Hyperthyroidism in Feeby - Questions

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FeebysOwner

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Frukto oligosakarida translates to Fructo-oligosaccharides in English - and is also known as Chicory Inulin Hydrolysate. It is used as a sweetener in some foods, but is also used as a prebiotic on the assumption that it promotes good bacteria growth in the intestines. Although, from what I have read about it, there is no solid evidence to verify that it does promote good bacteria growth in humans, much less cats. It is added to many processed foods, mainly as a prebiotic or fiber supplement.

Some of the bacteria in Probiotic Optima are also in some of the supplements like Azodyl, but I don't think this particular product is available in the US.
 
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MissClouseau

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Frukto oligosakarida translates to Fructo-oligosaccharides in English - and is also known as Chicory Inulin Hydrolysate. It is used as a sweetener in some foods, but is also used as a prebiotic on the assumption that it promotes good bacteria growth in the intestines. Although, from what I have read about it, there is no solid evidence to verify that it does promote good bacteria growth in humans, much less cats. It is added to many processed foods, mainly as a prebiotic or fiber supplement.

Some of the bacteria in Probiotic Optima are also in some of the supplements like Azodyl, but I don't think this particular product is available in the US.
You may order it from Turkey maybe. Our currency is doing horrible so it might cost cheaper than you think.

This is their Amazon Turkey link: NBL Probiotic Optima 30 Çiğneme Tableti : Amazon.com.tr: Sağlık ve Bakım

If they don’t ship it to the USA it might help to email the manifacturer. I know it’s not as easy as getting something from the USA but just putting it as an option.
 
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FeebysOwner

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Today was Feeby's specialty vet visit - while some good news, no real definitive path forward. Poor little girl endured x-rays, sedation, belly shave, echo, abdominal ultrasound, BP Doppler, and another urine culture. In at 8:30AM - and out at 1:00PM. They are praising her overall condition for a cat of ~17 yo!!!!! I am praising her because she is one hell of a trooper! Came home to want to eat and eat and eat!!

No enlarged heart, no fluid in the chest cavity, no 'definitive' heart murmur. She does have a leaky valve, which is most likely due to old age and is not something that requires treatment. Asthma was not ruled out, but no treatment was recommended at this time.

Definitely has CKD, but since her kidney values are what they consider stable, no action is needed. She does have what they call dilation of the part of the kidneys leading to the ureters and into the ureters themselves (bilateral pyelectasia/proximal hydroureter), so that could be new or it might be an older condition that was never identified before, given her past with stones/UTIs. It could also be a kidney infection, so they did take urine for a culture to be done. Results won't be until late this week, or early next week.

She does have one adrenal gland that is enlarged, but they see nothing that looks like a mass (benign tumor or cancer). However, since it is enlarged it could be over-producing hormones that might explain the occasional rapid breathing.

Her spleen is enlarged, but another inconclusive observation. It could mean cancer or it could mean nothing. A fine needle aspiration would be needed to analyze the tissue.

BP was once again slightly high, but not enough to suggest any meds.

Recommendation was to do another abdominal ultrasound in about 3 months to monitor the kidneys/ureters, adrenal gland, and the spleen. Otherwise, observe her for changes and stay the course. No need for B Complex, especially if it is deterring her from eating her food and taking her H-T meds.

I guess I should be happy, but it just seems that Feeby is 'border line' on all aspects, so no one thinks much should be done other than observation. It is sad that a cat has to get really sick before somebody sees the need for more action.
 

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(((HUGS)))) Honestly, I think this is a great report!! I really do...
Feeby is an awesome cat ..... She is doing so good. It is a testament to your love and care.

Borderline is good... It really is... If it were me, I would happy with this.. and follow to up with an a repeat ultrasound in 3 months.

I know it is frustrating.. All of us... humans included; have to have really 'bad' things before anything is picked up on imaging exams. This is from my own experience; both as a medical professional and as a regular person..

(((Hugs))) love, and prayers to both of you... This is really painful to go through...
:vibes::vibes::vibes:
 

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Congratulations on making it through the appointment....to both of you. It is probably a toss up as to who had a harder time enduring all that. It does sound as if Feeby got a good report for the most part which is not surprising given the excellent care you have given her.

I can say conclusively that if the enlarged adrenal gland is producing hormones, it is causing the panting....or at least is playing a part in it.

Do you want the vet to address some of those issues right now? I really do see your point about taking a wait and watch approach, which seems very common so much of the time. My cat vet, and even the cardiologist Jamie saw, both are following the exact same train of thought. Do they think that at Feeby's age it is better to monitor than to treat?
 
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Congratulations on making it through the appointment....to both of you. It is probably a toss up as to who had a harder time enduring all that. It does sound as if Feeby got a good report for the most part which is not surprising given the excellent care you have given her.
I can say conclusively that if the enlarged adrenal gland is producing hormones, it is causing the panting....or at least is playing a part in it. Do you want the vet to address some of those issues right now? I really do see your point about taking a wait and watch approach, which seems very common so much of the time. My cat vet, and even the cardiologist Jamie saw, both are following the exact same train of thought. Do they think that at Feeby's age it is better to monitor than to treat?
Thanks! I do think that given her age, they all feel 'wait and see' is the best mode. And, I understand that to a point. She is the 'energizer bunny', until she is not. She has got 'moxie' that I do not!!!
 

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I do think that given her age, they all feel 'wait and see' is the best mode.
I had a feeling this is what they were implying by your comments. And I would agree this is good news. :thumbsup: I'm sure you were pleased Feeby got such a thorough exam albeit the length and time it took to evaluate her. Feeby's health and longevity can be attributed to your diligence and perseverance. I know you leave no stone unturned when it comes to her care.:heartshape:
 

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She does have one adrenal gland that is enlarged, but they see nothing that looks like a mass (benign tumor or cancer). However, since it is enlarged it could be over-producing hormones that might explain the occasional rapid breathing.
This is the part of your post that startled me!
Did they tell you how enlarged the gland is? Did they say anything about it? Do they think to run a test on the aldosterone hormone?

Lola had it too. It was found out during a routine ultrasound scan for her CKD. The vet said the right gland was three times larger than the left one, but that no action was required yet... then our nightmare began!

I would advise you to keep a close eye on this.
 
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This is the part of your post that startled me!
Did they tell you how enlarged the gland is? Did they say anything about it? Do they think to run a test on the aldosterone hormone?
Lola had it too. It was found out during a routine ultrasound scan for her CKD. The vet said the right gland was three times larger than the left one, but that no action was required yet... then our nightmare began! I would advise you to keep a close eye on this.
The vet said it was enlarged but I don't recall if she actually said by how much. She never mentioned testing her aldosterone level. She actually said that removing the gland would be about the only way to investigate the significance of the enlargement - and, of course, she said that would not be her recommendation to do so. I suspect she is assuming the hormone level is high based on the gland's size and the possibility it might be behind the occasional fast breathing. Oddly enough, I have a benign tumor on one of my adrenal glands - I was told tumors are fairly common and are generally always benign - but, those comments were made based on human medical data, and may or may not apply to cats.

She is more concerned about the condition of the kidneys as I explained above, and if it is related to an infection, then she wants to get treatment going. If not, it is being assumed that this is something that has developed over years, and is likely to remain static - and, is independent of her CKD.

Feeby is paying the price for yesterday's events. She threw up late last night for no apparent reason, and today she doesn't want to eat (other than baby food meat). She is quite subdued and quiet. I am hoping she 'shakes this off' by tomorrow.
 
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Poor baby is exhausted and will probably recover herself after some rest at home. I know of no Cushing's/Addisonian dogs who had the tumors removed to be tested. I am sure that some have, but if that is an issue, I am with Antonio65 Antonio65 on hormone testing.
She seems like maybe she is rebounding a bit (fingers crossed)!

I will ask about the aldosterone testing, but I think her issues overlap with typical H-T and CKD symptoms that it is assumed those are her causes. The only other thing I have to go on is that it would seem Addison's disease results in shrunken/atrophied adrenal glands, and it is common for sodium and potassium levels to be abnormal, as well as an abnormally low heart rate, not to mention dehydration. None of these apply to Feeby. As I said, the other related symptoms apply to both of the conditions she is deemed to have. But, it is worth a follow up question.
 

Antonio65

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I'm not talking about Cushing's or Addison's, I'm talking about hyperaldosteronism, which is what my Lola had.
She had an enlarged adrenal gland, low potassium level, extreme weakness (because of the low potassium), BP surges (that led to blindness), mild dehydration.
A simple aldosterone testing would clear any doubt away.
 
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I'm not talking about Cushing's or Addison's, I'm talking about hyperaldosteronism, which is what my Lola had. She had an enlarged adrenal gland, low potassium level, extreme weakness (because of the low potassium), BP surges (that led to blindness), mild dehydration. A simple aldosterone testing would clear any doubt away.
Yes, I read about that - it is called Conn's Syndrome. So far, Feeby is not exhibiting any of the most common signs (except the enlarged gland) of this syndrome, and certainly none of the ones you described above. I think that is why this specialty vet didn't suggest testing her aldosterone level. But, I will still ask about the test anyway.
 
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In continuing to research Feeby's adrenal gland issue - I ran across a term used by the specialty vet in our discussion that is no where in her written report. Pheochromocytoma - an adrenal gland cancer. While relatively rare in cats, in over 50% of the cases identified, the cats were generally asymptomatic, and if there were any symptoms they were typically intermittent. Removal of the affected adrenal gland is the only viable treatment.

Given the vet mentioned this particular condition, I am guessing that is something she is considering. She kind of glossed over it, so until I came across the term today I had pretty much 'forgotten' it. I will ask for clarification as to whether this is her underlying suspicion. The only conclusive way to confirm this tumor is through removal of the gland for tissue analysis. She wrote in her report that removal would be the only option for determining the significance of the enlargement.

This would also explain why she didn't suggest running any other tests to determine adrenal function. Follow up ultrasounds, and/or CT scans, to monitor it (and Feeby's other issues) is probably the only thing to be done at this point, and that is exactly what she proposed.
 

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I did not know this particular term, never heard of it before, but good to know it has a name.
I wonder if what Lola had, had the same name. What they told me was that Lola had an adrenal adenocarcinoma and that it had to be removed as soon as possible.

As I wrote earlier, it was first noticed during an ultrasound scan for her CKD, but the specialists wanted to run a CT scan to assess the precise position and size of the mass. This was done the day before the surgery.

All the vets involved in this story told me it was an extremely rare condition, and it seems that only a case a year is diagnosed worldwide. Don't know if it is true, but the websites I had read told of around 45 known cases in the previous 35 years in the world.

Hope Feeby is doing fine.
 
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