Hyperthyroidism in Feeby - Questions

FeebysOwner

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I know this is a loaded issue/question, but here goes anyway. Feeby (16+ yo) has just been diagnosed with hyperthyroidism. She has weight loss, but no increase in appetite. She is more lethargic (may be old age, and she does sleep a lot), but could also be described as more vocal and a bit 'on edge' at times. No vomiting, no diarrhea, drinking/peeing as usual (always been big on both).
The vet said it is mild, so rather than drugs, he wants to try prescription food (Hill's Y/D canned food). Lots of problems in my mind about this option due to her recent pickiness about her food - not to mention the ingredients in the food. Can't imagine how I can get her to eat this food exclusively for a week, much less the next several months. She can have NOTHING else.

But, before I even talk about radioiodine (another thread, to be issued much later), can we talk about hyperthyroidism symptoms, food changes and/or meds?
My questions to you all -
1.) did any of your cats go through a food pickiness/loss of appetite that you found was related to their hyperthyroidism? If so, was it resolved through a change in diet or with methimazole?
2.) how many have ever tried the food approach, and if you did, how long did it work, and/or is it still working?
3.) how many have gone the med path (methimazole), and if you did, how did it go/is it going?
- side effects - short or long term? How quickly did you see adverse effects, what were they, and did they resolve themselves over time?
- effective ways of administering it?
- were any of you advised you could administer the meds just once daily vs. twice a day (everything I've read said every 12 hours)?

I know this thread and its questions are over-simplifying a complicated issue, but I have to start somewhere. Thanks.
 

mrsgreenjeens

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I've never had a cat with hyperthyroidism, so can't really answer your questions, but did find this thread which you may find quite helpful:

Hyperthyroidism advice

One thing I do know though, is that you can get her medication in transdermal gel rather than pill form, if that's easier to do. I've read on many threads that methimazole is quite effective that way

It's really odd that Feeby's appetite isn't good, isn't it. She must barely have it, else I would think she'd be following you around for food.
 
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FeebysOwner

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mrsgreenjeens mrsgreenjeens - Thanks for the link. I've already researched so much on this, but it was very nice to see the posts from members who have experienced hyperthyroidism with their cats. I've read many posts on this site in the past related to the radioiodine treatment, but it is different in how one processes that kind of data when they are not directly impacted.
It's really odd that Feeby's appetite isn't good, isn't it. She must barely have it, else I would think she'd be following you around for food.
I am not sure, but I did read that there are cats who don't necessarily display some of the most common symptoms. I do know the vet said it was mild, but I am pretty sure Feeby is showing the heart-related signs. If her case is so mild still, it seems like her heart would not have been impacted so quickly, but I am still trying to read up on all of this more.

It could also be that she is developing an unrelated heart condition, but that would seem strangely coincidental given there have been no previous issues detected with her heart. Although I haven't found any correlation, I just wonder if the heart symptoms could actually be what is reducing her appetite.

I am still processing all of this...
 

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firstly, do not expect 16 year old cat reaction to this disease like young people. appetite is very relative under your cats age, comorbidities are common on that age. ie ckd, hepatic/pancreatic disease etc.
the drug really helps controlling hyperthroid. but it has side effects that your cat's need to tested regularly. at least for the first 3 months crucial. if you going to administer this drug you gotta check kidney, cardiac, hypertension and hepatic values.
food helps treatment of mild hyperthroidism. it needs 8-12 weeks to work, if you cannot give the drug to your cat cuz of some side effects etc its good alternative.
lastly you give methimazole twice a day 2.5, once a day do not work properly in cats.
last but the best treatment option is surgery because unlike humans, cats do not require external thyroid hormone daily. they handle it very good. (but for 16 year old cat that is a decision hard to make and should be done by professionals.)
 

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Fiona herself was hyperthyridic. She was dxed at about 12 or 13 and lived to be 16 1/2 approximately. I did not consider the radio iodine treatment as it was not suggested that strongly by my vet but if I had a cat now who were dxed I would want more information. I don't believe that my vet had any reasons for not talking it up such as bad experiences with it, etc. She was disinclined to go all out in most cases, competent in what she did, but I did take my dogs to another vet eventually. Cats don't see her anymore either.

Fiona was a little picky with food, not sure if I would have picked it out on my own as it was a blood test that gave the first warning. I did not consider the special food as I could not control who else might eat it when I was at work or whether Fiona would eat it. I think we tried one can to see if she would and it did not appeal to her, but then absolutely no one has ever eaten prescription food. I gave her felimazole which I crushed and put in BFF pouches as she loved that food and took the pill that way. We were quite successful with this and she followed this protocol for 4 years. I never saw any side effects from the medication and she seemed to feel good and resumed her normal life. She was unable to jump, so was allowed in the back yard when I was home and could monitor her. She loved to sit out and many lizards and pigeons lost their lives due to the fact that she was a steel eyed killer who evidently felt well enough to continue her hunting.

I gave the meds every 12 hours and did not question if it could be altered. It fit my work schedule. Of course you would be running all the usual blood tests to see if everything else was acceptable.
 

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I've never had a cat with hyperthyroidism, so can't really answer your questions, but did find this thread which you may find quite helpful:

Hyperthyroidism advice

One thing I do know though, is that you can get her medication in transdermal gel rather than pill form, if that's easier to do. I've read on many threads that methimazole is quite effective that way

It's really odd that Feeby's appetite isn't good, isn't it. She must barely have it, else I would think she'd be following you around for food.
The transdermal also has fewer side effects, such as gastrointestinal upsets, than the pills.
 

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I know this is a loaded issue/question, but here goes anyway. Feeby (16+ yo) has just been diagnosed with hyperthyroidism. She has weight loss, but no increase in appetite. She is more lethargic (may be old age, and she does sleep a lot), but could also be described as more vocal and a bit 'on edge' at times. No vomiting, no diarrhea, drinking/peeing as usual (always been big on both).
The vet said it is mild, so rather than drugs, he wants to try prescription food (Hill's Y/D canned food). Lots of problems in my mind about this option due to her recent pickiness about her food - not to mention the ingredients in the food. Can't imagine how I can get her to eat this food exclusively for a week, much less the next several months. She can have NOTHING else.

But, before I even talk about radioiodine (another thread, to be issued much later), can we talk about hyperthyroidism symptoms, food changes and/or meds?
My questions to you all -
1.) did any of your cats go through a food pickiness/loss of appetite that you found was related to their hyperthyroidism? If so, was it resolved through a change in diet or with methimazole?
2.) how many have ever tried the food approach, and if you did, how long did it work, and/or is it still working?
3.) how many have gone the med path (methimazole), and if you did, how did it go/is it going?
- side effects - short or long term? How quickly did you see adverse effects, what were they, and did they resolve themselves over time?
- effective ways of administering it?
- were any of you advised you could administer the meds just once daily vs. twice a day (everything I've read said every 12 hours)?

I know this thread and its questions are over-simplifying a complicated issue, but I have to start somewhere. Thanks.
First really sorry to read this.

Our prior cat Casper, developed hyperthroid late in life. Because he was already so far into being a senior (I think he was 16ish when diagnosed) our vet recommended we NOT do radiation therapy and we certainly were not going to put him into surgery. So we opted to pill him daily. He also was on the mild end of the disease but was being treated for kidney disease, diabetes and various other health issues.

Anyway

1. Absolutely noticed a change in appetite. His diabetes was under control at that time. I remember it became more difficult to get him interested in food. Gerber baby food became an almost daily "treat" because it was the only thing I knew he'd eat. At least some calories was going into him.

2. I never even heard of a food control way of treating this. Our vet never mentioned it. It's medication, surgery or radiation therapy. Maybe just being careful of carbs (there's a correlation with HT and diabetes) and certainly the amount of iodine in the food which one could easily find out. And high protein is a must.

IDK, my feeling is that at an advanced age, why not just feed what the cat loves instead of trying to force it into something they are less enthusiastic about. Figure out what needs to be avoided and I'm sure there are regular wet cat foods (I would avoid dry) that will be appropriate for Feeby. Plus my understanding is that these diet foods are meant more for when the cat isn't able to be treated in any other way.

3. As already mentioned we used pills. Casper had no side effects. I don't recall how long it took for him to start feeling better (and acting more normally) but the pills certainly made a difference. Had no problem giving them to him, I'd hide it in a lump of cream cheese, which he adored. His dose was low so we were able to split one pill into 4 and he'd get 1/4 2x daily but I'm sure every cat is different so dosages will vary as will the methods of administering it.

Here's a site that may be helpful; it addresses the Hills Y/D diet - both pros and cons

https://www.animalendocrine.com/wp-content/uploads/2011/01/Nutritional-Management-of-Feline-Hyperthyroidism-VMA-NYC.pdf
 
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FeebysOwner

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Thank you so much!!!!
Our prior cat Casper, developed hyperthyroid late in life. Because he was already so far into being a senior (I think he was 16ish when diagnosed) our vet recommended we NOT do radiation therapy and we certainly were not going to put him into surgery. So we opted to pill him daily. He also was on the mild end of the disease but was being treated for kidney disease, diabetes and various other health issues.
Do you know why at Casper's age (Feeby is 16+yo) that they recommended against radioiodine treatment - was it because of his other health issues?
 

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Thank you so much!!!!

Do you know why at Casper's age (Feeby is 16+yo) that they recommended against radioiodine treatment - was it because of his other health issues?
Both
First, his health prohibited it. Being as he had so many other concurrent illnesses going it was pretty much out of the question (he had a slight murmur). In fact, sometimes the HyperT will hide an underlying kidney problem and I believe, some vets will do a medication trial first anyway. They are then tested and if the renal functions are stable they could be a candidate for the radiation therapy. Since Casper already was known to have kidney disease, right off the bat it was prohibited.

Second, was his age and general temperament. He would have had to be kept at the hospital for several days after treatment. We felt he would not be happy away from home for that long and to complicate it, afterwards you are supposed to limit your exposure to the cat for a few weeks. That would have meant he couldn't sleep with us and his usual routine was always to snuggle up against me in particular, and he would spend nearly the entire night in bed with us. It's a very low level of the radioiodine left but still, one really needs to keep away from the cat as much as possible. He was also very gregarious and attached to us - really, wouldn't have been good for any of us.
 

Antonio65

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Feeby (16+ yo) has just been diagnosed with hyperthyroidism. She has weight loss, but no increase in appetite. She is more lethargic (may be old age, and she does sleep a lot), but could also be described as more vocal and a bit 'on edge' at times. No vomiting, no diarrhea, drinking/peeing as usual (always been big on both).
Hi FeebysOwner FeebysOwner , I'm sorry you have to deal with this crazy disease.
You might have followed my story with my cat Pallina a couple of years ago.
She was diagnosed with HT at 16 years of age, though her symptoms were th opposite I would have expected. She was quieter, more lethargic, less hungry, which led her to lose weight, not edgy at all.
The vet said she was suffering from an uncommon form of HT which is called Apathetic Hyperthyroidism.

The vet said it is mild, so rather than drugs, he wants to try prescription food (Hill's Y/D canned food). Lots of problems in my mind about this option due to her recent pickiness about her food - not to mention the ingredients in the food. Can't imagine how I can get her to eat this food exclusively for a week, much less the next several months. She can have NOTHING else.
I tried with that wet food, I bought three or four cans, she liked it and I bought more, but then, she disliked it, as I was sure she did, because I knew already that that food isn't appreciated by cats at all.

1.) did any of your cats go through a food pickiness/loss of appetite that you found was related to their hyperthyroidism? If so, was it resolved through a change in diet or with methimazole?
Pallina didn't become picky, she lost her legendary appetite anyway due to the disease and an IBD that was tormenting her. Using the methimazole (pills first, cream later) seemed to improve things a little. She was also in therapy for her IBD, so I don't know which gave her the boost to eat more.

2.) how many have ever tried the food approach, and if you did, how long did it work, and/or is it still working?
Tried food, had to give up before a week was gone.

3.) how many have gone the med path (methimazole), and if you did, how did it go/is it going?
We used the methimazole from day 1, pills for about three months, then we followed the path of the ear cream which was way better.

- side effects - short or long term? How quickly did you see adverse effects, what were they, and did they resolve themselves over time?
Side effects: I'm sure the pills worsened her stomach issues and gave her a little more nausea. I noticed these side effects after, probably, three weeks/a month? They didn't reverse, until we switched to ear cream.

- effective ways of administering it?
Depending on the cat. Pills had always been a problem with Pallina, no matter how tiny they were, and the methimazole pills were absolutely tiny, so tiny that if I dropped one it was lost. They were fractions of a bigger pill for human use, I had them divided in fractions by the pharmacist for free. A box of 100 pills was €4.00, each pill had to be divided in 8 parts. A fraction of a pill twice a day.
Using the cream was way better. No fights with Pallina, just a pass of my finger inside one of her ears twice a day. I would cover my finger with a finger of a disposable glove. A glove would provide me 5 fingers, so I had two days and a half worth covering of finger.
The con of the crea was that it was much more expensive. Two weeks of cream in a small syringe were about €18, and I had to go to the compound pharmacy every 2 weeks for a new syringe to be kept in the fridge.

- were any of you advised you could administer the meds just once daily vs. twice a day (everything I've read said every 12 hours)?
You're right, the gold standard advice is to give the med twice a day because this way the levels of methimazole in the cat's system are more constant along the day, without sudden peaks.
I don't want to paly the vet here, but most vets advise to give 2.5 mg twice a day, which is way too much. All forums and groups on HT cats advise users to start with 1.25 mg twice a day. The time of the day when you administer the med has to be respected, if it's 8 am and 8 pm, then you shouldn't change to 7 am and 9 pm the next day.

The dosage of the methimazole has to be constantly adjusted along the course of the therapy, that's way a blood test for thyroid levels is advised every 5-6 weeks. The med takes about 3-4 weeks to show its effect on the body, so you have to wait at least this lapse of time before re-check.

The methimazole isn't a cure, it's a palliative treatment to keep the symptoms of HT at bay, or under control, but the disease goes on and on and it can only get worse. The med also gives other side effects, like kidneys, heart and stomach damages, which, in some cases, can be irreversible.
This is the reason why the iodine treatment is the best way to go.
Some health issues with the cat, typical of the senior age, when HT also shows, might be an obstacle to the iodine treatment, but don't let them discourage you. Pallina had a slight kidney disease, a very slight heart murmur, her IBD and cholangio-hepatitis, along with a mysterious lung disease. At first sight, the vets at the facility were going to refuse her, but then they discussed it and went on all the same, and I will never say thanks to them enough.

Best wishes!
 
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Second, was his age and general temperament. He would have had to be kept at the hospital for several days after treatment. We felt he would not be happy away from home for that long and to complicate it, afterwards you are supposed to limit your exposure to the cat for a few weeks. That would have meant he couldn't sleep with us and his usual routine was always to snuggle up against me in particular, and he would spend nearly the entire night in bed with us. It's a very low level of the radioiodine left but still, one really needs to keep away from the cat as much as possible. He was also very gregarious and attached to us - really, wouldn't have been good for any of us.
My cat stayed away 4 days only, and though I was advised against staying close to her in the weeks after the treatment, I disregarded it totally. I thought that if the lingering radiations were safe on a 4 kg cat 24/7, why would they have been harmful on an adult human being in contact with that cat a few hours a day?
 

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My cat stayed away 4 days only, and though I was advised against staying close to her in the weeks after the treatment, I disregarded it totally. I thought that if the lingering radiations were safe on a 4 kg cat 24/7, why would they have been harmful on an adult human being in contact with that cat a few hours a day?
To each their own. We did not want to chance it.

FeebysOwner FeebysOwner Our vet prescribed Cerenia to combat Casper's nausea. We'd give a 1/4 of a pill daily for a few days, then it gets stopped. Almost always that helped him for a couple of weeks if not more. Rinse and repeat as necessary.
 

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FeebysOwner FeebysOwner Adding, if Feeby is a candidate for the treatment - keep in mind it will be costly to do since there are fw vet hospitals which do this and they could be far from home. The one we would have had to bring Casper to was about an hour away from us, and the only one in our state with that facility.
One needs to compare cost of that treatment over a lifetime of administering medication. If a cat is young, for sure I'd have opted for the treatment but with an elderly cat, their time with us is always questionable. As it turned out, Casper wasn't with us for much over another year or so after diagnosed with the HT. He passed due to his kidneys finally failing to the point where nothing would have helped.
 
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FeebysOwner

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Antonio65 Antonio65 & sivyaleah sivyaleah - thank you both so much! I truly appreciate you taking the time to share information with me - you have no idea how much it means to me.
We used the methimazole from day 1, pills for about three months, then we followed the path of the ear cream which was way better.
I have read the transdermal gel is not as effective, but does have less side effects. Were you told the same thing about the cream?
Casper had no side effects... Our vet prescribed Cerenia to combat Casper's nausea.
So, the Cerenia was for another purpose unrelated to the methimazole?
keep in mind it will be costly to do since there are fw vet hospitals which do this and they could be far from home. The one we would have had to bring Casper to was about an hour away from us, and the only one in our state with that facility.
I don't mind the expenses associated with all of this, really - not if it gives Feeby relief from whatever effects she is currently going through related to the hyperthyroidism. I think I have a VCA hospital very close by that does the radioiodine treatment - need to pursue more information on that.

But, I too, am reeling over the idea of her being away from me for at least 3 days - we really haven't been separated much over a few hours for most of her life. She, too, sleeps with me most nights...another mental hurdle to cross.

As I said before, I expect to go down the med path first, if for no other reason than to try to eventually get my vet on board about considering the radioiodine treatment. That is assuming, her racing heart is related to the hyperthyroidism and no kidney issues are unmasked after she has been medicated for a while.
 
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We tried the pills and the diet with Felix. He was getting better but I was told it would only slow down the damage the hyperthyroidism was doing to his body. He also hated the food so getting him to eat it was frustrating. The ingredients were pure trash and it was super expensive. That on top of the pills, I figured it would be better to just spend the $1,400+ for the radioactive iodine. I made a thread here that details everything that happened but I don't remember what it was called. This was all 2 years ago so my memory is foggy. Everything happened so fast. I don't even think he was on the pills for very long before I decided to go through with the treatment. Before he was diagnosed, he would eat a ton but not gain any weight. I didn't know cats could have thyroid issues so I didn't think much of it, just fed him more. But we took him in for a full physical and that's when they told us his T4 was high. He got the methimazole pills twice a day. I'd sit on top of him, pry his mouth open and drop it down. Then close his mouth until he swallowed it. He's alright now. He just has some teeth issues. I gotta get the rest pulled. But I hardly even remember him having high T4 because he's pretty much back to normal.

Oh! Also, he was away from me for an entire week. It was so weird not having him around and I checked up on him frequently. I wore a shirt until it got smelly and left that with the doctor for him and he dragged it around the whole time and slept on it from what they told me. The clinic was 2 hours away. We had to rent a car. The other option would have been New Brunswick. Thank God we found one closer.
 

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Antonio65 Antonio65 & sivyaleah sivyaleah - thank you both so much! I truly appreciate you taking the time to share information with - you have no idea how much it means to me.
Such moving words :)

I have read the transdermal gel is not as effective, but does have less side effects. Were you told the same thing about the cream?
No, I wasn't. What I saw that we got better result from it. The blood panel we did after starting the gel were better than the ones we did during the pills period.

I don't mind the expenses associated with all of this, really - not if it gives Feeby relief from whatever effects she is currently going through related to the hyperthyroidism.
That's the kind of approach I like!

As I said before, I expect to go down the med path first, if for no other reason than to try to eventually get my vet on board about considering the radioiodine treatment. That is assuming, her racing heart is related to the hyperthyroidism and no kidney issues are unmasked after she had been medicated for a while.
Also because I think that all radioiodine facilities want you to have done a period with methimazole in order to stabilize/assess the disease.
Then you will be asked to stop the medication a few days (4 to 7 days, according to the facility) prior to the treatment.
I strongly advise you to go to a facility where they can perform the scintigraphy as well. It is strongly recommended because it helps the doctors to dose the radio iodine to be injected to the cat.
Too low a dose, the cat could have the treatment repeated a few months later.
Too high a dose, the cat will become HYPO-thyroid, and there's no way back.
The scintigraphy is able to assess the precise dimension of the mass in the cat's throat and the possible presence of hectopic masses.
 

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FeebysOwner FeebysOwner I do believe that the hyperthyroidism played a part in her demise and that it ran its course; she also had been dxed with kidney disease near the end. She became very thin and weak and I made an appointment to have her put to sleep but when I returned to the house that day she had passed away in her sleep.
 
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FeebysOwner

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FeebysOwner FeebysOwner I do believe that the hyperthyroidism played a part in her demise and that it ran its course; she also had been dxed with kidney disease near the end. She became very thin and weak and I made an appointment to have her put to sleep but when I returned to the house that day she had passed away in her sleep.
I am so sorry. I know what it is like to come home and find that your cat has passed away - that happened with Gracie who had cancer.
Anyway, I would like first for Feeby to get on some form of the meds, be that oral pill or liquid, or transdermal gel, so that we can see if her activity/anxiety based heart-racing subsides and to make sure she doesn't have an underlying kidney issue. If those two things are met with positive outcomes after med treatment, hopefully by then I will have been able to wrap my head around 'abandoning' her at a hospital for how ever many days our state laws mandate.

I know there is no 'cure' with the meds, and any tumors will continue to grow and possibly become cancerous - but maybe I am being unrealistic to think that at her age going for radioiodine treatment is the best for her. It's just that aside from this most recent health issue, as far as I know she is in relatively good health for a 16+ yo. I was hoping it would stay that way.
 

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I think that you are taking a good approach for Feeby. Fiona did well with the pills but I would not discourage you from pursuing the radioiodine treatment if you think that it would be best. I am not sure how Fiona would have done left at a vet clinic for days on end so I understand your concern about that. Fiona was in good health and might have done well with the treatments but, as I said, it was not discussed with me at the time.
 
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