Civvie with Hyperthyroidism...need help please

[Marje and Gracie]

Good morning! We normally post on Lantus Land with our kitty, Gracie, who has been FD for eight months. But this morning, I have a question and need help regarding our 16 year old civvie, Teddi.

Teddi started losing weight in spring 2009 and a senior panel indicated a fT4 (ED) of 59.4 and a tT4 of 2.4 (normal) in August, 2009. My vet put her on 1.25 mg methimazole bid. Her thyroid levels tanked and her kidney levels went up. She was taken off the methimazole and rechecked in one month and had normal thyroid levels. Three
months later I sent a blood sample to Dr. Dodds at Hemopet; she ran the full thyroid panel including the TGAA. Her thyroid levels were normal. My new vet
does Nutrition Response Testing and Teddi has been on Standard Process 1/4 calcium lactate bid and 1/4 thytrophin pmg sid for quite some time which I think
has been a great help in keeping her so stable; this vet tests her for all things which can stimulate her thyroid and we've removed it all from her diet or the
house. Teddi has been doing fine and I've sent three more subsequent blood samples to Dr. Dodds just to keep an eye on Teddi. Her kidney values came back
into normal range as well. However, recently, I noticed she seemed to be exhibiting signs of hyperT again and my vet did a senior panel. Her tT4 was 4.7
and fT4 (ED) was 62.4; I sent a sample to Dr. Dodds and she confirmed hyperT and that Teddi needed to start methimazole. Vet started her on 1.25 mg sid (compounded liquid). I noticed, though, that Teddi was starting to scratch a lot around her ears and she was vomiting at night with hair in it...she seemed to be overgrooming. She was showing pink/red around the eyes, ears, mouth. A recheck showed the thyroid levels back into normal ranges (high end...the tT4 was 3.68) and creat up a little to 2.5 from 2.2. Vet put her on 1/4 pituitrophin pmg sid and took her off the methimazole oral for three days until all pink/red cleared up (and Teddi did not vomit off the methimazole). We tried the transdermal gel; however, one application of the gel in her right ear and she vomited that night and all the pink/red came back in both ears and above eyes. I'm sure she didn't ingest any of it because she is a Scottish Fold with little tiny folded ears...I think it's almost impossible for her to get the gel
on her paws when she's grooming. This occurred on the weekend so I did not give any more gel. Spoke with vet yesterday and we have an appt today.

Are there any medication alternatives to methimazole? I do not believe Teddi is a candidate for I131 and I worry about her age and surgery. I did ask our vet if there were any supplements which could bring her thyroid levels down and she said it's possible but not like the methimazole will do and she was hoping the gel would work. Teddi is eating and drinking alot but is spending more time in a condo that she typically doesn't lie in. I'm worried about her....I know she doesn't feel well, I can see it in her eyes.
I'm just not sure where we go if she can't take the methimazole and other than this, she's a healthy, happy girl....we've always called her "Rock Steady Teddi".

Thanks for any thoughts for our girl.

 

[tuckers mom]

There's a yahoo group (Feline HyperT) I think it's called, they have great information.

I never had luck with the transdermal gel, also don't see your kitty as a candidate for I131 because of the kidney values that go up when T4 is lower.

Did your vet discuss lowering the Tap dose to .625 (1/8 of a 5mg pill)?

Overgrooming and vomitting water with some fur were common signs of Hypert for all of my cats.

 

[Lisa and Merlyn (GA)]

If you can afford it, I would look into the I-131. My conor had borderline kidney numbers..very early. on the cusp of creatinine being high. He was on the Methimazole so they knew his kidneys wouldnt crash so they did do the I-131. EVery facility is different.

Teddi is having all the classic methimazole allergy responses. Sometimes cats with the itching face symptom can be started on a very very low dose and edged up with better response however the spike in kidney numbers would be a worry.. the thing I dont know is if the allergic response could cause that or the unmasking of kidney issues.

We had a shelter cat that had liver failure whenever the vets gave her methimazole, so we fundraised to get her the I-131. Some cats can not tolerate it.

Sending cyber hugs for sure.

 

[Phoebe_TiggyGA_NortonGA]

I had to start Buster on a lower dose than 1.25mg.

We had to cut the pills into 8ths.

Since you are giving a liquid, maybe you could either give less or get it diluted?

We have not tried the transdermal gel.

He is now up to a larger dose -- but the first 9 months or so, he only needed 1/8th of a 5mg pill.

He does still vomit the clear liquid with fur sometimes -- the Tapazole doesn't help vomiting. We try to make sure there is plenty of food when we go to bed -- because 99% of the time, he is vomiting at 4 or 5 a.m. when they have run out of food.

(same canned food that Tiggy can have of course)

 

[Marje and Gracie]

Thank you all very much for your responses. We had the I131 done on another cat quite successfully but his kidneys were in great shape going into it. So we don't have any hesitation in doing it..we know how well it can work and we can afford it (also have pet insurance). It's not just her kidney values that cause us concern with the I131; she is a very shy cat and very picky about eating. I'm not sure how she would do sequestered for a week with unknown people trying to feed her and they absolutely will not let beans in with the kitty. Gus did fine because he's very outgoing, loves everyone, and eats anything you put in front of him. Teddi...I just don't know. And the vet specialist who does it told me that on cats with compromised kidneys, the I131 will generally worsen the condition....sometimes very quickly, sometimes not. I'm glad, Lisa, that Conor had success with it.

I'm going to talk to the vet today about restarting her on an even lower dose of methimazole as you all suggested and gradually building up and see if that helps. When we retested last week, her liver values were good...all her bloodwork looked pretty good. She did not have this allergic/vomiting reaction when she was on it the first time and she was on a much higher dose so I'm not sure why the problems this time. On the methimazole, she did the clear, foamy vomit once; mostly it's just a little blurp with hair in it and not a full stomach emptying but without the methimazole...no vomiting.

eta: thanks also for the suggestion of the FelineThyroid yahoo group. We've been a member there since Aug, 2009. I did post there but no response. There seems to be an OT issue that has their attention.