Well, it looks like my Mojo has a diagnosis - hyperthyroidism. I’ll be picking up his new meds at the vet tomorrow, but he’s such a bad pill-taker that I’m hoping there are other options. I’ve done a little research, and it looks like drugs are the cheapest option, but they’re a daily, sometimes twice-daily, ordeal, and it will be extremely stressful for both me and the cat. There’s surgery, which is obviously more expensive and riskier, but Mojo is healthy and would likely do well. Then there’s the new and very expensive option of a radioactive iodine injection, to kill off the thyroid. Sounds nice and non-invasive, but he’d be hospitalized for at least a week to let the radioactivity die down, I think?
Who’s got a hyperthyroid cat, and what treatment is working for you?
You can get the medicine compounded into a gel you rub into the ear. If you didn’t have to wrestle with the pills, would you be more on board with that option?
If you can afford the iodine treatment, I’d go with that. Have seen many cats do very well after that procedure. My own cat had it but he was older and I didn’t do the iodine. He liked Pill Pockets so the pill-taking was non-eventful. They do have an ear ointment also that you can use instead so it’s less of a battle. The treatments worked very well for about 2-3 years but at some point, his body couldn’t regulate it even with the meds and he went downhill pretty fast :(. If I could have afforded it, I would have done the iodine.
I chose radioiodine in 2004 for my 14 year old cat. My vet did a pill, not an injection, and kept my cat for 11 days, as to release him with no restrictions pertaining to handling (except holding his scooped litter for 3 weeks in the garage).
It was expensive - $1100 in 2004, but that included initial and all follow ups, the treatment, boarding, etc…
I’d do it again. I figured the cost of the pills over time, plus the stress, plus the fact that the methimazole was causing him to lose hair - it was well worth it.
We crushed the pills into gushy food and the cat ate it without any problem. Except when she didn’t feel like eating in general. Usually we would crush the pill into a little bit of food so she would eat all of it and get the pill, and then give her the rest of her food for at-will eating. I’ve known people who’ve had good luck with the ear cream, too.
Wedgewood Pharmacy. If you want chewable tablets that cats eat readily, or the derm gel that you can rub inside an ear - that’s the place to get it at the least expense. Your vet can call it in and have it billed and delivered to you, or I believe you can fax a scrip to them - you can check their website for the easiest thing for you to do.
I second the radioactive iodine treatment. The shelter where I work uses RadioCat, for two lucky hyperthyroid cats a year, a generous donor pays for their treatment. We’ve had very good results and made a bunch of cats more adoptable because of it. Generally, surgery is not really recommended any more. There’s no telling whether all of the problem tissue is removed, or whether it’s even all in the surgical site, sometimes it can be located in other areas of the body (verifiable with a nuclear scan) and only daily medication or the I131 will treat it.
Methimazole can also be prepared as a flavored liquid for veterinary use. I’m hyperthyroid and have to take the bitter tablets, and I’ve been slightly jealous that my friend’s cat gets her methimazole chicken-flavored.
What is the aftercare required with the iodine treatment? My doctor has told me that I would likely have to take replacement thyroid hormone afterward if I went that route, to keep my levels from then falling too low. Is that not true for cats?
Generally, no. The vast majority of cats treated with I131 normalize and are considered “cured.” In the 10 years I’ve been working with felines, I don’t know how many I’ve seen treated (a lot), but of all of them only one ended up with hypothyroidism and needed treatment. All the rest needed nothing further. I think the RadioCat site states something like 98% of treatments are curative.
My cat, Feather, was diagnosed with hyperthyroidism this winter. We started her with meds, but she got a very itchy head from them (she had scabs all over her head from constantly scratching). She’s in the middle of a food trial right now, and one month in, her thyroid levels have gone down to normal. So far, it looks like hyperthyroid food is looking like the best option for my kitty - she eats it, no problem, and she doesn’t seem to have any side effects at all. The one small difficulty with this is that she really can’t have any other food, but she’s never been much of a beggar or anything (I still give her a teeny, tiny bit of cheese once in a while, and that seems okay).
We did the radioactive thyroid thing for my older cat back in winter 2008/2009. Cost us about the same as **Hanna **- in the neighborhood of $1100. (For full disclosure, I think the treatment itself was cheaper, but there was a couple of other visits for testing, so it came out about a wash, I think.) She tolerated it very well, but did have to stay at the facility for a week.
In our case, however, the hyperthyroid masked a kidney problem (as is often the case in older kitties - Tosha was 16). We had her put down due to the kidney disease about 6 months after the thyroid treatment. I’m not sure I’d go for the treatment again with a cat of the same advanced age.
That said, in a younger cat, I’d do it again, no reservations. I’m no good at pilling cats, even with some of the tricks they’ve got now. I might check out the ear stuff, as that seems like it wouldn’t be a bother. But do a cost analysis, for sure - depending on your cat’s age, the radioactive treatment might be cheaper, in the long run.
That’s absolutely a more attractive option. He used to be better with pills but lately, he runs and hides if he hears anything resembling a pill bottle, and we have to chase him, find him, pin him, wrestle him, and hope he doesn’t cough it up. He’s got a bad infection in his mouth right now which may be contributing to his unwillingness to have my fingers near his teeth (he’s currently taking chicken-flavored liquid Flagyl to clear that up). If the thyroid meds come in a gel, then I think that’s a pretty good start.
The vet initially recommended the special diet that **Cat Whisperer **mentioned, but Mojo is so ridiculously picky that I don’t think he’ll go for it. He will only eat Giant brand “indoor formula” kibbles - he won’t touch the name brand ones or the fancy pet store kinds, and when we moved him to wet food for a suspected UTI a while back, we finally found one he’d recognize as food, after going through 2 brands and 10 flavors (result: case after case of Friskies salmon flavor). Also, we have three cats, and they’re grazers, so keeping everyone apart and eating the right foods will be complicated.
The vet said we should start with meds to see if there are kidney issues underneath and then we can consider the iodine treatment. I’m not sure I understand how the thyroid can mask a kidney problem, and wouldn’t it be just as bad to use meds or iodine, in terms of bringing it to light? He had bloodwork done last month, and his liver and kidney function were perfect.
The same for my cat. Austen’s been taking crushed up pills for seven years now. I did look into the radioactive treatment back when we started, but it seemed too expensive for me at the time and too stressful for her.
We had the radioactive iodine treatment done for our then 11-year-old cat, who had been on oral meds for 2 years but became too sick (low potassium, bad heart) to continue them. She’s still around over 5 years later. So we’d recommend the iodine if you can afford it.
We did NOT have to leave her at the vets for a week, but did have to lock her in an isolated room for 2 weeks to avoid exposing the other pets. Also, we had to keep her used cat litter for over 3 months until the iodine decayed sufficiently, because apparently some trash dumps have radiation detectors that would be set off by the used litter.
Yeah, multiple cats does make the food route much more difficult. And cats being the contrary beasts they are, we found that when we started feeding Feather the special food, it quickly became Max’s (our other cat’s) preferred food, too.
If you find your cat scratching his head like crazy, what we did for Feather was cut her meds in half, and the scratching pretty much stopped. The vet didn’t recommend this, but he’s coming at it from a different perspective than we were - he wants her thyroid levels perfect, but we want her thyroid levels reduced AND to not have her miserable every day and scratching her head off. He suggested a cortisone cream, but I don’t like the idea of adding meds on top of meds. Anyway, that’s just something to keep in mind with the meds - it’s apparently a common side-effect.
I went the apparently unusual route of surgery at the advice of my excellent vet who has a lot of delicate surgical experience. We decided not to try the other options because we had just spent a year treating Milo (then 13 years old) for feline stomatitis with steroids, finally surrendering to the option of having his back teeth all pulled - it worked a treat. His immune system was exhausted and none of us thought he could stand another medication regimen, so the surgery was our best option.
He came through it great, had no complications, and has had several healthy years since then, although at 19 his kidneys are getting dickey.
I used the trans-dermal gel on Frank’s ears for a year or so, but the uptake wasn’t great. Levels were still too high. Eventually I did go the radioactive iodine route. Expensive, but it cured him No trouble with hypothyroidism.
Eventually kidney disease got him, but don’t know how much of that might have been masked by the thyroid, he was part of the pet food melamine scandal and that did a number on his kidneys.
I give him the same meds you give, only I managed to get my vet to use a pharmacy that will compound it into liquid form for me. I get tuna flavored (methimazole); one squirt down his little gullet, followed by several kitteh greenies and he’s dosed. He’s been on this for several years – probably at least five years by now. I also tried another form of the meds where you squirt a tiny bit into the cat’s ear and rub it around a bit. He tolerated that okay, but I found it to be a messy pain in my ass. He’ll take pills with a pill popper, but he fights it. For the tuna flavored stuff, he jumps up on the counter and demands his daily dose. He’s really after the Greenies (and you could try the hollow Greenies and stuff the pill in there), but he’s now trained to take his meds first. I could not afford the radiation treatment (as I had two dogs with a handful of medical problems each). He may still be a candidate (probably not too old yet), but I think we’re doing fine with the tuna flavored stuff.
I have six cats and my 16 years old cat (not the oldest, BTW), has been home a week after her radioactive iodine treatment. I did the ear gel methimazole for a couple of months, but her thyroid levels were not decreasing with that. In addition, she was getting some heart failure from the hyperthyroid condition, so after getting her in shape with some lasix shots, we went with the 131-I. She was only there 2 nights, as her radiation level dropped enough in that time for her to come home. Once that level is below 0.7 they can leave, so there is no definite time they have to stay. It’s only a single injection, and that’s it. Much easier on me and the cat. Yes, altogether it was $1100, but the gel meds were quite expensive and they were not working. Also, this cat will not take pills, so we felt we had to go with the iodine.
So far, so good. She is showing signs of improvement.
We happened to have a geiger counter and the residual radiation levels in her body and her wastes are quite low, almost undetectable a week later.
I think you should check the effectiveness of the medicines regularly, maybe every two weeks with a blood test; otherwise you might be treating Mojo and getting no effect. If the methimazole gets his thyroid level down, fine. But I wanted to share that my cat had what the vet called a resistant hyperthyroidism, so be sure to check Mojo’s levels regularly, especially at first.
Question: What are you supposed to do with the radioactive kitty litter? (Ooo! Band name!) It’s not like I can just toss it in my trash can for the garbage people to pick up – I don’t want radioactive kitty litter in my town’s landfill.
How do you dispose?
ETA: I am in week 5 of the medicated food trial. Kitty doesn’t like to eat the leftovers that have been sitting in the fridge, but he’s cool with the fresh room-temp can. Anyone have any suggestions?