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Hi, this is Cheryl. My cat Molly is 15 1/2. She has had diarrhea for a few months now. She lost 2 lbs over a couple of months, going from 11 lbs to 9 lbs. She eats well, maybe more food than most cats, and she began drinking a bit more last fall, not glued to the water bowl or anything but more than usual for a cat. (She eats a combination of Taste of the Wild dry food and Fancy Feast wet food.) She races around and meows loudly sometimes when she comes from the litter box, and she meows loudly at night sometimes. She sleeps a lot but last week for a few days she seemed to be feeling a bit better and actually played with her toys. She has the fur licked off her belly and some off her legs but we have recently sold our house and moved and I think she was stressed by the packing up, having to go in the car during house viewings, etc. She has licked her fur off in the past when she was younger possibly during times of stress, it always just grew back so I’m not really concerned about that now.

We went to the vet 4 weeks ago. Molly had a heart murmur. The bloodwork showed no diabetes, some early kidney disease and some heart problems. Her T4 was 41. The vet couldn’t find a reason for the diarrhea and weight loss, except that she thought Molly had developed an allergy. She wanted to do urinalysis to further assess the kidneys, an echocardiogram to further assess the heart and X-rays and a bowel scope to rule out bowel cancer but by that time I had spent over $600 and she told me there would be no treatment for any of the conditions even if they were diagnosed. So I didn’t have all of those diagnostic tests done.

I went home with a hypoallergenic hydrolized protein dry food. They had no wet food in stock in this type of food. Molly’s diarrhea increased from 2-3 times daily to at least 4-5 times daily. The next week, the vet prescribed an antibiotic for the diarrhea, metronidazole. The diarrhea didn’t improve at all and Molly looked sick. So after another week, I put Molly back on her old food which includes 2-3 cans of Fancy Feast a day and she perked up a bit. I’m thinking that she may have been dehydrated.

I reviewed Molly‘s bloodwork from January 2020 and her T4 was 27 then. T4 was 41 in January 2021.
I’ve read that 10-60 is normal but 30-60 is in the grey zone for an older cat with symptoms and may be treated.

Now I’m wondering if all of Molly’s symptoms may be pointing toward hyperthyroidism. Should I bring Molly back to the vet and get more tests done? If so which tests? I’ve read theres‘s a more specific thyroid test. Or should I call the vet and ask about a trial of meds for hyperthyroidism? Are there any dangers of thyroid meds at this level?

Does anyone have experience with this or have a cat who was treated for hyperthyroidism with T4 at this level?
 

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After going through these same symptoms with two cats, also in that older range...YES! I would say she needs a specific thyroid test!
I've got one on thyroid pills now, to help balance her out, to old for surgery, unfortunately...
 

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Of Interest!!
I don't know if it was a typo...
BUT...METHIMAZOLE is what is prescribed for Thyroid issues!
My cat gets 5mg in the am, then another 5mg in the pm.
It comes in tablet form, and a pill cutter easily cuts it.
It is very, very important, to stay consistent with the time frame.
I would have a very serious chat with your vet...
It might be time for a Second Opinion!
Best Wishes!
 

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Mimi, Nathaniel
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Does anyone have experience with this or have a cat who was treated for hyperthyroidism with T4 at this level?
[/QUOTE]

I agree, this could be hyperthyroidism but also kidney disease - the symptoms are quite similar and sometimes both issues can co-exist.
Here's my experience with hyperthyroidism: My Mimi girl had similar symptoms, but less diarrhea and vomiting than your kitty. We had multiple tests done as well. The first few tests (T4 and the other one) showed hyperthyroidism. She was put on a medication which helped with the symptoms. Her second tests still showed elevated results. We were scheduled to do a radioactive iodine treatment (costs about $2000 but has 98% success ratio and no need for meds later). The treatment clinic wanted to do another test before the treatment, so we had to stop giving her the daily medication for about 2-3 weeks before the final tests in as to not get an unbiased test result. And the final tests ($600) showed that her thyroid levels were fine and she was doing well, so the clinic said she doesn't need the treatment yet. The vet thought she could have a beginning hyperthyroidism that could be controlled by diet. She has a diet wet food and a dry food too. It's important to give her wet food to keep her hydrated and we ordered 2 types of hyperthyroid diet food from Chewy to give her some variety. She's been doing so much better since!

Another thing that I noticed - and this is just my observation but I think it's important - . Before the first tests, she ate only canned fish food for about a month because we ran out of canned chicken during the quarantine and she just loves fish so much. I read it somewhere that fish has higher iodine levels, so I think this also could have contributed to her alarming test results the first time.

As of now, she's solely on diet food and no fish. She had a check up a few months ago, and her thyroid levels are good. I asked for another check up in March, just to keep a close eye on her.

My advice:
  • try to get to the bottom of this soon because later on this could be really serious.
  • Wet food is important, if you're interested I can tell you what my Mimi girl eats. Make sure you feed her the diet food and I would get another test done to monitor the thyroid levels when on a diet food.
  • From my understanding it's can be tricky to diagnose a cat with Hyperthyroidism. False positive and negative T4 tests can also occur. Other medical conditions (e.g. kidney disease), nutrition (in my case I think the fish food), medications (that's why they asked us to stop giving her meds before the test) can also affect the T4 levels in the tests. Sometimes multiple tests need to be done to be sure. The necessary tests are: Chemistry panel, Complete blood count, T4 test. They do all these tests in the same time to get a good analysis.
  • You are right: 41 nmol/L is in the grey zone for old and symptomatic cats. Since this increased from 27 nmol/L within a year it tells me that there's something going on with your kitty. If you start the treatment with pills her thyroid levels could be under control. I had a friend whose elderly cat was on diet food and thyroid pills for 4 years so she could still live for a long time with treatment.

I hope you will be able to get a proper diagnosis and Molly will do better. Please keep us updated on Molly! Sending lots of love to your kitty!
 

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How is Molly doing?
🙏❤🐾🐾
 
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