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As I have suspected for a while now, I just found out (from the vet) that my 15yo Siamese mix, Kona, has a slightly overactive thyroid. She's been losing weight, despite eating like a PIG, and her hair is thinning while her nails have been thickening. My last vet suspected hyperthyroidism, but we moved before having a chance to get the test done... so I took her to my new vet yesterday, and he did a full "Senior test panel." Cost me a pretty penny, though, at a total of $280 for the visit + labwork. The cost of having an elderly pet!
Anyway, the good news is that everything else they tested looks great - even her kidneys, which is apparently unusual for a kitty her age. But they said we should monitor the kidneys when she starts thyroid treatment, since the meds can often lead to kidney problems down the road. I'm supposed to call them back tomorrow, as it wasn't my usual doctor who called with the results today... in the meantime, does anyone have advice or insight into this condition? For example, what kind of meds are commonly used, and how much do they cost monthly? Also, what is the prognosis for a 15yo with an overactive thyroid? I'm not expecting her to live forever, but 16-20 would be nice.
P.S. My old vet had mentioned a topical medication, which only had to be applied monthly (or was it weekly?) behind the ear. That sounds MUCH less stressful for everyone, and he said it doesn't cost much more than oral meds... has anyone heard of this treatment?
Amber was diagnosed with hyperthyroid around 2-3 years or so ago (it is hard to keep track of after a while so it might be more like 3 years, but I'm sure it's over 2 years now). She turned 16 in May, so we caught this a little earlier than your Kona or maybe just showed its symptoms earlier, whatever. Cats in single digit ages can get hyperthyroid so it's not always a senior disease although it more often turns up then. Amber had same deal, lost weight with plenty of eating, quite a lot of weight in fact. This wasn't super critical because she weighed probably north of 14 pounds (weighed over 15 at one point earlier in her life) and went down to around 12 or 11, but still not good to lose so much so quickly. We don't pick her up often (because like many cats she is not that fond of it) so it was a little sudden feeling, like "Holy hell feel how light she is!"
Anyway. Hyperthyroid. Plenty treatable and livable in my experience. We deal with same thing. Now you do have some choices. You could choose, for example, to have Kona undergo the radioiodine therapy. This cures hyperthyroid, in many cases it works in one treatment. It's very expensive though, around $1000. There are also limited places to have it done, but I'm sure in the Bay Area it wouldn't be difficult to find one. She would have to be quarantined for several days after.
My way of thinking is that's overkill for an older cat, as long as your cat responds to medication. Typical medication is methimazole, which is the same med used in humans (original brand name Tapazole, but typically it is generic these days). It can be had in various forms including the topical application you mentioned if I remember right. I have never tried the topical, and I don't know if it's so infrequent as you say. I'd be surprised if it wasn't still daily, but I really don't know. For Amber we went with pills and are using a commercial pill pocket treat made by Mars sold under the Greenies brand. The pill pockets are much more expensive than the pills themselves in our case! We have a local grocery chain that has methimazole in their special low price prescription plan. You know the $4 for a month supply or $10 for a 90-day supply pioneered by Walmart? It's just like that. Only from what I can tell Target and Walmart (at least a while back) did not have methimazole in their plans, but this chain does. (The store is Giant Eagle for anyone in PA, OH, MD areas where they exist.) So I have the vet write out a prescription for 90 pills, and the store charges me $10 for 90 pills. They don't care that it's for a cat, or that 90 pills is right now only a 60-day supply. When I run out, they fill another 90 pills for 10 bucks, no problem. While you might not be so fortunate as to find it at this low a cost, it really shouldn't be that expensive. Pill pockets, on the other hand, cost about $7 for 45 of them. Heh. There are other ways to pill a cat though, or you can try to get the topically applied variant. Some cats will see right through your attempt to mask the pill as a treat. And some will actually not react well to methimazole at all unfortunately.
Assuming this med works out okay, you'll probably have a trial run and went to recheck the T4 levels in about a month or somewhere around that. It may require adjusting the dose a bit, but the vet should be able to guess pretty well at the beginning. After that, you want a specific blood panel to recheck for thyroid and related issues (kidney, etc) about every 6 months max. At my vet they have a specific panel they order called thyroid recheck. In fact Amber was just in for a recheck less than 2 weeks ago, and her kidney function levels are good. Treatment for hyperthyroid does sometimes uncover a kidney issue. Some think it causes a kidney issue but from most accounts that is not quite right, usually the kidney issue was there before and was not clear because the hyperthyroid actually "helped" the kidney function a bit until the thyroid was controlled with medication. Anything unusual and have your kitty back to vet, nasty as it probably is for both of you. Otherwise, 6 months.
I think the prognosis is fine with just hyperthyroid. If you unearth some kidney issues, it might be a little harder, but cats can and do sometimes live for years with kidney issues as well. In fact they almost always live for years with kidney issues when they have them, it's just that we don't discover it until kidney function is over half gone.
Not sure I organized this in the best way but hope it helps a little. If I forgot anything I'm sure someone else will be along to add to this. We've had people post who have done the radioiodine treatment and have otherwise also lived with hyperthyroid cats. Good luck to you.
Thank you for the great info! I agree the radiation sounds like overkill for a 15yo cat, not to mention I simply don't have $1000 to spare right now... if it were an emergency/necessary I'd scrape up the cash, but for this situation I think daily (or whatever frequency) meds are my best option. If I do go with the pills instead of the topical, the good news is that she's pretty easy to pill - she doesn't like it of course, which is why I'd rather do topical, but I've never had a problem getting them down without tricks. Those Pill Pockets don't really work for cats anyway, since (as you said) the felines are a bit too smart for that. Now my less-clever dog, on the other hand, would literally eat battery acid if I wrapped it in a hot dog.
Thanks again for the advice, and I'll let you know how things go from here.
Btw - Our beloved family cat, a purebred ruddy Abyssinian, was named Amber... she lived with my sister once she returned from college, and passed away at nearly 19 a few years ago. Your kitty's name just made me think of her.
If I do go with the pills instead of the topical, the good news is that she's pretty easy to pill - she doesn't like it of course, which is why I'd rather do topical, but I've never had a problem getting them down without tricks. Those Pill Pockets don't really work for cats anyway, since (as you said) the felines are a bit too smart for that.
That's good if you can do other pilling methods. I haven't found myself interested in trying that. Don't generalize too much about cats vs dogs and hiding pills. Amber has gone over 2 years and still looks forward to her twice a day "treats" (that she knows come around the same times morning and evening) even though she has managed to eat around the pill a handful of times. No biggie, I just have to get another treat, and she eats it. I don't know what the ratio is as far as percentage of cats who will happily eat these for months and year and percentage who see through the ruse. A couple other people have posted here that their cats wouldn't eat the pill pockets, but overall it can be an option. It's an unnecessary expense though if you are comfortable with traditional pilling.
Our boy turns 19 in a couple weeks. He was hyper-T about 5 years ago and found he got a severe reaction to the methimazole, severe itching between his nose and ears, which led to large gaping holes in his head. So, we had to choice between surgery or radioactive iodine. We chose radioactive iodine. He is now hypo-T and take meds for that.
All in all, he is doing fantastic. He has kidney issues, a heart condition (HCM), and hypo-T, but you would never know he's 19 by looking at him run the stairs.
P.S. My old vet had mentioned a topical medication, which only had to be applied monthly (or was it weekly?) behind the ear. That sounds MUCH less stressful for everyone, and he said it doesn't cost much more than oral meds... has anyone heard of this treatment?
My Harls (17 years old) is hyperthyroid. The vet talked about a patch but it had to be changed more frequently than once a month. He didn't recommend it though as cats tend to pull them off.
Harls is on Methimazole liquid which is adminstered by mouth twice a day. I pay $20 for a bottle that lasts about six weeks. Harl's is funny. He HATES getting his medicine but he knows it makes him feel better. He'll follow me around until I give it to him and then clench his mouth shut. After a few seconds, he gives me this "Oh all right" look and takes it. It's a love/hate relationship with his medication.
Harls lost 12 pounds before he was diagnosed (He was really overweight so losing weight was good until we realized it wasn't stopping). He does have kidney issues that are aggrevated by the medication so he's not taking the full dose he needs. Just enough to keep him eating and not feeling sick. He's only 12 pounds now which is pretty small for him (he should be about 15 pounds).
My first cat was on the pills for her thyroid from about age 17 to about age 20 when she died of renal failure. I was unaware of a topical treatment, but pill pockets worked wonders with her. The pills were tiny, so I broke her pockets in half and got double use out of them. Some cats aren't fooled by pill pockets. My current cat isn't fooled, so when he's needed pills I've just popped them in and then given him regular treats to help get the taste out of his mouth.
Thank you all for the advice and encouragement! I still haven't called the vet back (this thread actually reminded me I have to do that ASAP), but it looks like the standard meds are the way to go. Luckily I have some experience with pilling cats, as mentioned above, and Kona isn't too difficult about it - she'll growl and hiss, but usually stays still once I have her in my grip.
FYI, she has lost about 2.5-3lbs since this all started, but she was pretty small to begin with... her TOP weight in adulthood was only like 10.5lbs, and she is now just over 8lbs. She looks pretty thin, except for her deflated "pooch" that flip-flops when she jogs. But she had the floppy belly for a few years already, so I can't blame it on the disease.
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