Can HYPOthyroid affect blood glucose?

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Gracie85

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Can being very HYPOthyroid (low) affect blood glucose levels? Full explanation below, but the quick version is that someone has not been giving the cat his thyroid pills for several months, and the cat is now hungry all the time, and the last few days literally attacking the waterbowl (shoving it all around, even flipping it) when he hasn't even been drinking from it for a long time--he's toothless except for diagonally opposing fangs, so we liquify his canned food to about 50/50 food/water, so he can just lap it up instead of trying to eat without poking his own gums with his remaining two teeth.

Lamborghini is over 18 years old. When he was 12, we found out he was HYPERthyroid. Treated with meds for about a year and a half, but then they were no longer sufficient so we had the radioactive iodine treatment done. This was so effective (they thought he might be going malignant, so they basically overdosed him to be sure all would be gone) that he became severely HYPOthyroid, and has been on levothyroxine ever since.
About the time of discovering the hyperthyroid, he also was borderline diabetic, but a strict diet change to very low carb has kept that in check all these years.
Now, I find out yesterday that my hubby, who handles all pills, etc because I am disabled and nearly legally blind, has been "occasionally forgetting" Lamborghini's thyroid medicine. I looked in the bottle, and it's mostly full. The date is scuffed off the label, I cannot see the month it was filled, but it appears to start with a zero, which means the best it could be would be 09/xx/2024. Which means my poor old cat has gone without his medicine for at least 4 months.
During the last several months, he has gone severely downhill. To the point where when he is sound asleep, I watch to see if he is still breathing. We figured it's because he's on the upper side of 18 years old, and has had so many medical problems during his life, that it was just his time. I am furious to find out husband has been just plain not giving him his essential medicine, because he forgot about it. He KNOWS this is critical. He has for the last 6 years. And it just occurred to me that he has probably not been giving him his daily gabapentin for the arthritis pain. At least I know he's been getting his solensia shots because I make the arrangements for those.

So, will being severely hypothyroid affect blood sugar? It may just be that Lamborghini IS very old, and his time is nearing its end. Or it may likely be that he is just so metabolically messed up at this point. I don't want to subject him to all kinds of medical torture to find out that he's just old, so am wondering if I should just wait and see if restoring his thyroid levels help him out, or take that long hard look at his situation. He gets so freaked out by going to the vet that he pees and poops in his carrier, and foams at the mouth so badly that the thick saliva sheets down his front. And the vet insists if he comes into the office, he has to have a rabies shot because it's now a few months overdue--but we learned the hard way with previous cats that when old, frail cats get vaccinated, they die within a couple of weeks (and, if after 18 years of rabies vaccines he doesn't have immunity yet, then the whole vaccine thing is a sham anyway.) We do have a mobile vet who comes to the house once a month for the solensia shots, but it's expensive just to have them show up, let alone testing and procedures, and he just got a shot so he's not due for almost 4 weeks for her next visit.

Oh I am so mad at husband I could beat him with a stick. A really big one.
 
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I kept my levothyroxine next to my cat's food bowls, and when preparing her breakfast I would add the water and then the pill and let it disolve and then add the food and mix it all up. I don't know if hypOthyroid affects blood sugar.
 
It's no problem pilling him, he has no teeth except for two front ones, and he's been on the med for years.
The problem is hubby, who I forgot to micromanage and nag. After 6 years, I guess I just relaxed.
We have 5 cats and a dog, so bowls, food, etc are kept in a lower cabinet where keeping pills is not a good idea.
I will just add this to my micromanagement schedule again. sigh.
 
I’m not sure about impacting BG, but thyroid issues can definitely impact kidneys. Hyperthyroidism increases blood flow to the kidneys, meaning it can help perfusion and mask any kidney disease. Hypothyroidism could then theoretically affect the kidneys in the opposite direction, I’d think, meaning it could make them work harder and any existing kidney disease (which most 18 year old cats already likely have) could be exacerbated. Drinking lots of water is a hallmark of kidney disease, as is weight loss snd, usually, reduced appetite (they tend to feel nauseated).

Before making any final decisions, I think I’d have the vet come out and run a blood panel to check kidneys, thyroid levels, and even BG (although that’s something you can/should do at home with a handheld meter). It might be that being off levothyroxine might explain what you’re seeing. Or not. But at least you’d have some data and a possible path forward to improve quality of life for whatever time that remains. Also, if it is kidney disease, there are additional things you can do.
 
Can being very HYPOthyroid (low) affect blood glucose levels? Full explanation below, but the quick version is that someone has not been giving the cat his thyroid pills for several months, and the cat is now hungry all the time, and the last few days literally attacking the waterbowl (shoving it all around, even flipping it) when he hasn't even been drinking from it for a long time--he's toothless except for diagonally opposing fangs, so we liquify his canned food to about 50/50 food/water, so he can just lap it up instead of trying to eat without poking his own gums with his remaining two teeth.

Lamborghini is over 18 years old. When he was 12, we found out he was HYPERthyroid. Treated with meds for about a year and a half, but then they were no longer sufficient so we had the radioactive iodine treatment done. This was so effective (they thought he might be going malignant, so they basically overdosed him to be sure all would be gone) that he became severely HYPOthyroid, and has been on levothyroxine ever since.
About the time of discovering the hyperthyroid, he also was borderline diabetic, but a strict diet change to very low carb has kept that in check all these years.
Now, I find out yesterday that my hubby, who handles all pills, etc because I am disabled and nearly legally blind, has been "occasionally forgetting" Lamborghini's thyroid medicine. I looked in the bottle, and it's mostly full. The date is scuffed off the label, I cannot see the month it was filled, but it appears to start with a zero, which means the best it could be would be 08/xx/2024. Which means my poor old cat has gone without his medicine for at least 4 months.
During the last several months, he has gone severely downhill. To the point where when he is sound asleep, I watch to see if he is still breathing. We figured it's because he's on the upper side of 18 years old, and has had so many medical problems during his life, that it was just his time. I am furious to find out husband has been just plain not giving him his essential medicine, because he forgot about it. He KNOWS this is critical. He has for the last 6 years. And it just occurred to me that he has probably not been giving him his daily gabapentin for the arthritis pain. At least I know he's been getting his solensia shots because I make the arrangements for those.

So, will being severely hypothyroid affect blood sugar? It may just be that Lamborghini IS very old, and his time is nearing its end. Or it may likely be that he is just so metabolically messed up at this point. I don't want to subject him to all kinds of medical torture to find out that he's just old, so am wondering if I should just wait and see if restoring his thyroid levels help him out, or take that long hard look at his situation. He gets so freaked out by going to the vet that he pees and poops in his carrier, and foams at the mouth so badly that the thick saliva sheets down his front. And the vet insists if he comes into the office, he has to have a rabies shot because it's now a few months overdue--but we learned the hard way with previous cats that when old, frail cats get vaccinated, they die within a couple of weeks (and, if after 18 years of rabies vaccines he doesn't have immunity yet, then the whole vaccine thing is a sham anyway.) We do have a mobile vet who comes to the house once a month for the solensia shots, but it's expensive just to have them show up, let alone testing and procedures, and he just got a shot so he's not due for almost 4 weeks for her next visit.

Oh I am so mad at husband I could beat him with a stick. A really big one.
@Wendy&Neko
@Suzanne & Darcy

Any ideas

Previous post
https://felinediabetes.com/FDMB/threads/washing-cleaning-a-very-old-cat.296514/


https://felinediabetes.com/FDMB/threads/accessing-solensia-questions.295131/#post-3216759
 
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I don't know why Diane tagged me, I don't have experience with this. Hyperthyroidism can make it harder to regulate, but that's not what you are dealing with.
 
HyperT and hypoT both have an effect on blood glucose levels, definetly, confirmed by vet and by my observations with Aida.
I don’t know yet exactly how it functions, but when the T4 is high, there’s some level of insuline resistance and Aida, still undiagnosed with hyperthyroidism, needed more insulin to have good curves,
Now that her T4 is controlled, her BG curves are super flat and mostly on the greens
@Gracie85 , I would definitely resume the levothyroxine regiment and go back to the vet for a full CBC+chemistry+TSH 4 weeks later, to give time to his system to adjust anew.

Low T4 damages the kidneys yes. In fact, it’s the reason why I-131 isn’t preferred in Europe because they are typically giving a huge dose of it and won’t do any follow up, they don’t test T4 with TSH and they never give levothyroxine, which means that after a I-131 treatments, many cats go into hypothyroidism and die fairly quickly from kidney failure.
There’s a paper that explains how low circulating T4 negatively impacts the kidneys, let me search for it.
 
It’s a paper from M. Broome, I have the pdf but can’t upload it.
On researchgate you have to request to get it, title:
Feline Hyperthyroidism - Avoiding Further Renal Injury
 
Since he takes gabapentin already could he take a dose to make him less stressed at the vet (your vet could suggest an appropriate dose, we on this forum shouldn’t guess at one since he’s so old and potentially severely hypothyroid at this point. I don’t know what dose of levothyroxine he was on but I’d suggest calling your vet first to confirm if he can restart or needs to start lower and build up the dose. Levothyroxine puts some stress on the heart —in older humans we start with a very low dose and slowly titrate upward.

I’d get him back to normal numbers before making decisions on his quality of life. I echo the suggestion that he be back on his regular dose (which may take awhile—see above re going SLOWLY) for 4-6 weeks then get a full senior panel and tft.

In humans if their thyroid is off—hyper or hypo—I’d correct that before getting too excited about other labs unless life threatening as the thyroid affects so many other things
 
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