Hyperthyroid cat th...
 

[Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?  

Kat Canz
Originally Answered: [Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?

Like the title says, my 15 year old cat is kind of between a rock and a hard place right now. He was on methimazole for over a year and did fine on it. A month ago his T4 levels were slightly elevated so our vet increased his dose and ordered a CBC to be done in 3 weeks. In those 3 weeks his white cells, red blood cells, and platelets all dropped. We took him off the medication completely and retested 2 weeks later, his levels went back to normal but his T4 shot up. The vet is suggesting we keep him off of thyroid medications because it is too much of a risk and to instead put him on Hill's Y/D Diet. She also spoke to another internist and while she mentioned the option of radioactive iodine treatment, she advised against it because his CBC before the increase of his medications showed that his creatine level went up to 2.4 and they feel that since he was showing signs of beginning kidney disease that the radioactive iodine treatment would risk damaging his kidney's further.

I really don't have high hopes that a food, especially one that is pretty poor quality, is going to help my cat long-term but right now I am at a loss for what else to do since it is obvious that doing nothing will lead down a bad path too. I am not sure if I should maybe ask if his thyroid can be removed or if he can be put on a low dose of thyroid medication instead? It also sounds like food can either be made for him or from other brands as long as they don't contain iodine rich foods/sources in them. My vet never saw a cat have an issue with methimazole after being on it for so long so she did contact two other internists to ask for advice, only one of them saw another case of this happening but I have read other cat owners say this same thing happened to their cats. So I am honestly questioning this whole thing because it seems like we don't have a full understanding of the thyroid (as well as in humans and I say this as someone who has hypothyroidism) and it kinda feels like relying on diet solely with this issue is skirting around it.


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Ms Poppy
Originally Answered: [Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?

Hi

My Poppycat is hyper-T, has liver issues so the drug is out, and we can't afford the other treatment. In other words the diet is our only choice. You could do the surgery but I personally think that managing your cat's issue through diet is a viable, workable option.

However there's a caveat. Currently the Hills Y/D canned is unavailable, although the kibble is available. The ONLY commercial food that has the iodine content at the minimum AAFCO requirement is Weruva and their brands (Soulistic for Petco, B.F.F. et al), at 0.6 mg/kg. 

In conversations with Weruva it was mentioned that some of their customers will add unseasoned chicken to their chicken varieties to bring the iodine down even further but he didn't give me numbers. When I run out of Y/D cans, if Hills hasn't gotten more on the shelves I'm going to utilize Weruva WX (no prescription required, and it is extremely low in phosphorus and therefore not harmful to Poppy's kidneys) and mix in the Y/D kibble.

Be aware that iodine is in darn near everything, even coat conditioners such as those with avocado.

 

 


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Aisling O'Keeffe MVB CertSAM ISFMAdvCertFB
Originally Answered: [Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?

Hi Kat,

Thanks for your question and sorry to hear that your cat hasn’t been doing well with their hyperthyroidism. It sounds like you’ve had a difficult time recently.

To answer your question, there are still a few options for your cat.  Diet is a good option but you have to make sure that your cat doesn’t eat anything else as iodine is present in so many things. It could be very difficult to do this if you have other cats or if your cat goes outdoors and eats food elsewhere. If your cat is the only cat in the house and is indoors only, you could give this a try as it’s a very safe option. Technically as the thyroid gland needs iodine to make thyroid hormones, if they’re restricted enough in the diet then the thyroid gland can’t produce high levels of thyroid hormone.

Surgery is also an option and it can offer a good long term solution in a lot of cases. It works particularly well in cats that have a palpably enlarged thyroid gland as this would indicate which gland needs to be removed. If your cat doesn’t have an obviously enlarged gland, a technetium scan can highlight the part of the thyroid tissue that is affected and needs to be removed. I think it would be worth discussing this option with your vet to see if they think your cat is a good candidate for this.

It seems like she had been doing well on the medication until the dose was increased. I can understand why your vet would like to avoid putting her back on this as her levels dropped so low. However if you don’t think that the food or surgery is an option, you could discuss re-introducing this at a lower dose with your vet with close monitoring of her CBC as these levels could drop again. This option would come with a degree of risk and the other options are likely to be safer.

I hope this helps,

Aisling


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Aisling O'Keeffe MVB CertSAM ISFMAdvCertFB
Originally Answered: [Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?

@mspoppy thanks for this information, it's good to know about the brands available and that the canned Y/D is currently unavailable. I hope your cat is doing well


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Ms Poppy
Originally Answered: [Sticky] Hyperthyroid cat that cannot be on thyroid meds and not ideal candidate for radioactive iodine treatment. What should I do?

@aisling Thank you, and I'm always glad to pass along information to try and help 🙂


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