Need Advise Please! My Tinker has Feline Hyperthyroidism

[kaffe]

I think you should follow your gut feeling, Bonkers and withhold the Tapazole until an iron-clad diagnosis is made based on bth T4 abd T3 reads (this is in the standard thyroid panel - Antech offers it, and so must Idexx).  Peg is right - a week waiting won't do any harm.

Raw broccoli and cabbage are known to suppress thyroid hormone production.  If the high T4 is merely a "spike" then a temporary diet change may bring it back to normal levels - as it did for Kaffe.  If the high T4 is due to an adenoma in the thyroid glands (the most common cause of feline hyperthyroidism), then it needs to be regulated by thyroid medication like Tapazole methimazole).  But the"rule of thumb" now is to start at a low dose, even if the manufacturer recommends the 5mg per day.  Other options are Surgery and I131.  If these are not options and kitty cannot tolerate Tapazole, there's something you can get - I can't remember the name of the chemical (its not a drug); but I'll check in the feline hyper-T group.
The Acetyl-L-Carnitine supplement is to prevent what is called a "thyroid storm" which happens when a kitty on Tapazole is suddenly taken off it in preparation for I131 treatment.  Or when thyroid hormones suddenly go amuck, affecting many organs and systems in the body - heart, kidney, everything! It also helps in the transport of fats and is a great dietary supplement for obese kitties.

$2000 for the I131!  Oh my!  In Oregon, when I was checking clinics, I found the going price was between $800 and $1200. What state are you in, Bonkes?

[Bonkers]

   I looked up Idexx and found nothing about a T 3 test. But what I did find which I found interesting is that according to Idexx that 90% of cats will have an elevated ALT or ALKP (whatever those are). According to her bloodwork, Tinker's are both in the mid normal range. But then I suppose she could be in the 10% whose are not elevated.

[kaffe]

Bonkers:  ALT and ALKP are liver enzymes.  And yes - lab results can turn uo with errors andven the labs admit this.  Antech had an article about their thyroid T4 results and that for some reason, these numbers turn up elevated in as many as 25% of patients.  It can be the same with Idexx.  That's why retest is always in order if throid T4 results are borderline high or low or too high or otherwise not normal.

Your vet will know if you ask specifically for a thyroid panel blood test.  This will contain a minimum of 4 values:

TT4 (Total T4)
fT4 (free T4)
TT3 (Total T3)
fT3 (free T3)

This time, see if you can get Antech lab (there should be one in servicing the vets in your area).  I've seen some pet parents obtain test results from both labs for comparison.

[kaffe]

And Bonkers, I know how scary it is; but try to remember that hyperthyroidism in cats is so very treatable and manageable.  It is one of a few feline diseases that actuly has a permanent cure!  The thing to concentrate on now is get a firm diagnosis.  {{{Hugs}}} and give a smooch on the nose for Tinker from me.  I'll tell Cato to send a kitty-telepathy messag to her that she has to bring that T4 down becuase she's scaring her Meowmie!

[GreyGhost]

I just seen this. been sick for about week with a cold. I agree with everyone that a full thyroid panel should be done to confirm. Hope it works out. I know you must be a wreck. Prayers are going out to all of you from Me & the gang.

[GreyGhost]

I thought this might be helpful. I like the idea of a transdermal gel. Much easier to deal with than a pill.

Two closely related medications,  methimazole (Tapazol , Northyx USA) ,carbimazole (Neomercazole UK,etc) are very effective in preventing excessive thyroid hormone production. Methimazole is relatively inexpensive. Unfortunately, every cat requires its own special dose and the difference between too high a dose, too low a dose and the right dose is small. So cats going this rout run the larger expense of frequent thyroid hormone level checks to be sure the dose is working correctly. In most cats, twice-a-day dosing is required, but dose frequency ranges from 1-3 times a day.

Although both drugs do work, I am not enthusiastic about their use in pill form. Too many owners report that their cats hardly eat when on the medication. Vomiting and lethargy are also common and it is s very difficult to get cats to take this bitter pill. Lowering the dose and then increasing it again ,very gradually, sometimes avoids some of the side effects. These bitter medicines must be given for the rest of your cat's life. After a while, most cats will become very displeased with you. The medications can also have a number of serious side effects which include diarrhea, liver damage and bone marrow suppression. A few cats develop skin irritation while taking either drug. A newer option that may avoid some of these problems is to have a compounding pharmacy custom-make the medication into a transdermal gel that you apply to your cat's ear.

[GreyGhost]

Found this too.

How Much Will Iodine Treatment Cost?

Many cat owners are of the mistaken opinion that radio-iodine therapy is more expensive than treatment with methimaole. It is true that methimazole tablets are relatively inexpensive. But the number of thyroid hormone level checks and repeat visits to the vet will make up for this. Besides, radio-iodine treatment gives consistently better results than managing the condition with medications.

The cost of radio-iodine therapy varies widely between facilities in the United States and Europe. A casual look on the internet in 2009 found the cost running from $785 in Arkansas to $1,700 in the New Jersey/New York area. Costs in Canada are generally a bit lower than in the USA. In Belgium it is a bargain. The University of Gent offers the procedure for 320€ ($446). So it is very wise to check a number of facilities within your driving distance when planning this treatment for your cat.

[Bonkers]

   Out of curiosity I called Ohio State University as they have a large veterinary teaching hospital. Cost for the I 131 is $1,600.00 and that does not include all the pre-admission testing that has to be done.    There is only one other facility that does the treatment and it is privately owned so I am sure their cost would most likely be higher.

    I guess I need to move to Canada........

[kaffe]

is there a Radiocat in your area, Bonkers?  I think they charge a little over $1000.

[Bonkers]

is there a Radiocat in your area, Bonkers?  I think they charge a little over $1000.

  No, There are none in my state.

[coontuffy]

Spoke to AV a bit today about Tinker.

AV says a T3 and freeT3 are almost impossible to get from cat blood.
Very beneficial when testing humans for hyperT, however.

AV said it was good to hold off on the meds right now Bonkers.
She suggested a repeat T4
                               and a FreeT4ED (equilibrium dialysis)

She too mentioned some pharmacies being able to compund transdermal methimazole as Greyghost said, and AV also said her clients have had success with the new flavored chews 

Missed ya GG.
Hope you are on the road to recovery

[Bonkers]

    I am at a loss for words that you would think of my Tink Tink when you are going thru hell with your lil boy. I am forever grateful. 

     

[GreyGhost]

This has been one hell of a cold. I missed everyone here too. Thanks. Right now I am just worried sick about Tinker.

[Bonkers]

  Ahhh, Thanks GG.  I must say that Tinker is now pretty much back to eating on her own. But now she is acting like she is hungry all the time! Hopefully she is just trying to make up for the days when she was not eating.

  This whole thing has me baffled as she seemed fine before she came down with whatever illness it was, but I still believe the canned food she ate prior to becoming ill played a major part in it.
 
   If she continues to constantly beg for food, then I would tend to believe her labs are correct and she is Hyper T. 

[Bonkers]

  Yesterday I neglected to give Tinker her vitamins and she ate hardly at all. Today she is eating much better. I really believe the B vitamin supplement is helping to increase her appetitite, which is what the vet had hoped they would do. My plan is to contact her vet this week and inquire about an F4TD test to confirm as to whether she is truly hyperthyroid.