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Methimazole (gel) = Twitching?

Discussion in 'Cat Health' started by ChaoticEva, May 21, 2017.

  1. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    Hello all!

    My 15 (almost 16) year old cat has hyperthyroidism and is currently on the Methimazole gel (transdermal) and I was wondering if anyone here is giving this to their cat?

    If so, have any of you seen your cat twitch? For example, Oscar will be laying next to me and every now and then, his head or body will twitch. He also twitches a lot when he is anxious (like when I'm cutting his nails or when he's in the car).

    Has anyone had this as a side effect? Or could be something else?

    Also, how long can we continue giving him this drug? I heard that it can sometimes stop working? Do you think it's something I can give for the rest of his life?

    It's kinda weird as he didn't have any symptoms (no weight loss and no enlarged glands). We only found out due to getting him a blood test back in February or March. His levels were actually pretty high (for me at least). If I remember correctly, it was over 60. But I could be completely wrong. My vet told me that it wasn't that high and that she's seen higher, but it still kinda scared us.

    Any info would be greatly appreciated! :)
    Thanks!
    16406849_10158121207255524_8823318705373007009_n.jpg
     

  2. missmimz

    missmimz TCS Member Top Cat

    2,297
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    Jan 11, 2015
    Arizona
    Hyperthyrodism is caused by a tumor on the thyroid. The only cure is i-131. The medication controls the T4 levels but the tumor will continue to grow. Your kitty will need to be on medication for life and will regular blood tests to monitor T4 levels and adjust medication as needed. I have heard of hyper-t cats twitching, although I don't know if it's a side effect of the medication or not, but it does seem possible.
     

  3. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    I know that his glands are not enlarged at all, so nobody knew he had it until the blood test came back. Even my vet was surprised. I also know that he'll need to be on meds for the rest of his life. My question was is the trandermal Methimazole a good option for the rest of his life? Or will it stop working eventually? Trust me, my vet and I are working hard on keeping all my cats healthy, as I have 2 special need cats. He'll be getting regular blood test (even more, just to make sure all is well) as well as regular vet visit. I'm at the vets multiple times a month, so I know what I'm in for. The I-131 is not an option for now as he doesn't show any signs and he seems to be doing well on meds. And not to mention that it's a pretty costly procedure to put up front, which I cannot afford right now, as I'm still paying off both of his surgeries that he had back in April.
     

  4. missmimz

    missmimz TCS Member Top Cat

    2,297
    351
    Jan 11, 2015
    Arizona
    Hyper-t doesn't cause any glands to swell, but some vets can feel the tumor, while others aren't as good at feeling for it. There aren't really any other options other than transdermal, or oral meds. Transdermal is usually better tolerated than oral meds. It is possible that if he lives a long life that tumor will eventually become so large that he'll need a very large dose of meds to control the T4 levels, or that ultimately meds stop controlling the T4 all together. Unfortunately, there aren't really any other options at that point. Surgery isn't a good option for the most part, and Y/D food doesn't control T4 levels well at all. If you did want to consider i-131 he should have a thyroid scan first to verify the tumor. T4 level tests are typically pretty accurate, so if his T4 levels were high, that's usually a good enough indication of hyper-t, even if he's not symptomatic.
     

  5. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    If I could afford the I-131, it would be something I'd consider. But I'm pretty sure my vet cannot do this at her own clinic, which means I'd need to do it at the big vet clinic and they don't like taking payment plans. I can't afford it right now anyway. Maybe eventually I'll get it done. But it won't be for at least a year. He's doing well, he isn't in any pain or discomfort and he's happy, so that's the main thing right now. Transdermal may not be the best option for really treating hyperthyroidism, but it's the only option I can give him for the time being.
     

  6. Antonio65

    Antonio65 TCS Member Top Cat

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    Feb 27, 2017
    Orbassano - Italy
    My cat is on Methimazole transdermal gel in her ears twice a day.
    It's life lasting cure, you cannot interrupt it, you can't suspend it, you can't skip an application.

    As Missmimz told you, the Methimazole is not the cure, it's a control over the disease. The situation may change in time, that's the reason for the 5-6 weeks blood check-ups.
    Though the Methimazole can control part of the disease, it might not be able to avoid some of the thyroid related physical problems, like liver, heart and kidney failures.
    Furthemore, the Methimazole can damage a cat's kidneys.
    As a matter of fact my cat is showing the first signs of kidney troubles.

    I'm struggling at having cat treated with I-131 because in the country where I live this treatment is not allowed because we have medieval laws. I shoud take my cat abroad and have her treated in another country.
    As long as a cat is treated with drugs only they will never be able to heal or improve. Hyperthyroidism can only worsen and lead a cat to death.

    As for your question, no, I haven't noticed any twitching, but I have noticed that lately she's feels a bit itchy at night. She starts scratching her cheeks and mouth with her paws for a long time, but only after 9 pm. She randomly has a slight quiver of her head, it last a few seconds every now and then during the day, but I'm not sure if this is related to the Methimazole.
     

  7. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    Thanks for the info. I'll probably be calling the big emergency vet tomorrow to see how it works, what's the cost and what it does to the cat. Luckily, he has no signs of having it. No heart issues, no liver issues and no kidney issues. He had no weight loss or nothing. The vet couldn't feel any tumors either. So it was a complete surprised when we found out. I understand that Methimazole is not a cure and all it's doing is stopping some of the hormones that help grow the tumor. I'm also lucky because I give him his Methimazole only once a day. That will probably change soon, as I'm sure he'll need it twice a day eventually.
     

  8. Antonio65

    Antonio65 TCS Member Top Cat

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    Feb 27, 2017
    Orbassano - Italy
    @ChaoticEva, what is the dose your cat is on?
    It is strange that you're giving him the med only once a day as it doesn't control the hormones too well.
     

  9. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    I'm currently giving him .05ml. When he had a blood test, a few weeks after starting the medication, his T4 showed that his thyroid hormone went down to pretty much normal levels.
     

  10. Antonio65

    Antonio65 TCS Member Top Cat

    2,155
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    Feb 27, 2017
    Orbassano - Italy
    What is the concentration of your gel?
    In my case, for instance, it is 12.5 mg/ml, so if I give my cat 0.05 ml (which I actually give) the dose of Methimzole is 0.625 mg each time, twice a day.
    The dose of 1.25 mg twice a day is the one the doctors usually start with.
     

  11. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    Ok, so if I'm reading this correctly, I have 50mg/ml. Does that seem possible? I'm guessing the 3ml at the end there is just the amount I actually have (so 3x 3ml syringes). I know it's written in french, but the med name is still the same.
    IMG_20170524_123540_edit.jpg
     

  12. Antonio65

    Antonio65 TCS Member Top Cat

    2,155
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    Feb 27, 2017
    Orbassano - Italy
    If the photo depicts the label of your prescription syringes then you have a composition of 50mg of Methimazole every 1 ml of gel.
    This means that every 0.05 ml of gel is 2.5 mg Methimazole per day, which could sound right except for the fact that you're giving this dose in one application rather than splitting it into two applications each day.
    According to what I was told, it's important not to give high shot of med once a day, it's better to give a lower dose twice a day.
     

  13. ChaoticEva

    ChaoticEva Thread Starter TCS Member Adult Cat

    157
    39
    Mar 25, 2017
    Montreal, Canada
    Guess I'll have to talk to my vet and see if I could split the dose in 2. Even if I give him, lets say .02 in the morning and then .03 in the evening, I think that could work. It's just very difficult due to my schedule to give him the morning dose at the same time every day. Would that cause issues if I were to give him a dose at 9am or 11am?
     

  14. Antonio65

    Antonio65 TCS Member Top Cat

    2,155
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    Feb 27, 2017
    Orbassano - Italy
    I've been told that it would be much better if the dose is given everyday at the same time. Of course the world isn't a perfect place and some tolerance is allowed, and they told me that 1 hour earlier or later should still be fine.
    Past two hours from the "chosen" time they told me to skip the dose, otherwise it would be too close to the next one.
    Completely skipping a dose might be not too bad, but if it becomes a habit then it's bad. One skipped dose a week is too much.
    They advised to set an alarm on the phone clock, and so I did.
     

  15. Angela&ruffles

    Angela&ruffles TCS Member Kitten

    1
    0
    Dec 2, 2017
    Hello!

    I just started my cat, ruffles, on methimazole a few weeks ago for hyperthyroidism! And YES. I HAVE NOTICED TWITCHING. I’ve noticed it in his arms mostly... he now does this weird kicking thing when he drinks or eats. And yesterday I noticed his head twitches too when he was sitting with me. I haven’t asked the vet about it yet because his next appointment is in a few weeks. Also, I’m switching my cat to a different medicine, one where you run ointment in his ear, because ruffles tries to avoid the food with medicine mixed in it. Hopefully that will make it stop??

    Thanks for confirming that this is a thing, I thought I was imagining it.

    Angela



     

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