# older cat gradually loosing weight



## just_jason (Jun 13, 2010)

First, I want to thank everyone here for sharing their experience and opinions. I just recently decided to change my cats diet. She is sixteen and has been feed Iams dry food and Pounce tarter control treats her entire life. I never questioned that this was the best diet for her until recently. She has always been a skinny cat weighing about eight pounds. However, recently she has become to skinny. This has been a very gradual change and she is still a very happy cat. 

Anyway, I've decided to add a 3 oz. can of wet food per day to her diet. So I went out and bought a can of Nutro Natural Choice, Science Diet, and Purina Proplan, all senior cat formulas, as well as, a can of Blue Wilderness. This last one says 95% chicken on the label, although I am concerned that it does not say it is specifically for older cats. I've already fed her the first two cans and she ate it right up. I'm pretty confident she'll eat just about anything I give her.

She is my first cat so I'm trying to learn as much as I can. What makes a senior cat food a senior cat food? Do I have to feed her senior cat food? Or is that something for cats that are naturally obese in old age? Also, if I can encourage her to eat more, are there certain foods that are really hard on her kidney's and what not that I should avoid? I have so many questions that I am really just looking for any kind of advice at all.


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## laurief (Jun 22, 2008)

First of all, congratulations on having a 16 yr old cat! You've obviously been doing something right for her to have reached such an advanced age. With advanced age, however, comes the necessity for more proactive health management. There are several serious diseases that are fairly common in geriatric cats, including renal failure, hyperthyroidism, and diabetes. All of these diseases can be medically managed, but the best prognosis for successful management comes with early diagnosis. For this reason, it is important for you to have a complete blood chemistry, CBC, and Total T4 blood test run on her every 6 mos to keep an eye on any emerging health concerns. The results of these tests will also help you determine if she requires any special dietary adjustments. 

Cats don't lose weight just because they get old. There is a reason for your gal's weight loss, and the above recommended blood tests, along with a thorough physical exam, should help determine the cause(s).

Without knowing the status of her health, I can only make generalized comments about her diet. It would be very much to her advantage if you could switch her gradually to an exclusively canned food diet. Especially at her age, proper hydradion is critical. She should be getting a lot of her water requirement from her food, but kibble is not doing that for her. In fact, kibble is pulling fluid out of her system rather than putting it in, and that's not good for aged kidneys. To help maintain good hydration, it would be best to feed her canned food mixed with warm water to make it a nice "canned food soup" that she can lap up.

I really can't comment on the specific canned foods that would be best for her without knowing her medical status, but ANY canned food would be better for her than kibble. But, of course, you need to feed her food that she wants to eat.

So get those blood tests done, find out how her old body is really doing, then come and share the results with us so that we can offer you more targeted and appropriate dietary advice. Be sure to ask your vet for copies of all of her test results so that you have them handy.

Laurie


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## just_jason (Jun 13, 2010)

Thanks Laurief. You are absolutely right there must be a reason for her weight loss. I guess a vet visit is in order. She hasn't been to the vet since she was declawed. I never liked the idea of taking her to the vet, mainly because of the sick animals, so I don't really know what to expect. What kind of questions should I ask? Should I expect the vet to perform blood chemistry, CBC, and Total T4 blood tests or will I need to request them? How do I know I have a good vet? What vaccinations will the vet want to give her and how do I know they are necessary? I'm just concerned that the vet may cause her more stress than necessary.


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## laurief (Jun 22, 2008)

just_jason said:


> I never liked the idea of taking her to the vet, mainly because of the sick animals


There is always the possibility of a cat picking up something at a vet office, but any decent vet is going to take all necessary precautions to keep the exam rooms as sanitary as possible.



> What kind of questions should I ask? Should I expect the vet to perform blood chemistry, CBC, and Total T4 blood tests or will I need to request them?


It's always a good idea to request exactly what you want done, even if the vet doesn't suggest it. Now, it is possible that your vet may offer you a "senior panel" or "superchem" or some other name for combined blood testing. These combined tests are usually more cost effective, but it's important that you ask exactly what's included in them. Make sure that they include a complete blood chemistry, CBC, and Total T4. 

Make sure your vet also performs a complete physical exam including listening to her heart and lungs; checking her eyes, ears, and inside of her mouth; and palpating her abdomen. If your vet has a dopplar machine (unfortunately, most vets don't), have him check her blood pressure, as well.

Before the appt., make a list of any concerns or questions you may have about your cat's health or behavior and any changes you've noticed in her lately (like the weight loss). It's a lot easier to remember what you want to discuss if you have it written down ahead of time.



> How do I know I have a good vet?


Call people you know who have pets and ask which vets they use and how they feel about them. Call any local pet stores and ask them for vet recommendations, too. Since your girl is geriatric, it sure would be nice to find a vet with a dopplar to check feline blood pressure, so you might want to call all of the vets in your area and check to see if any of them have that piece of equipment. While you're at it, ask if any of the vets specialize in feline medicine.

Ultimately, you'll be able to tell whether or not you like the way a vet handles your animal and relates to you.



> What vaccinations will the vet want to give her and how do I know they are necessary?


Personally, I wouldn't vaccinate a 16 yr old cat unless she was at significant risk of contracting a disease from an ill or unvaccinated animal. If your girl stays inside and away from other animals, her risk of exposure is low. But if she goes outside where she can contact other cats, and if she hasn't been vaccinated in the last 3 yrs., you might want to discuss the risks and benefits of vaccination with the vet.



> I'm just concerned that the vet may cause her more stress than necessary.


I know, but at her age, the risk of missing the early onset of a chronic disease is much greater than the risk of stressing her a little, so go ahead and take her in for a checkup and bloodwork. It's really very important.

Laurie


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## just_jason (Jun 13, 2010)

OK, I just got back from the vet a bit ago. I should have the results of the CBC and Total T4 sometime tomorrow morning. He also wanted to do a Urinalysis so I'll get those results too.

So far the vet has confirmed that she is dehydrated. He said her thyroid felt like it might be swollen. 

Oh, and he is a feline specialist but they did not have a dopplar machine. I am actually very pleased with how he and the veterinary assistant handled her. Though I suspect if she were stronger she would have given them a little trouble. I also like that it was a smaller place so I didn't have to keep her in a public waiting room with other sick animals and it looked very clean.

Thanks again Laurief, I probably wouldn't have taken her to the vet so quickly without your advice. Now comes the waiting.

I forgot to add she weighs 4.1 lbs now. She used to weigh 8 pounds about ten years ago.


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## laurief (Jun 22, 2008)

just_jason said:


> OK, I just got back from the vet a bit ago. I should have the results of the CBC and Total T4 sometime tomorrow morning. He also wanted to do a Urinalysis so I'll get those results too.


Excellent! Make sure you get copies of all of those test results for your own records and so that you can refer to them when asking questions online. You had a complete blood chemistry run too, right?



> So far the vet has confirmed that she is dehydrated. He said her thyroid felt like it might be swollen.


Did he suggest giving her subQ fluids to help rehydrate her?



> Oh, and he is a feline specialist but they did not have a dopplar machine.


Makes me crazy that more vets don't have dopplars. There isn't a dopplar with 100 miles of me, and my house is full of geriatric cats who could benefit from having their blood pressures monitored. I keep nagging my vet to get a dopplar.



> I am actually very pleased with how he and the veterinary assistant handled her.


That's extremely important, so it's great that they handled her well.



> I also like that it was a smaller place so I didn't have to keep her in a public waiting room with other sick animals and it looked very clean.


All good things.



> I probably wouldn't have taken her to the vet so quickly without your advice.


You did good getting her in so quickly. It's never fun waiting for test results, but it's so worth it once you get a handle on her current state of health and what you can do to preserve or enhance it.



> I forgot to add she weighs 4.1 lbs now. She used to weigh 8 pounds about ten years ago.


Yikes! I won't be at all surprised if she's hyperthyroid. Luckily, that's one disease that can usually be successfully managed with appropriate treatment. If she is hyperT, be sure to read the following thread to acquaint yourself with some of the basics:

viewtopic.php?f=3&t=68565

When you get the test results tomorrow, I'd be very curious to see them if you're willing to post them here.

Laurie


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## just_jason (Jun 13, 2010)

laurief said:


> You had a complete blood chemistry run too, right?


I think I got confused on that. CBC is complete blood count? I'm not sure. I asked specifically for CBC and T4, but he did more tests than that so... 



laurief said:


> Did he suggest giving her subQ fluids to help rehydrate her?


No. He seemed to think dry food was fine but her condition needs to be corrected. When I pressed him on the soundness of the idea of feeding dry instead of wet to a dehydrated cat, he said that diet is something we could discuss after we get the results. 

Also, he indicated that if the results did not turn anything up his next idea would be to give her an x-ray. 



laurief said:


> Yikes!


That's an understatement. I couldn't believe my own eyes. The assistant checked the scale and I made sure she tared it. 



laurief said:


> When you get the test results tomorrow, I'd be very curious to see them if you're willing to post them here.


Sure thing, I would like to hear your ideas.


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## laurief (Jun 22, 2008)

just_jason"}I think I got confused on that. CBC is complete blood count? I'm not sure. I asked specifically for CBC and T4 said:


> viewtopic.php?f=3&t=9107[/url]
> 
> 
> 
> ...


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## just_jason (Jun 13, 2010)

Just called the vet. The tests include the complete blood chemistry, CBC and Total T4.


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## laurief (Jun 22, 2008)

Perfect!


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## just_jason (Jun 13, 2010)

I just got back from the vet half an hour ago. I typed up the results (see below). The diagnosis was hyperthyroid. The prescription is 2.5 mg of Methimazole twice a day. Yes, I did discuss the idea that T4 is cummulative and the possibility of starting at 1.25 mg twice a day. He indicated that there is a threshold does (my words not his) at which Methimazole is effective. He suggested a vet visit in one month. Anyway here are the results sorry about the quality I guess I can't paste a table from MS word, and I will be going to the store to get some wet cat food. 


SUPERCHEM
Test Results Ref. Range Units
Total Protein 6.1 5.2-8.8 g/dL
Albumin 3.6 2.5-3.9 “
Globulin 2.5 2.3-5.3 “
A/G Ratio 1.4 0.35-1.5 IU/L
AST (SGOT) 127 (HIGH) 10-100 “
ALT (SGPT) 534 (HIGH) 10-100 “
Alkaline Phosphatase 88 6-102 “
GGT 1 1-10 “
Total Bilirubin 0.1 0.1-0.4 mg/dL
BUN 34 14-36 “
Creatinine 0.7 0.6-2.4 “
BUN/Creatinine Ratio 49 (HIGH) 4-33	
Phosphorus 4.9 2.4-8.2 mg/dL
Glucose 97 64-170 “
Calcium 9.8 8.2-10.8 “
Magnesium 1.8 1.5-2.5 mEq/L
Sodium 159 (HIGH) 145-158 “
Potassium 4.2 3.4-5.6 “
Na/K Ratio 38 32-41	
Chloride 123 104-128 mEq/L
Cholesterol 150 75-220 mg/dL
Triglyceride 30 25-160 mg/dL
Amylase 1567 (HIGH) 100-200 g/dL
Lipase 25 0-205 IU/L
CPK 1274 (HIGH) 56-529 IU/L

CBC
WBC 9.1 3.5-16.0 10^3/µL
RBC 8.3 5.92-9.93 10^6/µL
HGB 12.0 9.3-15.9 g/dL
HCT 40 29-48 %
MCV 48 37-61 fL
MCH 14.6 11-21 pg
MCHC 30 30-38 g/dL





RBC MORPHOLOGY NORMAL
Differential Absolute % 
Neutrophils 3731 41	2500-8500 /µL
Lymphocytes 5005	55 1200-8000 /µL
Monocytes 182	2 0-600 “
Eosinophils 182	2 0-1000 “
Basophils 0	0 0-150 “
Platelet Estimate	Adequate 
Platelet Count 177 (LOW) 200-500 10^3/µL
Platelet clumps are present. Platelet clumping is a common in-vitro phenomenon and prevents accurate automated or manual platelet counting. The platelet estimate is the best minimum indicator of the adequacy of platelet numbers. Any reported platelet count indicates only the minimum platelet number.

T4
T4 16.1 (HIGH) 0.8-4.0 µg/dL

ADD-ON URINALYSIS
Color Yellow 
Appearance Cloudy 
Specific Gravity 1.027 1.015-1.060	
pH 6.0 5.5-7.0	
Protein Trace (HIGH) Negative	
Glucose-Strip Negative Negative	
Ketones Negative Negative	
Bilirubin Negative Negative	
Occult Blood Negative Negative	
WBC/HPF 0-1 0-3 HPF
RBC/HPF 2-3 0-3 HPF
Casts/LPF None Seen Hyaline 0-3 LPF
Crystals/HPF None Seen HPF
Bacteria None Seen None Seen HPF
Transitional Epithelia/HPF 0-1 0-1 HPF
Ft Droplets 11-20 HPF


URINE MICROALBUMIN (FELINE)
Microalbuminuria 1.0 <2.5 mg/dL
The MA test is normal.


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## laurief (Jun 22, 2008)

OK, not unexpectedly, your cat is hyperthyroid. The rest of the bloodwork and urinalysis look good EXCEPT for her liver enzymes. It looks like she's battling a liver problem at the moment, in addition to hyperT. Go to:

http://www.broadwayvh.com/site/view/832 ... 92sm55i901

and download the following descriptions:

ALT high - severe
AST high

Your vet is incorrect about there being a threshold for methimazole effectiveness. Methimazole can be effective at extremely low doses for some cats. It's such an individual reaction that each cat must be dosed carefully and individually to find the minimum dosage that controls the hyperT without doing other damage in the body, particularly to the liver. Since methimazole can be liver toxic, and since your girl's liver already appears to be in trouble, I strongly advise you to reconsider the dose your vet has prescribed. You have every right to insist that your cat's dose be reduced and to bring her in for TT4 testing every 3 weeks until you find the appropriate dose. If, for some reason, you decide to chance the higher dosage your vet has prescribed, please, PLEASE do not put retesting off for a month. In fact, if dosing at that higher level, you should retest in 2-3 weeks, esp. with her liver compromise. When you retest, make sure to also retest her liver enzymes (ALT and AST).

Last year, the members of the hyperT mailing list created a database of our dosing experiences. The database has been submitted to Plumbs (the standard veterinary pharmaceutical text used by vets) to help reevaluate methimazole dosing guidelines in the next edition. If you join the hyperT mailing list (link below), you will be able to access the database where you will see that the majority of our cats are being maintained at euthyroid (normal thyroid levels) at lower daily doses than the 5 mg that your vet has prescribed, proving that methimazole is very effective at low doses.

http://pets.groups.yahoo.com/group/feline-hyperT/

As I have stated many times in many threads to many hyperT caretakers, there are nothing but advantages for the cat by following the "start low and go slow" dosing protocol for methimazole. It is undeniably safer and could potentially make the difference for your particular cat between recovery of her liver and complete liver failure.

Laurie


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## razzle (May 20, 2010)

Hi your cat may have chronic renal failure (kidneys) especially considering her age. My Razzle was diagnosed with hyperthyroidism about a year ago. I tried the medication but it made him throw up. I went with the radioactive iodine treatment. Expensive $1200.00 but it cured him. While getting the treatment the vet said his urine was cloudy so I had my regular vet check it and he has chronic renal failure (CRF) stage 1. It's now stage 3. Your cats BUN/Creatinine ratio is very high. That's why it might be CRF plus the cloudy urine. Two great sites to go to are felinecrf.com and felinecrf.org. You can check lab results on those sites. Didn't your vet check or mention to you about testing for CRF or liver disease? I think he should especially considering the cat's age, cloudy urine, and lab results. Make sure you check your cat's weight, eating and water intake, urine and stool, energy level, and anything else routinely. Make a chart to keep tract of all the results.

Kathy


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## just_jason (Jun 13, 2010)

So I ended up following my vets advice and giving 2.5 mg twice a day and wait four weeks before retesting. I realized your "start low and go slow" approach made sense but he convinced me. Here are her new results: 

SUPERCHEM​ Test Results Ref. Range Units
Total Protein 6.7 5.2-8.8 g/dL
Albumin 3.5  2.5-3.9 "
Globulin 3.2 2.3-5.3 "
A/G Ratio 1.1 0.35-1.5 IU/L
AST (SGOT) 48 10-100 "
ALT (SGPT) 55 10-100 "
Alkaline Phosphatase 13 6-102 "
GGT 2 1-10 "
Total Bilirubin 0.1 0.1-0.4 mg/dL
BUN 51 *(HIGH)* 14-36 "
Creatinine 2.1 0.6-2.4 "
BUN/Creatinine Ratio 24 4-33
Phosphorus 4.7 2.4-8.2 mg/dL
Glucose 86 64-170 "
Calcium 9.7 8.2-10.8 "
Magnesium 2.2 1.5-2.5 mEq/L
Sodium 151 145-158 "
Potassium 4.3 3.4-5.6 "
Na/K Ratio 35 32-41
Chloride 117 104-128 mEq/L
Cholesterol 163 75-220 mg/dL
Triglyceride 70 25-160 mg/dL
Amylase 2155 *(HIGH)* 100-200 g/dL
Verified by repeat analysis.
Lipase 25 0-205 IU/L
CPK 375 56-529 IU/L

CBC​ WBC 6.1 3.5-16.0 10^3/µL 
RBC 6.9 5.92-9.93 10^6/µL
HGB 10.6 9.3-15.9 g/dL
HCT 32 29-48 %
MCV 47 37-61 fL
MCH 15.4 11-21 pg
MCHC 33 30-38 g/dL


RBC MORPHOLOGY NORMAL
Differential Absolute %
Neutrophils 3599 59 2500-8500 /µL
Lymphocytes 2318 38 1200-8000 /µL
Monocytes 61 1 0-600 "
Eosinophils 122 2 0-1000 "
Basophils 0 0 0-150 "
Platelet Estimate Adequate
Platelet Count 307 200-500 10^3/µL

T4
T4 0.3 *(LOW)* 0.8-4.0 µg/dL
Verified by repeat analysis.


The vet said I should cut her dose in half and retest in another four weeks. 

Also she now weighs 5 lbs 4 oz. That is up from 4lbs 1 oz a month ago.


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## laurief (Jun 22, 2008)

just_jason said:


> I realized your "start low and go slow" approach made sense but he convinced me.The vet said I should cut her dose in half and retest in another four weeks.
> 
> Also she now weighs 5 lbs 4 oz. That is up from 4lbs 1 oz a month ago.


Well, your vet's high starting dose did make your cat go hypothyroid, as I expected it would, and your cat's kidney values did rise, which is also a common occurrence. On the upside, the high starting dose didn't cause her kidneys to crash, which is very fortunate (and lucky), and it has addressed the hyperT so that she is able to put on weight again, which is great.

At least your vet has enough sense to cut back the dosage significantly, though he's still recommending too long a gap before the next retest, IMO.

Has your girl had any adverse side effects to methimazole (nausea, vomiting, diarrhea, lack of appetite, lethargy, facial itching)?

Laurie


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## just_jason (Jun 13, 2010)

laurief said:


> Well, your vet's high starting dose did make your cat go hypothyroid, as I expected it would, and your cat's kidney values did rise, which is also a common occurrence.


So you think her overdose is responsible for the high amylase and BUN?

The vet said he thought the elevated BUN might be due to her still being a little dehydrated. Would an overdose on methimazole cause her to be dehydrated? 




laurief said:


> Has your girl had any adverse side effects to methimazole (nausea, vomiting, diarrhea, lack of appetite, lethargy, facial itching)?


I think she felt a bit itchy for the first day or two. She was lethargic before taking methimazole and she still is but I've seen improvement. She still needs to regain muscle mass but she has made a few jumps she was to weak to make before. It also became harder to make her pur and she became more aloof. The purring seems to have improved already with the lower does but she is still less social. Her appetite had been decreasing, I guess the low T4 could account for that though. By decreasing I mean that she ate almost none of her dry food, she also ate less of her treats but she didn't show much of a loss of interest in her wet food. Currently, I give 1.5 oz of wet food twice a day. Since she has been effectively eating all wet food as a result, I should probably just offer her more right? My gut feeling is that she would eat one and a half cans a day, maybe two.


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## Mom of 4 (Jul 29, 2006)

I would give her as much wet as she wants. 

We give the girls each 3/4 of a 3 ounce can twice a day. Normally we leave a bit of dry out during the day (Evo), but my daughter's cat is visiting and a food pig. I want Zoey to gain a bit, so she get a little extra wet.

During the summer and winter, we add a bit of water to their food for extra hydration.


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## laurief (Jun 22, 2008)

just_jason said:


> So you think her overdose is responsible for the high amylase and BUN?


Amylase is not reliable in cats, so the elevation of that enzyme has no significance. BUN is a different matter. It is one of the kidney values, along with creatinine. Creatinine is kidney-specific, but BUN can elevate for non-kidney reasons. The fact that both your cat's BUN and creat have risen, however, does imply some degree of renal insufficiency, even though her creat is still in the high normal range.

The methimazole is probably not responsible for the elevation in her kidney values. It's more likely that it just unmasked pre-existing renal insufficiency. Uncontrolled hyperT causes all of the body systems to work in overdirve, including the kidneys. If the kidneys are diseased, as is likely the case with your girl, hyperT's influence will make them work harder, and they may appear normal in bloodwork as a result. That's what may have been happening at the time of your girl's first blood test. Her uncontrolled hyperT at that time was making her diseased kidneys work harder, masking their true condition in her bloodwork. Now that the hyperT has been turned to hypoT and her metabolism has slowed waaaay down, the true condition of her kidneys has become apparent in bloodwork through the elevations in her kidney values.



> The vet said he thought the elevated BUN might be due to her still being a little dehydrated. Would an overdose on methimazole cause her to be dehydrated?


Her bloodwork doesn't give the impression of her still being dehydrated, so I don't believe that's a factor. As far as I know, methimazole overdose would only cause dehydration if it also caused vomiting and/or diarrhea in the cat.



> I think she felt a bit itchy for the first day or two. She was lethargic before taking methimazole and she still is but I've seen improvement. She still needs to regain muscle mass but she has made a few jumps she was to weak to make before. It also became harder to make her pur and she became more aloof.


It's difficult to tell which of her symptoms and behavior are or were attributable to the hyperT, hypoT, high methimazole dose, renal insufficiency, dehydration, and/or emaciation.



> Her appetite had been decreasing, I guess the low T4 could account for that though.


Yes, it certainly could, but so could any existing renal insufficiency and/or nausea caused by it or the methimazole. Still, the fact that she's gained more than a pound in a month is a very good indication that she's eating plenty right now, and that's great!



> Currently, I give 1.5 oz of wet food twice a day. Since she has been effectively eating all wet food as a result, I should probably just offer her more right? My gut feeling is that she would eat one and a half cans a day, maybe two.


I would eliminate all kibble from her diet (esp. with questionable kidney health) and feed her 5-6 oz of canned food a day split into 3-4 small meals.
It would also benefit her to mix some warm water into each meal to make it a thick gruel that she can lap up, if she'll eat it that way (most cats love canned food gruel). That would help keep her properly hydrated which will help support her kidneys.

You said in your first post that she had always been skinny at 8 lbs, so I'm guessing that her ideal weight would be somewhere between 8.5-9 lbs. With her hyperT controlled, you will hopefully be able to bring her up to that weight over the next few months.

BTW, your vet is now having you give her 1.25 mg of methimazole twice daily, right (I hope)? Not 2.5 mg once daily. She will maintain more even thyroid hormone levels if she is dosed twice daily.

Laurie


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## just_jason (Jun 13, 2010)

laurief said:


> Amylase is not reliable in cats, so the elevation of that enzyme has no significance. BUN is a different matter. It is one of the kidney values, along with creatinine. Creatinine is kidney-specific, but BUN can elevate for non-kidney reasons. The fact that both your cat's BUN and creat have risen, however, does imply some degree of renal insufficiency, even though her creat is still in the high normal range.


According to Feline CRF Information Center - Tests & Diagnostics
"Some vets feel that slightly elevated Amylase levels can sometimes be a pre-cursor to CRF before other symptoms occur." 

Have you heard this? You mention renal insufficiency. 



laurief said:


> Her bloodwork doesn't give the impression of her still being dehydrated, so I don't believe that's a factor. As far as I know, methimazole overdose would only cause dehydration if it also caused vomiting and/or diarrhea in the cat.


I think he got the impression from her physical. Either way renal insufficiency could cause dehydration as well right? She certainly drinks well but she doesn't urinate excessively in my opinion. I only change her litter box completely twice a week. I remember having to change it three time a week on occasion when she was younger.




laurief said:


> Yes, it certainly could, but so could any existing renal insufficiency and/or nausea caused by it or the methimazole. Still, the fact that she's gained more than a pound in a month is a very good indication that she's eating plenty right now, and that's great!


What testing beyond what has been done would also indicate renal insufficiency? 



laurief said:


> BTW, your vet is now having you give her 1.25 mg of methimazole twice daily, right (I hope)? Not 2.5 mg once daily. She will maintain more even thyroid hormone levels if she is dosed twice daily.


Twice a day. I went out and bought a pill splitter and crusher. It worked, though not as easily as I hoped. Maybe I just need to get the knack of it or I'll buy another model.

Gratefully,
Jason


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## just_jason (Jun 13, 2010)

Mom of 4 said:


> I would give her as much wet as she wants.
> 
> We give the girls each 3/4 of a 3 ounce can twice a day. Normally we leave a bit of dry out during the day (Evo), but my daughter's cat is visiting and a food pig. I want Zoey to gain a bit, so she get a little extra wet.
> 
> During the summer and winter, we add a bit of water to their food for extra hydration.


How much do your cats way?


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## laurief (Jun 22, 2008)

just_jason said:


> According to Feline CRF Information Center - Tests & Diagnostics
> "Some vets feel that slightly elevated Amylase levels can sometimes be a pre-cursor to CRF before other symptoms occur."
> 
> Have you heard this? You mention renal insufficiency.


No, as many hundreds of hours as I've spent reading through info on that site, I never read that particular tidbit before. It's consistent with what appears to be going on with your girl, though.



> renal insufficiency could cause dehydration as well right?


Yes, it certainly can.



> What testing beyond what has been done would also indicate renal insufficiency?


A urinalysis can be helpful. Other methods of early detection of CRF can be found here:

http://www.felinecrf.org/early_detection.htm

Laurie


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