Follow up for hyperthyroidism

[dorymb]

One of my cats was diagnosed with hyperthyroidism. Her T4 was 14.6. She was dosed with 5 mg Tapazole once a day. When I took her in 1 month later, they told my her T4 was 18 (?.) Vet upped her Tap to twice a day. The recheck after 1 month showed a T4 of 1.4. There was no follow up scheduled and when I inquired, I was told by the vet that she doesn't have to be seen for a year. This doesn't seem right. I am curious what others on this forum have experienced.

 

[Alldara]

Can you call and have the tech regive you the number? Perhaps you heard wrong and it was .18?

When my cat was on medication I had to do follow up every 3 months for the rest of her life. That's because hyperthyroid can mask other problems and also because it can grow quickly and the levels can rise again.

 

[FeebysOwner]

I would think you should probably ask for another check in 3 months, just to see - particularly since bringing down the T-4 level can unmask kidney disease. That is a lot of the med, but sometimes it is necessary, and her T-4 is in a good place now - assuming she does not have kidney disease.

 

[neely]

When my cat was on medication I had to do follow up every 3 months for the rest of her life. That's because hyperthyroid can mask other problems and also because it can grow quickly and the levels can rise again.

I've never heard of a cat who was diagnosed with H-T waiting a year to be rechecked especially given the initial score.

I would recommend either calling your vet back and requesting a repeat of her T-4 levels in three months or consulting with another vet for your own peace of mind. As the above two members have said, H-T can mask kidney disease. It can also mask high blood pressure and in some cases CHF. Please keep us updated.

 

[dorymb]

Can you call and have the tech regive you the number? Perhaps you heard wrong and it was .18?

When my cat was on medication I had to do follow up every 3 months for the rest of her life. That's because hyperthyroid can mask other problems and also because it can grow quickly and the levels can rise again.

 

[dorymb]

Hi. Thanks for the responses! Yes, I called back when they left the message and asked how that was possible. Tech told me maybe it was because the first dose wasn't correct. It just didn't seem logical. I will get her checked in a few months and have a full work up. I'm not comfortable with the care. She did gain a bit of weight (now 6.8 from 6lbs.) but her long hair is coming off in gobs and has gotten so terribly matted. I read that this can be a side effect of the meds. I also read that they often reduce the dosage after the cat is on medication for a time.

 

[neely]

I also read that they often reduce the dosage after the cat is on medication for a time.

This is true but all the more reason for her T-4 levels to be rechecked before making any changes to the dose. Best of luck!

 

[FeebysOwner]

Usually starting off with higher thyroid med dosages can cause side effects that are often reversed when the med is stopped and later resumed, or at least reduced. It seems to always be better to gradually reduce the thyroid level while adjusting the meds to see what happens, both with side effects and with results. If the gradual approach is taken, it is not common to have to reduce the dosage after a period of time. That happens when the dosage was too much to start with.

The other thing that can cause issues is when the med is only given once a day vs. twice a day that enables maintaining a constant stream in their system. That could explain the second reading, if the timing was off between when the med was administered, and the blood was taken.

Given the hair issue, I would be inclined to impress upon your existing vet or a new one that retesting is probably more appropriate sooner than later, and then possibly proceed with a dose lowering.

 

[silent meowlook]

Honestly, if it was the vet themselves and not some misguided staff that told you a one year recheck, I would be finding a vet that specializes in cats. Thyroid meds, Methimazole is a twice a day ( every 12 hour drug) it is not prescribed once a day because the levels will be dipping and rising and still causing health concerns. Most places check a T4 every 30 days until regulated within normal range, then are checked in 3 months and if all goes well another 3 months, then if good every 6 months from there on. Every time the dose gets adjusted you have to start all over again. Also, have to be sure you are giving the meds on time and haven’t skipped a dose in the week leading up to the test.

 

[dorymb]

I appreciate all responses and advice. One more question: shouldn't they be doing a complete panel blood test to also look at her kidney and liver now that she's on the Tapazole?
(Also, I reached out to the only cat centered clinic in my area and they are booking 6 weeks out. So I may have to take her back to regular vet.)

 

[Alldara]

I appreciate all responses and advice. One more question: shouldn't they be doing a complete panel blood test to also look at her kidney and liver now that she's on the Tapazole?
(Also, I reached out to the only cat centered clinic in my area and they are booking 6 weeks out. So I may have to take her back to regular vet.)

Yes I would if you can. Even my non-cat centered vet did that I think twice? Lily only lived a year with hyperthyroidism due to other health complications.

 

[silent meowlook]

It is always a good idea to check a complete blood panel on a senior cat or any cat that has another illness such as hyperthyroidism at least once a year or every 6 months.

 

[neely]

I reached out to the only cat centered clinic in my area and they are booking 6 weeks out. So I may have to take her back to regular vet.

If it were me I'd definitely call and make an appointment since the longer you wait the longer you'll be able to get a second opinion from a feline only vet.

 

[emmabelle]

after my cat was diagnosed they did a blood test a month later and then told me to bring him in six months later for a recheck.

Just to let you know he's doing really well on his meds. I get a liquid compounded version that supposedly tastes like chicken. Way easier than pills. I just put it in a small amount of cat food.