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View Full Version : Looking for a vet (in Chicagoland) able to treat felinehypothyroidism


Alice[_2_]
December 12th 07, 09:36 PM
Yes, that is hypOthyroidism not hypERthyroidism. Not that vets know
how to deal with hyper-t either... But I need the first one... A vet
who suffers from thyroid issues himself/herself is also OK. I am
getting a little desperate... Please help. I am willing to travel 2
hours from home if I can find a good vet...

yngver
December 12th 07, 09:51 PM
On Dec 12, 3:36 pm, Alice > wrote:
> Yes, that is hypOthyroidism not hypERthyroidism. Not that vets know
> how to deal with hyper-t either... But I need the first one... A vet
> who suffers from thyroid issues himself/herself is also OK. I am
> getting a little desperate... Please help. I am willing to travel 2
> hours from home if I can find a good vet...

I don't know specifically about hypothyroidism, but two of the top cat
clinics in Chicago are the Chicago Cat Clinic on Devon and the Chicago
Cat Hospital on Irving. If anyone could treat the condition, I imagine
they could.
-yngver

Alice[_2_]
December 12th 07, 10:40 PM
> I don't know specifically about hypothyroidism, but two of the top cat
> clinics in Chicago are the Chicago Cat Clinic on Devon

My cat was their patient when dr. Stein was still alive, and then I
left for the second clinic you listed (dr. Currigan's clinic).

No. They are of no help.

I am actually hoping that maybe some excellent dog vet experienced in
canine hypo-t (and who goes above and beyond the call of duty while
treating it) could be of help?

A.

Alice[_2_]
December 13th 07, 12:53 AM
I have just thought of another possibility: a vet who trained in dr.
Plechner's protocol might be of help as well.

A.

mariib via CatKB.com
December 13th 07, 01:56 AM
Alice wrote:
>Yes, that is hypOthyroidism not hypERthyroidism. Not that vets know
>how to deal with hyper-t either... But I need the first one... A vet
>who suffers from thyroid issues himself/herself is also OK. I am
>getting a little desperate... Please help. I am willing to travel 2
>hours from home if I can find a good vet...

I'm not quite sure what the problem is. You're saying there are no vets in
Chicago familiar with thyroid diseases? This is hard to believe.
Hypothyroidism is not such a difficult disease either to diagnose or to treat,
in fact it's rather straightforward. My sister has been hypothyroid (since
surgery) for the past 10 years & has been on thyroxine (thyroid hormone)
since. She's monitored once a year & has been stable since the first few
months of treatment. I used to work in a research Endocrinology lab for a
number of years doing various thyroid hormone tests & this was (ouch!) 30
years ago. Actually at that time, we were running the thyoid-screening
program on newborn (human) babies for all of the province of Ontario. In
animals, diagnosis & testing for hypothyroidism shouldn't be a problem, the
symptoms are fairly standard, & treatment is oral medication of thyroid
hormone once or twice daily. The dose will start out adjusted to your cat's
weight & will be monitored frequently at the beginning by checking the T4
levels. Depending on the results, the dose will continue to be adjusted until
stabilized & from then on, your cat should only need to be monitored once or
twice a year. Sorry to sound so surprised but if a vet can treat
hyperthyroidism, & hyperthyroidism is fairly common in cats (over the years
I've had 2 cats that were treated for it), it shouldn't be such a stretch for
them to be able to (research if necessary &) treat hypo-
Good luck! M.

--
Message posted via CatKB.com
http://www.catkb.com/Uwe/Forums.aspx/cat-health/200712/1

Alice[_2_]
December 13th 07, 04:31 AM
> Hypothyroidism is not such a difficult disease either to diagnose or to treat,
> in fact it's rather straightforward.

There is no TSH assay available for cats so it is not easily diagnosed
in cats at all. In fact, there is no way to diagnose it properly.

There is no rT3 assay for cats either (so there can't be a
differentiation made between ESS and secondary hypo-t). TSH (canine
assay is used for that) moves immediately downwards the moment a tiny
thyroid supplement is given (so it is useless to see if the hypo-t is
retreating). T3 assays are not considered for calibration of euthyroid
because as one feline specialist (I kid you not) told me, "in cats T4
is the active hormone". And the sun sets in the East. Oh and there is
the medieval concept of 'false hypo-t" - don't try to explain that
without falling on your face repeatedly - there is no way to do
that... doesn't stop the 'feline specialists'.

There are few small animal endocrine specialists in this country, none
of them in Chicago, none of them in the nearby veterinary schools,
where endocrine disorders are treated by internists. There is no
endocrinologist who specializes exclusively in cats (except for
Peterson, who deals exclusively in feline hypERthyroidism). The
closest specialist in Chicago is a ...radiologist, who wrote Ph.D. on
how to treat feline hyper-t with I-131 (radioiodine). Hypo-t is
considered rare in cats (how would we know without TSH assay?), hyper-
t is an epidemic we don't know how to prevent and barely know how to
treat (3 meds available, one not used ever, and one with severe side
effects; I-131 treatment or surgery not good for renal patients, which
is 30% cases because that's how many cats present with CRF at the time
they present with hyper-t)... And that is the reality. So sorry to
disappoint. Believe me, I am not happy about it myself. But that is
what I have to deal with. Hence my post.

Oh, and I respectfully disagree that hypo-t is a straightforward
disease in humans. Having worked with many thyroid patients and having
been cursed with this issue in the family, I can assure you - nothing
is easy about thyroid. Nothing. There is a very good forum for thyroid
patients on yahoo groups, called simply Thyroid (your sister, even if
she thinks she does not need it now, will need it in the future - sick
thyroid always finds a way to get you down...), it was started by Mary
Shomon, who is probably the most outspoken thyroid patient in USA, and
thank God for that... Or we would still be dealing with old human
assay for TSH according to which my mom was NOT hypo-t after I-131
treatment, despite severe symptoms. She was also denied treatment (for
entire year) like my cat is today. It was the activity of the patients
that made the medicine reconsider TSH assay. And it is up for revision
again. So, no, nothing is easy about thyroid. Nothing.


Alice

Alice[_2_]
December 13th 07, 04:55 AM
On Dec 12, 8:26 pm, "Matthew" > wrote:
> My cat was just diagnosed with this. I can't believe you can't find as vet
> to treat this. Good vets are hard to find but my vet is training newbie and
> one fresh out of vet school new how to deal with it.
>

Matthew, if you had no problem diagnosing it then it is feline hypER-t
you're talking about, not hypO-t.

There are very few described cases of feline congenital hypO-t,
usually they are juvenile. There were no adult cases of hypo-t
described in cats until recently. Cats have very stable thyroid. Or
'had', until we started messing with their food.

There is some evidence that before hyper-t sets in in cats (when
adenoma causing it is not toxic yet, when it is only developing due to
presence of varied thyroid disruptors, like soy and toxic chemicals
present in food), that at that time cats are hypo-t but... we can't
test for that, there is no way to prove this theory... We see the
thyroid issue only when thyrotoxicity is already present in the blood
serum, i.e., when hypER-t is present.

Most adult hypo-t cases present after radioiodine treatment of
hypERthyroidism. (In Europe similarly after thyroidectomy, although
that can also be associated by hypocalcemia due to damage to the
parathyroids.) Also, after I-131 treatment for thyroid cancer. A
significant portion of the thyroid is destroyed (the part that was
taken over by the toxic adenoma, or whole thyroid in the case of
thyroid cancer). And the tissue that is left in the gland is just not
enough to produce normal levels of thyroid hormones, that makes
pituitary release extra TSH (which we can't see, because we can't
measure it), that in turn turns on the entire endocrine system and all
sorts of things go out of balance... That is the case with my cat. He
underwent I-131 treatment and has at present max 30% of thyroid
functioning. Hence hypOthyroidism.


A.

mariib via CatKB.com
December 13th 07, 06:56 AM
Alice wrote:
>There is no TSH assay available for cats so it is not easily diagnosed
>in cats at all. In fact, there is no way to diagnose it properly.
>
>There is no rT3 assay for cats either (so there can't be a
>differentiation made between ESS and secondary hypo-t). TSH (canine
>assay is used for that) moves immediately downwards the moment a tiny
>thyroid supplement is given (so it is useless to see if the hypo-t is
>retreating). T3 assays are not considered for calibration of euthyroid
>because as one feline specialist (I kid you not) told me, "in cats T4
>is the active hormone". And the sun sets in the East. Oh and there is
>the medieval concept of 'false hypo-t" - don't try to explain that
>without falling on your face repeatedly - there is no way to do
>that... doesn't stop the 'feline specialists'.
>
>There are few small animal endocrine specialists in this country, none
>of them in Chicago, none of them in the nearby veterinary schools,
>where endocrine disorders are treated by internists. There is no
>endocrinologist who specializes exclusively in cats (except for
>Peterson, who deals exclusively in feline hypERthyroidism). The
>closest specialist in Chicago is a ...radiologist, who wrote Ph.D. on
>how to treat feline hyper-t with I-131 (radioiodine). Hypo-t is
>considered rare in cats (how would we know without TSH assay?), hyper-
>t is an epidemic we don't know how to prevent and barely know how to
>treat (3 meds available, one not used ever, and one with severe side
>effects; I-131 treatment or surgery not good for renal patients, which
>is 30% cases because that's how many cats present with CRF at the time
>they present with hyper-t)... And that is the reality. So sorry to
>disappoint. Believe me, I am not happy about it myself. But that is
>what I have to deal with. Hence my post.
>
>Oh, and I respectfully disagree that hypo-t is a straightforward
>disease in humans. Having worked with many thyroid patients and having
>been cursed with this issue in the family, I can assure you - nothing
>is easy about thyroid. Nothing. There is a very good forum for thyroid
>patients on yahoo groups, called simply Thyroid (your sister, even if
>she thinks she does not need it now, will need it in the future - sick
>thyroid always finds a way to get you down...), it was started by Mary
>Shomon, who is probably the most outspoken thyroid patient in USA, and
>thank God for that... Or we would still be dealing with old human
>assay for TSH according to which my mom was NOT hypo-t after I-131
>treatment, despite severe symptoms. She was also denied treatment (for
>entire year) like my cat is today. It was the activity of the patients
>that made the medicine reconsider TSH assay. And it is up for revision
>again. So, no, nothing is easy about thyroid. Nothing.
>
>Alice

Have you been on the MSU website & seen what they have to say? specifically
points 3 & 4 re the TSH assay & cats? or perhaps spoken to someone there? My
not-so-beloved late ex- trained & did post-grad work there many years ago.
http://animalhealth.msu.edu/FAQ/Endocrinology/Thyroid_Feline.php

Again, as far as human thyroid problems, my sister has been problem-free the
past 10 years on thyroxine. My mother, now almost 87 years old had her
thyroid removed in 1949, that's more than 50 years ago & has been thyroid
problem-free all these years, so I think your statements are somewhat
dogmatic & too absolute. Ironic that I used to (hands on) do very large
radioimmunoassay runs of TSH, T3, T4 etc - probably 200 patients or more in
duplicate each assay in a special research endocrine lab for 4-5 years in the
mid-late 70's. Repetitive work, but rewarding given the value of the newborn
thyroid screening in detecting hypothyroidism & preventing the subsequent
mental retardation.
M.

--
Message posted via CatKB.com
http://www.catkb.com/Uwe/Forums.aspx/cat-health/200712/1

Alice[_2_]
December 13th 07, 08:02 PM
> Here in Florida university of Florida in Gainesville has a vet specialty
> schools so does the university of Kentucky. My Rumble has been to both. I
> would call the local university and see if they can help.

The veterinary teaching hospitals in Urbana and Madison (the nearest
universities with veterinary schools) don't have small animal
endocrinologists. Internists treat hyper-t in cats and then they send
the cat to radiology for I-131. The nearest few endos are in ...
Cornell (Mark Peterson among them,without whom we would be putting our
cats to sleep en mass - hyper-t epidemic, but as I said, he
specializes in hyper-t). MSU used to have one but I think no longer...
I have been sending my cat's blood test to dr. Dodds in California and
getting her opinion, but I don't want to ask her to prescribe drugs
based on blood test alone. That would not be fair to her. (I do think
that despite her age - or maybe because of it, she is the most
reliable veterinary endo in this country, the sheer number of cases
she examined exceeds experience of any other endo. And I like her
pragmatic approach - treat first, iron out diagnostic difficulties
later... the damage that is done to the body by insufficient amount of
hormones is happening now, and once it happens, it is done - new
processes are in place and God only knows where it will lead...
cancer? severe metabolic disorder? organ failure?, the effects will be
seen in a year or two but the damage is done NOW, action is
paramount.)

And its not like I don't know how I want to treat him. I just need a
vet who will listen and follow my suggestion. My old vet would, but we
had established a close relationship over the years so she knew she
could trust me and I knew I could trust her. (I have a lead on a vet
who has dealt with multiple hypo-t cases. I'm about to call him...
Keep your fingers crossed!)

> On another note I wonder with the rash of hyperthyroidism being linked to
> the flame retardant chemicals in our carpet and furniture if we won't start
> seeing more of hypothyroidism also
>

The chemical in fire retardant is a goitrogen - a thyroid disruptor.
Meaning (if it is the cause of hyper-t epidemic) it works the
following way: it disrupts the iodine processes in thyroid tissue
causing hypO-t (not enough hormones can be produced), the pituitary as
a result starts to stimulate thyroid to produce more hormones (to
alleviate the deficiency) by producing extra TSH, the thyroid can't do
it (as we established) so the tissue swells up (initially
inflammation), and something changes within the enlarged cells - we
have a new process that is physical, crossover from the chemical realm
- and suddenly the thyroid can produce hormones independently from the
outside stimulation and it does immediately. And we have toxic thyroid
hormone levels in the body. In a sense the hyper-t is the body's
resolution to the problem that the thyroid disruptor created (hypo-t).
That's one theory anyway and we can't test it because we don't have a
reliable fTSH assay. But if it is true, we ARE seeing more hypo-t
cases.

It is more likely that we will be seeing more hypo-t cases due to
increased number of diabetes in cats (this particular disease in an
obligatory carnivore is particularly perverse... imo).

But the bottom line is: don't feed thyroid disruptors to the cat. And
that means don't feed soy. I find it in all commercial foods these
days that aren't from the 'top shelf'. It is utterly insane.


A.

Alice[_2_]
December 13th 07, 08:03 PM
> Have you been on the MSU website & seen what they have to say? specifically
> points 3 & 4 re the TSH assay & cats? or perhaps spoken to someone there?

I know of MSU testing. The canine TSH assay is sensitive in 75% dog
cases. Worse than that - in some cases - it can provide false readings
(the TSH can be normal and the cat/dog can be still hypo-). The
sensitivity of this test is less than the sensitivity of the same test
in humans, and in humans that test leaves a lot to be desired. And
despite of what MSU says, we don't know how valid it is in cats. We
don't test routinely for TSH in cats. The efforts to establish fTSH
assay failed repeatedly (studies proved to be inconclusive). If we
knew we would be much closer to resolving the epidemic of hyper-t in
cats. Diagnostically speaking we can't move forward with any theories
that we have on feline autonomous (toxic) adenoma until we can measure
what happens to the thyroid prior to its toxicity. But we can't do
that - the measurements provided by cTSH in cats are inconclusive. MSU
is marketing their product on their website that is why they say what
they say. Reality is much different.

MSU takes about 2 months to get the sample analyzed by experts and
send it back. Meanwhile you wait. (I am not kidding you, my neighbor's
dog got sick and they sent the test to MSU, then they got tired of
waiting for the results and started supplementation, finally the
results came back - negative for hypo-t, but the dog was doing better,
lost the bold patches, so they continued supplementation...). This is
by no means a good solution. Dr. Dodds proposes simply to try T4
supplementation in iffy cases and see if it works (that makes her, the
top endocrinologist in the country, the mother of the science, a
pariah in the medical community - when you're her age you stop caring,
I love women at that age...). Instead of going thru the nonsense of
testing and waiting and at the end having answer that if it is
negative may be doubtful. But dr. Dodds is in California and I am in
Illinois. And lets remember that my cat's total T4 is still within the
normal range. You can't discuss with vets high euthyroid cases because
they don't know what that is. Feline specialists don't even know how
to read T3 levels in comparison to T4 - I had to teach my old vet
that... And she was brilliant... (Too bad she is no longer here in
Chicago.)

My cat is symptomatic of hypo-t, and the symptoms are dismissed
because of his age. The point is - I don't need him diagnosed. It
makes sense that with his diminished thyroid he would be hypo-t. He's
symptomatic of it. As far as anyone can see he IS hypo-t. The problem
is he's a cat, so he gets dismissed. All I need is a vet who will
listen to me and treat him. And not treat him with thyroxine because
in his case T4 will not be enough.

I read recently a paper on diagnostic differentials of hypo-t in cats
(btw, the publications on hypo-t in cats are scarce, 5-10 in the
entire history of medicine?) in which the author spends half a page on
differentiating ESS from secondary hypo-t. It is a fascinating read,
because ...well, ESS (euthyroid sick syndrome) is NOT treated in cats.
So basically the entire point of the differentiation is to find a way
to ...not give the thyroid supplement. (T3 would have to be
supplemented for ESS, that's never considered in cats, I have few
friends who in ESS supplement T4 and that's only because they begged
their vets with tears in their eyes to try it... I kid you not... ESS
shows up in many chronic cases and these become routine these
days...).


> Ironic that I used to (hands on) do very large
> radioimmunoassay runs of TSH, T3, T4 etc - probably 200 patients or more in
> duplicate each assay in a special research endocrine lab for 4-5 years in the
> mid-late 70's.

In the late 70s human TSH assay had different range than it has now.
And it is up for revision again, btw.

My mom underwent thyroidectomy as well. It didn't work. Then she had
I-131 done. It worked. Then she became hypo with severe symptoms (in
medicine hypo-t cases are considered a success in I-131 or surgery
treatment... studies showing the rate of hypo-t occurrences are not
common and mostly retrospective, which doesn't give a good view). She
begged multiple doctors for thyroid supplement. They refused. It
lasted a year, meanwhile she developed huge BP levels and increased
number of platelets (stroke! - and yes, the differentials were
excluded like bone cancer - anyway she's alive today so it wasn't any
cancer)... In critical condition she was taken to the hospital where a
new and very young endo took a chance and prescribed her the
supplement. She got better within days. That's after a year of hell.
THis all happened over 30 years ago... Since she lives in Europe and
thyroxine supplemnt alone causes her to have bipolar like symptoms she
has to import Armour from the US (the big pharmas in EU managed to ban
Armour for a synthetic version, sort of like you can't get carbimazole
in the States and methimazole in EU... but there is no monopoly in
pharma..., no... ). And she is not an exception of the rule. She
simply has Grave's. These and similar problems are routine for thyroid
autoimmune sufferers. There is some evidence that surgery is better
for Grave's... if it works... But in many cases it doesn't. And it is
a mute point because in US thyroidectomy is not a preferred method of
treatment.

Yes, the medicine has made progress in combating thyroid disorders. In
1990s Switzerland implemented mandatory iodine supplementation and
pushed the goiter belt out of their territories. It was so impressive
that by the 1920 (right after the WWI) all countries in Europe
followed. By that time the thyroid surgery was routine (a doc got a
Nobel Prize for it, if I remember correctly - he operated on Lenin's
wife, btw!). In 1940 we found a way to utilize radioactive compounds
equipped with iodine bullets to eradicate the sick thyroid tissue.
That does not change the fact that the really good treatment for
thyroid disorders continues to elude us. Danish authorities instituted
(as the last country in Europe) mandatory supplementation of iodine in
1990s. Well, what followed was an increase in thyroid disorders.
Significant increase. We don't understand why.

If your family members didn't suffer much from their disorders then
you guys are a) lucky or b) they don't tell you how they feel. With
hypo-t the first thing that happens is a drop in IQ. And that means
diminished awareness. Often enough T4 supplementation alone (keeping
the hormones in normal range) does not adjust it. In my mom who has
high euthyroid the symptoms were extremely visible. During that year
off meds she became aggressive, mean, constantly angry,
inarticulate... We called that her Mr. Hyde period. My mom teaches
advanced economy (she is a mathematician by training) in a known
university. She didn't get there by being inarticulate. As she finally
got on Armour (which is not a med for everyone, but one needs that
choice!) her erudition returned, and I swear it returned that same day
and that's why we noticed... That is why I suggested that you get
your sister on line with other hypo-t sufferers. There are lot of
symptoms that one does not connect with thyroid and only networking
with other patients allows you to see that there may be a connection.
If you can connect it - you can treat it. Otherwise you are just going
to dismiss it to some other causes, like old age... Similarly to what
happens to my cat.


A.

P.S.: Oprah had a show on thyroid (well, she just mentioned her
thyroid issue at the beginning of the show), her online forum had to
be reset afterwards. The thyroid patients (older women who watch
Oprah) shut it down, upset with the treatment they got. There is more
to thyroid than you think. And may you never find out...

December 14th 07, 08:33 PM
Cornell Vet School has a consultation service phone/fax for
feline issues. There is a reasonable charge. I used the
service when I had a kitten with FIP and thought they
were very helpful. I'm sure they have had experience with
hypothyroidism and may well have an feline endocrinologist
on staff. Take a look at :

http://www.vet.cornell.edu/fhc/camuti.htm
http://www.vet.cornell.edu/fhc/contact.htm

Good Luck,
Debbie


On Dec 12, 4:36 pm, Alice > wrote:
> Yes, that is hypOthyroidism not hypERthyroidism. Not that vets know
> how to deal with hyper-t either... But I need the first one... A vet
> who suffers from thyroid issues himself/herself is also OK. I am
> getting a little desperate... Please help. I am willing to travel 2
> hours from home if I can find a good vet...