Why Is It So Important To Treat Hyperthyroidism
Cats that have hyperthyroidism not only have a reduced quality of life but, if untreated, the condition can result in heart failure, blindness or death. It is therefore recommended that you take your cat straight to the vets if you spot any signs of hyperthyroidism.
Page last updated 07/02/2020
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What To Do With The Old Cat With Early Hyperthyroidism And Renal Insufficiency
The jury is out on what to do with this subgroup of cats. Some cats with renal insufficiency and hyperthyroidism improve after definitive therapy, putting on condition without deterioration in renal status and having a good quality of life. However other cats, and it can be difficult to predict exactly which ones, decompensate after radioiodine therapy or thyroidectomy, and develop overt signs of decompensated renal insufficiency. I suspect this latter group were not going to do well in the long term in any case, however it looks really bad to recommend an expensive treatment, and to then find the treatment has precipitated decompensated renal failure.
Therefore, in cats with substantial loss of renal concentrating ability and/or azotaemia, it may be prudent to determine the effect of establishing a euthyroid state by using carbimazole, before deciding whether to proceed to more definitive therapy. This is an unnecessary step in patients without azotaemia and with good urine concentrating ability.
An alternate approach is to treat the renal insufficiency with appropriate dietary therapy ), phosphate binders, blood pressure control etc., while administering atenolol to protect the cats heart from some of the effects of uncontrolled hyperthyroidism. I guess this is really benign clinical neglect, but in some patients, and for some owners, it represents an acceptable option.
Surgical Treatment For Hyperthyroidism In Cats
There are four different ways a cat with hyperthyroidism may be treated: medication, radiation, chemical ablation or surgery. A thyroidectomy, surgical removal of the thyroid, is a popular treatment option for cat owners. The ideal surgical candidate is a cat that deals well with anesthesia, whose thyroid gland is not too large and the thyroid tissue has not migrated to other parts of a cat’s body.
One of the biggest advantages of a thyroidectomy is that a cat will be cured of having a hyperactive thyroid if all of the affected tissue is removed. The cost of the procedure is affordable since the price of the thyroid medication a cat would have to take for the rest of his life would be the same cost as the surgery in the long-run. A cat that just had a thyroidectomy will need to be hospitalized for a short period of time to make sure he recovers well from the anesthesia and the procedure.
Like all surgical procedures, complications may arise from the removal of a cat’s thyroid. These complications include infection, the accidental removal of the pituitary gland, hypocalcemia, hypothyroidism, and paralysis of the larynx. If all of the affected tissues were not removed during the thyroidectomy, a cat may develop hyperthyroid disease again in the future.
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Radioactive Iodine Treatment For Cats
Radioactive iodine is used in the treatment of hyperthyroidism which is the most common endocrine disorder to affect cats. It is estimated that 10% of cats over ten of cats over the age of ten will develop the disease. The disease is caused by a benign, hormone-secreting tumour on the thyroid gland which is located in the cats neck these hormones control metabolism and growth.
There are several treatment options for cats with hyperthyroidism which include:
Hills y/d is low in iodine, which is required by the thyroid gland to produce its hormones, low iodene=reduced hormone production. It can take a few weeks for this food to take effect.
Methimazole or carbimazole which block the synthesis of thyroid hormones.
Removal of the enlarged thyroid lobe, known as a thyroidectomy. In some cases, the parathyroid gland may be accidentally damaged or removed during this procedure, resulting in hypoparathyroidism.
To destroy the tumour which is the focus of this article.
Some of these treatments manage the condition , while others cure it .
Are There Any Side Effects To Treatments For Feline Hyperthyroidism
The main side effect associated with treatment of feline hyperthyroidism is unmasking of previously hidden kidney disease. There is an increasing prevalence of kidney disease as cats age, and therefore cats who develop hyperthyroidism may also have underlying kidney disease. Hyperthyroidism can hide kidney disease, and therefore when treatment for hyperthyroidism is started the kidney disease can become rapidly visible. These cases can be challenging to manage, as a balance between control of hyperthyroidism and maintenance of kidney function needs to be reached. Treatment with the oral drugs is reversible, therefore is generally recommended before curative treatment is undertaken to reduce the risk of unmasking significant kidney disease.
Treatment can also be too effective in cats, leading to the opposite problem: hypothyroidism, or low thyroid levels. This can make cats unduly quiet, lethargic and not want to eat. It can also lead to the previously mentioned kidney problems and therefore, in some cases, cats who have undergone curative treatment may require ongoing thyroid hormone supplementation.
As with all medications, the drugs used for hyperthyroidism can also lead to mild, often self-limiting side-effects. The most commonly seen include vomiting and reduced appetite, however, other less common consequences are also described, including skin problems and facial itching.
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How Is Hyperthyroidism In Cats Diagnosed
Your veterinarian may suspect that your cat has hyperthyroidism based on the signs you describe and by feeling the enlarged thyroid gland in your cats neck. Your veterinarian will likely confirm the diagnosis by doing blood tests that measure the level of your cat’s thyroid hormones.
What Is Feline Hyperthyroidism
Hyperthyroidism is a relatively commonly diagnosed disease in older cats and is caused by overproduction of thyroid hormone by the thyroid glands which are located in the neck. Thyroid hormone is important for many normal body functions, including growth, fur production and activity levels, but in older animals its most profound effect is on metabolism. Thyroid hormone is responsible for increasing the metabolic rate, therefore patients with hyperthyroidism have an excessive energy demand and energy consumption which leads to the classic signs of this condition.
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Heart Failure Due To Hyperthyroidism
Nowadays it is unusual to diagnose hyperthyroidism in cats that present with CHF, either with pleural effusion or pulmonary oedema. This is because thyrotoxic cardiomyopathy resulting in CHF is typically a late manifestation of hyperthyroidism, and most cases are diagnosed during annual health checks well before this stage is reached. It is only when owners forgo regular veterinary attention that cats are thyrotoxic for sufficiently long to develop overt CHF.
Cats with CHF in the setting of hyperthyroidism are very tricky to manage. The first priority is to improve respiratory function by draining pleural effusion by thoracocentesis and diuretic therapy . The next priority is to quickly re-establish a euthyroid status. Surgery is probably an unacceptable risk for these patients, so the choice is between 131I and carbimazole. Personally, I prefer 131I because it reliably and rapidly establishes euthyroidism , but the problem with this option is that you then have to manage a radioactive patient that has the propensity to develop recurrent pleural effusion. For this reason, many colleagues prefer to first stabilise these patients with carbimazole, while simultaneously managing the CHF with frusemide, and possibly an ACE inhibitor such as benazepril. It is vital to NOT give this cohort of cats a blocker such as atenolol or propranolol while they are in congestive failure, as this often causes marked decompensation and sometimes death.
Why Choose Sash For Your Cats Radioiodine Treatment
- SASH has a dedicated feline department and quiet cat only ward to maximise your cats comfort
- SASH is an International Society of Feline Medicine Cat Friendly Clinic Gold Standard accredited hospital, the first clinic to have become accredited in Australia
- Your cats assessment and treatment will be overseen by an internal medicine specialist
- SASH has feline dedicated nurses, especially trained in caring for cats
- SASH has specialists in other disciplines such as ophthalmology, surgery, anaesthesia and critical care if you pet has more than one problem.
- SASH has state of the art facilities for radioiodine treatment and aftercare
- At SASH we take great pride in tailoring our care to your individual cat, to minimise the stress of hospitalisation, cater for needs of older cats, and encourage you to bring in their favourite foods to increase the chances of them eating well in hospital
- We work closely with your local vets to keep them informed of your cats condition and treatment, liaise closely with them regarding follow up after treatment, and are also available to answer ongoing queries that your local vet may have about your cats health
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Diagnosing Hypothyroidism In Cats
Veterinarians diagnose hypothyroidism in cats through a combination of symptoms and diagnostic testing. If your cats symptoms suggest possible thyroid gland involvement, your veterinarian will most likely recommend laboratory tests that measure blood concentrations of thyroid hormones in conjunction with high levels of TSH .
Depending on your cats symptoms, the veterinarian may also suggest additional diagnostic testing to rule out other potential causes.
Feline Hyperthyroidism: An Opinionated Perspective
Richard Malik, PGFVET CONFERENCE CENTRE, BUILDING B22UNIVERSITY OF SYDNEYE
Feline hyperthyroidism is the most common endocrine disease of cats in Australia, and one of the most important diseases of the geriatric cat. Unlike many diseases of the older cat, it can be treated with complete success. Interestingly, the condition is thought to have occurred infrequently prior to about 1980, the time when commercially prepared cat food started to be fed more routinely to cats in the developed world. Thus, some current theories of causation implicate certain characteristics of commercially prepared rations, such as a high iodine content, or the chemicals involved in the preservation of canned foods. A logical inference, therefore, is that by feeding cats more natural food i.e. raw meaty bones, the disease is less likely to occur. Whatever the cause, hyperthyroidism is commonly diagnosed in feline practice, and a veterinarian in a busy clinic seeing many cats will diagnose new cases on a weekly or monthly basis. In Sydney, one private clinical pathology laboratory routinely diagnoses more than 20 new cases each week.
In my opinion, most switched on vets working in practice are good at diagnosing hyperthyroidism. Thus, from my perspective, the controversial issues relate to how to best manage cases, and that will be the key focus of the present article. I should state at the outset that some of my views may not be shared by other colleagues.
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How To Treat Hyperthyroidism In Cats
Alycia Washington is a Doctor of Veterinary Medicine with nearly a decade of experience as a small animal emergency veterinarian. She currently works as a relief veterinarian for various emergency and specialty hospitals. Dr. Washington recognizes the importance of education and also works as a freelance veterinary writer.
No one wants their cat to get sick but some illnesses can be easily managed with proper treatment. Hyperthyroidism is one such disease and is fairly common in older cats. By knowing the common symptoms of this disease, you can get your cat the veterinary attention that is needed to treat and manage it before other serious problems develop.
How Much Does Radioactive Iodine Treatment For Cats Cost
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. Similarly, it is asked, how safe is radioactive iodine treatment for cats?
Radioiodine Treatment:Radioiodine is safe and effective with cure rates approximately 95 – 98% with one treatment. Cats can receive a second treatment, if necessary. Radioiodine treatment avoids surgery, anesthesia, and anti-thyroid drugs.
how much does radioactive iodine treatment cost for cats in UK? The current cost of treatment is £2250.00 inc VAT. This cost is essentially a ‘package deal’ covering pre-treatment investigations, the treatment itself and hospitalisation for 10 days, after which time your cat can be discharged if you can limit the time spent in direct contact with your cat for a further 18 days.
In respect to this, how long do cats live after radioactive iodine treatment?
Cats survive on average over 5 years after treatment with radioactive iodine. In comparison, the average survival time with medication or with surgery is only 2 years.
How much does it cost to have a cats thyroid removed?
In many cats, only one thyroid lobe is abnormal, so only one surgery is needed. Cost of surgery is approximately $1000-1400.
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Methimazole: Management Of Feline Hyperthyroidism
David Bruyette, DVM, Diplomate ACVIM VCA West Los Angeles Animal Hospital & Veterinary Diagnostic Investigation and Consultation
Methimazole is a safe and effective medication for the treatment of feline hyperthyroidism. Dr. Bruyette discusses drug administration and monitoring, plus 10 key points of owner education.
Methimazole is commonly used for the pharmacologic management of feline hyperthyroidism.1 This article reviews the properties of methimazole that are of importance to practitioners treating this common endocrinopathy.
Risk Factors For Hyperthyroidism In Cats
While no specific cat breed has a definitively higher risk for developing hyperthyroidism than another, any cat senior is at a greater risk for the disease. Some studies suggest that cats that eat mostly canned food, especially fish-based canned food, are at increased risk. One study showed that longhaired, non-purebred cats have a higher risk of developing the disease while Siamese, Burmese, Tonkinese, Persians, Abyssinians, and British shorthairs have a decreased risk when compared to domestic shorthairs.
More information is needed to continue to help cat owners and hopefully one day be able to prevent hyperthyroidism in all cats.
Crossley VJ, Debnath A, Chang YM, Fowkes RC, Elliott J, Syme HM. Breed, Coat Color, and Hair Length as Risk Factors for Hyperthyroidism in Cats. J Vet Intern Med. 2017 31:1028-1034. doi:10.1111/jvim.14737
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Known Drug Interactions With Methimazole Transdermal
If your pet is taking other medications, vitamins, herbal therapies, or supplements, you should let the veterinarian know about them. This includes the drug dosages and administration schedules, to help avoid any potential risk of interaction with this medication.
Drugs currently known to have interactions with methimazole include bupropion, digoxin, and warfarin.
Symptoms Of Thyroid Medicine Allergy In Cats
If your cat is having an allergic reaction to thyroid medication, he will have a variety of symptoms. The onset of symptoms will occur within a few weeks of starting the drug. Symptoms may include:
- Scratching at the skin
- Loss of appetite
There are several types of medications which can affect the way methimazole works for your cat. Methimazole should not be given if your cat is taking the following types of medications:
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Presenting Complaints And Physical Findings
In these enlightened times, most cats are diagnosed by an astute veterinarian during an annual health check, or as a result of screening before performing an elective procedure in the geriatric patient. Physical findings indicative of hyperthyroidism are detectable by a veterinarian some time before an owner recognises a health issue of their cat. This is partly because clinical signs develop insidiously and are not associated with a reduction in appetite. Of signs likely to be noticed by owners, weight loss despite an excellent appetite is perhaps the most common, although occasionally owners will seek attention for polyuria/polydipsia, vomiting, change in temperament or signs referable to cardiorespiratory compromise.
Physical findings suggestive of hyperthyroidism include:
- A loud, fast heart
- An easily palpable femoral pulse
- A palpable thyroid nodule or nodules
In summary, a tentative diagnosis of hyperthyroidism can be made by palpation of one or more thyroid nodules in a cat with a loud, fast heart, often in association with a history of weight loss despite good appetite.
Costs And Payment Options
The cost for any treatment for feline hyperthyroidism is significant. The fee for radioiodine therapy ranges from $1,685 – $1,910, depending on how much drug is required to treat each patient . This fee includes the radioiodine itself, the cost of hospitalization and monitoring, blood pressure measurements as needed throughout your cats stay, and any oral anti-anxiety medications or appetite stimulants required while hospitalized. Any additional treatments required during the hospitalization stay would result in additional fees. Boarding beyond the initial hospitalization period would also result in additional fees. While this is a higher upfront cost than other options, it is less expensive than other options over the lifetime of the cat. Radioiodine treatment generally results in fewer thyroid blood tests for the remainder of the cats life as well, which makes the treatment more cat-friendly from the patients point of view as well.
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Please note: Because we must order the dose of radioiodine before the treatment is administered, and the dosage is tailored specifically for your cat, cancellation of a scheduled appointment less than 72 hours before the appointment time will result in a charge of $335.
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Ipodate And Iopanoic Acid
Since publication of the study, ipodate is no longer available in the United States. However, a similar product called iopanoic acid is available through compounding pharmacies. Like ipodate, iopanoic acid inhibits the peripheral conversion of T4 to T3. No published studies on the efficacy of iopanoic acid are available, but in my experience the dose, efficacy, and side effects appear to be similar to those reported with ipodate .
We do not know whether treatment with these iodine-containing contrast agents results in only temporary abatement of hyperthyroidism, as occurs in people, because no long-term studies have been done in cats. Animals that have been treated with ipodate or iopanoic acid probably should have the medication discontinued before beginning radioiodine therapy since both medications affect thyroid iodine uptake.