Hyperthyroidism in Feeby - Questions

Antonio65

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My cat Pallina had stopped eating her usual amount of food, she was much less hungry than her usual, she was quieter too. She was losing weight.
At that time my other cat Lola was seriously sick and we were all so sad and depressed.
Pallina was a very sensitive cat, so I mistook these signs and thought she was sensing our mood.

A few months later Lola went to the Bridge, Pallina didn't resume her habits, so three or months later I took her in to the vet and he said he was suspecting HT.
I said he was wrong because Pallina was showing symptoms that were the opposite, and he said it was an uncommon case of Apathetic HT.

You know the rest of the story, she was put on methimazole pills, then eargel, which was easier on her stomach. I joined that group where they gave me lots of suggestions that my vet agreed with.
Because I had rejected the pills from the beginning, I started looking for a facility that could do the I-131, and I had the luck to cross that member that helped me.

As far as I know, the Apathetic HT shouldn't interfere with the meds differently to the common form of the disease.
The group was informed of Pallina's uncommon condition, but didn't said anything different to what they said to others.
Anyway, if you want to look for more info about this, you are doing the right thing.
 
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fionasmom

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Fiona had no side effects to the meds at all.....you want to watch for them, but we are all too used to the commercials for meds which have to disclose that two of the side effects are cancer and death.

You will soon determine who the most reliable members are in the group, as Antonio65 Antonio65 has pointed out. Groups like these always have a few of the overly blunt, or even the zealot who is on the wrong trajectory, but once you sift through, you will figure out who to listen to.
 
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FeebysOwner

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Fiona had no side effects to the meds at all.....you want to watch for them
I hope Feeby follows in Fiona's path and is side effect free. I will watch for side effects, but as I said before, with her seeming to be apathetic H-T, that is going to be bit harder to do.
 

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Hi FeebysOwner, I've read the thread with great interest and wonder how Feeby is doing? I hope she's doing OK :) I wonder what dosage you settled on in the end? I'm new here and my cat Panda (14 years) was just diagnosed with Hyperthyroid (her T4 was 96). The vet also prescribed methimazole at 2.5mg twice a day, she weighs 4kg and is fairly good condition. Her thyroid symptoms were very subtle, and she was only diagnosed last week when they checked her blood prior to a tooth extraction. I'd like to suggest a lower dose to my vet, and wonder if you settled on the 1.25mg twice daily for Feeby?
 
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FeebysOwner

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Hi FeebysOwner, I've read the thread with great interest and wonder how Feeby is doing? I hope she's doing OK :) I wonder what dosage you settled on in the end? I'm new here and my cat Panda (14 years) was just diagnosed with Hyperthyroid (her T4 was 96). The vet also prescribed methimazole at 2.5mg twice a day, she weighs 4kg and is fairly good condition. Her thyroid symptoms were very subtle, and she was only diagnosed last week when they checked her blood prior to a tooth extraction. I'd like to suggest a lower dose to my vet, and wonder if you settled on the 1.25mg twice daily for Feeby?
Hi! Feeby's T4 was 4.5 when this all started. Her free T4 was >100. So, I am not sure which reading you are referring to with Panda. However, while the vet wanted Feeby on 5mg twice a day, I whittled him down to 2.5mg twice a day. And, then a member on this site recommended I join this blog: feline-hyperthyroid groups.io Group. After consulting with them, I convinced the vet to lower the dose to 1.25mg twice a day, and that is what she is currently on. She had 5 days at the 2.5mg twice a day, and for the past 15 days it has been at the lower amount. She is due for her first re-check later this week, so we will then see if the dosage is appropriate.

Feeby's symptoms were pretty much isolated to weight loss and a higher heart rate. And, over the course of the past 1 1/2 years her T4 was steadily climbing, as her weight was slowly decreasing.

I would highly recommend that you join the group above and see what they say. They are a bit conservative about the starting dose, saying that doing so helps reduce/avoid side effects from the meds - most common being vomiting/diarrhea. So, I am guessing that they might tell you it would be wise to start at the lower rate of 1.25mg twice a day. That seems to be their baseline. You just have to get used to the idea, if that is what they tell you, and then discuss your worries about side effects and too high of a dosage with the vet to get them to buy into a lower dose, if applicable. I think the group's thought process is the lower dose helps give the cat's body time to adapt to the meds. This group often refers to Dr. Mark Peterson at the Animal Endocrine Clinic in NY - Animal Endocrine Clinic | Where science and compassion cure. Also, a good resource for information!!

As my vet and I discussed, the worse case scenario is that we will have to raise her dose if the current amount hasn't gotten the appropriate results. You can also read through my thread on that site, if you wish: (Feeby - new diagnosed with hyperthyroidism)


Keep me posted, and I will look for your post on that group's site as well!!
 

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Thank you so much, FeebysOwner! This is so helpful, I'll join the group and will keep you updated, and I look forward to hearing how Feeby is doing after her check this week! I think you did very well to ''negotiate'' your vet down from 5mg x twice a day, that did seem very high! It makes sense to start lower, and increase the dose if/as needed. This is strong medication! Oh yes I'd got my T4 results confused :) It must have been her free T4 that measured 96. She's been on both Methimazole (thyroid) and Metacam (pain relief) over the past 5 days since she had her 2 teeth extracted. However her appetite was very low, and she barely ate two days ago, which had me very worried. I stopped both pills immediately (after consultation with vet) as both meds can cause anorexia/nausea.

Thankfully it worked and she ate very well yesterday and today! I'm not sure if the culprit was the Methiamazole or the Metacam, but having read a bit more about Methiamazole, I'm going to discuss her dosage more with the vet tomorrow. Panda mostly hid her thyroid problem from me, she didn't lose weight or cry constantly for food. Her only changes were more vocalising, slightly more irritated behaviour and lying on the floor resting a bit more (perhaps those indicators may help someone reading this! :) I'll look forward to reading more tonight and will check out Mark Peterson's research, another great resource thank you! :)
 
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FeebysOwner

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I took Feeby in last Friday for her follow up blood work. The vet called Monday and told me that her thyroid level was down to the mid-range of normal and there was no change in any of her kidney values. So, he said to 'stay the course' and, unless I want it sooner, he would recommend re-testing in 3 months. I hadn't posted here as I was waiting for a copy of the test results. And, just today, I was able to review them.

T4 down to 2.6 from 4.5 (10/20). BUN was higher than before, but creatinine was pretty much the same as last blood work. I understand that BUN can be impacted by many things, including stress and a tad bit of dehydration, so I'll reserve judgement on this. HOWEVER, her triglycerides went through the roof!!!! 396 (compared to the last 3 readings of 53, 58, 98 - reverse chronological order going back to 4/2019).

I asked the H-T forum about this, no one seems concerned - blowing it off to possible food consumption shortly before testing. That was not the case - pretty consistent in terms of when she last ate before the previous tests. The forum did state that Feeby needs to be tested sooner than in 3 months. I haven't found much on any correlation between H-T, H-T meds, and elevated triglycerides, but I cannot understand why such a change if there is not a connection.

I know not many members are following this thread, but did anyone else have such an elevation in triglycerides following H-T meds? Any other insights????
 

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I don't know if there are any solid explanations for this, but there is a connection between hypothyroid ( I did mean to write hypo in this case) and high triglycerides. I have had two dogs with high triglycerides...a border collie mix and it does run in collie breeds, and the current boy who has Cushings. With the collie, I remember the vet saying something about a condition that does not produce high cholesterol in animals but specifically high triglycerides. The dog also had hypothyroid, as does Cushing's boy. Frankly, it never went anywhere with either dog in terms of longevity or health. Often it is connected to other conditions that you have probably ruled out or that Feeby does not have to begin with. Big meal before the test is another explanation as you have found out from the forum. This is probably some sort of a rule out process, or a retesting to see what happens the next time...but frustrating. I am glad that Feeby received other good news in the report though.

Fiona never had high triglycerides and she was treated for hyperthyroidism for several years and was a very big girl at one time.
 

fionasmom

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I have been thinking about this and while it was years ago...the border collie passed on in 2010...I recall her vet telling me that while high triglycerides in a dog could indicate another condition, it was not the same risk as in humans where you might need a drug to lower them. She felt that the number was not itself an indicator and that in animals it could be much higher than humans without the same consequences.
 

Antonio65

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I took Feeby in last Friday for her follow up blood work. The vet called Monday and told me that her thyroid level was down to the mid-range of normal and there was no change in any of her kidney values. So, he said to 'stay the course' and, unless I want it sooner, he would recommend re-testing in 3 months.
I wouldn't wait 3 months before the next test. Things may change meanwhile and you wouldn't be able to catch those changes in time.

T4 down to 2.6 from 4.5 (10/20). BUN was higher than before, but creatinine was pretty much the same as last blood work. I understand that BUN can be impacted by many things, including stress and a tad bit of dehydration
Good one!
It seems that after all lowering the dose to 1.25 twice a day wasn't wrong at all, was it?

HOWEVER, her triglycerides went through the roof!!!! 396 (compared to the last 3 readings of 53, 58, 98 - reverse chronological order going back to 4/2019).
I think it might also be an error from the lab, unless Feeby ate something without you knowing it, or, worse, she ate something "bad" on the days before.
In humans, triglycerides are impacted by fat food, or high calories food, alcohol, liver diseases, pancreatitis, etc.
So, is it possible that Feeby has been eating something that she shouldn't have in the days before (even way before) the test?
I also read that HYPO-thyroidism can give high triglycerides. Would it be possible that the quick lowering of T4 level might be seen as a HYPO-T from the body and the react as it was?
 
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FeebysOwner

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It seems that after all lowering the dose to 1.25 twice a day wasn't wrong at all, was it?
That 1.25mg seems to be a good base dosage, that's for sure!!
I also read that HYPO-thyroidism can give high triglycerides. Would it be possible that the quick lowering of T4 level might be seen as a HYPO-T from the body and the react as it was?
You know, I thought about that too! No one else has suggested it though. But, Feeby has been a little bit of a weird case throughout this (at least if you consider the apathetic aspect), so it would figure some oddball result would show up.

I will ask for a re-test in another month. As much as Feeby won't appreciate it, I will feel better if I do so. Last testing, she growled at the tech - she doesn't normally growl!

Btw: This cat doesn't eat anything I don't give her (and, sometimes doesn't eat what I do give her!). If one of the foods I added to her regiment could cause this, it would surprise me given I have her on a rotation where her main meal is the same food only about once a week. The rest of her foods are the same ones she has been getting for months now.
 
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Antonio65

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That 1.25mg seems to be a good base dosage, that's for sure!!
I'm glad that you followed this suggestion.

You know, I thought about that too! No one else has suggested it though. But, Feeby has been a little bit of a weird case throughout this (at least if you consider the apathetic aspect), so it would figure some oddball result would show up.
Yes, uncommon cases can have uncommon response sometimes, a kind of responses that aren't included in the manuals.

I will ask for a re-test in another month. As much as Feeby won't appreciate it, I will feel better if I do so. Last testing, she growled at the tech - she doesn't normally growl!
She's going to get annoyed by so many attentions and handlings, maybe?
I don't know what kind of signals you might want to look at for these triglycerides. I have them high myself and don't have any particular signal or issue or ailment that could reveal them.

Btw: This cat doesn't eat anything I don't give her (and, sometimes doesn't eat what I do give her!). If one of the foods I added to her regiment could cause this, it would surprise me given I have her on a rotation where her main meal is the same food only about once a week. The rest of her foods are the same ones she has been getting for months now.
This makes me think of the lab error, or that the quick lowering in the T4 might have tricked her methabolism.

P.S.: Sorry for the bad grammar in the last line of my last post, I stumbled on my own words.
 

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FeebysOwner, I'm so happy to hear Feeby's T4 level has improved so much! I've been following your thread in the Feline Hyperthyroid Google group too, and I'm so glad you got her dosage down to 1.25mg. I'll share Panda's journey and ask some questions in the group in the coming weeks too, I've already learned a lot from there and this group too! I'm not familiar with triglyceride, but I just did an internet search (so please take with a grain of salt, I'm not sure if the vet has been ''vetted'' :)
''Methimazole (Tapazol), given to control hyperthyroidism in cats, is said to sometimes elevate the pet’s triglyceride and cholesterol levels''.
The link to the vet's website and article is here, he also said it's best for the cat to not eat at least 6 hours before their blood test, perhaps that could be a factor if Feeby had a meal within 6 hours of her test?
Why Are My Dog And Cat's Blood Triglyceride Levels High Or Low?

It's interesting that HYPO can also cause high triglyceride levels, as Antonio mentioned above! It seems a very delicate balance to get the thyroid levels right.

Panda also gets very stressed and struggles when she has blood tests, Feeby was probably tired of being poked and prodded! Panda needs an extra Assistant (and me) to hold her in place, even for a regular checkup! I think it's good to re-check Feeby in a month if it's not too horrible for her. I'm told to take Panda first for a 3 week check, then a check again 4 weeks following that. I'm not sure if it's an option for you, but sometimes vets offer home visits for older or stressed cats. Panda's had one vet home-visit and it went (slightly!) better, she was a bit less stressed :)
 
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FeebysOwner

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ClaireandPanda ClaireandPanda - thanks for the link! I only read about the triglyceride level and HYPOthyroidsm. So, what you found is good to know!

Feeby's blood test was done right in the middle of her two daily med doses - about the 6 hour mark. I had read that was the best timing and was lucky enough to time it right when I took her to the vet for the blood draw. Her last food before she had the blood work done might have been 3-4 hours before. I'll try to pay better attention to that aspect as well next time.

She was pretty tolerant with me to/from the vet in her carrier (thankfully only about a 5 minutes drive each way); it was probably just the 'stick' that caused the growling. I'll chance it in a month again, and hopefully after that she will have 3 months to forget about the 'sticks'. She made the most noise when her blood was drawn immediately following her last check up - after all that poking and prodding - you could hear her in the back room 'squawking' away clear into the lobby! So, a growl seemed a lot 'better'.
 

Antonio65

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Her last food before she had the blood work done might have been 3-4 hours before. I'll try to pay better attention to that aspect as well next time.
Well, I had understood that Feeby had been fasting longer than that, so I think "only 4 hours" might be very good explanation, though not a complete explanation, to your doubt.

I've been always told to fast my cats for not less than 8 hours.
So, I usually book the blood tests at 9am, so the last meal is 11pm to midnight the night before, then nothing till after the test. This way the cat has been fasting 9 to 10 hours, that should return reliable levels in the blood test.
 

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Hi, I know you started this thread a couple of months ago but was wondering if you'd ever looked at Tanya's Comprehensive Guide to
Feline Chronic Kidney Disease? She covers all potentially related diseases like Hyperthyroid and Heart- complete with food suggestions, symptoms etc.
 
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FeebysOwner

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Hi. Still waiting to do a one-month re-test (that being 7-8 weeks on the H-T meds) for blood work and T status. At the 3 week mark of her taking H-T meds, her kidney function had not really changed from pre-med status, while her T level had improved. That is why I wanted another check now, just to see not only where her T stats are but whether or not her kidney levels have changed. Not going down the path of corrective action if it not needed. I am not saying she doesn't have an issue, but want to see something in her tests that tells me she does.
 
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FeebysOwner

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Hi. In lieu of repeating myself here, I am linking to my last post in Feeby's 'regular' thread, if anyone wants to review my comments on her last blood work results. For as much as I have been able to research and digest so far on her results, I am 'at best' confused right now.
I Don't Know What To Do - 15+yo Cat | Page 23 | TheCatSite - post #455
 
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FeebysOwner

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Just to let anyone know who might still be following this thread, I posted about Feeby's bloodwork results on the Feline H-T forum and, after the site resolved some connection issues they were having, I finally heard back from one of the helpful members. She seems to agree with the vet that waiting a few months to re-check her levels is probably the best way to go. None of the numbers seemed alarming to her, and she thought that the vet's 'let's wait and see' approach to the high calcium level was appropriate.

I am glad because I really, really did NOT want to take her back to the vet again so soon. Her semi-annual check up is due Feb-Mar; that is soon enough for her - and me!!

Oh, btw - if you didn't look at my other thread about the blood results, her creatinine stayed stable from the previous tests, so I think the vet is not concerned right now about the H-T meds unmasking a kidney issue. I guess (more) time will tell.
 
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