8/19 Ivy Amps 144, +3 168, +12 225, +9 238, Pmps 170, +3 197 Libre Thyroid Lab Results

[Staci & Ivy]

8/18/24
Amps 144 Libre

Good morning,
Mostly blue yesterday on her Libre with some green and a few yellow highs and lows. She’s been mostly blue on her Libre the last 5 days and lots of blue in August at this dose. (**We must note that in a handheld bg will be higher so take these numbers accordingly).

We got some not great news yesterday about her thyroid blood results. Her T4 has gone UP since she’s been on methimazole transdermal .625 mg since March when she was diagnosed with hyperthyroidism. Not what I was hoping for
At diagnosis her T4 was 3.92 at Hemopet, in May it was 4.0 at Antech, and now it was 4.6 at Hemopet.
I will update all lab results on her labs tab.

Hemopet’s suggestion is to either switch to pills (from what I read, the side effects from pills can be really bad. That’s why I was trying to use the transdermal medication) And or increase the dose to 5 or 7.5 mg. That seems like a huge increase going from .625 so I’m not sure I’m comfortable with such an increase. It almost seems like it would be better to go to a smaller increase.
I will have to get some expert guidance on that.

*Her appetite has been good and she’s not lost any weight, no vocalizing (typical hyperthyroid symptoms).

So that investigation will consume my day

Her other lab results were mostly good from Antech. Her creatinine was 1.0, BUN is 29, she is concentrating urine well 1.060, HCT is 33 (she tends to be in this lower range), T4 4.2, Phosphorus 5.3, Potassium 4.4 (both normal range)
Another question is: is the thyroid masking the true kidney function?

If anyone has any experience or suggestions on a methimazole dose increase, I’d love to hear your thoughts

Have a safe day everyone

 

[Alicia & Kit cat (GA)]

I'm sorry to hear the results had gone the opposite direction. I know you had high hopes for the transdermal meds. And that seems like a huge increase. Yeesh.
It's really good that her appetite has been good and that she's not losing weight, and isn't vocalizing.
I hope you're able to find some folks who know more - have you also posted on the main health section to see if more folks pop up there with experience with hypothyroidism? I tend to forget and only post here almost all the time.
Scritches to Ivy and to you.

 

[carfurby (GA)]

 

[Jack & Mopem'sMom]

Hi Ivy,
I'm sorry the transdermal isn't working as well as you had hoped. Me personally, I would increase the transdermal, but maybe not so much all at once. I would avoid the pills, but that's based on my personal experience. I do know that hyperthyroidism definitely masks kidney issues, the vet told me that, and I have seen the kidney values climb in every cat that had hyper-T and was cured through the I-131..how much varied by cat/age/etc. I hope you are able to make a decision you are comfortable with for Ivy. Sending you much love and many hugs....

 

[Mikanmama (Mikan GA)]

Oooh. That must be so disappointing to see her numbers up.
I wonder if it is possible to re-test, given that she isn't showing clinical signs?
Labs can have errors and especially if they are recommending to go up on the dose that much, it feels reasonable to redo the test?
Maybe with another lab?
Also, her methimazole dose is relatively low, right? Would you be able to get higher dose transdermally? Pills are so hard to administer.

Hope others with more experience will chime in to help you figure out the best course of action.
Don't stress yourself too much, Staci. You will find a way. You always do!

 

[Madeline528]

Hi Staci. I'm sorry to hear Ivy's T4 has gone up and methimazole transdermal isn't working as well. Maybe an increase.
I don't know much about transdermal, but my cat Jinx had hyperthyroidism and was on methimazole compounded oral liquid that I had to administer twice a day. Once his T4 was in the normal range it was discovered that he had kidney disease.

Paws crossed and thinking of both of you

 

[Heike & BInie]

Hi Staci, I like to start with a big hug! I know, that it must have been disappointing to get these results.

Just from my understanding: The hyperthyroidism is caused by benign tumors on the thyroid gland. Usually these tumors are not static but they tend to grow over time. As I understand, that's why we have to control from time to time and to adjust the dose. I don't have any clue about the dosing but I know that many vets - and maybe also hemopet - tend to treat rather aggressively and with higher doses. That brings the t4 down more quickly but the organism can't adapt. I remember our vet also took the more aggressive road and at the first check after we started the treatment Binies t4 was almost too low. I can imagine, that this is more tiring for the organism than the approach you took. But that's just my logic, let's see what the experts say.

I don't know if it is a helpful thought but in a German lab 4.6 would be still in range (the "healthy" range goes up to 4.7). Together with the fact, that Ivy doesn't show any clinical signs and feels well, that could also mean, not to worry too much.

If there should be ever the idea to switch to oral meds, I can tell you about my experience with that. But I heard many good things about the transdermal so I don't know, if this even makes sense to consider.

I hope you find bit by bit all the answers you need to make a good decision for Ivy! And I hope you also take your time to relax. I send you a hug and healing thoughts for Ivy!

 

[Staci & Ivy]

Hi Ivy,
I'm sorry the transdermal isn't working as well as you had hoped. Me personally, I would increase the transdermal, but maybe not so much all at once. I would avoid the pills, but that's based on my personal experience. I do know that hyperthyroidism definitely masks kidney issues, the vet told me that, and I have seen the kidney values climb in every cat that had hyper-T and was cured through the I-131..how much varied by cat/age/etc. I hope you are able to make a decision you are comfortable with for Ivy. Sending you much love and many hugs....

What do you mean” not increase all at once” Christine? Thanks as always in your support in this subject I really appreciate your experience and letting me know.

Hugs to you and the herd @Jack & Mopem'sMom

 

[Staci & Ivy]

Hi Staci, I like to start with a big hug! I know, that it must have been disappointing to get these results.

Just from my understanding: The hyperthyroidism is caused by benign tumors on the thyroid gland. Usually these tumors are not static but they tend to grow over time. As I understand, that's why we have to control from time to time and to adjust the dose. I don't have any clue about the dosing but I know that many vets - and maybe also hemopet - tend to treat rather aggressively and with higher doses. That brings the t4 down more quickly but the organism can't adapt. I remember our vet also took the more aggressive road and at the first check after we started the treatment Binies t4 was almost too low. I can imagine, that this is more tiring for the organism than the approach you took. But that's just my logic, let's see what the experts say.

I don't know if it is a helpful thought but in a German lab 4.6 would be still in range (the "healthy" range goes up to 4.7). Together with the fact, that Ivy doesn't show any clinical signs and feels well, that could also mean, not to worry too much.

If there should be ever the idea to switch to oral meds, I can tell you about my experience with that. But I heard many good things about the transdermal so I don't know, if this even makes sense to consider.

I hope you find bit by bit all the answers you need to make a good decision for Ivy! And I hope you also take your time to relax. I send you a hug and healing thoughts for Ivy!

Hi Heike, thanks so much for all the detailed information. I know you went through some of this with Binie.
We love and appreciate the hugs, too.
I’m waiting to speak with our vet to see what he thinks. I think I’d like to bump her up to 1.25mg transdermal and see if that’s a better dose. (I really don’t want to go too high, too fast, as with insulin I don’t want to go past a good dose).
It’s been a very stressful day since I read these results last night. I had higher hopes that she was on a good path
I hope you and Binie had a good day and you are feeling better. Thanks so much for your kind support of us.
Sending you good vibes for a peaceful night

 

[Staci & Ivy]

I'm sorry to hear the results had gone the opposite direction. I know you had high hopes for the transdermal meds. And that seems like a huge increase. Yeesh.
It's really good that her appetite has been good and that she's not losing weight, and isn't vocalizing.
I hope you're able to find some folks who know more - have you also posted on the main health section to see if more folks pop up there with experience with hypothyroidism? I tend to forget and only post here almost all the time.
Scritches to Ivy and to you.

Thanks, Alicia. We appreciate your support. It means so much to us.
I took your great suggestion and did post on the main forum. Great idea, I forget to do that, too.

Sending all the love back to you and Kit

 

[Staci & Ivy]

Oooh. That must be so disappointing to see her numbers up.
I wonder if it is possible to re-test, given that she isn't showing clinical signs?
Labs can have errors and especially if they are recommending to go up on the dose that much, it feels reasonable to redo the test?
Maybe with another lab?
Also, her methimazole dose is relatively low, right? Would you be able to get higher dose transdermally? Pills are so hard to administer.

Hope others with more experience will chime in to help you figure out the best course of action.
Don't stress yourself too much, Staci. You will find a way. You always do!

Hi Kit, I believe the results are accurate. They were slightly higher in May and now even higher in August.
And I did use 2 labs on this T4. The local Antech lab was 4.2 and Hemopet’s was 4.6 (I guess they run higher).
And yes her dose has been the lowest possible. I can see bumping her up to 1.25 mg (but certainly not what the lab suggested, way too high).

And everyone says the pills are super toxic. So I’d like to avoid those if possible.
This is stressing me out so much. I need to see some good results so she feels ok and her values are better. My poor baby to have to go through all of this. As if FD isn’t enough
Thanks for your sweet support as always, Kit. I appreciate you always

 

[Staci & Ivy]

Hi Staci. I'm sorry to hear Ivy's T4 has gone up and methimazole transdermal isn't working as well. Maybe an increase.
I don't know much about transdermal, but my cat Jinx had hyperthyroidism and was on methimazole compounded oral liquid that I had to administer twice a day. Once his T4 was in the normal range it was discovered that he had kidney disease.

Paws crossed and thinking of both of you

Hi Madeline, thank you for letting me know of your experience.
How did Jinx do on the medication? Any side effects? Or did he feel ok?
I appreciate your support and the information

 

[Diane Tyler's Mom GA]

Hi Staci, I'm sorry her T4 went up. I hope someone comes a long with some advice for you . Sending you lots of hugs

 

[Madeline528]

Hi Madeline, thank you for letting me know of your experience.
How did Jinx do on the medication? Any side effects? Or did he feel ok?
I appreciate your support and the information

Hi Staci. Jinx did very well with the medication and didn't have any side effects. He continued to have a good appetite too. At the time of his diagnosis, I did not know about transdermal gel.
Sending hugs to you and Ivy

 

[Staci & Ivy]

Hi Staci. Jinx did very well with the medication and didn't have any side effects. He continued to have a good appetite too. At the time of his diagnosis, I did not know about transdermal gel.
Sending hugs to you and Ivy

Thanks, Madeline

 

[Staci & Ivy]

Hi Staci. Jinx did very well with the medication and didn't have any side effects. He continued to have a good appetite too. At the time of his diagnosis, I did not know about transdermal gel.
Sending hugs to you and Ivy

Hi Staci, I'm sorry her T4 went up. I hope someone comes a long with some advice for you . Sending you lots of hugs

Thanks, Diane! Hugs back to you and Tyler

 

[Staci & Ivy]

Hi Staci. Jinx did very well with the medication and didn't have any side effects. He continued to have a good appetite too. At the time of his diagnosis, I did not know about transdermal gel.
Sending hugs to you and Ivy

Thanks, Madeline hugs to you and Butch

 

[Jack & Mopem'sMom]

What do you mean” not increase all at once” Christine? Thanks as always in your support in this subject I really appreciate your experience and letting me know.

Hugs to you and the herd @Jack & Mopem'sMom

Sorry for confusion- I should have said, that over time, I wouldn't be opposed to the dose they suggest if Ivy needs it, but that I wouldn't jump that high immediately. I would ask what a good, but lower, increase would be. My thought was that I wouldn't want to bombard the poor cat with a massive dose when she is just adjusted to a low dose. I like to do things gradually, to give the pet time to adjust, especially if it's going to be a long term med- I'd want to find the lowest effective dose, and jumping from her starting dose, which wasn't even 1mg up to 5 or 7mg seems excessive. Of course, this slow/steady method may take longer to find the appropriate dose for her, and if the tumor keeps growing, then she may eventually need another increase. Just my opinion. Since most cats exhibit excessive thirst as a symptom the kidney values are often obscured due to their excessive drinking and urinating, thus flushing the kidneys. Once the thyroid is corrected/controlled they generally go back to their normal water consumption, which most times is less, so you get a 'truer' picture of what her kidneys are doing. Keeping you both in my thoughts and prayers.