HyperT - I-131 treatment - Thank you

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I'm wondering if anyone has had a similar experience to ours or any ideas on what could be going on with our cat, Ace? Ace has been OTJ since August 2006 and is approximately 10 years old (that is based on the shelter's guess when we adopted him in 2004, I think it is possible he could be older). Last fall we noticed he had lost a lot of weight, so took him to the vet and he was diagnosed as Hyper T. We elected to go with the I-131 treatment, and per the standard protocol our vet wanted to put him methimazole first to lower his thyroid values so that we could make sure his kidneys were OK before doing the I-131. After just one dose of the methimazole, he stopped eating, became extremely lethargic and later started having bloody diarrhea and vomited a few times. We took him to the vet the next day and he spent 4 days there - I think he got one or two more does of the methimzole while there, because at first the vet thought the dose was just too high, before they stopped it completely (in retrospect I think giving the additional doses was a mistake). We finally brought him home and managed to get him well enough to have the I-131 treatment. A month later things were looking good - he had gained back a half pound, seemed perkier (although not back to his old self), coat looked good, and was eating well. We did a blood check and kidney values were OK, thyroid was a little low but vet was not concerned. A week or so before the 3 month check it was obvious he was losing weight again, and was now having liqui-poo. He was still eating, just not as much as normal. We had blood work done, which showed a high white cell count, low red blood cell count, and his thyroid level is still below normal. We did a week on clavamox with no improvement, then switched to metronidazole and sent off urine and poo samples, both of which turned up no problems. After a few days on the metronidazole he started having solid poo again. He has now been off the metronidazole for a week, and continues to have solid poo, is eating OK (just not as much as his old normal self), but remains extremely lethargic and is down to skin and bones. His digestive system also makes gurgling noises (like a person's will do, but I have never heard a cat do that before). We are going to re-run the blood work tomorrow. Vet at first thought he could have IBD, but now that the poo is back to normal, I don't know? He has only vomited once during this ordeal. If through the process of elimination the vet concludes that he has IBD the treatment is steroids, which I would like to avoid if possible so as not to throw him back into diabetes - and again, since the poo issue has cleared up and he is not vomiting, I'm wondering if it really is that. Vet also thinks it could be the low thyroid level causing the lethargy, but didn't want to start supplementing until we know if something else is going on. He looks so sad and miserable - spends all his time curled up on his chair, or in a meatloaf position, but comes to the kitchen and waits for food and eats at each meal; other thing I noticed is that he doesn't seem to be grooming himself very much. Any one have any similar experience, advice, or ideas? I feel bad because this downhill spiral all began with that one dose of methimazole - he was a happy cat before that. Thanks.
 
Re: HyperT - I-131 treatment but now not doing well

Ann & Scatcats said:
I'm concerned about the low red blood cell anemia.

I did not get a copy of the blood work so I don't know the exact number, but the vet said he was on the borderline of being anemic. I'm not sure what the low red blood cell count means, especially in relation to the other results of a high white celll count and low thyroid....I'll have to ask when we are at the vet's office tomorrow.
 
Re: HyperT - I-131 treatment but now not doing well

Sometimes a bad reaction to a medicine with cause bone marrow suppression (it does this in humans, too). If the thyroid tests are low, I'd supplement him rather than waiting, as thyroid hormone kicks most other systems to a higher level, and he needs to produce some red blood cells.

A high white cell count may indicate infection, inflammation, or neoplasia (tissue growth, benign or malignant).
 
Re: HyperT - I-131 treatment but now not doing well

BJM said:
Sometimes a bad reaction to a medicine with cause bone marrow suppression (it does this in humans, too). If the thyroid tests are low, I'd supplement him rather than waiting, as thyroid hormone kicks most other systems to a higher level, and he needs to produce some red blood cells.

A high white cell count may indicate infection, inflammation, or neoplasia (tissue growth, benign or malignant).

Thanks - these are all good things to ask our vet about.
 
Re: HyperT - I-131 treatment but now not doing well

It takes a while to get the thyroid med regulated in the system too, I agree with BJ, supplementation is needed. DH had same I-131 treatment many years ago - the time between treatment and beginning of meds was he!!. He just wanted to sleep with a grouch and grumble in between....

HUGS,
 
Re: HyperT - I-131 treatment but now not doing well

Deb & Ace,
What does your vet consider low? Civvie Slappy is going thru the thyroid issue as well. Her first blood work, it was high. Was put on the meds, compounded and rubbed in the ear. Script was one time per day @ 1/2 of 2.5g, I believe. Another test, vet said all was ok.
New vet, read the blood work from previous vet, said it was still a bit high - think it was 3 from 5?? Darn, cant remember. Anyway, he doubled the amount & doing 2 times per day - 2.5 total .
New set of blood work, now she is at 1. He says that is fine.
Question being, when she had first set of blood work, she was very very sick, not eating...almost lost her and have no idea why, except the thyroid.
Now she is eating me out of house and home and seems to want to eat constantly....
 
Re: HyperT - I-131 treatment but now not doing well

ohbell said:
Deb & Ace,
What does your vet consider low? Civvie Slappy is going thru the thyroid issue as well. Her first blood work, it was high. Was put on the meds, compounded and rubbed in the ear. Script was one time per day @ 1/2 of 2.5g, I believe. Another test, vet said all was ok.
New vet, read the blood work from previous vet, said it was still a bit high - think it was 3 from 5?? Darn, cant remember. Anyway, he doubled the amount & doing 2 times per day - 2.5 total .
New set of blood work, now she is at 1. He says that is fine.
Question being, when she had first set of blood work, she was very very sick, not eating...almost lost her and have no idea why, except the thyroid.
Now she is eating me out of house and home and seems to want to eat constantly....

I don't have his most recent blood work - forgot to get a copy last time, but will get it today. At diagnosis he was at 7.9, and the normal range was shown as 0.8 - 4.0. At the one month post I-131 check he was at 0.8 (and the vet used a different lab, which had the reference range as 0.6 - 3.0 - not sure why there is a difference there with the ranges). I think he was lower than 0.8 at the last check, which was not quite 3 months post-treatment, but I just got a verbal result and now I can't remember- but will find out today.
 
Re: HyperT - I-131 treatment but now not doing well

Hi,
My Trina is diabetic & had I-131 done this past November. I'm a member of 2 yahoo groups for feline thyroid & thanks to them & the knowledge of Dr. Mark Peterson & Dr. Dodds, I was well informed that a "newer" type of blood test needs to be performed after having I-131. It's called a full thyroid panel which includes T4's, T3's & TSH. It is much more detailed & will tell you everything you need to know about what's going on with the thyroid. Trina's numbers were very low & she was started on the supplement Levothyroxine in February. She is doing well. (other than an allergy issue we are trying to figure out....uugh) The members on "The Feline Thyroid" group & "Feline hyper-t" group are very helpful & would be more than happy to help try to figure out what is going on with Ace. I hope he is feeling better soon!
 
Re: HyperT - I-131 treatment but now not doing well

HI my cat Sitka had I131 and was also very low energy/lethargic after treatment. My vet ran a followup thyroid panel as well as a Free T4 test which found no discernable thyroid hormones being created. So we did start her on a thyroid supplement soloxine. I don't remember how long it took for her to get back to her old self but don't think it was very long. I think if its been two-three months and your kitty is still showing no thyroid hormone production its time to supplement. The vet who did my cats I131 said "its much easier to supplement an underactive thyroid then control an overactive one". Sitka does still get soloxine because her thyroid never did start back up. Jan
 
Re: HyperT - I-131 treatment but now not doing well

Thank you all for the replies and advice. Unfortunately, Ace went downhill very rapidly and it became clear he had something else going on ruather than just low thyroid. When I took him to the vet on Friday, she discovered a mass and fluid in his abdomen. He was so frail that we didn't think he'd survive exploratory surgery, and given how quickly he declined my vet was not at all optimistic that we would be able to help him. He was clearly suffering, and over the weekend he continued to decline and I could tell he was ready for us to let him go. We had the weekend to love on him and let him sit outside in the sun one last time, and on Monday afternoon we said our goodbyes and helped our sweet little guy cross the rainbow bridge. We had a wonderful time together, it was just far too short. He will be sadly missed, but fondly remembered. Fly free, sweet Ace Cat!
 
Re: HyperT - I-131 treatment but now not doing well

So sorry for your loss. It's so difficult to have them going through so much, despite your every effort. A very hard decision to make, but likewise a very loving choice. God bless you all.

Lu-Ann
 
Re: HyperT - I-131 treatment but now not doing well

I am so sorry for your loss.

May all your wonderful memories of Ace comfort you...

...'til you meet again.
 
Re: HyperT - I-131 treatment but now not doing well

Oh, Deb...
so terribly sorry to hear this.

land softly, little one...

Celi, Binks, Smudge, and Annie

cat_and_candle.jpg
 
Re: HyperT - I-131 treatment but now not doing well

Deb - I'm so sorry for your loss. I know you are missing Ace terribly. I hope you can find comfort in memories of your time with him and knowing you did everything you could for him. He was a lucky fella to have someone love him so much.

Praying for you and your family -

Libby
 
Re: HyperT - I-131 treatment but now not doing well

What a sad story... But Ace knows that you did your best to do what would help him, and how much you loved him.
 
Re: HyperT - I-131 treatment but now not doing well

Oh Deb, was soo suprised to see that candle this a.m.
Tears flowing for your Ace!
Ace, please let my Gumpy show you the best places to watch those butterflies!
rb_icon
 
Re: HyperT - I-131 treatment but now not doing well

Deb, I'm so sorry that you had to say good bye to your furbaby. I'm sure he knew you did the best you could for him. My heart goes out to you and your family. Jan
 
Re: HyperT - I-131 treatment but now not doing well

I'm so sorry for your loss. You did right by your Ace Cat. My heart goes out to you.
jeanne
 
Re: HyperT - I-131 treatment but now not doing well

((Deb)) I am so sorry for the loss of your sweet Ace. There never is enough time with them.
 
Re: HyperT - I-131 treatment but now not doing well

{{hugs}}

May your good memories of him help lighten grief.
 
I just wanted to thank everyone for your kind words. I know many of you have suffered your own heart-wrenching losses recently. I haven't ever posted much on the board- Ace went OTJ in the summer of 2007 after only 8 months on insulin, and I have mostly just lurked over the years. But if not for all the things I learned here and the diet changes we made as a result, we likely would not have had so many good years with our sweet boy. When this new issue came up, even though it wasn't related to diabetes, this was the first place I turned to - everyone has been so kind and caring during this difficult time. I added a pic of my handsome boy to my avatar (finally figured out how, after all these years). Ace was only about 11 years old (best guess) and we only had him for a little over seven years; he burned through all 9 lives way too quickly. I was really hoping to have at least 7 or 8 more good years, but the years we had were filled with tremendous joy and love. We will always miss you, Ace cat,till we meet again.
 
I'm so sorry for your loss.
Having had to witness my Sweety's downward spiral with kidney failure recently, I know how hard it is to watch and how hard the decision is to make, but you did it out of love.
Think of your baby sunning herself with my Sweety over the bridge.

((((((hugs))))))))
 
I am so sorry for your loss of Ace. Your love for him is obvious and I am glad you were able to help him to a place where he is no longer in pain. Peace to you as you mourn his loss.
 
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