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poivre

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Sweet little 14 year old Norma Jean has hyperthyroidism. There are 2 forms of treatment we are considering.
Many years ago our Edith-Ann had it and we rubbed thiamazole gel (wrong spelling?) in her ear which she took to very nicely.
Three years ago we tried the same thing with Norma Jean's sister Nellie and she freaked out, so we never did it again. She ended up having the radioactive iodine therapy and was absolutely perfect after that.
Now that Norma Jean is our only beloved cat left the same thing is happening to her. However, she will be 15 in April and has lost a lot of weight even though she eats well.
Do we take the chance of curing her completely with the radioactive iodine or are we better off just trying the gel in her ear which is not a cure and must be done every day?
I read that age is not a problem but I am coming to you -- the experts who adore their babies -- to ask which method you would opt for, the gel rubbed in her ear every day or the radioactive iodine which is a complete cure but she'd have to stay in the hospital for 3-4 days?
 

Furballsmom

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Hi -
To let you know my experience, my angel Poppycat already had liver issues so my only choice was the diet. Additionally he would have done very poorly being away from us at 17 years old, so the radioactive iodine wasn't an option either.

I have read one TCS member who's cat had trouble with the medication - although the cat didn't have pre-existing liver issues, the med caused a negative effect on that cat's liver. They even tried it twice while using the diet approach inbetween, and the same thing happened the second time.

Just a note regarding the diet, for you and anyone reading this thread, Hills can't manufacture enough of their y/d thyroid food to meet demand, both wet and dry (They say they're building another manufacturing facility which will be done in 2023). Weruva brands are at the minimum aafco requirements for iodine which is 0.6 mg/kg and their representative told me that some of their customers add chicken to their chicken varieties to bring the iodine down even further. Also, to mention because Hyperthyroidism can mask other issues including kidney problems, Weruva WX is extremely low phosphorus while having the other nutrients at aafco requirements (no prescription required).

If you and Norma Jean can manage and handle it, I think the radioactive iodine treatment is a better option.
 
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FeebysOwner

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I thought that meds (or low iodine foods) were used to 'stabilize' the level first before moving forward with the I-131 treatment, as additional testing to check things like renal function can reap misleading results otherwise. That being the case, Norma Jean will likely need to take meds for some period of time beforehand. Did you not have to do that with Nellie?

There are also oral meds that can be given instead of the transdermal gel. Feeby gets Felimazole twice a day, and I crush it up into either a bite or two of her food or into a lickable treat. For a cat that hates most meds, she has managed to tolerate this med quite well when given in this manner. Most instructions say not to cut or crush the meds, but there are numerous members who do with no issues, and her vets had no issue with doing so either. The worst that happens in these situations is that the dosage may not be as effective and possibly need to be increased as a result of the crushing.

Feeby (18+yo) was diagnosed in 2020 with hyper-T and has been getting the oral med since. I opted not to try the I-131 treatment as she was also diagnosed shortly afterward with CKD. She also would not have tolerated being isolated even for a few days.
 

fionasmom

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Fiona herself was on felimazole for several years. At the time, no one discussed the radioactive treatment with me and I was not informed about it. She took the pill crushed in BFF food easily, so I never tried the ear gel.

I also had thought that the medication was a preliminary to the I-131.
 
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poivre

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I thought that meds (or low iodine foods) were used to 'stabilize' the level first before moving forward with the I-131 treatment, as additional testing to check things like renal function can reap misleading results otherwise. That being the case, Norma Jean will likely need to take meds for some period of time beforehand. Did you not have to do that with Nellie?

There are also oral meds that can be given instead of the transdermal gel. Feeby gets Felimazole twice a day, and I crush it up into either a bite or two of her food or into a lickable treat. For a cat that hates most meds, she has managed to tolerate this med quite well when given in this manner. Most instructions say not to cut or crush the meds, but there are numerous members who do with no issues, and her vets had no issue with doing so either. The worst that happens in these situations is that the dosage may not be as effective and possibly need to be increased as a result of the crushing.

Feeby (18+yo) was diagnosed in 2020 with hyper-T and has been getting the oral med since. I opted not to try the I-131 treatment as she was also diagnosed shortly afterward with CKD. She also would not have tolerated being isolated even for a few days.
Thanks Feebys Owner:
We already went through the pill in a pill pocket but that pill pocket is chicken and she is allergic to chicken. She loved taking it wilth the pill pocket but refused it any other way so the Vet suggested the gel in the ear. I am worried because it really freaked out our Nellie (Norma Jean's sister who died a year and a half ago) but she thrived with the radioactive iodine method and was like a new cat.
Vet feels that because Norma Jean's tests for hyperthyroid came back only as borderline (taken twice to make sure) he feels it could be damaging to the kidney if she gets the iodine therapy. He wants to do the gel -- I am terrified and wonder how many cats freaked out from the gel or did they just like it?
 

neely

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Every cat is different and we had a long discussion with our vet regarding treatment. I wasn't ready to start with the I-131 right away plus I had to save up for it so I tried the Methimazole in the transdermal gel form for our cat. I had no problem whatsoever and It did bring his T-4 down a little but due to the fact that he did not have any organ involvement our vet strongly encouraged us to do the I-131 radioactive iodine treatment. Since Nellie had the I-131 you already know what to expect and fortunately had successful results.

Just out of curiosity, why did your vet think the I-131 would be damaging to Norma Jean's kidneys? It's certainly worth trying the ear gel and go from there. As I said, I had no problem and our cat did not mind it either. You sound like a very concerned and conscientious cat parent so take your time to think it over and make an informed decision that you feel is best for Norma Jean. Best of luck and please let us know what you decide. 🤗
 
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FeebysOwner

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We already went through the pill in a pill pocket but that pill pocket is chicken and she is allergic to chicken. She loved taking it wilth the pill pocket but refused it any other way so the Vet suggested the gel in the ear.
Since she took the meds in a pill pocket - try this pill masker 'paste'. It does not contain chicken and Feeby has done well with it too. It can easily be formed around most any pill.
TOMLYN Pill-Masker Bacon Flavored Paste for Cats, 4-oz canister - Chewy.com

I guess I would check as neely neely said above about her kidney values. Perhaps they are already high, even with only a borderline thyroid level.

Also, just so you know, Feeby gets a transdermal treatment for her Mirataz and has absolutely no issues with it at all!
 

Furballsmom

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Given your situation (to summarize; the iodine treatment will be hard on her kidneys and you're not comfortable with the gel plus it could be hard in her liver), why not utilize a diet, with some raw, and Weruva plus added chicken to bring the iodine in the weruva down even further?
 

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I'd say that some of this depends on how easy it is to give medications to your cat. Nimbus is a terror to give medicine to, and our vet said that the gel isn't a good choice if you have multiple cats since the other cat would almost certainly be exposed. However it seems more viable for you in a single-cat home.

Radiotherapy was recommended, and we ended up going with that.
 
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poivre

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Every cat is different and we had a long discussion with our vet regarding treatment. I wasn't ready to start with the I-131 right away plus I had to save up for it so I tried the Methimazole in the transdermal gel form for our cat. I had no problem whatsoever and It did bring his T-4 down a little but due to the fact that he did not have any organ involvement our vet strongly encouraged us to do the I-131 radioactive iodine treatment. Since Nellie had the I-131 you already know what to expect and fortunately had successful results.

Just out of curiosity, why did your vet think the I-131 would be damaging to Norma Jean's kidneys? It's certainly worth trying the ear gel and go from there. As I said, I had no problem and our cat did not mind it either. You sound like a very concerned and conscientious cat parent so take your time to think it over and make an informed decision that you feel is best for Norma Jean. Best of luck and please let us know what you decide. 🤗
To answer your question about our Vet's hesitancy: It has to do with the fact that she was given 2 blood tests and found both of them to only be borderline. This concerned him as far as using the iodine treatment because the iodine could cause a kidney problem. He consulted with another Vet and decided that if she had had a decent case like Nellie did, he wouldn't hesitate to do the iodine but in this case he wants to try the gel first and see what happens and go from there. This seems reasonable to me and your post makes me feel even more comfortable.
Now let's hope this skittish little lady will allow us to mess with her ear without having to force it. (sigh!)
I thank you all for your (as uusual), sage advice.
 

neely

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Good luck and fingers crossed the transdermal gel helps her. :crossfingers::crossfingers: As for applying it to her ear I found what worked best for me was to kneel down from behind my cat and apply the gel without hesitating.
 

cejhome

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We had a cat quite a few years ago that was hyperthyroid. We did the radio iodine treatment, as he wasn't easy to pill or do ear gel. It was expensive even back then, but well worth it. For us, it was pretty easy, as there was a Radiocat very close to us. Maybe about 8 - 12 miles from where we were living. He did great and he had no issues. I think you have to weigh the age, overall health, health issues, ease of giving meds, the expense for you, distance to the radio iodine facility, etc... Everyone's situation is different.
 
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poivre

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We had a cat quite a few years ago that was hyperthyroid. We did the radio iodine treatment, as he wasn't easy to pill or do ear gel. It was expensive even back then, but well worth it. For us, it was pretty easy, as there was a Radiocat very close to us. Maybe about 8 - 12 miles from where we were living. He did great and he had no issues. I think you have to weigh the age, overall health, health issues, ease of giving meds, the expense for you, distance to the radio iodine facility, etc... Everyone's situation is different.
Yes I agree. We went throught the same thing with our other cat 3 years ago and it worked out perfectly. The toughtest part for us was missing her desperately for those 3 days.
We will try the gel first and see what happens.
 

neely

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We went throught the same thing with our other cat 3 years ago and it worked out perfectly. The toughtest part for us was missing her desperately for those 3 days. We will try the gel first and see what happens.
I understand about missing your cat since the specialty center we used for Carleton's I-131 kept him there 5 days and we could not have close contact for 2 weeks after he came home. They use Scintigraphy which I learned is very important, if not imperative, but we decided if we were going to treat his Hyperthyroidism with the radioactive iodine treatment we wanted to insure the best possible outcome. I first heard about Scintigraphy from Antonio65 Antonio65 and am very grateful. My husband and I thought it would be heartbreaking for us to wait the full amount of time before we could see Carleton or cuddle him but I told myself if we were going to follow their instructions we would do whatever it takes for him to get well. I sincerely hope the transdermal gel works for you and her T-4 level comes down to the normal range as well as any organ involvement. 🤗
 
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poivre

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I understand about missing your cat since the specialty center we used for Carleton's I-131 kept him there 5 days and we could not have close contact for 2 weeks after he came home. They use Scintigraphy which I learned is very important, if not imperative, but we decided if we were going to treat his Hyperthyroidism with the radioactive iodine treatment we wanted to insure the best possible outcome. I first heard about Scintigraphy from Antonio65 Antonio65 and am very grateful. My husband and I thought it would be heartbreaking for us to wait the full amount of time before we could see Carleton or cuddle him but I told myself if we were going to follow their instructions we would do whatever it takes for him to get well. I sincerely hope the transdermal gel works for you and her T-4 level comes down to the normal range as well as any organ involvement. 🤗
I never heard of scintigraphy when we took our Nellie and she was fine for 4 days. Is it something new? Does it mean they need to stay extra days?
 
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poivre

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Good luck and fingers crossed the transdermal gel helps her. :crossfingers::crossfingers: As for applying it to her ear I found what worked best for me was to kneel down from behind my cat and apply the gel without hesitating.
Question: Do you have to do both ear flaps or just the one?
 

neely

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I never heard of scintigraphy when we took our Nellie and she was fine for 4 days. Is it something new? Does it mean they need to stay extra days?
In lay terms, Scintigraphy is a diagnostic procedure done prior to the radioactive iodine injection. Since it is done before giving the injection it does not require the cat to stay longer. It helps the radiologist determine the size of the tumor on the thyroid so that they know the exact amount of radiation required to treat the Hyperthyroidism. Without the use of Scintigraphy they're merely guessing or giving all cats the same amount of radiation. I honestly don't know if it's new. But the radiologist also explained to me that if there are multiple tumors or extremely large tumors they would opt for removing the thyroid as opposed to doing the I-131.

Here is an article with a thorough explanation of Scintigraphy: Thyroid scintigraphy in hyperthyroidism - PubMed
 
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neely

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Question: Do you have to do both ear flaps or just the one?
Make sure you use a finger cot to administer the ear gel. The pharmacy you get the medicine from should include finger cots for you or else be sure to ask for them. (Some people cut the fingertip off a latex glove but the compound pharmacy the vet sent us to included the finger cots.) It's important to use this so that none of the Methimazole gets absorbed into your system. Use the prescribed dose of gel on the finger cot and gently rub it into the inside of the cat's ear until all the gel is applied, it only takes a few seconds. The instructions I got were to apply it to one ear and then 12 hrs. later to the alternate ear. However, you need to clean the ear approx. 8 hrs. after you apply the gel. The reason for this is so that the gel gets fully absorbed. If you don't clean the ear it leaves a residue build up. I made up a little trick that helped me remember which ear to medicate, i.e. Right at Night. That way I always knew to do the Left ear in the Morning.

Note: you may get different instructions, this was the procedure for our cat. Talk to the pharmacist and ask any questions or concerns you may have about the gel. As I said in a previous post, once I got the hang of it the application worked really well. I hope this helps and if you have any other questions please feel free to ask. I'm more than glad to offer my support. :heartshape: And there are other members who have gone this route that I'm sure would be glad to help too.
 
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