Hyperthyroid Diagnosis

[cocoanlace]

My 15-year old kitty Kaylaya just had her annual wellness exam. BW shows T4 is 5.2 (vet says normal is 4). She is down to 7.3 pounds (from 11 pounds in 2022), but her appetite is fine, and her urinalysis was unremarkable. She does pee outside the box onto a towel/puppy pad, but vet thinks it is behavioral. She does vomit mucus, hairballs or food about every other week or so. She is extremely skittish and difficult to access (luckily, I scruffed her during a brushing session and only THEN called for a vet appointment). So medicating daily is off the table. I am too old, and she runs too fast. Regarding kidneys, vet estimates she is in Stage 1 to possibly Stage 2, which I would expect for a senior. I am considering the I131 treatment as a good choice since I learned that medication does not cure it anyway. I am seeking advice from those who have been through this. Thanks so much.

 

[Antonio65]

Hi, I'm sorry to read that your Kaylaya is having all this issues.
Yes, typically the weight loss is si sign of hyperthyroidism, but also the senior age and the kidney failure lead to weight loss. Anyway, the blood work shows a high level of T4.

I understand that you want to follow the path of I-131, but as far as I know, before your cat is considered a good candidate for this treatment, you still have to treat her with methimazole to stabilize her condition, have a few blood work done to see how she responds to it, then discuss the I-131 path with the clinic or facility. I don't think it's a straightforward thing.

You say that Kaylaya doesn't let you approach her for medication. Unfortunately, methimazole has to be administered daily (even twice daily) at precise times of the day (every 12 hours). There are medications that allow one administration a day, but anyway you have to give her the pill.
You'll have to find a way to pill her daily

 

[SundaesPerson]

Unfortunately yes, she needs to be treated daily in order for her T4 to regulate in addition to looking at her overall health before they go ahead with I-131. Given that she's just over the threshold of normal, the medicine should work well in getting it back to baseline.
If she's difficult to pill, you could ask to have it compounded into a liquid that you would rub in her inner ear 2x a day.

 

[neely]

In addition to the advice given above you should be aware that a series of tests have to be performed to determine if Kaylaya is even a good candidate for the I-131 treatment, e.g. urine analysis, full blood chemistry/CBC panel, T-4, lung/chest x-rays, etc. And you should be also be aware that sometimes a cat may have an underlying condition after receiving the I-131 such as high blood pressure or kidney disease that still requires being treated with medication. The good news is our cat went through all the tests before receiving the I-131 and had a successful outcome after. Talk with your vet and come up with a plan that works for your cat and you. Good luck!

 

[FeebysOwner]

There is a transdermal version of methimazole that you apply to the upper portion of the inner ear. Maybe that is something that could be done at the end of a brushing session? Although I believe it too needs to be done twice a day. So, ask your vet about it. A lot of vets go gang-busters with the dosage, which can cause its own set of issues, so please talk to the vet about using a very low dose to start with and then adjusting as needed after her T-4 is retested. And, make the vet go through the process that must happen before I131 treatment can be done.

Once her thyroid is under control, you may likely see an increase in her kidney levels. Even at Stage 2, treatment usually begins with a change in diet to renal or low phosphorus foods.

Although, it is common for many older cats to acquire kidney disease it is by no means expected, or considered normal.

 

[rubysmama]

So medicating daily is off the table. I am too old, and she runs too fast.

I have some recent experience with a cat that absolutely hated to be restrained in any way, who was diagnosed with hyperthyroidism. I was convinced there was no way I could ever give her the methimazole pills twice a day, but she surprised me, and would willingly eat them if they were hidden in a piece of pill pocket, sometimes coated in Fortiflora.

Although after a bit, I didn't need to go to this extreme, this video shows the version of the trick I used in beginning. Maybe it will work for you and Kaylaya.

 

[mrsgreenjeens]

If you absolutely cannot get her medication into her, even using that marvelous method shown above, there is a food made especially for hyperthyroid cats. The issue with that is that you cannot feed them ANYTHING else with it, including any treats, and it's probably not kidney friendly. This, of course, would need to be discussed with your Vet.

 

[tyleete]

My 15-year old kitty Kaylaya just had her annual wellness exam. BW shows T4 is 5.2 (vet says normal is 4). She is down to 7.3 pounds (from 11 pounds in 2022), but her appetite is fine, and her urinalysis was unremarkable. She does pee outside the box onto a towel/puppy pad, but vet thinks it is behavioral. She does vomit mucus, hairballs or food about every other week or so. She is extremely skittish and difficult to access (luckily, I scruffed her during a brushing session and only THEN called for a vet appointment). So medicating daily is off the table. I am too old, and she runs too fast. Regarding kidneys, vet estimates she is in Stage 1 to possibly Stage 2, which I would expect for a senior. I am considering the I131 treatment as a good choice since I learned that medication does not cure it anyway. I am seeking advice from those who have been through this. Thanks so much.

Hi there! I'm in too big a hurry to read all the previous replies. But know you Can crush the pill and sprinkle it on their food. I have seriously picky cats so I taste tested the pill after I squished it into fine powder & it was gnarly tasteless! And I grind it by taking the opposite end of a pill popper(shoots the pills down their throats) and squishing it in my cats bowl. Then I just sprinkle it over his food twice a day. He has no clue

 

[cocoanlace]

I understand that you want to follow the path of I-131, but as far as I know, before your cat is considered a good candidate for this treatment, you still have to treat her with methimazole to stabilize her condition, have a few blood work done to see how she responds to it, then discuss the I-131 path with the clinic or facility.

I have been reading on Reddit and radio-iodine treatment sites and did NOT catch that I HAD to give her medicine first. That is such bad news. This will add days of stress trying to trap her and get her into my small holding cage for further testing at her regular vet after the meds start. (I read that the I131 places need the cat to be OFF meds and Y/D food for weeks before a consultation and testing with them can begin.) I thought the I131 vets did the "prequalifying" including their OWN tests, not the regular vet. I have experience with a cat that had a nonfunctional biliary system who had surgery but still died, an asthma cat on inhaled meds before she died, a cat with lung cancer who died and another with intestinal lymphoma who also died. The diabetic cat is still with me. I feel overwhelmed. I just ordered a large cat condo off Chewy. I am going to need a place for Kay to live 24/7 to access her to medicate and take to the vet; and she will not be happy. She cried for 24 hrs. in the small holding cage before her vet appt. Thursday. I have condo neighbors that must have heard it. Appreciate your insight. Thank you.

 

[cocoanlace]

If she's difficult to pill, you could ask to have it compounded into a liquid that you would rub in her inner ear 2x a day.

Thanks. I have ordered a cat condo for Kay to live inside while we navigate this journey. Not sure she would allow me to rub something into her ear flap (I have used transdermal meds on other cats so I am familiar; effectiveness was an issue). Kay yanks away quickly fearing I will scruff her. So smart. Thanks for the insight.

 

[cocoanlace]

The good news is our cat went through all the tests before receiving the I-131 and had a successful outcome after. Talk with your vet and come up with a plan that works for your cat and you. Good luck!

Thanks!!

 

[cocoanlace]

There is a transdermal version of methimazole that you apply to the upper portion of the inner ear. Maybe that is something that could be done at the end of a brushing session? Although I believe it too needs to be done twice a day. So, ask your vet about it. A lot of vets go gang-busters with the dosage, which can cause its own set of issues, so please talk to the vet about using a very low dose to start with and then adjusting as needed after her T-4 is retested. And, make the vet go through the process that must happen before I131 treatment can be done.

Thanks, all this information helps.

 

[cocoanlace]

Hi there! I'm in too big a hurry to read all the previous replies. But know you Can crush the pill and sprinkle it on their food. I have seriously picky cats so I taste tested the pill after I squished it into fine powder & it was gnarly tasteless! And I grind it by taking the opposite end of a pill popper(shoots the pills down their throats) and squishing it in my cats bowl. Then I just sprinkle it over his food twice a day. He has no clue

I do plan to ask the vet if the pill can be crushed. I have read both Yes and No on that specific point. Folks do not seem to agree. You said tasteless; another said it is nasty. But I guess Kaylaya gets to decide that one.

 

[FeebysOwner]

Hi there! I'm in too big a hurry to read all the previous replies. But know you Can crush the pill and sprinkle it on their food. I have seriously picky cats so I taste tested the pill after I squished it into fine powder & it was gnarly tasteless! And I grind it by taking the opposite end of a pill popper(shoots the pills down their throats) and squishing it in my cats bowl. Then I just sprinkle it over his food twice a day. He has no clue

The only word of caution about this approach is that the crushed pill should really be added to just a bite or two of food or treat to ensure it is all ingested/

I crush my cat's thyroid meds and mix it with either a bite of food or a lickable treat. It seems to be OK this way for her to eat and has kept her thyroid level in check. I do get the cat version -Felimazole - because it comes in a smaller dosage than methimazole, and I can better cut the pills into the dosages I need.

 

[cocoanlace]

I have some recent experience with a cat that absolutely hated to be restrained in any way, who was diagnosed with hyperthyroidism. I was convinced there was no way I could ever give her the methimazole pills twice a day, but she surprised me, and would willingly eat them if they were hidden in a piece of pill pocket, sometimes coated in Fortiflora.

Although after a bit, I didn't need to go to this extreme, this video shows the version of the trick I used in beginning. Maybe it will work for you and Kaylaya.

I have used pill pockets with short-lived success in the past with other cats. Kay has rarely needed any drugs. I would LOVE it if she surprised me. The cats always wised up by the second dose and refused the treat. My cat Sister knows how to chew the pill pocket off of the tablet.and lets the medication fall onto the floor in a wet glop. Now, that's talent. I will watch the video. Thanks!

 

[cocoanlace]

The only word of caution about this approach is that the crushed pill should really be added to just a bite or two of food or treat to ensure it is all ingested/

I crush my cat's thyroid meds and mix it with either a bite of food or a lickable treat. It seems to be OK this way for her to eat and has kept her thyroid level in check. I do get the cat version -Felimazole - because it comes in a smaller dosage than methimazole, and I can better cut the pills into the dosages I need.

Thanks so much for that!! I am aware that vet offices sometimes give you what they have on hand and not necessarily what the cat can handle. I will make sure to get the small dose version. (I also read where peeps had difficulty getting the dose right because of the tablet size. One was too big; one was too small.)

 

[cocoanlace]

Although after a bit, I didn't need to go to this extreme, this video shows the version of the trick I used in beginning. Maybe it will work for you and Kaylaya.

LOVED LOVED LOVED this video. Going to try the treat sandwich!! So inventive. (And her kitty was hissy.)

 

[FeebysOwner]

My cat started on Felimazole when her T-4 was 4.5. Initially I gave her just 1.25mg twice a day because I didn't want to overdo it with a larger dose. With methimazole, that would have been pretty difficult. Felimazole comes in 2.5mg, so getting it cut in half was 'doable'. Now, she needs 1.875mg in the AM and 1.25mg in the PM. I can manage to cut the Felimazole into quarters pretty easily.

 

[cocoanlace]

My cat started on Felimazole when her T-4 was 4.5. Initially I gave her just 1.25mg twice a day because I didn't want to overdo it with a larger dose. With methimazole, that would have been pretty difficult. Felimazole comes in 2.5mg, so getting it cut in half was 'doable'. Now, she needs 1.875mg in the AM and 1.25mg in the PM. I can manage to cut the Felimazole into quarters pretty easily.

Sounds purrfect! So you never wanted to try the I131 treatment rather than medicating? I know it is expensive, but I look at it this way: I am just spending my estranged daughter's inheritance.

 

[neely]

So you never wanted to try the I131 treatment rather than medicating?

I don't want to answer for FeebysOwner and I'm sure she will give you her reason(s) for not choosing the I-131 treatment.

Even though our cat had a successful outcome the I-131 is not a "one size fits all" treatment. That is, there are numerous reasons besides expense why people don't choose this method. Just to name a few: their cat has a pre-existing condition that would cause a contraindication, their cat is too old in some cases or after having the series of tests one month prior to receiving I-131 they are not a good candidate for it, etc.

You're wise to do your homework and read about I-131 but there are some other more professional and knowledgeable sites than Reddit which you mentioned. I thought you might be interested in these:
Hyperthyroidism in Cats
Penn Vet | Feline Hyperthyroidism