Ok all you kitty guru's
Have you ever heard of a 9 month old kitty with hyperthyroidism???
I have not, but a new vet I started using (near my house and my normal vet is further away) diagnosed hyperthyroidism and I mentioned this to my normal vet who takes care of my seniors and faxed her his blood work said she doesn't believe that it is the correct diagnosis, she said it could be anything from nothing, to neurological (sp) to a possible infection he may have had prior to me getting him (he was from a feral litter and he has been tested for FeLV and FIV both negative) he is still a growing kitten, etc...
He was going in for his neuter and I mentioned some odd shaking/trembling he has been doing when falling asleep (stops when he is fully asleep) and thought he was possibly diabetic so I wanted him to run a complete diagnostic including CBC w/differential, superchem and T4.
His Glucose came back quite high (368) and his T4 came in at 2.6 everything else was within normal range except for his alkaline phosphatase (133) which was expect because of his age and he is growing.
Because of the high glucose and the possibility high glucose reading being stress induced I asked that he run his fructosamine which came back within normal range (302) so that ruled out diabetes.
We also ran a Free T4 which came in high at 92, hence the hyperthyroidism diagnosis.
He is now on methimazole, but I am still doubtful that this is the correct diagnosis.
Any opinions??? experiences?? knowlege of a kitten having hyperthyroidism.
I am not looking for a diagnosis here, just someone who may have knowledge/experiences of such a young kitten with hyperthyroidism.
Thanks
Hyperthyroidism
Re: Hyperthyroidism
Many of the chemical enzymes can be altered in kittens, and the ALP may not be too concerning, but if other enzymes were out of range, particularly renal and liver enzymes, you'd want to investigate further for these. Did the vet check kitty's heart and lungs carefully? Does he have a heart murmur, or anything unusual heard?
I'd be quite skeptical about a hyperthyroidism diagnosis, and would rerun the freeT4, and pay special attention to kidney and liver enzymes....assuming these had been done by a human hospital lab, have your primary vet find out if the results were accure, and/or make sure the results weren't mixed up with another client's (rare, but this happens occasionally). Also ask about getting a urinalysis and possibly an x-ray done as well. If the results are again questionable, I'd ask your vet for a consult with a feline specialist for further review.
If the thyroid glands weren't palpable or enlarged, and with no obvious accompanying symptoms, it is unlikely that hyperthyroidism is present. Your primary vet needs to get to the bottom of this, either through additional testing, or talking with a specialist for help in getting accurate results. I'd be very concerned about the methimazole treatment in a young kitten, and you certainly want to recheck the CBC and chem profile again anyway for a cat on methimazole (to monitor for renal deficiency).
Again, ask your vet to closely address kidney, liver and heart function for rule-outs.
I'd be quite skeptical about a hyperthyroidism diagnosis, and would rerun the freeT4, and pay special attention to kidney and liver enzymes....assuming these had been done by a human hospital lab, have your primary vet find out if the results were accure, and/or make sure the results weren't mixed up with another client's (rare, but this happens occasionally). Also ask about getting a urinalysis and possibly an x-ray done as well. If the results are again questionable, I'd ask your vet for a consult with a feline specialist for further review.
If the thyroid glands weren't palpable or enlarged, and with no obvious accompanying symptoms, it is unlikely that hyperthyroidism is present. Your primary vet needs to get to the bottom of this, either through additional testing, or talking with a specialist for help in getting accurate results. I'd be very concerned about the methimazole treatment in a young kitten, and you certainly want to recheck the CBC and chem profile again anyway for a cat on methimazole (to monitor for renal deficiency).
Again, ask your vet to closely address kidney, liver and heart function for rule-outs.
..........Traci
Re: Hyperthyroidism
Traci,
All his other blood work was within normal range (normal range for that lab anyway).
I have discontinued the use of the meds based upon my primary vets advice and will be scheduling him for a complete blood work up with her.
My primary vet is a hospital/emergency and have many specialists in house, which is nice and is one of the main reasons I travel the distance to use them (everything is under one roof)
His kidney, liver functions are (based on this blood serum) in normal range. His heart also sounded fine to him and he did not hear anything unusual.
He will be going in next week for a work up at my primary vet and I guess we will see.
All his other blood work was within normal range (normal range for that lab anyway).
I have discontinued the use of the meds based upon my primary vets advice and will be scheduling him for a complete blood work up with her.
My primary vet is a hospital/emergency and have many specialists in house, which is nice and is one of the main reasons I travel the distance to use them (everything is under one roof)
His kidney, liver functions are (based on this blood serum) in normal range. His heart also sounded fine to him and he did not hear anything unusual.
He will be going in next week for a work up at my primary vet and I guess we will see.
Re: Hyperthyroidism
Good to hear, and I'm glad you've discontinued the methimazole. In my opinion, that was a risky approach.
The shaking/trembling symptom....is that the only symptom you've noticed, and for how long has it been present? Your vet can perform simple neurological or neuromuscular tests to determine effects during normal resting state...if you have a video recorder, you could also try to record the events and your vet could take a look at the video.
If re-running the labs shows anything unusual, you might consider a feline serology to rule out viral infection or immunological problems, but a CBC and general blood profile should give some indication if this was a problem.
The shaking/trembling symptom....is that the only symptom you've noticed, and for how long has it been present? Your vet can perform simple neurological or neuromuscular tests to determine effects during normal resting state...if you have a video recorder, you could also try to record the events and your vet could take a look at the video.
If re-running the labs shows anything unusual, you might consider a feline serology to rule out viral infection or immunological problems, but a CBC and general blood profile should give some indication if this was a problem.
..........Traci
Re: Hyperthyroidism
The shaking/trembling really are the only symtoms, I only notice it when he is laying down and starting to fall asleep (if I get his attention with something they stop) and they stop when he is in a deep sleep.
The only other symtoms which are associated w/hyperthyroidism that I relate are vocalizing, aggression/exhitabilty and a "zoned" out expression. But then this a youngster and all of these are pretty normal kitten things.
His water intake is average, no excessive urination/bowel movements.
I first started to notice the shaking after his last round of vaccinations, which was his 2nd FeLV shot and his rabies. When I first noticed them, I really didn't make much of it, seemed to occur only when he seemed tired and they stopped once alseep (thought was possibly because he was in a growth spurt or something along those lines).
I've checked his eyes while occuring and they reacted to light/dark and he stops when you get his attention so I wasn't to concerned that it was seizures.
Maybe he just thinks and has to have something wrong with him to belong in my household. My 10yr old Dobie has wobblers diagnosed when he was 3), my persian has heart/kidney disease and my husband has a blown out disc and is awaiting the final approval for the ProDisc so he can have surgery. So I have my hands full!!!
The only other symtoms which are associated w/hyperthyroidism that I relate are vocalizing, aggression/exhitabilty and a "zoned" out expression. But then this a youngster and all of these are pretty normal kitten things.
His water intake is average, no excessive urination/bowel movements.
I first started to notice the shaking after his last round of vaccinations, which was his 2nd FeLV shot and his rabies. When I first noticed them, I really didn't make much of it, seemed to occur only when he seemed tired and they stopped once alseep (thought was possibly because he was in a growth spurt or something along those lines).
I've checked his eyes while occuring and they reacted to light/dark and he stops when you get his attention so I wasn't to concerned that it was seizures.
Maybe he just thinks and has to have something wrong with him to belong in my household. My 10yr old Dobie has wobblers diagnosed when he was 3), my persian has heart/kidney disease and my husband has a blown out disc and is awaiting the final approval for the ProDisc so he can have surgery. So I have my hands full!!!
Re: Hyperthyroidism
Just an update on my Flower, all his blood work was in normal range. His T4 came in at 1.8 (lab range 0.8-4.0) and his Free T4 came in at 36 (10-50).
Being a mom of a crf kitty, I pay close attention to kidney values and Im not sure I like what I see or I may be over obsessive. Flowers urea on this work up is 33 (range 14-36) his last workup (2/25) was 30, his creatinine came in at 1.1 (0.6-2.4), previous work up was 1.9, phosphorus 7.5 (2.4-8.2), previous was 4.2. Everything is in normal lab reference, but do you think the bun and phosphorus are kinda high?? All others values are in the middle of the lab ranges.
When I spoke with the vet, these values were not discussed, I was at the time only concerned with his thyroid, nor have I had a chance to yet, I always have the blood work faxed to me so that I can review it myself.
Any thoughts or am I obsessing.
Being a mom of a crf kitty, I pay close attention to kidney values and Im not sure I like what I see or I may be over obsessive. Flowers urea on this work up is 33 (range 14-36) his last workup (2/25) was 30, his creatinine came in at 1.1 (0.6-2.4), previous work up was 1.9, phosphorus 7.5 (2.4-8.2), previous was 4.2. Everything is in normal lab reference, but do you think the bun and phosphorus are kinda high?? All others values are in the middle of the lab ranges.
When I spoke with the vet, these values were not discussed, I was at the time only concerned with his thyroid, nor have I had a chance to yet, I always have the blood work faxed to me so that I can review it myself.
Any thoughts or am I obsessing.
Re: Hyperthyroidism
None of the enzymes should be too concerning, since they are still within normal reference range, and we're talking about a kitten -- the serum phosphorus levels in kittens can normally exceed those of an adult cat, but your kitty's levels still fall into normal range. Given that these same enzymes were normal over a month ago, there is probably little cause for concern.
Having said that, however, I would at least ask a few questions. What are you feeding him? Is the diet rich in phosphates or high in protein? Is the calcium/phosphorus in the diet imbalanced? Is the diet formulated with excess vitamin D? Are you, or have you, given any supplements? Your vet can help you determine the vitamin/mineral/nutrient makeup of the diet you're feeding to see if there may be some problems there.
Was either the calcium or albumin low on bloodwork?
Was your kitty fed or fed a high protein meal within a couple hours prior to bloodwork?
Did your vet listen to heart and lung sounds thoroughly at this last exam?
The only thing I could see to be concerned about would be if other enzymes were significantly altered, mainly liver and kidney of course, but when talking about phosphorus, particularly if it is above normal range, and if the albumin and calcium were low. If that were the case, and if the "trembling" symptoms were severe and combined with overall weakness, then you would want to be concerned and investigate further (i.e., hypoparathyroidism, although would be rare in a young kitten, or dietary discrepancy). What did your vet say about the trembling? Were you able to describe them and was your vet able to say they weren't concerning?
I doubt you have anything to worry about, but I would at least check the diet you're feeding, and make sure the trembling symptoms you refer to are nothing more than twitches during sleeping, which are common in many cats.
Having said that, however, I would at least ask a few questions. What are you feeding him? Is the diet rich in phosphates or high in protein? Is the calcium/phosphorus in the diet imbalanced? Is the diet formulated with excess vitamin D? Are you, or have you, given any supplements? Your vet can help you determine the vitamin/mineral/nutrient makeup of the diet you're feeding to see if there may be some problems there.
Was either the calcium or albumin low on bloodwork?
Was your kitty fed or fed a high protein meal within a couple hours prior to bloodwork?
Did your vet listen to heart and lung sounds thoroughly at this last exam?
The only thing I could see to be concerned about would be if other enzymes were significantly altered, mainly liver and kidney of course, but when talking about phosphorus, particularly if it is above normal range, and if the albumin and calcium were low. If that were the case, and if the "trembling" symptoms were severe and combined with overall weakness, then you would want to be concerned and investigate further (i.e., hypoparathyroidism, although would be rare in a young kitten, or dietary discrepancy). What did your vet say about the trembling? Were you able to describe them and was your vet able to say they weren't concerning?
I doubt you have anything to worry about, but I would at least check the diet you're feeding, and make sure the trembling symptoms you refer to are nothing more than twitches during sleeping, which are common in many cats.
..........Traci