# Misty has hyperthyroid



## Jenlee (Mar 21, 2008)

My beloved 12-year-old Siamese has been diagnosed with hyperthyroidism. Vet emailed results of labs today and said we need to start her on meds tomorrow.

I am devastated. I feel so horrible. Vet sent me a link to read about this disease on marvistavet.com. It says that feeding can food with a pop top can cause hyperthyroidism and that Siamese cats do not often get this disease. Misty is Siamese and I have been feeding her from pop-top cans for a few years now....I had no idea. Why don't vets tell people these things? I have cried since getting the news. 

I don't have children, and she is my baby. 

I desperately need help. I don't know what dosage of methimazole the vet will recommend starting her on, but I read on this forum to start slow with 1.25 mg twice daily and ramp up. If vet doesn't recommend going slow, I will do it on my own. Can anyone tell me how long to stay on 1.25mg and how to increase, etc.

I did join the yahoo group for hyperthyroidism in cats, but waiting to be accepted.

Please say prayers for my baby girl. I love her so much it hurts.


----------



## Jenlee (Mar 21, 2008)

*Hyperthyroid Surgery?*

Sorry, I tried to edit my post on "Misty has hyperthyroid" but could not find the edit button.

Vet mentioned hyperthyroid surgery could be an option. Anyone's cat had surgery for this?
Of course, I know I have to get her on meds for now and make sure kidneys are ok.

Thanks,
Jen


----------



## Digikid (Feb 27, 2011)

You have my prayers.


----------



## laurief (Jun 22, 2008)

Hi Jenlee,

I'm sorry for your girl's diagnosis, but try not to despair. HyperT is a very controllable, and even curable disease. I've written several lengthy posts on this subject lately which I strongly recommend you read, if you haven't already. They can be found in the following thread:

http://www.catforum.com/forum/38-health-nutrition/140657-resthyro-hyperthyroid.html

To answer your specific questions, the "start low and go slow" approach to dosing typically involves starting at a low dose of 1.25 mg of methimazole twice daily (1.25 mg once daily if there is known kidney disease), then retesting the blood in 3 weeks. If euthyroid (normal thyroid level) has not been achieved on the starting low dose, the dose is then increased by 1.25 mg daily (administered as 2.5 mg a.m. and 1.25 mg p.m.), and blood is retested again in another 3 weeks. This schedule of small dose adjustment followed by a 3 week retest is continued until euthyroid is reached. Whatever dose she is on when she achieves euthyroid is the dose you will maintain her on. HyperT is a progressive disease, however, so even after she has reached euthyroid, it will be necessary to retest her every 6 months in order to make sure her dosage is maintaining her euthyroid status.

Surgery is one treatment option, but it is not generally recommended. Sometimes diseased thyroid tissue can occur in places in the body other than the thyroid glands themselves, so even after surgery has removed the diseased thyroid glands, hyperT may still be present in the displaced thyroid tissue. Even if the only diseased tissue is in the thyroid glands themselves, the surgery to remove them is very delicate and risky and can result in serious permanent side effects.

The best option for treatment of hyperT, and the only CURE for this disease is radioactive iodine (I-131). It is much safer than surgery and will treat all of the diseased thyroid tissue no matter where it occurs in the body. It is an expensive procedure ($1000-1500) up front, but over the lifetime of your cat, it would most likely cost less than managing hyperT with medication and blood retests, and it would eliminate the potential risk of medication-induced side effects associated with long-term methimazole use. You can read more about I-131 here:

Radiocat - Centers For The Treatment Of Feline Hyperthyroidism

As far as canned cat food and its association with hyperT is concerned, yes, there has been speculation about a link. There are, however, other potential causes of hyperT, including many household items and foods which contain fire-retardant chemicals. The fact is, there probably isn't much of anything in our living environment that doesn't have the potential to cause some type of disease. We can no longer hide from our own pollution. Canned cat food probably doesn't present significantly more risk than anything else to which we expose our cats.

Please feel free to post again with any more questions you may have.

Laurie


----------



## Jenlee (Mar 21, 2008)

Thank you so much, Laurie. 

I read the link about I-131 treatment last night. It's what I truly want to do, but my husband is not on board at all. Two years ago, Misty had anal sac removal surgery. Hubby says it has to end somewhere. 

I honestly don't know how I can give the meds twice daily. I always have to get hubby to hold Misty whenever I give her meds. He is gone from home 14 hours a day. I know meds should be given 12 hours apart. If he even helped with the morning dose, I would have to give it at 3:30 AM.

I go to the vet's office today to pick up the med. If vet isn't on board with low dose, I will do it on my own, but don't think I could tell the vet. I really like her, but not sure she would appreciate the fact that I don't do what she recommends. Problem is, when I take her back for testing, if T4 hasn't went down, she will only continue to increase dosage. What to do?

I questioned her in the past, and she told me if I could show her legitimate medical studies, she would believe it. Any medical study sites I could show about low-dose for hyperthyroid? 

Truly, thank you for all your help. 

How does anyone with an hyperthyroid cat ever leave town for even a couple nights? My cat won't even let anyone else near her, so know I can't get anybody to give meds.


----------



## melysion (Mar 12, 2007)

My cat, Toby, was diagnosed with hyperT just after Christmas. He is currently on 10mg of methimazole.

Medicating him is a bit of a pain - I've hidden Tobys pills in 'treats' such as cheese or cooked chicken which has helped (just be aware you cannot crush the pills in his food - the pill has to be swallowed whole if its to work) - but I noticed a signficant improvement in his symptoms within days.

I'm not aware of the policy of slowly increasing the medication - Toby has been on 10mg per day from the start. I am battling with his (lack of) appetite at the moment which may be a side effect of the pills (just a thought of mine, rather than being confirmed by the vet). But I do know that the condition is easily controlled with meds generally speaking.

The radioactive treatment isn't even on my radar as a possibility - theres no way in heck I have that sort of money upfront.


----------



## tghsmith (Dec 9, 2010)

I have delt the meds, surgery and radcats, the meds were a stop gap untill we could get the surgery done, the surgery results lasted about 1.5 years, should have went rad from the start, emma had her rad treatment 7 years age and wakes me up everymorning(even with the time change) the rad treatment has upfront cost, but the saving can be relized in most cases next to nothing is reguired after, no daily pills, no monthly level checks, happy cat.. the rad treatment is also what seems to be the less stressfull of the options also(for both owner and cat)


----------



## melysion (Mar 12, 2007)

tghsmith said:


> I have delt the meds, surgery and radcats, the meds were a stop gap untill we could get the surgery done, the surgery results lasted about 1.5 years, should have went rad from the start, emma had her rad treatment 7 years age and wakes me up everymorning(even with the time change) the rad treatment has upfront cost, but the saving can be relized in most cases next to nothing is reguired after, no daily pills, no monthly level checks, happy cat.. the rad treatment is also what seems to be the less stressfull of the options also(for both owner and cat)


Very true I'm sure - i'd love to get the radioactive treatment for Tobe. However, I'd have to save a long time before I could ever consider it a possibility - I have no real way to just find the money from somewhere otherwise.


----------



## laurief (Jun 22, 2008)

Jenlee said:


> Thank you so much, Laurie.


You're welcome.



> I read the link about I-131 treatment last night. It's what I truly want to do, but my husband is not on board at all. Two years ago, Misty had anal sac removal surgery. Hubby says it has to end somewhere.


Try to get hubby to consider the long term. At only 12 yrs old, it is possible that Misty could live another 10 yrs (I've had two cats live to 22+ yrs old). 10 yrs worth of meds and blood testing is going to cost more than one I-131 treatment, and the meds and blood testing won't cure the disease.



> I honestly don't know how I can give the meds twice daily.


If you read the thread that I linked in my first response above, you'll see my suggestions for dealing with this problem. 



> I go to the vet's office today to pick up the med.


Assuming your vet gives you methimazole in pill form, you're also going to want to buy a pill cutter and some Pill Pockets (you should be able to get both either from your vet or a pet store - pill cutters can also be purchased at pharmacies). 



> If vet isn't on board with low dose, I will do it on my own, but don't think I could tell the vet. I really like her, but not sure she would appreciate the fact that I don't do what she recommends.


I know it can be difficult, but you need to change your mindset. Your vet is the professional you have hired to partner with you in Misty's care. Your vet makes treatment recommendations, but YOU AND ONLY YOU decide whether those recommendations are in the best interest of you and Misty. If you are uncomfortable with your vet's treatment recommendations, you should discuss your concerns and alternatives with the vet. If she is unwilling treat you like a partner and wants only to dictate to you, it's time to find another vet. 



> Problem is, when I take her back for testing, if T4 hasn't went down, she will only continue to increase dosage. What to do?


She would be right. If the T4 hasn't dropped into normal range when retested, the dosage should be increased. The only question would be the amount of the increase, which should be small (1.25 mg daily added to the current dose)



> I questioned her in the past, and she told me if I could show her legitimate medical studies, she would believe it. Any medical study sites I could show about low-dose for hyperthyroid?


These aren't studies, but they are recommendations presented at a veterinary conference. Print them out and bring them to your vet. You will see that their recommendations vary slightly from what I have suggested, but they still represent the "start low and go slow" practice of dosing.

Feline Hyperthyroidism - WSAVA 2003 Congress
Hyperthyroidism & Renal Function - WSAVA 2006 Congress



> How does anyone with an hyperthyroid cat ever leave town for even a couple nights? My cat won't even let anyone else near her, so know I can't get anybody to give meds.


You have five options:

Stay home
Board her
Get her accustomed to someone else who can stop by and give her her meds while you're gone
Take her with you
Leave her unmedicated in your absence and risk her health

Laurie


----------



## Jenlee (Mar 21, 2008)

Just got back from the vet. I asked what dosage she would be started at. Vet said only 2.5 mg once a day. I asked about 1.25 mg twice daily, cut she said it's nearly impossible to give such a small amount of liquid. Vet assured me she has seen no problems starting at her recommended dose. After 2 weeks, bloodwork will be repeated, and dosage increased at 1.25 mg until desired thyroid level reached.

I am thinking of switching her once a day dose for now to nights though, so my husband can hold her....wish I had thought of that before giving her AM dose today. So, would it be safe to skip tomorrow's AM dose and change to PM? 

Good news...when I got back from vet and explained med cost, labs, etc. to hubby, he is onboard for I-131 treatment if no kidney problems show up. Vet said she didn't think Misty could tolerate being away from me for 7 days and would not do well and recommends surgery. She did say there are 2 facilities that offer treatment, not far away from me. 

What is the best can food or pouch available at Wal-Mart? Misty has been only eating FF Classic (low glycemic)...hoping to prevent diabetes. So far, so good. She is just not eating great right now. I picked up Whiskas today, and she loved it. She wants her food changed around, doesn't like the same flavors.


----------



## laurief (Jun 22, 2008)

Jenlee said:


> Vet said only 2.5 mg once a day. I asked about 1.25 mg twice daily, cut she said it's nearly impossible to give such a small amount of liquid. After 2 weeks, bloodwork will be repeated, and dosage increased at 1.25 mg until desired thyroid level reached.


EXCELLENT! Another vet who is clued in to the "start low and go slow" approach to dosing! That's very encouraging. You're right, though. It would be best to split the dose and give it twice daily, because that would maintain a more even keel where Misty's T4 production is concerned. Liquid methimazole must be in vogue now, because I was only offered pills when my hyperT cats were diagnosed a few years ago. Pills, IMO, are easier because they can be cut into 1.25 mg doses and are usually eaten readily when put into Pill Pockets. I'm not acquainted with the liquid form, but would it be terribly difficult to draw the day's worth of med into the syringe, then administer half of it in the morning and the other half at night? The halves wouldn't even have to be exact as long as roughly half was given every 12 hrs.



> I am thinking of switching her once a day dose for now to nights though, so my husband can hold her


If you're only going to give it to her once daily, it should be given in the a.m. I can't remember why - I think it has something to do with the more active hours of thyroid production - but I do remember reading that once daily dosing should be administered in the morning. The same is true of uneven dosing. For instance, if you're giving 2.5 mg at one dose and 1.25 at the next dose, the larger dose should be in the morning, and the smaller dose at night.

You're really better off dosing her by yourself, anyway. Most cats are more cooperative with less restraint. The easiest way to administer liquid med is to sit on the floor with Misty between your legs. With one hand, hold the scruff of her neck and lift just her front feet off the ground. With the other hand, quickly insert the syringe into the side of her mouth and squeeze the med across her tongue (NOT toward the back of her throat). Then lower her front feet to the floor again, pet her for a moment, and let her go.

In case your vet didn't mention it, be sure to administer the med immediately after a meal. It will cause less digestive upset if administered with food in the stomach.



> Good news...when I got back from vet and explained med cost, labs, etc. to hubby, he is onboard for I-131 treatment if no kidney problems show up.


That IS good news, IF Misty can deal psychologically with the hospitalization.



> Vet said she didn't think Misty could tolerate being away from me for 7 days and would not do well and recommends surgery.


You did say that Misty is scared of everyone but you and your husband, so your vet may be right about the I-131 hospitalization. I don't agree with her about surgery, though. Personally, I would opt for medication before I would allow thyroid surgery on any of my cats. The only way I would consider surgery would be if I had a cat who would be terrified of the hospitalization and who had very serious side effects from the med. Then the only viable treatment option might be surgery.



> What is the best can food or pouch available at Wal-Mart?


Any canned food you can buy at Walmart is going to be low quality, but even low quality canned food is better than kibble. It is important to stay away from fish, though, so check the labels and avoid any flavors that contain fish.

Laurie


----------



## Jenlee (Mar 21, 2008)

I have been squeezing the med in the back of her throat. She tries to spit out meds, so I will need to try putting across her tongue.

I need to try the pills in pill pockets. Do cats just eat them like treats? I will definitely ask about that. I did read here that pills should not be chewed, but swallowed whole in order to work. Do cats not chew the pill pockets? I have a timed feeder, so I could even leave the med in there if I really needed to. Can pill pockets be bought at pet stores or need to be ordered?


----------



## Jenlee (Mar 21, 2008)

How will I know if Misty can tolerate the hospitalization?

Is there a safe med I can ask for to keep her calm? I found a facility 3-1/2 hours from me that only keeps them 4 days. 

How safe is it to bring them home that soon? It sounds scary about the radiation. Facility told me precautions that would need to be taken for 2 weeks after release such as flushing litter, not sleeping with cat, not allowed outside, etc.

Sorry for all the questions. I just pray Misty's kidneys are ok because I really want to get I-131 for her.


----------



## laurief (Jun 22, 2008)

Jenlee said:


> I have been squeezing the med in the back of her throat.


Never direct liquids toward the back of the throat. That makes it too easy for the cat to choke and possibly aspirate the liquid into her lungs. By directing the liquid across her tongue, instead, you give her time to swallow properly.



> I need to try the pills in pill pockets. Do cats just eat them like treats?


Pill Pockets come in two different flavors. I have found that my cats usually eat them as treats even with meds in them, though some cats prefer one flavor over the other. Some cats are so suspicious that they won't eat Pill Pockets with meds in them, but I have found that even if that's the case, having the med in a Pill Pocket makes it a lot less likely that the cat will try to spit it out if you have to drop it down her throat.

If you get methimazole in pill form, you'll be getting 5 mg pills and cutting them into quarters of 1.25 mg each with a pill cutter. These will be so small that you'll be able to cut each Pill Pocket in half and use only one half for each med dose. That makes it easier for the cat to swallow the med and Pill Pocket without chewing.



> I did read here that pills should not be chewed, but swallowed whole in order to work.


That's only an issue with time-release meds, which regular methimazole is not. 



> I have a timed feeder, so I could even leave the med in there if I really needed to.


I would NOT recommend that. You'd never know if the pill was actually consumed that way. Pills should always be administered personally to make sure they've been swallowed.



> Can pill pockets be bought at pet stores or need to be ordered?


Some vets carry them and some pet stores carry them. They're also available online through a variety of sources. Amazon.com is a good place to price shop for them.

Laurie


----------



## laurief (Jun 22, 2008)

Jenlee said:


> How will I know if Misty can tolerate the hospitalization?


That's something you'll need to determine based on what you know about Misty's personality. If she is extremely frightened by new people, places, and situations, hospitalization may be a dangerously high stress situation for her.



> Is there a safe med I can ask for to keep her calm?


I doubt it, but you could ask the I-131 facility. From what I understand, they won't accept cats who require regular medication because of the radioactive exposure to their clinic staff.



> I found a facility 3-1/2 hours from me that only keeps them 4 days. How safe is it to bring them home that soon?


Post I-131 quantine periods vary from state to state. In my state, the quarantine is 14 days, which seems altogether excessive to me. In another state I researched, quarantine is only two days. I feel confident that no radioiodine clinic is going to release patients until it is safe to do so. As long as you follow the post-release instructions and precautions, I don't think you have anything to worry about with a 72 hr quarantine.



> I just pray Misty's kidneys are ok because I really want to get I-131 for her.


I hope that she has healthy kidneys, too. At her age, there's a good chance her kidneys are fine.

Laurie


----------



## Jenlee (Mar 21, 2008)

Laurie,

Thank you so much. You have been such a great source of info.


----------



## spockally (Mar 7, 2011)

Jenlee:
I am a little late to notice that you posted this, but I just wanted to join in this conversation because I am on the same boat. First, I am very sorry to hear about Misty diagnosed with Hyper-t. I totally understand how you felt when you heard about that from the vet because I just experienced the same thing. My 12 yr old baby, Spock, is diagnosed with Hyper-t also a few weeks ago and I still feel depressed about it. Was Misty showing any sypmtoms? Was losing her weight? I did not see any on Spock, so I was wondering. My vet said that sometimes they do not show any sypmtoms. Only thing the vet noticed first was heart murmur which might be caused from Hyper-t and he run the blood test. The blood work was 7.4. What was Misty's? The vet told me to give 0.25ml of Methimazole (1.25mg equivalent) twice a day, but I am starting with only once a day to see how he reacts. What dosage are you giving to Misty now? You already decided to go for the I-131 treatment? I am still not sure yet and "radiation" kind os scares me... I need to do more research about it.

It seems that there are lots of cat owners whose cats have this disease and they are here and there to help and educate us. (like Laurie! thank you!!!!) Let us put our heads together and learn each other so our babies will cope with it well and live longer and healthier.


----------



## Jenlee (Mar 21, 2008)

spockally said:


> Jenlee:
> I am a little late to notice that you posted this, but I just wanted to join in this conversation because I am on the same boat. First, I am very sorry to hear about Misty diagnosed with Hyper-t. I totally understand how you felt when you heard about that from the vet because I just experienced the same thing. My 12 yr old baby, Spock, is diagnosed with Hyper-t also a few weeks ago and I still feel depressed about it. Was Misty showing any sypmtoms? Was losing her weight? I did not see any on Spock, so I was wondering. My vet said that sometimes they do not show any sypmtoms. Only thing the vet noticed first was heart murmur which might be caused from Hyper-t and he run the blood test. The blood work was 7.4. What was Misty's? The vet told me to give 0.25ml of Methimazole (1.25mg equivalent) twice a day, but I am starting with only once a day to see how he reacts. What dosage are you giving to Misty now? You already decided to go for the I-131 treatment? I am still not sure yet and "radiation" kind os scares me... I need to do more research about it.
> 
> It seems that there are lots of cat owners whose cats have this disease and they are here and there to help and educate us. (like Laurie! thank you!!!!) Let us put our heads together and learn each other so our babies will cope with it well and live longer and healthier.


I am so sorry about Spock. I know you must be as devastated as I am.

Misty had lost weight, but I feel terrible because I had no idea she was sick. I took her to the vet 2 weeks ago for a nail trim, and told them she had lost weight. They didn't seem concerned either. She acted fine, except started vomiting more frequently. Her appetite had not changed...she has always enjoyed eating. 

Her T4 level was 11.7. Vet started her at 2.5 mg once a day. I switched to pills and decided myself to give her 1.25 mg twice daily. Actually, she acts sicker since I started the twice daily dosing. I am a little concerned because my vet is checking her level again in after 2 weeks on med, and then increasing. It is recommended here to increase at 3 weeks. I may keep her on the same dose another week after vet says up it. 

I am still trying to process the whole thing....very depressed about it and crying spells.  I know she can't live forever, but I just don't want her to be sick. 

Misty played and ate very well yesterday, but today she has not. I feed her 2 small cans per day and 1/4 cup dry. She is barely eating any dry food now, and only about half her wet food. I am at a loss. I am afraid she won't make it. 

She also has a bladder infection and is on Clavamox through Sunday. She has horrible diarrhea from the med. I called the vet, but she wants her to remain on it.

I don't know if I-131 treatment will be an option. I will have to wait until we know for sure she doesn't have any kidney problems. Even then, I am hesitant also. It sounds so simple, yet radiation is involved. I don't know if it's completely safe or not. Do you know if cats can die from this treatment? I can't really find any info when I research. 

Hugs to you and Spock,
Jen


----------



## my5kitties (Sep 13, 2005)

Jenlee said:


> She also has a bladder infection and is on Clavamox through Sunday. She has horrible diarrhea from the med. I called the vet, but she wants her to remain on it.


I would think that if the meds are giving her horrible diarrhea, then the vet should be concerned. Wouldn't the diarrhea make her sicker? I think if I were in your shoes, and since you know your cat better than the vet, I'd give her a call and tell her that you aren't comfortable continuing with a medicine that gives her such bad diarrhea.


----------



## Jenlee (Mar 21, 2008)

my4kitties said:


> I would think that if the meds are giving her horrible diarrhea, then the vet should be concerned. Wouldn't the diarrhea make her sicker? I think if I were in your shoes, and since you know your cat better than the vet, I'd give her a call and tell her that you aren't comfortable continuing with a medicine that gives her such bad diarrhea.


Anyone know how many days a bladder infection is usually treated with Clavamox? Vet said give it 10 days, but I am thinking of discontinuing. She only needs to take 3 more doses for the 10-days to be finished. I can't reach the vet on weekends....only an emergency center 30 miles away. 

I am concerned that the diarrhea is dehydrating her. I notice her urine output is not as good....not going as much and not large clumps.


----------



## Jenlee (Mar 21, 2008)

Pill pockets are a gift from above! Misty is so excited to take her treat. She gobbles it up and begs for more! 

Thanks for the recommendation...definitely worth the cost.


----------



## laurief (Jun 22, 2008)

Jen,

Continue Clavamox for the full 10 days. If you quit early and the infection hasn't been completely killed off, the remaining bacteria may become resistant to Clavamox and be much more difficult to kill. Antibiotics should ALWAYS be continued through the entire course of treatment UNLESS they are switched to a different antibiotic.

You can add back some of the fluid Misty is losing in her diarrhea by mixing warm water into her canned food and making it "canned food soup" that she can lap up. Also, use the probiotics I recommended in your other thread to repopulate her good gut bacteria. She probably has diarrhea because her good gut bacteria that normalizes her stool is being killed off by the antibiotic. Probiotics will help.

As far as retesting T4 after 2 weeks is concerned, that's fine. It's generally recommended to retest 2-3 weeks after a med adjustment. I just usually stretch it to 3 weeks because that was the first recommendation I read when I was first learning about hyperT. There's nothing wrong with a retest after 2 weeks, though.

I have never heard of a cat dying from I-131. This is a very safe treatment that is used in human medicine, as well. I have a hyperT friend who had I-131. The radioactive dose is titrated VERY CAREFULLY so that the lowest possible effective dose is administered. As far as I know, these are the things that could possibly go wrong with I-131 in cats:

1) If the cat has masked renal failure, I-131 will unmask it, and the cat's renal failure may (or may not) be more difficult to manage after I-131.

2) If too much of the cat's thyroid glands are diseased, the cat may become permanently hypOT following treatment, which will necessitate thyroid supplementation for the rest of the cat's life. This is not a big concern, though, since thyroid supplementation has no negative side effects once the proper dose is established.

3) Very rarely, a cat may require a second (and even more rarely, a third) I-131 treatment to permanently cure hyperT.

Laurie


----------



## laurief (Jun 22, 2008)

Ah, yes, Pill Pockets! I will NEVER be without a stash of PP's again! If you know you'll be using them long-term, you can buy them cheaper if you buy at discount online from a seller that offers free shipping. Amazon.com and some of its sellers offer free shipping if you order a certain amount. So does Pet Meds | Dog Supplies | Pet Supplies | Pet Products | Pet Supply. It's worth shopping around for best prices.


----------



## Jenlee (Mar 21, 2008)

I cry as I write this. Is it time to let Misty go and cherish the wonderful years we've had together?

Misty finished the Clavamox last night and continues methimazole at 1.25 mg twice daily, which will be increasing in another week...not sure what dosage. She has taken probiotics for several years because of ongoing diarrhea, which finally cleared when I switched her to mostly can food.

She was vomiting before I got her to the vet and was given a Cerenia injection. Today was the first time she had vomited in 10 days....clear liquid. I will let the vet know what's going on.

Misty is not eating well at all. Saturday she ate like a pig, yesterday only about half her normal amount. Today, she would not eat her food. She finally ate a jar of turkey baby food after she vomited. She will always eat treats. I could only get what I found at Wal-Mart, which was Whiskas Temptations...junk I know. I traveled 30 miles Friday to a larger town to buy different foods for her to try....Blue Spa, Natural Life, Wellness, Halo. She wouldn't eat any of them, except Natural Life...only ate if one time and refused next time. She won't even eat her beloved FF. She ate a few bites of tuna yesterday, and I made tuna water for her.

I am at a loss here. I tried syringe feeding her, but she spits it out and then hides from me for hours. I feel like she is miserable. Vet told me last week we could try an appetite stimulant if needed. Would that work? Misty acts like she is hungry by going to the cabinet and meowing, but just refuses everything I give her. She sniffs and walks away.


----------



## melysion (Mar 12, 2007)

Jenlee said:


> I cry as I write this. Is it time to let Misty go and cherish the wonderful years we've had together?
> 
> Misty finished the Clavamox last night and continues methimazole at 1.25 mg twice daily, which will be increasing in another week...not sure what dosage. She has taken probiotics for several years because of ongoing diarrhea, which finally cleared when I switched her to mostly can food.
> 
> ...


Sounds like you are though the sort of thing I've just gone though with my hyperT cat, Toby. He has been doing what you have described (not eating despite acting like he is hungry and vomiting plus has suffered from two nasty infections) for about two months.

Its been incredibly stressful but finally he is beginning to eat properly again. He vomited once last week - Saturday morning and refused to eat until later on in the day - but other than that last week for the first time since mid Jan, I saw signs that my cat pig is returning. 

I think Toby has been reacting to the hyperT medication he has been taking but is finally adjusting to it so its entirely possible that Misty is going though something similar.


----------



## laurief (Jun 22, 2008)

Jen,

No, it absolutely is NOT time to give up on Misty! The Clavamox and/or methimazole have upset her stomach, and there are ways to correct both problems. Yes, I know it's difficult seeing her unhappy right now, but this is only a temporary setback, I assure you. Go drink a nice cup of hot tea (or hot cocoa, if you're like me) and take some deep breaths. Sit and stroke Misty for a few minutes. Once you're feeling a little more relaxed, call me. I'm going to PM you my phone number. I'll stay offline until 9:00 CST so you can get through (I'm on dialup, so I can't use the phone and be online at the same time). Don't panic. This isn't nearly as big a problem as you think it is.

Laurie


----------



## Jenlee (Mar 21, 2008)

laurief said:


> Jen,
> 
> No, it absolutely is NOT time to give up on Misty! The Clavamox and/or methimazole have upset her stomach, and there are ways to correct both problems. Yes, I know it's difficult seeing her unhappy right now, but this is only a temporary setback, I assure you. Go drink a nice cup of hot tea (or hot cocoa, if you're like me) and take some deep breaths. Sit and stroke Misty for a few minutes. Once you're feeling a little more relaxed, call me. I'm going to PM you my phone number. I'll stay offline until 9:00 CST so you can get through (I'm on dialup, so I can't use the phone and be online at the same time). Don't panic. This isn't nearly as big a problem as you think it is.
> 
> Laurie


Hi Lauria.....truly appreciate your help.

I am sorry I did not get your message until now. I went to vet's office to return liquid methimazole. She wants to decrease the med to 1.25 mg once daily and see if Misty feels better at this dosage....I completely agree with her. 

I tried calling you, but sure I got back too late to catch you off line.....thought I was the only one that still had dialup! 

I left a message with my phone number, but I will also send you a PM.

It is so kind of you to offer help.


----------



## Jenlee (Mar 21, 2008)

Misty is doing better! 

She ate quite well later in the day. Of course, she is going to be spoiled rotten because I am offering her food multiple times daily to get her to eat more. For now, I'm just thankful she is eating again.


----------



## laurief (Jun 22, 2008)

I'm so glad to hear that Misty ate well today. But, I don't want you to get upset if she doesn't eat much tomorrow again. Sometimes when they eat real well one day, they'll feel a little overstuffed and then not want to eat much the next day. Just don't let it throw you if that happens. Keep doing what you did today - offer a variety of foods in 3-4 hr intervals to try to keep some food in her stomach most of the day.

Try also to get her to eat right before you go to bed and again as soon as you get up in the morning, and leave some kibble out for her overnight if you can. Remember that acid stomach may become a problem and cause nausea and inappetance if she goes too many hours without food in her stomach.

You're doing fine, Jen, and so is Misty. Hang in there and be patient. She became hyperT over time, and it's going to take some time to return her T4 level to normal. She'll get there.

Laurie


----------



## Jenlee (Mar 21, 2008)

laurief said:


> I'm so glad to hear that Misty ate well today. But, I don't want you to get upset if she doesn't eat much tomorrow again. Sometimes when they eat real well one day, they'll feel a little overstuffed and then not want to eat much the next day. Just don't let it throw you if that happens. Keep doing what you did today - offer a variety of foods in 3-4 hr intervals to try to keep some food in her stomach most of the day.
> 
> Try also to get her to eat right before you go to bed and again as soon as you get up in the morning, and leave some kibble out for her overnight if you can. Remember that acid stomach may become a problem and cause nausea and inappetance if she goes too many hours without food in her stomach.
> 
> ...


Wow, Laurie! You were exactly right....Misty did not eat well at all today. I tried to syringe feed her, but she wouldn't go for that either. I managed to get her to eat about half her normal amount. Hope she will do better tomorrow. 

Thanks for all your help,
Jen


----------



## Whaler (Feb 13, 2011)

thanks for the concise overview on treatment laurief

i just got the lab results today and found out that my morriss is hyperT and this thread has been very helpful.

here are the issues with morriss;
he suffers from ibs and while it had been under control he has been vomiting just about every other day for three weeks.
he is on the verge of crf.
he is impossible to pill but even the smallest amount of med in his food will be detected by him.
he is 18+ years old and while in decent shape is still nonetheless a bit frail.

luckily his vet wants to start him at a very low dose of methimazole but has left it in my hands as far as what to try; liquid form mixed in his food, the gel or try to pill him. since she knows how difficult he to pill is she is recommending the liquid mixed in his food as opposed to the gel since at least we have a reasonably good idea how much he is getting of it.

the i-131 treatment is available at his vets practice so if all goes well with the drugs that is an option, but given his age as well as the issues with his kidneys we probably would not go that route but would continue with the drug therapy long term.

so, since i have great concern for his tummy issues do you think that the gel might be a better starting point? i would prefer to use carbimazole but since it should not be broken we come back to the impossible task of trying to pill him successfully w/o stressing him out and making matters worse.


----------



## laurief (Jun 22, 2008)

Whaler said:


> i just got the lab results today and found out that my morriss is hyperT and this thread has been very helpful.


I'm sorry to hear of Morriss' diagnosis, but I'm glad this thread has been helpful. Do you have a copy of his test results that you can post to this thread so that I can see it? If so, please include the lab's reference ranges along with Morriss' results. If not, I strongly recommend you get copies of all of his test results from your vet ASAP.



> he suffers from ibs and while it had been under control he has been vomiting just about every other day for three weeks.


HyperT can cause vomiting all by itself, so that may have nothing to do with his IBS.



> he is on the verge of crf.


What exactly does this mean? What are his renal blood values (creatinine and BUN)?



> luckily his vet wants to start him at a very low dose of methimazole


What does your vet consider to be a "very low dose"? With a cat with known renal insufficiency, I would recommend starting at 1.25 mg once daily and retesting in 2-3 weeks.



> since she knows how difficult he to pill is she is recommending the liquid mixed in his food as opposed to the gel since at least we have a reasonably good idea how much he is getting of it.


That doesn't make sense to me. If you know he won't eat medicated food, how can it possibly be a better idea to mix methimazole liquid into his food rather than applying a transdermal gel to his inner ear flap? The transdermal gel is a sure bet, but the med mixed into his food is almost certainly doomed to rejection. If the transdermal gel is produced by a competent compounding pharmacy, the dosage should be as accurate as oral meds.



> the i-131 treatment is available at his vets practice so if all goes well with the drugs that is an option, but given his age as well as the issues with his kidneys we probably would not go that route but would continue with the drug therapy long term.


A cat with known renal insufficiency is not considered a good candidate for I-131 unless the cat is completely intolerant of drug therapy or unless the drug seriously compromises the cat's liver.



> so, since i have great concern for his tummy issues do you think that the gel might be a better starting point? i would prefer to use carbimazole but since it should not be broken we come back to the impossible task of trying to pill him successfully w/o stressing him out and making matters worse.


If I had a hyperT cat with IBS, I'd be inclined to opt for transdermal gel so as not to risk exacerbating the existing digestive issues. Carbimazole might be an option if an oral med is preferred, but a small number of cats can't tolerate carbimazole any better than they can methimazole. It is my understanding that only the time-release formula of carbimazole is associated with any concern of being cut into smaller doses. Regular, non-time-release carbimazole pills can be cut into whatever dose sizes you need (but good luck finding any carbimazole pills in the U.S.). As I noted earlier in this thread, I manage my hyperT cat with soft, liver-flavored, carbimazole-medicated chews ordered from BCP Pharmacy in Houston, TX. Carbimazole has virtually no flavor of its own, so Tommy eagerly snarfs down her liver chews as treats - no pilling necessary.

If you want to use Carbimazole as a transdermal gel, you could check with BCP and see if they could compound it into that form for you (I suspect they could).

Laurie


----------



## spockally (Mar 7, 2011)

Jenlee:
I am sorry that I haven't had a chance to post much earlier. I read everything and I was just wondering how Misty and you are doing. Is Misty eating better now? How is her kidney condition? Is her diarrhea resoved now? Is she still on hyper-T medication? If so, how much? How about yourself? Are you feeling okay? I was concerned how you are doing because I can tell that you have so much burden on your shoulder. I am still feeling devasted about the fact that my baby has Hyper-T but Misty seems to be going through much more. I just pray for you and Misty 
Today, I needed to take my another baby, Ally, to the vet office for her teeth cleaning. About a month ago, I took both of them, Spock and Ally, for check-up. As I mentioned, the bloodwork showed that Spock has hyper-T and Ally has no problem, except for gigevitits (sp?). So, I took Ally in for teethcleaning today. Then, the vet called me and said that Ally lost weight and wants to test her blood again for hyper-T suspecting that Ally could be the one who actually has hyper-T, not Spock.... Maybe there was a mix-up in their blood sample. I was suspecting the same, so I was giving 1.25mg equivalent of the medicine once a day to Spock and never increased. Until I hear the result, I will not give the med to Spock anymore. I just hope that giving the med to Spock who did not have hyper-T did not cause any harm... 
My heart and prayers go to Misty and you. I hope you are doing okay!


----------



## fairness (Feb 24, 2011)

Which Pet Foods have BPA free cans?

This page has information about which pet foods have BPA free cans. 
It seems that most brands don't use BPA for 3 or 5 oz cans.


----------



## Whaler (Feb 13, 2011)

laurief said:


> I'm sorry to hear of Morriss' diagnosis, but I'm glad this thread has been helpful.  Do you have a copy of his test results that you can post to this thread so that I can see it? If so, please include the lab's reference ranges along with Morriss' results. If not, I strongly recommend you get copies of all of his test results from your vet ASAP.


thanks for the reply.
his T4 is 3.9 and his freeT4 is 88. 




> HyperT can cause vomiting all by itself, so that may have nothing to do with his IBS.


yea, i do feel that the recent vomiting is due to the hyperT not the IBS. his IBS was really under control as of 3 weeks ago with nothing more than limited ingredient food.




> What exactly does this mean? What are his renal blood values (creatinine and BUN)?


his creatine is2.1 and his urea nitrogen is 52. additionally his specific gravity is 1.018.




> What does your vet consider to be a "very low dose"? With a cat with known renal insufficiency, I would recommend starting at 1.25 mg once daily and retesting in 2-3 weeks.


that is what we are going to try first.




> That doesn't make sense to me. If you know he won't eat medicated food, how can it possibly be a better idea to mix methimazole liquid into his food rather than applying a transdermal gel to his inner ear flap? The transdermal gel is a sure bet, but the med mixed into his food is almost certainly doomed to rejection. If the transdermal gel is produced by a competent compounding pharmacy, the dosage should be as accurate as oral meds.


i should have worded it better. he is able to detect larger amounts of pills in his food, but i have been able to get him to eat up to 2.5 mg of famotidine mixed in food. seems that if it is a small enough amount i can trick him into eating it, so i feel that the liquid will be doable.





> A cat with known renal insufficiency is not considered a good candidate for I-131 unless the cat is completely intolerant of drug therapy or unless the drug seriously compromises the cat's liver.


that is sort of my plan, only doing i-131 as a last resort. if he tolerates the meds i plan to stay with that. with his advancing years, as well as how easily stressed he gets, i do not want to put him through being separated from me for the 3 or more days of treatment.




> If I had a hyperT cat with IBS, I'd be inclined to opt for transdermal gel so as not to risk exacerbating the existing digestive issues. Carbimazole might be an option if an oral med is preferred, but a small number of cats can't tolerate carbimazole any better than they can methimazole. It is my understanding that only the time-release formula of carbimazole is associated with any concern of being cut into smaller doses. Regular, non-time-release carbimazole pills can be cut into whatever dose sizes you need (but good luck finding any carbimazole pills in the U.S.). As I noted earlier in this thread, I manage my hyperT cat with soft, liver-flavored, carbimazole-medicated chews ordered from BCP Pharmacy in Houston, TX. Carbimazole has virtually no flavor of its own, so Tommy eagerly snarfs down her liver chews as treats - no pilling necessary.
> 
> If you want to use Carbimazole as a transdermal gel, you could check with BCP and see if they could compound it into that form for you (I suspect they could).
> 
> Laurie


thanks for the tips on carbimazole. what we are going to try first is the liquid methimazole mostly due to the fact that he has always had hyper-sensitive ears (possibly due to abuse from whoever abandoned him in the streets). i worry that he would go nuts with the gel and end up clawing at his ears from the gel.

the methimazole liquid should be here on monday so hopefully we will have positive news (tolerance wise) soon.

thanks for all of your help.


----------



## laurief (Jun 22, 2008)

Whaler said:


> his T4 is 3.9 and his freeT4 is 88.


What are the lab's reference ranges for those values? It's important to know the reference ranges because they can vary somewhat from lab to lab. Without knowing the reference ranges, I will assume that his TT4 is within the reference range, while the FT4 is elevated. Does your cat have a palpable thyroid tumor? Weight loss? Heart murmur? Any other symptoms of hyperT?



> his creatine is2.1 and his urea nitrogen is 52. additionally his specific gravity is 1.018.


Again, the lab's reference ranges are necessary to put these values into accurate perspective.



> seems that if it is a small enough amount i can trick him into eating it, so i feel that the liquid will be doable.


That depends on what the liquid tastes like. if it's bitter or otherwise unpleasant, your cat may reject it in food.



> thanks for the tips on carbimazole. what we are going to try first is the liquid methimazole mostly due to the fact that he has always had hyper-sensitive ears


I understand about the ears. If he can't or won't take methimazole, though, oral carbimazole, either as liquid or in vet chews might be a viable option. Carbimazole itself has almost no taste (very slight sweet taste), whereas I think I remember reading that methimazole is bitter (I might be wrong about that). I never tasted methimazole when I was using that, but I did taste carbimazole.



> thanks for all of your help.


You're welcome.

Laurie


----------



## Jenlee (Mar 21, 2008)

Whaler...

I am so sorry to hear about Morriss. I hope he is doing well.

Have you thought about trying hyperT pills and putting them in pill pockets? Worked like a dream for me. Misty now begs for her treat!


----------



## Jenlee (Mar 21, 2008)

Spockally,

Thank you for your concern and prayers.

I am happy to report Misty is doing very well and eating lots. I took her back to the vet today, and she had even gained weight from 7.3 lbs. to 7.9 lbs. in 2 weeks. She is still too thin, but hope she continues to gain. 

Vet did run labs and will call me with results tomorrow. 

Thanks to everyone that helped Misty and me....we love you!


----------



## laurief (Jun 22, 2008)

Half a pound in two weeks is great progress! And she's eating well, too! You're going to have to keep an eye on her weight, though. Now that the hyperT isn't making her body burn through calories as quickly as it was before, she'll probably continue to pick up weight rapidly. If she's anything like Tommy, she'll pick up TOO much weight and be too heavy before you know it. Tommy picked up a pound more than she should have before I started restricting her food portions. Now she's back down to her ideal weight.

In case I didn't mention this to you before, it's a very good idea to buy a digital baby scale and weigh Misty every two weeks. By charting her weights, you'll know when to start rationing her food so that she doesn't become overweight. More importantly, if she starts to lose weight again, you'll know that you need to get her T4 checked again to see if she needs a med increase.

You're on the right track now! Congratulations!

Laurie


----------



## spockally (Mar 7, 2011)

Jenlee:
I am soooo glad to hear such a good news! You must be feeling much better as well. I am very happy for you and Misty. Keep us posted so we can contact and educated each other. Misty's steady condition will still be in my prayers.


----------

