? Arthritis Med Options, and Possible Hyperthyroid

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Asrael

Asrael

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Hi Everyone,
I haven't been on here in a ling time, but the beautiful members of this board helped nurture my cat Trouble into remission over 3 years ago. He has been OTJ since and still testing great:)

His 17th birthday is coming up this July, and his arthritis is really getting bad. He is 3 legged (back left missing), and gets around- with stairs to the bed and couches.. but we can feel his discomfort. We took him to the vet, had a full blood panel done.. as well as urine.. and got the recommendations.

She had suggested starting with gabapentin .25mg once to twice a day, as we have some at home and just seeing how it affects him. She is then going to send me some information on the other options.

1. Cartrophen is her first choice- it's an injection that we would give him once a week for 4 weeks and then move from there.
2. Her second choice if that did not work would be an NSAID like Orsion, or Metacam (I said NO to Metacam, but am not familiar with Orsion).. she said because there is no long term testing, they aren't sure how it works for kidney values over time.. but she said low dosing not every day may be an option. And it would be her second choice because of the possible effects on the kidneys.

The Gabapentin could be used with the Cartrophen, if it doesn't make him to sleepy.

I thought I would ask here and see if anyone had any thoughts about the best way to treat or move forward.

We have tried acupuncture- and he freaked out- would try it again.. but he definitely did not like it the last time, or at least the vet who came to the house who did it. Hesitant to try as he really was upset.

We have also tried CBD- small dose seemed to work for a while, then we went a little higher.. ,and it just spaces him out.. going to a smaller dose then didn't do anything. He is on Cosequin 1 tab a day.. Not sure if it's helping. He has been on that for 6-8 months.. with higher dosing at the beginning :)

In his blood tests- I didn't write the numbers down..- will get her to send me the paper tomorrow- She said Kidneys were high normal, urine was a little dilute.. and the hyperthyroid was in a grey area.. and we would need to do further testing.. expensive and she is not sure she is recommending it (can decide tomorrow) as she said sometimes to treat hypothyroid can affect kidneys- and at his age and in the gray area it may be best to just keep an eye. RBC was a little low..

So she is thinking some Kidney issues, and possible Hypothyroid..
Would love your thoughts on Testing for the T4- or just waiting and seeing.. He had lost a little weight over the last 2 years, but not much (.5 lb maybe).

Thanks for any insight and hope you are all well :)
 
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Can't comment on the blood tests, but have you looked into Adequan? It's for dogs/horses but is used off-label for cats. You administer it like you would insulin. There's a loading dose of eight injections and then it's once a month (or more frequently if needed). Several of us here have really good success with it. My tomcat was in a lot of pain and Onsior didn't even help (not saying it doesn't help at all, it just didn't make a difference for him) and there's always Cosequin as well.
 
Aleluia Grugru & Minnie said:
The only thing I can speak for is gabapentin. You can go up to as much as 50mg twice a day so start with what she recommended and go from there. Minnie was on 50mg twice a day and never got sleepy at all so no side effects. I think it did help but as you know, ECID. Good luck!! :cat:
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Thanks so much :) Yes- she said 25-50mg.. so good to know that you had luck with it at the 50mg, and no sleepiness!! So glad Minnie noticed the effects!
And Thank you!
 
Panic said:
Can't comment on the blood tests, but have you looked into Adequan? It's for dogs/horses but is used off-label for cats. You administer it like you would insulin. There's a loading dose of eight injections and then it's once a month (or more frequently if needed). Several of us here have really good success with it. My tomcat was in a lot of pain and Onsior didn't even help (not saying it doesn't help at all, it just didn't make a difference for him) and there's always Cosequin as well.
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Thanks- I wonder if Adequan is like the Cartophen? It's an injectable just like the insulin- I think she told me 4 injections at first and then supplement. I will ask her tomorrow if it's the same thing. And yes- he is already on the Cosequin- I will edit above to say that. We have also tried CBD.. but hasn't seemed to help! Thank you so much for you input, and so glad the Adequan is helping your Tom:)) It's so hard to see Trouble struggle, especially when overall he is doing so well! <3
 
Asrael said:
Thanks- I wonder if Adequan is like the Cartophen? It's an injectable just like the insulin- I think she told me 4 injections at first and then supplement. I will ask her tomorrow if it's the same thing. And yes- he is already on the Cosequin- I will edit above to say that. We have also tried CBD.. but hasn't seemed to help! Thank you so much for you input, and so glad the Adequan is helping your Tom:)) It's so hard to see Trouble struggle, especially when overall he is doing so well! <3
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You're welcome! A quick google search tells me that Cartophen is used in Canada and acts similarly to Adequan which is commonly used in the US, so it might be the same thing! Or close to it. :)
Cosequin didn't really do anything for my tom either, though I had him on it only a couple months. Adequan had him zooming up and down the trees again! For 17 years old I'd say he must have been doing pretty good for arthritis to only start bothering him. My fella started aching at 11!
 
Panic said:
You're welcome! A quick google search tells me that Cartophen is used in Canada and acts similarly to Adequan which is commonly used in the US, so it might be the same thing! Or close to it. :)
Cosequin didn't really do anything for my tom either, though I had him on it only a couple months. Adequan had him zooming up and down the trees again! For 17 years old I'd say he must have been doing pretty good for arthritis to only start bothering him. My fella started aching at 11!
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Great- We will definitely try it then-:). He has been sore for a long time.. he has 3 legs so hops everywhere.. The last year we have really noticed..that's when we got the stairs, and started CBD and cosequin.. but its probably been then last 2-3 years where he has been slowing down.. He was always slower because of the hopping- poor guy! His front legs now bend at weird angles when he sits up :( But his fur is glossy, he purrs alot, eats well, and still loves to wander around the garden. We love him so much <3

So glad that your baby is better!! And thank you so much for your help!!
 
Neko was on Cartrophen. I've had three cats on it now, with varying degrees of success. It's close, but not exactly the same as Adequan. Adequan is only really available in the US, Cartrophen elsewhere. I had a vet look into getting actual Adequan, and it was really expensive here. The unfortunate thing with Cartrophen is that the vial doesn't last long, so it's not cost effective to buy for just one, or even two cats at once a month dosing. So you buy prefilled syringes. Get just one doe at a time - it doesn't last long once in syringes. Get the vet to put the Cartrophen in insulin syringe or other smaller needle syringes. Their tendency is to put it in syringes with harpoons for needles.

Onsior - don't do it. It's an NSAID. Even the manufacturers website says it's only to be used for a max of three days. It's ideally used for short term pain after operations. Last I looked, there had been no long term studies in older cats. If gabapentin doesn't work for you, try buprenorphine. I tried both gaba and bupe. Gaba just made Neko sleepy and didn't do much for her pain, while buprenorphine was a game changer. Went from quiet and not much interaction to playing! It's a bit ECID which is best for your cat. If you go buprenorphine, I got my compounded in a vial with chicken flavour. It was much more acceptable that way. You can do both gaba or bupe and Cartrophen.

Acupuncture - my vet ended up using mostly acupuncture pens, which are a type of laser. She did just one or two needles to relax her, and the rest the laser. Neko wasn't fond of lots of needles either - loved the lasers. Leaned into the vet when she was using it. Over time she learned that it helped. At times the vet and I would be chatting at the beginning of the session, and Neko would go over to the sofa (where treatments happened) and try to get us to get on with it. :p

Other things to consider. First ditch the Cosequin, he's beyond that. Fish oil can help inflammation as can Duralactin. Check that one with the vet - don't give if his calcium numbers are high or he has a dairy allergy. You can just buy it on line. Another thing to help the joints is hyaluronic acid. I used the brand Hyaflex.

The hypothyroid - do you mean T4 or hyperthyroid? Only kitties that get the i131 treatment for hyperthyroidism are one that go hypothyroid. Or the odd ones that have pituitary radiation - which is how I found out about it. Weight loss is a symptom of hyperthyroidism. And yes you should treat hyperT if he has it, otherwise you are masking possible kidney issues. Meaning once you treat the hyperT, the true state of the kidneys shows up. Until then, you might not be treating something you should because you don't know it's there.
 
Hi Wendy
Thank you so much for all this info! I hope you and your husband and family are well. I feel so blessed to be in BC at this time :)

Yes- Hyperthyroid. T4 test.. not hypo.. I will change it up above.. And I so appreciate your insight on it- as the test is an additional $100- (that is discounted price)- but I think it is worth doing- especially as the blood is already at the testing place.

And great to know you have used the Cartophen- it is so worth trying- and I was hesitant about the NSAIDS- the vet too wasn't feeling like that where she wanted to go either so that is good. She mentioned the syringes.. and very small dosing like insulin- so will remind her about smaller needles. And will definitely try it.
I will get his full test numbers tomorrow- and see about the fish oil, Duralactin and Hyaflex.

We gave him the Gaba tonight- low dose .25 and he seems tired- but just heard my husband laugh as he was playing with something.. so maybe not that tired :). . but will ask her about the Bupe.. I think she would be open to trying it as well.

It has been my biggest fear that he will be fine but his legs will just go one day.. So want to do whatever we can to help. The vet that came for the acupuncture did try lasers but by that time he was so worked up it wasn't happening... But I might try again- our current vet, who we do like alot is more allopathic and doesn't do that- yet is open to it. .. but I know another one I can try that does house calls unless that has changed due to COVID (He really didn't like the last one that came so don't think I would try her again).

Thank you again for your time and energy! I so appreciate it!!
:bighug::bighug::bighug:
 
Wendy&Neko said:
Did you ever read this article?
I went to a different acupuncture vet with a friends dog, and they had a clinic cat in a wheelchair. Came around and greeted everyone. :) He'd been in an accident that impacted his back half, been in the wheelchair for years.
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I haven't seen that article, but we often talk about how a prosthetic leg would be handy. The wheel chair looks even better.. not sure how Trouble would feel about it though lol.. How cool that you have met one with one :)

Thanks again for everything @Wendy&Neko
 
We recently started using cartophen and we are on our fourth week now. We move to monthly afterwards. Cosmo has had several issues besides arthritis and diabetes as of late, so it has been hard to tell if it is making a difference. We also give CBD (Hemp terpines) and it has made an impact for the positive for sure. He had a constant knee/ankle crack when we walked but that is gone now since the CBD.
 
If Cartophenit’s similar to adequan, do that!!! Without it my cat limps. She started taking adequan about three years now. The loading dose was twice a week for four weeks, then once a week for a month, then once a month. We found we had to give it every three weeks, and for the last year about once a week, but it really does work!!! We also tried gabapentin but it just made her lethargic and tipsy.
Cc is also on methamezole for hyperthyroidism.
 
@Larry and Kitties Thank you- I hope Moxie is doing well :)
@thebigfuzz We decided to try the cartphphen- same thing- once a week for 4 weeks, then once a month.. She said we may not notice any effect til at least the first month is done.. What company do you use for your CBD? We had great response at first..but switched bottles (went for a stronger bottle so less drops) an it seemed not to help at all, just make him out of it!
@JanetNJ So glad that your cat is doing so well on the Adequan. Fingers crossed it will help Trouble! We are going to try small dose- .25 gabapentin and just see what we notice for a week.. it seems to make him sleepy too.. but he is sleepy alot anyways.. so not sure.. .And thanks re: the hyperthyroidism med.. I may connect with you re: that depending what his T4 test says!

Thank you all so much!!
:bighug::bighug::bighug:
 
Asrael said:
@Larry and Kitties Thank you- I hope Moxie is doing well :)
@thebigfuzz We decided to try the cartphphen- same thing- once a week for 4 weeks, then once a month.. She said we may not notice any effect til at least the first month is done.. What company do you use for your CBD? We had great response at first..but switched bottles (went for a stronger bottle so less drops) an it seemed not to help at all, just make him out of it!
@JanetNJ So glad that your cat is doing so well on the Adequan. Fingers crossed it will help Trouble! We are going to try small dose- .25 gabapentin and just see what we notice for a week.. it seems to make him sleepy too.. but he is sleepy alot anyways.. so not sure.. .And thanks re: the hyperthyroidism med.. I may connect with you re: that depending what his T4 test says!

Thank you all so much!!
:bighug::bighug::bighug:
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There are three forms of the hyperthyroidism need. A pill, or they can compound it to a flavored oral liquid, or a transdermal ear ointment. We went with the flavored oral liquid because it’s easier to get in her then a pill, and I mess too much with her ears already. You aren’t supposed to get it in your own skin because you can absorb it and mess with your own hormone vets tend to prescribe way too high a dose of gaba. .25 is good. We were supposed to give half a caplet , but that knocked her out and made her unsteady. (She’s 16.5 lbs but a half was way too much). If she’s really limping because of snow or something I’ll give maybe a third. I really haven’t given her any thisYear except oBe does after surgery on her leg. (The vet wanted me to give her a whole capsule..... no way that would have knocked her out for days!)
 
JanetNJ said:
There are three forms of the hyperthyroidism need. A pill, or they can compound it to a flavored oral liquid, or a transdermal ear ointment. We went with the flavored oral liquid because it’s easier to get in her then a pill, and I mess too much with her ears already. You aren’t supposed to get it in your own skin because you can absorb it and mess with your own hormone vets tend to prescribe way too high a dose of gaba. .25 is good. We were supposed to give half a caplet , but that knocked her out and made her unsteady. (She’s 16.5 lbs but a half was way too much). If she’s really limping because of snow or something I’ll give maybe a third. I really haven’t given her any thisYear except oBe does after surgery on her leg. (The vet wanted me to give her a whole capsule..... no way that would have knocked her out for days!)
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Great- Thanks for this- still waiting to hear the results of his T4 test.. and the gabapentin.. so hard to say definitely .25 is plenty.. I do think it makes him sleepy... but he's sleepy anyways lol.. Figure I will try it for a week :)
 
@JanetNJ Well test results are back and he is hyperthyroid. We weren't offered the liquid.. not sure if they have it in Canada or not? But had the pill or ear gel.. Going with pill at first as she said there is better results.. if it's hard to give it to him will then do the gel.. Poor Trouble... :( Thanks for your sharing, helps to know that Trouble isn't alone in the hyperthyroid diabetic world! xo
 
Asrael said:
@JanetNJ Well test results are back and he is hyperthyroid. We weren't offered the liquid.. not sure if they have it in Canada or not? But had the pill or ear gel.. Going with pill at first as she said there is better results.. if it's hard to give it to him will then do the gel.. Poor Trouble... :( Thanks for your sharing, helps to know that Trouble isn't alone in the hyperthyroid diabetic world! xo
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Oh man, bummer. If you can afford it and your cat is a candidate you can look into radiation therapy. Mine wasn't a candidate because she had our kidneys.
 
JanetNJ said:
Oh man, bummer. If you can afford it and your cat is a candidate you can look into radiation therapy. Mine wasn't a candidate because she had our kidneys.
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I know. I think with his age we won't do the radiation- price wise its alot (but if he were younger we would do it), but also he would have to be away for 1 week in Vancouver which is not super close to us.. think that would stress him out so so so much! Hoping he takes the pills well!

Thanks again :)
 
Asrael said:
We weren't offered the liquid.. not sure if they have it in Canada or not?
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Absolutely available. This side of the water a good friend of mine got it in liquid for her kitty, compounded chicken flavour. I used to give it to him when I did petsitting duty. He'd happily take it as. a "gravy" on top of his food.
 
Wendy&Neko said:
The other side benefit of liquid is that it is much easier to change the dose if you need to, that cutting a pill.
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Totally! I am not sure why she didn't mention it.. so thankful once again for posting here! Hope you are having a great weekend. Rain is holding off right now- and just about to go teach some yoga in the park... fingers crossed it stays dry til 2:30!
 
Asrael said:
Totally! I am not sure why she didn't mention it.. so thankful once again for posting here! Hope you are having a great weekend. Rain is holding off right now- and just about to go teach some yoga in the park... fingers crossed it stays dry til 2:30!
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It's a lot pricier than the pills but I find it so much easier to get her to take.
 
@JanetNJ and @Wendy&Neko got the meds today. Starting him on .25 ml twice a day. The 30 ml bottle was $46. CAD. Will try to give him some with food in a little bit... otherwise.. might just give him a quick dose mouthwise :) How do you give yours @JanetNJ ?

Just wanted to update- Hope you are both well :)
 
Asrael said:
@JanetNJ and @Wendy&Neko got the meds today. Starting him on .25 ml twice a day. The 30 ml bottle was $46. CAD. Will try to give him some with food in a little bit... otherwise.. might just give him a quick dose mouthwise :) How do you give yours @JanetNJ ?

Just wanted to update- Hope you are both well :)
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Hey there. It should be put directly in the mouth to make sure he gets it all.
I usually let her eat a little.... then squirt it in her mouth, then she goes back and eats more to get the taste out of her mouth.
 
what was your cat's t4? I just got the results from CC's t4 and it's still a little high at 3.9 , so I"m goign to try raising her dose just a little. She was getting 2.5 mg (.5 ml of a 5 mg/ml concentration)
 
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JanetNJ said:
what was your cat's t4? I just got the results from CC's t4 and it's still a little high at 3.9 , so I"m goign to try raising her dose just a little. She was getting 2.25 mg (.5 ml of a 5 mg/ml concentration)
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It was 69 pml/L and the average is 10-50. So I think looking at conversion calculator that is 5.3. He will start at .25ml twice daily of a 10mg/ml concentration. I think we are going to test at 4-6 weeks and see how it is going..
 
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