Hyperthyroidism in Cats

Hey, guys. Dr. Lara here today. Here. I'm here with Pele Biggins. Pele is here for hyperthyroidism recheck. So if you guys stay tuned, we're going to talk about what the cause is, what the treatments are, how you diagnose it, and also what the prognosis is. Stay tuned. All right, guys, so Pele is here for a recheck on his blood regarding his hyperthyroid. And so hyperthyroidism is. The thyroid is an organ which goes ahead and produces a hormone. I know, I know. It's okay. Oh, yeah, I see that. So what it does is it produces hormone, amongst many things, that helps with the metabolism and that kind of stuff. And so what will happen sometimes, and what I'm going to do is I'm going to hand Pele off to one of my team members just because he's a little nervous and he wants to. I know, I know, I know, I know. It's okay, kiddo. I know, I know. Well, then, yeah, that was just a handoff. So what ends up happening is 96 to 98% of patients who have hyperthyroidism are patients. Usually it's going to be benign. The tissue, the tumor tissue is going to be. Because it is caused by a tumor on the thyroid gland, it's going to be benign. And 96 to 98% of the time, it is typically seen in older patients. Some of the breeds that are predisposed to it are Tonkinese, Burmese Persians are just some of the most common breeds that we see that are prone to this. We do typically see it in older patients. We also typically see, I think if cats are eating 50% or more wet food. There has been some data that suggests otherwise, that that is something that can make them more predisposed to it. We're thinking it's primarily genetics rather than anything. That being said, the way that typically cats will come to the office or the symptoms that they'll present for will be they'll have a voracious appetite, they'll be losing weight, they may be vomiting. And so normally, you know, when I have a patient that's coming in for that, the thing that we start off with is doing blood work. Now, that blood work, we'll take a look at the red blood cells and the white blood cells. It'll take a look at some of the kidney values as well as some of the thyroid values. And so typically what we will end up doing is when we do the blood work, we'll also do a urinalysis to Take a look at all the things that the kidneys control, and we will go ahead and usually get that with what we call a total T4. If the value is borderline or we're not sure, then we will do some other tests potentially to confirm the diagnosis. But usually we're able to go ahead and confirm that diagnosis with that preliminary blood work. Once we have a diagnosis, then we have a couple of different options in regards to treatment. One we can look at doing which is the most common medication. It's called methimazole, and that's a tablet that's given by mouth, usually every 12 hours. And it's something that we will go ahead and have the patients on normally for the rest of their life. But we will go ahead and recheck those values about two to three weeks after we go ahead and get the patient started some medications. It's important to go ahead and have the patients come in four to six hours after administering the medication. This particular case in cats, it is not crucial that they come in four to six hours after medicine administration. So pretty much any time of the day, as long as they've been on the medication to be safe, three weeks. If all that comes back normal, then you'll typically have a full blood panel checked every two to three weeks for the first two to three months to make sure that the kidney values are not changing. And the reason that we want to make sure that the kidney values are not changing is because it is common for cats who have hyperthyroidism. What it does is it increases the blood flow to the kidneys, which helps the kidneys actually filter out more of that kidney waste if they're not working as well, because maybe they're in a stage of kidney failure. And so it can, quote, unquote, mask kidney disease. So sometimes what will end up happening is we will unmask kidney disease once we start the patients on the hyperthyroid medication. And so that's why it's important for us to go ahead and see where we're at with the patient's kidneys as well as the thyroid values. Sometimes we'll end up tweaking the dosage of the medication to help increase the blood flow to the kidneys, but maybe not have a super low thyroid level that still would be considered normal. And so it really depends on how the patients are doing in regards to when we are figuring out and tweaking the dosages of the medication. It is important for us to go ahead and continue to monitor those patients closely so that if we do start having any sort of values changes, we can go ahead and make some adjustments to make sure that the patient is getting the care that they need and deserve and making sure that their quality of life is maintained. There are some other options in terms of treatment we can look at using Hills YD food. It is typically used for patients who have a more mild case of hyperthyroidism. It is not typically used for patients who have a more severe case. That being said, it is easier to go ahead and have them eat the food than it is to go ahead and administer the pill every, you know, twice a day. That being said, because cats sometimes can be a bit of a challenge to go ahead and administer the pills they have come, come up or developed, you know, probably a long time ago. What's called a transdermal medication. What that means is we order the medication from a compounding pharmacy and they make the medication in a cream to where you can go ahead and apply it on the inside of the ear every 12 hours and it gets absorbed through the skin. Instead of having to fight with your cat to administer the medication. Some people might say, why don't we do this, this medication right off the bat, that formulation is typically going to be more expensive than if we were to go ahead and just sell you the commercially made pills. So that's something to be aware of. The last, there are two more options for treatment. One is to go ahead and surgically remove the, the thyroid tissue, the abnormal thyroid tissue. That is something that most the time nowadays is not used just because we have so many other options. The last option. Whoops, sorry about that. And what seems to be the gold standard for treatment of thyroid or hyperthyroidism cats is what we call the radioactive I131. That is an iodine that usually concentrates itself in the what we call hyperplastic or neoplastic tissue. Hyperplastic means growing thyroid tissue that's growing fast or neoplastic tissue. Neoplastic means new growth or cancer. And so it is something that typically works very, very well for the patients. It's something that typically the patients do have to be in the hospital for about a week or so as they go ahead and excrete the radioactive iodine. It is not something that is readily available in every hospital or anything like that. So it is that we do have to go ahead and, you know, potentially plan for. It is most likely the one that has the biggest upfront cost besides maybe surgery. But I would say in the long term, it's probably going to be the least stressful and it's also probably going to end up being the least expensive depending on how long your cat lives with this particular disease on the medication. That being said, about 20% of cats will have a reaction to the the methimazole, which can lead to vomiting, lethargy and anorexia, which are pretty common symptoms that are associated with hyperthyroidism. If that is the case, please make sure that you bring your cat back to the veterinarian so that they can go ahead and recheck them blood as well as physical exam. If you guys found this video helpful, please give us a thumbs up. Subscribe and share. Thanks for watching and be safe. Sam.