Newly Diagnosed Hyperthyroid

[mommytobuck]

Unfortunately (as I often tell my relatives asking me about their radiology results)—X-rays and ultrasounds aren’t 100% diagnostic. No matter what it looks like on films you need a piece of it “in a pan” to send to the lab for the final answer, otherwise it’s a best guess. So there’s no way to tell from these particular results—but on the positive side they don’t show other abdominal tumors, for instance. Open (surgical) biopsy carries more risk than a needle biopsy with Ultrasound…but needle biopsies can miss getting the piece of tissue most needed. That’s a risk-benefit analysis to do for all three options: no test, FNA, or open biopsy, that you need to do with a vet you trust, keeping in mind (as it seems you have) the age and other health problems of Buckwheat and what you’d do differently with the results.
wishing you the best

Yes. I just don't know if it is worth it to know. And my gut is just telling me that he doesn't currently seem sick enough. Perhaps in 6 month things will be more clear. I also note he had a full elderly blood panel and nothing was amiss.

 

[FeebysOwner]

Thanks for the extra notes from the vet (and I also did miss the reference to 'Ileo-colic' nodes that you did provide before - my bad). I hate to say this, but you sound like you are pretty much in the same boat as I am. There was 'inflammation' in some of Feeby's intestinal lymph nodes, and they did an FNA which came back inconclusive for cancer cells. So, I will be honest, the FNA in Feeby's case did nothing to help matters out. But no one - just as in your case - will actually rule out IBD either. And, just like your results, there is nothing to even hint at IBD - other than, as you said, symptoms that apply to a gazillion other things, including old age.

I am not about to automatically treat IBD because of a 'maybe', ditto for lymphoma. Besides, from all the research on this site and reading across the internet, IBD seems to be the most recent vet 'go to' for cats. If not that, then lymphoma. There does seem to be a pattern among the medical field that if a 'piece of tissue' can't be obtained, then nothing else can be conclusive. Thankfully, what was mentioned above, is that the piece that is chosen isn't always the 'right one'.

Feeby's last ultrasound was in December, and I am contemplating another soon, along with another FNA - and a PARR test if I can get someone to agree to it (I have mentioned that test to you before). The bottom line is - she does not have enough signs to explain IBD. She may have lymphoma, and I may be shortening her life by not treating it with chemo. But, for the love of god, if this is lymphoma then I would expect changes from her last ultrasound to the next ultrasound to indicate as much - without putting her through a surgical biopsy. I would kill myself to put her through that for them to come back and say - uh, no, it isn't lymphoma. She also, unlike Buckwheat, has hyper-T and CKD, so I am just trying to keep her afloat with dealing with those.

I guess I am at the end of my rope to help you because it seems you've reached the point that I am at - at least in terms of IBD/lymphoma - and I have not yet figured out how to move beyond it.

 

[mommytobuck]

I guess I am at the end of my rope to help you because it seems you've reached the point that I am at - at least in terms of IBD/lymphoma - and I have not yet figured out how to move beyond it.

You have been very helpful! It is nice sometimes to just bounce ideas off people.

As you know, and I don't think this is a horrible thing.... I am not insanely in love with my cat the way some people might be. Of course I want him around but if it appears he is suffering even if I don't have a diagnosis I will make the decision to put him down. He just isn't the type of cat that can be dragged to the vet every 15 minutes like some cats are. It is something HE hates.

One thing that stops me now is that he does just seem too healthy to do that and my gut is telling me that if I can't find something on the tests that I have given him then I probably never will.

I joined a lymphoma group on facebook and they post their cats and, to me, my cat seems healthier. I am guessing I have another 2 or so years. He is 13.6 lbs. Granted at one time he was 16.5 but many of those cats are in the 7lbs and lower range.

She also, unlike Buckwheat, has hyper-T and CKD, so I am just trying to keep her afloat with dealing with those.

Well according to my vet Buckwheat does too.. on both but.. yes, I do worry that soon (maybe in the next year) both will become real issues. At that point I might make the decision. I had a CKD cat die on me once when I was living in denial land about her ability to be treated so not sure I want to do that again.

Just trying to take things one day at a time.

Thank you so much for all of your help.

 

[FeebysOwner]

He is 13.6 lbs. Granted at one time he was 16.5 but many of those cats are in the 7lbs and lower range.

Feeby was once over 17 pounds, just a mere 3+ years ago - and now is around 11.5. I have been able to keep her stable for the past year, despite the H-T and CKD, so that is something.

Overall, Buckwheat is doing much better than Feeby, and yet I would not consider putting her down at this point.

We will keep forging on, as I am sure you will with Buckwheat.

 

[mommytobuck]

Well he threw up again today. And today was massive. Tons of hair. Don't know what to think...

 

[pearl99]

I haven't read all the posts lately, but is it his own hair he's throwing up? Or ingesting some other fur/hair as in pica?
For hairballs I've used Egg Yolk Lecithin and it has helped with one of my cats in particular for hairballs when she's shedding, it emulsifies the fat around ingested cat hair so it can be passed easier.
I gradually increased the amount, it comes in a capsule and I open the capsule and sprinkle some on food (it's powder), kibble or wet. I got it at a health food store, brand is NaturesPlus. I started I think with about 1/4 of a capsule and went to 1/2 capsule.
I have no idea what is causing this, or if this would help, I just thought of the EYL and hair.
It doesn't have and side effects from what I know. I read some cats may have some loose poo if too much.
If you did a search on TCS here for it I know there are some posts about it. Needs to be Egg Yolk Lecithin, not plain lecithin.
I hope something is found!

 

[mommytobuck]

I haven't read all the posts lately, but is it his own hair he's throwing up? Or ingesting some other fur/hair as in pica?
For hairballs I've used Egg Yolk Lecithin and it has helped with one of my cats in particular for hairballs when she's shedding, it emulsifies the fat around ingested cat hair so it can be passed easier.

I am going to give that a try. I have done some research and lost of motility does seem to describe my cat. It is his own hair he is throwing up. Once again after a throw up... he had gone a few days largely happy and healthy. So, seems to me that whatever is happening has to build up. Also, it is slowing down in frequency after his ultrasound where they shaved his hair on his belly. And I purchased a rubber glove -- recommended by the other vet - and I rub him every day with it. He purrs so I think I get a lot off.

I think I am done with my vet. I suggested this (motility loss due to aging) and she blithly suggested that doesn't happen with older cats. Sadly I can only find like 500 articles by vets on line that says it does. I also suggested that Caplex that came very highly recommended by someone who's cats had hairballs and the vet said it doesn't look like something that would work... (because she will have to order it as it is only offered to vets) Well then what is is YOUR diagnosis, Missy? Aren't I paying you for that? Her diagnosis is a $2500 FNA. No thank you.

 

[pearl99]

I think I am done with my vet. I suggested this (motility loss due to aging) and she blithly suggested that doesn't happen with older cats.

Doesn't sound right to me either!
I hope you find a vet that serves you and Buckwheat better. Frustrating.

 

[mommytobuck]

Doesn't sound right to me either!
I hope you find a vet that serves you and Buckwheat better. Frustrating.

Well, Buckwheat had a terrible night. First I think he did a real hair ball throw up. I had forgotten that hair ball throw ups have a "noise" to them. Hack hack hack...He also had zero liquid with this one.

Typically his regular throw ups are mostly water, no noise -- just blurg - all at once and a little hair.

He spent most of the night awake and meowing.

My best guess is that I tried a bit of an egg yolk and maybe that made him sick. But it was a very small amount.

I also purchased him new hairball food and of course, he hates it and won't eat it. My vet suggested it.

I am growing desperate. I have to go back to work and I can't be feeing him every 4 hours wet food.

I also can't spend any more money on the vet. For example the vet charged me 500 for the ultrasound. My insurance will only pay to a maximum of $150.

 

[FeebysOwner]

Well, Buckwheat had a terrible night. First I think he did a real hair ball throw up. I had forgotten that hair ball throw ups have a "noise" to them. Hack hack hack...He also had zero liquid with this one....My best guess is that I tried a bit of an egg yolk and maybe that made him sick. But it was a very small amount...I also purchased him new hairball food and of course, he hates it and won't eat it. My vet suggested it.

Perhaps the egg yolk merely caused him to throw up the hairball. Given he didn't vomit anything else is actually a good sign, and maybe he will have another break before any more vomiting goes on!! Those hairball foods really are pretty much worthless, so if it were me, I wouldn't bother with them, especially since he doesn't like it anyway.

I am growing desperate. I have to go back to work and I can't be feeing him every 4 hours wet food.

You really need to consider the motion/automatic feeders as a possible resolution. Apparently, he needs to eat more often than you will be able to take care of when you are at work.

 

[pearl99]

My best guess is that I tried a bit of an egg yolk and maybe that made him sick. But it was a very small amount.

I also purchased him new hairball food and of course, he hates it and won't eat it. My vet suggested it.

My one cat barfed up a hairball also after starting the egg yolk lecithin, I just gave it a couple of time a week in small amounts, hopefully it was just loosening it up in Buckwheat.
Does he overgroom that he ingests so much hair? Or is he one that sheds year round?

Perhaps the egg yolk merely caused him to throw up the hairball. Given he didn't vomit anything else is actually a good sign, and maybe he will have another break before any more vomiting goes on!! Those hairball foods really are pretty much worthless, so if it were me, I wouldn't bother with them, especially since he doesn't like it anyway.

I also found the hairball foods useless. Mostly the just have more fiber in the form of powdered cellulose which basically is sawdust.

I second the auto-feeder. You can get ones designed for wet food that keeps the food cool. Before I had to use microchip feeders I used the auto ones with great success!

 

[mommytobuck]

My one cat barfed up a hairball also after starting the egg yolk lecithin, I just gave it a couple of time a week in small amounts, hopefully it was just loosening it up in Buckwheat.
Does he overgroom that he ingests so much hair? Or is he one that sheds year round?

No not sure where the fur is coming from. I have taken to brushing him daily with the "brush glove" and the furminator. Not only that... his entire stomach has been shaved. (for an ultrasound). He is a short hair cat. I even vaccum daily and have hard woods.

Not sure what is happening with the food... so I am going to hold off on getting an automatic feeder. It doesn't seem a sure thing that giving him food will stop him from thowing up. In particular lately seems he doesn't want to eat without me standing there. We will see what happens this week.

ETA also... I saw something yesterday about how fasting a cat can lead to helping motility issues. This makes some sense because as I noted, after the ultrasound, where Buckwheat couldn't eat for 17 hours, his throwing up stopped for the longest time I have ever seen. So I am wondering, has my being home, and giving into his eating every 4 to 6 hours.. slowing his motility?

 

[FeebysOwner]

I saw something yesterday about how fasting a cat can lead to helping motility issues. This makes some sense because as I noted, after the ultrasound, where Buckwheat couldn't eat for 17 hours, his throwing up stopped for the longest time I have ever seen. So I am wondering, has my being home, and giving into his eating every 4 to 6 hours.. slowing his motility?

Just in case it would help any, below is a link to an article on gastric mobility disorders in cats. You have had a lot of tests done that are mentioned, so assessing those with this article's information might be beneficial. I do want to point out that nowhere in this document is there any mention of fasting a cat to help with motility.
Gastric Motility Disorder in Cats (petplace.com)

 

[mommytobuck]

Just in case it would help any, below is a link to an article on gastric mobility disorders in cats. You have had a lot of tests done that are mentioned, so assessing those with this article's information might be beneficial. I do want to point out that nowhere in this document is there any mention of fasting a cat to help with motility.
Gastric Motility Disorder in Cats (petplace.com)

I have seen it a few times now but here is the link. I am not saying I am going to do 24 hour fasts but I might see what happens if I give him the same food but just with more space between them.

https://medium.com/@kalcevka/fat-fibre-and-fasting-for-felines-c3d47c77a2c9https://medium.com/@kalcevka/fat-fibre-and-fasting-for-felines-c3d47c77a2c9

Fasting

I didn’t find a lot of information on fasting in cats, but here are the few examples I did find.

Hunger is an essential part of how a carnivore’s digestive system works. Indigestible solids (for example, fur) are pushed out of the stomach by hunger pangs. If the cat is never allowed to become hungry, this movement doesn’t happen and hairballs or other motility issues can occur.¹⁰

Traditionally, dogs and cats with acute vomiting and diarrhea due to dietary indiscretion have been managed by withholding food for 24 to 48 hours for “bowel rest.”¹¹
The bowel does not necessarily “rest” when empty. During fasting, cats have a pattern of intestinal motility known as “housekeeping waves” (from what I understand, the author is talking about peristalsis — contractions of muscles in the digestive system to carry hair and food through the body).

Veterinarian Dr. Karen Becker writes about the benefits of therapeutic fasting (reducing food, but providing enough nutrition for organ and muscle function) for dogs, but recommends never fasting cats for more than 12 hours.¹²

There are risks to fasting a cat that is overweight, but both my cats are lean and muscular and I feel comfortable fasting them for up to 16 hours once per week by skipping one of their three daily meals.

This one too Feeding indoor cats just once a day could improve health

New research has found that feeding cats one large meal a day may help control hunger better than feeding them several times a day.

 

[FeebysOwner]

OK. Your cat, your choice. But I am curious when a lot of other things were mentioned in that same article about the varying ways to help a cat's digestive system (psyllium husk, egg yolk, etc.), you've pretty rejected them but 'locked onto' the fasting portion. It would seem the credibility of other parts of the article are 'suspect' in your mind?

You've had a long run regarding undetermined/undiagnosed issues with Buckwheat, but I think I can recall a time quite a while ago when he was throwing up and you weren't feeding him as often as you have been recently. So, perhaps you've come full circle on how to help prevent vomiting?

If it works, that is great. If it doesn't - and I hope that is not the case - please remember to tell us about this fasting experiment on which you are about to embark.

 

[mommytobuck]

OK. Your cat, your choice. But I am curious when a lot of other things were mentioned in that same article about the varying ways to help a cat's digestive system (psyllium husk, egg yolk, etc.), you've pretty rejected them but 'locked onto' the fasting portion. It would seem the credibility of other parts of the article are 'suspect' in your mind?

I have tried them all. But the Egg Yolk Lectin will still be tried. It just arrived.

I think fasting is a possibility. I had only one solid run where my cat didn't throw up. That was after he had an ultrasound. At first I thought that was because of lack of hair on his tummy. But as he still has no hair on his tummy and has resumed throwing up about every 72 hours and I am daily brushing him so that seems unlikely. But I was required to fast him from 10 pm the night before the ultrasound until 10 am -- and because he was at the vet from 10 am to 3 pm - he ultimately went about 17 hours.

Prior to the Pandemic he got food at 7 AM and 6 PM... every day. He might get a small snack at 3 AM. But I was pretty strict. But when I was home every day (and had zoom calls that he was demanding food during) I started giving in. When he started losing weight I just kept giving him more... but what if it is just too much?

 

[FeebysOwner]

Prior to the Pandemic he got food at 7 AM and 6 PM... every day.

But I thought he was throwing up then too, no?

When he started losing weight I just kept giving him more... but what if it is just too much?

It is only too much if he's gaining weight and continues to gain weight from being fed more.

However, the key is not necessarily to feed a whole lot more quantity of food because one is feeding more frequently, but rather to give smaller meals more often so there is not so much of a stretch between meals. By that I mean, feeding a cat two times a day equaling 'xx' ounces of food, does not mean that if you feed a cat 4-5 times a day you can't still feed the same 'xx' ounces of food.

Part of the problem with any cat who throws up can be from not having food often enough so that it evokes acid build up causing vomiting due to the acid. Which by the way, can also be tied to motility - in the opposite of what you are thinking.

 

[mommytobuck]

But I thought he was throwing up then too, no?

No not that far back. It started around summer of last year... 2021. He has had bouts of throwing up before (1x every 4 weeks or so) but not the constant 72 hour throw ups

Part of the problem with any cat who throws up can be from not having food often enough so that it evokes acid build up causing vomiting due to the acid. Which by the way, can also be tied to motility - in the opposite of what you are thinking.

I don't know .. I have given him Pepcid AC and that has not worked. In addition I have set it up so he is getting food about every 4 hours and that too, not working, so makes sense to go the other way. He gets food around 7 AM, 2 PM, 6 PM and recently I put his feeder dish to 11 PM, 1 AM and 4 AM. He may not eat all of it but he eats all the wet food during the day.

I did all the things they said for acid (such as raising his dish) didn't work.

He has, in his healthy past, thrown up because he didn't get food soon enough. But I was perfectly able to go all day at work and not come home to throw up.

 

[FeebysOwner]

He has, in his healthy past, thrown up because he didn't get food soon enough. But I was perfectly able to go all day at work and not come home to throw up

All you can do is try if you think going back to not feeding him all day might be the answer.

 

[mommytobuck]

I emailed my vet to ask her for more gabapentin. (thinking I would use it to get a new vet) and my vet suggested that we do a GI function test (she says that is a blood test) does anyone know anything about that?