Need advice on hyperthyroidism and diabetic cat

The vet ran a fruc test it seemed to show that Chloe was going into remission or needed less insulin. We dropped her insulin slowly and a new test was run but seems( I haven't seen the labs yet was told by Phone) that she isn't into remission. I have been reading that cats with hyperthyroidism can show lower fruc readings. Her liver panel was up also and she showed dehydration. The vet said she was testing for ketones and I asked them to check her thyroid panels. They called to say her thyroid level was 11 again I haven't seen the tests but assume this is total t4. Chloe is drinking a lot of water and peeing and we have been slowly increasing her insulin. She has lost a lot of weight in March she was at 10 lbs and is now at 7.2 lbs. I know it's tough to figure this all out as they could have many things.

My question here is would you all share how you handle your cat if they have diabetes and are hyperthyroid.

Wht meds are they on and type-pill, liquid, ear etc? Methimazole? What dose based on what level that your cats thyroid panel showed? What side effects have you seen and how do you handle that? How do you space out your prozinc dose time wise versus when you give your cat her hyperthyroid treatment? Anything that you can share to look for, do, determine if the vet is figuring this all out correctly on her condition and dose would be appreciated.

Thank you..Cheryl & Chloe

 

Hyperthyroid and diabetes together can be really tricky because their symptoms are practically identical. When I took Rocky to the vet in January hyperthyroid was the first thing he suspected until the blood test confirmed diabetes.

The typical treatment is Methimazole. I've read that the transdermal gel you apply to the inside of their ear results in less symptoms than the oral form (pill or liquid). As for the dose of the medication that's something your vet needs to calculate based on the cat's blood panel (and you typically need to retest every 6 weeks or so to see if it needs to be adjusted), that's not something anyone here can advise you on. Hyperthyroidism can be completely cured with a one time radioactive iodine treatment. Though it's expensive ($700-$1000) and can be stressful for the cat (they often need to be quarantined in the lab for a few days for the radioactivity to wear off) it will be less stressful and likely less expensive overall than a lifetime of medication.

As far as I know Methimazole shouldn't interfere with insulin, so I don't see any reason to not do it at the same time you do your Prozinc. The only complication I can imagine is that Methimazole in some cats (I believe 10-15%) can cause vomiting and a weak appetite, obviously nasty things for a diabetic cat that needs insulin. Though I also read these symptoms can subside after some time

 

On her great catinfo.org site, Dr Lisa Pierson makes a very cogent and persuasive case for going straight to the radioactive iodine (I-131) treatment for hyperthyroidism. Methimazole just suppresses the excess hormone production without addressing the underlying condition. The I-131 should be a permanent cure.

To my mind it makes sense to first definitively resolve the hyperthyroidism, and then move on to treating the diabetes. Otherwise, you're dealing with two serious conditions at once, and probably two different medication and testing regimes. Better to be able to just focus on managing the diabetes.

Last November we, all on the same day, discovered that my friend Thomas was suffering from hyperthyroidism, hyperglycemia (pre-diabetic) and a diseased maxillary canine. Since then, we've been through the I-131 treatment, started to address his now full-blown diabetes with diet changes and insulin, and had the bad tooth extracted (too far gone, alas, for a root canal).

I'd be happy to talk off-forum about what the radioactive iodine therapy was like. - Tom

 

I think in the long run the iodine treatment will be cheaper than years worth of medication. However I believe that most labs require the cat to be treated for a few weeks before the procedure to get thyroid levels somewhat under control. It depends on the specific facility