4/11 Guinness AM/354. +2.5/351 PMPS 271, +2 364 +4 310

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linda and guinness

linda and guinness

Member Since 2009
Posted these facts/questions on my thread yesterday. Reposting here today for more eyes. Thanks.

Not for sure Hyper-T

T4 test was a 2.5 (I was told this was the high end of normal for a cat his age)
Free T-4 was 56.8 (<50 is normal), but vet felt this might not be the true indicator of Hyper-T.
He was diagnosed with an enlarged heart (a symptom of hyper-T)
And he is CONSTANTLY yowling for food.

Symptoms he is not displaying that are Hyper-T
He hasn't lost any weight
He's not aggressive or unfriendly
His coat is not unkempt or patchy

So, my vet could not give me a definitive answer. She said I could move forward with the radioactive iodine therapy ($1,000+), but she wouldn't recommend just haphazardly putting him on the Tapazole medication. I'm kind of at a standstill right now and don't know what to do. She recommended waiting about 3 months and then testing him again to see what his T4 levels are doing. That's probably what I am going to do at this point.

I plan to call the place that does the radioactive iodine treatment this week and ask some questions about the treatment and what they recommend for a cat that might be borderline. In the meantime, I am doing all I can to help control his enlarged heart issue, starting with getting rid of his Halo Pet Treats which are made with sodium. I just cooked up a bunch of fresh chicken for treats for his BG tests.

Lastly, he's not responding to the insulin, so that makes me wonder about the hyper-t as well. Any experience or thoughts surrounding the hyper-t, our test results or anything else would be greatly appreciated.
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

no advice from me other than you can try and cross post it on the health part of the board for more eyes. Hope you get some advice soon
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

I'm not sure that I'd conclude that Guinness isn't responding to insulin. I'd encourage you to increase his dose every 6 cycles. I think you're holding the dose too long. Also, don't assume this round of treatment will be the same as the last time.

This site has good info on hyperthyroidism. From the information you noted, you didn't say what symptoms of hyper-T Guinness is exhibiting.
 
Re: 4/11 Guinness AMPS 354, +2.5 351 Dose Increase?

I guess I was waiting for someone to let me know when to increase the dosage. Do you think I should bump him up to 1.75 now? I was also waiting to see how he would do after the dental before I bumped him up.

The only symptom he's seems to be experiencing on my end (aside from the enlarged heart) is a constant and insane hunger. Following me around looking for food, crying for food, jumping up on the table looking for crumbs, waiting under our chairs in case we drop anything, crying at 3am so that we will feed him. Eating and then looking for food immediately after he's eaten.
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

How are his renal values? Hyperthyroidism can mask renal insuffuciency. Treatment can then make the kidney values worse (i.e. the actual state of the kidneys can be seen once the hyperthyroidism is under control). I might be tempted to wait and retest in 3 months if the test results were borderline, and if symptoms of hyperthyroidism are not causing problems. I can't comment on effect on the heart - I don't know about that. I would assume that it is important to treat anything which is affecting the heart.

I tend to lean in the opposite direction from your vet. The radioactive iodine is very effective, but I don't know if I would go for something so drastic for borderline results. I would prefer to get a full blood panel, start treatment with a very low dose of methimazole, and then recheck bloodwork within a month or two to check the thyroid levels, and monitor the impact on kidneys and other body systems. If the kidneys tolerate it well, you could consider a more permanent treatment with radioactive iodine.

Methimazole can cause GI side effects. The transdermal form may cause fewer side effects. The dose should always be started very low and gradually titrated upwards.

Thus is just from my experience with Bear's hyper-T, not as an expert opinion.
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

His renal values were normal, but the vet mentioned upon feeling his kidneys, they seemed small in comparison to my other cats. She did mention the hyper-T masking kidney disease. Which is the worse of the two? Either one is gonna kill him eventually. I'll ask my vet about the low dose of the methimazole and see what she thinks. Maybe waiting and retesting are a good idea. Has anyone ever tried any of the natural remedies touted online? I'm guessing they are bunk, but wondering if anyone has had any experience?
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

I would lean towards re-checking bloodwork in a month to 6 weeks (T4 and Free T4) - if still in the gray area, consider a low dose of Tapazole (Methimazole) and see if the numbers come back to normal. Zoe was dx'd a year ago with HyperT and her blood work was in the Gray Zone for the T4 but the Free T4 was slightly elevated; we waited 6 weeks and re-checked and it was definitive at that time. If you want her actual numbers I will find them and post them for you. She responded well to Methimazol and stopped crying in the middle of the night for more food. She always looked good - her coat was always soft and shiny, but she wanted to eat all the time and cried at night.

I decided to go ahead with the radioactive iodine - it was a miracle - she was so much better after it was done. I wish I hadn't wait so long to do it (6 months after dx).
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

Hyperthyroidism does need to be treated if it is present. You want to monitor carefully so that you can see the impact on the kidneys, to see if you need to start treatment there, and also so that you don't exceed the ideal methimazole dose. It becomes a balancing act when the kidneys are involved.
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

Good luck Linda. I don't have much more to add than I did yesterday - but i think you've got some good input here. Good luck to with the dose increase when you decide to proceed with that.

Have a great day guys!
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

Did the vet check his blood pressure? Is his heart rate high? Those are 2 things which may be increased by hyperthyroidism and which put strain on the heart. They can be managed medically while you wait to recheck the thyroid.
 
Re: 4/11 Guinness AMPS 354 Hyper-T questions

Hi guys .. I don't really have anything else to offer in the way of hyper-T answers .. I hope the extra juice works out for you when you take the increase .. have a great day!
 
Re: 4/11 Guinness AMPS 354, +2.5 351 HyperT ?

She said both his heart rate and blood pressure were good. He was just put out for his dental so she was sure to monitor him closely. She said he had a good pulse the whole time and blood pressure remained good. I think we are catching all of this fairly early, but I don't want to go to long without doing anything about it. I'm going back to the vet in a week to check his extraction incisions, so I will gather all my information and questions and talk to her about it then.
 
Re: 4/11 Guinness AMPS 354. +2.5 351 Hyper-T questions

Question about increasing dose every 6 cycles...is a cycle a shot/12 hour period? So increase after every six shots? Or is a cycle a full 24 hour period? Increase after every 6 days. Could someone clarify this for me?
 
Re: 4/11 Guinness AMPS 354. +2.5 351 Cycle question

yes, 1 cycle is 1 shot & the subsequent 12 hours.
 
Re: 4/11 Guinness AM/354. +2.5/351 PMPS 271 shot 1.75u

Although BG was actually down from his normal 300 range, I shot a 1.75 instead of the 1.5u. I was 1/2+ late with his shot due to long doctor's appointment for my daughter and frickin' So. California traffic!!! I will monitor his +2, +4 and +5 or 6 tonight and then try and slowly ease him back to our 4:30am/pm shot times. Thank you all for all your help with the Hyper-T questions. I had hoped to call the imaging place today that would do the radio iodine test, but just ran out of time. Maybe tomorrow.
 
Re: 4/11 Guinness AM/354. +2.5/351 PMPS 271 shot 1.75u

Hi Linda,
I concur with what Linda and Sherry advised with regard to Hyper T. When Stu was diagnosed with both Hyper T and CRF last summer, we were made aware that the Hyper T masked the actual condition of the kidneys and were advised to begin a course of Tapezole to see if the renal values got worse (they did). If we had jumped in and just had the I-131 treatment, there would have been no going back, since I-131 is a cure for Hyper T, and the Hyper T would then no longer "protect" the kidneys by increasing blood flow to them. The advantage of starting with Tapezole is that the dose can be adjusted if the renal values deteriorate; a balance could be struck. If it turns out that Tapezole does not make the kidneys worse, then it is safe to pursue the I-131. I agree that since your tests were borderline, the best course would be to wait a while and then re-do the T4 and Free T4 tests.


As it turned out, Stu's CRF was too severe and he was not a candidate for I-131 (we took him to the Hypurrcat I-131 treatment center in Bedford Hills, NY for evaluation).

I hope this will help you in your decisions.

Ella
 
Re: 4/11 Guinness AM/354. +2.5/351 PMPS 271 shot 1.75u

Thank you so much Ella for your explanation. It's so interesting how so many things are explained by my vet in such a quick and exasperating manner that my head spins. Once I come to this board and look for clarification, I get so many long, detailed, rational views that I can start to relax and actually see the bigger picture. That's what makes this forum so great and the people on it so special. I hadn't considered the "balance" aspect and figured it was an "either, or" situation. You know, damned if you do, damned if you don't sort of thing. So I can see how the medication would be a better alternative if the kidneys are damaged. My vet explained to me that if I do the medication route, i would have to have the cat tested every 3 months for the rest of his life at a large expense. Do you have this test all the time?
 
Re: 4/11 Guinness AM/354. +2.5/351 PMPS 271, +2 364 food spi

Hi again, Linda,
As it turned out, Stu was much sicker than we thought. His renal values went through the roof. We had to let him go on Sept. 28th, the same day we took him for evaluation for the I-131. He had gone downhill so very quickly beginning 2 days before our appointment. At the suggestion of Dr. Peterson at Hypurrcat (he is the doctor who pioneered the I-131 treatment for cats; http://www.hypurrcat.com/index2.html), we took Stu to an excellent vet hospital in Katonah NY with the hope of getting him stabilized. His test readings were off the charts and it was also discovered that he had a large, cancerous mass on his spleen and cancer cells in his bloodstream. He knew it was his time to go, and it was the right thing to do. We miss him very much.

Now that I look back on it, I can see that he wasn't well all summer (had lost a lot of weight), but being a cat he masked his pain.

So I'm sorry I can't answer your question about constant testing, but I can see that it would probably be necessary. If Guinness were my kitty, and had normal renal values, I would not hesitate to have the I-131. It is a real cure.

Best of luck,

Ella
 
Ella,

I'm sorry to hear about Stu, I didn't realize. :sad: I can imagine you miss him terribly.

I do plan to get the I-131 test if deemed necessary in Guinness's case (and of course if his kidney values will allow it). I'm guessing because of the "borderline" nature of his diagnosis, I will wait and have him retested to see how his values have changed. I really wish I could get his BG under control right now though.

We will be heading back to the vet in a couple of weeks, so I will thoroughly discuss the options with her then. Thank you again for the information and your kind words.
 
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