Weight loss, ravenous appetite and vomiting

Musiaka

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My cat Musiaka hasn’t been doing well lately. He’s lost a huge amount of weight and is ravenous whole day long, increased peeing and pooping as well. At some point he started urinating exclusively on the sofa but it stopped once we changed the litter. He’s also vomiting extra much lately and increasing his Pred doesn’t seem to work as well anymore. He’s skin and bones, but still interested in food and going outside. And his heart does seem to beat irregularly according to the vet.

All of this sounds a lot like hyperthyroidism right? Especially the weight loss and the insatiable appetite. Well, we tested for it. And yes, his thyroid levels are elevated, but…not by much! He still got the diagnosis but the vet says it’s probably not the main reason for his latest new severe symptoms. What the hell? So what is it? Glucose, kidneys, liver, general blood test all came back good. But he’s wasting away. I’m suspecting cancer but the vet doesn’t want to prescribe chlorambucil without a biopsy. I don’t want to travel to another city with an emaciated cat and put him through invasive stuff. He’s been through so much lately. All I could do was to up his Pred to 5 mg and give Cerenia but it hasn’t worked yet.

Musiaka is on Ursodiol (for gallstones), enzymes (chronic pancreatitis), 5 mg Pred (IBD symptoms), oral b12 and now hyperthyroid meds. I’m giving him recovery food from Royal Canin right now hoping it will make him poop less and get absorbed better. He’s losing weight no matter how much he eats. And he acts like he’s starving, nothing exist for him right now except food.

What else can I do?
 

Alldara

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Its likely still hyperthyroidism. Some cats with hyperthyroidism are on the high end of normal. There's another test that can be done.

In about 1 months time after starting hyperthyroid meds, your vet should recheck. If the thyroid levels remain up, then more testing should be done for other diseases.

Hyperthyroidism in Cats | VCA Animal Hospital | VCA Animal Hospitals
 
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Musiaka

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Its likely still hyperthyroidism. Some cats with hyperthyroidism are on the high end of normal. There's another test that can be done.

In about 1 months time after starting hyperthyroid meds, your vet should recheck. If the thyroid levels remain up, then more testing should be done for other diseases.

Hyperthyroidism in Cats | VCA Animal Hospital | VCA Animal Hospitals
thanks Alldara. Exactly, we are scheduled for another blood test in a month. We started the hyperthyroid med today, but the vet warned us that in 25% of times it has so many side effects that it has to be discontinued. I’m praying that my cat is gonna be in those 75% of cases. I can’t see him going through with neither the radioactive iodine therapy, nor the surgery. He’s so tired and has a bunch of other illnesses.
I bought some Hills y/d but he’s not keen on it so far. We can’t afford him refusing food as he’s down to 3.1 kg (from his regular 4).
 
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Musiaka

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If the thyroid medication and increased Pred won’t help him gain weight and control his other symptoms, I will check for EPI and if I could get the chemotherapy drug to try out as last resort. If those don’t work out, I think it will be time for my precious baby to go rest in peace over the rainbow bridge…
 
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Musiaka

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One step at a time then :) my vet had us go slowly with introducing the medication. I chose the pill not the ear one. That apparently reduces risk.

Theres some different tips to get them to eat in another thread. Any Good Tips To Get Your Cats To Eat? Share Them Here!
My cat got a liquid oral suspension, it’s formulated especially for cats. Not sure if we had any other option but hopefully it reduces the risk as much as the pill does!
 

IzzysfureverMom

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The first cat I had with hyperthyroidism I had to ask to have the extra tests that Alldara mentioned above. Those tests gave the vet more information to get him appropriate treatment.
Back then you just had the pill.
My girl now is high normal but only T4 was tested. I have looked into the gel ear medicine for her but I do not know if that is As effective. If she does end up being diagnosed I have a lot of questions to ask.
Hang ing there♥ I am hoping for the best for you and Musiaka.
 

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Hi. I don’t agree with that percentage of cats having bad side effects from the Methimazole. At least not in the cats I have seen. Also, what would be a bad side effect? Nausea? Is that worse than wasting away to nothing? Of course not. So, give the thyroid meds and recheck to make sure the levels are good.
So, I would assume he has IBD because of the Prednisolone. It is best to give these cats a novel protein canned prescription diet if you are able.
My cat, who has hyperthyroidism, and had IBD which turned into lymphoma eats Royal Canin PR canned rabbit food. She also gets Methimazole twice a day, as well as Prednisolone, and Chlorambucil (chemotherapy) pill every other day. I have been treating her this way, along with SQ fluids ( also has kidney disease) and Vitamin B12 injections ( absorbed better than in a compromised GI tract) for the last 3 years and she is still doing well.

Try talking to your vet again about the chemotherapy if she feels this is lymphoma. My cat is not a good surgical candidate and we used an abdominal ultrasound as the diagnostic as opposed to biopsy.

If your cat really isn’t doing well and you don’t have the option of doing biopsy etc I don’t see what the harm is in trying. Because it isn’t a “ standard of care” your vet might not be comfortable, and in that case find someone who is or try to persuade her to try.
 

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It can't hurt to try the hyperthyroid med first before going to more invasive procedures or harsh medications.

I don't remember being told about any severe side effects when Iris was started on methimazole, just that we would have to watch her liver and kidney lab values.

We tried the compounded liquid first, but that didn't work well because she would fling her head around and half the med went flying. The transdermal paste irritated her poor ears so much I had to stop that. So we're on to the pills and those have worked very well. It can be tricky getting the pill into her, but at least I know she's getting the full dose.

She's gained back a lot of her weight. She's not completely up to her ideal weight, but she's also almost 16 years old and probably won't ever be as muscular as she was when she was younger. Her coat looks and feels wonderful. She still begs for food 5 or 6 times a day, but I think that's habit more than hunger at this point. (And no, I'm not feeding her that often).

So far her labs have stayed in the normal range. She actually has an appointment this afternoon for her 6-month check, so :crossfingers: that the labs still look good.
 
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Musiaka

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Can the side effects come after already first dosage? He is doing worse and worse each hour each day…
Very skinny, have never seen him like this, has diarrhoea and pukes. Appetite suddenly gone today (I tried giving him some recovery food which he refused and now he doesn’t want to eat anymore). He’s breathing fast. Was lively up until today but every passing hour makes him worse. Do we keep on trying the thyroid meds? Or is it time to let go? My heart is breaking to pieces thinking that he might be starting to truly suffer…
 

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Can the side effects come after already first dosage? He is doing worse and worse each hour each day…
Very skinny, have never seen him like this, has diarrhoea and pukes. Appetite suddenly gone today (I tried giving him some recovery food which he refused and now he doesn’t want to eat anymore). He’s breathing fast. Was lively up until today but every passing hour makes him worse. Do we keep on trying the thyroid meds? Or is it time to let go? My heart is breaking to pieces thinking that he might be starting to truly suffer…
Did your Vet discuss what the side effects are and what to look for? I would give them a call and tell them what is going on.
 
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Musiaka

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Did your Vet discuss what the side effects are and what to look for? I would give them a call and tell them what is going on.
Yes, but he as I understand he shouldn’t be having those side effects after only one dose of 0,25 ml (she started him on a lower dose specifically to avoid side effects). I suspect that he’s having those because of other things… He’s been getting gradually worse the entire time lately. A lot of vomit and pooping and some of it diarhea. My poor sweet baby
 
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Musiaka

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It can't hurt to try the hyperthyroid med first before going to more invasive procedures or harsh medications.

I don't remember being told about any severe side effects when Iris was started on methimazole, just that we would have to watch her liver and kidney lab values.

We tried the compounded liquid first, but that didn't work well because she would fling her head around and half the med went flying. The transdermal paste irritated her poor ears so much I had to stop that. So we're on to the pills and those have worked very well. It can be tricky getting the pill into her, but at least I know she's getting the full dose.

She's gained back a lot of her weight. She's not completely up to her ideal weight, but she's also almost 16 years old and probably won't ever be as muscular as she was when she was younger. Her coat looks and feels wonderful. She still begs for food 5 or 6 times a day, but I think that's habit more than hunger at this point. (And no, I'm not feeding her that often).

So far her labs have stayed in the normal range. She actually has an appointment this afternoon for her 6-month check, so :crossfingers: that the labs still look good.
Oh I so wish it worked for us as well as your kitty. I’ve got the liquid but it’s pretty easy to give it to him. My baby is very docile and easy to medicate.
fingers crossed for your kitty!
 

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Still might be GI lymphoma.

Speak to your vet, the head vet or owner of the practice, or seek out another vet. Tell them you believe the diagnosis (endo + biopsy on an unstable cat) is more risk than the drug and you are giving informed consent to try chemo without a cancer diagnosis. I did this with Krista and it made a difference from the first dose.

I take this back. Sort of. I don't have experience with hyperthyroidism. You may want to discuss with your vet how much time to work this angle before deciding to try the chemo. I would not try them both at the same time unless you are certain he has both.
 

Alldara

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Still might be GI lymphoma.

Speak to your vet, the head vet or owner of the practice, or seek out another vet. Tell them you believe the diagnosis (endo + biopsy on an unstable cat) is more risk than the drug and you are giving informed consent to try chemo without a cancer diagnosis. I did this with Krista and it made a difference from the first dose.

I take this back. Sort of. I don't have experience with hyperthyroidism. You may want to discuss with your vet how much time to work this angle before deciding to try the chemo. I would not try them both at the same time unless you are certain he has both.
Usually, they re-test hypothyroid after 1 month of medication to see. They can sometimes tell with bloodwork at that point if there's something else going on as hyper-t sometimes masks other illnesses.

Frequent vomiting can also happen with hyper-t.
 

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The first cat I had with hyperthyroidism I had to ask to have the extra tests that Alldara mentioned above. Those tests gave the vet more information to get him appropriate treatment.
Back then you just had the pill.
My girl now is high normal but only T4 was tested. I have looked into the gel ear medicine for her but I do not know if that is As effective. If she does end up being diagnosed I have a lot of questions to ask.
Hang ing there♥ I am hoping for the best for you and Musiaka.
The risk with the transdermal is actualy for people. When people apply it without gloves on it can cause hypothyroidism by soaking into the fingers.

Iodine treatment is consodered the gold standard for hyperthyroid. If your cat has heart issues though they are poor candidates for it.
 

neely

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If he is doing worse and breathing rapidly, you need to get him to a vet ASAP. Even if it means the ER.
I completely agree! :agree:

Our cat had Hyperthyroidism with absolutely no negative side effects from the Methimazole which he was on for nine months. We ended up going with the I-131 radioactive iodine treatment but only because he was a good candidate and had no organ involvement. I'm so sorry you are going through this with Musiaka. Thinking of you and sending special thoughts.:vibes::vibes:
 

IzzysfureverMom

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The risk with the transdermal is actualy for people. When people apply it without gloves on it can cause hypothyroidism by soaking into the fingers.

Iodine treatment is consodered the gold standard for hyperthyroid. If your cat has heart issues though they are poor candidates for it.
I have read here and other places the ear gel can cause irritation to their ears, but will need to ask how common that is. I have not personally used it.
I don't know if Izzy is a candidate for the I -131 treatment as she needs medication daily and she is very anxious. I am hoping when she is retested she test lower then very high in the normal range but vet seems to think that will not be that case. So I am going to be prepared with questions at that time.
 
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