? Now a new problem- Katie has hyperthyroidism

Katie had a senior panel done and just as I suspected, her T4 was high. She has lost weight and has been overly hungry for a while now. Her T4 was normal last Sept. though.

I am totally depressed about this. I have a few questions for others that have gone through this.

1.- Can I expect any change in her BG after starting the meds for her hyperthyroidism? Up or down?

Her BG numbers have been great for a the last year or so, always in the normal range on 1/4-1/2 unit of lantus. I havent updated her SS in ages, I have been keeping a log at home, but her numbers are always between 50-80, normally in the 60's on the relion micro. I hope that doesnt change.

2.-Have those using medication had any success crushing the pill and adding it to their food? I know I cannot pill her twice a day, that will not work with her.

3.-Anybody had problems with bad side effects from the med? Vomiting, diarrhea?

I know about the I-131 treatment, and it's the best thing to do. I dont know if that is realistic option. At least not at this point. I dont care about the expense, but the doc says we would have to travel to OSU to have it done. That is a 4-5 hour drive. Katie does not travel well. She pukes, pees and poops in her carrier for a 10 minute ride the vet. Hyperventilates, screams, pants..........We tried to take her to a specialist that was an 1.5 hours once and that car ride was honestly one of the worst experiences of my life. And hers. Absolutely horrible. So I have to do some thinking on that. For now we will try the meds.

On top of it all, Katie is in desperate need for a dental (original reason for vet visit, I was getting her pre-dental done), probably needs some extractions. We cant do it til we get the thyroid under control.

My poor girl. She has a complicated medical history and been through a lot. *tears*

So for anyone whose has a diabetic kitty with hyperthyroidism, any advice or if you can share your experience, I would appreciate it. Thanks.

 

Maybe you could have the vet give you a light sedative, something to relax her. Years ago, I had a cat who could not even be taken to the vet (no more than 10 minute car ride) without it. It lasted for hours.

I am sorry you got another diagnosis on top of her other issues. I know there are people here whose cats have both diabetes and hyperthyroidism, so hopefully, you will get some helpful replies.

 

My kitty Ginger had hyperthyroid when she was 12 going on 13. It was a 1.5 hour drive to the Animal Endocrine Center where she had the i131 done. It was the long wait of 3.5 days before she could come home and I could hold her again that bothered me. She didn't like the wait either. But she's cured now, and all is well. No more hyperthyroid.
I strongly recommend the facebook group called Hyperthyroid Cats. I found them to be very supportive and informative.

 

@Dyana How did you handle the aftercare? OSU states the kitty has to be quarantined at home away from other pets for 4 weeks and you can only handle her 10 minutes a day. I dont how we would do that. There is another cat in the house. Neither of them would tolerate being cooped up in a room for weeks. They cant even stand it if I try to shut them in a room when a repairman is here or something. How did you do it?

 

One of my diabetics developed Hyper-T at age 12, four years after being diagnosed with diabetes. We started with tapazole pills and he became very ill with nausea, vomiting and inappetance. Then we tried transdermal which wasn't much better and added severe facial itching to his misery. It's really a nasty, toxic drug and these reactions are not uncommon. Sending him for radioiodine treatment was the best decision because it cured him and he lived to be 19. My only regret is that I wasted time worrying about possible kidney issues while he were miserable. Hyper-T is really hard on the body and the medication can have some pretty bad side effects. If another cat were to develop it I'd go straight to i131.

The facility that he went to was an emergency hospital open 24/7 and had a webcam so I could check on him anytime. He was their first diabetic and because he was radioactive, they couldn't test him but would give insulin. He was on a very low dose so I sent along a syringe with B-12 in it measured to a slightly lower dose just to be safe (red food coloring would also work), labeled and the needle clipped off so it couldn't be accidentally injected. I brought an assortment of food, a bed, an old worn t-shirt and a detailed list of instructions about what and when to feed, give insulin, etc.

Wendall was there 3 days and sent home with instructions but the veterinarian who administered the i131 told me not to worry about most of them. I did not isolate him, just washed my hands after handling and because we had another 13 or so cats, was extra vigilant about cleaning the litter boxes. We did have to save the litter for about 8 weeks before disposing. His first T-4 test post treatment was a little low which I was told is common, but a few weeks later was a perfect normal.

 

@Deborah & Muffy(GA) & Wendall

Thanks so much for your reply..after some research, hubby & I decided we are going to try and find a way for the i131 treatment. According the OSU website, their protocol is to do a "Methimazole challenge" to "unmask" concurrent chronic kidney disease. Their website also states cats that are diabetic or have other illness are not good candidates. I hope that is not written in stone and they will accept her. They state their space is limited and they only take a small number of cats. Sigh.

She just had her 2nd dose of meds....do you remember when the adverse side effects started showing up for Wendall? Was it pretty immediate or take several days? She is on a really low dose. But Katie usually has reactions to everything, so I will be amazed if this doesnt make her sick.

 

One concern is that I doubt that blood glucose would be measured before each shot and likely not at all since the cats are radioactive right after the injection and people minimise close contact with them. The radioactive relatively quickly decays and they are safe to go home after 3-6 days. The first cat I had I dropped off on monday and picked him up Saturday. The next at was dripped off Monday and picked up Thursday. Neither was diabetic.

 

Our regular vet kept telling me that Ginger's T4 was rising slowly, and that she thought she would go hyperthyroid.

That scared me, but after researching hyperthyroidism, I knew all along that I would go the i131 route.

My vet wanted to start her on the thyroid medication, and I told her I wanted to get the i131 done instead.


We only tried the thyroid medication Felimazole on Ginger for 2 weeks in August of 2016, it made her throw up. We had to stop the medication before the i131 which was originally scheduled at the end of that month.
She had a blood test before her i131 appointment and it turned out her T4 was only 4.1, and they said she should be at least 5.0 for the treatment, so we decided to wait a few months and then I didn't want to make the long drive in the winter time (I don't like driving where I am unfamiliar especially during commute traffic, and with possible snow and ice and the stress from dropping Ginger off, was just too much for me to bear).
She was scheduled for March of 2017, but there was a big snow storm predicted, and so rescheduled again for May. By April her T4 was 7.7 and in May at her i131 appointment it had risen to 8.3.



I was fortunate to live just over 100 miles away from Dr. Mark Peterson's clinic and had to drop off Ginger Monday morning and picked her up on Thursday afternoon.
They are expensive, but I felt were the best, and since they were in driving range, I felt that was the place I should take her. They have big condos where the cats stay and Ginger got a double condo. They have gerbils for the kitties to watch for entertainment. They also have the webcams, so I could see her everyday on my computer.
While I was in the waiting room waiting for Ginger's admittance there were 5 other cats brought in at the same time.
They only treat hyperthyroidism in cats there, and all are admitted on Mondays and picked up on Thursdays at that clinic (New York State).
We were to bring the food for our kitties to eat, any medications, all instructions for feeding and medication times and amounts and something that smelled like home, and told that none of it would be returned to us upon discharge.
I was told that they have given i131 to several cats in their 20s, and one of the cats in the waiting room was old like that, and another had severe kidney disease and her mom had to bring in her fluids, lots of medications, and raw food.
The staff wear geiger counters and those are closely monitored, so they can give the medications, fluids, feed and attend to their patients.
I was told that it is common for the cats to not want to eat while away, and after about 24 hours, they will give them Mirtzapine. I never saw Ginger eating on the Webcams and that bothered and worried me a lot (and she is not diabetic), but some of my friends who would also check the cams said they saw her eat, and I was told by the hospital that she did eat (how much I don't know) and did not need the mirtzapine, but other cats there did get it. That would be an even bigger worry for me if I had an insulin dependant diabetic and the doctors did not test the blood sugar. I would ask if there is any way they can do that, or ask the question on the face book group I mentioned to you earlier.


Along with the Thyroid Scintigraphy that helps the doctor determine the dose of i131 to give each cat, also included in the price I paid was post i131 blood work and urinalysis at 1 month, 3 months, 6 months and 12 months. Because Dr. Peterson is the leading researcher in the field, and Ginger's thyroid stayed a little low for the first year after treatment, he continues to advise me and pay for her blood work and urinalysis. It has been 2 years now. After 1 year post i131, she was started on thyroid hormone pills to bring her thyroid levels up, and through the blood tests this past year, she has needed less and less thyroid hormone, and the doctor's last report said "It is very possible that the hypothyroidism has spontaneously resolved.". I am hoping so. Right now, she gets 0.1mg of thyroid hormone (which is tasteless) dissolved in water and added to a spoonful of her regular food every morning. As long as it is a food she will eat, it is easy peasy to medicate her.

The after care was to gather Ginger's used litter for 2 weeks and then to store it for 3 months in a sealed container (I bought a large plastic paint container from Home Depot), and then dispose of it. I was told to limit close contact with Ginger (holding and snuggling) to 20 minutes total per day, for 2 weeks. She could sleep in my bed, as long as she was my arm's length away. She did not have to be isolated from my other cat at all, and they could share litter boxes, and water and food bowls.

Sorry for rambling.

 

We have a HyperT cat, and he is doing great on the transdermal methimazole. We use the twist-pen, and just rub it right inside his ear twice a day. He doesn't care at all anymore. Our vet had us start at a very low dose; from what I read that minimizes reactions to it, unfortunately many vets don't do that and start out with a high dose which can really mess things up (they make the cats hypothyroid, which also makes them sick). Definitely suggest you go to Hyperthyroid Cats on Facebook, https://www.facebook.com/groups/42301610484/ they are a wealth of information and experience.

 

Hi Katiesmom,
So sorry to hear your dealing with this on top of a diabetic kitty. Having a senior kitty can be rough, they need a lot of care! Good thing we love them so much. I have a diabetic kitty who is also hyperthyroid. He gets 1 5 mg pill in a pill pocket every morning, with no issues. I chose to do the medication both because of his age and because the drive to the treatment center was too far, and would just put further stress on him. He is also a picky eater, so I knew putting him on thyroid diet food wouldn’t work either; I knew he wouldn’t eat the food. He has also had all of his teeth removed, and he eats just fine. I never noticed it interfering with his insulin doses and I keep very good notes!
Best,
Yvonne

 

Seems others have had issues with it, but I had very good results with tapazole/methamazole transdermal cream for my last kitty. She was pretty well regulated for a good 7-8 years. She was on a low dose. I got the prescription by mail from Pine Pharmacy, they specialize in compounding and had reasonable prices, could mail me a 3 month supply at a time of pre filled syringes. The transdermal cream gets measured out of a pre filled syringe, you squirt out the correct dose, put on a latex glove so you are not absorbing medication through your skin and rub on the inside of cats ear, as we know there are lots of capillaries in the ear and the cream gets soaked into the skin and into the bloodstream. This was for a non diabetic cat, so would need to consider ear poking also since both would be on ears. You could do the cream on a different edge of ear than where you poke.

All that was required was occasional labs at vet to see if transdermal dose was keeping thyroid levels in good range, and then adjustments could be made from lab results.

Just a consideration if other options don’t work.