Hyperthyroidism advice

QueenofWinter

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My cat Pinky was just diagnosed with hyperthyroidism and his vet prescribed methimazole. The medication has some bad side effects. Anyone have any experience with this medication that they’d like to share. Should I be concerned about giving it to my cat? Are their any natural supplements I should look into? I‘m feeling pretty nervous and could use any help you guys can give. Thanks.

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molly92

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I'm so sorry. There are no natural supplements that help with hyperthyroidism. There is a prescription diet that limits iodine, but cats need iodine, so this causes other negative effects.

This might be something that has to wait until after more business restrictions have been lifted, but by far and away the best option for hyperthyroidism is I-131 radioactive iodine treatment. It must be done by a specialized facility, it requires the cat to stay there for about a week, and it is usually around $1000-1500, so vets often recommend methimazole first. BUT, radioiodine is a complete cure, it is very safe (much safer than methimazole), and it only needs to be done once.

When my cat was suspected of having hyperthyroidism I did some research and decided not to even try methimazole at all and went straight to booking her an appointment for the radioiodine. (The methimazole has to be discontinued for a few weeks before the treatment anyway.) Hyperthyroidism is overgrowth of the thyroid, and methimazole doesn't stop the thyroid from growing, it only manages the symptoms. So the thyroid will keep growing and methimazole dosage will need to go up. Radioiodine works by injecting radioactive iodine. The only place in the body that uses iodine is the thyroid, so it all gets sucked up by the thyroid, but because of the radioactivity, it kills off the overactive tumor parts. The effect is pretty immediate, but hormone levels will cycle back and forth for a few months before things level off completely. The radioactive iodine is excreted through the urine, and because a lot of exposure to radioactivity should be avoided, they stay in a special facility until enough radioactivity is excreted that they can legally go home. This is almost the exact same procedure used for humans with hyperthyroidism, except humans flush away their waste so they don't need to be as isolated.

The reason I encourage everyone to do the radioiodine if at all possible is because they hyperthyroidism takes such a toll on the body. Extra thyroid means extra thyroid hormone, which puts the entire body system into overdrive. Heart beats faster, organs work faster, calories burned faster, etc. Everything going faster and faster really puts a toll on organs that only gets worse and worse with time. The day I brought my cat home from the radioiodine, I could immediately tell she felt calmer. Her heart was racing a mile a minute when she climbed into my lap any more. Also, treating with methimazole for life very likely going to be more expensive in the long run than the one time procedure.

The "drawback" to treating hyperthyroidism, with medication or radioiodine, is that kidney function often seems to get worse with treatment. This is not because the treatment hurts the kidneys, but rather the kidneys already had some loss of function but it wasn't detected before because hyperthyroidism was causing everything to get pushed through the kidneys more rapidly. But I 100% think it's better trying to manage kidney disease than being unaware of kidney disease while all of the cat's other organs get ravaged by hyperthyroidism.

For more information, I recommend the Hypurrcat website (the leading experts in feline radioiodine therapy). Hyperthyroidism is an unfortunate disease, but also a relief of a diagnosis because it is completely curable.
 

LTS3

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Here are additional web sites with more information on hyperthyroidism and treatment options:


There is a prescription diet for hyperthyroidism but it only manages the symptoms, not shrink the thyroid growth that is overproducing the hormone. The prescription food must be the only food fed to the cat for the rest of the cat's life. No treats, no commercial canned cat food, table scraps, etc are allowed. Here is info:

 
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QueenofWinter

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I am sincerely grateful for your responses. The information you’ve provided is invaluable to me. I’ve been talking with my mother about the current situation and we’ve decided to continue the methimazole for 30 days, as recommended by his doctor, then to ask about the Radioiodine treatment. I just hope their’s a facility near us that provides that procedure.
 

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fionasmom

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Fiona herself took felizamole for years and had no issue with it. Many people on TCS have done the I-131 treatment so you should be able to get a lot of feedback about it. I did not do it with Fiona as she was old when dxed with hyperthyroidism but had I known that she would live as long as she did, I probably would have considered it...hindsight being 20/20. The idea of what it was did not concern me at all and I was not afraid of the idea of radiotherapy for Fiona.

I would imagine that you are close enough to a referral hospital to get the treatment if you want, given your location in Virginia. There are no supplemental or holistic treatments for this condition but there are websites which will claim that there are.

The food can only be eaten by the cat with the thyroid problem as I recall; other feline household members cannot and that can be an issue with feeding. Even with Fiona, I just thought that it was too hit and miss that she would eat enough of the food, etc. As it was, her pill was administered every day with a pill popper or in BFF wet food.
 
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Twylasmom

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The radioactive iodine treatment is the best solution for sure.

One option for administering the methimazole is to get it compounded into a transdermal gel that you apply to the ear. That can be just as effective as the pills and their are fewer side effects since it doesn't go through the gi tract.
 

kittyluv387

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These medications are like a bandage over a constantly leaking bloody wound. Your cat's heart will deteriorate from this. Highly recommend the I131 treatment if you can afford it. It is a real bona fide cure. Just make sure to get your cat a scintigraphy beforehand so they don't use too much of the substance which can make your cat hypothyroid.
 
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QueenofWinter

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Thank you all for the responses. I’m forever grateful. I have another question. We’ve been crushing his pill into a powder and mixing it into his wet food to get him to eat it. Is it ok to crush the pill? I looked it up online but got mixed answers. The nurse at his vet office said she thought it was ok but wasn’t sure.
 

LTS3

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Call and ask the vet directly. If the answer is no, try using Pill Pockets or one of these TCS tips on how to get pills into a cat:

Pilling Cats: Must-know Tips For Hiding Pills – Cat Articles
The Best Pill-taking Secret I Know...
Pilling Cats and Dogs Safely
How We Give Our Pill Hating Cat A Pill
Getting Cat To Take Pills... Post Tips Here.

Do look into compounding the methimazole if pilling is too difficult even with one of the above suggestions. The transdermal option is popular. One thing to note is to apply the gel to the inside of the cat's ear with a cotton swab or gloved finger if the gel doesn't come with an applicator. You don't want to absorb the medicine through your skin. There are other options such as a flavored chewable treat and a capsule that you open and mix the contents into food. Wedgewood Pharmacy is a popular place to get compounded medicines from but a local compounding pharmacy will also work.
 

moxiewild

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Thank you all for the responses. I’m forever grateful. I have another question. We’ve been crushing his pill into a powder and mixing it into his wet food to get him to eat it. Is it ok to crush the pill? I looked it up online but got mixed answers. The nurse at his vet office said she thought it was ok but wasn’t sure.
Yes, this is fine so long as he eats it and all of it. Most people already give pills in pill pockets - same concept.

Most cats won’t take it crushed because methimazole is an incredibly bitter medication, but if you’re able to mask it with food, then that’s great!
 

moxiewild

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Call and ask the vet directly. If the answer is no, try using Pill Pockets or one of these TCS tips on how to get pills into a cat:

Pilling Cats: Must-know Tips For Hiding Pills – Cat Articles
The Best Pill-taking Secret I Know...
Pilling Cats and Dogs Safely
How We Give Our Pill Hating Cat A Pill
Getting Cat To Take Pills... Post Tips Here.

Do look into compounding the methimazole if pilling is too difficult even with one of the above suggestions. The transdermal option is popular. One thing to note is to apply the gel to the inside of the cat's ear with a cotton swab or gloved finger if the gel doesn't come with an applicator. You don't want to absorb the medicine through your skin. There are other options such as a flavored chewable treat and a capsule that you open and mix the contents into food. Wedgewood Pharmacy is a popular place to get compounded medicines from but a local compounding pharmacy will also work.
Yes, “finger condoms” work well for this.

You also want to ensure a topical has a correctly formulated base and comes in the syringes - not the click pen, which is inaccurate.

Topical methimazole is often way easier to deal with if you can afford it!
 
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QueenofWinter

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I know its been awhile since I replied to this thread, but I wanted to update you all on Pinky’s condition. He is scheduled for his Radioiodine treatment today. My mother is dropping him off right now. I know this is the best thing for him, but I can’t believe how much I’m going to miss him. He should only be gone for 3 - 5 days, but I’ve never had him away for so long. I hope he’s not traumatized when he gets back. I honestly can’t stop crying. Isn’t that crazy?!
 

susanm9006

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I know its been awhile since I replied to this thread, but I wanted to update you all on Pinky’s condition. He is scheduled for his Radioiodine treatment today. My mother is dropping him off right now. I know this is the best thing for him, but I can’t believe how much I’m going to miss him. He should only be gone for 3 - 5 days, but I’ve never had him away for so long. I hope he’s not traumatized when he gets back. I honestly can’t stop crying. Isn’t that crazy?!
No, I went through the same thing when I dropped my girl off years ago for the same treatment. Only they made her stay two weeks!! Anyway, I worried so much because she was such a mamas girl. But they called every day with updates, it all went fine and the treatment and two weeks at “camp” was well worth it. All they do is get them to swallow a pill and the rest of the time it is just cage rest while they become less radioactive. So, a little stress but not much.
 
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QueenofWinter

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No, I went through the same thing when I dropped my girl off years ago for the same treatment. Only they made her stay two weeks!! Anyway, I worried so much because she was such a mamas girl. But they called every day with updates, it all went fine and the treatment and two weeks at “camp” was well worth it. All they do is get them to swallow a pill and the rest of the time it is just cage rest while they become less radioactive. So, a little stress but not much.
Why did she have to stay for 2 weeks? Pinky’s thyroid levels are very high. Normal range is supposed to be 3-4 and his are 18. So I’m worried he may have to stay longer than most cats. They have a live camera feed on him so we can keep an eye on him. He is very scared and is hiding in a paper bag they gave him.
 

susanm9006

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Why did she have to stay for 2 weeks? Pinky’s thyroid levels are very high. Normal range is supposed to be 3-4 and his are 18. So I’m worried he may have to stay longer than most cats. They have a live camera feed on him so we can keep an eye on him. He is very scared and is hiding in a paper bag they gave him.
It really didn’t have anything to do with her thyroid levels. Hers were very high to begin with because she couldn’t take oral meds. But two weeks was just the standard time they kept them to make sure their radioactivity had gone down to safe levels. This is maybe fifteen years ago and possibly the protocol has changed.
 

molly92

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I'm so happy for you and your kitty! This is the hardest part, but soon this will be a distant memory for both of you and he will feel so much better.
 
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