Hyperthyroidism in Feeby - Questions

fionasmom

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I see an integrative and functional MD and while her practice is dedicated to that discipline, she is still a good traditional MD when she is asked to be. My previous GSD went to a hospital who was the same and received good treatment in both regular and integrative medicine, so don't give up. I personally think that you know enough about Feeby's conditions and veterinary medicine that if they really come at you with snake oil, you will be able to tell.
 
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FeebysOwner

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I see an integrative and functional MD and while her practice is dedicated to that discipline, she is still a good traditional MD when she is asked to be. My previous GSD went to a hospital who was the same and received good treatment in both regular and integrative medicine, so don't give up. I personally think that you know enough about Feeby's conditions and veterinary medicine that if they really come at you with snake oil, you will be able to tell.
I got the impression they offer both/either/or depending on the pet parent's wishes. I want the fully functional MD options presented to me, but I am not opposed to other forms of treatment as additive care for Feeby, especially when it comes to making her remaining time the most comfortable, however long that may be.
 

John Perram

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I tried the pills rerun stopped eating anything while she was on them. I decided to go the holistic route she has gained weight and actually takes the holistic meds more willingly, her fur has completely returned to normal. Sam my younger cat has lung cancer 12 to 13 years old was failing fast. I went with another holistic medication, and he is acting like a spring chicken. He's going to his vet in two weeks. I'll let you know what the xrays show. His last vet a month ago he was snotting up terribly now with his new meds he's normal.

Rerun is now 16 years 7 months old and seems to be doing fine. I had to leave her vet because of how batman was treated. I found the vet to be lacking in training with felines. Not to mention calling Batman's pneumonia a lump which they admitted to later. That was when I left. To late for my Batman who might have survived.

Anyway I'll get rerun back into the vet soon it takes time to gather the money. Sam seemed to be having more pressing issues.

I just didn't want to mention holistics because some feel it is pure bunk and some are. But I use them for my pain management.
 
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FeebysOwner

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No real new news specifically on the H-T front with Feeby, however she did see the 'second opinion' vet last Friday. So, I am not sure if I should start a new thread... but I'll just post here for now. It's a long post, but when the appt. lasts 2 hours, a lot goes on!!!

The 'potential' heart issues will remain as just that until she sees the specialty group on 8/26. Friday's vet said the x-rays of her chest are really inconclusive and she wanted to take 3 more x-rays. She also suggested an ultrasound and the Cardio BNP test, the latter being a blood test looking for a certain protein that is indicative of heart issues - the higher the protein level the more likely of there being a problem. But, she said she heard no heart murmur or unusual rhythm, with normal pulse palpations. She also said Feeby’s lungs sound clear. Her BP averaged 161 (systolic) which is on the high side of normal, but the vet said at this juncture until the BP testing is repeated a few more times, she would attribute it to the good old 'white coat syndrome'.

This vet admitted if any heart issues did show up with the testing, she would advise me to go to the specialty group I already have an appt with. So, I declined the tests, figuring it made better sense to let the specialty group suggest/run tests. I would think it is likely they will bypass more x-rays and go straight to an ultrasound. Depending on the outcome, they might also recommend the Cardio BNP test as well. (But, I now wonder if I should have gone ahead with this test as - I have come to find out since - it could have possibly ruled out heart problems.)

The vet thinks Feeby should get sub-Q fluids, but not until the heart issues are pursued. Sub-Q fluids, according to the H-T and CKD forums, would be premature at this point, regardless. The vet was more focused on Feeby taking Azodyl than she was worried about Feeby's phosphorus. Azodyl clears toxins in the body through the bowel to help what the kidneys might be struggling to remove. But, it is required to be taken in whole capsules without food (3 x daily) and I am not sure I want to put Feeby through that unless I can find out more about its value/worth. It can also skew Creatinine and BUN results, so I have to better understand that aspect too. It isn't commonly used in either the H-T or CKD forums.

When I asked about the phosphorus, she suggested low phosphorus foods vs. phosphorus binders. The CKD forum agrees, but the H-T forum does not and thinks Feeby should be on binders now.

Other things that I learned through the vet's write-up, but not from her directly:
  • Feeby has nuclear sclerosis - an old age disease of the eyes whereby the lens develops a blue/grey translucent haze. Hence the reason her eyes look dilated all the time to me. There is no impact to vision and no pain involved. After reading articles about it, this haze can become apparent in a cat's eyes as early as 7yo. I think Feeby's eyes became apparent to me about a year ago, so maybe it started much later in life for her than the average cat.
  • She also has moderate periodontal disease, which I did not know about. Not sure what, if anything, to do about this. More consideration will follow the heart check up/testing outcome.
Feeby did well with the 30 minute drive there, the 2 hour long appt, but let me know during the tail-end of the drive home that she had 'had it'!!
 

fionasmom

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Wow...what a day! It sounds as if you did have a good appointment and were given some direction, even if all questions were not answered. I would have done exactly what you are doing with the BNP test which is to wonder later if it should have been done. It is very hard to think on your feet in these situations and I don't think that it makes much difference if it is run at the next appointment. Does it rule heart disease out completely or is it just one indicator? The specialty group will absolutely go forward with all of this regardless.
I would not start any subQ right now, unfortunately have no experience with Azodyl. A whole pill with no food three times a day?

Azodyl

I am sure you are ahead of the game on this, but the VCA article was the first one that I found that seemed to have some decent info.

Big hug for Feeby for being such a good girl yesterday.
 
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FeebysOwner

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Does it rule heart disease out completely or is it just one indicator? The specialty group will absolutely go forward with all of this regardless...I would not start any subQ right now, unfortunately have no experience with Azodyl. A whole pill with no food three times a day?
The BNP test is considered helpful in screening for unknown heart disease. As far as I understand, it is often done if a heart murmur or an unusual rhythm is heard - which Feeby did not have - or, before surgery and/or anesthesia. It works by detecting a certain protein that is released in response to cardiac 'stretch' - or stress; the higher the protein value, the greater the concern for heart disease. So, I guess I can't really answer your question, tbh.

As far as the Azodyl, as noted in the article you provided above, it can be given with food - as long as the cat swallows the capsule whole. I just can't see Feeby doing that, based on past behavior. She currently spits out a small piece of her H-T meds if I fail to thoroughly smash it up. I've attached a pic of the capsule below - it is the smaller of the two capsules in the pic when compared to a quarter. Feeby's dose would be 2 in the AM and one in the PM.
 

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fionasmom

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To me, that is still not that small. That is really something to think about. Mine would not take anything that size whole either. Jamie's atenolol and plavix were microscopic and he still acted as if I were trying to give him cyanide.
 

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When my Lola was diagnosed with CKD and was given Fortekor, I made some researches (it was back in 2006, internet was poor in information at that time) and found a forum where the azodyl was mentioned and I wanted to get hold of it, but it came out it was only available in the US, it could be sent over here, but not through regular channels, I should have found a "mule" to have it here, and the drug has to be kept refrigerated (I don't know if it's still true), so my plan was abandoned.
But I kept searching and found that a combination of two particular probiotics could do the same thing as Azodyl. So i pursued this road and it worked very fine, at least Ithink it did. I used to give them to Lola in the morning after her breakfast, once a day. Her kidney levels stayed within the ranges for years, till her death.
Maybe that mix of probiotics was a myth, I will never know, but it was so easy to administer and to have at home.

This post of mine adds nothing to your thread, I just wanted to tell you that I tried to use Azodyl, but had to give up.
 
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But I kept searching and found that a combination of two particular probiotics could do the same thing as Azodyl. So i pursued this road and it worked very fine, at least Ithink it did. I used to give them to Lola in the morning after her breakfast, once a day. Her kidney levels stayed within the ranges for years, till her death.
There are 3 main strains of probiotics in Azodyl, and other than Renadyl (the human version), I am not sure these can be replicated elsewhere:
  • Enterococcus thermophilus (KB19)
  • Lactobacillus acidophilus (KB27); and
  • Bifidobacterium longum (KB31)
The thing that bothers me about this med is from all I have read so far it can make creatinine and BUN numbers look better, but it isn't stopping the ongoing kidney demise. So, now I need to find out what elements are used instead to monitor kidney function since those numbers would no longer be reliable indicators.

What kidney levels were being used to monitor Lola? If it was creatinine and BUN, then the probiotics you gave her did just what I have read - improved those particular values.
 

Antonio65

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There are 3 main strains of probiotics in Azodyl, and other than Renadyl (the human version), I am not sure these can be replicated elsewhere:
  • Enterococcus thermophilus (KB19)
  • Lactobacillus acidophilus (KB27); and
  • Bifidobacterium longum (KB31)
The thing that bothers me about this med is from all I have read so far it can make creatinine and BUN numbers look better, but it isn't stopping the ongoing kidney demise. So, now I need to find out what elements are used instead to monitor kidney function since those numbers would no longer be reliable indicators.

What kidney levels were being used to monitor Lola? If it was creatinine and BUN, then the probiotics you gave her did just what I have read - improved those particular values.
The (Italian) forum I used to read in those days had a member who was working in a chemistry lab and had deep knowledge of the matter, and found out that there were two probiotics, human grade, that in their composition with several strains (one of them had up to 12 different strains), the ones similar to Azodyl could be found and, if mixed between them, could make up something like Azodyl itself.

As I said above, the info available on the web at those times was poor and I don't think anybody questioned whether these probiotics were making number look better or they actually worked on the kidneys. They were doing their job, and that was enough. My vet was surprised at the results.

Lola was monitored and checked every 4 months. Full blood panel and kidney ultrasound scan every four months. The scans were telling us that, after all, the kidney structure wasn't changing much, the kidneys were retaining their functions. BUN and creatinine were always within the ranges or nearly borderline.

For a different issue of hers, she had to undergo several CT scans in a couple of years, at a different clinic, and I had to inform those vets that Lola had CKD. But when they looked at the levels ad reports of the past years, and the body condition of Lola, they even doubted that she ever had such a disease.

I'm not telling that Lola's kidneys were healed or recovered with the help of the probiotics. I would also give her the Fortekor half pill daily, renal food only, and would add vitamins B and E to her meals in the mornings.
But I can't rule it out that it was mostly luck. She was diagnosed with CKD between 5 and 6 years of age, she left me shortly before she could turn 17, and her kidneys were, probably, among the few best and working organs in her body.

Only a year before her death she was fully checked at another clinic and they ran the SDMA test, which I had never heard about before, and they found out it was 36 (range 0-14) when her BUN was 40 (16-38) and the creatinine was 2.1 (<1.9). So, with rather good Crea and BUN, her SDMA was through the roof. I never investigated it further, after all Lola was fighting against something terrible, and we had a higher priority in that moment, and a few months later she was diagnosed with an oral SCC, so understandably the kidney issue was the least of our concerns...

Let me know if I missed something that you may be interested in.
 

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Sorry no advice on Feeby's current health issues but just wanted to offer my support and let you know I'm sending special thoughts to both of you. :vibes::vibes::vibes:I'll be curious to hear what the specialty vet group has to say on August 26th. Hugs!🤗
 
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John Perram

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Yep, saw that. And, when you read the details, it was acknowledged that Azodyl was added to a full meal of food. A far cry from how they are recommending it to be administered now.
I just wanted to make sure you knew that. Cats are difficult to pill and that pill is a monster pill.
 

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Either Azodyl isn't available in Turkey or there has been some stock issues the past year. Either way, I have seen some vets recommend this:

1628842481002.png
I've seen some good comments from users. Although everyone is uncomfortable it has Vitamin C and sweetener in it (it's for human use), but out of less than ideal options, that seems to be working for some people I guess.

There are other supplements too:

PRONEFRA® Palatable Oral Suspension

There are some alternative names here too: Comparative palatability of five supplements designed for cats suffering from chronic renal disease

I actually saw a post from a Turkish vet just a few months ago asking people to stop trying to import Azodyl from the USA as if it's a miracle product and that there are alternatives for it. (It costs a fortune to get Azodyl imported)
 

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Although everyone is uncomfortable it has Vitamin C and sweetener in it (it's for human use), but out of less than ideal options, that seems to be working for some people I guess.
Why is Vitamin C felt as a problem?
And what sweetener is used in Probiotic Optima?

asking people to stop trying to import Azodyl from the USA as if it's a miracle product and that there are alternatives for it. (It costs a fortune to get Azodyl imported)
What I also knew is that Azodyl has to be kept refrigerated during the shipment, but due to the long times for delivering and customs, too often the product would reach the buyer when it was useless.
 

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