Conference misery::feline

    I had Muffin on medication for an overactive thyroid for years
    and I've never heard of increased vomiting as a side effect and
    never noticed an increase in her vomting either.  You might want
    to give it a try anyway and see if it does help her.
    
    One of the reasons that she could be nagging you for food is that
    she is constantly hungry.  Having an overactive thyroid makes you
    hungry all the time and could also be one of the causes for her
    thinness.  
    
    Muffin was on thyroid medication for at least five years with pills
    twice a day.  I had to have her put to sleep but she lived comfortably
    until the day she died.  
    
    Good luck.
    
    

    Thank you for the input...AND your good experience.  She has ALWAYS
    been hungry since birth!  ;)  I think I may bring her to my *new* vet
    and see what he has to say...
    
    Thanks,
    -s

    My 15 year old Zoe's T3/T4 uptake just came back as hyperthyroid. Both
    were hightly elevated. She has been on an anti-thyroid medication for 5
    days now, and I'm noticed changed for the better almost immediatly. She
    is no longer nervous, she isn't overgrooming (and as a result, has
    stopped vomiting), her appitite has gone back to "normal" and she is
    affectiate. She will be retested after two weeks on it, and we will decide
    to keep her on it for another two weeks or to discontinue it. She is taking 
    methizole (bradname Tapazole,I think) which kills off a little bit of the
    thyroid. If they kill off too much of the thyroid, she would go
    "hypothyroid", (which would cause her to become lethargic and put on
    weight) and would have to take a synthetic thyroid hormone (like synthroid)
    for the rest of her life.) This is why they are testing again after two
    weeks. Hopefully, she will wind up perfect.
    
    By the way, they usually don't like to do thyroidectomy's in cats
    because in the course of removing the thyroid, the parathyroid (about
    the size of a grain of rice in a cat) often inadvertantly comes out
    too.
    
    You mention a TSH test. Where were you able to have this performed? My
    vet said that none of the labs perform this for cats, and none of the
    vet supply houses sell would sell him the chemicals needed to measue
    it, nor could he get it from the local hospital). He has asked
    AngellMemorial for help in getting it but their standard answer seems
    to be "we have it; tell your client to being the cat here and we'll do
    the test".
    
    
    Good luck,
    Deb

    My Cindycat was 16 1/2 yrs old when diagnosed with hyperthyroid. She lived
    on a tablet each morning and evening for 2 more years. Symptoms began
    with an incredible appetite, lots of vomiting, and a thirst for water
    all the time. Several days after starting meds, the appetite became
    more normal - she always was a light eater, the vomiting decreased but
    never totally stopped, and the water drinking went down a bit as well.
    Our vet visits increased to every 3 mos, most times doing blood work. I
    was assured each time Cindycat was in no pain and she could continue on
    her medicine for some time. We did not feel she would do well with
    surgery at all. She remained very active but for shorter periods of time.
    Cindycat actually died more from complications of old age. 
    
    Your new vet sounds so wonderful,by all means go to him. I wouldn't
    hesitate putting your kitty on the medicine, although pilling a kitty
    twice a day for perhaps the rest of her life, is not something to look
    forward to.
    
    Good luck,
    Linda  

    Sorry about Cindycat...that's the worst part of being a part of an
    animal's life...losing them.  I still can't handle it.
    
    T's symptoms are similar, sort of.  Her bloodwork doesn't show
    abnormalities, only slight.  Liquid intake hasn't changed much, she
    doesn't drink excessively.  She's ALWAYS hungry, but that isn't
    something out of the ordinary.  Hmmmmmm...I think by everyone's
    replies, I really had best get her to my new vet because now I'm not
    that sure of her diagnosis.  
    
    Regarding the pilling, I just hate doing that.  I feel like I'm forcing
    them to take poison!  They hate it so.  Even Floyd started expressing
    his displeasure with me.  
    
    Thanks for the input and I think that a 2nd opinion is no longer an
    option now.  Thank you all for helping me see that.
    
    Sandra

    Sandra,
    
     What made your vet think your cat had a problem?  I have Maine Coons
    my male Max is about 22 pounds and always hungry, his sister is also
    large ( 19 pounds).  The only thing my vet said was Coco was fat and
    needs to lose weight.
    
      We also see another brother and he is over 20 pounds but their vet
    doesn't see anything unusual either.
    
     I am new to this conference if this was discussed earlier.
    
    Thanks for any answers,
    
    Dennis

    
    
    
    I didn't have a 'concrete' reason why I thought she might not be well
    other than the fact that she *was* a fat cat and got real thin quickly. 
    She was eating and drinking as usual and her litter box was normal
    (stinky!).  It was the weight loss that concerned me.  I know that when
    these critters get older, especially the females, they tend to thin out
    somewhat and they get that 'sag' that we all get as we age (UGH!). 
    That was my only clue that something wasn't quite right.
    
    Sounds like Max and Coco put a major dent in your grocery bill!!! :) 
    Ah, the love of animals...Doesn't sound like anything's wrong with
    them!!!  Anyway, Maine Coon Cats are big ANYway and I 'heard' that for
    them to weigh in around the high teens/lower 20s is about right.  Is
    it?
    
    My new addition, Floyd, decided to grace us with his presence this
    morning after a 24 hour hiatus.  He was none too pleased about getting
    his a.m. meds and as I pried open is mouth, OH MY, did his breath knock
    me out!!!!!  WHEW!!!!!  And that was PRE-feed!  I give him his canned
    food AFTER his meds, kinda like washing that awful taste away. 
    Hopefully, after his neutering on Friday he'll stay around a bit more.
    I wonder if he *knows* something is up and that's why he's making
    himself scarce these days; or maybe he just doesn't like the
    antibiotics he's been getting since last Thursday... :)  

    Re: .7
    
    I wonder if Floyd needs his teeth cleaned.  Perhaps you
    should ask the vet in case he wants to also do that when
    Floyd is neutered, so Floyd doesn't have to go thru
    anesthesia twice (although I have the dim idea that my vet
    once said something about not doing those two things
    together if the teeth were in bad shape, as it let lose
    bacteria when the system was vulnerable from surgery;  I
    may be remembering that completely incorrectly, though.)
    

    RE: .8
    >anesthesia twice (although I have the dim idea that my vet
    >once said something about not doing those two things
    >together if the teeth were in bad shape, as it let lose
    >bacteria when the system was vulnerable from surgery;  I
    >may be remembering that completely incorrectly, though.)
    
    I think that you are remembering it right, but that only applies if the
    cat wasn't on antibiotics. Since the cat has been on them for a few
    days, that would take care of the "loose bacteria" problem.
    
    Deb

    Thanks for the answer.  Yes Maine Coons get big. I have five, the
    girls (3) average about 12 pounds ( mainly because the 1 1/2 year old is 
    "only" about or 8 pounds. Of the two boys Max is 3 1/2 and almost done
    growing (I hope).  The baby 6 months is now as big as the littlest
    girl.  
    
      My breeder girl has very bad breath.  My vet has said she has very
    bad gum disease.  He can't really do anything.  He said just try to 
    clean her teeth with peroxide to see if it will help.  I just can't
    bring myself to do this.  I try to brush her teeth but she doesn't like
    that either.  Maybe when she's done nursing I'll try the peroxide.
    
    Dennis  

    Re: .10
    
    I would ask for a referral to a vet who specializes in dental problems.
    One of my kitties, for example, has had a root canal, so there are
    vets out there who know how to treat mouth problems. I suspect the gum
    disease is uncomfortable for her.
    
    Also, there are special toothpastes for cats, human toothpaste isn't
    good for them.
    

    The toothpaste I was using is from Hartz Mountain supposedly made for
    cats.  I have this funny looking toothbrush that looks like a rubber
    thimble with tiny little brushes on it.  The big guy didn't care for it 
    either.  
    
    But thanks for the tip I'll ask my vet.  I have heard of one in Toledo
    (2 hour drive).  He is a dentist who works at the zoo on weekend a
    month doing dental work for the large animals.  He bought one of our
    kittens so at least one baby won't have problems.
    
    Dennis

    This is a great notesfile...all this information...I *thought* I had a
    good handle on what's what, but I have really come to rely on this
    notesfile.  You people (I know, wishing you were furfaces :D) are the
    best!  So quick to help.
    
    You REALLY are GREAT!
    
    Sandra
    
    P.S.  I know this has nothing to do with anything, but... :)

    Does anyone know of any side-effects to Tapazole?  My 11+ year old cat
    was diagnosed with Hyperthyroidism and has been taking a liquid 
    suspension of Tapazole, 1cm. twice a day for about two weeks.  Over the
    weekend, she started vomiting very frequently -- just some yellowish
    liquid -- no hair balls, food, etc.  I plan to call the vet, but
    wondered if anyone else had experienced similar problems.  I was also
    curious about the liquid suspension and whether there may be something
    in it that would cause this distress.
    
    Any info would be greatly appreciated.
    
    thanks.
    

    I suspect that you might have better luck with pills. I can't imagine
    that a liquid suspension wouldn't be able to totally disquise the taste
    of the pill (and if they don't quite go down, they taste horrible!)
    
    If you're getting the liquid because your cat is hard to pill, I've
    found that just smearing a bit of butter on the pill makes kitty want
    to take the pill.
    
    When one is  hyperthyroid , the metabolism is speeded up, and usually
    has a ravenous appitite; vomiting is common. It could be that the tapozole
    is not sufficent to bring your cat's thyroid down to the normal level,
    and going hours without eating she is throwing up excess gastric
    juices (that are there in anticipation of more food). It might be time
    for another blood test.
    
    Or, she could be getting into something (like the trash). You might want
    to try leaving out some extra food for her.
    
    Hope this helps. Do let us know how she is doing.
    Deb

    Thanks, Deb, for the suggestions.  I do leave food out all the time, so
    having enough to eat shouldn't be a problem -- and it is entirely
    possible that she got into "something" over the weekend in the cellar,
    which is the process of being cleaned out.  Anyway, I have a call into
    Dr. Mulcahy and am waiting to hear from her.  The original prescription
    was to give Clementine the Tapazole twice a day for 30 days.  We'll see
    if Dr. Mulcahy wants to do another blood test or change from liquid to
    pills or whatever.

    I looked up the side effects of Tapozole last night, and I forgot to
    bring them in. I do remember vomiting being a possible side effect, but
    there was a notation that if it occurred it would happen within the
    first two months of therepy. If she can't tolorate it, you may want to
    ask the vet about changing to another anti-thyroid drug, PTU.
    
    Deb

    Dr. Mulcahy called me back today and confirmed that vomiting is a
    possible side effect -- either pills or liquid.  She said that in that
    Clementine has only been on it for 2 weeks, we should try to hang on
    for at least another week (as long as she is drinking plenty of water,
    which she is).  So, we'll see what happens.
    
    Thanks again.
    

    If she is vomiting a lot, you might want to give her one of the
    hydration/electrolite solutions that they sell for infants, like
    Pedilyte or Infantilyte. The generic brands are about $2/bottle in the
    drug stores, $4 for the name brands.
    
    GOod luck,
    Deb

    Actually, the vomiting has quieted down to almost stopping -- I think I
    paniced on Monday after she had so many bouts over the weekend.  We're
    keeping an eye on her and will keep in touch with the vet as well.
    
    Thanks again for the suggestions -- this last one is great and I'm
    going to pick some up tonight just to have in the house.
    
    Sandy
    

    Well, after a month on the Tapazole, Clementine's T4 is back to
    completely normal -- it was 9 before we started.
    
    And, other than a panic with frequent vomiting after the first two
    weeks, it has been faily uneventful.  She hasn't gained back any weight
    yet but she didn't lose anymore either.
    
    If anyone is considering whether it is worth it to pill or give liquid
    to a cat twice a day -- I say it definitely is.  Our cat is only 11 -
    still very young.
    
    

    Two years ago I lost Cindycat to thyroid related problems. BUT,
    Cindycat had been on Tapazole for 2 years before that and lived a great
    life to the wonderful old age of 18-1/2. So I totally agree pilling her
    twice a day was worth it. Her appetitie and  weight stablized after we 
    found the right dose. She had very frequent checkups and blood work. It 
    was all worth it - she was the oldest "kitten" my vet ever saw.  
    
    It's hard at first pilling her, but I was just as stubborn and
    determined she was taking the pill as she was about not taking the pill. 
    
    Good luck to Clementine and you.
    
    Linda

    Vitamin, who's 14 now, is going through an operation today to remove
    one thyroid, possibly both, and I don't know yet if she'll make it
    through.  She was always a fat cat and in recent months lost a huge
    amount of weight, was still eating a fair amount and drinking like mad. 
    She's got arthritis as well so she's all bony but still ever so
    affectionate.  Her heart isn't strong and the blood tests show she has
    liver problems as well but the vet reckons her best chance is the op,
    rather than let her go on as she is.  She was on a hormone pill (sorry
    I don't know offhand what it is) twice a day for the last three weeks
    but all this has done is suppress her appetite & the vet agreed it
    wasn't really doing her much good.
    
    So keep your fingers crossed - I'm working away from home for a couple
    of days & I have to decide whether to call & find out how she is before
    or after I give a training course tonight....
    
    Does anyone know the life expectancy after thyroid removal?  Anytime
    feels like borrowed time now....
    
    Pam

    my Aunt Olga lived for 40 years after having her's out. Similiarly with
    a cat, so long as they get ther synthroid, they will be fine.
    
    Are you sure that the cat is having the thyroid, not the parathyroid
    removed? I ask this as there is ony 1 thryoid gland,  but 2 (or 4?)
    parathyroid glands which sit on the thyroid; they are about the size of
    a grain of rice in the cat.) Thyroid glands aren't usually removed in
    cats...
    
    good luck, I wish your cat all the best.
    Deb

    My sisters 16 year old kitty went through the operation to
    have one side of the gland removed and from what Deb states...
    it must have been a parathyroid. (I didn't know that!!)  Mitzi
    also had a leg amputated during the same operation to remove
    the thyroid and what amazed us most was how well Mitzi did
    during the operation and during recovery.  She was amazing....
    
    The sad part is after about 6 months after the operation....she
    started having problems with the other parathyroid.  According
    to the vet this is VERY unusual.  Because my sister decided not
    to have another operation...Mitzi was put back on the thyroid
    pills and did very well again.  Mitzi finally was laid to rest
    due to other medical problems (cancerous tumor) but she never
    had any other thyroid problems.
    
    Good luck....and please keep us posted.
    
    Sandy

    In January of 94, my Minew had one side of the gland removed.  She was
    14 years old at the time, was showing heart problems and possible
    liver problems at the same time.  After surgery, we no longer had to
    give her thyroid medication, but is still on heart medication.  The liver
    problem seemed to go away.  A few months ago she started losing weight,
    last month she was diagnosed with kidney failure.  Now she is on
    K/D (loves the dry stuff) and looks/feels like a million bucks.  She
    hasn't had to have fluid since she was first diagnosed with kidney
    trouble.  Good luck!
    
    Diane

    Pam, please let us know how Vitamin is doing.  She is in my thoughts,
    
    Karen
    

    Well, so far so good.  Vitamin has got through the operation and is
    full of life today - ravenously hungry and causing lots of noise &
    nuisance at the hospital; they said she was their favourite there at
    the moment which was nice.  They're keeping her in for another couple
    of days as apparently it can sometimes cause fits after the event
    (anyone know about this?), so I should be able to collect her 
    tomorrow or Friday.
    
    Re .24, as I understood it, the vet was definitely removing 1 thyroid &
    possibly 2, so I'm surprised that there's only 1.  I understood things
    to be as Deb said in .3, that in the course of removing the thyroid, it
    can damage the parathyroid - this is how the vet explained it to me. 
    And if the parathyroid gets damaged, it means things go rapidly
    downhill.  Are we getting thyroids & parathyroids mixed up??
    
    Pam

    If I remember correctly they did keep Mitzi a few days too...
    and I'm not positive...but I believe it was the Calcium that
    has a potential to go out of whack right after the operation
    and they like to monitor it for a bit.
    
    Good luck...
    
    Sandy

    Well, thinking about it, it could be that one "lobe" of the thyroid gland
    is being removed. There is still only 1 gland, but made up of a left and
    right lobe; it looks sort of like a bow-tie. Removing part of the
    thyroid could help hyperthryoidism because there is that much less of
    it to produce thyroid hormome. But usually, they only due surgery when
    there is cancer; otherwise they "kill" part of it off with drugs (or
    radioactive iodine). Or at least that is what I was told.
    
    I think that Sandy is right about the parathyroid; it has something to
    do with the calcium level in the blood, which controls heart rate. I
    think that it releases a cortosteroid as well. But, I'm not sure about
    that. 
    
    >                       They're keeping her in for another couple
    > of days as apparently it can sometimes cause fits after the event
    > (anyone know about this?),
    
    Well, I recall that then I was told I had to stay in the hospital a
    couple more days, I had a fit, but that was probably different than
    what you  are asking.
    
    I'm glad Vitamin is doing well. Are you going in to visit her?
    
    Deb

    Actually when my sisters cat was having problems with the
    thyroid (not sure if it was the gland or the parathyroid) she
    had three options:  1. continue with the medicine 2. have it
    removed 3. Go to Tufts to have radiation to kill part of it.
    
    She had these options even though the thyroid had no tumors
    and was not cancerous.
    
    Sandy

    Vitamin is in for another night, just to make sure and to monitor any
    hormone changes.  She seems OK & is eating well but the vet said today
    one of her kidneys is enlarged, although the recent blood tests showed
    they were coping OK.  This bit worries me as I lost Mineral last year
    to a kidney tumour.  
    
    Funnily enough I didn't even think of going to see her - I suppose
    because none of my girls has ever been away for more than a night - but
    I'll see if I can go there tonight.  Hopefully I'll be able to collect
    her tomorrow.
    
    Pam

    It is calcium that has to be monitored.  When they remove the thyroid
    (one or both sides) gland, they remove the parathyroid (one or both
    sides) gland as well.  The hormone produced by the parathyroid (PTH) 
    regulates the calcium level in the blood.  
    
    Hope Vitamin is doing well!
    -liz

    Well I hate to disagree, but the vet said to me about removing
    the thyroid but the danger was if the parathyroid got damaged -
    presumably for the calcium regulation.  
    
    Anyway, I went to see Vitamin last night and she's bouncing around,
    purring like an outboard motor and seemed really pleased to see me. 
    I'm going to collect her this evening & no doubt she'll be thrilled to
    be home.
    
    Pam  

    We're in agreement actually - the problem with the parathyroids is that
    they're located right on the thyroids.  They have a separate capsule,
    but that does not protect them or help the surgeons to locate them during 
    a thyroidectomy.  You're right, and I shouldn't have worded it so 
    absolutely, they don't intend to remove the parathyroids but often they 
    come out or are damaged & that's why they monitor calcium.
    
    Glad to hear your kitty is doing well.
    Regards,
    liz

    RE: -1
    
    right; they are so very tiny (like a rice grain) that they often
    inadvertintly removed.
    
    Deb 

Hi all, 

My cat Mosa (16) has been on Tapazole now for a couple
of months to  treat her hyperthyroid.  She has been 
responding pretty well to the medication, she had 
gained weight, was eating more normally, and her hormone
levels went right back to were they should be, 
according to the vet.  I'm continuing the meds 
regularly (rarely miss a pill), but she seems to be
loosing weight again.  The *only* difference in what
I was doing before and what I am doing now is I got 
her latest round of Tapazole at the CVS pharmacy
(a people's pharmacy)
instead of the animal hospital.  According to the 
person who dispenses the meds at the animal 
hospital, the Tapazole sold in pharmacies for 
people is exactly the same. Even my vet didn't know
this, he had to go out and check with the person
dispensing the meds.

The pills looks exactly the same as the ones from the animal 
hospital, even have the same manufacturer's stamp and number on 
each pill.  What is strange is that her weight loss seemed to 
start about 2 weeks after I started giving her the 
Tapazole I got at the pharmacy (which is 1/2 the price,
btw).   I wonder if this is just a coincidence -- she
does have a renal tumor that might be finally affecting her 
too.  But, she seemed to be doing so well right up until
I started giving her the Tapazole from the pharmacy.
I'll take her in for a blood test if I have to, but I was
just wondering if if there was any remote  possiblity that 
the Tapazole I got from the pharmacy and the Tapazole 
from the animal hospital aren't really the same even though
they pills are identical physically and identically marked?


Diana

    Hi Diana...
    
    It is very possible that this is all a coincidence
    and she might need the amount of Tapazole adjusted.
    I know my sisters kitty did well on Tapazole for
    over a year...but then needed to have it adjusted
    for a bigger dose.
    
    Only a blood test will tell....
    
    Sandy 

    On the other hand, I've seen tv reports of counterfit(sp?) medications
    making their way to various pharmacies.  Myself, I'd go back to the
    vet for medication and see if it made a difference.  You should be
    able to do this without having to bring your kitty in.
    
    Karen
    

RE .37 (Hi, Diana - small world! :-) ) - My cat, who also is 16, has
been getting Tapazole from the pharmacy for about 5 years now, and is
doing really well (knock on wood!).  I go to a local (Nashua, NH), non-chain 
pharmacy rather than a CVS, but I wouldn't think that would make a difference 
(at least, I hope it wouldn't).  

Unfortunately, the price of Tapazole went up significantly recently (used
to be about $17 for 100 5-mg pills, now is $25!).  But of course my cat is
worth it. :-)  (The pharmacist suggested I could check with the vet about whether
there might be a less expensive alternative. I may do that the next time
I take Chayna in for a checkup, which I think will be in the semi-near future,
anyway, since it's almost annual checkup time.)

Good luck...

-- Nina

Hi Nina,

Yes, a very small world!  :-)

I think I paid about $12.00 for 30 5 mg. pills at CVS.  
Works out to more than it cost you, actually.  I might try 
a smaller pharmacy.  I did ask about generic versions
of the drug, but they told me that Eli Lilly is the 
only company that makes it and there is no generic
brand.   

I still can't decide if Mosa's weight loss is my imagination
or due to her shading half of her fur for the  summer.
I'll probably take her back for a blood test next week
just to make sure.  

It's expensive maintaining sickly old cats -- but it's
worth every penny to have that cute fur face with us for
as long as we (and she) can.

Diana 

    For what it's worth, two of my kitties have slimmed down a
    bit lately, and they both got aok bills of health at their
    semiannual checkups, which included blood tests.
    

>It's expensive maintaining sickly old cats -- but it's
>worth every penny to have that cute fur face with us for
>as long as we (and she) can.

You said it! :-)

-- Nina

    
    As long as the cats themselves are not in pain for being
    kept alive beyond the natural course ;-(...
    
    
    Eva

    Tapazole is a brand name for methimazole (I think that this is called
    "carbimazole" in England). However, most pharamacies don't carry the
    generic because this drug is usually prescribed as a "NO SUBSTITUTION
    ALLOWED".
    
    Both Anti-thyroid and Thyroid drugs are like allergy drugs in that
    if they vary even a little from batch to batch, their effect will be
    different. And this is why endocrinologists for humans tend to prefer
    brand name drugs for thyroid conditions rather than the generics. (You
    may have heard of the trend away from some of the natural drugs like
    Armour Thyroid and animal derived insulin to the synthetic drugs like
    syntoroid and humilin. The argument for using these is that their
    potency doesn't vary from batch to batch and thus it is easier to
    regulate the patient).
    
    There is a wealth of info out there on thyroid problems. Probaby the
    best starting place is http://www.io.org/~thyroid/Canada.html, and the
    news group alt.support.thyroid .
    
    
    BTW- both my 16-year old cat Zoe and I are hyperthyroid, and we have both
    lost some weight over the past couple of weeks. I think it has to do
    with the weather change though. I last filled Zoe's prescription last
    week at the vet and it was $11.02 for 30 5mg tablets.
    
    Deb 
    

RE .45 - Thanks for the info and pointers!

RE .44 - My cat is doing very well, thank you.  "Sickly" can't really
be applied to her. (I was going to say something to that effect in .43
but decided to keep it short :-) ).  If she was really suffering, of
course I'd do what I could to relieve that suffering, then, failing
that, do what was necessary to end her misery.....

-- Nina

P.S. Surely 16 years is not "beyond the natural course" of a cat's life?
Although I must admit this is the longest-lived cat I've ever had.  However,
she is an indoor-only cat (unlike previous cats I/my family had).  No doubt
this makes a difference!

>P.S. Surely 16 years is not "beyond the natural course" of a cat's life?
>Although I must admit this is the longest-lived cat I've ever had. However,
>she is an indoor-only cat (unlike previous cats I/my family had).  No doubt
>this makes a difference!

My cat Jimmy is 18, and Zoe (the one with Hyperthyroidism) is also 16. Len 
Fehskens cat Merlin just celebrated his 21st birthday!!! So, I'd say that
your  kitty still has a lot of life ahead of her!

I think that we are hearing about so many cats getting into old age because
more people are keeping them in, and there have been so many improvements
in vet care and feline nutrition.

Deb

    Did anyone consider getting the radioactive Iodine treatment for their
    kitty's hyperthyroidism?  I'm interested in hearing the reasons why
    folks chose the medication route as opposed to the radioactive Iodine
    treatment or even over surgery (although I understand that some cats
    are not good surgical candidates).
    
    Thanks/Regards,
    liz

    Let me start by telling you what I was told by my endocrinologist; the
    way that they "cure" it is to turn you hypo, and hopefully you will
    bounce back to normal (euthyroid), and if you don't, they will make you
    euthyroid by means of daily taking a synthetic hormone. I was
    "fortunate" with Zoe since I have just gone through this a few months
    before she was diagnosed.

    Radioactive Iodine treatment isn't offered everywhere for cats; my vet
    told me that if I was considering it for Zoe, I'd probably have to go
    to Angell or Tufts. I know that even for humans, not just every
    endocrinologist can give you the "atomic cocktail"; they have to be
    specially licensed.

    As for surgery, it is often tricky on cats since often in removing a
    cat's thyroid, the one or more parathyroid glands accidentally come out;
    they are about the size of a grain of rice, and regulate the amount of
    calcium in the body, which in turn has something to do with the heart rate.
    Another factor is that most hyperthyroid cats are elderly, so putting them
    under for surgery is pretty risky to start with.

    I know that with humans, it is difficult to gauge just the right amount
    to nuke out or to remove, so most humans then wind up taking a
    synthetic thyroid hormone for the rest of their life. 

    Finally, I know that in my case, they were able to put me into remission
    with just drugs (which I don't need to take any longer) and some life
    style changes (no caffeine, stress reduction). 


    I guess the bottom line is that while Zoe isn't in remission, we are
    able to maintain her in a euthyroid state with Tapozole, and she is
    quite easy to pill, so it isn't a problem. Had we gone with the other
    solutions, along with costing a lot of money, she would probably need
    to be taking a daily pill anyway.

    Deb

In Mosa's case, they are more worried about her large renal 
carcinoma than the thyroid condition.  Surgery was never mentioned
as an option at Angell Memorial, just the medication.  I was told 
by two vets there that Mosa was not a good risk for surgery of
any kind -- kidney or thyroid, and that with the Tapazole, at least
we could stop her rapid weight loss and crazy metabolism.  The
medication has put her levels right back where they should be. 
Pilling her has gotten much easier -- especially since we reward a 
little cat treat after.  For when we are away and friends have to
pill her, we leave them soft treats with the pill embedded inside.
Mosa wolfs it right down.  I hope that kind of pill delivery
system is equally as effective as when we just put the pill
down her throat.

Diana

    How is Mosa doing now?  Is she still losing weight?
    
    Karen
    

RE radioactive iodine or surgery vs. Tapazole pills: I decided on the 
pills because my vet told me that the radioactive treatment would require a 
month's isolation for my cat plus very uncomfortable side effects, and there 
was no guarantee that it would take care of the condition, anyway.  I just 
couldn't subject my kitty to that much discomfort.  

The vet also said that there was no guarantee of success with surgery, for 
the reasons Deb mentioned in .49. So the pill route seemed to be the best way 
to go, and it has been working fine for 5 years (knock on wood! :-) ).

-- Nina

>How is Mosa doing now?  Is she still losing weight?
    
>Karen

She seems good.  Perky, good appetite,  She is thin,
but doesn't seem to have lost anymore weight.  She "feels"
the same weight when I pick her up.  I think some of 
what I perceived as weight loss was an incredible 
amount of shedding due to the summer.  We will have
her blood tested soon though just to make sure her
metabolism is still on track.  The vet said to bring
her back in three months, so she'll go back for an 
evaluation soon.

D.

    RE: .50
    
    note 50 mentions the RAI at ANgell. I happened to be perusing The
    Thyroid Foundation of America's website and found this at :

http://welchlink.welch.jhu.edu/homepages/dscooper/tfaweb/bridge/bridge.vol10.no3.html#cats


                                  Cats Too?

(Introductory note by Mark E. Peterson, DVM, ACVIM: Since the first clinical
reports in l979 and l980, hyperthyroidism in cats has been recognized with
increasing frequency. In clinical veterinary practice, hyperthyroidism is
now by far the most common endocrine disorder of cats. Indeed, domestic cats
are the only nonhuman species to develop spontaneous hyperthyroidism with
any frequency. However, the feline disease most closely resembles the human
toxic nodular goiter, rather than Graves' disease. Cats with hyperthyroidism
can be treated with the same three methods commonly used in human
hyperthyroid patients: radioactive iodine, surgery, or drugs.)

I-131 Treatment Gives New Life to Hyperthyroid Cats

When Nipper came to Angell Memorial Animal Hospital in Boston, she was thin,
agitated, and couldn't sit still for long. She was eating more than double
her usual diet but losing weight. She seemed to be losing her hair. And many
nights she howled and ran around the house until dawn. Nipper suffered from
hyperthyroidism and her concerned -- and frustrated -- owners were referred
to Angell by their local veterinarian for treatment.

Angell is one of only a few veterinary hospitals in the country to offer a
specialized cure for hyperthyroidism. Adapted from human nuclear medicine,
the radioiodine (I-131) treatment eliminates the benign or malignant thyroid
tumors that cause the disorder. In normal cats, the thyroid gland absorbs
iodine from the food they eat and uses it to make thyroid hormones. In
hyperthyroid cats, tumors -- malignant in only 2 percent of affected animals
-- cause the thyroid to overfunction. The radioiodine administered during
I-131 treatment is rapidly absorbed by this hyperactive tissue, so the
tumors are destroyed. Most cats return to normal thyroid function within one
to four weeks after treatment. Rarely, a cat may require a second dose.

The I-131 is administered by injection. Therapy takes about l0-14 days.
Because I-131 treatment involves the use of a radioactive substance, cats
undergoing treatment must remain in Angell's specially equipped
nuclear-medicine ward until safe to release to owners.

"Some owners express concern over their cat spending a week or two in the
hospital," says Angell radiologist Lori Hartzband, DVM. "But we've found
most cats tolerate it without a problem. The ward is very quiet -- no dogs!
-- and a specially trained technician cares for the cats." She adds that
owners are encouraged to call daily to check on their pet's progress, though
no visits are allowed.

For two weeks after its discharge from the hospital, the cat should not be
allowed to sleep on or near people and must stay indoors. How much radiation
could owners be exposed to during this time? About the same amount they
might receive by flying from Boston to Los Angeles in a commercial airliner,
says Hartzband. In fact, regulations are much more strict for animals than
for people who are treated with I-131. If the owner prefers, the cat can be
boarded at Angell during this time. Either way, after two weeks both the cat
and the owners can return to their normal routine.

The cost of I-131 treatment is $l,000, including examination, limited
pretreatment blood work, X-rays, a special nuclear medicine thyroid-imaging
procedure called thyroid scintigraphy, treatment, daily monitoring,
hospitalization, and follow-up testing at Angell.

Alternative treatments for hyperthyroidism, such as daily medication or
surgery, can cost somewhat less in the short term -- though they are not
appropriate for all cats. Medication does not cure the animal's
hyperthyroidism, but it does block the production of thyroid hormones. This
alleviates the clinical signs and can improve the cat's quality of life. But
medication can also cause side effects, such as vomiting and loss of
appetite, and some cats -- especially those with hyperthyroidism -- can be
difficult to medicate orally. The estimated cost for medication and
veterinary care is $400-600 a year.

Surgically removing the affected thyroid gland(s) is another option for some
cats. If only one thyroid lobe is involved, the surgical prodecure is
relatively simple. If both thyroid lobes must be removed, risk of
postsurgical complications increases. If hyperactive thyroid tissue exists
within the chest cavity, surgery is usually not an option. The estimated
cost for testing, surgery, and follow-up care is $800-1000.

"With I-131 treatment, we can offer a real cure -- without risking
anesthesia or surgery. This is important because hyperthyroid cats are often
over l0 years old. In fact, we've successfully treated cats over 20," says
Hartzband. She points out that, left untreated, hyperthyroidism can cause
severe, life-threatening heart disease.

For more information about radioiodine treatment or hyperthyroidism, call
Jean Duddy, DVM, at Angell Memorial (617) 522-7282.

(Reprinted with the kind permission of the Massachusetts Society for the
Prevention of Cruelty to Animals from the Spring l994 issue of their
quarterly Animal Action.)

    I have to add this, since I would hate for someone to put a cat down
    after reading this article and thinking that they can't afford to care
    for the cat.
    
    They quote an amount of $400-$600 per year for medication and vet care
    for a cat to be treated with Tapozole. It doesn't cost any where near
    that. I pay $11/per month for her pills. She has her annual shots
    (which she would get anyway) for $35, another $10 for her rabies shot.
    One CBC a year would be $60, and $70 for a thyroid profile. That is a
    little over $200, and given that she seems "regulated" (not loosing
    weight, not nervous, not balding, the vet suggests not tramatizing her
    for the thyroid profile, as the blood has to be taken from the jugler
    vein, nor wasteing my money). Now, the veterinary literature (which I'm
    sure Angell goes by) reccommends quarterly thyroid profiles, so that
    could be where the high cost comes in. 
    
    Deb

You can also save money on the meds by buying them at your local 
pharmacy and not Angell memorial hospital, where the cost runs  
about double.

    actually, I may have spoken too soon about th cost of meds. I just got
    Zoe's prescriptin filled Saturday and the price went from $11.02 to
    $17.85.  To make a long story short, the vet vet told me that the price
    increase was pure price gouging on the part of the pharmacutical
    company. My vet had heard about the price increase and got a 3 month
    stash of the drug which is why I was paying less that what it sounds
    like other folks were paying. 
    
    But still, even with the price increase, it down't cost that much to
    keep Zoe maintained.
    
    Deb

 Blood screen and X-rays today.
 Technicium scan tomorrow to determine extent of involvement.
 I-131 injection Tues or Weds.
 You hear from the Dr. every 2-3 days and they have a short written status
report available by noon daily.
 We get to pick him up when his radiation drops to background levels (7-10 days
after the iodine treatment is typical).
 Then another 2 weeks of life in a cage to keep him away from us while the I-131
continues to break down.

 Dr. Jean Duddy's the I-131 Big Kahuna - I was quite impressed with her handling
of Oliver - *I* wouldn't have been that mellow with him (he's not at all happy
about going to the vet's). But I didn't see any major scars on her arms or
hands, so she must know what she's doing :-) - she spent a fair amount of time
holding and petting Big-O while he growled away at her. She even managed to get
him to stop for a bit.

 Only bummer was that it was almost a 2-hour drive in traffic and Oliver did the
pee-and-poo thing in his carrier when we where about 2 blocks from the hospital.
Yech.


.49 Mentions irradiation at Tufts. Angell does it, Tufts doesn't.

There's also a place in Conn. that does it. I've heard it's a couple of hundred
dollars cheaper than Angell - not worth the drive for me, however.  Angell's
pretty good about letting you take your cat home soon (don't know if it has to
do with the specific hospital rules, state laws on radiation exposure, ...).
At places like Cornell and Michigan they keep the cat for up to 6 weeks.

		Looking forward to getting my Glow In The Dark Big-O back,
						Trace

    Let us know how he's doing...
    

    Trace...keep me posted I have a cat with hyperthyroid and as
    of right now he is doing well on his daily meds...but I'd like
    to learn more about this.
    
    Can I ask...why did you choose this over the surgery or daily
    medication. 
    
    Sandy 

He was regulated on 5 mg Tapazole once daily for several months, but then his
bloodwork started looking a bit worse, appetite went back up as did water
consumption. He started on 5 mg twice a day but didn't deal with it well - we
couldn't escape the vomiting thing. An IV injection poses less immediate
physical risk than does surgery - even minor surgery. He isn't even current on
all his vaccines because I didn't want to challenge him more than necessary.
I wanted a thorough, complete solution. I could have had the surgery done for
just about free where I work (tech-ing has its advantages) but I wanted to use
someone who does it all the time. Radiation was only a few hundred dollars more
than surgery and cats tend to tolerate rediation pretty well. A physical exam
indicated only one side of the gland was involved (simpler surgery) but I didn't
want to miss anything brewing on the other side. Could have upped his Tapazole
and tried to re-regulate him, but he's already 8 years old and I didn't want to
be facing possibly as hard or harder choices at 10, 12, or 14 - better to take
care of it sooner while he's in good health otherwise.  Sides, stuck in a cage
with a litter pan and no carpet for the next two weeks, maybe he'll start
pooping in it again - about the time he first became symptomatic he started
using the floor right next to the pan.

One of our vets studied under Dr. Pavletic at Tufts - he's one of their big
soft tissue surgeons. I paid a visit to him first. A very nice, competent Dr.
He was willing to do the surgery but also felt Big-O was a good radiation
candidate.

						Trace

Trace--I hope Oliver is doing well.

I went through this whole thing with my first cat, Jennyanydots, about 10 years 
ago.  I wish this note had been around then--I didn't have any idea what was 
going on until things were nearly terminal.  Jenny was about 15 at the time and 
her only symptom was unexplained weight loss.  She was eating voraciously.  
Well, I thought, she's just turning into a frail little old lady.  But she kept 
losing weight and eventually I brought her in to the vet (I'm still kicking 
myself for not doing that sooner!).  He took a blood sample for a T3/T4 test and 
started her on tapazole immediately, before the results came back (as he put it, 
"when you see the barn door open, you don't need to look inside to know that the 
horses have bolted").  Her thyroid hormone level was about 4x normal and while 
tapazole reduced the activity, we couldn't get her to normal level.  She stayed 
on tapazole for a few months until she regained enough weight for surgery to be 
OK.  At that time radioiodine wasn't a viable option.  She made it through the 
surgery OK, but of course was hypothyroid after that and had to take thyroid 
supplements.  Jennyanydots lived for about another year before succumbing to 
what can only be described as a general metabolic collapse.  But we all have to 
die of something eventually.

As my vet and the specialist described the situation, hyperthyroidism is quite 
common in very old cats.  Nobody knows why.  It used to be that vets saw a good 
number of old cats whose only symptom was inexplicable weight loss, sometimes 
accompanied by slightly elevated temperature or vomiting.  Then a vet happened 
to order a T3/T4 test on one of these animals and the mystery was solved.

They said that tapazole is the preferred option, when it can control the 
situation and there aren't bad side effects.  Vomiting is one side effect, as a 
previous poster noted.  Another side effect is poor condition of the fur 
(Jennyanydots had that one).  Treatment with tapazole isn't always effective and 
sometimes it loses its effect over time.  The alternatives then are radiation or 
surgery.  Surgery runs the risk of accidentally removing the parathyroid as well 
as the thyroid.  Radiation is a lot more expensive and means an extensive 
quarantine period.

--PSW

Oliver's bloodwork, rads, etc. all checked out okay (learned he has a slightly
enlarged heart), and he tried to bite the tech taking his blood so he's feeling
up to par :-). Got his iodine yesterday. The next small hurdle is seeing if
he'll continue to eat; they get sore throats some times. After that, he just
hangs out until he stops emitting enough radioactivity that we can take him
home. They don't even start checking his levels until 5 days after the
treatment. Dr. Duddy calls daily with updates so I don't even bother contacting
Angell's liason office for his noontime reports. Miss him already - no cat poops
on the carpet immediately next to the litter box to clean up every day...

						Trace

His radiation level was 3 on Tuesday and 2.5 Thursday. They expect he'll be
able to come home this weekend. He's apparently gone from his rather
grumpy-because-I'm-at-the-doctor's behavior to hi-good-to-see-you, because every
time someone drops by to visit they feed him. He's supposed to spend another 2
weeks at home in a cage to keep him away from us, something he'll surely hate.
The urine stench is almost gone in my car. Think we'll splurge and put a towel
in the carrier for him on the trip home.

						Trace

    Great news...I'm sure he'll be very happy to be home and he
    probably won't even mind the cage for awhile.
    
    

But since he has to be caged for 2 more weeks and he gets a 2-day pickup grace
period before they start tacking on boarding charges, I figure I'll let him stay
down there until Weds.

						Trace

Not too happy about being caged but it's only for 2 more weeks.

Until then,
People over 45 have to stay 3 feet or further away from him except for brief
	periods of necessray care.
People under 45, ... 6 feet...
Under 18 or pregnant, no contact.

He continues excreting iodine for a couple of weeks so we have to be careful
with litter till the middle of the month. Follow-up T4 (thyroid level) blood
tests at 1 & 3 months, and after that it should be a done deal unless he's in
the small minority of cases which need retreatment. Even get to draw the blood
up here and send it to Angell, where they test it for free as part of the
package.

Overall, a true bargin at only $1,177.50.

						Trace

    Has he got a sore throat?
    Who was his radiologist?
    
    Deb

         Yeah for Oliver!  Does he glow in the dark ;^) ?
    
    					- Andrea
    					  Loki, Midnight & Patches

She's listed as specializing in Internal Medicine. Spends most of her time
dealing with cats. She and Dr. Hartzband appear to run the radiology show. If
Big-O needs vet attention or should die in the next 2 weeks I'm supposed to
notify her, and if there are questions about the radioisotope itself one
contacts Hartzband.

He may not glow, but I guess his urine may for a bit, and since cat kidneys do
such an efficient job concentrating urine, I'd imagine they might still be a
bit hot, too.

They worry a bit about a sore throat the first couple of days after the
injection, so when you drop him off they ask about favorite foods in case they
need to try tempting the cat a bit.

Part of his report reads: "His X-rays did show mild cardiomegaly which I hope
will return to normal now that the tyroid has been treated.  Also he did have
some air in his mediastinum most likely a result from getting blood.  He did
give us a good fight."

I'd warned them that he typically wasn't to happy about being at the vets' so at
least they knew in advance. It would be a spiffy bonus if his heart corrects
itself. Hopefully he'll be taking dumps on our carpets for many years to come.

						Trace

    
    
    	Wow.  Best of luck to him, Trace!
    
    	And I'll try to remember to bring that little scale in so
    	I can return it to you.  Thanks for the use.  
    

>Overall, a true bargin at only $1,177.50.

>    Has he got a sore throat?

If he has, for that price, 
I'd hope they'd throw in some linctus!! ;-) ;-)


Good luck to big O sounds like he's doing well ...