A cat forum. CatBanter

If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below.

Go Back   Home » CatBanter forum » Cat Newsgroups » Cat health & behaviour
Site Map Home Register Authors List Search Today's Posts Mark Forums Read Web Partners

Hyperthyroidism v. kidney failure



 
 
Thread Tools Display Modes
  #1  
Old February 25th 05, 10:29 PM
Kate
external usenet poster
 
Posts: n/a
Default 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




  #2  
Old February 26th 05, 01:17 AM
Kelly
external usenet poster
 
Posts: n/a
Default

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






  #3  
Old February 27th 05, 09:00 AM
Phil P.
external usenet poster
 
Posts: n/a
Default


"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




  #4  
Old February 27th 05, 03:47 PM
Kate
external usenet poster
 
Posts: n/a
Default


"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


  #5  
Old February 28th 05, 04:05 AM
Phil P.
external usenet poster
 
Posts: n/a
Default


"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



  #6  
Old March 1st 05, 11:51 AM
Kate
external usenet poster
 
Posts: n/a
Default


"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  
Old March 7th 05, 08:31 PM
Kate
external usenet poster
 
Posts: n/a
Default


"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




  #8  
Old March 9th 05, 05:56 AM
Phil P.
external usenet poster
 
Posts: n/a
Default


"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



  #9  
Old March 9th 05, 05:29 PM
Kate
external usenet poster
 
Posts: n/a
Default


"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



 




Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Help!!! My cat is dying of kidney failure!!! lydiainflorida Cat health & behaviour 13 February 13th 05 12:27 PM
Amlodipine (Norvasc) for treating kidney failure / eye problems? Cat Person Cat health & behaviour 2 October 30th 04 02:47 AM
cat with mild kidney failure rinn Cat health & behaviour 8 February 10th 04 05:28 PM
kidney failure and force feeding arda Cat health & behaviour 30 November 12th 03 03:38 AM
Trying to Get a cat with suspected Kidney Failure to eat Bill Cat health & behaviour 24 August 31st 03 05:09 PM


All times are GMT +1. The time now is 01:29 PM.


Powered by vBulletin® Version 3.6.4
Copyright ©2000 - 2024, Jelsoft Enterprises Ltd.
Copyright ©2004-2024 CatBanter.
The comments are property of their posters.