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Feline Hyperthyroidism

Hyperthyroidism in Cats

What is it?

Hyperthyroidism occurs when the thyroid gland, a small paired gland in the neck, overproduces thyroid hormone.  Thyroid hormone regulates the metabolism in the body, and when it is over-produced, the metabolism speeds up, resulting in weight loss and a rapid heart rate, and sometimes in excess drinking, urination and diarrhea.  The good news is that it is a treatable condition in cats.  There are three treatment options:  lifetime medication, surgery to remove the thyroid, or injection with radioactive iodine.  A consideration with any of these treatment options is that sometimes these cats, who tend to be elderly, have underlying kidney disease.  When the body is in a hyperthyroid state, the blood pressure tends to be higher, which brings more blood to the kidneys, masking any kidney disease.  If we return the thyroid level to normal, if there is underlying kidney disease, the cat may start to show signs of problems with the kidneys (vomiting, poor appetite, etc.)

Medication with Felimazole

Felimazole (methimazole) is a medication that reduces the production of thyroid hormone.  The pros of medication with Felimazole are that we can stop administering it if the cat does experience any kidney problems.  The cost is about $30 per month.  Side effects sometimes include problems with the liver, reduced appetite or vomiting, although most cats do not experience side effects.  The cons include having to administer the pills twice daily, and over time, the cat will need an increasing amount of felimazole because the underlying thyroid condition is not definitively treated and the gland will continue to produce more and more hormone.  The cost of the medication and rechecking bloodwork (to make sure the cat’s system is tolerating the medicine and that the dose is correct) can add up.

Radioactive Iodine Treatment

If the cat’s kidneys are normal and the cat is otherwise healthy, the cat may be a good candidate for radioactive iodine treatment.  This treatment involves going to Cornell University where an injection of radioactively tagged iodine is given.  This chemical is taken up only by the abnormal cells in the thyroid that are overproducing hormone.  These cells are killed, leaving behind the healthy cells which can still function normally.  The treatment is very safe and carries few side effects.  The only drawback is that the cats need to be boarded at the University for approximately five days, to minimize human exposure to the radioactive chemical.  After discharge from the University, some precautions will need to be taken with the kitty litter for a time after the treatment.  Some of these cats may require re-treatment years later if they re-develop the condition.  The cost is approximately $800-1300.

For more information, please visit these links:

 

Feline Hyperthyroidism

Winn Feline Foundation on Hyperthyroidism

 

Feline Health Articles

Feline Asthma: Therapy Options

Onyx with Asthma

Onyx, who has been lived with asthma and used an inhaler

Feline asthma is a result of inflammation in the lungs which causes constriction of the airways, or bronchioles.  Basic treatment of feline asthma involves both relief of the underlying inflammation with anti-inflammatory treatments such as steroids and also opening up the airways by using brochodilators.

Option one – Oral medications:

Prednisone and theophylline:

Pros:  Inexpensive.  These drugs can be withdrawn immediately by simply not giving a pill if there is an adverse reaction to them.  The dose can be adjusted to the lowest possible dose to achieve an adequate effect.

Cons:  Your cat must be pilled daily, which is a difficulty for many cats and owners.  Also, prednisone is a systemic steroid therapy and as such can have side effects.  Over time systemic therapy with steroids can increase the risks of diabetes, pancreatitis and Cushing’s disease and in some cats may cause behavioral changes, increased drinking and urination, cystitis (bladder inflammation) and inappropriate elimination (urination outside the litterbox).

Option two – Inhaled therapy:

Pros:  This is a locally-delivered treatment (Flovent) that is inhaled into the lungs.  There are far fewer side effects and less risk of systemic side-effects such as pancreatitis, diabetes and Cushing’s disease.  Albuterol, a bronchodilator, can be administered daily as a quick relief of symptoms and can also be kept on hand as a rescue drug if the cat has an asthma attack.   The inhaled method of treatment is preferred because the risk of systemic side effects is low.

Cons:  Flovent (the inhaled steroid) takes 10-14 days to start working.  An Aerokat inhaler needs to be purchased at approximately $60.  The Flovent itself is expensive, as well, at approximately $300 for a month’s supply.  Albuterol is much less expensive (less than $20 for a greater than 2 month’s supply) and can be kept on hand as a rescue drug even if Flovent treatment is not chosen for the cat.  Another drawback is that not all cats are amenable to having the spacer (Aerokat) placed over their face.

If your cat is diagnosed with asthma, please discuss these options with your pet’s doctor to determine what the best treatment method is for your situation.