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#1
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Jackie Update
Ok, No parasites. T3 is normal but T4 is elevated (6.9 and normal is
4.0). So it is a bit inconclusive. The Vet says that Tapazole (sp?) can cause cats to stop eating somewhat (because of upset stomach) which is not something she can take right now, and he would prefer that we just wait a few weeks until the mouth ulcers are gone. She is on antibiotics to deal with those and he feels that the ulcers could be the primary cause of her weight loss. Apparently if she can't chew the food properly it won't be assimilated (or laminated as it were). It doesn't seem likely to me but I suppose it's possible. The real problem is that we can't get more blood out of her and putting her under is too risky. It could be diabetes or kidneys or anything else and we just can't do anything more right now. He says to wait a few weeks until she is more comfortable and hopefully gains some weight. I did note that she is not drinking much water. She had some diarrhea yesterday, nothing major, just a bit loose here and there. I noticed it after she sat on my pants. The most likely cause is eating too much combined with the antibiotic. The advice to just sit tight for a bit is probably good. I think she might be gaining a bit of weight and it's only been three days. Boy does she eat. Oh, the boys were out in the backyard yesterday so I let her roam around upstairs (where her room is). She checked out all the rooms and then wanted to go downstairs but I wouldn't let her do that yet. They all got to look at each other while I sat between them. Lots of stares and a few muttered cat curses but nothing overly unhappy. Looks like it might work out. I have a call into the petstore and will find out more of her history. I await the return call. I need to know how long she has been this thin. I suppose I could take a trip to the Specialty Vet but I think I will just sit tight for a week or so and see how it goes. I really don't want to put her through too much right now. Well, there is all that I know at this time. I can't wait to get home and feed her some more. Dave |
#2
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"dgk" wrote in message ... Ok, No parasites. T3 is normal but T4 is elevated (6.9 and normal is 4.0). So it is a bit inconclusive. You might want to speak to your vet about a free T4 by equilibrium dialysis (fT4ED) assay. The fT4ED is the most accurate way to measure a cat's thyroid function. Its especially more sensitive in assessing thyroid function in sick cats that might have concurrent or secondary illnesses that could alter tT4 results. Don't let the word "dialysis" scare you! A simple, routine blood sample is all that's needed. The sample is dialysed *after* its taken from the cat. The test requires only about a 1 1/2 ml sample of blood and costs about $20. The T3 suppression test is only good for diagnosing borderline cases when the tT4 consistently falls inside the normal range. The Vet says that Tapazole (sp?) can cause cats to stop eating somewhat (because of upset stomach) which is not something she can take right now, We were having a few problems with some our hyperthyroid cats experiencing adverse effects from Tapazole. In many of the cases, I found the problem to be the dose, not the drug. I solved most of the problems by stopping the treatment for a few days and then restarting the treatment at a lower dose and then I gradually increased the dose until the cat could handle the therapeutic dose without any adverse effects. Some cats just need a little time to gradually adapt to the medication. In serious cases where therapy could not be stopped without significant risks, I switched the cats to either carbimazole or iopanoic acid (Telepaque). Both of these drugs produce significantly fewer and milder side effects than Tapazole - carbimazole is probably the better of the two. Unfortunately, neither drug is available commercially, however, both drugs are available through compounding pharmacies and therefore, cost a bit more than Tapazole. Antithyroid drugs have the advantage over radioiodine tx of being "adjustable" whereas I-131 is irreversible. Hyperthyroidism is a dynamic disease and antithyroid drugs give you the flexibility to adjust the therapy as the disease changes. This ability is particulary important for cats with underlying kidney disease. In older cats with both diseases, sometimes you must strike a very delicate balance between an "acceptable" level of hyperthyroidism and an "acceptable" level of azotemia. You can accomplish this only with antithyroid drugs. and he would prefer that we just wait a few weeks until the mouth ulcers are gone. She is on antibiotics to deal with those and he feels that the ulcers could be the primary cause of her weight loss. Apparently if she can't chew the food properly it won't be assimilated (or laminated as it were). It doesn't seem likely to me but I suppose it's possible. Possible but not probable. If your vet suspects nutrient malassimilation, a simple gross examination of the feces for undiĀ*gested food might help him determine if malabsorpĀ*tion or maldigestion is happening. In the vast majority of cats with hyperthyroidism weight loss is usually the result of increased energy expenditure. The real problem is that we can't get more blood out of her and putting her under is too risky. It could be diabetes or kidneys or anything else and we just can't do anything more right now. He says to wait a few weeks until she is more comfortable and hopefully gains some weight. Speak to your vet about restarting her Tap at half or 1/4 of her therapeutic dose and gradually increase the dose as she adapts to the medication. If that doesn't work, try carbimazole. Many cats that can't handle Tap take carbimazole without any adverse effects. I did note that she is not drinking much water. If she's eating canned food, she's meeting nearly all her water needs directly from her diet. She had some diarrhea yesterday, nothing major, just a bit loose here and there. I noticed it after she sat on my pants. The most likely cause is eating too much combined with the antibiotic. Could also be caused by rapid gastric emptying and shortened small and large bowel transit times. Drop a stool sample off at your vet. The advice to just sit tight for a bit is probably good. I think she might be gaining a bit of weight and it's only been three days. Boy does she eat. Despite her increased food intake, she's probably still in a state of chronic caloric and nutritional insufficiency. You're going to have to slow her system down pretty soon. I gotta run. I hope this helped a little. Keep the faith. Phil Oh, the boys were out in the backyard yesterday so I let her roam around upstairs (where her room is). She checked out all the rooms and then wanted to go downstairs but I wouldn't let her do that yet. They all got to look at each other while I sat between them. Lots of stares and a few muttered cat curses but nothing overly unhappy. Looks like it might work out. I have a call into the petstore and will find out more of her history. I await the return call. I need to know how long she has been this thin. I suppose I could take a trip to the Specialty Vet but I think I will just sit tight for a week or so and see how it goes. I really don't want to put her through too much right now. Well, there is all that I know at this time. I can't wait to get home and feed her some more. Dave |
#3
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"dgk" wrote in message ... Ok, No parasites. T3 is normal but T4 is elevated (6.9 and normal is 4.0). So it is a bit inconclusive. You might want to speak to your vet about a free T4 by equilibrium dialysis (fT4ED) assay. The fT4ED is the most accurate way to measure a cat's thyroid function. Its especially more sensitive in assessing thyroid function in sick cats that might have concurrent or secondary illnesses that could alter tT4 results. Don't let the word "dialysis" scare you! A simple, routine blood sample is all that's needed. The sample is dialysed *after* its taken from the cat. The test requires only about a 1 1/2 ml sample of blood and costs about $20. The T3 suppression test is only good for diagnosing borderline cases when the tT4 consistently falls inside the normal range. The Vet says that Tapazole (sp?) can cause cats to stop eating somewhat (because of upset stomach) which is not something she can take right now, We were having a few problems with some our hyperthyroid cats experiencing adverse effects from Tapazole. In many of the cases, I found the problem to be the dose, not the drug. I solved most of the problems by stopping the treatment for a few days and then restarting the treatment at a lower dose and then I gradually increased the dose until the cat could handle the therapeutic dose without any adverse effects. Some cats just need a little time to gradually adapt to the medication. In serious cases where therapy could not be stopped without significant risks, I switched the cats to either carbimazole or iopanoic acid (Telepaque). Both of these drugs produce significantly fewer and milder side effects than Tapazole - carbimazole is probably the better of the two. Unfortunately, neither drug is available commercially, however, both drugs are available through compounding pharmacies and therefore, cost a bit more than Tapazole. Antithyroid drugs have the advantage over radioiodine tx of being "adjustable" whereas I-131 is irreversible. Hyperthyroidism is a dynamic disease and antithyroid drugs give you the flexibility to adjust the therapy as the disease changes. This ability is particulary important for cats with underlying kidney disease. In older cats with both diseases, sometimes you must strike a very delicate balance between an "acceptable" level of hyperthyroidism and an "acceptable" level of azotemia. You can accomplish this only with antithyroid drugs. and he would prefer that we just wait a few weeks until the mouth ulcers are gone. She is on antibiotics to deal with those and he feels that the ulcers could be the primary cause of her weight loss. Apparently if she can't chew the food properly it won't be assimilated (or laminated as it were). It doesn't seem likely to me but I suppose it's possible. Possible but not probable. If your vet suspects nutrient malassimilation, a simple gross examination of the feces for undiĀ*gested food might help him determine if malabsorpĀ*tion or maldigestion is happening. In the vast majority of cats with hyperthyroidism weight loss is usually the result of increased energy expenditure. The real problem is that we can't get more blood out of her and putting her under is too risky. It could be diabetes or kidneys or anything else and we just can't do anything more right now. He says to wait a few weeks until she is more comfortable and hopefully gains some weight. Speak to your vet about restarting her Tap at half or 1/4 of her therapeutic dose and gradually increase the dose as she adapts to the medication. If that doesn't work, try carbimazole. Many cats that can't handle Tap take carbimazole without any adverse effects. I did note that she is not drinking much water. If she's eating canned food, she's meeting nearly all her water needs directly from her diet. She had some diarrhea yesterday, nothing major, just a bit loose here and there. I noticed it after she sat on my pants. The most likely cause is eating too much combined with the antibiotic. Could also be caused by rapid gastric emptying and shortened small and large bowel transit times. Drop a stool sample off at your vet. The advice to just sit tight for a bit is probably good. I think she might be gaining a bit of weight and it's only been three days. Boy does she eat. Despite her increased food intake, she's probably still in a state of chronic caloric and nutritional insufficiency. You're going to have to slow her system down pretty soon. I gotta run. I hope this helped a little. Keep the faith. Phil Oh, the boys were out in the backyard yesterday so I let her roam around upstairs (where her room is). She checked out all the rooms and then wanted to go downstairs but I wouldn't let her do that yet. They all got to look at each other while I sat between them. Lots of stares and a few muttered cat curses but nothing overly unhappy. Looks like it might work out. I have a call into the petstore and will find out more of her history. I await the return call. I need to know how long she has been this thin. I suppose I could take a trip to the Specialty Vet but I think I will just sit tight for a week or so and see how it goes. I really don't want to put her through too much right now. Well, there is all that I know at this time. I can't wait to get home and feed her some more. Dave |
#4
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On Wed, 12 May 2004 02:47:45 GMT, Laura R.
wrote: Has the vet recommended a T3 suppression test? AIUI, in cats with elevated T4, giving the cat T3 (orally) will cause the T4 to decrease in a cat that isn't hyperthyroid, but not in cats that are hyperthyroid. No, but we couldn't do anything right now anyway. No way to get more blood. Is Pepcid an option for her? I know that my vets prescribed it for my CRF cat for his tummy acid and it has helped immensely. Also, did the vet mention any high-calorie foods or supplements? (e.g., Hill's A/D or Nutrical) I'm not sure there is a problem here. She was a bit moist yesterday but there were also some normal stools. I'll give it another day. Well, if it is diabetes or CRF, since the vet has examined her and come up with at least an initial course of treatment, at least both diseases tend to be chronic rather than acute. How much is "much" water? Do you feed her wet food? I leave her dry food (science diet this time) during the day because I want her eating something, but she really likes the wet stuff. Her first feeding (morning and night) gets the antibiotic mixed in. Then, for the evenings, I give her more food spaced an hour apart or so. I think her teeth are bad for the hard stuff. Certainly one fang is missing. She may be missing most of her teeth. I can't really tell yet. When she took a stroll into the bathroom (where the normal cat feeding station is) she did take a big drink at the pet fountain. She barely touches the water in her bowl, which is in the Cat Introduction Room. She is confined there almost all the time. I'm not sure when she is going to join the boys on a regular basis. There was a major screaming session yesterday between the three of them. She was in the room with the door open and came waltzing out. The boys took a bit of offense and hissed at her. She hissed back. Nipsy seems to be getting along with her a bit but Espy is freaked out. Still, nothing unexpected and, for the first major interaction, I think it went pretty well. From the reading I've done, if her T4 is that high even though her T3 isn't, that's usually pretty indicative of hyperthyroidism. I can probably dig up some references to make sure, but IIRC, T3 tends to fluctuate more than T4 and therefore be less reliable an indicator. I'll look into it some more. I would consider radiation rather than foul pills. Surgery is out. But since she would have to be boarded for a week or so for radiation, it will have to wait. It's still premature since I want more tests done before I do anything. One oddity is that she walks a bit funny, like her backend sways somewhat. Maybe girl cats just walk differently than boy cats? I can't really figure out just what it is that seems a little off. Perhaps some arthritis or maybe an old injury. I can't even decide which leg it is, or even if there is anything wrong at all. The pet shop wasn't a huge help in any of this. They really don't know her history. Oh well. |
#5
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On Wed, 12 May 2004 02:47:45 GMT, Laura R.
wrote: Has the vet recommended a T3 suppression test? AIUI, in cats with elevated T4, giving the cat T3 (orally) will cause the T4 to decrease in a cat that isn't hyperthyroid, but not in cats that are hyperthyroid. No, but we couldn't do anything right now anyway. No way to get more blood. Is Pepcid an option for her? I know that my vets prescribed it for my CRF cat for his tummy acid and it has helped immensely. Also, did the vet mention any high-calorie foods or supplements? (e.g., Hill's A/D or Nutrical) I'm not sure there is a problem here. She was a bit moist yesterday but there were also some normal stools. I'll give it another day. Well, if it is diabetes or CRF, since the vet has examined her and come up with at least an initial course of treatment, at least both diseases tend to be chronic rather than acute. How much is "much" water? Do you feed her wet food? I leave her dry food (science diet this time) during the day because I want her eating something, but she really likes the wet stuff. Her first feeding (morning and night) gets the antibiotic mixed in. Then, for the evenings, I give her more food spaced an hour apart or so. I think her teeth are bad for the hard stuff. Certainly one fang is missing. She may be missing most of her teeth. I can't really tell yet. When she took a stroll into the bathroom (where the normal cat feeding station is) she did take a big drink at the pet fountain. She barely touches the water in her bowl, which is in the Cat Introduction Room. She is confined there almost all the time. I'm not sure when she is going to join the boys on a regular basis. There was a major screaming session yesterday between the three of them. She was in the room with the door open and came waltzing out. The boys took a bit of offense and hissed at her. She hissed back. Nipsy seems to be getting along with her a bit but Espy is freaked out. Still, nothing unexpected and, for the first major interaction, I think it went pretty well. From the reading I've done, if her T4 is that high even though her T3 isn't, that's usually pretty indicative of hyperthyroidism. I can probably dig up some references to make sure, but IIRC, T3 tends to fluctuate more than T4 and therefore be less reliable an indicator. I'll look into it some more. I would consider radiation rather than foul pills. Surgery is out. But since she would have to be boarded for a week or so for radiation, it will have to wait. It's still premature since I want more tests done before I do anything. One oddity is that she walks a bit funny, like her backend sways somewhat. Maybe girl cats just walk differently than boy cats? I can't really figure out just what it is that seems a little off. Perhaps some arthritis or maybe an old injury. I can't even decide which leg it is, or even if there is anything wrong at all. The pet shop wasn't a huge help in any of this. They really don't know her history. Oh well. |
#6
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"Phil P." wrote:
The Vet says that Tapazole (sp?) can cause cats to stop eating somewhat (because of upset stomach) which is not something she can take right now, We were having a few problems with some our hyperthyroid cats experiencing adverse effects from Tapazole. In many of the cases, I found the problem to be the dose, not the drug. When we were giving our cat tapazole before he finally received radio iodine treatment, we got from our vet a chicken flavored soft treat compounded with the proper dosage of tapazole. They are packaged in individual blister packs. The cat couldn't get enough and sure made it easy compared to traditional pilling. We got the double dosage ones and then sliced them with a knife into 2 servings. This was cheaper than buying single dose treats. They are very easy to cut as they are a very soft treat and the blister pack is re-sealable to keep the unused part fresh. We also received drugless samples in different flavors to try first but he loved them all. There is apparently no taste of the drug at all and it is evenly distributed throughout the treat. I should have asked what other drugs are available in this form. You have to be careful that they stored safely as I'm sure he would chew through the packaging and eat them all if he could. -mhd |
#7
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"Phil P." wrote:
The Vet says that Tapazole (sp?) can cause cats to stop eating somewhat (because of upset stomach) which is not something she can take right now, We were having a few problems with some our hyperthyroid cats experiencing adverse effects from Tapazole. In many of the cases, I found the problem to be the dose, not the drug. When we were giving our cat tapazole before he finally received radio iodine treatment, we got from our vet a chicken flavored soft treat compounded with the proper dosage of tapazole. They are packaged in individual blister packs. The cat couldn't get enough and sure made it easy compared to traditional pilling. We got the double dosage ones and then sliced them with a knife into 2 servings. This was cheaper than buying single dose treats. They are very easy to cut as they are a very soft treat and the blister pack is re-sealable to keep the unused part fresh. We also received drugless samples in different flavors to try first but he loved them all. There is apparently no taste of the drug at all and it is evenly distributed throughout the treat. I should have asked what other drugs are available in this form. You have to be careful that they stored safely as I'm sure he would chew through the packaging and eat them all if he could. -mhd |
#8
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When we were giving our cat tapazole before he finally received radio iodine treatment, we got from our vet a chicken flavored soft treat compounded with the proper dosage of tapazole. They are packaged in individual blister packs. The cat couldn't get enough and sure made it easy compared to traditional pilling. We got the double dosage ones and then sliced them with a knife into 2 servings. This was cheaper than buying single dose treats. They are very easy to cut as they are a very soft treat and the blister pack is re-sealable to keep the unused part fresh. We also received drugless samples in different flavors to try first but he loved them all. There is apparently no taste of the drug at all and it is evenly distributed throughout the treat. I should have asked what other drugs are available in this form. You have to be careful that they stored safely as I'm sure he would chew through the packaging and eat them all if he could. -mhd Thanks. That makes it easy. |
#9
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When we were giving our cat tapazole before he finally received radio iodine treatment, we got from our vet a chicken flavored soft treat compounded with the proper dosage of tapazole. They are packaged in individual blister packs. The cat couldn't get enough and sure made it easy compared to traditional pilling. We got the double dosage ones and then sliced them with a knife into 2 servings. This was cheaper than buying single dose treats. They are very easy to cut as they are a very soft treat and the blister pack is re-sealable to keep the unused part fresh. We also received drugless samples in different flavors to try first but he loved them all. There is apparently no taste of the drug at all and it is evenly distributed throughout the treat. I should have asked what other drugs are available in this form. You have to be careful that they stored safely as I'm sure he would chew through the packaging and eat them all if he could. -mhd Thanks. That makes it easy. |
#10
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On Wed, 12 May 2004 09:31:06 -0400, "Phil P."
wrote: "dgk" wrote in message .. . Ok, No parasites. T3 is normal but T4 is elevated (6.9 and normal is 4.0). So it is a bit inconclusive. You might want to speak to your vet about a free T4 by equilibrium dialysis (fT4ED) assay. The fT4ED is the most accurate way to measure a cat's thyroid function. Its especially more sensitive in assessing thyroid function in sick cats that might have concurrent or secondary illnesses that could alter tT4 results. Don't let the word "dialysis" scare you! A simple, routine blood sample is all that's needed. The sample is dialysed *after* its taken from the cat. The test requires only about a 1 1/2 ml sample of blood and costs about $20. The T3 suppression test is only good for diagnosing borderline cases when the tT4 consistently falls inside the normal range. .... Greatly appreciated and filed. Jackie hasn't been on any medication yet. We aren't really even sure it is thyroid. I'm hoping so because the other potential causes of her light weight are worse. I think I give her a week or so, as the vet suggested, and then see where we stand. I at least want the course of antibiotics to end so we see what was infection and what is something else. The vet felt strongly that clearing up the ulcers in the throat was the first thing to be done and that the antibiotics would do that. We'll see. |
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