Update: Buddha's Hyperthyroid Treatment

Finally, after four visits, they got a urine sample from Buddha today. The
vet said her urine looks good and does not indicate any kidney problems in
and of itself. (He checked it for "specific gravity?")

He wrote us a prescription for Tapazole in 10 mg tablets, half of one every
12 hours. He said we should test her blood again in two weeks to see if her
kidney function really is fine or was being masked by the hyperthyroid. If
it is fine we will schedule her visit to Radcats to receive radioactive
iodine treatment.

Thanks again to everyone for their help with this--particularly to Phil for
persisting until I understood the relationship between hyperthyroid and
kidney and liver function

I'll post her blood test results in two weeks.

"Mary" wrote:

He said we should test her blood again in two weeks to see if her
kidney function really is fine or was being masked by the hyperthyroid. If
it is fine we will schedule her visit to Radcats to receive radioactive
iodine treatment.

Mary, that is too soon. You just have back down a little with the need
to rush into it. I think a month or two of stable T4 numbers is
required to observe renal function. You also may not get the tapazole
dosage perfect first time either and an adjustment after the first
blood test may be necessary.

I think this vet is not really all that experienced in the management
of hyperthyroid cats if he is giving you this timetable. So far he has
depended too much on outside sources for information and has needed to
have too many important facts pointed out.

-mhd

"Mary" wrote:

He said we should test her blood again in two weeks to see if her
kidney function really is fine or was being masked by the hyperthyroid. If
it is fine we will schedule her visit to Radcats to receive radioactive
iodine treatment.

Mary, that is too soon. You just have back down a little with the need
to rush into it. I think a month or two of stable T4 numbers is
required to observe renal function. You also may not get the tapazole
dosage perfect first time either and an adjustment after the first
blood test may be necessary.

I think this vet is not really all that experienced in the management
of hyperthyroid cats if he is giving you this timetable. So far he has
depended too much on outside sources for information and has needed to
have too many important facts pointed out.

-mhd

wrote in message
...
"Mary" wrote:

He said we should test her blood again in two weeks to see if her
kidney function really is fine or was being masked by the hyperthyroid.
If
it is fine we will schedule her visit to Radcats to receive radioactive
iodine treatment.

Mary, that is too soon. You just have back down a little with the need
to rush into it. I think a month or two of stable T4 numbers is
required to observe renal function. You also may not get the tapazole
dosage perfect first time either and an adjustment after the first
blood test may be necessary.

I agree that two weeks is too soon. Personally, I'd wait a minimum of two
months. I don't know how long it normally takes for CRF numbers to become
unmasked after hyper-T treatment has begun, but it can (note: doesn't
always, though) take a couple of months to arrive at the correct dose of
med.

Cathy

wrote in message
...
"Mary" wrote:

He said we should test her blood again in two weeks to see if her
kidney function really is fine or was being masked by the hyperthyroid.
If
it is fine we will schedule her visit to Radcats to receive radioactive
iodine treatment.

Mary, that is too soon. You just have back down a little with the need
to rush into it. I think a month or two of stable T4 numbers is
required to observe renal function. You also may not get the tapazole
dosage perfect first time either and an adjustment after the first
blood test may be necessary.

I agree that two weeks is too soon. Personally, I'd wait a minimum of two
months. I don't know how long it normally takes for CRF numbers to become
unmasked after hyper-T treatment has begun, but it can (note: doesn't
always, though) take a couple of months to arrive at the correct dose of
med.

Cathy

wrote


Mary, that is too soon. You just have back down a little with the need to
rush into it. I think a month or two of stable T4 numbers is required to
observe renal function. You also may not get the tapazoledosage perfect
first time either and an adjustment after the first blood test may be
necessary.


I can wait--my sense of urgency is just worry. I want to get this problem
cleared up for her as soon as I can. I'm really worried that she has already
incurred kidney damage as a result of my not acting last year when she was
first diagnosed.

I think this vet is not really all that experienced in the management of
hyperthyroid cats if he is giving you this timetable. So far he has depended
too much on outside sources for information and has needed to have too many
important facts pointed out.


This is probably true. I'll look into the matter with other local vets over
the next couple of weeks, and, most importantly, speak with the specialists
who deal with hyperthyroid cats on a regular basis and see what they think
is a reasonable time frame to have her on tapazole to find out if she has
underlying kidney problems. Thank you.

wrote


Mary, that is too soon. You just have back down a little with the need to
rush into it. I think a month or two of stable T4 numbers is required to
observe renal function. You also may not get the tapazoledosage perfect
first time either and an adjustment after the first blood test may be
necessary.


I can wait--my sense of urgency is just worry. I want to get this problem
cleared up for her as soon as I can. I'm really worried that she has already
incurred kidney damage as a result of my not acting last year when she was
first diagnosed.

I think this vet is not really all that experienced in the management of
hyperthyroid cats if he is giving you this timetable. So far he has depended
too much on outside sources for information and has needed to have too many
important facts pointed out.


This is probably true. I'll look into the matter with other local vets over
the next couple of weeks, and, most importantly, speak with the specialists
who deal with hyperthyroid cats on a regular basis and see what they think
is a reasonable time frame to have her on tapazole to find out if she has
underlying kidney problems. Thank you.

"Cathy Friedmann" wrote


I agree that two weeks is too soon. Personally, I'd wait a minimum of two
months. I don't know how long it normally takes for CRF numbers to become
unmasked after hyper-T treatment has begun, but it can (note: doesn't
always, though) take a couple of months to arrive at the correct dose of
med.

Thank you, Cathy. I will definitely look into it. If she stays on Tapazole
for two months I want her bloodwork done frequently, because I am really
afraid that her elevated liver enzyumes may NOT be due to her overactive
thyroid, and I would rather not keep her on Tapazole long enough for it to
cause further kidney damage. We will test after two weeks, and talk about it
then. In the meantime, as I wrote above, I will speak to some other local
vets (and maybe a professor at the NC State Vet School could help) and
report back on what they say a reasonable length of time might be for her to
be on Tapazole to determine how much her overactive thyroid may be skewing
her blood values for liver and kidney function.

Cathy

"Cathy Friedmann" wrote


I agree that two weeks is too soon. Personally, I'd wait a minimum of two
months. I don't know how long it normally takes for CRF numbers to become
unmasked after hyper-T treatment has begun, but it can (note: doesn't
always, though) take a couple of months to arrive at the correct dose of
med.

Thank you, Cathy. I will definitely look into it. If she stays on Tapazole
for two months I want her bloodwork done frequently, because I am really
afraid that her elevated liver enzyumes may NOT be due to her overactive
thyroid, and I would rather not keep her on Tapazole long enough for it to
cause further kidney damage. We will test after two weeks, and talk about it
then. In the meantime, as I wrote above, I will speak to some other local
vets (and maybe a professor at the NC State Vet School could help) and
report back on what they say a reasonable length of time might be for her to
be on Tapazole to determine how much her overactive thyroid may be skewing
her blood values for liver and kidney function.

Cathy

"Cathy Friedmann" wrote in
Yes, this part makes sense to me - to keep very close tabs on her liver
enzymes, to make sure the Tapazole doesn't agravate a possibly
pre-existing
condition, rather than clear it up. And of course alos her BUN &
creatine
levels, to make sure CRF hasn't been lurking.

By the way, these were very good. The vet commented on them.

I thought you meant to do the
radioactive treatment after only 2 weeks.

I did, because that is what he said.

I agree that my vet is not presenting well in this case, but I don't want to
be hardcore about it. I like him, and feel certain he will use what he has
learned to help others and pass it on the the younger vets. He is a good and
compassionate caregiver, and near retirement age. I like him enough to give
him the benefit of the doubt. He may have gone through a slump and failed to
keep up with current literature on hyperthyroidism. On the other hand I love
my girls and will now have to be hyper-wary. Thank God for this group. All
BS and conflicts aside, you people have really come through when I needed
you to help me know what is best for this sweet cat. I won't forget it, and
will try to contribute similarly if I can.