Lamborghini's Test Results

Here are the blood and urine results we got from Lamborghini last week, that sent us down our current path:
(putting down only the out of range ones

Test Result Ref. Range

• BLOODWORK:
• T4 14.4 (high) 0.8-4.0 ug/dL
• Glucose 240 64-170 mg/dL fructosamine not run yet
  
• ALT (SGPT) 109 (high) 10-100 IU/L
• Alk Phosphatase 156 (high) 10-100 IU/L
• Creatinine 0.5 (low) 0.6-2.4 mg/dL
• BUN/Creat. Ratio 56 (high) 4-33
• Lymphocytes 1027 (low) 1200-8000 /uL

• URINALYSIS
  
• Protein +1 (high) negative
• Microalbuminaria 1.4 <2.5 mg/dL test is normal
  
• Glucose +3 (high) negative

Everything else was normal.

So he is without a doubt very hyperthyroid. I know he has had high blood glucose before, don't know how it compares, but the vet said something like "he might be prediabetic or diabetic" at the time. I know that the stress of being at the vet can raise their glucose, but does it then also show up in their urine, like it did here?

Reading through the link that Harley Baby & Michele gave me in another thread, it seems that being hyperthyroid wreaks havoc on their sugar metabolism, causing insulin resistance and often making it worse once the thyroid levels are under control, and possibly progressing to full blown diabetes, so without a doubt we need to treat him as if he is diabetic, right? Here's that link, very interesting reading with lots of details about not just weight but muscle loss and why as well, with both diseases: http://www.animalendocrine.com/wp-c...agement-of-Feline-Hyperthyroidism-VMA-NYC.pdf

 

Glad the articles were helpful.

Yes, if there is a high glucose level in the blood it will "spill over" into the urine. You can not test for high blood glucose using urine test strips as the sugar in urine is several hours old not immediate as with an actual blood reading. The reason I mention this is there are Glucose/Ketone sticks available, they should only be used for Ketone testing. And on that topic, I would recommend testing Lamborghini for Ketones.

http://www.diabeticcatinternational.com/knowledge/dka/

I would also suggest doing at least 1x/day blood glucose testing even if your doc does not start insulin at this time. Yes, glucose can be elevated due to stress response. So, if you test at home you will have a better idea if glucose is artificially elevated due to stress or if the kitty is really diabetic. My non diabetic cats read 50's - 60's on a human meter.

My Harley was reading in the 200's at the vets office during 2 or 3 visits over about 1 year. The doc attributed the elevation to stress from dental cleaning and routine vet visits. If I knew then what I know now I would have immediately started testing at home and got him on insulin promptly. Harley developed DKA x 2 before starting insulin. I almost lost him.....twice. It still pisses me off that we did not start insulin with the first episode of DKA.

I wish Vets had a protocol for every "pre-diabetic" cat to immediately begin home testing for blood sugar and ketones. That is really wishful thinking as entirely to many vets don't even want home testing when the cats are taking insulin!! Don't even get me started on what I think of that!

BTW....weight loss and muscle wasting can be caused by hyperthyroidism OR diabetes. I free feed Harley as much canned food as he will eat to try and get some weight back on him. So....feed low carb diet to start on this journey to health.

Sorry I am rambling now but it is past my bedtime. Nighty, night.

 

This is very much like what my Thomas went through a few months back, high TT4 and moderate hypergylcemia. Since the fructosamine level was still in the normal range, he was considered possibly pre-diabetic. In your other thread you got the steer towards what Dr Lisa Pierson has to say about hyperthyroidism. Here, as in so much else, her thoughts are cogent, reasonable and very helpful.

If there is any way you can swing it, go for the I-131 treatment. This should cure the hyperthyroidism and so spare you from having to deal with two serious ongoing conditions at once.

It may take some time before you can get scheduled for the I-131 treatment. In the meanwhile, your doctor may prescribe methimazole to ease the symptoms of the hyperthyroidism. If this brings the T4 down, it also serves as a confirmation of the diagnosis. You will be asked to discontinue the methimazole a week or two before the I-131 treatment. But if you can get in quickly, you don't need the methimazole (and that is Dr Pierson's recommendation). Lamborghini does have a pretty high T4 value.

In the meanwhile, a low-carb diet and home testing are certainly good recommendations. Consult with both your doctor and wherever you would go for the I-131 treatment about what other measures might be appropriate at this time.

I read one journal article that said I-131 treatment may permanently decrease the cat's glucose tolerance. I would still rather knock out the hyperthyroidism, even with the greater likelihood of diabetes. After the I-131 treatment, Thomas did go full diabetic.

I would be happy to talk off-forum about what the I-131 treatment was like. It is just a single injection, but then the cat has to stay in the quarantine unit until his or her eliminations are no longer highly radioactive. The hardest part is that you cannot tell your cat that he or she will be coming back home in a few days.

Hope this helps. Thanks. - Tom

 

Least expensive I-131 treatment I can find is $1800, which we just do not have, son in is in last year of college, and while I have the tuition money for the second semester set aside, I do not have his room and board money (but he lives in his fraternity house, and says they will take monthly payments). Daughter starts college next year, don't have a penny left for her....
They could take us in December. Told me that the cat has to go through a trial of the thyroid medicine first, to confirm that the iodine treatment would be the right thing, otherwise it would have been next month. But I don't have the money.

An article I read said that insulin resistance is common with hyperthyroid, and then seems to get worse when thyroid levels are reduced, not better. So, I'm guessing that path is inevitable. He is greatly enjoying his new diet of increasing levels of wet food. Dry food consumption is way down, and we are in the process of transitioning it to a better kind. Biggest problem is the logistics of it all, with two cats, two dogs (one who is insane about food), my disabilities, and then the money.

But we will get things figured out as soon as we can.

 

$1800 ±$200 was the estimate I got. Fortunately we came in at the low end of the cost range. Still, this is a lot of money.

You've very quickly acquired a lot of information, and a good perspective on both conditions. Your vet sounds knowledgable and helpful. So, Gracie, all I can add is my heartfelt best wishes as you and Lamborghini move forward.

 

I'm trying. In my former life, long ago, before life and idiots driving while on their cell phone whacked me, I was a scientist, with two degrees in biology and one in chemistry, so understanding medical stuff generally comes easily. However, a multitude of eye problems makes reading anything at all very difficult (I keep my laptop screen blown up to as much as 150% just to see it), with all I've been doing since getting the results on Friday, I am in actual, physical, eye muscle pain every time I try to focus on a word. So hoping you all will bear with me if I ask you to tell me stuff or calculate food values or whatever, instead of doing it myself.