Ckd/hyperthyroid cat only will eat tuna...

[FeebysOwner]

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 use unscented, hypo-allergenic wipes to clean Feeby's ears. Some others have used witch-hazel. I have added a couple of drops of witch hazel to the wipes as it does seem to help clear the residue with less 'rubbing'. It does contain a small percentage of alcohol, so I don't use much of it. Feeby is not on Methimazole transdermal (she takes oral Felimazole), but I do apply Mirataz transdermally. I suspect any of these gels will cause a residue buildup, but you'd be amazed how many vets don't seem to think it is necessary - probably because none of them have actually had to use it themselves.

If you can get finger cots, ideally for free, that's great. I think I said before, I use the most basic plastic gloves and cut off a finger for each dose. So, one glove at least lasts me 6-7 doses since I also cut the glove palm in half for two more doses.

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.

That is the whole thing about starting doses out low, to let the cat's body get used to the meds and to help reduce the chance of side effects - or a too large dose. If there are side effects, most of the time, the meds can be stopped temporarily and then re-started. But why go through that for the sake of trying to expedite the process - when in fact that would delay it anyway?

When you call around ask about the effectiveness level of oral vs. transdermal - it could help you to make a better decision about the dosage. As I said before perhaps a bit higher dosage is acceptable when using the transdermal.

neely probably already told us, but maybe for (my) sake of clarity, perhaps she can tell us what T4 level her cat had to begin with and what dosage level was initiated at that time, whether/when there were dosage increases over time, and how long before an acceptable level was reached for the I-131 treatment. I understand no two cats will respond in the exact say way, but it would be a good baseline for you to have. I cannot give that kind of information because I am not using the transdermal version for Feeby's H-T, and I have pretty much ruled out I-131 for her given her age, so we are merely trying to maintain a 'respectable' level for her.

Sorry for the long post!

 

[neely]

neely probably already told us, but maybe for (my) sake of clarity, perhaps she can tell us what T4 level her cat had to begin with and what dosage level was initiated at that time, whether/when there were dosage increases over time, and how long before an acceptable level was reached for the I-131 treatment. I understand no two cats will respond in the exact say way, but it would be a good baseline for you to have. I cannot give that kind of information because I am not using the transdermal version for Feeby's H-T, and I have pretty much ruled out I-131 for her given her age, so we are merely trying to maintain a 'respectable' level for her.

Carleton's T-4 level was at the high end of normal, i.e. 4.3. One of the reasons our vet was concerned was because it was 1.9 the year before. He gets bloodwork done yearly at his physical and now that he's considered a senior they recommend every six months. The vet started him at 1.25 mg of Methimazole twice p/day. That dosage never changed throughout the time he was on the medicine and his T-4 was checked regularly according to standard protocol. The vet left it up to me whether I wanted to use the pill or transdermal gel form. Since Carleton is so difficult to pill and I knew he wouldn't eat it in his food the decision to go with the transdermal gel was much easier for both him and me. Plus it has less GI side effects because it does not pass through the digestive system. His T-4 level was 3.6 at the time he received the I-131 treatment. However, the T-4 level alone is not enough to make a cat an ideal candidate for the I-131. There are other tests that need to be done prior to approval, e.g. urine analysis, full chemistry panel/CBC, T-4, lung/chest x-rays, etc. When approved the cat goes off Methimazole for two weeks before the radioactive iodine is injected. It has been a little over one month since Carleton had the I-131 and his T-4 is 2.0. He will repeat the T-4 at three, six and 12 months from the date he received the I-131.

 

[Honehh]

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. 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.

All of the information you have provided me is amazing, thank you so much for the knowledge.

Regarding the vet or the pharmacist, the most they told me was to apply to part of the ear that doesn't have hair and rotate ears. The pharmacist even told me just to use my finger and then wash it off when done. I did this the first two times, but didn't feel comfortable doing it because, truthfully, I don't know if I have the ability to absorb some of the medication through my skin? So I purchased disposable gloves today and will do what the other poster said and cut the fingers off so 1 glove gives you up to 6 uses.

Regarding the ear cleaning. Could I clean his ears with a warm damp towel or paper towel? I have ear cleaning wipes from Petco, which probably has some iffy ingredients (but to be fair, I researched a whole bunch of ear cleaning wipes for Max a while back and a lot of them contained chemicals and preservatives that I did not agree with).. could I just use his ear cleaning wipes, perhaps? Or just a warm towel? I do have witch hazel wipes as well.. but I'm not sure if there is any alcohol in it or not. I'm the type that likes the most simplest way possible (holistic even.. but everything I read, hyperthyroidism isn't something that can really be tackled with holistic treatments).

I wish the pharmacist or vet would have provided me finger [condoms.. I don't know how else to say it lol] protection, but it was never even mentioned.

Also, I spoke with my vet today about reducing Max's methizamole from 2.5mg x2 daily to 1.25mg x2 daily.. and the vet said because Max is a big cat (he really is, but he has lost some weight.. but he's a bigger boned cat) that I should keep him on 2.5mg x2 daily. Yesterday, I actually reduced the amount I gave him because of everything I read, I am wondering if I should keep the reduced amount, if it means my Max will handle things better, I am willing to.

One thing I havent asked yet to anyone though.. the reason why I took my cat to the vet was because I started to hear a wheez in his voice . Not always, but after a long meow or purr (my Max is a talker.. so I know exactly what he sounds like or should sound like).. I could hear him wheezing. When I brought him in, the vet was like.. his thyroid is huge, we need to do labs. And the rest is history. However, has anyone else who has a hypert cat experience wheezing/sounds that make it seem like it's taking a bit more to talk or catch breath? It's not constant, but it's definitely there and my vet originally said his wheez would not be caused by hypert.. but now he says it very well could be (which is what I have read as well).. I'm scared because I don't have a cat inhaler or anything to make him breathe easier in the event that anything happens with his breathing. I do trust my vet, I had a terrible vet before. I like this vet because he is down to earth.. but I am almost thinking I should be getting a second opinion. Max and his breathing was my real concern.. then again, the vet caught the kidneys and hypert.. so I might just be a dramatic mom. But I am curious if anyone else had cats with hypert that experienced wheezing or breathing problems..

Anyway, sorry for how long this is. I'll end it here.

Thank you again for all the info!!

 

[Honehh]

I use unscented, hypo-allergenic wipes to clean Feeby's ears. Some others have used witch-hazel. I have added a couple of drops of witch hazel to the wipes as it does seem to help clear the residue with less 'rubbing'. It does contain a small percentage of alcohol, so I don't use much of it. Feeby is not on Methimazole transdermal (she takes oral Felimazole), but I do apply Mirataz transdermally. I suspect any of these gels will cause a residue buildup, but you'd be amazed how many vets don't seem to think it is necessary - probably because none of them have actually had to use it themselves.

If you can get finger cots, ideally for free, that's great. I think I said before, I use the most basic plastic gloves and cut off a finger for each dose. So, one glove at least lasts me 6-7 doses since I also cut the glove palm in half for two more doses.


That is the whole thing about starting doses out low, to let the cat's body get used to the meds and to help reduce the chance of side effects - or a too large dose. If there are side effects, most of the time, the meds can be stopped temporarily and then re-started. But why go through that for the sake of trying to expedite the process - when in fact that would delay it anyway?

When you call around ask about the effectiveness level of oral vs. transdermal - it could help you to make a better decision about the dosage. As I said before perhaps a bit higher dosage is acceptable when using the transdermal.

neely probably already told us, but maybe for (my) sake of clarity, perhaps she can tell us what T4 level her cat had to begin with and what dosage level was initiated at that time, whether/when there were dosage increases over time, and how long before an acceptable level was reached for the I-131 treatment. I understand no two cats will respond in the exact say way, but it would be a good baseline for you to have. I cannot give that kind of information because I am not using the transdermal version for Feeby's H-T, and I have pretty much ruled out I-131 for her given her age, so we are merely trying to maintain a 'respectable' level for her.

Sorry for the long post!

I took your advice and bought a pack of disposable gloves and will use your method of cutting a finger off to use. My vet and pharmacist never mentioned anything except the pharmacist said just use my finger and put in his ear in the part with no hair, rotate ears. And wash my finger. I mentioned in a previous post that I'm a bit uncomfortable using my finger without protection because I am unsure if I am able to digest any of that medication on my finger? I'm not sure, but that wouldn't be good at all if I could. So thank u so much for that tip, that's what I will do.

Also, I did mention this in my reply previously to the other user, but I talked to my vet today and he said because my cat Max is a large cat, he think 2.5mg x2 day is the correct amount to give.. yesterday, I actually gave Max 1.25mg x2 daily, because of what I read. I don't want max to fe any side effects.. so now I'm stuck on listening to the vet at 2.5mg x2 daily, or perhaps give a bit less .. I'm already having a hard time getting Max to eat because I switched his diet from seafood to actual meat (which he hates, but after reading some comments to my post here, I have been giving him fish every couple days.. I would rather not because of iodine, but he has to eat.....).

Also, thank you for the information on cleaning the ears. Again, I was never told this. I will start this tomorrow. Are ear cleaning wipes for cats okay? I also have witch hazel wipes, I dont know the alcohol content tho without going to grab them.. maybe just a warm damp cloth? When Max turned about 15 his ears quit disposing of wax on their own, so I clean out his ears quite frequently as it is..

Also, I will reply again to Feeby and find out how they went about their cats hypert and how they were able to get the radioactive iodine treatment. Thank you for letting me know this.

I am on a journey, but I will do anything for my best friend Max <3

 

[Honehh]

I took your advice and bought a pack of disposable gloves and will use your method of cutting a finger off to use. My vet and pharmacist never mentioned anything except the pharmacist said just use my finger and put in his ear in the part with no hair, rotate ears. And wash my finger. I mentioned in a previous post that I'm a bit uncomfortable using my finger without protection because I am unsure if I am able to digest any of that medication on my finger? I'm not sure, but that wouldn't be good at all if I could. So thank u so much for that tip, that's what I will do.

Also, I did mention this in my reply previously to the other user, but I talked to my vet today and he said because my cat Max is a large cat, he think 2.5mg x2 day is the correct amount to give.. yesterday, I actually gave Max 1.25mg x2 daily, because of what I read. I don't want max to fe any side effects.. so now I'm stuck on listening to the vet at 2.5mg x2 daily, or perhaps give a bit less .. I'm already having a hard time getting Max to eat because I switched his diet from seafood to actual meat (which he hates, but after reading some comments to my post here, I have been giving him fish every couple days.. I would rather not because of iodine, but he has to eat.....).

Also, thank you for the information on cleaning the ears. Again, I was never told this. I will start this tomorrow. Are ear cleaning wipes for cats okay? I also have witch hazel wipes, I dont know the alcohol content tho without going to grab them.. maybe just a warm damp cloth? When Max turned about 15 his ears quit disposing of wax on their own, so I clean out his ears quite frequently as it is..

Also, I will reply again to Feeby and find out how they went about their cats hypert and how they were able to get the radioactive iodine treatment. Thank you for letting me know this.

I am on a journey, but I will do anything for my best friend Max <3

Just a typo... I don't want max to fe any... *Feel

i don't know how to edit my replies or posts yet, so yeah lol

 

[neely]

i don't know how to edit my replies or posts yet

You need to have 20 posts before you can edit.

Regarding the ear cleaning. Could I clean his ears with a warm damp towel or paper towel? I have ear cleaning wipes from Petco, which probably has some iffy ingredients (but to be fair, I researched a whole bunch of ear cleaning wipes for Max a while back and a lot of them contained chemicals and preservatives that I did not agree with).. could I just use his ear cleaning wipes, perhaps? Or just a warm towel?

I think the most important thing is to clean the ears regularly so the residue doesn't build up otherwise the Methimazole won't be absorbed properly. I personally wouldn't use a paper towel because of the texture which is why I suggested a cotton round which is softer. A warm towel or washcloth would work as long as it's soft, not scratchy, and you don't keep using the same one over and over every day, another reason why I used cotton rounds because they're cheap and disposable. You will be able to see and feel the residue on your cat's ears so you'll know right away if the material you're using is cleaning his ears properly.

Once again, I'm sorry you didn't receive more information or instructions from both your vet and pharmacist. Regarding the medicine dosage, I'm not sure if I would change what the vet told you to give Max. I completely understand your concern and if I had any doubts I'd consult a feline specialist for a second opinion. I know you mentioned trusting your vet and liking him better than the previous one so this is a decision you have to make and be comfortable with yourself. Keep in mind if you lower the dosage from what your vet told you and his T-4 level does not improve you will be back to square one. It's a lot to think about so you may want to speak with your vet again.

I will reply again to Feeby and find out how they went about their cats hypert and how they were able to get the radioactive iodine treatment. .

I don't want to speak for FeebysOwner but if I understood correctly her cat has not had the I-131 radioactive iodine treatment. Perhaps she can clarify for you.

 

[FeebysOwner]

I see neely offered more information about cleaning Max's ears, so I won't repeat anything. I will say that the tiny amount of meds that you could absorb through your finger shouldn't likely be an issue, but using the gloves takes any possibility out of the equation - so, a 'better safe than sorry' attitude on this one. And, witch hazel does contain a certain percentage of alcohol, but apparently most people have not had an issue with using it.

I don't know what to tell you about the dosage for Max - I can't recall ever hearing about a cat's weight making a difference on the dosage, but it does seem logical. I am going to include another web site link (see below) that goes into a lot of detail about hyperthyroidism, including dosage recommendations, and the I-131 treatment. It is a bit harder to navigate through the various sections, but your best bet would probably be to start with the FAQs and move on from there. Animal Endocrine Clinic | Where science and compassion cure. EDIT: You probably should inform your vet if you choose to go against his recommendation.

neely is the one whose cat has gone through I-131 treatment - and she did post some additional information above that you may have missed (5 posts before this one). I am sure she can answer other questions you have about the actual treatment too.

For now, I wouldn't worry so much about a new dry food trying to cover all the bases you mentioned, maybe some time down the road when you have more information regarding Max's status on his thyroid & kidney levels. One step at a time. And I don't think it is terrible that he eats some fish food; as you said - and most everyone will concur with you - getting him to willingly eat is more important. Some fish contain more iodine than others, so perhaps you can add that to your list of research goals!

I also don't know about the wheezing and if it would connect at all with an enlarged thyroid gland. I honestly don't recall reading about that (could have forgotten). If you ever do post on the H-T forum, that question - along with soliciting more opinions about the dosage - would be a great idea!!

Hopefully, we both have covered your most recent questions/issues. If not, or you come up with more, please post away!!

 

[neely]

EDIT: You probably should inform your vet if you choose to go against his recommendation.

I completely agree! We are not vets and cannot give you medical advice. We can share our experience(s) but every cat is different as are their individual health issues. I know you have a lot on your mind and want to do what is best for Max so perhaps having a heart to heart with your vet and/or consider a second opinion would be the most helpful advice for you.

 

[Honehh]

I completely agree! We are not vets and cannot give you medical advice. We can share our experience(s) but every cat is different as are their individual health issues. I know you have a lot on your mind and want to do what is best for Max so perhaps having a heart to heart with your vet and/or consider a second opinion would be the most helpful advice for you.

I wanted to reply back and say thank you and Feebysowner for all the help, advice, and Information you have provided me. I did bring up the dosing again with my vet, and decided on the higher dose
, His first check up is on Feb 18, I ready hope he shows improvement.

Carleton's T-4 level was at the high end of normal, i.e. 4.3. One of the reasons our vet was concerned was because it was 1.9 the year before. He gets bloodwork done yearly at his physical and now that he's considered a senior they recommend every six months. The vet started him at 1.25 mg of Methimazole twice p/day. That dosage never changed throughout the time he was on the medicine and his T-4 was checked regularly according to standard protocol. The vet left it up to me whether I wanted to use the pill or transdermal gel form. Since Carleton is so difficult to pill and I knew he wouldn't eat it in his food the decision to go with the transdermal gel was much easier for both him and me. Plus it has less GI side effects because it does not pass through the digestive system. His T-4 level was 3.6 at the time he received the I-131 treatment. However, the T-4 level alone is not enough to make a cat an ideal candidate for the I-131. There are other tests that need to be done prior to approval, e.g. urine analysis, full chemistry panel/CBC, T-4, lung/chest x-rays, etc. When approved the cat goes off Methimazole for two weeks before the radioactive iodine is injected. It has been a little over one month since Carleton had the I-131 and his T-4 is 2.0. He will repeat the T-4 at three, six and 12 months from the date he received the I-131.

Out of curiosity, how was/is Carleton's eating habits? Max doesnt seem as interested in food. He does eat, I'm assuming when he's really hungry (and he's always been a super picky eater) but now there are times he won't even eat the tuna I put in front of him (he loves tuna, was trying to switch him over to meats, which he hates.. so I tried fish again, now that even seems like a hit or miss). I'm guessing ckd or ht has something to do with this. I've been looking up natural appetite stimulants, or perhaps a calorie dense paste that I can give him so he doesn't continue to lose weight.

Anyhow, to make things shirt. Did Carleton eat less once diagnosed?

Thank you!

 

[neely]

I wanted to reply back and say thank you and Feebysowner for all the help, advice, and Information you have provided me. I did bring up the dosing again with my vet, and decided on the higher dose, His first check up is on Feb 18, I ready hope he shows improvement.

You are more than welcome, that's what makes TCS such a great place to come for support and advice. When Carleton was diagnosed with H-T I had just as many questions and concerns as you. Although my vet was very helpful I appreciated hearing other members' experiences and learned a lot from them.

Out of curiosity, how was/is Carleton's eating habits?

Carleton is super picky about food too. It was very difficult to get him to eat wet food since he liked dry better so it took a long time to transition him over. He still likes dry food so I give it to him as a bedtime snack. I honestly don't know if his appetite was affected before being diagnosed with H-T due to being fussy about his food. However, he accepted a new wet food after the I-131 and has been eating it like a champ! I know that it's common for cats with H-T to lose weight so you may want to get a baby scale and keep track of it. That was one of the suggestions our vet encouraged us to do.

I'll be keeping my fingers crossed for your next vet appointment on Feb. 18. Please feel free to check in with updates or ask anymore questions that you may have about Max.