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Discussion Starter #1
My cat Gilligan was diagnosed with a Hyperthyroid. The Dr. put him on Tapazole (1 ml twice a day). I was putting the medication in his food. (They made it into a tuna flavored liquid). After some vomiting and itchy face, the DR. decreased the dose (to .75 ml twice a day). After a month, the DR. gave Gilligan a blood test and found the thyroid was still hyper. So he increased the medication a little (.85). Now, Gilligan stopped eating. So he hasnt gotten the medication for two days.

I have two questions:

1. We tried to orally administer the med with a syringe and could not do it. I held him and my friend tried to put the med in his mouth. Gilligan shook his head frantically and growled. Any suggestions or advise on the proper procedure to administer liquid meds?

2. It seems like he can't tolerate this med anyway. If 1 ml is too much for him. .75 is too little. The Dr. said that if .85 doesnt work, we'll have to either do the surgery to remove the thyroid or the Radioactive Iodine injection. I know he's trying the med first cause he detected a slight kidney problem. He said though that if .85 doesnt work, we would have to go ahead with the other procedure and deal with the kidney problem as it arises. I feel like he should just do the Iodine now and be done with it. Gilligan is obviously not tolerating the med. Any advise on this?

Thanks everyone
 

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When we have to give Assumpta liquid meds, I usually just try to get the syringe back between her molar teeth (while holding her head from the top) instead of trying to open her mouth and squirt it in...seems to work better that way. You could try wrapping Gilligan in a towel to limit his range of movement, as well.

I recently did a little reading on feline hyperthyroidism (for one of my special shelter kitties), and was pretty boondoggled by the cost (substantial), necessary precautions (to deal with radioactive waste), and hospital stay (a week or so) that go with the radioactive iodine treatment (plus there is no RI treatment center within 2 hours of where I live), as well as the risks and possible complications involved in a surgical thyroidectomy...so I can see why the vet might want to give the meds a fair trial (as a thyroid patient myself, I know it takes some tinkering at first to find what works). I'd discuss your concerns about the medication with the vet and start making a treatment plan to address things like how long to try the meds before switching to another treatment, what the next treatment should be, and stuff like that, so you have an idea of where you're going with all this.

BTW, is Gilligan eating at all, or just refusing food with the meds in it?
 

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Discussion Starter #3
Thanks for your reply! No, Gilligan is not eating whether the med is in the food or not. He's just starting to eat a little again. Right now, he's eating about a 3oz can of soft food a day when all is said and done. I'm going to try to give him the meds directly again tonight. I've been reading up on it and a lot of websites also suggested holding the head from the top like you said. Maybe that's why I was having such a hard time. I was holding his body totally still but he was moving his head around like a crazy kitty. Also, it breaks my heart to hold him a shove meds in his mouth. When he screams it kills me! I know it's for his own good but he still gonna hate me for it. :( Also, if the meds are causeing him not to eat, I hate to give him more of it. I know the dr just wants to be sure but it's still hard for me.

I'll let you know how it goes.
 

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One thing that helps with Assumpta is to tip her head back slightly while administering the dose, then tipping her chin back down (while lightly holding her mouth shut) so she can swallow more easily (try swallowing with your head tipped way back and you'll see what I mean). I usually grip across the top of her head with my left hand, standing to her right, and use my left thumb to pull up her upper lip just far enough so that I can get the dropper in her mouth along the side of her cheek. This might go better for you of you wrap him in a towel and have someone hold him while you work with his head. I also usually do 1ml doses in a couple of swallows to make it a bit easier on her. (note: do NOT let go of the cat between swallows...trust me! :roll: )
 

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Discussion Starter #5
Hi Gudewife,

I just wanted to let you know... Success!!! I gave Gilligan a dose last night and another this morning. He likes to crawl under the comforter in the bedroom. So what we did was uncover just his head. My partner then held him in place while I held his head with my left hand while with my right putting the syringe between his cheek and teeth. At first I wasnt sure if he was swallowing it cause it didnt seem like he was but I slowly emptied the syringe without any spilling back out.

Only problem was. Last night, an hour after the med, he threw up liquid. Probably just the med since he hasnt eaten anything significant in like 4 days. Im going to wait another 2 days. If his eating doesnt get better, Im calling the vet again. I think he just wants to see if its the Med thats causeing the loss in appetite. ALso, if he throws up even once more, im calling the vet. I think Gilligan is just not tolerating the med. We'll see.

Thanks again!
 

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Tapazole can be compounded as a topical ointment that you just rub on the inside of his ears; the veins in the ears absorb the medication. However, if he is becoming allergic to the medication, he'll still be allergic no matter what form it's in; you'll need to try another treatment.

For more info on hyperthyroidism and the 3 treatment options, please see:
http://www.littlebigcat.com/index.php?a ... iatriccats

Cheers,
Dr. Jean
 

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Discussion Starter #7
Thanks Dr. Jean. With all the stuff I've read on Hyperthyroidism lately I feel like an expert on the subject. :)

My Dr. mentioned the ear gel. Only concern I have about that, is that he said that each cat absorbs the Gel differently. So it would require even more extensive dose adjustment/blood testing. Since I seem to be doing ok with the oral med, I'll stick to it.

I read in your article as well as others that hyperthyroidism causes the cat to undergo an increase in appetite. Last night, I was reading a Cat Fancy article that said the opposite. It said it would cause a loss in appetite. Is this true? Cause maybe that's why my Gilligan isn't eating much. Maybe once his thyroid is regulated his appetite will build up again?
 

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Discussion Starter #9
Hi Everyone,

There have been some further developments that I need some advise on.

Last Friday I took Gilligan to the Vet because of his lack of eating. They took him off the Throid med (tapazole) immediately. They did some extensive bloodwork, rehydrated him, and gave him an appetite stimulant.

After a couple of days Gilligan started eating again. Now he cant get enough food. Which is probably due to the thyroid being hyper again.

When they got the blood work back, it showed the thyroid was regulated perfectly. No doubt, a result of finally getting him to take his meds orally rather than in his food. The bad thing they found was an increase in the liver enzymes. They had been high in previous blood work but the DR said that it was probably due to the hyperthyroid. Even though the thyroid was regulated, he said that it would take some more time to bring the enzymes back down.

Now here's my dilema. It's not clear whether Gilligan's liver enzymes are high because of the hypertyroid or because of liver disease. It's also not clear if Gilligan actually had stopped eating because of the Tapazole or because of some other reason (the liver). The DR. thought we should just go ahead with the Iodine now and deal with the liver later (if it turns out not to be related to the thyroid). My concern is, I read that liver disease can cause loss in appetite. What if, being hyperthyroid was actually counteracting the appetite loss that would have occured from liver disease? That;s why as soon as his thyroid was regulated, he lost his appetite. If I do the iodine, an my theory is correct, he could conceiveable stop eating for good. Im thinking with the tapazole i could at least regulate it to get a good balance.

Is their any logic to this? Or do you think that the Iodine is the way to go at this point?

Thanks.

Rich
 

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How old is your cat?

Hi:

How old is your cat? Also, I thought that even after the iodine treatment they have to stay on medication the rest of their life. Dr. Jean can you eleborate on this for me. Thanks

I've had 2 hyperthyroid cats, one developed cancer at 13 and had to be put to sleep. The one I have left is going on 16 and she takes her tapazole every day with no problems. I'm lucky that she lets me put the pill right down her throat.
 

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Liver disease can definitely cause a loss of appetite and I'm speaking from experience. Also, you may want to get some more tests done and or consult with another vet, liver disease is an awful thing for an animal to live with and is very serious. The attitude of dealing with the elevated liver enzymes later scares me.
 

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Discussion Starter #12
lotocats,

Gilligan is 16. I've heard that in some cases cats have to continue to be on Tapazole even after the Iodine but its the exception. Most cats are 'cured' after the Iodine.

Addfran,

Thanks. The Dr. decided to put the Iodine on hold and do an Ultrasound the abdominal area. He found the Liver looked fine but the Speen was enlarged so he ended up taking tissues from the Spleen and the Liver and sent them out for biopsy. The results for the spleen show some irregular activity but no cancer. They need to get the Liver results now to get a better idea of whats going on. We'll see what happens.
 

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NJ,

I'm new here and I don't want to alarm you unnecessarily but I just lost my 18-year-old Lily on August 2nd. She was diagnosed with hyperthyroidism in May but developed an almost complete loss of appetite in mid-July (she was boarding at the time while we were on vacation and not much intervention was done to help her regain her weight or strength). Please do monitor your baby's food intake carefully. I will never forgive myself for not taking Lily in to the vet sooner. I thought I could syringe feed and spoon feed her enough to get her back on her feet but it wasn't the case.

Lily was also very difficult to pill so I used the compounded ear gel for her, which worked beautifully. My vet's pharmacy was pretty expensive; however, I ordered it on-line from Drs. Foster and Smith (Smith and Foster? I always get confused!) and it was a bit over $30 per month. It might be an option if you resume treatment with the tapazole.

As far as the radioactive iodine treatment, the closest place to me was a university vet school and the cost was approximately $1000 and Lily would have had to board with them for 2 weeks after treatment was performed. Due to her age and appetite-related problems, we opted not to perform the treatment. It was my understanding that after the radioactive treatment, medication for the thyroid condition is no longer required. However, many times in older cats, other medical conditions (previously masked by the thyroid condition) surface after the radioactive iodine treatment and these conditions might require medication.

Sorry if I've overwhelmed you with too much information but having just gone through all this, I just wanted you to be aware of some of the things to watch for.

Best of luck and do keep us all updated!

Deborah
 

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Glad you posted

Deborah - Glad you posted your message. I was having the same thoughts about the iodine treatment, but didn't want to say anything because I hadn't personally gotten treatment for my cats. I've had 3 cats with thyroid condiition, all elderly. My first was 15 and very timid. He would never have survived being away from home for the length of time it takes to give the treatment. The second one was the same. As for the third one, she's my psycho cat and would never tolerate being caged and handled by strangers everyday. The iodine treatment is almost a catch 22 situation, whereby it might help, but most times it's not even feasible. That's just my thoughts.
 

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Discussion Starter #16
3catmom.

Thanks for posting! Im really sorry to hear about your Lily. I can't imagine what it would be like to lose a pet after 18 yrs together. :( It must be really hard. Gilligan has only been with me 2 months (i saved him from being dumped in a shelter by his previous owners), and I feel attached to him.

I've done a lot of research regarding hyperthyroid and it's treatments. It seems that the majority of Hyperthyroid cats undergo an increase in appetite (which is the case with Gilligan). If kept untreated though, even though he's eating great now, he will continue to loss wieght because of the super charged metabolism. In about 20% of the cases however, there is loss in appetite associated with the disease. Lily probably fell into that %. (Unless there was something else wrong with her).

The boarding time at the Iodine facilties varies but nowadays it doesnt seem necessary to keep the Kittys for two weeks. The place I'd take Gilligan and many I've researched on the internet only keep the cat for 5 days. Once you take the cat home, however, there are certain restrictions that you have to follow for two weeks. Such as, the cat cant sleep with you. You cant handle him. You cannot be closer than a foot from him for more than an hour a day. You have to use golves when handeling his litter box or food bowls. etc. Ive also heard though that this is somewhat of an overkill but recommended nevertheless.

Your right about the thyroid condition masking other problems. Mainly Kidneys. If your cat had Kidney problems, the increase blood flow to the kidneys helps them. Once the thyroid is regulated and the blood flow slows down, the problems with the kidneys become apparent.

If the Thyroid is not treated though, the cat will eventually develop heart problems that will lead to death. The vet compared the thyroid condition to running a marathon 24 hours a day. The wear and tear on the heart is too much.

Just wanted to share all the info i've gotten. Hope it's helpfull to any of the readers on the board (and their Kitty's :)).

I'll make sure and keep everyone posted on Gilligan. Thanks.

Rich
 

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Rich,

I hope Gilligan continues to do well. Your vet sounds very knowledgeable in his treatment approach so that's a real positive. Do continue to give us updates and know that we're all cheering you on in coming to a happy medium ... successful control of the thyroid problem plus a good equilibrium of all other bodily functions.

Deborah
 
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