Hyperthyroidism in Feeby - Questions

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Thanks for asking. Bottom line is that Feeby is holding her own. Now that the weather is consistently warmer, she is eating pretty well and her weight has bumped up from 11.9 to 12.1. The rest of everything going on related to her is a bit frustrating.

I think my vet is having some kind of health/personal issue and has been out of the office a lot in the past month or two. I did talk to him after the last set of tests on 5/11 and since her T-4 was down from 3.8 to 3.4, he wanted to stay on the same H-T med dose that we increased it to at the end of March. Despite her increased creatinine and BUN, he wasn't ready to call it cause for alarm. He also wasn't ready to place her on any kind of phosphorus control. He did however want a urine culture done, given the bacteria in her urinalysis. So, back she went to the vets on 5/24 for another urine draw.

It took forever between the lab and my vet's office to advise me of the results. When I finally did hear from them (6/3), it was a vet tech who called me - which has never happened before; the vet always calls me. The tech said the bacteria was lactobacillus species, and due to that finding the lab stopped the culture process and said the bacteria was non-pathogenic. So, no antibiotics. The tech couldn't really offer any more of an explanation, and although I have twice requested to speak with the vet, I have not heard from him. The results made no mention of e-coli (as has been the case in the past), so the D-Mannose must be doing its job.

Since Feeby seems to be doing OK, I have pretty much taken the position of giving up on getting any more answers for now. I also got no where with the CKD forum and it would seem the H-T group doesn't really have anything more to offer me. As long as nothing negative develops, I guess we will re-test everything when her semi-annual check up is due which isn't until September. Sorry for the long post.
 

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It must be annoying not being able to speak to the vet himself, there are always questions to be asked but maybe he will phone you soon. It's good news that she is putting a little weight on, from the information my vet gave me when Guinness had hyperthyroidism, it is difficult for them to regain much weight. Guinness went from 8.3lb to 9.2 and my vet was pleased with that. Just keep doing what you are doing, Feeby is in your excellent caring hands.
 
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Things have changed a bit since my last post. I was just going to wait until Feeby's next semi-annual check up (due in Sept) but she seems to have developed an occasional breathing issue - fast, shallow breathing here and there, but still mostly maintaining a 32ish BPM when sleeping. Took her back to the vet - another person in the practice since my vet is apparently retiring and no longer available.

This vet did another blood work up and x-rays as well. The blood test results didn't yield any earth shattering results - in a nutshell:
  • Creatinine 2.8 - same as in May (March's results were 1.8)
  • BUN 44 down from 53 in May​
  • Phosphorus 5.3 down from 5.5 in May​
  • T4 2.8 down from 3.4 in May​
  • Amylase/Precision PSL back up to the high levels that were seen last August - we'll see if they go down again like they did on their own last time​
Re: the x-rays - all new, as far as I know (no x-rays have been done since ones for her spine several years ago):
  • Enlarged heart and aorta
  • Small amount of fluid in chest cavity
  • Possible asthma
All this vet recommended was sub-Q fluids (before even seeing the blood work results) and getting an internist involved to manage all of her 'conditions'. Wouldn't discuss phosphorus control or any other supplements that might benefit Feeby's issues. She isn't phased by the phosphorus, since it is in range (even though it is high according to the H-T forum), but said I could start a homemade diet that would lower her phosphorus intake.

Updated the H-T and tanyackd forums with the above as well as the actual blood work results to see what they might have to offer/suggest. Also, looking for an internist - and, a new vet practice.

Feeby is maintaining her weight, eating/drinking well, using the litter box normally. So, besides the occasional breathing thing, and the fact that her naps are now longer per session, I am not able to pick up on any other significant changes in her.
 

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I'm thinking the breathing issues may be caused by the enlarged heart and aorta plus slight fluid in her chest. Does she have any symptoms of asthma? Usually they sound kind of like they are coughing, don't they? does she do that?

It's great that she is still eating/drinking well! I take that as a very good sign.

It will be interesting what the other forums have to say.
 
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I'm thinking the breathing issues may be caused by the enlarged heart and aorta plus slight fluid in her chest. Does she have any symptoms of asthma? Usually they sound kind of like they are coughing, don't they? does she do that? ...It's great that she is still eating/drinking well! I take that as a very good sign....It will be interesting what the other forums have to say.
No coughing of any sort. I am sure the breathing issues are related to what was seen in the x-rays. The key is whether or not that is somehow affiliated to the H-T or the apparent kidney issues, and somewhat reversible or at least controllable with related treatments. Still waiting on the other forum responses.
 

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My cat Pallina was diagnosed with a fluid build-up in her chest on the very day of the I-131 therapy.
They went on all the same, but told me to keep her monitored.
She suffered from this strange issue for the rest of her life (365 days) and no vet, in any clinic I took her to, was able to understand what the cause was.
Pallina was drained 5 times due to this, but weirdly enough she was feeling much worse right after the draining, when she had trouble with breathing, than before, when she had no problem at all. We would check her regularly with an US scan, the fluid would build up again 5 days after the draining, but she didn't bother.
Each draining was about 140 ml of fluid. We would analyze that fluid with every possible test available, but every time it was clear.

Hopefully Feeby won't have to go through such an ordeal.
 
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Pallina was drained 5 times due to this, but weirdly enough she was feeling much worse right after the draining, when she had trouble with breathing, than before, when she had no problem at all.
Don't know if it the same, but fluid drains don't always result in overall relief. The fluid draws cause chemical/electrolyte imbalances which result in other issues... balancing issues... I thank you for your input, but don't think this the issue with Feeby.
 
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Frustrating update -

After looking for a 'regular' vet second opinion, I kind of gave up for the moment. Most vets are overbooked and some are not even taking new patients. I did receive 4 positive Next Door Neighbor reviews for this specialty group 'my' vet recommended, so I went ahead and called them. They wanted to send me to one of their locations that is about 45 minutes away, or work with the vet I am now seeing to 'authorize' an 'emergency' appt. with the closest location. 'Ca-ching, Ca-ching', of course.

I had to call the vet I am seeing now to let her know the update, and am waiting for a call back. This specialty group said once she calls them and sends Feeby's records someone will be calling me to tell me the emergency appt. is a go. I guess I take Feeby with me for a 'consultation' with an internal medicine vet, then I get kicked out to my car while they exam Feeby. UGH! They will call me to tell me what they think and we'll go from there.

Is this how this crap normally goes?????

Btw, I don't know what it is about me, but no one from tanyackd has even bothered to respond to me, and the H-T forum said 'don't do fluids' while suggesting I look into radio-iodine treatment. I guess I expected too much from these groups.
 

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I took Jamie to the veterinary cardiologist about a month ago, and yes, they took him in and left me in the car. The vet then did have a quite long phone consult with me though. It took 4 freeways to get there and my friend who rode shotgun (impeccable sense of direction so could navigate) was allowed inside to use the bathroom.

No vets here, at least the ones that I use, are letting anyone inside. However, this may be more fluid where you are and you might be allowed in. Hoping that you are happy with them and that they are able to provide some answers.

The feline diabetes group was remarkable when I joined for my Stella. The K9 Cushing's group I joined for my dog has been so-so. I realize that everyone is doing this on a volunteer basis in between everything else that goes on in their lives, but I share your frustration that if they are going to bill themselves as support groups, someone should be at the other end.
 

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I'm guessing her hyperthyroidism is under control? (I'm sorry, I haven't read this entire thread since it's pretty long) I know you posted her T4 is 2.8, but I don't know what the "normal" range is. When your Vet told you about the enlarged heart, did he suggest it might be caused by the thyroid issue? In any case, I wonder why he didn't suggest you see a cardiologist about it, and I also wonder why he suggested fluids. Was she dehydrated?

As far as sitting in your car while they examine her, this is the norm here in the Phoenix area too. For about a month they reopened the exam rooms to everyone, then closed them up tight again with the new Delta varient spreading like wildfire. It's great fun waiting out in the car when the temp if over 110 degrees. You probably have the same issue where you are.

I'm sorry you aren't getting any answers from the other forums. Maybe they just don't have any?
 
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FeebysOwner

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'My' vet won't give the go ahead for an emergency appt. with the specialty group because if they don't deem it an emergency, then it could 'discredit' her with them for future referrals. At least she was honest (:disappointed:). So, back to Square One.

Can't answer any of the above questions -same as I have asked.
 

mrsgreenjeens

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'My' vet won't give the go ahead for an emergency appt. with the specialty group because if they don't deem it an emergency, then it could 'discredit' her with them for future referrals. At least she was honest (:disappointed:). So, back to Square One.

Can't answer any of the above questions -same as I have asked.
How frustrating!
 

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I know you posted her T4 is 2.8, but I don't know what the "normal" range is.
Generally speaking the normal range is between .9 - 2.4.

'My' vet won't give the go ahead for an emergency appt. with the specialty group because if they don't deem it an emergency, then it could 'discredit' her with them for future referrals. At least she was honest (:disappointed:). So, back to Square One.
I'm so sorry and honestly, if you don't mind me saying so, I find your vet's reply a bit worrisome. I doubt that the specialty group would discredit her if they don't deem Feeby's health issues an emergency. Obviously I can only speak from my own personal experience but when our regular vet felt our dog needed to be seen by a specialist and wasn't sure what type of specialist would be the most suitable he referred us to a veterinary specialty group associated with a veterinary medical school. There was no problem whatsoever. I realize every situation is different but when you're trying to get the best possible care for your pet you would not want to be turned away because your vet thought it might discredit "her."

This must be so terribly frustrating and disappointing for you. :hugs: Is there anyway your previous vet who is in the process of retiring can be contacted to lend his support and/or make the call to the specialty group for you? I'm just trying to brainstorm to help Feeby and you.

I also wanted to let you know that starting in July our feline only vet's practice started allowing one person in with their cat, a mask must be worn, but that's better than waiting in the car. However, I'm sure this varies state by state and county by county.
 
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Is there anyway your previous vet who is in the process of retiring can be contacted to lend his support and/or make the call to the specialty group for you? I'm just trying to brainstorm to help Feeby and you.
I am being selfish in that I wanted to go to a location 15 minutes from my home for the sake of Feeby who has never had to endure more than a 5 minute drive to the one and only vet office she has ever known vs. one that is 45 minutes from my home. That one is on me. And, I guess I can't be that picky.

If I had a contact to my retiring vet, I would most certainly call him directly - despite whatever he is going through - but I do not.

The vet that Feeby is used to going to allows pet owners to be with their pets throughout the exam. Not so with this specialty group. It is a really big mixed, messed up 'bag' here in FL.
 

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Me, too. Worrisome. The "this better be an emergency or it is on you that you weren't ill enough" is just a strange way to look at it. Or like you took someone's "real" emergency appointment. No one else thinks that a 16 year old cat with several conditions including an enlarged heart and fluid in the chest might not be an emergency.....of course, hopefully Feeby will be here for a long time to come, but I do think that this could be expanded to at least urgent.

I certainly agree with you on the car ride if you can avoid the long one. I was not thrilled about the one with Jamie and realized later that my friend had brought a huge "emergency" bag with her in case something happened like a big rig jack knifed and we were stuck on the freeway for 4 hours with a cat in a carrier.
 

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I'm sorry you can't have your Feeby referred to the specialist group only because your vet fears to have her reputation stained over a possible wrong referral.
Isn't it possible to have you and Feeby referred to them by another vet?
Isn't it possible to "by-pass" this rule of the referral and get straight access to the specialist group?

Sorry for my dumb questions, but things work differently in different parts of the world, and sometimes it is hard to get hold of others' rules.

As for waiting outside and staying in touch over the phone, this is what was said at the beginning of the pandemic here too, no pet owners would have been allowed in, but all clinics and practices I had the chance to visit in the last 18 months don't bother at all if the owner goes in along with the pet, the only rule observed is that one person at the time can go in with the pet.

I'm sorry for you and Feeby, this world situation is wearing us out!
 
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I'm sorry you can't have your Feeby referred to the specialist group only because your vet fears to have her reputation stained over a possible wrong referral. Isn't it possible to have you and Feeby referred to them by another vet? Isn't it possible to "by-pass" this rule of the referral and get straight access to the specialist group?
I am probably not being very clear - sorry. This group will take Feeby (on referral only) - BUT NOT at the location I wanted to go to. They told me that the only way I could go to the location that I wanted was for Feeby's 'current' vet to declare a visit as an emergency, which she wouldn't do. There is an earlier opening at this particular location and the specialty group felt Feeby should be seen sooner rather than later. The 'current' regular vet pretty much told me - not in these exact words - to 'suck it up' and go to the location with the earliest opening, which 2-3 weeks away. I am not sure how many more weeks I would have to wait for the location I wanted.

Best I can tell in my area, if the vet practice states that they don't permit pet parents in their building, there are no exceptions. That is, except, to PAY the bill, of course. My 'regular' vet's practice started letting pet parents in the building last August, but many others have not lifted their restrictions.

I am still looking at other options with regard to getting a second opinion - with or without a specialty group.
 
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OK - I have now reached the babbling stage. Two appts. - one with the 'specialty' group, not until 8/24. The second appt. is with an 'integrative' animal hospital (who use both eastern and western treatments) on 8/6. The specialty group is 'by default' the only one I can go to other than UF here in FL. UF is at least 2 hours away.

I hope I am making the right choices for Feeby. I feel for all of you who have had to travel down pathways similar to the one I am about to embark.
 
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