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November 29th 05, 02:27 AM
All,

My twelve year old female cat has been diagosed with hypertyroidism.
I'm presented with the two options: tapazole and radioactive iodine.
What is the group-think as to the best course of action?

Thanks,
Rob

Phil P.
November 29th 05, 04:44 AM
> wrote in message
...
> All,
>
> My twelve year old female cat has been diagosed with hypertyroidism.
> I'm presented with the two options: tapazole and radioactive iodine.
> What is the group-think as to the best course of action?


Initially, all hyperthyroid cats should be put on Tapazole for a few months
to evaluate kidney function after their T4 levels have stabilized in the
normal range. If her kidney function remains normal while her T4 levels are
normal, you can consider radioiodine tx. If her kidney function declines
while on Tapazole, she is not a good candidate for radioiodine tx.

If you opt for radioiodine tx. without a trial treatment with Tapazole, you
run the risk of *irreversibly* unmasking underlying kidney failure.
Hyperthyroid cats over 12 are at high-risk of having underlying kidney
disease despite normal BUN/ creatinine levels.

Hyperthyroidism increases blood flow through the kidneys which can make the
kidneys seem like they're working better than they are. After
hyperthyroidism is controlled, kidney blood flow returns to its normal rate
and can unmask kidney failure in cats with underlying disease.

You can significantly reduce the risks of your cat developing adverse
reactions to Tapazole if you begin treatment with a low dose- e.g., 2.5 mg
once a day for 5 days. If no adverse effects develop, the dose can be
increased to 2.5 mg twice a day. Recheck her T4 and BUN/creatinine in 7 -
10 days, then in 14 days, then monthly. If necessary, the dose can be
increased.

Tapazole has a very bitter taste that cats *hate*. You can make your cat
much more comfortable and pilling much easier if you put the pill inside a
#4 gelcap. Follow the pill with canned food or water to make sure it
doesn't get stuck and begin to dissolve in her esophagus. If your cat is
difficult to pill, Tapazole can be formulated into several flavored liquids
or a transdermal gel that is applied to the inside of the ear flap.

Best of luck,

Phil

cybercat
November 29th 05, 04:49 AM
> wrote in message
...
> All,
>
> My twelve year old female cat has been diagosed with hypertyroidism.
> I'm presented with the two options: tapazole and radioactive iodine.
> What is the group-think as to the best course of action?
>

Hi Rob!

My cat was diagnosed with this a couple of years ago.

Tapazole (given in pills 12 hours apart) can control the thyroid hormone
levels, but there are side effects and risks involved. I suggest you Google
the disorder to read about them.

Radioactive iodine treatment is considered by many a "cure" as opposed to
just a means of controlling the thyroid hormone levels. However, some cats
come through that hypothyroid or with other problems. We have discussed
these things at length in this group, so again, Google is your friend.

Since my cat (almost 11) is doing really well on Tapazole and I am not
having trouble pilling her now, I will probably stick with that. I have her
examined and tested regularly to make sure everything is okay.

The most important thing is that you address the high thyroid hormone
levels as soon as possible. My cat's heart rate was over 300 bpm when
she was diagnosed. (The norm for cats is about 150-180.) She developed
arrythmia (we think) as began having fainting spells, so is now on beta
blockers too. The most dangerous thing about hyperthyroidism, if I
recall my vet's words correctly, is that the cat cat "throw a clot."
In other words, have a stroke.

If I were you I would discuss the potential side effects of Tapazole with
your vet, then have battery of blood tests and urine tests to see how
her liver, kidneys, etc. are functioning and get her on Tapazole asap.
Since her metabolism will slow, she should gain weight fairly soon
after being on it.

Good luck and keep us posted.

cybercat
November 29th 05, 04:51 AM
"Phil P." > wrote in message
ink.net...
>
> > wrote in message
> ...
> > All,
> >
> > My twelve year old female cat has been diagosed with hypertyroidism.
> > I'm presented with the two options: tapazole and radioactive iodine.
> > What is the group-think as to the best course of action?
>
>
> Initially, all hyperthyroid cats should be put on Tapazole for a few
months
> to evaluate kidney function after their T4 levels have stabilized in the
> normal range. If her kidney function remains normal while her T4 levels
are
> normal, you can consider radioiodine tx. If her kidney function declines
> while on Tapazole, she is not a good candidate for radioiodine tx.
>
> If you opt for radioiodine tx. without a trial treatment with Tapazole,
you
> run the risk of *irreversibly* unmasking underlying kidney failure.
> Hyperthyroid cats over 12 are at high-risk of having underlying kidney
> disease despite normal BUN/ creatinine levels.
>
> Hyperthyroidism increases blood flow through the kidneys which can make
the
> kidneys seem like they're working better than they are. After
> hyperthyroidism is controlled, kidney blood flow returns to its normal
rate
> and can unmask kidney failure in cats with underlying disease.
>
> You can significantly reduce the risks of your cat developing adverse
> reactions to Tapazole if you begin treatment with a low dose- e.g., 2.5 mg
> once a day for 5 days. If no adverse effects develop, the dose can be
> increased to 2.5 mg twice a day. Recheck her T4 and BUN/creatinine in 7 -
> 10 days, then in 14 days, then monthly. If necessary, the dose can be
> increased.
>
> Tapazole has a very bitter taste that cats *hate*. You can make your cat
> much more comfortable and pilling much easier if you put the pill inside a
> #4 gelcap. Follow the pill with canned food or water to make sure it
> doesn't get stuck and begin to dissolve in her esophagus. If your cat is
> difficult to pill, Tapazole can be formulated into several flavored
liquids
> or a transdermal gel that is applied to the inside of the ear flap.
>
> Best of luck,
>
> Phil

This was the important thing I left out. Thanks, Phil. I could never have
explained it that well.

SLURRRRRRRRRP! :)

And I mean that with all sincerity.

November 29th 05, 10:45 AM
On 29 Nov 2005 05:49:35 +0100, "cybercat" > wrote:

>
> wrote in message
...
>> All,
>>
>> My twelve year old female cat has been diagosed with hypertyroidism.
>> I'm presented with the two options: tapazole and radioactive iodine.
>> What is the group-think as to the best course of action?
>>
>
>Hi Rob!
>
>My cat was diagnosed with this a couple of years ago.
>
>Tapazole (given in pills 12 hours apart) can control the thyroid hormone
>levels, but there are side effects and risks involved. I suggest you Google
>the disorder to read about them.
>
>Radioactive iodine treatment is considered by many a "cure" as opposed to
>just a means of controlling the thyroid hormone levels. However, some cats
>come through that hypothyroid or with other problems. We have discussed
>these things at length in this group, so again, Google is your friend.
>
>Since my cat (almost 11) is doing really well on Tapazole and I am not
>having trouble pilling her now, I will probably stick with that. I have her
>examined and tested regularly to make sure everything is okay.
>
>The most important thing is that you address the high thyroid hormone
>levels as soon as possible. My cat's heart rate was over 300 bpm when
>she was diagnosed. (The norm for cats is about 150-180.) She developed
>arrythmia (we think) as began having fainting spells, so is now on beta
>blockers too. The most dangerous thing about hyperthyroidism, if I
>recall my vet's words correctly, is that the cat cat "throw a clot."
>In other words, have a stroke.
>
>If I were you I would discuss the potential side effects of Tapazole with
>your vet, then have battery of blood tests and urine tests to see how
>her liver, kidneys, etc. are functioning and get her on Tapazole asap.
>Since her metabolism will slow, she should gain weight fairly soon
>after being on it.
>
>Good luck and keep us posted.

Cybercat,

She did have a full-blood panel done and all is well. Weight loss is
not a problem as she's overweight to begin with and hasn't seemed to
have lost much, if any weight. She was diagnosed by a heart rate of
200 and the t4 value was out of range (I forget about how much). I
guess my biggest concern is simple economicss..the cost of the
medication. Does it make sense to go the iodine route if the cost of
the meds and repeated tests will equal the iodine in about two years?

Thanks for the reply,
Rob
>

cybercat
November 29th 05, 01:58 PM
> wrote

> Cybercat,
>
> She did have a full-blood panel done and all is well. Weight loss is
> not a problem as she's overweight to begin with and hasn't seemed to
> have lost much, if any weight.

Rob,

This is odd, because as your vet probably told you, most hyperthyroid
cats are skinny. They have a hard time keeping weight on because their
overactive thyroids are revving up their metabolism. They usually have
dull or oily fur, too, from what I have been told. What is stranger still is
that my cat, just like yours, was fat. She weighted 16-18 pounds at
diagnosis, and the vet said she would gain once we corrected the thyroid.
I put her on a diet of premium canned food (beef/chicken/meat as a first
or second ingredient, not byproducts), a bit too much at first, every 12
hours. (She had been free feeding diet Iams dry.) I cut this back by
1/4 whenever she stopped losing. At her last checkup she weighed
10 lbs. So don't worry, she does not have to gain weight when you
correct her thyroid, but you may have to change her feeding.


?She was diagnosed by a heart rate of
> 200 and the t4 value was out of range (I forget about how much). I
> guess my biggest concern is simple economicss..the cost of the
> medication. Does it make sense to go the iodine route if the cost of
> the meds and repeated tests will equal the iodine in about two years?
>

As for cost, I get a generic of Tapazole that costs $10 a month. (Without
insurance of course, for some reason they do not cover my cats!) Since
the radioactive iodine treatment runs $1,200-1,500, it would even out over
a few years.

To be honest with you, what keeps me from getting the radioactive
treatment is that I cannot stand the thought of taking her there and
leaving her for weeks. (Different laws about radioactive waste
in different states mean that vets keep the cats different periods
of time, essentially because their waste is radioactive.)

She howls piteously at the vet and I would miss her
too much. Also I worry about reported problems with hypothyroidism
and other problems. But it would beat pilling twice a day.
Listen to Phil, he knows much more than I do about this.

Phil P.
November 29th 05, 04:25 PM
> wrote in message
...

I
> guess my biggest concern is simple economicss..the cost of the
> medication.

Tapazole is very inexpensive- A bottle of 100/5 mg pills costs about
$30-$35. Most cats can be managed on 2.5 mg/twice a day or 5 mg/twice a
day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose. I
try not to use generics because of variations from batch to batch.

As far as treatment options, you may not have a choice. She may not be a
candidate for radioiodine. At her age, she's in the high-risk category for
underlying kidney disease. You or your vet won't know the status of her
kidneys until she's been on Tapazole for at least 2-3 months. And that's
still not a guarantee. More than 50% of the cats treated with radioiodine
develop renal disease within a year after treatment despite normal
pre-treatment BUN/creatinine/USG values. Also, about 30% develop transient
hypothyroidism- 10% require long-term supplementation with L-thyroxine.

Another factor to consider is that radioiodine tx. is *irreversible*- which
means if she develops kidney disease you can't adjust the dosage. OTOH,
with Tapazole, you can adjust the dose to strike a balance between an
"acceptable" level of azotemia and an "acceptable" level of hyperthyroidism.
Mild hyperthyroidism can actually augment kidney function.

Also, depending on your state laws, your cat must remain in the radioiodine
facility for 1-3 weeks. This can be extremely stressful for an older cat.


Does it make sense to go the iodine route if the cost of
> the meds and repeated tests will equal the iodine in about two years?


After the first 3 months, you can recheck her T4 levels every 2-3 months or
when signs of hypo or hyperthyroidism develop. A complete feline thyroid
panel costs about $35; just T4 costs about $10 and a T4/T3 combo costs about
$20- depending on how much your vet marks up the lab bill. Radioiodine is
more economical only with cats under 10-12 years of age.

Radioiodine tx. is generally the safest and most effective treatment,
actually, cure, for hyperthyroidism, but it certainly isn't without serious
risks nor as economical as it may seem.

Gail
November 29th 05, 10:11 PM
As posters have said, it depends on the individual cat and on you. My cat
was on Tapazole for many years and did just fine. She died of cancer at age
17 last year.
Gail
> wrote in message
...
> On 29 Nov 2005 05:49:35 +0100, "cybercat" > wrote:
>
>>
> wrote in message
...
>>> All,
>>>
>>> My twelve year old female cat has been diagosed with hypertyroidism.
>>> I'm presented with the two options: tapazole and radioactive iodine.
>>> What is the group-think as to the best course of action?
>>>
>>
>>Hi Rob!
>>
>>My cat was diagnosed with this a couple of years ago.
>>
>>Tapazole (given in pills 12 hours apart) can control the thyroid hormone
>>levels, but there are side effects and risks involved. I suggest you
>>Google
>>the disorder to read about them.
>>
>>Radioactive iodine treatment is considered by many a "cure" as opposed to
>>just a means of controlling the thyroid hormone levels. However, some cats
>>come through that hypothyroid or with other problems. We have discussed
>>these things at length in this group, so again, Google is your friend.
>>
>>Since my cat (almost 11) is doing really well on Tapazole and I am not
>>having trouble pilling her now, I will probably stick with that. I have
>>her
>>examined and tested regularly to make sure everything is okay.
>>
>>The most important thing is that you address the high thyroid hormone
>>levels as soon as possible. My cat's heart rate was over 300 bpm when
>>she was diagnosed. (The norm for cats is about 150-180.) She developed
>>arrythmia (we think) as began having fainting spells, so is now on beta
>>blockers too. The most dangerous thing about hyperthyroidism, if I
>>recall my vet's words correctly, is that the cat cat "throw a clot."
>>In other words, have a stroke.
>>
>>If I were you I would discuss the potential side effects of Tapazole with
>>your vet, then have battery of blood tests and urine tests to see how
>>her liver, kidneys, etc. are functioning and get her on Tapazole asap.
>>Since her metabolism will slow, she should gain weight fairly soon
>>after being on it.
>>
>>Good luck and keep us posted.
>
> Cybercat,
>
> She did have a full-blood panel done and all is well. Weight loss is
> not a problem as she's overweight to begin with and hasn't seemed to
> have lost much, if any weight. She was diagnosed by a heart rate of
> 200 and the t4 value was out of range (I forget about how much). I
> guess my biggest concern is simple economicss..the cost of the
> medication. Does it make sense to go the iodine route if the cost of
> the meds and repeated tests will equal the iodine in about two years?
>
> Thanks for the reply,
> Rob
>>
>

November 30th 05, 01:39 AM
On 29 Nov 2005 14:58:50 +0100, "cybercat" > wrote:

>
> wrote
>
>> Cybercat,
>>
>> She did have a full-blood panel done and all is well. Weight loss is
>> not a problem as she's overweight to begin with and hasn't seemed to
>> have lost much, if any weight.
>
>Rob,
>
>This is odd, because as your vet probably told you, most hyperthyroid
>cats are skinny. They have a hard time keeping weight on because their
>overactive thyroids are revving up their metabolism. They usually have
>dull or oily fur, too, from what I have been told. What is stranger still is
>that my cat, just like yours, was fat. She weighted 16-18 pounds at
>diagnosis, and the vet said she would gain once we corrected the thyroid.
>I put her on a diet of premium canned food (beef/chicken/meat as a first
>or second ingredient, not byproducts), a bit too much at first, every 12
>hours. (She had been free feeding diet Iams dry.) I cut this back by
>1/4 whenever she stopped losing. At her last checkup she weighed
>10 lbs. So don't worry, she does not have to gain weight when you
>correct her thyroid, but you may have to change her feeding.

Cybercat,

I think the weight is because he caught it early when he noticed the
heartrate.

>
>
>?She was diagnosed by a heart rate of
>> 200 and the t4 value was out of range (I forget about how much). I
>> guess my biggest concern is simple economicss..the cost of the
>> medication. Does it make sense to go the iodine route if the cost of
>> the meds and repeated tests will equal the iodine in about two years?
>>
>
>As for cost, I get a generic of Tapazole that costs $10 a month. (Without
>insurance of course, for some reason they do not cover my cats!) Since
>the radioactive iodine treatment runs $1,200-1,500, it would even out over
>a few years.
>
>To be honest with you, what keeps me from getting the radioactive
>treatment is that I cannot stand the thought of taking her there and
>leaving her for weeks. (Different laws about radioactive waste
>in different states mean that vets keep the cats different periods
>of time, essentially because their waste is radioactive.)

The place my doctor is high on (had his done there) is certfied for
treatment and release in 96 hours.

>
>She howls piteously at the vet and I would miss her
>too much.

Mine is extremely high strung and I think we would have problems
pilling her and getting her to the vet for repeat thyroid tests.

> Also I worry about reported problems with hypothyroidism
>and other problems. But it would beat pilling twice a day.
>Listen to Phil, he knows much more than I do about this.
>
Thanks much,
Rob

November 30th 05, 02:17 AM
On Tue, 29 Nov 2005 16:25:43 GMT, "Phil P." >
wrote:

>
> wrote in message
...
>
>I
>> guess my biggest concern is simple economicss..the cost of the
>> medication.
>
>Tapazole is very inexpensive- A bottle of 100/5 mg pills costs about
>$30-$35. Most cats can be managed on 2.5 mg/twice a day or 5 mg/twice a
>day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose. I
>try not to use generics because of variations from batch to batch.

Phil,

Where do you get yours from?

>
>As far as treatment options, you may not have a choice. She may not be a
>candidate for radioiodine. At her age, she's in the high-risk category for
>underlying kidney disease. You or your vet won't know the status of her
>kidneys until she's been on Tapazole for at least 2-3 months. And that's
>still not a guarantee. More than 50% of the cats treated with radioiodine
>develop renal disease within a year after treatment despite normal
>pre-treatment BUN/creatinine/USG values. Also, about 30% develop transient
>hypothyroidism- 10% require long-term supplementation with L-thyroxine.

You sound very knowledgable on the subject. Are you a vet by chance?

>
>Another factor to consider is that radioiodine tx. is *irreversible*- which
>means if she develops kidney disease you can't adjust the dosage. OTOH,
>with Tapazole, you can adjust the dose to strike a balance between an
>"acceptable" level of azotemia and an "acceptable" level of hyperthyroidism.
>Mild hyperthyroidism can actually augment kidney function.
>
>Also, depending on your state laws, your cat must remain in the radioiodine
>facility for 1-3 weeks. This can be extremely stressful for an older cat.

Apparently the facility I was referred to is certified to do it all in
96 hours.

>
>
>Does it make sense to go the iodine route if the cost of
>> the meds and repeated tests will equal the iodine in about two years?
>
>
>After the first 3 months, you can recheck her T4 levels every 2-3 months or
>when signs of hypo or hyperthyroidism develop. A complete feline thyroid
>panel costs about $35; just T4 costs about $10 and a T4/T3 combo costs about
>$20- depending on how much your vet marks up the lab bill. Radioiodine is
>more economical only with cats under 10-12 years of age.

She's about 13.5. You've given me alot to think about. My only
remaining concern is actual pill delivery. I travel several times a
month so it would leave my wife to pill her herself. I worry about
how that will work out given how much a fuss we've with her in the
past (the cat, not the wife :) )

Thanks so much,
Rob

Phil P.
November 30th 05, 11:56 AM
> wrote in message
...
> On Tue, 29 Nov 2005 16:25:43 GMT, "Phil P." >
> wrote:
>
> >
> > wrote in message
> ...
> >
> >I
> >> guess my biggest concern is simple economicss..the cost of the
> >> medication.
> >
> >Tapazole is very inexpensive- A bottle of 100/5 mg pills costs about
> >$30-$35. Most cats can be managed on 2.5 mg/twice a day or 5 mg/twice a
> >day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose.
I
> >try not to use generics because of variations from batch to batch.
>
> Phil,
>
> Where do you get yours from?


I get our drugs from a vet supplier- but you can order 100/5 mg brand
Tapazole- not a generic with just a script from your vet for about $40-
which breaks down to $12/month- .20 a dose or .40 a day (@ 2.5 mg/b.i.d.)

http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T


> >As far as treatment options, you may not have a choice. She may not be a
> >candidate for radioiodine. At her age, she's in the high-risk category
for
> >underlying kidney disease. You or your vet won't know the status of her
> >kidneys until she's been on Tapazole for at least 2-3 months. And that's
> >still not a guarantee. More than 50% of the cats treated with radioiodine
> >develop renal disease within a year after treatment despite normal
> >pre-treatment BUN/creatinine/USG values. Also, about 30% develop
transient
> >hypothyroidism- 10% require long-term supplementation with L-thyroxine.
>
> You sound very knowledgable on the subject. Are you a vet by chance?


No. I have a hyperthyroid cat and worked with several hyperthyroid cats in
my shelter.


>
> >
> >Another factor to consider is that radioiodine tx. is *irreversible*-
which
> >means if she develops kidney disease you can't adjust the dosage. OTOH,
> >with Tapazole, you can adjust the dose to strike a balance between an
> >"acceptable" level of azotemia and an "acceptable" level of
hyperthyroidism.
> >Mild hyperthyroidism can actually augment kidney function.
> >
> >Also, depending on your state laws, your cat must remain in the
radioiodine
> >facility for 1-3 weeks. This can be extremely stressful for an older
cat.
>
> Apparently the facility I was referred to is certified to do it all in
> 96 hours.


We have a facility in my state with the same policy. Most states have a 1-3
week requirement but I think the laws might be changing to 7-10 days in some
states.


> >Does it make sense to go the iodine route if the cost of
> >> the meds and repeated tests will equal the iodine in about two years?
> >
> >
> >After the first 3 months, you can recheck her T4 levels every 2-3 months
or
> >when signs of hypo or hyperthyroidism develop. A complete feline thyroid
> >panel costs about $35; just T4 costs about $10 and a T4/T3 combo costs
about
> >$20- depending on how much your vet marks up the lab bill. Radioiodine
is
> >more economical only with cats under 10-12 years of age.
>
> She's about 13.5. You've given me alot to think about.


My hyperthyroid cat is 12.5 . Her kidney function has been stable and well
within the normal range and her USG has been >1.050 for the last 3 months
that she's been on Tapazole. Although she's considered an 'ideal' candidate
for radioiodine tx. I'm very reluctant to opt for the tx.

I had her scheduled for quantitative renal scintigraphy (Planar Renal
Scintigraphy) by which individual and total kidney function is measured
noninvasively while she's awake, but I cancelled the test. Even PRS which
is the most accurate test for renal function available can't predict what
her post-treatment kidney function will be a year after tx. Most of the
cats that developed renal failure after radioiodine also had normal kidney
and USG values. At her age, its just not a risk I'm prepared to take with
her. If her hyperthyroidism ever becomes life-threatening and nonresponsive
to Tapazole, or she develops adverse reactions, I'll certainly reconsider my
decision. Too many cats have been
successfully managed with Tapazole for life for me to justify taking the
risk with radioiodine.


My only
> remaining concern is actual pill delivery. I travel several times a
> month so it would leave my wife to pill her herself. I worry about
> how that will work out given how much a fuss we've with her in the
> past (the cat, not the wife :) )


Not a problem. Tapazole can be formulated into a transdermal gel that's
applied to the inside of the ear. As long as your cat lets your wife touch
her- she can medicate your cat. Tapazole gel comes in clearly marked
syringes- just apply .1 ml to your finger and rub it into the inside of her
earflap. After about 20 minutes, wipe off any excess. You must wear a
finger cover or exam glove so you won't absorb the Tapazole through your
skin. I prefer the finger covers so the cat can still feel my touch.

http://www.maxshouse.com/Drugs/tapazol_gel+finger_cover.jpg


Best of luck,

Phil

November 30th 05, 12:09 PM
On Wed, 30 Nov 2005 11:56:46 GMT, "Phil P." >
wrote:

>
> wrote in message
...
>> On Tue, 29 Nov 2005 16:25:43 GMT, "Phil P." >
>> wrote:
>>
>> >
>> > wrote in message
>> ...
>> >
>> >I
>> >> guess my biggest concern is simple economicss..the cost of the
>> >> medication.
>> >
>> >Tapazole is very inexpensive- A bottle of 100/5 mg pills costs about
>> >$30-$35. Most cats can be managed on 2.5 mg/twice a day or 5 mg/twice a
>> >day. One bottle should last 1 1/2 - 3 1/2 months depending on her dose.
>I
>> >try not to use generics because of variations from batch to batch.
>>
>> Phil,
>>
>> Where do you get yours from?
>
>
>I get our drugs from a vet supplier- but you can order 100/5 mg brand
>Tapazole- not a generic with just a script from your vet for about $40-
>which breaks down to $12/month- .20 a dose or .40 a day (@ 2.5 mg/b.i.d.)
>
>http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T

Thanks for the link. 1800petmeds wants over $1 a pill. Was quite a
shock when I did the math.

>
>
>> >As far as treatment options, you may not have a choice. She may not be a
>> >candidate for radioiodine. At her age, she's in the high-risk category
>for
>> >underlying kidney disease. You or your vet won't know the status of her
>> >kidneys until she's been on Tapazole for at least 2-3 months. And that's
>> >still not a guarantee. More than 50% of the cats treated with radioiodine
>> >develop renal disease within a year after treatment despite normal
>> >pre-treatment BUN/creatinine/USG values. Also, about 30% develop
>transient
>> >hypothyroidism- 10% require long-term supplementation with L-thyroxine.
>>
>> You sound very knowledgable on the subject. Are you a vet by chance?
>
>
>No. I have a hyperthyroid cat and worked with several hyperthyroid cats in
>my shelter.

I appreciate someone with personal experience who can make me think.
Thanks.

>
>
>>
>> >
>> >Another factor to consider is that radioiodine tx. is *irreversible*-
>which
>> >means if she develops kidney disease you can't adjust the dosage. OTOH,
>> >with Tapazole, you can adjust the dose to strike a balance between an
>> >"acceptable" level of azotemia and an "acceptable" level of
>hyperthyroidism.
>> >Mild hyperthyroidism can actually augment kidney function.
>> >
>> >Also, depending on your state laws, your cat must remain in the
>radioiodine
>> >facility for 1-3 weeks. This can be extremely stressful for an older
>cat.
>>
>> Apparently the facility I was referred to is certified to do it all in
>> 96 hours.
>
>
>We have a facility in my state with the same policy. Most states have a 1-3
>week requirement but I think the laws might be changing to 7-10 days in some
>states.

I think for now, we're going to go the Tapazole route and see what the
kidney function does and how she takes to the pill popping.

>
>
>> >Does it make sense to go the iodine route if the cost of
>> >> the meds and repeated tests will equal the iodine in about two years?
>> >
>> >
>> >After the first 3 months, you can recheck her T4 levels every 2-3 months
>or
>> >when signs of hypo or hyperthyroidism develop. A complete feline thyroid
>> >panel costs about $35; just T4 costs about $10 and a T4/T3 combo costs
>about
>> >$20- depending on how much your vet marks up the lab bill. Radioiodine
>is
>> >more economical only with cats under 10-12 years of age.
>>
>> She's about 13.5. You've given me alot to think about.
>
>
>My hyperthyroid cat is 12.5 . Her kidney function has been stable and well
>within the normal range and her USG has been >1.050 for the last 3 months
>that she's been on Tapazole. Although she's considered an 'ideal' candidate
>for radioiodine tx. I'm very reluctant to opt for the tx.
>
>I had her scheduled for quantitative renal scintigraphy (Planar Renal
>Scintigraphy) by which individual and total kidney function is measured
>noninvasively while she's awake, but I cancelled the test. Even PRS which
>is the most accurate test for renal function available can't predict what
>her post-treatment kidney function will be a year after tx. Most of the
>cats that developed renal failure after radioiodine also had normal kidney
>and USG values. At her age, its just not a risk I'm prepared to take with
>her. If her hyperthyroidism ever becomes life-threatening and nonresponsive
>to Tapazole, or she develops adverse reactions, I'll certainly reconsider my
>decision. Too many cats have been
>successfully managed with Tapazole for life for me to justify taking the
>risk with radioiodine.

My mother did three cats.

>
>
>My only
>> remaining concern is actual pill delivery. I travel several times a
>> month so it would leave my wife to pill her herself. I worry about
>> how that will work out given how much a fuss we've with her in the
>> past (the cat, not the wife :) )
>
>
>Not a problem. Tapazole can be formulated into a transdermal gel that's
>applied to the inside of the ear. As long as your cat lets your wife touch
>her- she can medicate your cat.

Any idea where you can get that gel made up?

>Tapazole gel comes in clearly marked
>syringes- just apply .1 ml to your finger and rub it into the inside of her
>earflap. After about 20 minutes, wipe off any excess. You must wear a
>finger cover or exam glove so you won't absorb the Tapazole through your
>skin. I prefer the finger covers so the cat can still feel my touch.
>
>http://www.maxshouse.com/Drugs/tapazol_gel+finger_cover.jpg
>
>
>Best of luck,
>
>Phil

Thanks so much for all the info,
Rob

cybercat
November 30th 05, 07:14 PM
> wrote

>
> I think the weight is because he caught it early when he noticed the
> heartrate.

Makes sense! I'm glad he caught it early.
>
> >
> >
> >To be honest with you, what keeps me from getting the radioactive
> >treatment is that I cannot stand the thought of taking her there and
> >leaving her for weeks. (Different laws about radioactive waste
> >in different states mean that vets keep the cats different periods
> >of time, essentially because their waste is radioactive.)
>
> The place my doctor is high on (had his done there) is certfied for
> treatment and release in 96 hours.
>
That's pretty good, compared with other places.

> >
> >She howls piteously at the vet and I would miss her
> >too much.
>
> Mine is extremely high strung and I think we would have problems
> pilling her and getting her to the vet for repeat thyroid tests.
>
> > Also I worry about reported problems with hypothyroidism
> >and other problems. But it would beat pilling twice a day.
> >Listen to Phil, he knows much more than I do about this.
> >
> Thanks much,

Good luck with her, and keep us posted. Phil guided me through
this problem and these decisions with my cat, and she is doing great
now, so between him and your vet you are in good hands, and so is
your kitty.

Phil P.
November 30th 05, 07:43 PM
> wrote in message
...
> On Wed, 30 Nov 2005 11:56:46 GMT, "Phil P." >
> wrote:

> >I get our drugs from a vet supplier- but you can order 100/5 mg brand
> >Tapazole- not a generic with just a script from your vet for about $40-
> >which breaks down to $12/month- .20 a dose or .40 a day (@ 2.5
mg/b.i.d.)
> >
> >http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T
>
> Thanks for the link. 1800petmeds wants over $1 a pill. Was quite a
> shock when I did the math.


A buck a pill??? That's probably why so many people think radioiodine tx.
is cheaper.




> >No. I have a hyperthyroid cat and worked with several hyperthyroid cats
in
> >my shelter.
>
> I appreciate someone with personal experience who can make me think.
> Thanks.


Experience is the best teacher.



> I think for now, we're going to go the Tapazole route and see what the
> kidney function does and how she takes to the pill popping.


I'm glad to hear it. That's the smart play. Radioiodine tx. is the first
choice tx for young cats (<10) and the 1-2% of cats that have thyroid
carcinomas or hyperfunctioning ectopic (noncervical) thyroid tissue- or
cats that develop severe adverse reactions to Tapazole. But for older cats,
Tapazole is the wisest choice.





Too many cats have been
> >successfully managed with Tapazole for life for me to justify taking the
> >risk with radioiodine.
>
> My mother did three cats.



You'll have plenty of moral support! ;)



> >Not a problem. Tapazole can be formulated into a transdermal gel that's
> >applied to the inside of the ear. As long as your cat lets your wife
touch
> >her- she can medicate your cat.
>
> Any idea where you can get that gel made up?


Any human compounding pharmacy. All you need is a script from your vet.
The transdermal gel is a little more expensive, but well worth it.
Initially, your cat may take a few days longer to respond to the gel than to
the pill because the medication has to make its way through the skin before
it reaches systemic circulation and the thyroid glands. But after that, the
efficacy is the same or perhaps even a little better. Just make sure you
wear a finger cover or exam glove! ;) If you ever have to give your cat
Tapazole pills, be sure to put the pill in a #4 gelcap- otherwise pilling
will be a nightmare. Tapazole tastes nasty.



>
> Thanks so much for all the info,


Your welcome. I hope it helps.

Best of luck,

Phil

December 2nd 05, 12:33 PM
On Wed, 30 Nov 2005 19:43:49 GMT, "Phil P." >
wrote:

>
> wrote in message
...
>> On Wed, 30 Nov 2005 11:56:46 GMT, "Phil P." >
>> wrote:
>
>> >I get our drugs from a vet supplier- but you can order 100/5 mg brand
>> >Tapazole- not a generic with just a script from your vet for about $40-
>> >which breaks down to $12/month- .20 a dose or .40 a day (@ 2.5
>mg/b.i.d.)
>> >
>> >http://www.candrugstore.com/custdrugsearchAtoZlist.asp?search=T
>>
>> Thanks for the link. 1800petmeds wants over $1 a pill. Was quite a
>> shock when I did the math.
>
>
>A buck a pill??? That's probably why so many people think radioiodine tx.
>is cheaper.

That's the reason for my heart attack when I started this research.

>
>
>
>
>> >No. I have a hyperthyroid cat and worked with several hyperthyroid cats
>in
>> >my shelter.
>>
>> I appreciate someone with personal experience who can make me think.
>> Thanks.
>
>
>Experience is the best teacher.
>
>
>
>> I think for now, we're going to go the Tapazole route and see what the
>> kidney function does and how she takes to the pill popping.
>
>
>I'm glad to hear it. That's the smart play. Radioiodine tx. is the first
>choice tx for young cats (<10) and the 1-2% of cats that have thyroid
>carcinomas or hyperfunctioning ectopic (noncervical) thyroid tissue- or
>cats that develop severe adverse reactions to Tapazole. But for older cats,
>Tapazole is the wisest choice.

We should be starting in the next couple of days. This should be
quite an adventure :)

>
>
>
>
>
>Too many cats have been
>> >successfully managed with Tapazole for life for me to justify taking the
>> >risk with radioiodine.
>>
>> My mother did three cats.
>
>
>
>You'll have plenty of moral support! ;)

She's got a dog now !

>
>
>
>> >Not a problem. Tapazole can be formulated into a transdermal gel that's
>> >applied to the inside of the ear. As long as your cat lets your wife
>touch
>> >her- she can medicate your cat.
>>
>> Any idea where you can get that gel made up?
>
>
>Any human compounding pharmacy. All you need is a script from your vet.
>The transdermal gel is a little more expensive, but well worth it.
>Initially, your cat may take a few days longer to respond to the gel than to
>the pill because the medication has to make its way through the skin before
>it reaches systemic circulation and the thyroid glands. But after that, the
>efficacy is the same or perhaps even a little better. Just make sure you
>wear a finger cover or exam glove! ;) If you ever have to give your cat
>Tapazole pills, be sure to put the pill in a #4 gelcap- otherwise pilling
>will be a nightmare. Tapazole tastes nasty.

I assume you can get this at a pharmacy as well?

December 3rd 05, 08:13 PM
All,

Well we got our first couple of doses of Tapazole into the kitty. I
found a drug store that had a couple of gel capsules on hand and it
helped the process. I only have a few as they are absolutely
impossible to find. I found one drugstore that would order them for
me, but it will be a couple of days. My wife will be stuck pilling
capsuleless for a day or two as I will be away.

Rob

cybercat
December 3rd 05, 11:26 PM
> wrote in message
...
> All,
>
> My wife will be stuck pilling
> capsuleless for a day or two as I will be away.
>

Rob,

I have to pill my kitty twice a day, and after trying many things
have found this method to work best with her. (One of her medicines
is Tapazole, which as Phil mentioned is very bitter, the other is a
beta blocker.)

Because I feed canned twice a day I pill when I feed her, to make
it easier to remember. I let her begin gulping down her canned
food, then I swiftly interrupt her by lifting her head up and back using
my left hand (cat is looking right) over the top of her head, fingers
holding her by the corners of her mouth, opening her mouth that
way and with one finger from my right hand (the hand with the
pills in it) and quickly and gently tossing the pills [this is the important
part]
as far back the MIDDLE of her throat as I can. (If it goes to the
side they can work it out onto their tongue, then they taste it, hate
it, drool, foam at the mouth, etc. A bad scene.) Then I hold her head
up for a little bit, gently rubbing her throat. She nearly always swallows
in a hurry so she can get back to her food!

I hope this helps you and your wife. (I also have to close the pocket doors
to the kitchen after I put the food down so she won't try to run away. It
saves me the traumatic "chasing her down" if I get busy with something
else before I can pill her.)

December 4th 05, 10:40 PM
On 4 Dec 2005 00:26:44 +0100, "cybercat" > wrote:

>
> wrote in message
...
>> All,
>>
>> My wife will be stuck pilling
>> capsuleless for a day or two as I will be away.
>>
>
>Rob,
>
>I have to pill my kitty twice a day, and after trying many things
>have found this method to work best with her. (One of her medicines
>is Tapazole, which as Phil mentioned is very bitter, the other is a
>beta blocker.)
>
>Because I feed canned twice a day I pill when I feed her, to make
>it easier to remember. I let her begin gulping down her canned
>food, then I swiftly interrupt her by lifting her head up and back using
>my left hand (cat is looking right) over the top of her head, fingers
>holding her by the corners of her mouth, opening her mouth that
>way and with one finger from my right hand (the hand with the
>pills in it) and quickly and gently tossing the pills [this is the important
>part]
>as far back the MIDDLE of her throat as I can. (If it goes to the
>side they can work it out onto their tongue, then they taste it, hate
>it, drool, foam at the mouth, etc. A bad scene.) Then I hold her head
>up for a little bit, gently rubbing her throat. She nearly always swallows
>in a hurry so she can get back to her food!

We've worked it so that she gets wet food immediately after pilling.
This has the added benefit of making sure she isn't hiding the pill.

>
>I hope this helps you and your wife. (I also have to close the pocket doors
>to the kitchen after I put the food down so she won't try to run away. It
>saves me the traumatic "chasing her down" if I get busy with something
>else before I can pill her.)

We close off the bedroom (if she gets under the bed, it's all over).
The pilling, for now is done in a closed bathroom.

>

cybercat
December 5th 05, 12:57 AM
> wrote:
> >
> >I hope this helps you and your wife. (I also have to close the pocket
doors
> >to the kitchen after I put the food down so she won't try to run away. It
> >saves me the traumatic "chasing her down" if I get busy with something
> >else before I can pill her.)
>
> We close off the bedroom (if she gets under the bed, it's all over).
> The pilling, for now is done in a closed bathroom.
>

I know how hard this is in the beginning. It gets easier--on you and on
the cat.

NMR
December 5th 05, 01:15 AM
I might get easier once you know the cat but they get smarter. My rumble
takes a pill 2x a day he knows some how he knows that I am coming to give
him a pill. He can be laying next to me and I take my medication no problem
but I get his pill he is gone like a shot and hides for hours. I have to
hide the medication through out the house and snag him when he ain't
looking; you try that with a cat. Pill pockets he spits the pill back out,
can't crush it he won't touch it and the other cats would eat it. Hide it
in other food he is such a little devil he will eat the food and leave the
pill in a obvious place ( I watched him do it). I catch him no problem pill
gone by the count of 3 with a lot of loving afterwards.
They can be such little devils.


Matthew



"cybercat" > wrote in message
...
>
> > wrote:
>> >
>> >I hope this helps you and your wife. (I also have to close the pocket
> doors
>> >to the kitchen after I put the food down so she won't try to run away.
>> >It
>> >saves me the traumatic "chasing her down" if I get busy with something
>> >else before I can pill her.)
>>
>> We close off the bedroom (if she gets under the bed, it's all over).
>> The pilling, for now is done in a closed bathroom.
>>
>
> I know how hard this is in the beginning. It gets easier--on you and on
> the cat.
>
>

cybercat
December 5th 05, 04:23 AM
"NMR" > wrote in message
.. .
> I might get easier once you know the cat but they get smarter. My rumble
> takes a pill 2x a day he knows some how he knows that I am coming to give
> him a pill. He can be laying next to me and I take my medication no
problem
> but I get his pill he is gone like a shot and hides for hours. I have to
> hide the medication through out the house and snag him when he ain't
> looking; you try that with a cat. Pill pockets he spits the pill back
out,
> can't crush it he won't touch it and the other cats would eat it. Hide it
> in other food he is such a little devil he will eat the food and leave
the
> pill in a obvious place ( I watched him do it). I catch him no problem
pill
> gone by the count of 3 with a lot of loving afterwards.
> They can be such little devils.
>

Matthew, you do not mention giving him the pill while he is eating, which is
what I am describing above. My Boo did all of the things you describe, and
pill-giving was an ugly thing. It's totally different now. Try it if you
haven't.

cybercat
December 5th 05, 04:23 AM
"NMR" > wrote in message
.. .
> I might get easier once you know the cat but they get smarter. My rumble
> takes a pill 2x a day he knows some how he knows that I am coming to give
> him a pill. He can be laying next to me and I take my medication no
problem
> but I get his pill he is gone like a shot and hides for hours. I have to
> hide the medication through out the house and snag him when he ain't
> looking; you try that with a cat. Pill pockets he spits the pill back
out,
> can't crush it he won't touch it and the other cats would eat it. Hide it
> in other food he is such a little devil he will eat the food and leave
the
> pill in a obvious place ( I watched him do it). I catch him no problem
pill
> gone by the count of 3 with a lot of loving afterwards.
> They can be such little devils.
>

Matthew, you do not mention giving him the pill while he is eating, which is
what I am describing above. My Boo did all of the things you describe, and
pill-giving was an ugly thing. It's totally different now. Try it if you
haven't.

NMR
December 5th 05, 04:27 AM
"Hide it in other food he is such a little devil he will eat the food and
leave the pill in a obvious place ( I watched him do it)"

He will eat the food and spit the pill out or take the pill and leave it
right in front of me with a look of whatcha you going to do now. He is a
little devil but he makes life interesting the chase is part of life :-)


"cybercat" > wrote in message
...
>
> "NMR" > wrote in message
> .. .
>> I might get easier once you know the cat but they get smarter. My
>> rumble
>> takes a pill 2x a day he knows some how he knows that I am coming to give
>> him a pill. He can be laying next to me and I take my medication no
> problem
>> but I get his pill he is gone like a shot and hides for hours. I have to
>> hide the medication through out the house and snag him when he ain't
>> looking; you try that with a cat. Pill pockets he spits the pill back
> out,
>> can't crush it he won't touch it and the other cats would eat it. Hide
>> it
>> in other food he is such a little devil he will eat the food and leave
> the
>> pill in a obvious place ( I watched him do it). I catch him no problem
> pill
>> gone by the count of 3 with a lot of loving afterwards.
>> They can be such little devils.
>>
>
> Matthew, you do not mention giving him the pill while he is eating, which
> is
> what I am describing above. My Boo did all of the things you describe, and
> pill-giving was an ugly thing. It's totally different now. Try it if you
> haven't.
>
>

cybercat
December 5th 05, 04:32 AM
"NMR" > wrote in message
...
> "Hide it in other food he is such a little devil he will eat the food and
> leave the pill in a obvious place ( I watched him do it)"
>
> He will eat the food and spit the pill out or take the pill and leave
it
> right in front of me with a look of whatcha you going to do now. He is
a
> little devil but he makes life interesting the chase is part of life :-)
>

No, NMR. I am not talking about hiding it in his food. You feed him his
wet food, then you wait until he has had a bite or two and pill him. If he
is
like my cat he will swallow the pill without a hassle so he can get to the
food.

NMR
December 5th 05, 04:38 AM
I have done that before he will spit the pill back up and drop it in front
of me and give me the look of hah. When I can grab him I turn him around
butt to the chest neck back open mouth drop pill and massage throat and
give him some lovin. Count to 3 it is all over except when he runs the
chase is on :-)

Check your e-mail :-)

"cybercat" > wrote in message
...
>
> "NMR" > wrote in message
> ...
>> "Hide it in other food he is such a little devil he will eat the food
>> and
>> leave the pill in a obvious place ( I watched him do it)"
>>
>> He will eat the food and spit the pill out or take the pill and leave
> it
>> right in front of me with a look of whatcha you going to do now. He is
> a
>> little devil but he makes life interesting the chase is part of life :-)
>>
>
> No, NMR. I am not talking about hiding it in his food. You feed him his
> wet food, then you wait until he has had a bite or two and pill him. If he
> is
> like my cat he will swallow the pill without a hassle so he can get to the
> food.
>
>

Phil P.
December 5th 05, 11:08 AM
> wrote in message
...
> All,
>
> Well we got our first couple of doses of Tapazole into the kitty. I
> found a drug store that had a couple of gel capsules on hand and it
> helped the process. I only have a few as they are absolutely
> impossible to find. I found one drugstore that would order them for
> me, but it will be a couple of days. My wife will be stuck pilling
> capsuleless for a day or two as I will be away.
>
> Rob

Try to drop the pill as far back as possible without it touching the tongue.
You might want to wash the pill down with tuna water in an oral syringe- it
will help mask the taste until you get the gelcaps. You should still follow
the pill with water or canned food even after you get the gelcaps to make
sure the pill clears the esophagus.

Check out my site:

http://www.maxshouse.com/Medicating_Your_Cat.htm

Phil

December 5th 05, 12:35 PM
On Mon, 05 Dec 2005 11:08:18 GMT, "Phil P." >
wrote:

>
> wrote in message
...
>> All,
>>
>> Well we got our first couple of doses of Tapazole into the kitty. I
>> found a drug store that had a couple of gel capsules on hand and it
>> helped the process. I only have a few as they are absolutely
>> impossible to find. I found one drugstore that would order them for
>> me, but it will be a couple of days. My wife will be stuck pilling
>> capsuleless for a day or two as I will be away.
>>
>> Rob
>
>Try to drop the pill as far back as possible without it touching the tongue.
>You might want to wash the pill down with tuna water in an oral syringe- it
>will help mask the taste until you get the gelcaps. You should still follow
>the pill with water or canned food even after you get the gelcaps to make
>sure the pill clears the esophagus.

Phil,

Hopefully the new capsules will be in today or tomorrow. In the
meantime, I was able to find some No1 capsules and only use the top
portion and pinch it shut. We always follow up with some wet food as
a reward and to ensure she's not pocketing the meds.

Thanks,

Rob
>
>Check out my site:
>
>http://www.maxshouse.com/Medicating_Your_Cat.htm
>
>Phil
>
>

Cathy
December 27th 05, 06:13 PM
Rob,

The tapazole can also made into a liquid formula with different
flavors. My cat was recently diagnosed (last week) and so far has
gobbled his liver flavored tapazole with a little wet food with no
problem. The only thing I worry about is whether or not he will
continue to eat his laced food once the meds kick in and his appetite
isn't as ravenous.

Good luck,
Cathy

December 27th 05, 07:26 PM
On 27 Dec 2005 10:13:06 -0800, "Cathy" > wrote:

>Rob,
>
>The tapazole can also made into a liquid formula with different
>flavors. My cat was recently diagnosed (last week) and so far has
>gobbled his liver flavored tapazole with a little wet food with no
>problem. The only thing I worry about is whether or not he will
>continue to eat his laced food once the meds kick in and his appetite
>isn't as ravenous.
>

Cathy,

How much more did it cost than in pill form? The poor little girl has
been through so much this last, I want to minimize trauma if it's
affordable.

>Good luck,
>Cathy

Thanks so much,
Rob

Cathy
December 28th 05, 03:41 AM
It sounds like the liquid is more expensive than the pills... I paid
$48 for this bottle that I really don't know how long it will last
since I've only been giving it for one week. He gets 1ML per day and
at this rate, it looks like the bottle *may* last only 3 or 4 weeks. I
didn't think to ask. I was ready to just go for the radiation
treatment because I didn't want to stress him out trying to give him a
pill every day and I honestly didn't think he would like the liquid but
so far so good. My vet recommended I try the meds first and recheck
his T4 in 3 or 4 weeks. He did say that if I decided to do the
radiation, then they would have to do an x-ray and some other tests to
make sure he didn't have any underlying problems with his kidneys.

I think if I continue with the meds, I will try to find another less
expensive source, i.e. a different pharmacy.

December 28th 05, 12:06 PM
On 27 Dec 2005 19:41:49 -0800, "Cathy" > wrote:

>It sounds like the liquid is more expensive than the pills... I paid
>$48 for this bottle that I really don't know how long it will last
>since I've only been giving it for one week. He gets 1ML per day and
>at this rate, it looks like the bottle *may* last only 3 or 4 weeks. I
>didn't think to ask. I was ready to just go for the radiation
>treatment because I didn't want to stress him out trying to give him a
>pill every day and I honestly didn't think he would like the liquid but
>so far so good. My vet recommended I try the meds first and recheck
>his T4 in 3 or 4 weeks. He did say that if I decided to do the
>radiation, then they would have to do an x-ray and some other tests to
>make sure he didn't have any underlying problems with his kidneys.
>
>I think if I continue with the meds, I will try to find another less
>expensive source, i.e. a different pharmacy.

Cathy,

Thanks. Let me know if you find a better price out there. We've had
some better success popping the pill just after she wakes up.

Rob