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Re: hyperthyroidism - anyone tried herbal treatment?

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  • acrocat@rocketmail.com
    Hi Ruth Hyperthyroidism cannot be controlled with herbs or homeopathy. I131 therapy is a good option, if your cat s kidneys are ok. For I131 purposes,
    Message 1 of 15 , Aug 7 4:18 PM
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      Hi Ruth

      Hyperthyroidism cannot be controlled with herbs or homeopathy. I131 therapy is a good option, if your cat's kidneys are ok. For I131 purposes, changes in the BUN and creatinine are appropriate measures of kidney function. For best results, cats who are on methimazole should be taken off it for at 10-14 days pre-procedure.

      Just to clarify as well, I131 kills abnormal thyroid tissue so there is some 'leftover' thyroid tissue afterwards. Adult cats need very little thyroid hormone so it is quite rare for cats to need supplementation afterwards -- I131 fixes the problem completely.

      Hyperthyroidism often causes elevated liver values for reasons that are unclear. These resolve when hyperthyroidism is controlled. It is very important to control hyperthryoidism quickly -- there are serious consequences to having an out of control thyroid.

      hope this helps.
      Adriann
    • acrocat@rocketmail.com
      Hi Carol ... I m surprised that your vet said this. Excess thyroid hormone can only come from thyroid tissue, so regardless of whether or not you can palpate
      Message 2 of 15 , Aug 7 4:29 PM
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        Hi Carol

        --- In feline-heart@yahoogroups.com, "C.R." <carolroar@...> wrote:
        > I'm sorry that Vienna has hyperthyroid. Hyperthyroid can be caused from a benign tumor or it can be an idiopathic thing too, where they're not sure what's causing it. Misty doesn't have any tumor on her thyroid, but she is hyperthyroid. All of the tests they've done, and they still don't know what's causing hers.

        I'm surprised that your vet said this. Excess thyroid hormone can only come from thyroid tissue, so regardless of whether or not you can palpate a tumor, there is abnormal thyroid tissue there which is producing too much hormone. It can be due to a malignant tumor (rare), or a benign overgrowth of thyroid tissue. This can often be palpated on the throat. Has Misty ever had scintigraphy done? This would light up the overactive thyroid tissue. It is unusual, but it is possible to have 'ectopic' thyroid tissue -- thyroid cells that are growing somewhere other than the thyroid gland. Anyway, I would just assume that Misty has benign growth that can't be palpated very well. Thyroid hormone only comes from thyroid cells.

        Also just to clarify, radioactive thyroid treatment rarely results in a clinically hypOthyroid cat so there is no need for thyroid supplementation afterwards. The normal thyroid cells are often 'asleep' when there is a massive overproduction of hormone but they can come back once the thyroid levels have dropped significantly. This is why some cats will have severely low thyroid levels in the first few months after I131, but will have slightly higher numbers (though usually still on the low end) after a bit of time has passed. Since adult cats need very little thyroid hormone to begin with, supplements are rarely needed.

        Adriann
      • Carol
        hi Adriann, No, Misty never had a scintigraphy done. They only palpated her and did ultrasounds. They did tell us that the cat doesn t have to have a tumor
        Message 3 of 15 , Aug 7 4:50 PM
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          hi Adriann,

          No, Misty never had a scintigraphy done. They only palpated her and did ultrasounds. They did tell us that the cat doesn't have to have a tumor for them to be hyperthyroid. I don't know enough about why they said that, only that they said it was idopathic in Misty's case. I agree that it probably is something too small to be felt though. Makes sense to me.

          >>
          Also just to clarify, radioactive thyroid treatment rarely results in a clinically hypOthyroid cat so there is no need for thyroid supplementation afterwards.
          >>

          It was actually the vets at RadioCat here in our area who told us that sometimes cats need to be on thyroid supplement after the RI treatment. I guess it all depends on the severity of the situation and how much the thyroid gets zapped. Sometimes it doesn't work either. Our angel Ducky had the RI done twice and both times it was unsuccessful. :-(

          Carol, Misty and Angel Snowball
          and the gang




          [Non-text portions of this message have been removed]
        • BubbaCat1@aol.com
          Adriann: I rarely post to this group as these dedicated members are so knowledgeable it appears all areas of feline heart issues are well covered. But there
          Message 4 of 15 , Aug 7 4:59 PM
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            Adriann:
            I rarely post to this group as these dedicated members are so
            knowledgeable it appears all areas of feline heart issues are well covered. But there
            is an error in your statement re: Hyperthyroid:
            "Also just to clarify, radioactive thyroid treatment rarely results
            in a clinically hypOthyroid cat so there is no need for thyroid
            supplementation afterwards. "

            While this is not the correct forum for discussing hyperthyroidism, there
            is an active discussion currently ongoing at this HyperT board:
            _feline-hyperT : A support list for people whose cats have been diagnosed
            as hyperthyroid (hypothyroid also welcome)._
            (http://pets.groups.yahoo.com/group/feline-hyperT/)

            Experts in the field are now realizing the importance of running full
            thyroid panels POST-I131 in order to properly supplement and support these
            kitties. HyPOthyroid is NOT uncommon in I131 kitties, and can be a serious issue
            for any kitty with kidney issues, just as Carol explained earlier.

            Having had nine (9) HyperT kitties myself, I would urge anyone with a
            HyperT kitty to join one (or more!) of the HyperT groups in order to benefit
            from the same type of expertise you find here re: heart issues. Members there
            are in ongoing dialog with the experts, so the "news" is evolving daily.

            Best Regards,

            Jo





            Hi Carol

            --- In _feline-heart@yahoogroups.com_ (mailto:feline-heart@yahoogroups.com)
            , "C.R." <carolroar@...> wrote:
            > I'm sorry that Vienna has hyperthyroid. Hyperthyroid can be caused from
            a benign tumor or it can be an idiopathic thing too, where they're not sure
            what's causing it. Misty doesn't have any tumor on her thyroid, but she is
            hyperthyroid. All of the tests they've done, and they still don't know
            what's causing hers.

            I'm surprised that your vet said this. Excess thyroid hormone can only
            come from thyroid tissue, so regardless of whether or not you can palpate a
            tumor, there is abnormal thyroid tissue there which is producing too much
            hormone. It can be due to a malignant tumor (rare), or a benign overgrowth of
            thyroid tissue. This can often be palpated on the throat. Has Misty ever
            had scintigraphy done? This would light up the overactive thyroid tissue. It
            is unusual, but it is possible to have 'ectopic' thyroid tissue -- thyroid
            cells that are growing somewhere other than the thyroid gland. Anyway, I
            would just assume that Misty has benign growth that can't be palpated very
            well. Thyroid hormone only comes from thyroid cells.

            Also just to clarify, radioactive thyroid treatment rarely results in a
            clinically hypOthyroid cat so there is no need for thyroid supplementation
            afterwards. The normal thyroid cells are often 'asleep' when there is a
            massive overproduction of hormone but they can come back once the thyroid levels
            have dropped significantly. This is why some cats will have severely low
            thyroid levels in the first few months after I131, but will have slightly
            higher numbers (though usually still on the low end) after a bit of time has
            passed. Since adult cats need very little thyroid hormone to begin with,
            supplements are rarely needed.

            Adriann



            [Non-text portions of this message have been removed]
          • acrocat@rocketmail.com
            Hi Jo Thanks for opening up the discussion. Since untreated or undertreated hyperthyroidism can cause heart failure and death, it s not totally off-topic
            Message 5 of 15 , Aug 7 6:00 PM
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              Hi Jo

              Thanks for opening up the discussion. Since untreated or undertreated hyperthyroidism can cause heart failure and death, it's not totally off-topic here.

              I actually am aware that there are cats who need thyroid supplementation after I131 -- it's just not that common. Some vets will give it based on T4 results, which is why I specified 'clinically hypothyroid' i.e. those cats who have symptoms of hypothyroidism. I know of two cats who have had symptoms and benefited from thyroxine, but it's just not common. (What do you mean by it being common BTW? 50% of cats?)

              As I also mentioned, TT4 levels will be often be very low after I131 treatment, but often go from very low to 'low normal' in a few months as suppressed thyroid function recovers.

              --- In feline-heart@yahoogroups.com, BubbaCat1@... wrote:
              > Experts in the field are now realizing the importance of running full
              > thyroid panels POST-I131 in order to properly supplement and support these
              > kitties.

              All I131 places, and probably every single vet that treats an I131 cat, runs thyroid panels after treatment and wants them re-run in a few months. So that shouldn't be news to vets who give decent follow-up care.

              I like to keep up on the literature -- do you have any references or names of experts? I know there is some talk of the problems with 'fixed dose' I131 therapy -- the dose is not calculated for a specific cat based on the degree of hyperthyroidism, size of the tumor, etc., and it is reasonable to think that some cats will get 'overdosed' (or underdosed) with this method. I know Dr. Peterson (the endocrinology guru of the veterinary world) has said he thought that one-size-fits-all dosing may be a factor in causing hypothyroidism. As far as I know, he and other specialists still put hypothyroidism in the uncommon category. He is the one who first described hyperthyroidism in cats and investigated various treatments, and does ongoing research, so I do put stock in what he says in particular.

              I'll just throw one other thing out there, FWIW. My late dog was hypothyroid and I found that he was definitely peppier when he was slightly over-supplemented. Many cats that are hyperthyroid have gradually become so, and it's possible to get used to a cat that's just slightly more revved up than s/he would be otherwise. When a cat's thyroid level suddenly and dramatically drops, there will be behavioral changes (less of a voracious eater, less energetic) which may diminish when the thyroid is pushed up again. So there may be cats who benefit from thyroid supplementation but are not clinically hypothyroid (skin, belly, fur, extreme lethargy).

              Just to be clear, I am not trying to be offensive or pooh-pooh anything. I think that the word "from the trenches" should always be taken seriously as such a large group of informed caregivers can provide info a simple short academic study certainly can't, even keeping in mind that the population sample is skewed on group lists as the people join and stay active almost always do so because of issues (the treated stable cats drop off the radar). Perhaps you and I just have different ideas on how common is common-?

              Adriann
            • BubbaCat1@aol.com
              Adriann: I didn t intend to open this discussion, but rather to refer those with interest to the corresponding group. As all of my HyperT kitties have passed
              Message 6 of 15 , Aug 7 7:56 PM
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                Adriann:
                I didn't intend to "open" this discussion, but rather to refer those with
                interest to the corresponding group. As all of my HyperT kitties have passed
                on, I don't follow the group as closely as I once did, or as closely as
                I'd like since I am more involved with other groups. But I marvel at the
                impact a group of committed caregivers can make on the veterinary community,
                and the HyperT group has gained the attention of those that can make a
                difference. You'll be pleased to know that Dr. Peterson (along with Dodds,
                Wakeling and others) is involved with sharing research and ideas with the group
                and these exchanges are ongoing.

                We can only guess at the number of felines that are actually hypothyroid.
                No doubt, more than we realize as their humans just aren't posting/no
                longer active in the group. And no doubt more cats than we realize need to be
                on thyroid hormone replacement. The Cornell study found a thirty percent
                risk of post I131 permanent hypo-t. Risk may vary from clinic to clinic,
                however, depending on I131 dosing protocol...going with lower dosing might serve
                to retain more normal thyroid cells...going with lower dosing might allow
                some adenoma cells to remain. I don't believe, for purposes of this
                discussion, that a particular number/percentage is necessarily relevant. My
                intentions were simply to correct the statement: "Also just to clarify,
                radioactive thyroid treatment rarely results in a clinically hypOthyroid cat so
                there is no need for thyroid supplementation afterwards. "

                I'm off my soap-box now. My apologies to the Moderators. Anyone needing
                further info is welcome to join the HyperT group.
                _feline-hyperT : A support list for people whose cats have been diagnosed
                as hyperthyroid (hypothyroid also welcome)._
                (http://pets.groups.yahoo.com/group/feline-hyperT/)

                Jo






                In a message dated 8/7/2011 9:00:37 P.M. Eastern Daylight Time,
                acrocat@... writes:




                Hi Jo

                Thanks for opening up the discussion. Since untreated or undertreated
                hyperthyroidism can cause heart failure and death, it's not totally off-topic
                here.

                I actually am aware that there are cats who need thyroid supplementation
                after I131 -- it's just not that common. Some vets will give it based on T4
                results, which is why I specified 'clinically hypothyroid' i.e. those cats
                who have symptoms of hypothyroidism. I know of two cats who have had
                symptoms and benefited from thyroxine, but it's just not common. (What do you
                mean by it being common BTW? 50% of cats?)

                As I also mentioned, TT4 levels will be often be very low after I131
                treatment, but often go from very low to 'low normal' in a few months as
                suppressed thyroid function recovers.

                --- In _feline-heart@yahoogroups.com_ (mailto:feline-heart@yahoogroups.com)
                , BubbaCat1@... wrote:
                > Experts in the field are now realizing the importance of running full
                > thyroid panels POST-I131 in order to properly supplement and support
                these
                > kitties.

                All I131 places, and probably every single vet that treats an I131 cat,
                runs thyroid panels after treatment and wants them re-run in a few months. So
                that shouldn't be news to vets who give decent follow-up care.

                I like to keep up on the literature -- do you have any references or names
                of experts? I know there is some talk of the problems with 'fixed dose'
                I131 therapy -- the dose is not calculated for a specific cat based on the
                degree of hyperthyroidism, size of the tumor, etc., and it is reasonable to
                think that some cats will get 'overdosed' (or underdosed) with this method.
                I know Dr. Peterson (the endocrinology guru of the veterinary world) has
                said he thought that one-size-fits-all dosing may be a factor in causing
                hypothyroidism. As far as I know, he and other specialists still put
                hypothyroidism in the uncommon category. He is the one who first described
                hyperthyroidism in cats and investigated various treatments, and does ongoing
                research, so I do put stock in what he says in particular.

                I'll just throw one other thing out there, FWIW. My late dog was
                hypothyroid and I found that he was definitely peppier when he was slightly
                over-supplemented. Many cats that are hyperthyroid have gradually become so, and
                it's possible to get used to a cat that's just slightly more revved up than
                s/he would be otherwise. When a cat's thyroid level suddenly and
                dramatically drops, there will be behavioral changes (less of a voracious eater, less
                energetic) which may diminish when the thyroid is pushed up again. So there
                may be cats who benefit from thyroid supplementation but are not
                clinically hypothyroid (skin, belly, fur, extreme lethargy).

                Just to be clear, I am not trying to be offensive or pooh-pooh anything. I
                think that the word "from the trenches" should always be taken seriously
                as such a large group of informed caregivers can provide info a simple short
                academic study certainly can't, even keeping in mind that the population
                sample is skewed on group lists as the people join and stay active almost
                always do so because of issues (the treated stable cats drop off the radar).
                Perhaps you and I just have different ideas on how common is common-?

                Adriann






                [Non-text portions of this message have been removed]
              • jruthaitken
                thanks everyone for the debate - very interesting but very worrying too... I have joined the hyperthyroid group. Vienna is not symptomatic at all, but since
                Message 7 of 15 , Aug 8 8:36 AM
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                  thanks everyone for the debate - very interesting but very worrying too...

                  I have joined the hyperthyroid group.

                  Vienna is not symptomatic at all, but since she has been taking the meds (a week) she has been more lethargic than usual. I am not keen on medication given the terrible harm it did to Rigsby and I don't like one size fits all dosing regimens. I am very worried about causing harm to Vienna with the treatment. we only found out she was hyperT during routine blood tests - all else, apart from liver enzymes was fine.

                  I do not want her to become hypothyroid....I do not know what to do for the best. She is impossible to pill and very difficult to handle. I am full of scratches, she is so unlike her brother who would let me do anything.

                  my head is spinning....
                  all the best to you

                  Ruth
                • jruthaitken
                  hi an update with Vienna s blood work all is normal apart from these below free T4 80 (ref range 15-40) Total T4 70 (ref range 15-40) ALT 112 (ref
                  Message 8 of 15 , Aug 8 12:29 PM
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                    hi

                    an update with Vienna's blood work

                    all is normal apart from these below

                    free T4 80 (ref range 15-40)
                    Total T4 70 (ref range 15-40)
                    ALT 112 (ref range 0 - 20)

                    renal values
                    urea 9.5 (ref range 6 - 10)
                    creatinine 87 (ref range 60 - 170)

                    with regard to metacam dosing, she had 0.42mls of metacam for dogs by injection followed by 7mls of oral solution for cats for 3 days in 2008. Her last blood work a few years ago did not reveal any results outside the normal range.

                    she started medication July 30th Felimazole (2.5mg) twice daily. She seems a lot quieter...not that she was noisy but she is interacting with me a lot less.

                    any opinions would be very welcome

                    many thanks
                    Ruth


                    --- In feline-heart@yahoogroups.com, "jruthaitken" <jruthaitken@...> wrote:
                    >
                    >
                    >
                    > thanks everyone for the debate - very interesting but very worrying too...
                    >
                    > I have joined the hyperthyroid group.
                    >
                    > Vienna is not symptomatic at all, but since she has been taking the meds (a week) she has been more lethargic than usual. I am not keen on medication given the terrible harm it did to Rigsby and I don't like one size fits all dosing regimens. I am very worried about causing harm to Vienna with the treatment. we only found out she was hyperT during routine blood tests - all else, apart from liver enzymes was fine.
                    >
                    > I do not want her to become hypothyroid....I do not know what to do for the best. She is impossible to pill and very difficult to handle. I am full of scratches, she is so unlike her brother who would let me do anything.
                    >
                    > my head is spinning....
                    > all the best to you
                    >
                    > Ruth
                    >
                  • Ana Gutierrez
                    I would ask Dr. Richard Pitcairn for homeopathy richard@drpitcairn.com or Dr. Patrick Mahaney for accupunture patrickmahaneyvet@gmail.com Both are very
                    Message 9 of 15 , Aug 8 4:24 PM
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                      I would ask Dr. Richard Pitcairn for homeopathy richard@... or
                      Dr. Patrick Mahaney for accupunture patrickmahaneyvet@...

                      Both are very accesible and nice persons... plus they're great vets :)

                      Best,
                      Ana


                      On Sun, Aug 7, 2011 at 10:11 AM, jruthaitken <jruthaitken@...> wrote:

                      > **
                      >
                      >
                      > hi
                      >
                      > I used to post on this list about my cat Rigsby who has now passed away -
                      > he developed renal failure due to off label metacam administration following
                      > an RTA.
                      >
                      > I got a new vet and had Vienna, his sister tested for everything you could
                      > think of a few weeks ago - just to make sure she is okay. She hasn't had any
                      > health problems or any symptoms of anything in particular. She is 12years
                      > old.
                      >
                      > She has hyperthyroidism with raised liver values - she is on meds twice
                      > daily and the new vet has suggested the iodine treatment. I found out that
                      > she had been given the double whammy of metacam injection for dogs followed
                      > by oral dosing (I knew about the oral dosing bit but at that time had no
                      > idea metacam was risky) so I am worried she might have some renal damage. We
                      > are going to test again in two weeks to see if her kidneys seem okay. of
                      > course, these tests don't show the harm until 75% of function is lost so can
                      > we even trust them?
                      >
                      > She had a very bad reaction to a vaccine 18 months ago (I haven't
                      > vaccinated her since) and I was just reading an article suggesting vaccines,
                      > flea treatments and wormers all contribute to the development of hyperT in
                      > cats. The guy who wrote the article is a veterinary herbalist. I was
                      > wondering if anyone had ever had hyperT resolve following herbal treatment?
                      > I am so afraid to trust any vet with Vienna after the mess they made with
                      > Rigsby.
                      >
                      > thanks
                      > Ruth
                      >
                      >
                      >


                      [Non-text portions of this message have been removed]
                    • Ana Gutierrez
                      From Pitcairn s book: http://books.google.com/books?id=xgOV0Kiq1IYC&printsec=frontcover#v=onepage&q&f=false Page 407, One dose of *Thuja* reversed rapid heart
                      Message 10 of 15 , Aug 8 4:37 PM
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                        From Pitcairn's book:
                        http://books.google.com/books?id=xgOV0Kiq1IYC&printsec=frontcover#v=onepage&q&f=false
                        Page 407, "One dose of *Thuja* reversed rapid heart beat and the appetite
                        problems (but I think you should read the whole section, or ask Dr. Pitcairn
                        directly)
                        See also p 31 & 374

                        Best,
                        Ana


                        On Mon, Aug 8, 2011 at 6:24 PM, Ana Gutierrez <anagtz@...> wrote:

                        > I would ask Dr. Richard Pitcairn for homeopathy richard@... or
                        > Dr. Patrick Mahaney for accupunture patrickmahaneyvet@...
                        >
                        > Both are very accesible and nice persons... plus they're great vets :)
                        >
                        > Best,
                        > Ana
                        >
                        >
                        >
                        > On Sun, Aug 7, 2011 at 10:11 AM, jruthaitken <jruthaitken@...>wrote:
                        >
                        >> **
                        >>
                        >>
                        >> hi
                        >>
                        >> I used to post on this list about my cat Rigsby who has now passed away -
                        >> he developed renal failure due to off label metacam administration following
                        >> an RTA.
                        >>
                        >> I got a new vet and had Vienna, his sister tested for everything you could
                        >> think of a few weeks ago - just to make sure she is okay. She hasn't had any
                        >> health problems or any symptoms of anything in particular. She is 12years
                        >> old.
                        >>
                        >> She has hyperthyroidism with raised liver values - she is on meds twice
                        >> daily and the new vet has suggested the iodine treatment. I found out that
                        >> she had been given the double whammy of metacam injection for dogs followed
                        >> by oral dosing (I knew about the oral dosing bit but at that time had no
                        >> idea metacam was risky) so I am worried she might have some renal damage. We
                        >> are going to test again in two weeks to see if her kidneys seem okay. of
                        >> course, these tests don't show the harm until 75% of function is lost so can
                        >> we even trust them?
                        >>
                        >> She had a very bad reaction to a vaccine 18 months ago (I haven't
                        >> vaccinated her since) and I was just reading an article suggesting vaccines,
                        >> flea treatments and wormers all contribute to the development of hyperT in
                        >> cats. The guy who wrote the article is a veterinary herbalist. I was
                        >> wondering if anyone had ever had hyperT resolve following herbal treatment?
                        >> I am so afraid to trust any vet with Vienna after the mess they made with
                        >> Rigsby.
                        >>
                        >> thanks
                        >> Ruth
                        >>
                        >>
                        >>
                        >
                        >


                        [Non-text portions of this message have been removed]
                      • acrocat@rocketmail.com
                        Hi Ruth I know you are located outside the US, but I m not sure where. Regarding hyperthyroid treatment, check out Dr. Mark Peterson s site for info:
                        Message 11 of 15 , Aug 9 7:28 PM
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                          Hi Ruth

                          I know you are located outside the US, but I'm not sure where. Regarding hyperthyroid treatment, check out Dr. Mark Peterson's site for info: http://www.animalendocrine.com/hypurrcat/hypurrcat/ and why not use the 'contact us' link to see if they know of facilities in your country. Dr. Peterson is well known in the field and probably knows who his counterpart experts are in other countries. The best thing to do would be to make an appointment with an endocrinologist and discuss options with him or her. If you are in the UK, I have heard of Stijn Niessen (DVM DECVIM-CA MRCVS), he has a good reputation.

                          --- In feline-heart@yahoogroups.com, "jruthaitken" <jruthaitken@...> wrote:
                          > she started medication July 30th Felimazole (2.5mg) twice daily. She seems a lot quieter...not that she was noisy but she is interacting with me a lot less.

                          Has she had a follow up blood test? After starting methimazole/felimazole, cats should have follow-up blood work (blood chemistry and CBC, and can check T4) in two weeks, sooner if you notice problems. The methimazole side effects show up quickly.




                          > --- In feline-heart@yahoogroups.com, "jruthaitken" <jruthaitken@> wrote:
                          > > I don't like one size fits all dosing regimens.

                          Standard practice now is to start out on a low dose and titrate up as needed; there are tiny cats with raging hyperthyroidism who may need a higher dose than an heavy-set cat with borderline disease. So you can start low and just repeat T4s till you hit the right dose.

                          >I am very worried about causing harm to Vienna with the treatment. we only found out she was hyperT during routine blood tests - all else, apart from liver enzymes was fine.

                          The beauty of blood screening tests now is that fewer cats have to become rail thin and come into hospital with severe hypertension and a heart rate that is through the roof -- we can catch and control hyperthyroidism much earlier.

                          > > I do not want her to become hypothyroid....I do not know what to do for the best.

                          Please don't let the discussion here or on any other list here guide your individual decisions for your cat -- if I131 is an option in your area, speak to a local specialist (or two!) about your cat's case.

                          >>She is impossible to pill and very difficult to handle. I am full of scratches, she is so unlike her brother who would let me do anything.

                          Any luck hiding it in food, or soft cheese? It helps to crush the pill if you're giving it in food, and when I've had to give pills in treats I always use a pill cutter to cut it into quarters and give them in wee pieces of treat. If you put a big fat pill in a wad of cheese, the cat will chew it and inevitably chomp on the pill. Little bits that don't need much chewing will be quickly swallowed. Start and end with 'dummy' pieces that don't have anything hidden in them.

                          I would also check if there are compounding pharmacies in your area that can make a flavored medicated treat. These work great in most cats with medications that don't taste terrible (like methimazole).

                          I would make an appointment to have the follow up blood test, it will put your mind at ease as to the scariest side effects.

                          Take care and keep us posted.
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