Possible hyperthyroidism

Christina & King Chuck

Christina & King Chuck

Member Since 2023
We just can’t catch a break! I brought Chuck into the vet for a dilated pupil that wasn’t responding to light. The vet couldn’t find anything wrong with him physically so we ran bloodwork and his AST/ALT liver function tests were very high. ALT was 560U/L ref range 27-158 and his AST was 120 U/L ref range is 16-67. His t4 was 5.1 which was slightly over the ref range of .8-4.7 micrograms/dL. His thyroid and liver function this time last year was normal.

The vet isn’t convinced it could be a thyroid issue because he’s just barely over the reference range but I have a feeling that’s what this is. After cyberknife in August Chuck put on 3lbs so the Vet is pushing for an ultrasound of the liver/pancreas as a next step. I’m just not sure that’s going to give us the answers we need. I’ve looked around the previous posts here and wondering if his t4 level is really that insignificant? Are there any other tests we can do in the meantime?
 
Gaining weight and hyperthyroidism don’t seem to fit the picture. With regard to the elevated liver enzymes, would start on one of the Denamarin products as soon as possible as they really do help.

As to thyroid… @Daphne and Aida can you comment?
 
You'll get more folks experienced with hyperthyroidism if you post on the Feline Health forum. Another good resource is the groups.io group on feline hyperthyroidism. Gaining weight and a possible side effect of SRT/Cyberknife is actually hypothyroidism. There are other thyroid tests, including a thyroid panel, including things such as the free T4, T3, and TSH (thyroid stimulating hormone).

Is the vet you are seeing an internal medicine vet? If not, might be time for one, preferably with an interest in endocrinology.

He getting any other medications such as steroids? How are his teeth?
 
I have read about post-SRT cats getting hypothyroidism. That is why I was surprised his T4 was elevated. When I didn’t trust the T4 test in my cat, I had them test the Free T4 by Equilibrium Dialysis. It’s a good suggestion to join the groups.io group.
 
Wendy&Neko said:
You'll get more folks experienced with hyperthyroidism if you post on the Feline Health forum. Another good resource is the groups.io group on feline hyperthyroidism. Gaining weight and a possible side effect of SRT/Cyberknife is actually hypothyroidism. There are other thyroid tests, including a thyroid panel, including things such as the free T4, T3, and TSH (thyroid stimulating hormone).

Is the vet you are seeing an internal medicine vet? If not, might be time for one, preferably with an interest in endocrinology.

He getting any other medications such as steroids? How are his teeth?
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I read about the radiation and hypothyroid but his test results are more consistent with hyper. It’s all very strange! His CT scan prior to cyberknife also showed an enlarged right thyroid lobe and the radiologist suggested it could be related hyperthyroid.

We’re waiting on free t4 and t3 to come back. His TSH came back undetectable consistent with hyperthyroid. His teeth are relatively fine. He lost some teeth with the acromegaly, it looks like they disappeared into his gums. His molars and are still in tact!
 
Suzanne & Darcy said:
I have read about post-SRT cats getting hypothyroidism. That is why I was surprised his T4 was elevated. When I didn’t trust the T4 test in my cat, I had them test the Free T4 by Equilibrium Dialysis. It’s a good suggestion to join the groups.io group.
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Thanks for responding! we’re waiting on his free t3 and free t4. TSH came back undetectable, consistent with hyperthyroid. He’s an odd case! I’ll post an update once we get the remaining tests.
 
Suzanne & Darcy said:
Gaining weight and hyperthyroidism don’t seem to fit the picture. With regard to the elevated liver enzymes, would start on one of the Denamarin products as soon as possible as they really do help.

As to thyroid… @Daphne and Aida can you comment?
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Sorry i don’t seem to get any messages from here…

Suzanne I think you overestimate my knowledge!

Undetectable tsh is concurrent with hyperthyroidism, yes. Regarding the weight gain, it is odd, but it can happen. I think that hypert cats that lose weight have been hyper for quite some time.

When Aida was diagnosed, she was also a bit overweight, and i had been struggling to get her to lose some - this fight is still ongoing! She was diagnosed with a tT4 over 6, was started with the lowest recommended dose (1.25mg bid) and went hypo. She’s currently getting 0.625mg bid and seems to be stable.

If fT4 also comes over the range, then you should start Chuck with the lowest possible dose of methimazole, 1.25mg bid.
 
Daphne and Aida said:
Sorry i don’t seem to get any messages from here…

Suzanne I think you overestimate my knowledge!

Undetectable tsh is concurrent with hyperthyroidism, yes. Regarding the weight gain, it is odd, but it can happen. I think that hypert cats that lose weight have been hyper for quite some time.

When Aida was diagnosed, she was also a bit overweight, and i had been struggling to get her to lose some - this fight is still ongoing! She was diagnosed with a tT4 over 6, was started with the lowest recommended dose (1.25mg bid) and went hypo. She’s currently getting 0.625mg bid and seems to be stable.

If fT4 also comes over the range, then you should start Chuck with the lowest possible dose of methimazole, 1.25mg bid.
Click to expand...

thank you for sharing your experience! Did Aida have anything else out of range on her bloodwork? I’ll keep you posted on Chuck’s t4 results
 
Daphne and Aida said:
Sorry i don’t seem to get any messages from here…

Suzanne I think you overestimate my knowledge!

Undetectable tsh is concurrent with hyperthyroidism, yes. Regarding the weight gain, it is odd, but it can happen. I think that hypert cats that lose weight have been hyper for quite some time.

When Aida was diagnosed, she was also a bit overweight, and i had been struggling to get her to lose some - this fight is still ongoing! She was diagnosed with a tT4 over 6, was started with the lowest recommended dose (1.25mg bid) and went hypo. She’s currently getting 0.625mg bid and seems to be stable.

If fT4 also comes over the range, then you should start Chuck with the lowest possible dose of methimazole, 1.25mg bid.
Click to expand...
Why did I think you had the radiation treatment for Aida’s thyroid?
 
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