Treating hyperthyroidism

[Chit Chat]

Hello All! My 11 yr old cat was just diagnosed with an overactive thyroid. All of her other blood work came back good, so we caught it early. My Vet said that the oral meds for this can sometimes make a cat feel worse, so she suggested managing it with diet. I really didn't know the right questions to ask, so I came home and starting researching it. I see that there is a treatment with the radioactive iodine available. I will need to get with the Vet and see if anybody offers that in my area (on a search, it doesn't appear so.) If that is not feasible, does anybody have any suggestions on different varieties of food I can try? The Science Diet for thyroid care is what we've got, but the moist food is really unappealing looking, and it's very thick. I bought some salt-free chicken stock, and I'm adding just a little of that in the moist food to give it some more flavor. Is this okay? I'm thinking about buying fresh chicken and cooking it and chopping it up for her and add that to the Science Diet moist food. I want to make sure she gets enough protein. We have 2 cats, so keeping their food separate is going to be a challenge, as we don't want the 1 yr old to eat the thyroid care dry or moist food. I don't think she'll bother with the moist food. It's one big lump in the can! Thanks for any advice!! Much appreciated.

 

[neely]

You mentioned your cat's other bloodwork came back good but didn't say if the vet ran a T-4 and, if so, what were the results? I'm assuming the med your vet discussed with you was Methimazole. Is that correct? It can be given in a transdermal gel form to the inner ear so that you wouldn't have to give her an oral med. This form of the med has less side effects too. Diet 'alone' cannot manage H-T, unfortunately it will decline if not treated with medical intervention. The radioactive I-131 treatment is very effective. However, should you decide to go this route make sure the facility you choose uses scintigraphy. You can read more about this treatment as well as H-T in some of these threads: Hyperthyroid cat,methimazole and I131 treatment
Hyperthyroidism advice
Hyperthyroidism in Feeby - Questions

Best of luck, please feel free to ask any more questions and keep us updated on your cat's progress.

 

[silent meowlook]

Hi,
With the Science Diet Thyroid diet, you have to feed it exclusively. No treats, no substitutes, no supplements. You feed only it. If you feed anything else it nullifies the diet, and you won't have the thyroid levels controlled.

I have worked at places that do the 1-131 treatments. You have to leave your cat in the hospital for 3 days. It is expensive, although I don't know how much it costs now, in 2007 it was around $1,000.00 but I am sure it is much more now. The cats receiving treatment would all spend the three days in a ward designed and used only for that treatment. There would be one Tech assigned to them and nobody else could even go in the room. Things may be different now, so be sure to ask all the questions, such as: Will they be checked at night? Are there cameras on them if not? What kind of preliminary testing must be done? Will that be done there or can you have your regular vet do it? What is the after care like? And have they noticed an increase in kidney disease in cats receiving this treatment within a few years of the treatment?

There is also a surgery that can be done where they remove the thyroid gland and then you supplement with pills. Most places don't do that surgery, so you would have to find a specialist to do it. Finding one that does them often enough might mean a university.

Another thing to consider is that often hyperthyroidism will mask kidney disease on the blood work. Once the thyroid is regulated you should run another blood panel.

A transdermal form of Methimazole (thyroid medication) is available and easy to use. You just rub it into the inner ear flap twice a day, alternating ears and wiping away any buildup of medication before applying any additional. It is convenient for people who have trouble getting pills into their cat. The downside is variable dosing due to absorption of the ear, temperature, etc.

My cat is hyperthyroid. I give her the Methimazole tablets. She is well regulated on that.

Sorry for the diagnosis.

I am sure that your cat will do fine with whatever you decide to give.

Side note: I did a few webinars on hyperthyroidism in cats. When discussing why cats get it, one of the theories is that it can be cause by environmental factors such as the glue that pop top cans are sealed with, flame retardant treatments on, you know, absolutely everything. Dry food containers and dry food itself, something to do with the irradiation of it when processed and also different types of plastic. That was frustrating to hear that these poor cats have really been doomed by human conveniences.

 

[Antonio65]

Hello All! My 11 yr old cat was just diagnosed with an overactive thyroid. All of her other blood work came back good, so we caught it early. My Vet said that the oral meds for this can sometimes make a cat feel worse, so she suggested managing it with diet. I really didn't know the right questions to ask, so I came home and starting researching it. I see that there is a treatment with the radioactive iodine available. I will need to get with the Vet and see if anybody offers that in my area (on a search, it doesn't appear so.) If that is not feasible, does anybody have any suggestions on different varieties of food I can try? The Science Diet for thyroid care is what we've got, but the moist food is really unappealing looking, and it's very thick. I bought some salt-free chicken stock, and I'm adding just a little of that in the moist food to give it some more flavor. Is this okay? I'm thinking about buying fresh chicken and cooking it and chopping it up for her and add that to the Science Diet moist food. I want to make sure she gets enough protein. We have 2 cats, so keeping their food separate is going to be a challenge, as we don't want the 1 yr old to eat the thyroid care dry or moist food. I don't think she'll bother with the moist food. It's one big lump in the can! Thanks for any advice!! Much appreciated.

Hi and welcome!
As others said, if you are attempting to keep HT under control with the diet, you should feed that specific food only, and nothing else, nothing.
Unfortunately that specific food isn't very appealing to cats, I tried with my cat and I failed, because she only ate the first two or three cans, then she refused to eat for good.

I guess the meds your vet is talking about is the methimazole, or carbimazole. Yes, they can give side effects and make a cat sick, but they are among the only options, and certainly they work on HT much better than the diet alone.
The pill form could give some GI issues, the eargel form is easier on the stomach and maybe even easier to administer, especially with cats who fight with pills.
The only thing is that both the diet and the pills do not treat the HT, which will progress despite the therapy, they only counter the side effects of HT on the body. Eventually the thyroid will so badly working that no med will be able to counter its damages.

The only two treatments that can really help are the surgery that would remove part or the whole thyroid gland, or the I-131 treatment, which I believe is the gold treatment.
Do you live in a country that doesn't offer this treatment to pets?

I live in Italy, and until a few months ago there were no facilities here for this therapy, so I had to travel abroad to have my cat successfully treated. Now we have one facility, but they have unaccessible prices, so I doubt that someone will ever walk in there to have their pets treated.

The I-131 treatment is a very effective one, it works 98% of cases, it's non-invasive, it's a single injection of this radioactive isotope of iodine, the cat remains in isolation for about 5 days, then it can go back home where the owners will receive a few instructions on how to handle and manage the cat in the first two weeks.
The treatment may be expensive (depending on the country), but in the medium to long term is much less expensive than treating the cat with pills and eargel, and about 15 to 18 months later it will be even cheaper.

If your vet doesn't want to support or help you in this adventure (like it happened to me) you could see another vet, or contact a I-131 facility and ask them what you should do.

 

[FeebysOwner]

Hi. It is probably in one of the threads that neely provided above, but here is a web site with loads of information about hyperthyroidism, as well as all associated treatments, including radio-iodine. Animal Endocrine Clinic | Where science and compassion cure

 

[Dos Gatos]

My cat was diagnosed with severe hyperthyroid in April and is now well controlled with the transdermal methimazole. She has a very sensitive stomach so we didn't even try the pills and she has had no problems with the transdermal. She actually seems to enjoy the "ear massage" twice a day.
I'm definitely not an expert on the I-131 therapy but my understanding is that you would want to treat with methimazole for a period of time beforehand to see what lowering the T4 does to the kidneys. In my cat's case, it uncovered moderate kidney disease for which we now have to treat on top of the hyperthyroid.
At your cat's age, I would definitely look in to the I-131 if feasible. 11 is still relatively young for a cat. My girl is close to 17yo so we chose to just treat with methimazole, even before we knew about her kidney disease.

 

[theyremine]

Although it was several years ago, my vet too recommended treating with transdermal methimazole before considering the I-131 therapy. While my Pedro tolerated the transdermal well, it allowed the vet to find a much bigger problem and so the I-131 was no longer an option.

 

[fionasmom]

I am just going to add Fiona's experience here along with the rest of the great information you have received. She was treated with Felimazole for several years. At the time, I was not offered or told about the radioactive iodine treatment but would have considered it if it had been presented. Ironically, in Los Angeles now, I could pretty much have a choice of places that provide this treatment. I was looking for a price for you currently, and found $1500 which is not too much more than what was quoted if that is still correct.

Fiona took her pills in BFF cat food without much of an issue.

If possible, I would get all the info about the 1-131, make sure that your vet did run a T4. As for the special diet, yes you have to follow it meticulously or all bets are off. I had other cats and they had been raised with free food available at all times, so sequestering her for the rest of her life was not going to work.

 

[Chit Chat]

Thank you all for your valuable info! It's disheartening to go to a Vet that you trust and then you're given very little information about a serious condition that you're just discovering (I wasn't sure what I needed to ask in that moment!). She just said that they treat it with diet because the meds can make cats feel worse. Of course I came right home and started researching it further. I'm fairly new to the area, so I asked my co-workers if they could recommend a good Vet, and my boss did just that. I've already got an appt. for Cookie next week to let that Vet do another exam. I'm going by my current Vet's office tomorrow and will get her records. Thanks again, and I'll be checking in with the forums and pass on any advice that I might get.
I agree, Dos Gatos, 11 is still young for a cat! I had one that almost made it to his 22nd birthday, and he was healthy up until the last year or so of his life. I credit Science Diet food, good genes and super loving humans for his longevity!!

 

[Antonio65]

When my cat was diagnosed with HT, I asked the vet to teke the I-131 in consideration, but they said they wanted to start with the pills first, ok, but it wasn't what I wanted to do.
So, after a few weeks with the pills, I asked them again, and again, and again, for several times, until they told me they weren't going to pursue this route and said I had to do that on my own. Which I did.
This because in my country (Italy), this therapy isn't done to pets, and my vets didn't want to break the routine.

I found the facility abroad, and dealt with them till the day I took my cat up there and they treated her successfully.

Sometimes we have to be stronger than the fate.

 

[fionasmom]

Call me slow, but I just reread your first post and realize that the vet really did mean that you should use diet alone. For some reason I thought that was a suggestion but not one that she was planning on holding you to if you had wanted another treatment. Yes, run far run fast to another vet and make a determination as to which of the standard treatments you want.

In the moment, we never know what to ask, especially in this case of treatments for hyperthyroidism.

 

[Chit Chat]

Call me slow, but I just reread your first post and realize that the vet really did mean that you should use diet alone. For some reason I thought that was a suggestion but not one that she was planning on holding you to if you had wanted another treatment. Yes, run far run fast to another vet and make a determination as to which of the standard treatments you want.

In the moment, we never know what to ask, especially in this case of treatments for hyperthyroidism.

When you're standing there and the Vet (whom you trust) tells you something in such a matter-of-fact way, it really takes away from the seriousness of the problem - even though I know how serious it is in humans, she was very nonchalant about it. Luckily we have the internet to be able to research these things! As I drove home that day, I kept thinking about why she didn't at least have me make an appointment in a few months to recheck the blood work, and all of the other questions I should've asked. I decided over the weekend to find another Vet. I picked up Cookie's records this morning, so I have that for the new Vet. I will tell him my expectations for the ongoing care of my cat, and if he can't help me with that, I'll find one who can! I asked the current Vet this morning if I could mix a little (less than a tablespoon) of some no-salt chicken stock into the special food Cookie's on to make it more palatable for her, and she said I could. I also cooked some chicken (no added ingredients) and cut up a little bit to mix in with it too. She needs her protein! She ate the whole thing awhile ago. The challenge will be keeping my other cat away from her food. It's a juggling act right now. Thanks again for the input!

 

[Antonio65]

When you're standing there and the Vet (whom you trust) tells you something in such a matter-of-fact way, it really takes away from the seriousness of the problem - even though I know how serious it is in humans, she was very nonchalant about it.

I wouldn't trust a vet that takes a serious disease like the HT in a less than serious way. A disease like this one requires a pro-active approach, and a vet that doesn't act this way clearly doesn't know what is going to happen.

I asked the current Vet this morning if I could mix a little (less than a tablespoon) of some no-salt chicken stock into the special food Cookie's on to make it more palatable for her, and she said I could.

As it has been said earlier, mixing other food with the special HT food makes all the efforts vain.
If Cookie doesn't like her special food, then you should pursue the pills/eargel route, which certainly works, even better than the special food. And meanwhile find a place where they can perform the I-131 therapy.