6/27 Junior PMPS 99 +5 85

Good morning LL!

Unlike yesterday, no cotton ball mouth today! Pokey times have been MUCH better. He still hisses but won't move his head around as much now. And I haven't gotten bitten in 3 days! His anger subsides faster where I can now pick him up after a poke. Hope I can start poking with a little more frequency tomorrow.

2 questions:
1) He's stayed mostly green this week and It's interesting to see how they've flattened out lately. I'm hoping that it's because that's when I started to feed him more to help him gain weight. Sometimes he's eating up to 30-45 minutes of +6 poke. Thoughts on a dose decrease?

2) Does anyone have any thoughts with radiation for a diabetic cat? I'm afraid I'm destroying his kidneys with Tapazole and his heart Atenolol. My vet diagnosed him w/ hyperT last Jan and brought up radiation. This was before he became diabetic.

After the wrong advice I got from my vet, I'm very skittish about my vet's thoughts on hyperT. I've seen posts like Dr. Pierson's but can't tell if they're for diabetic kitties or not. Cost is not an issue b/c Junior received Christmas money for radiation.

Have a great day!
Bonnie

Re: 6/27 Junior AMPS 95 Dose decrease?

Good morning! Glad the pokies are better. It will take time, but he will eventually at least tolerate it.

Hope you have a great day!!

Re: 6/27 Junior AMPS 95 Dose decrease?

Hi Boonie. I cannot help you with dosing. The only thing I see in your SS though, is that Junior has been on the same dose for too long. :shock:

Glad he is feeling better at poking time.

What gauge lancet are you using?

Re: 6/27 Junior AMPS 95 Dose decrease?

Gorgeous greens for Junior, hope you get some dose advice soon.

Glad to hear his anger issues are subsiding.

Re: 6/27 Junior AMPS 95 Dose decrease?

I'm glad to hear the pokies are going easier these days, and a lovely start today for Junior!

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

Bumping for HyperT/Radiation question.

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

Drop a note to Ella, Rusty's bean. She was considering the radiation treatment for Stu, who was diabetic.

Just to offer a correction. Atenolol is a beta-blocker and is commonly used to treat high blood pressure. It shouldn't have a negative effect on the heart. Not taking the med may cause problems related to high blood pressure.

I'd have to do some reading about the side effects of Tapazole. If there are the possibility of kidney problems, the combination of the drug and unregulated diabetes could have a negative effect on the kidneys. Junior is well below renal threshold at this point which should not cause diabetes related kidney problems. I do think the radiation treatment can have implications for the kidneys, at least in the short run. Any reputable place that does the iodine treatment will do a complete set of labs.

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

Bonnie:

While Gus is not a FD, he has had the radiation treatment. Sienne is right...any reputable clinic will look very closely at his labs. The I131 "may" have implications for kitties whose kidneys are compromised already. Gus's kidneys were totally in the normal range and it has been six years since he had the procedure. He is currently in renal insufficiency but he's also 15 now. I am VERY happy we did it for him; the methimazole (MMI) can have ugly side effects like we are dealing with Teddi right now (mostly allergic reaction) and they can get where they need more and more MMI. It's good to ask Ella about the FD part. If his kidneys are good, then talk with the specialist about any foreseeable problems with kidneys just in case.

Regarding the atenolol...I also had a cat on this; it is used for arrhythmia as well. Does Junior have high BP or arrhythmia?

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

morning!

What a nice amps for junior! hooray on the pokies!!

I can't help with the meds question, or the dosing. I have done the I131 radiation treatment for HyperT, but not with a diabetic cat. Ella is a good source, and here are a few others, unfortunately I can't remember who they are... :? For us the I131 was the best thing we did, took care of this kitty's thyroid problem and we had no issues or problems with the treatment.

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

i took atenolol for high blood pressure for about a year - don't know how it affects cats but i was SO TIRED that entire year that i finally went off and switched to an ace inhibitor instead. just fyi if junior seems more tired since he started taking it.

hopefully if you keep giving him treats with the testing he'll get used to it.

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

Methimazole (Tapazole) may have side effects, including anemia, but many cats do well on it. The thyroid, renal, and CBC values should be regularly checked to ensure that things are going well. It is my understanding (and I am not an expert) that treatment of hyperthyroidism, whether by a medication or by surgery, in a CRF cat may cause the kidney function to appear to worsen. The drug is not actually damaging the kidneys. Rather, the hyperthyroidism helped mask the actual state of the kidneys, and treating the hyperthyroidism can cause a worsening of the renal test values. In a renal cat, it may be a good idea to start treatment with oral meds to see how well the kidney function holds up before proceeding to a more permanent fix with radiation therapy. If necessary, the Tapazole dosage can be adjusted to achieve a good balance with the thyroid and renal values.

http://www.felinecrf.org/related_diseases.htm#hyperT_what_is_it

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

Thank you for all your thoughts guys!

@Sienna: I'll definitely connect with Ella. This board is full of resources! Also thanks for the correction. I had read on webmd that it could create new problems or worsen heart failure. Just wish my kitty wasn't on so many drugs.

@Marjorie: I don't know if he has high BP or arrhythmia. Vet just said that Junior needed to take it in conjunction with the Tapozole.

@Julie: I've noticed that he has been more tired this last year. I just figured he was tired from all the health-related treatments for both HT and diabetes. Also figured it's b/c he's aging into that ornery old man.

I'll keep the subject line up for the afternoon to see if anyone else wants to weigh in.

Re: dosing, I think his nadirs should be a more solid green (50's-60's) before we can reduce but I'm not sure. He's been at this dosage for so long.

Re: 6/27 Junior AMPS 95 Dosing & HyperT/Radiation Question

My senior, Mario is on transdermal tapazole, as well as amlodipine for high BP. HyperT and high BP often go hand-in-hand, so I bet that's why your vet has Junior on the atenolol. However, with that said, has your vet actually checked Junior's BP to make sure he needs the meds? I would double-check that.

With Mario, the first thing we did was get his thyroid under control. Every time he went in for blood work to make see if the thyroid was properly regulated and the kidneys were doing OK, the vet also checked his BP. Once we got Mario's tapazole dose correct (we only had to adjust once before we hit the right dosage), we went back for yet another BP check; sometimes correcting the thyroid corrects the high BP, but not in Mario's case. That's when we started the BP meds. And, he goes in very regularly to have all of these things rechecked, to make sure everything stays in balance. I would be very leary of giving any sort of BP meds without knowing for sure how the cat's BP is doing...high and low BP both give cause for concern. If Junior seems tired all the time, maybe his BP is running too low.

Mario's not a candidate for the radiation treatment, because he's 16, and he's in early stage CRF. A dietary changes has brought his kidney values back down to normal, and fortunately regulating his thyroid didn't unmask any further problems.

I know you you feel about all the meds, though. Mario's on the tapazole, amlodipine, as well as cosequin and adequan for his arthritis. He may have to go on a liver supplement, too, because his ALT was a little elevated in the last round of bloodwork. And all of this started in January...the same time Trixie was diagnsed. No easing us in to any of this! I can say this, though...despite all the meds, he's still a pretty sturdy cat!

Amy

Re: 6/27 Junior AMPS 95 +6 75 Dosing & HyperT/Radiation Ques

Hi Bonnie!

Zoe just had the I131 treatment in Sept 2010. She was diagnosed with HyperT in March of 2010. I originally was going to treat with the methimazol....she was on it, did well...her kidney values were normal before starting the methimazol and continued to be normal after taking it and getting the HyperT under control. In July she started to show side effects from the methimazol.....itchy, lack of appetite and increased liver enzymes....so we did the I131 treatment in Sept. I used RadioCat and they were fabulous with her....blood work before the treatment was done by our vet, RadioCat reviewed it and said she was a good candidate....they also looked at a chest x-ray. Zoe did well with the I131 treatment....she was a much more content cat when she came home - no more crying at night, great appetite (she gained almost 2 pounds) and was much calmer. She was OTJ at the time of treatment. I am happy we did the treatment.

Re: 6/27 Junior PMPS 99 Dosing & HyperT/Radiation Question

nice amps!!