RawPetMedics Feline Fridays: Hyperthyroid Cats

And that's enough of that. Yeah, don't you just love a bit of intro? Hey, I was trying to catch you out, you guys, to see whether I could catch you dancing as I put your picture up, but it's just You were too, too on it.

Yeah, I was dancing anyway. Yeah, don't care.

Oh guys, welcome, welcome, welcome. Um, uh, I see people coming on, so that's great. Say hi from wherever you are around the world. Um, it's always good to, uh, to see you on board, and, and thanks for joining us in the middle of the day on a Friday. Uh, Feline Friday's back!

Yay!

Oh, I love that, Julianne. You've got to do the—

it's going to be— yeah, I'm making cookies.

Oh, brilliant. So, um, today it's all about hyperthyroids. Okay, so I— do you know what, it's one of those things, isn't it? You say you're going to talk about something, and then this week I've just had hyperthyroid cats packing into the clinic. It's like, can you just watch on Friday? So all of you guys who have said watch us on Friday, welcome! We're here. This is a show specially put on for you by my two great friends, Julianne and—

oh, that way, on the other side.

Oh man, so great. Um, But before we get into hypothyroidism, how have you been, Julianne? What are you doing? What's coming up?

Funny you should mention, Brendan, that you mentioned hypothyroidism for today and had hypothyroid clients, because I did a live last week with a couple of other friends and we talked about inappropriate urination. And then this week I've been dealing with that in my house. So one of my boys has decided— I was playing with Leo, we were doing one-on-one play, and he kept going to the DVD player, like the TV stand, and he's sniffing, and he was doing what we call tiger face, which is using the, um, doing the feline response. She's a bit like, like this. I'm like, what are you doing? I had a look and I'm like, oh no, that's not good. So I got out my black light. Yes, I do have a black light for such, such instances. And I'm like, oh no, that is not good at all.

Um, all right, Dexter.

Yeah, it's my Friday evening lamp. No, no, it's not. Oh, you make me cry.

It was that—

it was like a fiver on Amazon, actually.

It's a little torch, and I don't think I'm helping myself here. So anyway, I ended up for like an hour and a half going around the house with this black light to find if we'd had, you know, any other instances anywhere. Um, so yeah, it's, it's been a bit of a— I'm trying to understand what's going on, you know, from the catman perspective. You go to like, oh, for goodness sake, you know, I've got to clean it up, and you get frustrated. I'm like, well, someone's obviously not happy, you know, that's, that's what I need to focus. Don't bring up the Red Room again. I think it was me that mentioned that last time.

I think I've got issues. I don't—

I won't do it next time, I promise.

I love you.

I think I said too much. Your, your entertainment, just in your value, is just That's what we've been dealing with, with one of the boys being— oh, I mean, it could be both, I don't know— with unhappy pussycats. Um, which, you know, it's not like there are other behavioral signs. They're eating, they're, you know, going on the bed as normal, like for cuddles. They are having play interactions. So I don't know, I need to get my behaviorist head on because at the moment my cat mum head is on, which is worry, you know, and that doesn't help anyone. We've talked about the energy side of things when we've looked at other illnesses and stuff, and, you know, I actually revisited one of my blogs and looked at how it's written, which was just from behavior, because I'm like, you know what, I've got to get out of my head, like, you know, look at what I can do to help them. So yeah, it's been a bit of a Bit of an up and down week, you know, like, like Red Room's Ween Cats, you know, just normal, just a Wednesday. Anyway, how about you, Maya? Maya?

Uh, okay, my life isn't as exciting as yours, I can say, with so many things, but, um, oh, nay contraire. Yeah, I moved to Mallorca. And you know, the thing is that all my clients were— well, all— no, but most of them, they called me and said, hey, uh, I need to move with my cat, how do I do it? And I was like, just hold on, hold that thought, I'll let you know next week when I do it myself. Because, you know, I know the theory, I know all the theory about it, and then it was like First of all, it came out easier than I thought it was going to be.

Good.

But the, the thing is that there are some things I didn't expect. For example, my anxiety.

It's the humans, people. It's always the humans.

I was like, okay, my cat— my cats are really, you know, calm. They, they didn't, uh, vomit. They didn't They didn't do anything. They were just like, okay, okay, the plane is going up, meow, the plane is going down, meow, and that's it. That was all.

And I was like, are you okay?

Are you okay, my sweet boy?

I was like— And that was just the way of— he was just changing the pressure in his ears so he could cope with the thing.

That was it.

That was it. Wow.

Amazingly. And I was like, oh my God, poor little baby, what am I doing?

I was like, this is where Harry, my new little kitten, would be. So he's discovered the kites. So we have birds of prey, um, you know, red kites, um, flying around, uh, over the neighborhood. And, uh, he will sit there up when the staff are eating their lunches. And instead of being in their dinners and trying to be, he's just sat on the windowsill watching the red kites. And then he does that little cat call to them. So he would be the— yeah, absolutely. It's so funny. We just sort of like, you know, as if he's going to take one on, you know. And but he would be the cat that would be complaining because he'd want to be at the airplane window. Watching the clouds going by.

Brilliant. It's so funny.

So, so, so are you in now? Are you actually— so you're over there in the new place in your— in Mallorca, Amaya?

Yes, this is a room that I rented for a while because it was hard to get a flat and, uh, there are many, you know, how do you say when— scams. There is a lot of scams with this. So I said, okay, I rent a room and then I'll see what I can do and maybe find a better town that it's, you know, more suitable. And actually I really like this one, but because I'm not near the beach, I'm in the mountains, but I found a better place, a better town that, well, I'm looking for places there now.

So are the cats with you in the room?

Yeah.

How is that going?

Oh well, uh, the, the only issue— the house is, is huge, so you know, yeah, they're, they're, they're right here behind me. They're like, what's up? Why do you wake me up for? But, uh, they can access to the rest of the house, that's okay. And, and we have a backyard which is better than Madrid. The thing is that we are on the ground level, so you can, you know, people walking by, they are like, what is that? What is that? You know, they're like that all the time. So, but it's a, it's a really nice and quiet place, so it's not that bad. Good. It's coming.

Yeah, great stuff.

And Brendan, how about you?

Oh, so I had a wonderful time away at a homeopathic conference last weekend and returned home to a cat who the nurse is looking after and coming off from feeding. I thank them very much. You know, it's all great when they can do that. But the first night back, you know, you get that immediate, you know, who are you? No, I don't, I don't speak to you now because— and then you sort of get yourself up. Yeah, you left me, you left me, you took the dogs and you left me. And, but she is one, she always sleeps at the foot of the bed. She's, you know, I sort of like do that thing of the nighttime routine and I go upstairs and then the dogs come upstairs and one disappears under the bed, one sleeps, you know, on the floor at the bottom of the bed. And she always sleeps on the bed, the bottom of the bed. Now I wake up at 2 AM with a fluffy scarf stuck to me, you know, with a, with a—

are you awake?

Are you still with me? Are you really there? So yeah, I had that to come home to. So no, all good, all good. But I've been looking forward to this. This all week. So actually, Amaya's sort of hidden a little thing that's been going on. So for some of you who haven't watched earlier this week, you know, she is now El Presidente.

I can't point at you anymore, I just do this randomly. Yeah, congratulations. Thank you. I'm excited to see what happens.

Yeah, brilliant, brilliant.

So lots of Year of the Cat people.

Yeah, I was gonna say, yes, brilliant. Well, it's the Year of the Tiger, isn't it, as well?

So yes, is it? Oh, okay.

Yeah, Chinese Year of the Tiger. So, you know, yep, into— so yeah, great stuff. I'm just gonna be all the way through.

We are all gonna get the cats all wound up. I got a pee in the house. Thank you.

Oh guys, actually we should crack on because there is so much to deal with. Uh, thanks for all of you guys putting up with our hilarity. And, um, you know, oh, we were going to literally, um, talk about hypothyroid this week. Julianne said that she doesn't come across a lot of it, so it looks like Julianne's gonna be— I'm gonna move, see if you can move you to this end of the presentation so you can now be the questioner. Do you feel it? Do you feel the power?

I like it.

And I think, you know, between me and Amaya, we should deal with— I mean, look, this is quite a common problem, and there is a food-related aspect to this, so we're going to deal with that, okay? Because some of the packaging that you guys may or may not know is wrapped around your food will have issues. But we sort of need to deal with what hyperthyroid is and probably some of the conventional stuff that you need to be talking to your vet about, uh, just so you've got that, uh, and then round that with some holistic approaches, things to watch out for, and we're We're going to try not to overrun like we did with the kidneys so that we can actually deal with one in one episode.

We've got 45 minutes, it's going to be tight. Yes. Okay, okay, we'll keep ourselves at the pace of the hyperthyroid.

Yes, yes.

Oh my goodness, look at this. Are you coming in?

Oh my God.

So Amaya, kick off with, uh, what is it?

Okay, so I like to say, 'cause in simple words, to say what is the hyperthyroidism. The thyroid is a gland that it's like a clock, you know? And it manages the rhythm and the pace of the body. It has multiple functions over the body, like temperature and the pace that the body works. So when we have hypo, the opposite, like dogs, usually everything goes slower metabolism-wise and everything. And once we go in the other direction, the hyperthyroidism, which is what cats usually have, is it's going really, really fast. It's like living on the edge, like you say. And what happens when the body goes to a pace that it cannot manage because it's not the regular, the normal pace, is that the body gets exhausted and it uses more resources than it needs. And that's the thing. It doesn't only affect the gland, it affects everything. And so you can have, well, there are different ways you can get hyperthyroidism. Most of the times are nodules or, well, there's a tumor that also they can cause it, but it's weird, it's not the most common one. But the, the one that is most more common is toxicity. You know, it is the amount of toxins in the body that can cause this inflammation on the, on the gland, and it will cause the, uh, the production of more hormones into the body that produces all this that I've been saying.

So, and we need to say to people, these glands where the thyroid glands are, say for your cats, we're going to deal with some of the symptoms, but these glands sit in the throat. So often all of the diagrams and stuff that we'll show you would, you know, dictate, you know, just either side of the windpipe, just below the larynx, so the voice box, that's where these glands sit. And so sometimes you will be able to feel up and down, you actually feel the nodule on these glands. Okay, so it is actually a tumor, a growth of that gland which is causing the excessive thyroid production. But they don't have to be very large growths to cause quite a dramatic effect across the whole body, as Amaya was saying, because of how that hormone acts on all of the organs from the heart to the kidneys to the liver, you know, all of those affected by that metabolic rate, the clock being driven at 100 miles an hour, okay, by that hormone. So that's what, you know, we will be feeling the neck for often when we're working out is this a hypothyroid cat.

But it usually is a benign tumor or growth.

Yes, except, except, except if you go down the one treatment course and you— and we'll talk about the treatment options— and actually it can change over time if you go no further than that first treatment course and just think, well, I've sorted it now and that's it. So we'll talk about that. Yeah.

Okay, so the fact that it's kind of a growth, you know, tumor or otherwise, does that mean that certain cats are predisposed to it, or is it something that kind of lifestyle can influence?

Lifestyle. I would say lifestyle massively over anything else. Very common disease in older cats. In fact, actually, in the routine, what we call a geriatric or a senior screening blood profile, often will include a thyroid level just to get a T4 in there because it's that common. So actually, it is something there, and it is lifestyle driven. As with all cancers, there are some major impacts from diet, but there are also some, you know, from the constituents of that. But there are some environmental elements to that. And so the level of stress that cat is under, the level of environmental contaminants, everything from glyphosate through to BPAs and things like that found in plastics. Have an impact on that. There are actually studies on that of looking at sachet and tinned foods because what do they do with those these days? They stick a plastic liner inside them and they actually heat or get put hot product into those plastic environments and that leaches out all of the BPAs and things like that into the foods. And they have actually shown an increased rate of hypothyroid cats that are fed on those particular food types. So it is really important, not just for your food, but actually start to look at all of the— how you give them water. You know, when— if you're giving them— if you're feeding them in plastic dishes, you know, you really should be considering moving away from that. We've talked about not using plastic dishes before, but, you know, water bottles, you know, checking, you know, if you're getting your water in, in water containers. And I know that it's quite common in Europe, you know, you'll buy your— you won't drink from the tap, you'll buy your water in 5-liter containers or whatever to use as drinking water. It's what plastics are they using for that? Not so much, you know, which spring does it come from, but actually which plastics, you know, is it stored in? 'cause that can go through a massive heat cycle when it's being transported around the country and, you know, those elements. But then you're seeing it in the store just at the end of that journey, not all the way through that journey. And that can have an impact.

And you can go even deeper, the kind of, you know, the bedding, the whatever you use, the cloth, the fabrics are treated with chemicals as well. And especially those that are prepared for animals. Sometimes come with worse chemicals. So we need to try to use the more organic kind of things you can find. And also with the fish flavor canned food, that's also very contaminated as well. So we need to reduce contaminants as much as we can. Of course, if you live like me before in Madrid, Uh, there's a, there's a few that you can do. I mean, I can clean up in my house, but the polluted air, uh, is not going to help anyway. And I, I've seen many, many cases of hyperthyroid in Madrid, like every day. It was really common.

Yeah.

Oh, sorry, Brendan, go on.

Yeah, sorry. No, that— so talking about furniture and stuff, I think it was the, uh, if you get the fire retardants or those, you know, where the, the chemicals that they'll spray on to reduce stain you know, to make your product stain resistant. You know, some of the fake leather sofas and stuff, the things that they spray on those to keep them looking appropriately polished and everything else, all of those chemicals, as Amaya was talking about, you know, they add to this. They actually research those in those, looking at why it's such a common product. And we all know, you know, our cats do not just march around on the floor. They are, you know, on wooden boards, you know, they're up on the soft furniture. Machines, and we're there thinking, oh, well, we'll protect them with whatever, and we're actually increasing their chemical load. They also do this with carpets. You know, they, they'll put product in there to reduce the fungal spores and the risk of moulds growing. And, you know, again, fire retardants can all go in those, and they will have an impact because they're, you know, that far away from your cat at all times. So those are the things to think about.

Yeah, absolutely. I think environmental toxins is something that impacts us all. And like you said, actually it impacts our cats even more because they're closer to it, to the ground, to the chemicals. So it's trying to minimize that as best we can. Absolutely.

And they say, and they say, you know, how much is— there is always a level of the toxins that are allowed, but how much is too much? Right. You know, if you keep adding from this and from that and from there, you know, there's a lot of things to consider. That's the thing.

Yeah. So you talked a little bit about Brendan then, just about, you know, food and considering where it comes from and how it gets to us. So let's talk a little, as we are raw pet medics, talk a bit about food and how it can impact hypothyroid. So, I mean, my understanding of like hypothyroid is a cat that's like, as you said, am I super duper hungry like all the time, you know? And I want to talk about what other sort of like behaviors and things to look for if we're trying to get a diagnosis. But can we just talk a little bit about food and, you know, how we can support the cat with this? Let's go to Brendan first.

Yeah, so the main things we will think about with food is the predisposition to any sort of growth. Now that can be led by inflammation. So there's some primary things that I would always say is trying to reduce carbohydrate load that may be added in. Believe it or not, guys, you know, we've talked about this often enough, but I will just go through it briefly again. Cats are carnivores. You know, look at what's on your food ingredients. If it ain't meat first— sorry, that's very Yorkshire of me— if it isn't meat first, okay, then, you know, realistically, is that right for your cat? And the number of kibble biscuits which will be maize or cereal-based foods, you know, that's actually been processed that's effectively like giving a starch and sugary diet to your cat. That's very pro-insulin, that's very pro-inflammatory, increase, you know, the insulin-like growth factors within there. You are more predisposed to getting cancerous growths. So the first thing that I would always advise to these guys is think fresh, think biologically appropriate, get rid of all of those starches and excess grains, etc. And just to reiterate, there is no taurine in grains, okay? It is not, you know, going to be taurine poor if you give a whole meat. Taurine comes from meat and actually is preserved if it's in a low-processed food. So, you know, you are safe if you're giving raw meats to your cats, okay, from that side of things.

Yes.

The second most important thing, and actually sort of reiterated by this question that's come up and we're going to talk about stabilization with some of the drugs in a moment. But the bottom part is about iodine. Okay, so seaweed and seaweed ingredients, etc. Now, there are diets out there that literally will talk about low iodine content to control the thyroid. So Hills produced a low iodine one to almost create a euthyroid, a low iodine level to drive down the level of thyroid hormone that those cats can produce. Okay, seems to be effective, but only if you can stop your cat from doing the things that 90% of them do, which is hunting, okay, eating other foods from other environments, and not having any sort of supplementation. There is very little work, I think, done on having an effect by driving them with seaweed supplement. So if they're controlled, giving them a seaweed supplement for their teeth should not increase the drive for them to produce more thyroid hormone. Okay. So I would not be afraid of giving them a normal supplementation like that. If they're otherwise controlled, okay? And we'll come back to how we achieve that control in a moment.

Yeah, okay, lovely. Amaya?

Well, I totally agree with the seaweed because once they are controlled and once you get the food, raw food diet, I usually use some, a little bit of kelp, but just the, you know, the normal dose in an it won't affect, uh, the, the whole thing. So, um, in my case, yes, I will also go to a more natural food, raw food, fresh. And, uh, one of the things that I noticed is that we have to take care of the, of the kidney once you got the, the animal stabilized, because there is a, there is a relationship between thyroid, you know, this the space that the thyroid is moving, it exhausts the kidney and also the liver as well. So those are very important organs that detoxify and helps to maintain the body clean and filtrates everything that is going on. So one of the things that I usually take care in the food is that once the cat is diagnosed and we started with a new diet, I usually move into detoxifying, using, helping the kidneys to, you know, to restore their levels again, kind of some of the supplements we discussed in the kidney disease. And also I do self-selection of certain herbs like dandelion or, you know, just to see how much the liver needs needs addressing as well because one of the things that you notice when you diagnose or one of the, in the blood test is sometimes the liver enzymes are a little bit high and maybe not too much, but then you can find, so, you know, sometimes the liver is stressed. So I take care of that. I just make sure that once I'm doing the transition to also keep in mind to clean it up, the body detox, and do even my self-selection into that in order to, you know, to stabilize the cat.

Yeah, lovely. Can we talk a little bit about what we need to look for? So like, my understanding is, you know, you've got a super hungry cat, that's like, oh, let's go and get tested for hypothyroidism, you know. But I'm sure that there is more, that's particularly, you know, that as you two are obviously veterinary practitioners, when they come in, there are other sort of— there's a checklist that you're looking for which helps you to go towards, you know, understanding understanding if that is the diagnosis. But as a cat mum, like, what do I need to look for to be aware of this condition?

Uh, okay, um, you can look— there are several and very different symptoms. I, uh, I would say the most normal one could be the, you know, eating more and losing weight. That's something that you will notice, you know, uh, but There are a variety of symptoms because I actually, I'm treating one that never vomits. It's not eating more, but the thyroid is, it's going up like, yay.

Wow.

They actually found out inflammation in the intestine, intestines, and the heart murmur, that gallop sound that you find, the typical sound that you can get in the heart. And that's how they find out. But it's not that easy sometimes. And in my experience, I got one cat that actually, it became a little bit more aggressive. That's it. That's all I got. So as Brenda said, it should be something like when you meet a cat that it's old enough, a senior, it's something that you should look into it just in case. But normal things that you can find are vomit, are eating more, you know, drinking a lot of water and then maybe vomiting afterwards, losing weight. There's, you know, changes in behavior.

Yeah, I would definitely say so. Those, those, they're usually allocated to the organ systems that are pressurized by having the excess. So, you know, as Amaya says, you know, the main one's going to be how quickly you metabolize your food, how quickly you'll burn through that. So that's the increased hunger weight loss. Yeah, that's a classic sign. You've got the kidney pressure, so you've got ultimately the drinking more, the urinating more, you know, that's forcing the kidneys to cope partly because of the blood pressure. So that's on the cardiovascular system. So the heart is driven more, so it will become thickened with increased muscle. It's able to pump less blood around, but it so it compensates by speeding up. So we may be able to feel the chest, feel a heartbeat that's racing, and in doing that, it increases the blood pressure. And the consequence of blood pressure again on the kidneys as increased filtration, pushing protein through in their urine, you know, pumping out more urine because of that. But then the consequences to that can then be on the retina. So in high blood pressure in cats, the retinas can actually be pushed forward away from the edge of the eyeball, distort the vision, and actually reduce their ability to see light. So they get dilated pupils, they get distorted vision, so they may start to bump into things. And absolutely, then you're into increased stroke levels. So you may not have realized that your cat has become hyper- thyroid and has high blood pressure, and the first thing you come across is that they have a stroke-like, you know, episode. They may have a seizure or something like that, and that's because the blood pressure is through the roof and they've had a true bleed or something like that, a clot form, those sort of things. All the way through to, you know, that behavioral change. Absolutely, we, you know, we'll talk about the naughty tortoises, you know, the tortoiseshell cats and how quick to strike they can sometimes be. But actually, if you see that your cat that used to be, you know, loving and calm and serene has suddenly started to run around the house like a berserker, you know, attacking things and pouncing on your feet and, you know, running up, and it never did that before, because there are cats that do that anyway, because Harry, behave yourself. Just, but just, you know, but if they've been that serene cat and you see that marked change, yeah, think about thyroid. You know, it may be that their, their skin is almost, you know, feeling like it's on fire. They want to just sort of, you know, run around to, to pounce on things, to scratch. And actually, I also see one of the symptoms if they have a reaction to fleas, sometimes just the fact that they've come in with a flea allergic dermatitis and they're itching like crazy over the base of their tail and you find them thick with fleas as a thin cat senior, I actually also would say think, just double check the thyroid because it's almost like those fleas are attracted to the hot cat, okay, and they're more likely to get those increased flea burdens and stuff, but the number of flea-burdened cats that I find, you know, actually have thyroid issues. So that's a little roundup of all of those symptoms and why they can occur and what to look out for. And I literally had one yesterday that came in with properly, oh, 6 or 7 of those symptoms all in one go. And you just sort of like, oh my God, and you just then feel for the nodule and there it was.

Like this, the nodule.

Yeah, but you've still gotta, before you give any treatment, which we're going to go on to shortly, you know, you've almost then got to do, but now I've got to do the blood test. I am 99% sure this is what your poor cat has, but yeah, you know, I've really got to do the blood test to give you the treatment options.

So Yeah, and that's a great segue. So I was going to say, like, the symptoms, like even with humans, you know, for conditions, there might be a list that are associated with that condition, but you don't— it's not a tick box exercise. You don't have them all on that list. You don't present with them all on that list. But I think that's been really helpful to give people an overview of not just why they happen and how they occur, but also what to look for. So as you said, Brendan, great segue into, you know, diagnosing and treatment. So tell us a little bit about that. How do we, uh, how do we deal with it?

Do you want to do the diagnostics first, Amaya? I'll let you do that one.

Okay. Yeah, okay. So, uh, well, there is a kind of controversial thing about diagnostics, but usually you can measure, uh, you can measure T4. Uh, I usually measure the whole thing. I really like to to watch how the thyroid is working in the whole system. Like, uh, you know, TCH is— it's like that.

Am I— what is T4? Because some people were—

yes, yes, you have, you have, uh, several, uh, hormones. Um, yeah, I'm trying to say this in English, so, uh, keep hope with me in just in case. Um, you have the The TSH, which is like— it comes from the hypophysis. Hypophysis, is that correct?

Yeah, pituitary gland. It comes from the back of the— yeah, okay, it's the thyroid stimulating hormone, TSH.

Yeah, exactly. Thank you. Because that's the thing, saying this, all this in English is going to be a bit complicated for me.

You got it, girl, you got it.

Um, so then it activates the thyroid to produce different sorts of thyroid hormone, okay? So you have an active way and then you have an inactivated one and an activated one. So when you measure T4, which is like the activated one, right? You get the sense of how is it, the gland working, you know, how much is releasing to the body and what it's going to do. But then, What I tend to do is to measure all of them, T3, T4, which are the ones that produce here in the gland, and also TCH to measure and have a complete overview of what the whole system is working out.

Okay.

Okay. And then usually I measured, of course, when the animal has fast before— well, without eating before 12 hours at least. And then I add that to a whole biochemist, let's say, liver enzymes or kidney. Also, I measure the kidney just to have then a comparison, because sometimes you will find that once you have all the image from the thyroid you might want to have also an image of whatever you have in the kidney at that time. But then you have to compare it in a month or so and see how it goes, because you will find, and I usually find this, that you will find that creatinine levels, for example, are low, right? And then once you start medicating, the creatinine levels just fly up. And then other thing that I look for is another, uh, I'm gonna say this one, uh, the measurement for, uh, muscle waste, uh, the creatinine kinase.

Creatine kinase. Creatine kinase.

Thank you.

I won't let you suffer any longer.

Thank you.

She was almost there.

Um, so that will tell me as well how how much damage is already in the muscle, you know, and how the body is, you know, it needs to be repaired. Because one of the things that it will measure, the kidney issue in the future, is how much protein, let's say, it's moving around and trying to get filtered by, pressured by the kidney. I don't know if this makes sense, just correct me. Okay, it's really hard to explain this now that I'm thinking about it because they are Latin words and I have to just pronounce it in a completely different way.

You did a great job, my love, honestly. Okay, so Brendan, is there anything you want to add to that? You're going to talk us through how to stabilize?

Yeah, I think other things, parts of the diagnosis So that gives you whether the thyroid is overactive or not and what those relative portions. So even if it's in the upper third of the, the scheme. So for the UK, generally we would look at a range between 13 and 60 as the range for the thyroid. And generally they're only in the lower third if they've got other illness or they've got a problem with you know, an attack on their thyroid in dogs. Okay, but for cats with hyperthyroidism, they often will be over the 60 by some considerable matter. So you'll probably find that the majority around 80 plus. Okay, however, it is noted in the textbooks, even if they are in the upper third of the range and they have all of the symptoms, they can still be classed as hyperthyroid. Because if you don't know what their baseline was, you don't know whether they've come from a baseline of 30 and they're now at 55. Okay, that is hyperthyroidism. In addition to that, as I've just said earlier on, if they're otherwise ill, so their liver is compromised, their kidneys are compromised, their thyroid hormone can often be used up in treating all of that, or their skin's got a problem, they, they can be used up in that, um, trying to help the body cope with that disease. So it's producing lots, but it's then using lots as well, so it brings it back down towards the normal range. So be aware of that upper third, and it's got symptoms still go forward and maybe check the free T4 levels and some of the other considerations within that, TSH, etc. If it's over, then definitively I would say that is a hypothyroid cat. I have seen levels over 150, and your cats can vary massively how many symptoms they have, even though they've got a massive range on, you know, they might be at 60 at the upper limit and have all of the symptoms, and I've seen them at, you know, 100 and they've just popped up with, they've got some behavioral changes. So, you know, you can't just say, oh, the severity will be judged by the bloods alone. They will be verified by the symptoms that they're exhibiting. And then lastly, in addition to that, I think it's so important that your vets also check their kidney function for prognosis and what you can treat with safely. Okay, that, and we'll go on to that very shortly. They should check the heart, okay, to check how much damage is going on there. That's an ultrasound that can be done conscious, a little clip on the chest, okay, and then they basically can scan the heart to judge the thickness of the wall, the level of damage that's going on. But blood pressure is probably the easiest way for them to also monitor the level of damage and risk that your cat is at. And that's a simple cuff around the tail. They use a machine just to monitor that, and those are options to look at. There are ways to cuff around the limbs, but strangely enough, I find that cats are actually more prone to rejecting a cuff inflating and deflating around one of their limbs than they are around the tail. And the thing is that the tail is generally at the same height, even if your cat is standing, as the heart. And the heart base is where we're trying to equilibrate that, the blood pressure too. So it's a useful thing. They'll put a cuff around the tail.

I have a question for you then. For example, here you it's not that easy to find that every single vet would have a blood pressure, you know, measure. So one of the things is it's really hard to find. I always tell them that if you want to really have a good diagnosis, I usually say this, but sometimes it's not that easy to get it here. Another thing, yeah. So we use, what we do is, is that the, you know, the listening to the heart. And, you know, you can almost always have this, you know, this galloping sound.

And yeah, yeah, yeah, instead of it just being a lub dub, it's lub-di-dub, lub-di-dub, lub-di-dub, lub-di-dub. That's the gallop rhythm. Sorry, did you not like that? Why are you giggling?

I loved it!

It was really good!

Julianne's going, what?

That's because Amaya and I do cat sounds and you do a gallopy sound. And just, you know, We, we got to do like, we got to do some, um, what they called some outtakes and do like, you know, RPM, like the sounds, the sounds of Feline Fridays, because I mean, God knows what we'd have. It just made me smile. Sorry, at least I didn't show you my cowboy moves at the same time. Oh my goodness. Okay, um, I love to cheer you up. You do a great job with it. So, uh, what have we got left? We've got just under 15 minutes.

Um, treatment. Yeah, treatment. Because you said that you have like, uh, different types of treatment. Yeah, oceans.

Yeah, yeah.

I know, but we don't have as many here in Spain.

You start then, Amaya. Let's tell us what you've got and then Brenda can add on to that.

Well, um, Now here, well, we, we go from, uh, medication like, uh, Metimasol, and, uh, and then, well, for example, I know that there are some places, but just a really few of them, uh, that do the transdermal. And, um, and then we have one company in the whole Spain that it's, uh, iodine. It's a, it's a more definitive, uh, kind of the therapy.

Radioactive iodine.

Yeah, radioactive iodine. And, um, and that's it. I'm actually— the surgery is now becoming a little bit more common where they remove, uh, thyroid gland. And, uh, but that's it. You know, if you, if you have to look at the majority, they most— they are— they're going to be most of them medication with methimazole.

And what does that do? What does that medication do?

It regulates the thyroid, the production of hormones.

So it helps actually depletes the circulating thyroid level that's going on. So it does not attack the gland. It does not actually reduce this. And so what I was saying earlier is a lot of people feel the benefits of using methimazole. Used to be neomercosol. There's a few of the azoles that are out there that will help to treat the thyroid hormone, and they will go, oh great, well, that's done, you know. And there's great— some— there's some liquid versions now over in the UK, there's various tablet versions at various levels. You do need to monitor because you need to monitor how well the liver is coping with those medications, and you do need to check that you are managing to get your cat back down into a normal level of thyroid do not just say, well, I'm giving the dose and that's it, because actually they could still have an excess. And some cats only need 2.5 milligrams a day, and some need 5 milligrams twice a day. And it literally does not necessarily depend upon weight, and it is something that you need to give them the right dose for your cat. However, there is the science out there that if you just do that for a year, 2 years, what you can do is that tumor that's in the gland can actually become a carcinoma. So you actually end up with it transmitting into a more aggressive type of tumor and is being left. And, you know, some people get really shocked when their gland suddenly flares up and, you know, they're sort of 5 years into treatment and they've suddenly got this much older cat with a much more serious disease that they thought was controlled. And actually, so I would say Don't just think, oh, that's it, done. There are consequences. And by the time you've done the monitor bloods, you know, initially every 3 months, then maybe every year thereafter, and you've added in the cost of the medication, some of the other treatments we're going to talk about actually, although they may seem expensive up front, can actually save you money in the long run.

Okay. Go for it.

So the next one that we've done quite often for quite some time is the surgery. Now, there are pros and cons to the surgery. It's quite simple to find, okay, believe it or not. The main consequences is under an anesthetic with a heart problem and, you know, the kidneys on the edge. You've got to be quite cautious. So often with all of these other treatments, we will be stabilizing them with the drug first and then moving on to these other elements. And the surgery— there is another— bless you, Julianne.

Sorry, Leo's just come in. No, Leo's just come in. He never comes to say hello. Oh, he's gone. Sorry.

There is above the thyroid, there is a parathyroid gland. And when we remove the thyroid gland, usually on both sides, we've got to be very careful we preserve that parathyroid, which controls the calcium-phosphorus levels. So some people will take it out and reimplant it in the muscle. Some people will try and preserve the blood supply and remove it, but there's a risk of leaving some of the growth of the thyroid behind. It's, it's all, you know, monitoring very carefully post-operatively that their calcium levels are maintained. And that's what's put a lot of people off that surgery is the level of monitoring post-operatively. But it is doable. You can then supplement them with vitamin D, you can supplement them with thyroid levels just to artificially give them something to carry on with post-surgery, and then they're, you know, they're absolutely fine. And I've had cats that have come in at 18 years old, we've done the surgery bilateral, we've then maintained them, they've lived to 21, 22, and actually in age, just those 3 years, you know, doing the surgery has probably saved them, even though it was 10 times more than setting them up on the drugs, has actually saved them a huge amount, you know, in the cost of that, because that drug is ongoing costs. The surgery, you know, it's initial, and actually supplementing is much cheaper than using the drugs and having to monitor the organ function.

I actually learned that from Pete Colshaw about the benefits of the surgery. But the thing is, you know, I heard about the carcinoma that, you know, it can come, but it's rarely seen. I don't know if you came across with this like more often.

Yeah, I've seen probably 3 cases. Yeah, it's not common, but it's You know, quite often the cats, if they— many of the cases that come to see us, they've not really been stabilized properly. People are disengaged after they've had the drug given. They've not really gone back to the vets often enough to monitor, to check the organ function, and actually they become so destabilized with organ function failure that actually they don't get to that point of having the carcinomas.

Yeah.

And it's actually the longevity of how long they've been giving the drug and not doing anything else that actually, you know, usually by good fortune that the cat's not had another problem with its organs, that actually they suddenly end up with this growth and they're saying, well, what do I do now? You know, my cat's really old and I'm not sure I can— they can cope with the surgery to deal with a carcinoma and deal with, you know, being offered a an option with chemotherapy on top of that, that they're then sort of like going, oh my God, you know, my poor cat, I don't want to put them through, you know, using, using those. So I think, you know, yes, it's rare, but it is one of the reasons why radioactive iodine, although it sounds super scary, is actually a very good option these days for these growths. And I think we should deal with that now.

Yeah.

So what have you come across in Spain? Because you're probably still talking about 6 weeks in hospital. Are they still saying that over there?

6 weeks in hospital?

Yeah, following the radioactive iodine to stop them from spreading the radioactive iodine around.

Yes, yes, still is.

Okay, so we're down. So in the UK, If the environment that you keep your cat in can be controlled, we're down to as little as 4 days in the clinic for that treatment. So they'll come in having had all of the bloods done to check their organ function, their kidney function is good, they will have the injection, they'll be kept in a cattery environment where their litter can be destroyed appropriately. But you remember that radioactive iodine the radioactive element to it only penetrates about half a millimeter into the tissues around the radioactive iodine. So when it's injected, it literally is not going to make your cat glow. You literally are just going to have the organ where the iodine is concentrated, which is the thyroid, effectively being depleted. And the big advantage to this is that thyroid gland when the kitten was developing in the womb, travels up from the chest, up a tract into the final resting place beside the voice box. And in doing so, it can shed cells all the way down past the thymus in the chest. And sometimes those growths that we've just talked about can occur at any point on that chain, and the radioactive iodine actually will get rid of those tumours wherever they are. So you're not having to do both sides, you're not having to treat anywhere else. So recurrence is rare, and many of the companies will say, we'll give a second shot for free if, if it comes back. But ultimately, you know, it should be a one-shot wonder. It is more expensive. So currently, as pricing today, it used to be around £1,500. I think it's around £2,000 for that treatment?

I don't remember exactly. No, because most of the times I tell them to go, because here we have just one place, it's Yogo Cat, it's called, and they work with that. And as far as I know, it's still like the 6 weeks like you said, but well, they maybe, you know, changed because they are very up, you know, up to date into that. But the thing is that most people can't afford it. And now the surgery, it's is coming more and more, more and more common. The thing is that the concerns, there are a lot of concerns about anesthesia with the fact of the heart, the age, probably if they have dental disease or something like that, you know, they, that is something that most people don't like to do. So they usually go through the medication. Despite of all the, the cons that it might have. And in order, for example, what would you say it's a good checkup for if you decide to do Metimazole? How do you, because what I do is usually I start with the medication, I check up in 3 weeks or so, and then I check up again in 4, in a month again, and then in 3 months, and then and so forth, so on, right? It's like 1 month, 3 months, 6 months, right? And then every 6 months. Um, so the thing is, uh, do you do that like that as well, or do you prefer to have more checkups or less checkups if you find that the animal's stable, or you just go directly to surgery?

Okay, look, for a gold standard, um, uh, for the thyroid checks, I think initially We get the confirmation, we will start medication and see them in within the week to make sure how are they managing to medicate. Are they managing to put the tablets in? Are they managing to, um, to give the liquid? Um, do we need to give an alternative? We don't use a lot of the transdermal, um, in the UK. Uh, there are huge issues with— if you get given a tablet, do not crush it, okay? It will affect human thyroid. Okay, it is not designed to be crushed into your cat's food, and you can inhale the dust and it can affect you. So if you are a hypothyroid patient who's already got a low thyroid, please handle this medication with care. Okay, it's not to be sniffed at, literally. And from a point of view of then, so once we know that they're taking the medication We will probably recheck blood pressures, make sure we don't need to give any Amedip as a blood pressure monitor, anything like that. Or even some of the beta blockers that we sometimes give, propranolol, if their hearts are going through the roof, you know, just to try and slow their heart rates down, to give their hearts a bit of a rest, maybe used temporarily. But generally, we're making sure that they're taking the medication, their blood pressure's controlled, their kidneys are okay by physical exam. You know, our nurses can do this. There's some great nurse clinics that are out there that are doing that sort of stuff. And then at 4 weeks, so, you know, you said 3, we say 4, we'll redo the bloods to check that organ function is coping with the drug, that their thyroid level has come down. Do we need to adjust dose. If we've adjusted dose, then we would retest again in another 4 weeks. If their dose is right, we would then have that conversation about do they want to go further with treatment to the hypothyroid cat clinic, or do they want to go, do they, you know, get the radioactive iodine? Do they want to do surgery, which is, you know, about half the cost of the radioactive iodine, but has increased risks and an increased likelihood of recurrence. So, those are the things that they would have a discussion about at that point. And then I would say, after that, very much look, rechecking on a quarterly basis their bloods, and making sure that, you know, so that's every 3 to 4 months, and then reviewing that, you know, how are they coping with the medications? And usually that's a review for their prescription as well, that they're, you know, looking at, you know, is it the appropriate levels, etc.

Okay. Yeah. Well, yeah, it's a little more thorough in Spain. It's like, okay, 6 months. Some people would say, yeah, every year. Yeah, don't worry, it's okay. I don't believe you.

I know you care about your cats.

No, no, I do, but you know, 6 months for me was okay. Now I changed, I really changed diet and I really help, uh, that's the— well, we didn't talk about much of the holistic side of things here, but there's, you know, the thyroid has like a, a lot of conventional things that we have to do, you know, first. And, and then the holistic side for me is nutrition and, uh, and addressing the kidneys, as we discussed before, you know, the, the different supplements that you can help with, uh, in that regard. I don't know if you do have something else.

Yeah, if you guys have got just 2 more minutes, let me just run through some first-line stuff without going into, you know, the, the constitution of your cats, etc., I would say, look, if your cats are really struggling with the medication, it's making them sick, the side effects are there, get those reported. You know, they may get hair loss across the head— that's not because I'm on medication— they may get extreme sort of itchiness, skin rashes, things like that. They may vomit on the medication. If that's happening, do look at some of the complementary medicine options. And certainly I would say homeopathically we can use a high potency thyroidinum, so that's made from the thyroid gland, so a 1M potency, and that literally is on a daily basis sort of plussed in. And then I would say a good 80% of cats which are hypothyroid are very strongly a natrum muriaticum constitution. So again, we go in with high potencies because the thyroid is driving their metabolism at such a rate that they burn through the remedies. If you just give a, a low potency like a 30C, you need to give that 6 or 7 times through the day in order for them to actually respond because they are just burning through that energy. Um, and so we look at a 1M sort of Natrum Muriaticum sometimes daily not on a sort of weekly basis, but you adapt to what you see. So if you see a marked response to anything with a homeopathic remedy, stop the remedy, let the homeopath know, and then wait for them to give you guidance on what you need to do next. But Natrum Muriaticum, Thyruidinum, two big ones to consider. There are some great little articles about Flor de Piedra, you know, for those really thirsty cats You know, these, these are sort of obscure remedies to do with what's going on, made from volcanic spring waters and things like that. So, you know, there's all sorts of things that are out there, but I would say those are the two big remedies to consider at first line for your cats. And, you know, to me, restricting that iodine in a raw diet I just don't think has a place. I would get them onto a raw diet and I would say they generally stabilize much better than staying on a kibble that's low in ID.

Nice. Okay, brilliant. Well, we have covered so much and I think it's safe to say we've kind of managed to do a topic in a session. So yay us! And I'm going to put it out there that for next time we are doing anxiety because we were meant to do anxiety this month with fireworks. And everything, and Brendan just went rogue and said, oh, let's do hypothyroidism. So everyone, just so you know, as part of the December Christmas special, we'll be doing anxiety so that I can share some information.

Yes, yes, that makes sense, because anxiety around all of the family descending on the households and things like that, of course You know, you're going to have all the Americans say, but we wanted it before Thanksgiving.

I can't please everyone, people. But yes, we are doing anxiety next month. Okay. So you two, as this is kind of your topic, one, one thing to give people food for thought or a resource or somewhere for more information. What's, what's the takeaway for people? Amaya, you go first.

About thyroid or anxiety?

Oh my God, resource.

Um, I don't know if I have a resource particularly for this.

Anything, anything. What's, what's one thing you can support people with?

Uh, okay, let's, let's do this, uh, this thing. Um, I would check— I would like to have— I mean, if you have a thyroid cut or I'm— you're not sure if you have one, make sure this is a good practice every single time, is having a calendar about every single thing that your cat does. Is it asking for water, like, too much? If he drinks from the tap water when he's asking for that, sometimes they increase this frequency. Have a diary, a journal about what they are doing, because that's a way to see the most smallest changes. And also don't, if your cat is on kibble, don't think that the fat or, you know, if your cat is losing weight or not, it's not going to be around the belly. It's going to be around the thighs. And that's not as simple to see if they're losing weight or not. If it's a, so it's best to have a journal of the weight, I don't know, every month, every 15 days, water, if they are vomiting or not. If you have too many cats, sometimes you do know which one is what and what they are doing in the litter box, but sometimes you don't. But if you don't, just write down whatever you feel because that's the way you're gonna get an everyday picture. Otherwise you forget or you don't notice until someone else comes in and says, oh, your cat is it has lost weight or something.

Or you generalize it, right? Because you're like, oh, my cat's been vomiting, and the vet says, how many times in the last 4 weeks? You're like, oh, a couple, when it could have been like twice a week, right? It could have been 3 times a week. So I think, I mean, I'm— I, we— I do write down what I feed my boys. I think it's important to keep a note of things. So I love that. So get a diary, whether you are dealing with a hypothyroid cat or they're not, or you're kind of, you know, they're not well. I think the diary is a great idea. Lovely. Brendan, why are you smirking? What have I said now?

I love working with women because only then do you realize, you know, it's such great stuff. You know, journals, brilliant they are, but that's what you guys do. If I was on here with Conor and Nick, it'd be like the furthest thing from their minds is, you know, having the minutiae written down in a diary. You know, it'd be like, yeah, be right. Oh, look, it's lost a bit of weight. Oh yeah, you know. It's just boys, isn't it? But you are so right, you know, I do love making—

Always!

Yeah, well, that's right, you get used to saying that as well when you work with women.

Brendan, what's your tip?

So what would be the boys' version of this?

Yeah, yeah, well, you know, pick them up, do they fit?

No, no, okay. People, that is not what we're advocating at all.

Now I would just say, look, the big ones are behavior change, okay? And, you know, have they marked behavior change? And just recognizing that it's not just about T4 levels, you know, make sure they check what's going on with the rest of the cat so that we've got everything in balance. Don't just think, oh, We tested the T4, it was normal. Don't, don't go get pulled into that. Make sure they look at all of the aspects when you go in.

Okay, brilliant.

Thank you very much. So great information, everyone. We really hope you've enjoyed it. Thank you to everyone that's been here with us live, and thank you to everybody who's commented. We really enjoyed engaging with you all. Just to confirm, the anxiety one for December will be, will be on Friday the 9th of December. So I am saying it now, so it's out in the ether. We are covering anxiety. So we hope you enjoy this.

And are you going to— well, just before we leave, I think, Julianne, you've got a great conference coming up. Okay. Um, I think you should just put out there so that everybody who's listening and going to listen to today and in December— so tell us just a little snippet about that, just so they can be prepared.

Oh, this is the first public announcement, Brendan. This isn't the I love it.

I love it. I like— that's what I've just pulled out of you.

This year in March, I hosted the first ever Holistic Cat Conference, and it was an absolutely massive success. So I'm bringing it back again. It is next February, um, the 25th and the 26th. It's a 2-day event. It's all online, and basically it's all about cats. So we have got talks this year. Um, I'm not going to give too many details away, but we are covering complementary treatments. We are covering holistic approach. We've got a mixture of vets, practitioners. It's going to be amazing. So there will be sign-up details on the Naturally Cats Facebook and Instagram pages from December, so be sure to follow me if you don't already on social media so you will find out all about it. So it's going to be an awesome event, and it's just about cats because there is so much for dogs, and I really wanted to be able to, as is my mission, give cats a voice. So we will We'll be looking at nutrition, health and wellbeing, mental health, emotional health, physical health. We've got something for everyone. So it is going to be February 2023. Watch this space.

Oh, I love an exclusive.

Oh, marvelous.

I'm going to be tapping your wrist in a minute when we're off camera.

As long as it's only my wrist, we're fine.

Okay, so you'll make me blush.

So that's great. Oh, thanks so much, guys, for joining us. Hope you've enjoyed it. Hope we've brightened your afternoon, and it'd be great to see you again back on the— what was it, in December?

9th of December at 1 PM.

The 9th of December.

I love it.

It was about asthma, right? Yeah.

I love you all. Take care.

Take care.

Thanks for joining us.