Kitty Just Started Methimazole - Cat Forum : Cat Discussion Forums
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post #1 of 16 (permalink) Old 11-08-2008, 04:06 PM Thread Starter
Jed
 
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Kitty Just Started Methimazole

Our 14 year old female came down with jaundice due to a liver problem, and this was helped greatly with Denamarin. At the same time, her weight dropped dramatically while her appetite and thirst went up. Sure, enough...hyperthyroid. She started on Methimazole today. Does anyone know how soon we'll start seeing an improvement? She's doing well in other respects... purrs, follows the sun, grooms... but we'd like to see her put weight back on. Thanks everyone.
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post #2 of 16 (permalink) Old 11-08-2008, 10:59 PM
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Re: Kitty Just Started Methimazole

I replied because it has been almost 7hrs since you posted. Unfortunately, I have no experience/advice to share with you, other than I helped save my cat from jaundice in 2006 around this time of year. Most of the regular members were expecting this forum to be down over the weekend, so many of them are probably not checking in. My reply will bump this to the top and hopefully someone with experience in this matter will chime in.

Welcome to CatForum and best of luck to your kitty,
Heidi



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post #3 of 16 (permalink) Old 11-08-2008, 11:33 PM Thread Starter
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Re: Kitty Just Started Methimazole

Thanks, Heidi, for your help and the nice welcome.
Jed
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post #4 of 16 (permalink) Old 11-09-2008, 12:32 AM
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Re: Kitty Just Started Methimazole

Jed, please be aware that many, many vets start cats on waaaaay too high a dose of methimazole, and that can cause very severe and serious side effects, generally 2-3 weeks after beginning the drug (though adverse side effects like vomiting and inappetance can occur sooner than that). High dosing is very old school medicine, but unfortunately far too many vets haven't caught up with current dosing recommendations. The safe way to administer methimazole adheres to the adage, "start low and go slow", meaning to start at a low dose and slowly increase dosage should the need arise.

So, may I ask at what dose your vet has started your cat? If it's more than 1.25 mg twice daily, you should be doing your own research to decide if you are comfortable with the higher dose. Many folks start their cats at just 1.25 mg once a day.

I wish I'd known about current dosing recommendations before I started my cat, Billy, on methimazole. My vet started him on 2.5 mg twice daily. Within 3 weeks, Billy was so hypOthyroid that his T4 didn't even register on the lab equipment. It took about 7 months to get him regulated on a correct dose. Regardless of your cat's starting dose, be sure to have his T4 tested again no more than 3 weeks after beginning the med so that his dose can be adjusted, if necessary.

I strongly recommend you join the Feline-hyperT mailing list. Those folks REALLY know this disease and all of the ins and outs of the various treatment options. If you join the list and spend some time reading the current and archived messages, you'll learn a ton. And of course you can post any questions you may have to the list, as well. Here's a link to the list:

http://pets.groups.yahoo.com/group/feline-hyperT/

I wish you and your cat all the best.

Laurie
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post #5 of 16 (permalink) Old 11-09-2008, 02:44 AM Thread Starter
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Re: Kitty Just Started Methimazole

Laurie, it's 5mg twice a day!
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post #6 of 16 (permalink) Old 11-09-2008, 08:38 AM
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Re: Kitty Just Started Methimazole

That is way, WAY too high a starting dose, esp. for a cat who has had liver problems! Please, PLEASE reduce that dose to 1.25 mg (1/4 tablet) once or twice a day before your cat suffers serious and potentially devastating side effects. Tell your vet that after doing some research, you are extremely uncomfortable with that dose and have made the decision to reduce it substantially. Then make sure you go back in 3 weeks to repeat the T4 test so that you can slowly increase the dose, if necessary.

I'm begging you, do NOT continue at 5 mg twice daily.

Laurie
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post #7 of 16 (permalink) Old 11-09-2008, 02:09 PM
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Re: Kitty Just Started Methimazole

It sounds to me as if Laurie has some experience with this problem. However, we can not prescribe for your cat. Considering what Laurie has posted, I would do a lot of reading today, so that you can discuss the possibility of a dosage change tomorrow knowledgably. I so hope your cat's health can be restored, and that you have many more years with her.




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post #8 of 16 (permalink) Old 11-12-2008, 12:34 AM
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Re: Kitty Just Started Methimazole

Absolutely do as much research and reading on hyperT and its various treatments and treatment side effects as possible, and absolutely discuss lowering the dose of methimazole with your vet. If your vet is reluctant to reduce the dosage for any reason, I strongly urge you to immediately seek a second opinion from a vet in a different clinic.

Also, as I mentioned earlier in this thread, join the hyperT mailing list. As a member, you will not only have access to the message archives and be able to post questions directly to the list, but you can also access the files section of the list website which contains extensive information on many aspects of hyperT.

I wish you all the best with your cat.

Laurie
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post #9 of 16 (permalink) Old 11-12-2008, 06:09 PM
 
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Re: Kitty Just Started Methimazole

I don't remember the dose my cat started on but he showed improvement pretty quickly. He was on the methimazole for 6-8 months before I decided to go with the radioactive iodine treatment. I went with that for 2 reasons. One, the methimazole was a pain to administer. He's very finicky about treats and his food so getting the pill down him twice a day was a challenge. They make a transdermal gel for the ear but he got to the point that he'd run when he saw me with the syringe. I also wasn't confident that he was getting a consistent dose. The 2nd reason is that the life expectancy is longer with the iodine treatment and it's safer. It's been 14 months since the treatment and he's doing good. He's actually gained back 8 lbs. and I'm trying to get him to lose weight. I encourage you to read up on hyperthyroidism. After the treatment my cat's kidney levels crept up but have since normalized for the most part. Hyperthyroidism can mask kidney failure and it can be a balancing act.
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post #10 of 16 (permalink) Old 11-12-2008, 10:43 PM Thread Starter
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Re: Kitty Just Started Methimazole

I called another vet who I've known for many years. He said that the range is 2.5 to 5 (twice a day), and depends on the data from the blood work, which I didn't have. According to the manufacturer, 5(x2) is the recommended dose. On the other hand, I found an article on-line from a vet journal that recommended starting low and gradually increasing! My wife discussed this with the vet, and the vet indicated that the dose was based on the blood test. She (the vet) wants to continue this dose for a 10 day course and see how the next test looks.

Kitty is still eating and drinking, but she isn't as ravenous for food and water as before. The potential serious side-effect of facial itching hasn't happened. She's lethargic, but she was slowing down even before this, so while that's a known side-effect, I can't say it's related.

Laurie, I appreciate your passion, but taking this all together, I'm going to stay with that dosage BUT continue to monitor her closely.
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