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Hyperthyroidism v. kidney failure
Last January I posted regarding our almost-16 years old cat, Toby,
being diagnosed with hyperthyroidism. His T4 reading was 287 at that time, his weight had dropped from 6kg to 3.5kg and his appetite was poor. My vet prescribed Felimazole initially, 1 tablet twice a day and after two weeks his appetite had improved and he had gained some weight. Two weeks further on, his weight had risen further and his appetite was still reasonably good. However, he was drinking a phenomenal amount and his urine output was copious. I also noticed that he seemed cold and the inside of his mouth was very pale. The vet said that he was anaemic and further blood tests showed that his T4 had dropped to 5 and his kidney enzymes had increased. Felimazole was reduced to 1 tablet a day. He started to feel warmer and his mouth pinked up, although his appetite dropped back again. His drinking and urination returned to normal. One week later he had a repeat of the blood tests which showed that his T4 had risen to 88 but his kidney enzymes were still high. As he seemed especially sensitive to the Felimazole, he was prescribed Neo-Mercazole instead at a very low dosage of half a tablet twice a day. The vet also recommended putting him on a special kidney diet. After his second dose of Neo-Mercazole he vomitted (something very rare with Toby) and he would not eat the new food. The vet said to stop giving him the Neo-Mercazole, and, as not eating was very bad for his kidneys, let him go back to his normal diet. Two weeks later his weight had dropped again and his appetite was poor. His heart rate was high at about 184 beats per minute while resting, although at the vet clinic it climbed to 256. So the vet gave him an anabolic steroid injection to boost his appetite, plus prescribing Fortekor (which is not licensed in the USA but contains - if that`s the right word - benazepril) to help his kidneys and also increase his appetite. At the same time, we were to resume giving Toby the Neo-Mercazole at the same rate as before. This was two days ago and until this afternoon he hadn`t had a bowel movement and his appetite had dropped even further. Today the vet advised me to stop the Neo-Mercazole but to continue with the Fortekor. I do not know if not giving him the Neo-Mercazole made the difference, but this evening he had a very good bowel clear out and his appetite was a little better, although he is not eating sufficient to maintain his body weight even without the complication of the hyperthyroidism. So, we have a dilemma : if we continue to treat his hyperthyroidism his kidneys will pack up, but if we do not treat the hyperthyroidism he will develop heart failure, or perhaps have a stroke. I get the impression that the vet has not come across such a difficult cat to treat for hyper-t and is struggling to find a regimen that will help without compromising his kidney function. If anyone has any hints, tips, or clues as to what we could try next, I would be most grateful. Many thanks Kate |
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Hi there,
I don't have any suggestions, but I am curious to see what people have to say on this matter. My brother has a hyperT, chronic renal failure cat. Although we have decided not to treat the hyperT because her T4 hasn't gone higher than 68 (high normal is 52), and she seems to be fine and has always had a good appetite. Not treating the hyperT has worked for her so far, but it sounds like your kittys thyroid problem is much worse. The special diet also seems to be controlling the urea/creatinine levels, so we are lucky so far. Hope your kitty gets well soon, Kelly "Kate" wrote in message ... Last January I posted regarding our almost-16 years old cat, Toby, being diagnosed with hyperthyroidism. His T4 reading was 287 at that time, his weight had dropped from 6kg to 3.5kg and his appetite was poor. My vet prescribed Felimazole initially, 1 tablet twice a day and after two weeks his appetite had improved and he had gained some weight. Two weeks further on, his weight had risen further and his appetite was still reasonably good. However, he was drinking a phenomenal amount and his urine output was copious. I also noticed that he seemed cold and the inside of his mouth was very pale. The vet said that he was anaemic and further blood tests showed that his T4 had dropped to 5 and his kidney enzymes had increased. Felimazole was reduced to 1 tablet a day. He started to feel warmer and his mouth pinked up, although his appetite dropped back again. His drinking and urination returned to normal. One week later he had a repeat of the blood tests which showed that his T4 had risen to 88 but his kidney enzymes were still high. As he seemed especially sensitive to the Felimazole, he was prescribed Neo-Mercazole instead at a very low dosage of half a tablet twice a day. The vet also recommended putting him on a special kidney diet. After his second dose of Neo-Mercazole he vomitted (something very rare with Toby) and he would not eat the new food. The vet said to stop giving him the Neo-Mercazole, and, as not eating was very bad for his kidneys, let him go back to his normal diet. Two weeks later his weight had dropped again and his appetite was poor. His heart rate was high at about 184 beats per minute while resting, although at the vet clinic it climbed to 256. So the vet gave him an anabolic steroid injection to boost his appetite, plus prescribing Fortekor (which is not licensed in the USA but contains - if that`s the right word - benazepril) to help his kidneys and also increase his appetite. At the same time, we were to resume giving Toby the Neo-Mercazole at the same rate as before. This was two days ago and until this afternoon he hadn`t had a bowel movement and his appetite had dropped even further. Today the vet advised me to stop the Neo-Mercazole but to continue with the Fortekor. I do not know if not giving him the Neo-Mercazole made the difference, but this evening he had a very good bowel clear out and his appetite was a little better, although he is not eating sufficient to maintain his body weight even without the complication of the hyperthyroidism. So, we have a dilemma : if we continue to treat his hyperthyroidism his kidneys will pack up, but if we do not treat the hyperthyroidism he will develop heart failure, or perhaps have a stroke. I get the impression that the vet has not come across such a difficult cat to treat for hyper-t and is struggling to find a regimen that will help without compromising his kidney function. If anyone has any hints, tips, or clues as to what we could try next, I would be most grateful. Many thanks Kate |
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"Kate" wrote in message ... Last January I posted regarding our almost-16 years old cat, Toby, being diagnosed with hyperthyroidism. His T4 reading was 287 at that time, his weight had dropped from 6kg to 3.5kg and his appetite was poor. My vet prescribed Felimazole initially, 1 tablet twice a day and after two weeks his appetite had improved and he had gained some weight. Two weeks further on, his weight had risen further and his appetite was still reasonably good. However, he was drinking a phenomenal amount and his urine output was copious. I also noticed that he seemed cold and the inside of his mouth was very pale. The vet said that he was anaemic and further blood tests showed that his T4 had dropped to 5 and his kidney enzymes had increased. Felimazole was reduced to 1 tablet a day. He started to feel warmer and his mouth pinked up, although his appetite dropped back again. His drinking and urination returned to normal. One week later he had a repeat of the blood tests which showed that his T4 had risen to 88 but his kidney enzymes were still high. As he seemed especially sensitive to the Felimazole, he was prescribed Neo-Mercazole instead at a very low dosage of half a tablet twice a day. The vet also recommended putting him on a special kidney diet. After his second dose of Neo-Mercazole he vomitted (something very rare with Toby) and he would not eat the new food. The vet said to stop giving him the Neo-Mercazole, and, as not eating was very bad for his kidneys, let him go back to his normal diet. Two weeks later his weight had dropped again and his appetite was poor. His heart rate was high at about 184 beats per minute while resting, although at the vet clinic it climbed to 256. So the vet gave him an anabolic steroid injection to boost his appetite, plus prescribing Fortekor (which is not licensed in the USA but contains - if that`s the right word - benazepril) to help his kidneys and also increase his appetite. At the same time, we were to resume giving Toby the Neo-Mercazole at the same rate as before. This was two days ago and until this afternoon he hadn`t had a bowel movement and his appetite had dropped even further. Today the vet advised me to stop the Neo-Mercazole but to continue with the Fortekor. I do not know if not giving him the Neo-Mercazole made the difference, but this evening he had a very good bowel clear out and his appetite was a little better, although he is not eating sufficient to maintain his body weight even without the complication of the hyperthyroidism. So, we have a dilemma : if we continue to treat his hyperthyroidism his kidneys will pack up, but if we do not treat the hyperthyroidism he will develop heart failure, or perhaps have a stroke. I get the impression that the vet has not come across such a difficult cat to treat for hyper-t and is struggling to find a regimen that will help without compromising his kidney function. If anyone has any hints, tips, or clues as to what we could try next, I would be most grateful. Kate, Hyperthyroidism with underlying CRF is indeed a dilemma. The only way I've any sucess in situations like yours is to restart methimazole therapy at a very low sub-therapeutic dose - 1.25 mg - once a day for a week, then gradually increase the dose and times until I struck a delicate balance between an "acceptable" level of hyperthyroidism and an "acceptable" level of azotemia. Sometimes, this can be difficult - but it can be done. Starting therapy with very low doses followed by very gradual increases will also greatly minimize adverse effects because his body will have a chance to slowly adapt to the medication. You can also have carbimazole reformulated into a flavored suspension or into a gel that you apply to the inside of his ear flap. Just be sure to wear exam gloves so you don't absorb the medication. You can control the cardiovascular effects of hyperthyroidism with a selective beta 1-adrenergic blocking agent such as Atenolol -- but this drug can be risky in a cat with CRF and will take a very careful assessment of the risk-to-benefit ratio. In a few situations I had no choice - and fortunately no problems. However blood glucose must be monitored very closely. Best of luck, Phil |
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"Phil P." wrote in message ... "Kate" wrote in message ... Last January I posted regarding our almost-16 years old cat, Toby, being diagnosed with hyperthyroidism. His T4 reading was 287 at that time, his weight had dropped from 6kg to 3.5kg and his appetite was poor. My vet prescribed Felimazole initially, 1 tablet twice a day and after two weeks his appetite had improved and he had gained some weight. Two weeks further on, his weight had risen further and his appetite was still reasonably good. However, he was drinking a phenomenal amount and his urine output was copious. I also noticed that he seemed cold and the inside of his mouth was very pale. The vet said that he was anaemic and further blood tests showed that his T4 had dropped to 5 and his kidney enzymes had increased. Felimazole was reduced to 1 tablet a day. He started to feel warmer and his mouth pinked up, although his appetite dropped back again. His drinking and urination returned to normal. One week later he had a repeat of the blood tests which showed that his T4 had risen to 88 but his kidney enzymes were still high. As he seemed especially sensitive to the Felimazole, he was prescribed Neo-Mercazole instead at a very low dosage of half a tablet twice a day. The vet also recommended putting him on a special kidney diet. After his second dose of Neo-Mercazole he vomitted (something very rare with Toby) and he would not eat the new food. The vet said to stop giving him the Neo-Mercazole, and, as not eating was very bad for his kidneys, let him go back to his normal diet. Two weeks later his weight had dropped again and his appetite was poor. His heart rate was high at about 184 beats per minute while resting, although at the vet clinic it climbed to 256. So the vet gave him an anabolic steroid injection to boost his appetite, plus prescribing Fortekor (which is not licensed in the USA but contains - if that`s the right word - benazepril) to help his kidneys and also increase his appetite. At the same time, we were to resume giving Toby the Neo-Mercazole at the same rate as before. This was two days ago and until this afternoon he hadn`t had a bowel movement and his appetite had dropped even further. Today the vet advised me to stop the Neo-Mercazole but to continue with the Fortekor. I do not know if not giving him the Neo-Mercazole made the difference, but this evening he had a very good bowel clear out and his appetite was a little better, although he is not eating sufficient to maintain his body weight even without the complication of the hyperthyroidism. So, we have a dilemma : if we continue to treat his hyperthyroidism his kidneys will pack up, but if we do not treat the hyperthyroidism he will develop heart failure, or perhaps have a stroke. I get the impression that the vet has not come across such a difficult cat to treat for hyper-t and is struggling to find a regimen that will help without compromising his kidney function. If anyone has any hints, tips, or clues as to what we could try next, I would be most grateful. Kate, Hyperthyroidism with underlying CRF is indeed a dilemma. The only way I've any sucess in situations like yours is to restart methimazole therapy at a very low sub-therapeutic dose - 1.25 mg - once a day for a week, then gradually increase the dose and times until I struck a delicate balance between an "acceptable" level of hyperthyroidism and an "acceptable" level of azotemia. Sometimes, this can be difficult - but it can be done. Starting therapy with very low doses followed by very gradual increases will also greatly minimize adverse effects because his body will have a chance to slowly adapt to the medication. You can also have carbimazole reformulated into a flavored suspension or into a gel that you apply to the inside of his ear flap. Just be sure to wear exam gloves so you don't absorb the medication. You can control the cardiovascular effects of hyperthyroidism with a selective beta 1-adrenergic blocking agent such as Atenolol -- but this drug can be risky in a cat with CRF and will take a very careful assessment of the risk-to-benefit ratio. In a few situations I had no choice - and fortunately no problems. However blood glucose must be monitored very closely. Best of luck, Phil Thank you so much for your help, Phil. I will pass on your recommendations to our vet tomorrow (Monday). The way things have been going lately, I am concerned that the yo-yoing of his blood pressure will do even more damage to his kidneys and/or heart, so a very gradual reduction sounds an excellent idea. I just hope we can get it down soon enough to prevent heart damage, though... BTW, he is an absolute star about taking pills, and his mouth is so huge, I can hardly miss! My thanks again Kate |
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"Kate" wrote in message ... "Phil P." wrote in message ... "Kate" wrote in message ... Last January I posted regarding our almost-16 years old cat, Toby, being diagnosed with hyperthyroidism. His T4 reading was 287 at that time, his weight had dropped from 6kg to 3.5kg and his appetite was poor. My vet prescribed Felimazole initially, 1 tablet twice a day and after two weeks his appetite had improved and he had gained some weight. Two weeks further on, his weight had risen further and his appetite was still reasonably good. However, he was drinking a phenomenal amount and his urine output was copious. I also noticed that he seemed cold and the inside of his mouth was very pale. The vet said that he was anaemic and further blood tests showed that his T4 had dropped to 5 and his kidney enzymes had increased. Felimazole was reduced to 1 tablet a day. He started to feel warmer and his mouth pinked up, although his appetite dropped back again. His drinking and urination returned to normal. One week later he had a repeat of the blood tests which showed that his T4 had risen to 88 but his kidney enzymes were still high. As he seemed especially sensitive to the Felimazole, he was prescribed Neo-Mercazole instead at a very low dosage of half a tablet twice a day. The vet also recommended putting him on a special kidney diet. After his second dose of Neo-Mercazole he vomitted (something very rare with Toby) and he would not eat the new food. The vet said to stop giving him the Neo-Mercazole, and, as not eating was very bad for his kidneys, let him go back to his normal diet. Two weeks later his weight had dropped again and his appetite was poor. His heart rate was high at about 184 beats per minute while resting, although at the vet clinic it climbed to 256. So the vet gave him an anabolic steroid injection to boost his appetite, plus prescribing Fortekor (which is not licensed in the USA but contains - if that`s the right word - benazepril) to help his kidneys and also increase his appetite. At the same time, we were to resume giving Toby the Neo-Mercazole at the same rate as before. This was two days ago and until this afternoon he hadn`t had a bowel movement and his appetite had dropped even further. Today the vet advised me to stop the Neo-Mercazole but to continue with the Fortekor. I do not know if not giving him the Neo-Mercazole made the difference, but this evening he had a very good bowel clear out and his appetite was a little better, although he is not eating sufficient to maintain his body weight even without the complication of the hyperthyroidism. So, we have a dilemma : if we continue to treat his hyperthyroidism his kidneys will pack up, but if we do not treat the hyperthyroidism he will develop heart failure, or perhaps have a stroke. I get the impression that the vet has not come across such a difficult cat to treat for hyper-t and is struggling to find a regimen that will help without compromising his kidney function. If anyone has any hints, tips, or clues as to what we could try next, I would be most grateful. Kate, Hyperthyroidism with underlying CRF is indeed a dilemma. The only way I've any sucess in situations like yours is to restart methimazole therapy at a very low sub-therapeutic dose - 1.25 mg - once a day for a week, then gradually increase the dose and times until I struck a delicate balance between an "acceptable" level of hyperthyroidism and an "acceptable" level of azotemia. Sometimes, this can be difficult - but it can be done. Starting therapy with very low doses followed by very gradual increases will also greatly minimize adverse effects because his body will have a chance to slowly adapt to the medication. You can also have carbimazole reformulated into a flavored suspension or into a gel that you apply to the inside of his ear flap. Just be sure to wear exam gloves so you don't absorb the medication. You can control the cardiovascular effects of hyperthyroidism with a selective beta 1-adrenergic blocking agent such as Atenolol -- but this drug can be risky in a cat with CRF and will take a very careful assessment of the risk-to-benefit ratio. In a few situations I had no choice - and fortunately no problems. However blood glucose must be monitored very closely. Best of luck, Phil Thank you so much for your help, Phil. I will pass on your recommendations to our vet tomorrow (Monday). The way things have been going lately, I am concerned that the yo-yoing of his blood pressure will do even more damage to his kidneys and/or heart, so a very gradual reduction sounds an excellent idea. I just hope we can get it down soon enough to prevent heart damage, though... Don't be too worried, Kate. Many hyperthyroid cats develop myocardial hypertrophy that's often confused for hypertrophic cardiomyopathy. Thyrotoxic myocardial hypertrophy often (usually) resolves when hyperthyroidism is brought under control. BTW, he is an absolute star about taking pills, and his mouth is so huge, I can hardly miss! You're *so* lucky! That alone increases his chances *dramatically*! My thanks again Kate Please keep me posted! Best of luck, Phil |
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"Phil P." wrote in message ... Thank you so much for your help, Phil. I will pass on your recommendations to our vet tomorrow (Monday). The way things have been going lately, I am concerned that the yo-yoing of his blood pressure will do even more damage to his kidneys and/or heart, so a very gradual reduction sounds an excellent idea. I just hope we can get it down soon enough to prevent heart damage, though... Don't be too worried, Kate. Many hyperthyroid cats develop myocardial hypertrophy that's often confused for hypertrophic cardiomyopathy. Thyrotoxic myocardial hypertrophy often (usually) resolves when hyperthyroidism is brought under control. BTW, he is an absolute star about taking pills, and his mouth is so huge, I can hardly miss! You're *so* lucky! That alone increases his chances *dramatically*! Please keep me posted! Best of luck, Phil I have started Toby on 1.25mg of methimazole, once a day, but my vet has also been researching and she wonders if his potassium levels might be too low. She would like to test for this, but, unless Toby`s condition deteriorates in the meantime, we are going to leave it for one week to see how he gets on with the low dose of methimazole. Regarding the pill-taking, having had a multi-cat household for more than 25 years, I have had my share of difficult customers. Toby is certainly the easiest to medicate that we have ever had. It may be because I have gained a lot of experience over the years and approach the task with confidence, which is picked up by the cat, or - more likely - that Toby is a great big, soft, dollop! Regards Kate |
#7
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"Kate" wrote in message ... "Phil P." wrote in message ... Thank you so much for your help, Phil. I will pass on your recommendations to our vet tomorrow (Monday). The way things have been going lately, I am concerned that the yo-yoing of his blood pressure will do even more damage to his kidneys and/or heart, so a very gradual reduction sounds an excellent idea. I just hope we can get it down soon enough to prevent heart damage, though... Don't be too worried, Kate. Many hyperthyroid cats develop myocardial hypertrophy that's often confused for hypertrophic cardiomyopathy. Thyrotoxic myocardial hypertrophy often (usually) resolves when hyperthyroidism is brought under control. BTW, he is an absolute star about taking pills, and his mouth is so huge, I can hardly miss! You're *so* lucky! That alone increases his chances *dramatically*! Please keep me posted! Best of luck, Phil I have started Toby on 1.25mg of methimazole, once a day, but my vet has also been researching and she wonders if his potassium levels might be too low. She would like to test for this, but, unless Toby`s condition deteriorates in the meantime, we are going to leave it for one week to see how he gets on with the low dose of methimazole. Regarding the pill-taking, having had a multi-cat household for more than 25 years, I have had my share of difficult customers. Toby is certainly the easiest to medicate that we have ever had. It may be because I have gained a lot of experience over the years and approach the task with confidence, which is picked up by the cat, or - more likely - that Toby is a great big, soft, dollop! Regards Kate Unfortunately, within 12 hours of giving Toby 1.25 mg of methimazole, he vomitted, so it seems that even that tiny dose does not agree with him. As his appetite had dropped even further, the vet prescribed an anti-emetic in case he felt nauseous. Then last Wednesday she took more blood to test for hypokalemia, urea and creatinine. The results showed that he does not have hypokalemia, and both his urea and creatinine were down slightly - still well above normal range, but down nevertheless. As his appetite was still very poor, I changed his food from canned Hill`s Senior plus a/d to Whiskas kitten food. I chose kitten rather than adult food because it is much finer and as Toby does not have any teeth, he rejects coarse food - well, spits it out, in fact! This new diet seems to meet with his approval, and although he is not eating sufficient for his size, at least he is eating. I realise that kitten food is high in protein and it does worry me that it will be bad for his kidneys, but, then, so is not eating. Still, I expect it won`t be long before he goes off the kitten food, and we can try him again on the Hill`s. I shall be speaking to the vet again tomorrow, but it now looks as though his hyperthyroidism cannot be treated without causing kidney failure. Although he is weak and lethargic and presents a pathetic figure, he does not seem depressed or in pain, which is good. I know that the prognosis is poor but will do my very best to help him enjoy what time remains to him. Thank you again for all your advice. Kate |
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"Kate" wrote in message ... "Kate" wrote in message ... "Phil P." wrote in message ... Thank you so much for your help, Phil. I will pass on your recommendations to our vet tomorrow (Monday). The way things have been going lately, I am concerned that the yo-yoing of his blood pressure will do even more damage to his kidneys and/or heart, so a very gradual reduction sounds an excellent idea. I just hope we can get it down soon enough to prevent heart damage, though... Don't be too worried, Kate. Many hyperthyroid cats develop myocardial hypertrophy that's often confused for hypertrophic cardiomyopathy. Thyrotoxic myocardial hypertrophy often (usually) resolves when hyperthyroidism is brought under control. BTW, he is an absolute star about taking pills, and his mouth is so huge, I can hardly miss! You're *so* lucky! That alone increases his chances *dramatically*! Please keep me posted! Best of luck, Phil I have started Toby on 1.25mg of methimazole, once a day, but my vet has also been researching and she wonders if his potassium levels might be too low. She would like to test for this, but, unless Toby`s condition deteriorates in the meantime, we are going to leave it for one week to see how he gets on with the low dose of methimazole. Regarding the pill-taking, having had a multi-cat household for more than 25 years, I have had my share of difficult customers. Toby is certainly the easiest to medicate that we have ever had. It may be because I have gained a lot of experience over the years and approach the task with confidence, which is picked up by the cat, or - more likely - that Toby is a great big, soft, dollop! Regards Kate Unfortunately, within 12 hours of giving Toby 1.25 mg of methimazole, he vomitted, so it seems that even that tiny dose does not agree with him. I've run across this problem a few times with subtherapeutic doses. It might be the taste of methimazole, not the dose, that's making him sick -- its horrible - very bitter - and has been known to make some cats vomit. Ask your pharmacist to compound his methimazole into a flavored suspension solution. Methimazole can also be formulated into a transdermal gel that's applied to the inside of his earflap. Another alternative is crushing the pill to fit inside a gelcap. When you pill him, do you drop the pill into his laryngopharynx so that he doesn't smell or taste it and also so it doesn't begin to dissolve in his mouth? http://www.maxshouse.com/Medicating_Your_Cat.htm As his appetite had dropped even further, the vet prescribed an anti-emetic in case he felt nauseous. Try the flavored suspension or transdermal gel -- I'd bet its the taste that's making him nauseous - it would make me nauseous! Then last Wednesday she took more blood to test for hypokalemia, urea and creatinine. The results showed that he does not have hypokalemia, and both his urea and creatinine were down slightly - still well above normal range, but down nevertheless. As his appetite was still very poor, I changed his food from canned Hill`s Senior plus a/d to Whiskas kitten food. I chose kitten rather than adult food because it is much finer and as Toby does not have any teeth, he rejects coarse food - well, spits it out, in fact! This new diet seems to meet with his approval, and although he is not eating sufficient for his size, at least he is eating. I realise that kitten food is high in protein and it does worry me that it will be bad for his kidneys, but, then, so is not eating. Still, I expect it won`t be long before he goes off the kitten food, and we can try him again on the Hill`s. I shall be speaking to the vet again tomorrow, but it now looks as though his hyperthyroidism cannot be treated without causing kidney failure. Although he is weak and lethargic and presents a pathetic figure, he does not seem depressed or in pain, which is good. I know that the prognosis is poor but will do my very best to help him enjoy what time remains to him. Thank you again for all your advice. Kate I have a very strong hunch that the taste of methimazole is making him sick and affecting his appetite. Speak to your vet about a flavored suspension or transdermal gel. Good luck, Phil |
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"Phil P." wrote in message ... When you pill him, do you drop the pill into his laryngopharynx so that he doesn't smell or taste it and also so it doesn't begin to dissolve in his mouth? Yes, it goes right to the back so that he doesn`t taste it. I don`t let him smell it, either. My vet thinks that it is the drug`s affect on his blood pressure and subsequent rise in kidney enzymes that makes him feel sick, so she has advised me to stop medicating him. Since stopping the methimazole, his BUN and creatinine levels have improved a little, especially the BUN, although his appetite has not improved much, despite the anti-emetic. We are more or less resigned to the fact that Toby`s hyperthyroidism is not treatable due to his CRF and his hyper-sensitivity to the medication. The vet has warned us about what may/will happen because of his high blood pressure. The ACE inhibitor (Fortekor) should help a bit, though, and he may confound us all by coping well with the hypertension. After all, as a Siamese, he shouldn`t have developed hyper-t in the first place, so he must be a contrary beast ;-) Regards Kate |
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