hyperthyroid surgery & CRF

[laur+danny+horde]

anyone have experience with the surgery for hyperthyroid?

My Venture was found as a stray last fall. He was extremely emaciated and weak. At first they thought he was hyperthyroid and I was pursuing the I-131, but then the specialist who put in his feeding tube said he wasn't hyper-t, that he had high blood pressure. So he was put on amlodipine for that. He put on weight nicely for a while. Then he unsurprisingly showed CRF which worsened a bit but is now stable / improving (now on daily sub-q's, binder etc). A week or so back I got him a new feeding tube since he just stopped eating even with cypro - being hospitalized didn't help. He had a dental when the tube was put in, and his teeth/mouth look good. He's very very thin and weak, though... but he's still fighting to live, which is why we haven't let him go.

Surgery is by far the most cost-effective option, since there is an awesome low-cost surgery/dental center in Richmond -- well worth the travel time. They did the feeding tube / dental for Vench last week. The doc there is the one who said he really needed to be tested again for hyper-t. So I had him tested and his Free T4 just cambe back as > 100 (range 10-50). We got luck with a cancellation and his surgery is tomorrow.

So, anything I should know or watch out for on the surgery, or aftermath? For sure we will be keeping a close eye on his CRF.

thanks,
laur

 

[tuckers mom]

Spunky(GA) did fine after her surgery, no complications or anything. But a year later she had HyperT again. They remove only one pituary gland, I think there are two and for Spunky only one had it at the time. By the time the hypert came back she was not a candidate for I131 because of her kidney disease. She passed away about 3 years after the surgery.

Her entire family, we adopted her and her three kittens, they all passed away young and had kidney failure in the end and all were hyperts, I don't her passing only 3 years after surgery was due to surgery but more due to genetics.

 

[Jess & Earl]

Hi Laur

He's not on methimazole already? Why not do that and wait until he's stronger for a surgery? I am a little nervous at the thought of a 'low cost' place -- thyroidectomy is a major surgery that should have 24 hour nursing care afterward. A surgeon who is not extremely careful can accidentally remove the parathyroid glands and leave the cat with hypoparathyroidism (life-threatening calcium derangement). How many has this surgeon done? Is there a veterinarian there overnight, or at least a nurse?

There is a benefit in controlling the hyperthyroidism before going to surgery in that the cat will be more stable (cardiovascularly) going into what can be a tricky surgery. If he's not doing well to begin with, I would get him strong and stable before going for it.

 

[laur+danny+horde]

Jess,

sorry I missed your post as it would have given me pause, but I think I might have gone ahead anyway. I am very leery of tapazole/methimazole given the risk (albeit) small of a fatal reaction. And I don't think Venture would have had the weeks needed for the tapazole to start taking effect -- perhaps medically he could have, but I really hated seeing him just so weak and honestly, just fading. I have been on the verge of letting him go for the past two weeks. Only reason that I didn't was that he was still fighting. The feeding tube helped some, but not enough. I promised him I would not let him continue to starve slowly, despite being fed as much as I could through his feeding tube. So I guess I felt a strong sense of urgency to help him -now-, or let him go.

The surgeon and I had talked at length about the risk to the parathyroids. The surgeon was very well experienced at doing the surgery, so I felt very confident. They are low cost because they are adamantly against economic euthanasia. They only do surgeries and dentals -- all day, every day. They have been written up in various papers and I think were even once on national tv.

At any rate, Venture has had the surgery already and is doing great. He only needed one side of the thyroid removed. Since then the improvement has been marked. For one thing, he has started eating some food!!!! His need for sub-q's is down, he's no longer sagging in the hocks, and I can feel that the weight loss has stopped. He actually had some heft to him this morning! Of course I am watching carefully for any sign of tremors.

thanks again so much for taking the time to respond. I think you brought up some great points. Probably the methimazole was the safer way to go, and I'm so glad we had a good outcome.

laur