Hyperthyroidism or something else

[alana0011]

Amber is an older cat, and her blood work showed that she is in the early stages of kidney disease, which I've dealt with before as many of you have.
Her thyroid levels were normal, but the vet suspects that she has hyperthyroidism based on the fact that she has been eating pretty well but losing weight. She suggested a test that is pretty complicated and sort of expensive, but I opted to go with the lowest dose of medicine for her. She gets it once a day, and I'll have blood work done again next week.
She had a uti according to the vet and was on an antibiotic for almost two weeks. After checking again last week, the vet said the infection wasn't completely cleared up yet, so she prescribed Enroflaxin, which I didn't know was Baytril. She has not had much of that at all because she is almost impossible to dose, but I threw the remaining pills away.
She is eating and drinking but sleeps all of the time. She isn't as perky as she has been in the past, but I know she's older.
If we continue the meds for the hyperthyroidism, I will get the kind that you can put on her ear.
I just wondered if anyone has ideas on what else I might ask the vet to do for her. There may be something else going on with her. I hate to have her on the meds for hyperthyroidism if she doesn't need it, and it will further damage her kidneys.

 

[Furballsmom]

Hi
Old age isn't a disease , so you may be right that there's something else happening. You need to tell the vet you didn't complete the round of medication for the uti so that she can check that situation again.

There might be something here, depending on whether you're ok with any further tests that might be required, but talk to your vet.
Health Concerns In Aging Cats – TheCatSite Articles

I threw the remaining pills away.

If something like this happens again, hang on to them in a safe place and see if your community has a drug turn-in/take back event.
Drug Disposal: Drug Take Back Locations

 

[FeebysOwner]

I personally don't see a reason to put a cat on thyroid meds whose T-4 level is normal. And, one week on a thyroid med isn't really long enough to determine if it is doing anything anyway - besides what is the vet going to base it on since her level wasn't high to begin with?

Did they consider testing her B-12 level? Some of the time it correlates to CKD, and a lot of times it will show up with weight loss - but I have a cat (18+ yo) that I can keep her weight maintained, and yet she is B-12 deficient. She is very lethargic (also has CKD and hyperthyroidism, as well as arthritis). She is only on Week 2 of B-12 shots and is expected to get them 4 more weeks before they may be reduced to once a month. So, something to discuss with your vet.

As far as the UTI, was there a urine culture done to determine the specific bacteria involved? That is the best way to identify the most effective antibiotic with which to treat it.

What are you doing with regard to the early kidney disease? Where is her phosphorus level? Has anything been done to see if she might also have arthritis that is affecting her desire to move about. This - and other things - are briefly addressed in the article provided above.

 

[alana0011]

Thanks for the great links. She does have arthritis and has had Adequan injections for that.

 

[alana0011]

I personally don't see a reason to put a cat on thyroid meds whose T-4 level is normal. And, one week on a thyroid med isn't really long enough to determine if it is doing anything anyway - besides what is the vet going to base it on since her level wasn't high to begin with?

Did they consider testing her B-12 level? Some of the time it correlates to CKD, and a lot of times it will show up with weight loss - but I have a cat (18+ yo) that I can keep her weight maintained, and yet she is B-12 deficient. She is very lethargic (also has CKD and hyperthyroidism, as well as arthritis). She is only on Week 2 of B-12 shots and is expected to get them 4 more weeks before they may be reduced to once a month. So, something to discuss with your vet.

As far as the UTI, was there a urine culture done to determine the specific bacteria involved? That is the best way to identify the most effective antibiotic with which to treat it.

What are you doing with regard to the early kidney disease? Where is her phosphorus level? Has anything been done to see if she might also have arthritis that is affecting her desire to move about. This - and other things - are briefly addressed in the article provided above.

Thank you for your feedback. I will ask the vet about the B-12 level. That's a great idea. So far, she has done well, I think, without meds for her hyperthyroidism, if that's what it is. The vet said she has a little nodule that she said was a thyroid tumor, but like I mentioned, her levels were normal according to the blood work. She said I had the option to give her the test that would determine if she had hyperthyroidism, and it's expensive and also stressful because it involves giving her meds every 8 hours over a few days. She does not pill well. The vet also said I could give her the transdermal medicine on her ear, and I haven't tried that.
Her UTI cleared after only a few days on Baytril.

 

[Furballsmom]

She said I had the option to give her the test that would determine if she had hyperthyroidism, and it's expensive and also stressful because it involves giving her meds every 8 hours over a few days

I'm not clear, I've never heard of this.

My cat was just diagnosed hyper-T. He had a couple symptoms, and a slightly enlarged thyroid at his wellness exam so even though on the initial blood test results the T4 was only on the high side of normal, since we'd been able to get enough blood drawn he directed the lab to test for free T4 by equilibrium dialysis. It cost less than $200.

 

[FeebysOwner]

She said I had the option to give her the test that would determine if she had hyperthyroidism, and it's expensive and also stressful because it involves giving her meds every 8 hours over a few days.

I agree with Furballsmom - never heard of such a thing. It may be a small additional cost if the original order doesn't include a free T-4 at the time of the T-4 testing. But the lab I know of will suggest a free T-4 be done if the T-4 is greater than 2.5, which is very much within range in the lab that my vet uses (range is 0.8 - 4.0). I think, as far as I understand, the vet would have to reference that as an option at time of T-4 testing.

Hyper-T meds do not further damage the kidneys - the damage is ongoing; it is just masked by hyper-T and becomes more apparent once the meds are doing what they need to do for the thyroid. It is, to be sure, a balancing act.

I have no issues with pilling Feeby for her hyper-T meds - they can easily be mixed with food or treats, and she could care less. There are many other meds that she is not willing to take but the hyper-T meds are not one of them.

 

[alana0011]

The test the vet recommended was a thyroid suppression test.
I'm just trying to decide what to do. When I was giving Amber the meds, I hid them in pill pockets, but it wasn't long before she stopped taking them. Another cat does absolutely fine with the same meds in pill pockets.

 

[neely]

I also have a cat who was diagnosed with Hyperthyroidism. He was treated for it last year, first with Methimazole in the transdermal gel form in his ear and then with the I-131 (radioactive iodine treatment). Please note the following article which explains the different tests used to diagnose Hyperthyroidism. It discusses the T-3 suppression test being used on rare occasions: Thyroid Hormone Testing in Cats | VCA Animal Hospital

You may want to consider getting a second opinion from another vet or a feline veterinary specialist. I understand if financial expenses are a concern and, if so, this TCS article may have some helpful information for you: No Money For Vet Care? How To Find Help And Save Your Cat’s Life – TheCatSite Articles

 

[SundaesPerson]

I would definitely get a second opinion. While the vet may think a T3 test is a good idea, there are a handful of other reasons cats can eat, but still lose weight.