really alarming at all at this point. BUN is impacted by many factors, so at this point, put that number aside.

Focus first on treating the T4 and go from there. That means, for right now, feed him what he wants and will eat. Get that under control, and that will give you a better idea on how to move forward.
Last year in November 2020 he weighed 14 pounds, he was 12 pounds Nov 2021. The vet said he's at perfect weight. So he's lost 2 pounds, but no, he doesn't seem to be loosing weight..I feared he would because he wasn't eating. I initially took him to the vet because I heard wheezing.

As for his hyperthyroidism, my vet sent his labs to the radioactive iodine treatment center and they came back yesterday and said he's not eligible for treatment because his kidneys and recommended the medication you put on the ears. I have heard terrible things about the medication though. My vet told me to call the treatment center and talk to them about it, because even on their website it says they treat cats with kidney disease and even heart failure...so I called and left a message and am waiting to hear back. My vet told me to bring him in next week for x-rays and to check if it's just one gland that's enlarged or both. He said if it's one, he could do the surgery but of course there is always complications. I was really hoping for the radio iodine treatment, so I still have a little hope in that since their own website states it.

As I have been waiting to hear back on labs and the treatment center I changed his diet (as I said in post) and started him on holistic treatments and supplements.. petwellbeing (I think or maybe it's petalive) supplements such as thyroid support gold, kidney support gold, lung support. I also have been using sovereign silver drops and tinkle tonic from petalive or petwellbeing (can't remember which one is what). I also purchased kidney restore powder because it's hard giving him the drops since he wasn't eating his wet food (I did start just start using a baby syringe to mix the supplement drops and then squirt it in his mouth though).

Regarding the topic of foods, I get it. I will start mixing it back in with what he likes. So is iodine a factor or not? I have heard yes it is and no it isn't.

Thank you so much for your reply
 
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Honehh

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I completely agree! :agree: A T-4 of 10.8 is very high and can affect other organs. Our 11-12 yr. old cat was also diagnosed with H-T and started treatment for it as soon as he was diagnosed. To reiterate what FeebysOwner FeebysOwner asked, what treatment did your vet recommend?

BTW, welcome to TCS! 😊 I'm glad you joined the site and came here for advice. There are many members who have or had cats with Hyperthyroidism and I'm sure can share their experience.
Can I ask you what treatment you went with for his hyperthyroidism?
 

neely

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Of course you can ask, I'm always glad to help in any way I can especially if it's beneficial information. We started our cat on the transdermal gel, Methimzaole, which I rubbed in his ear twice p/day. I'm guessing that's the medication you were referring to in your above post, is that correct? If so, I don't know where you heard horrible things about it because it has less side effects than the pill since it does not pass through the digestive system. He did very well on it and so have many other members' cats with H-T on this site. However, it's not a cure and our vet who is a feline specialist told us he was an excellent candidate for the I-131 treatment since none of his other organs were affected. We chose a veterinary specialty hospital that did scintigraphy which I feel is imperative and in the cat's best interest. But I won't lie, it's very expensive so we started saving up for it. Long story short, he had the I-131 last month and he will have his T-4 checked tomorrow. We have our fingers and paws crossed for a good report. :crossfingers: The I-131 has a 96% success rate so I'm hoping for the best.

If you have any other questions or concerns about the medication or treatment please do not hesitate to ask.
 

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Feeby has been on Felimazole - same as Methimazole - orally - since 10/2020. The only 'bad' thing about it is if the dosage is NOT started out low and raised in accordance with follow up blood work. Blood work is usually done about 3 weeks after the meds are started, and then re-assessed again after another 4 weeks. Adjustments can be made after the initial 3 weeks, etc., but they should be slow and methodical. The gradual increase in dosage is what prevents all the 'horrible' stuff you have heard. Getting the T-4 down is not a race, it is a marathon.

And, as I understand it, H-T meds are necessary for a period BEFORE the radioiodine can be considered - to get a baseline for the degree of response to the meds.

Max's CKD will most likely 'progress' as his H-T is brought under control, because it will usually unmask the degree of kidney issues. But I still say that has to be managed first and foremost. Even with Feeby, with her H-T under reasonable control, her CKD is more stable than might have been suspected. So, you just don't know.

Btw, Feeby's numbers all not all the different from Max's, with the exception of the T4. Even the H-T & CKD forums I have joined seems to think she is holding her own. I can provide you links to both, if you are interested.

EDIT: Yes, iodine 'feeds' the thyroid tumor, but that is what the H-T meds are for - to reduce the iodine level and help minimize feeding the tumor(s).
 
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Honehh

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Feeby has been on Felimazole - same as Methimazole - orally - since 10/2020. The only 'bad' thing about it is if the dosage is NOT started out low and raised in accordance with follow up blood work. Blood work is usually done about 3 weeks after the meds are started, and then re-assessed again after another 4 weeks. Adjustments can be made after the initial 3 weeks, etc., but they should be slow and methodical. The gradual increase in dosage is what prevents all the 'horrible' stuff you have heard. Getting the T-4 down is not a race, it is a marathon.

And, as I understand it, H-T meds are necessary for a period BEFORE the radioiodine can be considered - to get a baseline for the degree of response to the meds.

Max's CKD will most likely 'progress' as his H-T is brought under control, because it will usually unmask the degree of kidney issues. But I still say that has to be managed first and foremost. Even with Feeby, with her H-T under reasonable control, her CKD is more stable than might have been suspected. So, you just don't know.

Btw, Feeby's numbers all not all the different from Max's, with the exception of the T4. Even the H-T & CKD forums I have joined seems to think she is holding her own. I can provide you links to both, if you are interested.

EDIT: Yes, iodine 'feeds' the thyroid tumor, but that is what the H-T meds are for - to reduce the iodine level and help minimize feeding the tumor(s).
Hi again,
Sorry I was away for a bit and just seen this. Yes, I would definitely appreciate links to both. I want to learn everything I can and make sure Max gets the best treatment possible.

Thank you so much for the information.
 
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Honehh

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Of course you can ask, I'm always glad to help in any way I can especially if it's beneficial information. We started our cat on the transdermal gel, Methimzaole, which I rubbed in his ear twice p/day. I'm guessing that's the medication you were referring to in your above post, is that correct? If so, I don't know where you heard horrible things about it because it has less side effects than the pill since it does not pass through the digestive system. He did very well on it and so have many other members' cats with H-T on this site. However, it's not a cure and our vet who is a feline specialist told us he was an excellent candidate for the I-131 treatment since none of his other organs were affected. We chose a veterinary specialty hospital that did scintigraphy which I feel is imperative and in the cat's best interest. But I won't lie, it's very expensive so we started saving up for it. Long story short, he had the I-131 last month and he will have his T-4 checked tomorrow. We have our fingers and paws crossed for a good report. :crossfingers: The I-131 has a 96% success rate so I'm hoping for the best.

If you have any other questions or concerns about the medication or treatment please do not hesitate to ask.
I've read that the meds (yes the one you spoke of) has bad side effects because it's a human medication and not a feline medication (vomiting, lethargy, lack of appetite, itching, etc). But I'm glad to hear that the ear gel has less side effects than the pill. My vet is talking about putting max on the gel. I was hesitant, but I spoke with the radioiodine clinic and they said Max needs a 3 to 6 week trial of the med to see his true kidney levels and if they are around the same level then he would be a candidate. So my fingers crossed that this all works out.

You said you got a scintigraphy, I haven't heard of this. So prior to radioiodine treatment (if max becomes a candidate), should I request this? I'm willing to go into debt for my cat, money is no issue here.

Thank you so much for all the info. How did your cat do when he got his labs? I hope everything is looking up!
 

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You said you got a scintigraphy, I haven't heard of this. So prior to radioiodine treatment (if max becomes a candidate), should I request this? I'm willing to go into debt for my cat, money is no issue here.
Thank you so much for all the info. How did your cat do when he got his labs? I hope everything is looking up!
Scintigraphy is a nuclear medicine procedure that is done when the cat goes in for the I-131 treatment. It's done just prior to determine the size of the tumor so they know how much radioactive iodine to give your cat. Here's a more detailed explanation:
The facts about thyroid scintigraphy | Advanced Veterinary Medical Imaging

Thanks for asking about his bloodwork the other day. In just five weeks post treatment his thyroid level is in the normal range. :jive: But he's not out of the woods yet, he will have to be tested at 3 months, 6 months and 12 months. Then if all goes well he will be home free!
 
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Honehh

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Scintigraphy is a nuclear medicine procedure that is done when the cat goes in for the I-131 treatment. It's done just prior to determine the size of the tumor so they know how much radioactive iodine to give your cat. Here's a more detailed explanation:
The facts about thyroid scintigraphy | Advanced Veterinary Medical Imaging

Thanks for asking about his bloodwork the other day. In just five weeks post treatment his thyroid level is in the normal range. :jive: But he's not out of the woods yet, he will have to be tested at 3 months, 6 months and 12 months. Then if all goes well he will be home free!
Yay I am so happy about your cats recovery! 🙂 I'm sure everything will be great when you get the next set of labs done. Thank you for all of your input and help!
 

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I would definitely appreciate links to both. I want to learn everything I can and make sure Max gets the best treatment possible.
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Also, this site which is a really good read (but long and detailed), and the CKD forum prefers you check out this site first before posting questions, as a lot of people's initial questions are answered on this site:
http://www.felinecrf.org
I've read that the meds (yes the one you spoke of) has bad side effects because it's a human medication and not a feline medication (vomiting, lethargy, lack of appetite, itching, etc).
Felimazole was developed specifically for cats. Yes, side effects can still happen - however, most cats do not have side effects if the drug is administered at a very low dose and then gradually increased as needed based on follow up T-4 testing. While it can vary, the H-T forum (link noted above) generally recommends that the dosage start at 1.25mg twice a day, with testing after 3 weeks, and the dosage can then be adjusted upward - slightly - if needed, with testing again in another 4 weeks. While the ear gel is better in terms of side effects, it should also not be dosed at the higher end of the spectrum initially either. I was surprised at how many vets prescribe a higher dose of either the pill or the gel, to start off with - I guess they are looking to lower the T-4 as quickly as possible. And, IMO, that is when people are more inclined to see their cats experience side effects.

Not meaning to over inundate you but here is another site that discusses all the varying aspects of hyperthyroidism and the radio iodine treatment.
Animal Endocrine Clinic | Where science and compassion cure
 
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So my vet started my cat with methizamole ear transdermal gel @ 2.5mg twice a day, once on each ear. Do you think that's too high? I made sure my vet knew that I didnt want to put my cat on these meds because of side effects that I have heard of.. and the compounding pharmacy that I picked up the med from, I discussed it with them as well. But I am wondering if he started my cat too high? My vet said 2.5mg twice a day for the first 3 weeks and if his t4 isn't at 2.5 or lower (currently 10.8), then he would make it 5mg twice a day for 3 weeks and see what that does.

Thank you so much for the links. I have definitely been reading up on felinecrf.org, so much info!
 

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So my vet started my cat with methizamole ear transdermal gel @ 2.5mg twice a day, once on each ear. Do you think that's too high?
Personally I would say yes because they usually start them at 1.25 mg twice a day and increase if necessary. However, since your cat's T-4 was originally 10.8 I can understand how that may have concerned your vet. However, I'm glad he prescribed the transdermal gel form. Did he explain how to clean the ear so it is properly absorbed each day? What did the pharmacist say about the dosage?
 

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The transdermal typically has less of an effect than the oral meds, as I understand it. So perhaps 2.5mg twice a day isn't so bad, although I still would be a bit leery. I wonder if 2.5 mg once a day, and then 1.25 mg for the second dose wouldn't be a better approach - or, as mentioned above 1.25 mg twice a day.

But IMO jumping to twice the current recommended dosage by the vet after 3 weeks if the T4 isn't down from 10.8 to 2.5 or lower is absolutely ridiculous. I can't stand that these vets think this is some sort of race rather than a marathon. They all do it, including mine initially. We are currently OK with keeping Feeby around a T4 of 3.4. Not ideal, but for now that is what we are doing. She will likely have her dose increased in the future, but as I said this is a marathon.

Did you at least join the H-T forum that I gave you a link to? I am not familiar with the transdermal vs. oral H-T meds, so they might be able to provide you with some insight on that aspect.

And, yes, as noted above, cleaning the ears is essential in order to prevent residue build up - which can cause a loss of effectiveness of subsequent doses - not to mention general ear irritation.
 
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Honehh

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Personally I would say yes because they usually start them at 1.25 mg twice a day and increase if necessary. However, since your cat's T-4 was originally 10.8 I can understand how that may have concerned your vet. However, I'm glad he prescribed the transdermal gel form. Did he explain how to clean the ear so it is properly absorbed each day? What did the pharmacist say about the dosage?
Actually, no. The vet nor did the pharmacist talk to me at all about cleaning the ears. This irritates me, because I tried to be so clear with the vet that I am more into holistic treatments than anything and the fact that the vet (or the pharmacist) didn't give me full instructions makes me upset because I never wanted my Max to go on this med in the first place :( I am trying this med because the radioiodine treament center said my cat Max has to go on a trial of this to get his t4 low enough to see what his true kidney levels are at to see if he would even be eligible for the radioiodine treatment..

So I must ask, how do I go about cleaning his ears with the transdermal medication or keeping his ears clean on it / for best absorbtion?

And yes, I have joined,just haven't started looking through, reading and posting yet. But I will. Thank you again for the links and information :)
 
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Honehh

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Actually, no. The vet nor did the pharmacist talk to me at all about cleaning the ears. This irritates me, because I tried to be so clear with the vet that I am more into holistic treatments than anything and the fact that the vet (or the pharmacist) didn't give me full instructions makes me upset because I never wanted my Max to go on this med in the first place :( I am trying this med because the radioiodine treament center said my cat Max has to go on a trial of this to get his t4 low enough to see what his true kidney levels are at to see if he would even be eligible for the radioiodine treatment..

So I must ask, how do I go about cleaning his ears with the transdermal medication or keeping his ears clean on it / for best absorbtion?

And yes, I have joined,just haven't started looking through, reading and posting yet. But I will. Thank you again for the links and information :)
Quickly, my bad. I was looking at both responses at once, which is why I commented on the links/forum given..
 
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Honehh

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The transdermal typically has less of an effect than the oral meds, as I understand it. So perhaps 2.5mg twice a day isn't so bad, although I still would be a bit leery. I wonder if 2.5 mg once a day, and then 1.25 mg for the second dose wouldn't be a better approach - or, as mentioned above 1.25 mg twice a day.

But IMO jumping to twice the current recommended dosage by the vet after 3 weeks if the T4 isn't down from 10.8 to 2.5 or lower is absolutely ridiculous. I can't stand that these vets think this is some sort of race rather than a marathon. They all do it, including mine initially. We are currently OK with keeping Feeby around a T4 of 3.4. Not ideal, but for now that is what we are doing. She will likely have her dose increased in the future, but as I said this is a marathon.

Did you at least join the H-T forum that I gave you a link to? I am not familiar with the transdermal vs. oral H-T meds, so they might be able to provide you with some insight on that aspect.

And, yes, as noted above, cleaning the ears is essential in order to prevent residue build up - which can cause a loss of effectiveness of subsequent doses - not to mention general ear irritation.
I completely agree with you, if my cat can be on a lower dose, I don't understand why the vet didn't start him at the lowest and then move up slowly if needed. I think I will call tomorrow and discuss this, because I did make a huge fit about not having him start at a high dose because of how concerned I am with him having side effects (I am more into holistic treatments more than anything).

So I do believe it was actually the radioiodine treament center that sent my vet the mg dosage and the schedule to give my cat the methizamole.. the idea is that the treatment center will not even consider my cat a candidate until his t4 is 2.5 or under because at 2.5 they can see his true kidney values.. but I absolutely agree with you that doubling his dose after just 3 weeks sounds crazy, especially if other people have doses that are just 1.25.

I will make some calls tomorrow. I want what is best for my best friend Max.. it would kill me if he had any side effects because the vet and treatment center are trying to hurry this process up.

And as I mentioned in my other reply, I actually was not told anything about cleaning the ears for better absorbtion or anything.. I will look it up, but if you have any tips or info, it would be appreciated!

And also as I mentioned in my other reply, I did join the forum, thank you so much for that. I haven't started looking through or reading it or posting yet, but I will soon :)

Thanks again!
 

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So I must ask, how do I go about cleaning his ears with the transdermal medication or keeping his ears clean on it / for best absorbtion?
I'm really sorry neither your vet or the pharmacist explained the importance of cleaning your cats' ears when using Methimazole. Did they tell you to alternate ears when applying the medicine? For example, left ear in morning and right ear in the evening? I made up my own little trick to remember with a rhyme. :biggrin: Right ear at night!

I thought this article might help about applying and cleaning the ears: Transdermal Tapazole for Cats
I followed my vet's instructions and the pharmacist even showed me what to do the first time I filled our cat's medication. What worked best for me was cleaning the ears once a day although some people do it every other day. I would wait at least 8 hours after applying the morning dose and then gently rub the inside of the ear with a warm, moist cotton round and check to make sure any crusty material was gone. When Methimazole dries thoroughly it leaves a sort of crusty residue. I always washed my hands after applying the medicine and after cleaning his ears. Did the pharmacist give you a supply of finger cots to use when applying the medicine?

I hope this is helpful and please feel free to ask anymore questions or express your concerns. :alright:
 
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