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Discussion Starter #1
So .... Toby went to the vet on Saturday. His T4 levels are now normal, or so I am told, and I'm meant to keep him on the same dose of medication (10mg) for another three months and take him back for a check up.

I'm a bit worried. Toby is still not eating particularly well (he is eating enough, with a lot of encouragement, but is definately not his catpig self) and all the internet resources I've come across say his next check-up ought to be in 6 weks, not three months. I'm not best pleased, because I don't even think the vet weighed him (although its clear to me he has gained weight).

Anyway. Thinking of ringing up the vet and asking a few questions - I'm just not convinced about it all at the moment.

In the meantime: Picture of my wee boy getting a love from my brother over the weekend:

 

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Awww, the two of them look so content together. Toby looks great as usual.

I'd sure go ahead and ask more questions, if you're feeling uneasy about the vet.
 

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having had a cat go through this, they no longer are burning up calories like they were with a out of control metabolism, the reduced eating most likely is a more normal level.. once the weight is back up to a heathly point, diet control may be needed to keep at a good weight..(my wife went through graves desease years back(thats what they call it in humans)and has been dealing with this ever since..
 

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having had a cat go through this, they no longer are burning up calories like they were with a out of control metabolism, the reduced eating most likely is a more normal level.. once the weight is back up to a heathly point, diet control may be needed to keep at a good weight..(my wife went through graves desease years back(thats what they call it in humans)and has been dealing with this ever since..
Thats what the vet told me, but I know Tobys normal appetite - he has always been a little piglet - this is definately not normal. :?
 

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Did you get copies of all of his labwork that you can post here? If not, it's really very important that you do so (not necessarily that you post it here, but definitely that you go over it personally). I can't tell you the number of times or the number of vets that have told me that labwork was "fine" or "normal" just to have it not be at all fine or normal after I had a look at it myself. One of the most respected vets within 100 miles of me told me to maintain my CRF and hyperT cat on a dose of methimazole that had him severely hypothyroid - a condition this particular vet thought was just fine, but which I KNEW was NOT in any way fine for my cat.

Don't assume that your vet has provided you with a perfectly accurate assessment of Toby's bloodwork. Look at it yourself and see where his blood values lie. If his kidneys are healthy, his T4 should be toward the lower end of the lab's reference range. If his kidney values (creatinine and BUN) are elevated, his T4 would probably be best maintained in the upper half of the reference range. You need to know if these are the recommendations your vet is making, and the only way to know that is to see Toby's labwork for yourself.

Toby's appetite should diminish significantly once he has achieved euthyroid (normal thyroid levels), but he shouldn't have to be coaxed to eat enough. If he's gaining weight, however, he's clearly eating enough. With a hyperT cat, it's always a good idea to have your own scale to weigh him regularly. Weight loss is one of the first ways you may recognize when his T4 level has risen again (which it will do over time, as this is a progressive disease). A digital baby scale does a fine job of weighing a cat.

Lastly, when you have questions for your vet, don't hesitate to give him a call. The only way you can provide Toby with the best possible care is to make sure you understand his condition, his prognosis, and his management protocol. You and your vet need to be partners, and that means you need to have good communication and understanding with and of each other.

Laurie
 

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Discussion Starter #6
Well, just called the vet up again. It's a bit tricky as he has been treated by my mothers vet 'up north' (a lot cheaper than the London vet and they have been good in the past). Apparently Tobys T4 count is 'bang in the middle' of the normal range. I asked if 10mg was a lot but she didn't seem to think so but did suggest that I cut down on one tablet a day to see if that helps his appetite.

She did mention that it might be his teeth that are troubling him. He has a broken tooth and was due to go in for a dental before Christmas but the hyperthyroidism put paid to that for the time being.

So, my plan is to decrease the dose of medication and if his appetite has not picked up by Monday take him to my vet in London. I might do that anyway to check his t4 levels again with them.
 

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Did the vet run a blood chemistry along with the latest T4, and if so, how are Toby's renal blod values (creatinine and BUN)?

Laurie
 

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Did the vet run a blood chemistry along with the latest T4, and if so, how are Toby's renal blod values (creatinine and BUN)?

Laurie
Nope it was just the T4 test. To be honest it did all feel a bit rushed and I was left feeling very unsatified by the whole thing.
 

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It's extremely important that you have a blood chemistry run immediately to check Toby's kidney function. Uncontrolled hyperT can mask renal failure so that it doesn't show up in bloodwork. So even if Toby's renal function looked perfectly normal in his earlier bloodwork before you got his hyperT under control, that doesn't necessarily mean that his kidneys are healthy. In order to verify the condition of his kidneys, you need to have his renal values checked now that his T4 is in normal range. That will tell you whether or not his kidneys are healthy, and if they are not, it will give you the information you need to start effectively managing any renal problems he may have.

Please get that blood chemistry run ASAP. If he is in renal failure, the longer it goes unmanaged, the worse his long term prognosis.

Laurie
 

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Oh no.. Poor Tobster! So sorry to hear you guys are going through this. :( Can't really give any advice as I'm not really knowledgeable on health issues. Just want to wish him loads of strength and a good appetite!!
 

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Discussion Starter #12
Please get that blood chemistry run ASAP. If he is in renal failure, the longer it goes unmanaged, the worse his long term prognosis.

Laurie
I have no reason to believe that Toby is in renal failure. My money is on side effects of the medication or indeed his tooth giving him trouble. I've decided to go to the vet tomorrow rather than Monday though because his appetite has been appaling today and see what they say. I'll request the bloodwork of course - I had every intention of doing so anyway :)
 

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I have no reason to believe that Toby is in renal failure. My money is on side effects of the medication or indeed his tooth giving him trouble.
You may very well be correct. Gastric upset and inappetance are common side effects of methimazole, and of course mouth pain could cause an unwillingness to eat, as well. I am glad, however, that you are having a blood chemistry run to check his kidney and liver function. Inappetance is also a common side effect of renal problems.

Laurie
 

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Discussion Starter #14
You may very well be correct. Gastric upset and inappetance are common side effects of methimazole, and of course mouth pain could cause an unwillingness to eat, as well. I am glad, however, that you are having a blood chemistry run to check his kidney and liver function. Inappetance is also a common side effect of renal problems.
Yep. Well, I couldn't get a vet appointment for today, so he is going tomorrow afternoon. I've halved his medication in the meantime and this morning, although he wasnt his usual catpig self, he ate more than he has been doing recently. So, who knows. Hopefully it won't effect his bloodwork readings tomorrow too much.

If push comes to shove and it is the medication making him feel under the weather, I guess I'll have to consider either the op or the radioactive iodine route. Tobys vet is one of only 6 centres in the UK that does the radioactive iodine treatment so perhaps thats something to consider (although I fear it might be horrifically expensive!).
 

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if you compare the cost you are spending now per month and will have to keep spending ongoing, the rad treatment is a option, on our emma cat we went the surgical route first, that worked for 1.5 years and then she started burning up again. the rad treatment was done ,one blood test 3 months later perfectly healthy cat, that was around 6 years ago, this morning yeti pounced emma, emma responding by chasing him all over the house and letting him know that that was no way to treat a lady(she's just a solid happy cat)
 

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if you compare the cost you are spending now per month and will have to keep spending ongoing, the rad treatment is a option,
Very true. Certainly something to discuss with my vet tomorrow.
 
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